Prevention and “Fitting In”

Life as a scholastic square peg trying to fit into an academic round hole.

I wrote in my last post about my experiences at the 2022 ATSA conference in Los Angeles, CA. I want this post to focus more on what my team and I presented there and what it says about the state of CSA prevention in the US.

Our submission focused on our ongoing evaluation of The Global Prevention Project’s (TGPP) MAP Wellness Curriculum. This project started officially in 2020, after the founder and clinical director of TGPP and I had made contact. I reached out to TGPP in January of 2019 after hearing about them from colleagues in the field and following their work on Twitter (this was well before the current crises plaguing Twitter took place and it was still a fun site to use). I was impressed with their approach to CSA prevention and how, despite the obvious obstacles, they were able to build a following among non-offending minor attracted persons. Their approach was simple; they followed one core motto of “attraction is not action” and treated every person who sought their support as a human being deserving of empathy and compassion. I hadn’t seen this type of program in action since my days in Germany, so I naturally wanted to get involved and understand their methods better. My thought was, “if we can replicate this program and start getting some data from it, maybe this would be a good way to make a dent in MAP-based supportive services in the US!” I still maintain this program is a viable option for prevention in a country as judicially diverse as the US.

After meeting with the Director and getting to know their program and approach, a plan and collaborative relationship was hatched. We decided to replicate their program in New York State (where I reside) and proceed with an evaluation assessment, to see exactly how their program worked for their clients. In September 2020, we launched the replication group and invited our first group members to join. Summer 2020 saw us recruiting and training our clinical facilitator in the MAP Wellness Curriculum since none of us were familiar enough with it to use it adequately. I might mention here that I am not a clinician, so I learned the curriculum purely out of scientific curiosity.

Once the group was up and running, we started collecting data for evaluation purposes. My team and I set out to collect a wide range of data, since no empirical data existed yet for this program. Clinically relevant targets such as depression and anxiety symptoms, personality traits, self-reported impulsivity, coping skills, symptoms of sexual compulsivity, and a wide range of demographic questions were included in order to provide the team with an initial impression of MAP mental health. We designed this evaluation as within-subjects, meaning we gathered data from the same people over multiple time points. This allowed us to see changes in group over time, though a limitation was that we had no direct comparison group. Considering this project was meant as a pilot study to demonstrate worthiness of the program to be replicated and potentially upscaled, we accepted the lack of a comparison group.

So what happened? Well, in short 2021 happened. Late in 2021 the latest firestorm of hate toward MAPs and the researchers who seek to understand them occurred. The major story revolved around Dr. Allyn Walker and their interview with Prostasia Foundation, wherein they made a completely scientifically accurate statement regarding the morality/legality of minor attraction relative to engaging in sexually abusive behaviors (i.e. feelings cannot be argued as moral/immoral or legal/illegal, only behavior can be defined as such). Taken out of context (as most attempts at cancellation are) their statements appeared to support making CSA legal and moral. I cannot stress enough here that this was not true and Dr. Walker (and everyone else in our field) agrees that any and all CSA behaviors rightfully are illegal. No one questions that. However the hate did not stop with Dr. Walker – it bled out and took TGPP and others as collateral damage. This wasn’t TGPP’s first experience with hate mail and death threats (this was a regular occurrence since their inception in 2016), but it was severe enough to be their last experience. It was enough to cause them to shut their doors, cancel their MAP groups, and forward all remaining clients to us in New York. I don’t blame them for a second for making this decision; if there is one thing the pandemic has hopefully taught us all, it’s that mental health and self-care are crucial for both personal and professional success. No one should have to expect hate mail and death threats simply for doing a job – the fact that so many of us do is an indictment for the quality of society we live in.

