Stigma and misconceptions about pedophilia in contemporary society

Background Pedophilia is one of the most misunderstood psychological disorders. The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-V) has changed its definition of pedophilia several times to accommodate for shifting norms about what constitutes acceptable sexual orientation. Currently, pedophilia is described as having “recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children,” (Muller, 2016, p. 1). Although accurate for the most part, the problem with this definition is that it includes the word “behaviors.” Sexual activity with a prepubescent child or children is considered child molestation, which is not the same as pedophilia. Pedophilia has been misconstrued in the media, leading to counterproductive policies like the mandatory reporting of suspected pedophiles—people who do not offend but who simply expressed sexual interest in pre-pubescent children (Muller, 2016). Pedophiles are not “seducers and rapists of children,” probably the most commonly held contemporary stereotypes about the condition (Gilligan, 2014, p. 1). Another commonly held stereotype is that pedophilia is more “natural and normal for males” than it is for females, a misconception that seems to always have permeated sexuality and which is also related to differential gender norms regarding male and female sexual urges (Gilligan, 2014, p. 1). The most recent research on pedophilia is proving that the brains and biology of pedophiles are different from the brains and biology of child molesters. Moreover, recent empirical research has been slowly but surely dispelling common myths and stigmas about pedophilia, including the assumption that all pedophiles are male. Unfortunately, thought, “the current criteria for diagnosing a Pedophilic Disorder place some persons who have never molested a child into the same diagnostic category as those who have done so,” (Berlin, 2014, p. 404). Misconceptions about pedophilia have led to rampant social stigma, which has also led to laws that penalize people for seeking help for pedophiliac urges. It is essential that pedophiles cease to be stigmatized, so that they can seek help. Pedophiles who seek help are less likely to harm children than those who do not. Nature or Nurture? One misconception about pedophilia is that it is a learned behavior, something that a person picked up from their environment, and therefore something they can easily unlearn. However, this is not true. Most research shows that pedophiles are biologically different. There has been some emerging research showing pedophiles actually have different body types “pedophiles demonstrated reduced measured height and reduced leg length as compared with teleiophiles,” even when exposure to environmental stressors was controlled for (Fazio, Dyshniku, Lykins, et al, 2015, p. 1). The absolute causes of pedophilia are unknown because the condition has not been studied with much scrutiny. However, some researchers suggest a neurobiological component (Muller, 2016). Structural alterations in the brain also “account for common affective and neurocognitive impairments in pedophilia,” (Poeppl, Eickhoff, Fox, et al, 2015, p. 2374). More research needs to be done on what causes pedophilia rather than on stigmatizing people with the condition, to recognize early warning signs and offer effective treatment interventions. Pedophilia has been linked to impulse control, cognitive distortions, and “extreme urges,” which does suggest that some pedophiles might be prone to acting on their urges (Cochran & Cole, 2010, p. 1). Experience of trauma is not uncommon in pedophiles, and one theory is that “by sexually assaulting children, pedophiles attempt to re-live the trauma they experienced and they learn how to master it,” (Cochran & Cole, 2010, p. 1). However, this theory has yet to be proven and it has led to misperceptions about the disorder. Is Pedophilia a Sexual Orientation? Frame pedophilia as sexual orientation has been controversial, and yet doing so might help reduce stigma. “Experiencing ongoing sexual attractions to prepubescent children is, in essence, a form of sexual orientation, and acknowledging that reality can help to distinguish the mental makeup that is inherent to Pedophilia, from acts of child sexual abuse,” (Berlin, 2014, p. 404). Heterosexuality is recognized as a sexual orientation, and people with heterosexual orientation abuse children more often than people with pedophilia. It is difficult to know exactly how many people or what percentage of the population has a pedophiliac orientation but some research suggests between one to five percent of males (Muller, 2016) or up to one percent lifetime prevalence for males (Poeppl, Eickhoff, Fox, et al, 2015, p. 2374). While “males are far more likely than females to commit child sexual abuse,” it is important to recognize that there are females with pedophilia too (Pittaro, 2016, p. 301). Both female and male pedophiles need treatment in order to prevent their sexual urges from being acted upon. One of the greatest