To successfully prevent childhood sexual abuse, we must understand the *why*.
My apologies for not posting in a while. I welcomed my first child into this world and the first few months have been wonderful chaos. New mom life is nothing trivial. Respect to all the parents who have gone before me! I’ve been working on this post for a while, but my writing was put on hiatus when the babe arrived. So now after what feels like an eternity, I’m back to writing. Here’s my post on minor attraction and why it’s important for you to know about it.
In the words of close colleague and collaborator, attraction is NOT action. Remember this, as it’s important for the rest of our discussion here.
The prevention of child sexual abuse is one of the most important goals in society. I think we all agree on that. However, where we, as a society, tend to disagree is in *how* we most effectively achieve this. You can remember to the last post where I asked you to imagine in your mind’s eye what child sexual abuse prevention looked like and the ideas you developed. Incarceration, facilitation of reporting for affected children, programs to teach caregivers the signs of sexual abuse in children. The thing I wanted to highlight in the previous post was how if we only rely on these types of programs to prevent abuse, we will never achieve our goal. Abuse will continue because we are not attempting to stop it before it happens – only after it has begun. If we truly want to achieve prevention (specifically primary prevention), we must make society a place people want to be. Society must be worth living in and must be willing to accept all individuals, regardless of personality or trait. As put by a dear colleague Dr. James Cantor (whose career I can only hope to emulate), desperate people do desperate things in desperate times. In other words, if society is not a place where people feel welcome to exist without fear of consequence merely for *existing*, then we – as society – have failed. In this post I plan to discuss what pedophilia and minor attraction are and how we must fundamentally shift our assumptions about individuals with these preferences as one arm in our goal to prevent childhood sexual abuse.
What is pedophilia? I’m certain this is not a question many people ask themselves daily. Most are content to either not know or to assume what they are told from the media is accurate. I cannot blame anyone for taking either of these views, since this isn’t really a topic most want to discuss in-depth, much less for fun over the dinner table. But as someone who is a scholar in this field, I can tell you what pedophilia is not. It is not child sexual abuse. It is not behavior. It’s not the monstrous stories you see on TV or read in the news. It is a form of sexual orientation (though this is still debated in the scientific community, see here and here for examples). Pedophilia refers to how and what someone feels, not how they act or what they do. Orientation in this case refers to the physical developmental stage of the preferred sexual partner (age is sometimes used as a proxy variable for developmental stage, but this is incredibly unreliable as the age of puberty differs from person to person, culture to culture, and between the sexes). Developmental stage broadly refers to point during puberty, such as prepubertal (before puberty starts), pubertal (during puberty), and post-pubertal (adult). The fact that pedophilia is assumed by many to be synonymous with child sexual abuse is a result of incomplete journalism, historical studies that were unclear in their use of terms, and in our own (psychology/psychiatry) attempts to de-pathologize it (i.e. not make something that isn’t normally problematic a problem). I’ll focus a bit on that last point next.
For a long time, psychology and psychiatry have struggled with how to word diagnoses in the DSM such that clinicians are able to diagnose patients properly and adequately with a true disorder (true positive), while not diagnosing those without (true negative). But what happens when the diagnosis is based almost exclusively on behavior and not on thoughts or feelings? For many years it made legal sense to include pedophilia in the DSM to justify keeping child molesters in prison for longer. They must have had a mental illness which made them act out by sexually abusing children, right? The assumption behind this was that the behavior was disordered, therefore the person engaging in it must have some sort of mental illness. This gets us into a debate about what qualifies as a “mental illness,” and while it is an interesting and necessary discussion to have, it is perhaps best saved for another post. What we’ve come to realize in recent years is that not every person who experiences pedophilia *acts* on it (and the converse as well, many of those who engage in child sexual abuse behaviors do not have pedophilia). Mental illness cannot – and should not – be diagnosed from behavior alone. This leads us to confront that previous assumption about disordered behavior: if a person has these feelings but does not act on them, does that mean they have a mental illness? What this all means is that as experts and scholars in the field, we must realize that the answer to “what is pedophilia” is more complicated than previously thought. This is not a bad thing at all! This is what is supposed to happen in science and it means that the scientific approach is working. But what does this mean for you, the reader? Why do I feel that it’s necessary for you to know this? It is quite simple: the more you know, the more well prepared you’ll be to take care of your family and the higher the likelihood we’ll hopefully start advocating for more evidence-based prevention initiatives.