TGPP’s closure and subsequent forwarding of experienced group clients to us naturally had an impact on the data we were able to collect for our evaluation. My team and I attempted to continue collecting data as best we could, but it became clear that with only a few of us working on the project, we simply did not have the manpower to deal effectively with such an unexpected situation. This led to the executive decision to discontinue data collection in the manner previously described, call an end to the project as is, and redirect data collection to a more reasonable path in light of reduced manpower. In short, start over with different objectives in light of what we had experienced and learned. Did I enjoy admitting this in public at ATSA 2022? Not particularly. It’s always difficult for a scholar to admit that grand plans didn’t work out due to unforeseen consequences. It’s also painful in light of the much-deserved success of a related program in Canada – Talking for Change – which is the dream we had for TGPP. This is not to say my team or I are giving up….much to the contrary, this motivates me to focus more on grassroots support for such programs. It’s quite simple, really – if we were able to openly discuss all methods to CSA prevention – TGPP would likely still be open and our evaluation still ongoing as planned. This is where the “square peg” metaphor comes in.

I started in this field by conducting neurobiological research as part of a multi-center consortium project in Germany. Upon returning to the US and realizing (quite slowly, indeed) that the same infrastructure that enabled such a project in Germany did not exist here, I began a process of changing my research trajectory to facilitate such a large-scale project. This has taken me quite far away from my days as a neurobiology researcher, but has come with some advantages. While I may not be running SPECT or fMRI studies, or collecting neuropsychological data (though I will be returning to this soon), I have been able to develop grassroots organizing skills, public-speaking and science communication skills, and I’ve become fluent in program development, management, and evaluation literature. I’m nowhere near perfect in any of these areas, but they are skills I have now that I did not have before. Much of my research of late has been less traditional “psychology” research and more sociological/program development scholarship. I write grants not to fund traditional research projects, but to fund training initiatives, educational curriculum development, and project management personnel. While I do look forward to returning to traditional psychological research soon, it has been an experience to be the “square peg” in the field. If nothing else, I have learned that there is no such thing as a typical research trajectory and that sometimes “fitting in” requires us to take a detour.

Our experience at ATSA tells me the field is ready for these types of programs. The global perpetration prevention project spearheaded by Drs. Michael Seto and Elizabeth Letourneau suggests as much. The primary challenges in the US are our current political climate dominated by hateful and divisive speech (by one particular party) and a lack of opportunity for small programs like ours to gain traction. There is also a certain degree of gatekeeping involved, with larger programs with deeper funding pockets to define what is and is not a viable prevention initiative. Despite these challenges, my team and I will press on, advocate for adequate funding and recognition, and continue to build grassroots support for perpetration prevention initiatives that include MAP wellness as a treatment goal. We’re far from done with our work, even if it might have changed a bit since the beginning.

So that’s our story. As I write this piece, I’m finishing an invited book chapter on the neuropsychology of sexual offending (a topic I started in with my PhD and look forward to restarting soon), am waiting on revisions for a submitted MS, and am working on related pieces from other projects. Things don’t always work out as you would hope or expect, but as long as you keep going, things have a habit of working out as they should (or so I tell myself!). I have more pieces coming up for the blog about the role of neuropsychology and sexual preference, thoughts on how we should conceptualize and define pedophilia, and reviews of papers/books I’ve read recently. If there are any topics you think I should consider, please leave a suggestion in the comments!

Reflections on the ATSA 2022 Conference

MAP Wellness and CSA Prevention in the US.

Here are my thoughts and experiences from the Association for the Treatment and Prevention of Sexual Abuse (ATSA) Conference in Los Angeles, October 2022.

After 2 long years of virtual conferences resulting from the ongoing effects of the COVID-19 pandemic, this year the annual ATSA conference was held in-person in Los Angeles, CA. This meant I got to travel from my humble abode in upstate NY to sunny and warm LA to spend 3 days in windowless rooms learning all about sexual abuse prevention! No complaints about the windowless rooms though, as a ginger I have a love-hate relationship with the sun and I much prefer to appreciate it from inside a building. Seriously. I can’t stand being in the sunlight.