misconceptions about pedophilia is that it is a male condition. Female pedophilia has received some media attention and has also been the subject of literature and in popular culture. Research has also been illuminating the differences between male and female pedophiles, which should help dissolve myths and misperceptions. For example, “females who meet the DSM-IV criteria for pedophiles display similar cognitive distortions to that of males, such as irrational thoughts,” but are also more likely to exhibit comorbid psychiatric disorders, particularly substance abuse disorder (Cochran & Cole, 2010, p. 1). Also, Cochran & Cole (2010) claim that there is a stronger correlation with having been sexually abused as a child and female pedophilia than there is with male pedophilia. The Difference Between Pedophilia and Child Molestation The greatest misconception about pedophilia, though, is that it is the same thing as child molestation. In fact, “pedophilia refers to the sexual attraction to children, child molester is the term applied to people who act on their attraction,” (CBC Firsthand Productions, 2016, p. 1). Unfortunately, the mainstream media often uses the term “pedophile” to describe child molesters. The documentary I, Pedophile was produced in part to dispel myths about pedophilia and show that pedophilia is not the same as child molestation. For example, the authors of the documentary claim that “the great majority of pedophiles may never offend against children, and choose to keep their attractions a secret,” (CBC Firsthand Productions, 2016, p. 1).While some child molesters may be pedophiles, “many child molesters are not actually pedophiles,” (CBC Firsthand Productions, 2016, p. 1). If reducing child molestation is the goal, then this making this distinction is critical. Child molestation was not even always considered harmful psychologically; as long as the child was not physically harmed, many cases would have been readily dismissed until the middle of the 20th century (Mintz, 2012). Only in the 19th century was sexual abuse of young girls considered “pathological,” (Mintz, 2012, p. 1). Freud’s theory of psychosexual development dramatically changed views on human sexuality and on the lasting psychological consequences of having sex with children. Freud essentially promoted the more modern view of pedophilia, in that it can exist separately from actions. Ones sexual urges or fantasies can cause psychic distress (which forms the crux of the most recent DSM-V definition of pedophilia), but the urges do not need to be acted on in order for a person to be a pedophiliac. The psychological distress is reason enough for the person to seek and receive adequate psychological or psychiatric intervention. Pedophilia vs. Pederasty Pederasty was not uncommon in ancient Greece, but pederasty is not the same thing as pedophilia. Pedophilia refers to a general sexual interest in pre-pubescent children, and not necessarily acting upon those urges. One of the most common misconceptions about ancient Greek practices of pederasty is that they signified relationships between an older man and a pre-pubescent boy. In fact, older men would have relationships with adolescent, post-pubescent boys. Those relationships would have been defined not necessarily by their sexual nature but more as mentoring, in which it was the older man’s “duty to be the boy\\\'s teacher and protector and serve as a model of courage, virtue, and wisdom to his beloved,” (Gentry, 2009, p. 6). It was considered taboo to have such relationships with pre-pubescent boys, contrary to popular belief about ancient Greek society: “ men who had relationships with prepubescent boys around twelve or younger were generally looked down upon for their actions,” (Gentry, 2009, p. 6). Strictly speaking, pedophilia refers to a “recurrent, intense sexual interest in prepubescent children who, by definition, have not developed any secondary sex characteristics,” (Stephens, Leroux, Skilling, et al. 2017, p. 1114). Defining Pedophilia To dispel myths and misconceptions, it is important to operationalize the definition of pedophilia. The current DSM definition refers to “recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children,” (Muller, 2016, p. 1). Other researchers define pedophilia differently, such as a “dominant sexual interest in children,” (Jahnke, Imhoff & Hoyer, 2015, p. 21), or “sexual attraction to children,” (CBC Firsthand Productions, 2016). The Stephens, Leroux, Skilling, et al, (2017) definition of pedophilia means that the disorder is defined by attraction to prepubescent children only, not adolescents. The distinction is unimportant from a legal or ethical perspective when it comes to child abuse, though. Any person who is not considered to have full agency cannot offer consent; therefore, a sexual relationship between an older person and an adolescent is considered statutory rape. Pedophilia can be “exclusive” or “not exclusive,” meaning that some will only be attracted to children and not to adults (exclusive), whereas others are attracted to adults, too (non exclusive) (Cochran & Cole, 2010, p. 1). Some pedophiles, in fact, do develop sexual attraction for adults and many will be in relationships (CBC Firsthand Productions, 2016). “Pedophiles also differ in what age ranges they find attractive,” and interestingly, the age group (such as age 8-11 versus age 5-7) remains stable throughout the person’s life (CBC Firsthand Productions, 2016, p. 1). Furthermore, pedophilia can be homosexual, heterosexual, or bisexual. Typically a pedophile will be attracted to one or the other gender, and will also be less attracted (if at all) to adults (CBC Firsthand Productions, 2016). Stigma Stigmatizing pedophiles causes problems, the most important of which is that pedophiles will be less likely to seek help or support than if their condition was framed as a mental health issue. Another major problem with stigmatizing pedophilia is that it prevents researchers from studying the condition. The stigma on child molestation should remain, but pedophiles should also be able to confide in psychologists and receive appropriate interventions. It is important to study pedophilia also because neuroimaging studies show there are differences in the functional connectivity between pedophiles who commit acts of child molestation versus those who do not carry out their desires (Kargel, Massau, Weiss, et al, 2015, p. 783). The fact that research clearly distinguishes between pedophilia and child molestation should alone be sufficient to de-stigmatize this underserved population and put in place effective policies towards addressing the problem. Removing stigma will potentially increase the likelihood of pedophiles acting on impulse, turning their desires into harmful behaviors. “People with pedophilic sexual interests use societal thinking to self-stigmatize, which in turn may actually serve to increase their risk of committing a sexual offense,” (Harper, Bartels & Hogue, 2016, p. 1). Furthermore, stigmatizing can lead to self-harm and suicide (Muller, 2016). It is widely believed that current public policy and legislation is based more on stigma and “not consistent with empirical research findings,” (Harper, Bartels & Hogue, 2016, p. 1). Isolating and stigmatizing pedophiles is counterproductive, and can prevent the deployment of anti-child abuse programs and policies (Jahnke, Imhoff & Hoyer, 2015, p. 21). Stigma also hurts the quality of academic research. Human sexuality researchers may be shunned if they want to study pedophilia, even if they are studying it from a neurobiological position. Yet preliminary neuroimaging studies show there are differences in the functional connectivity between pedophiles who commit acts of child molestation versus those who do not carry out their desires (Kargel, Massau, Weiss, et al, 2015, p. 783). Therefore, studying the neurobiology of pedophiles is critically important. Studying the clinical and therapeutic interventions is also important and yet psychologists and psychotherapists are stigmatized for working with pedophiles (Jahnke, Philipp & Hoyer, 2014). Why Stigma Exists Stigma against pedophilia exists because pedophilia could lead to taking action on the urges. Those who want to continue public shaming and stigmatizing will argue, as Colb (2016) does, that “destigmatizing the orientation of pedophilia could have the negative effect of simultaneously destigmatizing the conduct of pedophilia as well,” (p. 1). This attitude is understandable. After all, pedophilia is a paraphilia and many other paraphilias can be harmful if they result in any coercive sexual acts or acts that harm the self, others, or animals. As understandable as stigmatizing pedophilia is, there are more reasons to remove the stigma than to perpetuate it. For one, stigmatizing does not work, and is not grounded in empirical evidence. There is no evidence to suggest that stigma has reduced instances of child abuse, for example. If a person has persistent thoughts and urges, they should be able to divulge those thoughts and urges precisely because doing so might prevent them from acting on them. Most pedophiles do not actually want to harm a child and understand that molesting a child is wrong. The American Psychiatric Association has acknowledged, “pedophilic urges and fantasies cannot be either punished or legislated away,” (Berlin, 2014, p. 406). Thus, the best approach is to stigmatize child molestation but to compassionately treat people with pedophilia. The common misconception that pedophiles are “ugly old men dressed in trench coats, hiding in the bushes, waiting to snatch young children off the street” needs to be replaced with the reality that pedophiles are “local neighbors, trusted friends, clergy, babysitters, teachers, and even family members,” most of whom have no intention of molesting a child (Cochran & Cole, 2010, p. 1). Yet because of the association of pedophilia with impulse control, it is critical to treat pedophiles in ways that prevents them from taking action on their strong urges. Treatments There are also misconceptions about how pedophilia can and should be treated.