September 21, 2011

The sexual molestation of a child is considered by many to be the most morally reprehensible act imaginable. The terms pedophile, child molester, perpetrator, and sex offender are often used interchangeably; they overlap and yet refer to distinct aspects of the behavior and the people who commit sexual acts with children. “Perpetrator” and “sex offender” are legal terms that refer to people who have been convicted of a sexual crime against a minor. “Child molester” is a social term that describes anyone who has sexually molested a child, regardless of legal status. Neither the legal nor the social definitions consider the eroticism of the person committing the behavior, that is, whether or not they are sexually attracted to children. Indeed, many sexual acts against children are committed by people who do not evidence a sexual attraction to children but who are motivated by other factors such as immaturity, opportunity, mental retardation, mental illness, or psychopathy. Most child molesters are male although female child molesters are reported in legal records. A significant number of the reported female molesters are accompanied and often directed by an adult male companion when they engage in the behavior in contrast to male child molesters who most frequently act alone.

The term “pedophilia” is a psychiatric diagnosis classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as a sexual disorder or paraphilia. It is characterized by the following: (a) recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger) over a period of at least 6 months; (b) the person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty; and (c) the person is at least age 16 years and at least 5 years older than the child or children. It does not include an individual in late adolescence involved in an ongoing sexual relationship with a 12or 13year old. While the DSM-IV-TR diagnosis specifies that the person has either acted on these urges or is distressed by them, many believe that actual touch or distress are not necessary components; that is, someone who has the recurrent intense urges but never acted on them nor been distressed by them, should still be considered a pedophile. Most pedophiles are male; as stated above, there are relatively few female child molesters and a very small percentage of those actually evidence a sexual attraction to children. However, all prevalence data are suspect because of the secrecy surrounding these behaviors.

Pedophiles typically report an attraction to children of a specific gender and age range. Those attracted to females usually prefer 8to 10-year-old girls while those who prefer males usually seek out 11to 13-year-old boys. A sexual attraction to young girls is more often reported than to young boys but this may reflect a greater reluctance to admit same-sex attraction. Some pedophiles are exclusively attracted to children while others profess a sexual attraction to adults as well. The stereotypic pedophile—single, shy, interpersonally awkward with adults, preferring to be in the company of children—certainly exists but is, by no means, the only presentation. Many pedophiles, particularly the nonexclusive type, marry, raise families, and function acceptably in an adult world. Incest offenders, those who engage in sexual behaviors with their own children, stepchildren, or other children with whom they function as a parental figure, may or not meet criteria for pedophilia. Those who do are most likely to have sexually transgressed with nonrelated children as well.

once established, the sexual attraction to children is ever present although the frequency and strength of the urges and behavior may fluctuate with stress and opportunity. opportunity may randomly present itself, such as a family with two children moving in next door, or it may be carefully orchestrated, such as the deliberate courtship of a woman with young children or the participation in a specifically youth-oriented event or activity.

Pedophiles may or may not be distressed by their sexual attraction to children. on one end of the continuum are those who seek each other out on the Internet, forming large networks to chat, trade child pornography, or hook up with children, and join societies such as NAMBLA (North American Man-Boy Love Association) that promote sexual behaviors between adults and children. They profess the belief that it is a repressive society, not sexual contact, that harms children. On the other end are those who experience their urges as intrusive, unwanted, and “sick.” They feel compelled to act upon these urges despite efforts to refrain and attempt to rationalize their behavior in order to reduce the internal conflict.

While cases of assault, rape, abduction, and murder of a child receive the most media attention, they represent a tiny fraction of the spectrum. Pedophiles are more likely to use psychological seduction rather than physical coercion to engage a child. This is often referred to as “grooming” and consists of a number of discussions and gentle touch designed to win over the child’s trust and complicity in suggested sexual behaviors such as fondling, genital exposure, oral-genital contact, and viewing of pornography and posing naked for photos. Anal or vaginal penetration are less frequent behaviors. They are more difficult to accomplish and are less likely to be agreed upon by a child. When the sexual interaction falls short of penetration, pedophiles often rationalize that they are not harming the child because, in their eyes, the child has agreed to participate and may even experience emotional and physical pleasure from the contact.

For all of us, the awareness of sexual attraction begins in childhood and evolves over time. Boys and girls interact in a number of settings and discover an excitement and interest in the opposite or same sex as they enter puberty. Most of the time, their sexual interest is directed toward peers within a narrow age range (1 or 2 years on either side). Pedophiles also trace their urges back to adolescence when they first became aware that they were attracted to a much younger age group than were their peers. Some explored this with younger siblings or children in the neighborhood; others confined their longings to fantasy and masturbation. Many felt guilty and ashamed and prayed to have their urges taken from them. All knew that what they were feeling was wrong and went to great lengths to hide or disguise any outward demonstration of their feelings.

Fear of condemnation and punitive consequences keep even those desperate for help from seeking it. By the time most pedophiles are caught, they have been acting out with children for years. Reports concerning number of victims and acts vary from study to study. Meaningful statistics are difficult to ascertain. It appears, however, that the largest number of victims and acts per offender occurs with those who molest nonrelated males (median of 10.1 acts) as compared with those who molest nonrelated females (median of 1.4 acts).

The etiology of pedophilia is unclear. Theories range from regarding pedophilia as a normal variant of sexual development to seeing it as a deviant pathway of sexual attraction occurring at some critical juncture of sexual development. Efforts have been made to examine underlying neurobiological, neuropsychiatric, and hormonal abnormalities. Many investigators have focused on the presence of childhood sexual abuse in the histories of abusers as the central cause. While data do suggest a significant number (43-57%) of pedophiles were sexually abused as children, an equal number were not. Moreover, it is important to recognize that childhood molestation per se will not automatically lead any child victim to an adult life of offending behavior against children. The impact of childhood sexual abuse is multidetermined and includes factors such as the personality of the child victim, the environment in which he or she lives, the nature and type of abuse, the relationship to the abuser, and the reaction and care given to the victim.

Pedophilia is considered a chronic disorder and, as such, is not curable. Treatment efforts to eradicate the unwanted sexual attraction to children and substitute a socially acceptable interest in adults have not been successful. However, the intensity or strength of the urges can often be significantly reduced by use of medications. For a long time, testosterone-lowering medications such as Depo-Provera and Depo-Lupron have been used to suppress sexual drive. More recently the class of antidepressants that are selective serotonin reuptake inhibitors have been successfully used to lower sexual drive by increasing the levels of serotonin. By lessening the intensity of the drive or urge, these medications increase the pedophile’s capacity to exercise self-control and to make use of therapeutic interventions. Cognitive-behavioral techniques done in group therapy settings have proven to be the most helpful in altering thinking patterns and preventing relapse. While ideally professionals treating pedophiles would like to develop a drug or a treatment intervention that would do away with the attraction to children altogether, ultimately it is the victimization of children, not the attraction to children, that must be addressed.

SEE ALSO: Incest, Sexual abuse

Suggested Reading

  • Abel, G., & Osborne, C. (1992). The paraphilias: The extent and nature of sexually deviant and criminal behavior. Clinical Forensic Psychiatry, 15, 675-687.
  • Cohen, L., & Galynker, I. (2002). Clinical features of pedophilia and implications for treatment. Journal of Psychiatric Practice, 5(5).
  • Fagan, P., Wise, T., Schmidt, C., & Berlin, F. (2002). Pedophilia. Journal of the American Medical Association, 285(19).
  • Zucker, K. (2002). Introduction to the special section on pedophilia: Concepts and controversy. Archives of Sexual Behavior, 31(6), 465-477.

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