Excluding some travel adventures (delays, late arrivals, missing luggage…etc.), the conference itself was a wonderful experience full of heartfelt reunions, interesting talks and posters, and opportunities to discuss the future of the field. It felt lovely to be back in-person and to actually *feel* the audience following along with each presenter. While virtual conferences have their utility, they can never really replace that intensity you feel when the audience is with you in the room, sharing that experience. Thankfully I have not tested positive for COVID-19, so the only things I have brought back from LA are memories, new ideas, new connections, and a renewed sense of purpose.

The first thing of note for me was that this was the first time I left my baby, who turned 6 months old in October. Learning about sexual abuse prevention and treatment took on a new meaning for me as I was experiencing a new form of homesickness, being away from my first child. Perhaps I shall bring the baby with me next year for ATSA 2023 in Colorado!

So what are my takeaways from ATSA 2022? While the field as a whole is making amazing strides toward the eradication of child sexual abuse, the United States is lacking woefully behind. I’ve written previously about this (check out the CSA Prevention post), but my time in LA has given me some new information and perspective about how dire the situation is here. It isn’t hopeless, but there is certainly lots of room for improvement. I think one of the biggest revelations for me was seeing how much progress was made in other countries, while in the US we are still struggling to agree that it takes multiple pathways to tackle an issue as broad as child sexual abuse. This post is meant to help us understand where we are now and where we should be going based on the lessons I learned in LA.

Where do we want to go? I think the goal is clear – we want to eradicate all forms of child sexual abuse (including online and offline offenses) and ensure that all children are able to fulfill their right to a harm-free childhood. How do we get there? One approach is the one we’re currently using; it’s primarily punitive, focused more on identifying abuse after it has occurred and places the burden of child protection on children themselves and on parents to identify risky behaviors in both children and fellow adults. This approach is neither evidence-based (since all forms of data suggest the opposite is more effective), nor human-rights centered. This idea of being human-rights centered was also a major theme of the ATSA conference this year, primarily taking the form of using person-first language to describe our work. Person-first language refers to using language that puts the human in the description, rather than using the description to wholly identify the human. For example, historically our field used descriptions like “sex offender” or “pedophile” or “child molester” to describe an individual who had engaged in problematic or sexually abusive behaviors. Now, the push is on the use language that does not describe the person as only the offense they engaged in. It may be a bit wordier, but in the end it is more humanistic.

How can we do better? In the words of a dear colleague (shout out to Dr. Allyn Walker!), prevention shouldn’t be controversial. Talking about these issues should not be relegated only to professional conferences where we are buffered by a sense of “safety in numbers.” The professionals who do this work (myself included, along with those [present] at ATSA) should be able to do their work and communicate about it to the public without fear of backlash. Child sexual abuse is a scary thing and I empathize with parents who are terrified of it happening to their child. I am in that boat now too. This is something no parent should ever have to face and no child should ever experience. But if we don’t talk about it – and in the same vein if we don’t listen to the professionals in the field about it – then the problem will not go away. It will stay the same, if not get worse.

Other than prevention, what else did I learn about in LA? Many of the talks I attended dealt with issues ranging from how to work with clients with Autism Spectrum Disorder (many of our current methods are not intended for this population and need to be adapted), how to frame the issue of child sexual abuse prevention (again, our current methods could use some improvement), what prevention programs in other countries are doing (and several times, more successfully), and what is new in the world of sexual offense treatment (I’m not a treatment provider, but I like to keep up with new trends for my students and research). The common theme for the conference was PREVENTION. How do we become better at prevention? A colleague with Johns Hopkins University and Director of the Moore Center for Child Abuse Prevention, Elizabeth Letourneau, poignantly stated that the US has several rather effective universal prevention programs – i.e. those directed toward the entire population and designed to stave off problematic behavior from the outset. These types of programs include sexual education programs (those that exist), teacher/caregiver training programs, poverty reduction initiatives, to name but a few. But when it came to initiatives that directly addressed child sexual abuse, particularly those whose focus is to work with individuals at risk of perpetrating it, there was resounding silence. Stop it NOW! is a wonderful organization providing support to both those concerned about children or adults in their lives, as well as those who are concerned about their own behavior. Their work should be applauded and completed funded. There is one other program that works with at risk individuals, The Global Prevention Project, and I will talk about them more here and in future posts.