The DSM-5 takes the term pedophilia and – for the first time – attempts to separate the feelings from the behavior to refine our ability to diagnose truly problematic feelings and/or behaviors. Remember until now that in the DSM, pedophilia could only be diagnosed if there was behavior associated with it, meaning the individual in question must have engaged in child sexual abuse behaviors. Now, the in the DSM-5, a person can be assessed by a mental health professional as having pedophilia (without a formal diagnosis) so long as they are neither distressed or somehow impaired by their feelings, nor have they engaged in any abusive behaviors. Pedophilia, in this case, refers simply to the feeling portion of the orientation. New in the DSM-5 is a diagnosis for pedophilic disorder, separate from pedophilia in that pedophilic disorder must have accompanying distress or impairment (feelings) OR behavior. So now, in theory, anyone who experiences distress or engages in sexually abusive behaviors with prepubertal children can be diagnosed with pedophilic disorder. The remaining unresolved challenge with the addition of a pedophilic disorder diagnosis in the DSM is the pesky or clause. The addition of this clause makes it such that a person without the feelings could be diagnosed with pedophilic disorder based on behavior alone. See the problem here?
Without getting too much into detail (seriously, I could go on about this for days and well, I don’t think I’m lucky enough to keep your attention for *that* long!), science still has a long way to go to fully understand pedophilia. There are many open questions that remain about its origins, development, phenomenology (i.e. personal experience), relationship to behavior, and associations with other disorders that scientists like myself will be busy for years to come. However, I hope now you understand that pedophilia does not automatically mean abuse. Before I let you go, there is another term I’d like to explain because it’s one you may see more frequently in both scientific and popular publications.
Perhaps you’ve seen the term “minor attraction” popping up in the news or on TV? Ever wondered what it means? Well I can tell you it’s not our (scientists, researchers, treatment providers) attempt to legitimize or somehow normalize pedophilia or child sexual abuse. Let me be perfectly clear about that last point – none of us are here to say that child sexual abuse is ok. It is not. It harms both the children who are victimized as well as the victimizer. Minor attraction is simply another term to describe pedophilia and hebephilia (a form of sexual preference toward pubertal children; debate still ongoing as to whether it is also a form of sexual orientation) without the negative stigma attached to the term pedophilia. Minor attraction as a term is not scientific and broadly refers to a sexual preference for individuals who are under the legal age to consent. I use this term in some of my academic writing on the subject when the topic is specific to stigma, treatment/support access, or prevention initiatives. When I am discussing sexual orientation development, behavioral correlates, or treatment outcomes I use the term pedophilia as that is a scientific term with a broadly understood definition among scholars in my field.
My experience outside the lab suggests that these terms are frequently misunderstood and misused. Scientists like myself require specific words with specific meanings to accurately understand the world around us (seriously, it helps when scientists can generally agree on something to help explain the world). In many news articles and media stories, pedophilia and minor attraction are used interchangeably with child sexual abuse, thereby allowing readers to make the connection between preference and behavior. In reality preference and behavior are not as connected as stories and TV shows may present. Minor attraction and child sexual abuse can exist exclusively to each other. This post only scratches the surface of what is an incredibly complicated topic. Preventing child sexual abuse is one of the most important things we can do as adults, but we won’t succeed unless we work together to achieve our goal. I am not here to tell you how to feel about pedophilia – it is an emotional topic and each person has the right to feel about it as they choose. I only hope that knowing a little more about the topic might allow us to have a fruitful discussion as to how to keep kids safe and prevent victimization. Our language matters; my next post will focus on how parenthood has changed my views on this subject. That post should be good, check it out!
Prof. Dr. Gilian Tenbergen 