The Global Prevention Project (TGPP) was a wonderful initiative out of Utah designed to provide supportive mental health services (not treatment proper, more like a clinician-facilitated version of AA) to non-offending minor attracted (i.e. pedophilic/hebephilic) individuals. I initiated contact with them in January 2019 after reading about them online and following their activity on Twitter. I found their approach to sexual abuse prevention to be very similar to my own and reflected an initiative with whom I had worked for a long time in Germany – the Prevention Project Dunkelfeld. I’ll write more about my collaboration with TGPP in my next post, but we were able to replicate their support group program in my native New York and are in the process of evaluating it. The primary challenge we’ve faced? The closure of TGPP due to online hate and bullying. Yes, you read that right – TGPP shut their doors a year ago in late 2021 as a result of online hate mail and threats about the work they do.

We can do better here and we must do better here. Programs like TGPP should be allowed to flourish and should be fully funded to do so. Talking about how to prevent child sexual abuse should not be relegated to the halls of professional conferences or to the annals of scientific publications. This is a topic that should be discussed openly and in such a way that parents can feel empowered to protect their children and those who feel at risk of engaging in online or offline problematic behaviors (or who simply need additional support for other reasons) can seek the help they need.

Are you like my colleagues at ATSA, ready for a brighter future?

Parenthood

What would you do if your child was a pedophile?

As I wrote in my previous post, I became a mother this year to my first biological child. I have worked in the field of sexual abuse prevention for over 10 years and until this year, I had really only worried about keeping kids (in general) safe, not my (specific) kid. How has life changed with the addition of my own little one? Well, it has me asking one unique question that I bet you haven’t asked yourself: what if my child turns out to have pedophilia? In order to help change the narrative away from punitive story-telling (as is commonly used) to more rehabilitative (less commonly used), I’m using person-first language in this post.

That’s my question for you: what if your child had pedophilia? What would you do? Surprisingly there is very little scholarship on this topic (a google search yielded nothing of direct relevance), most likely because it is simply difficult to accurately measure what a parent would realistically do in reaction to hypothetical research situations. I look at my child and wonder, what would I do? I work in this field and am an expert on the topic, so it’s easy for me to answer this question. I would still love my child and accept them as they are, while also enabling them to access supportive services as necessary. In practice, this means I will continue to advocate for better prevention and support services for individuals with pedophilia, I will love my child and do everything in my power to teach them the skills to maintain a productive, positive, law-abiding life. The alternative is disengaging with and potentially disowning my child and that, to me, is simply unacceptable.

Another question is this: if there were a prenatal test available that told you before your child was born that they either had or were likely to develop pedophilia as an adolescent or young adult, would you use it? If you had the power to know in advance that your child would develop pedophilia, would you want to know? To be honest, I don’t know what I would do. There is a difference between accepting a grown adult who is coming out to you versus knowing early who your child will eventually be. Knowing the end game) takes the joy out of discovering all the remaining components to your child’s personality.  

There’s another crucial aspect to my own experience with parenthood that I believe most others might not experience, namely the consequences of my work in the field. This subtopic (the role of cancel culture) is the focus of an upcoming piece for Prostasia Foundation, however it does have relevance here. You’ll find I’m writing this from a polemic, rather than scientific, standpoint as being a parent is a deeply subjective experience. I am a sexual abuse prevention scholar. But I’m not the kind of scholar you’ll see in the news any time soon because I primarily study the perpetration of sexual abuse from a psychological framework (not criminal justice), not its effects. I wholeheartedly support the work of my colleagues who study the effects of sexual abuse victimization and believe their work is not only important for scientific understanding, but also because it gives voice to those who so often have their voices ignored. But when you voluntarily choose to study the perpetration of sexual abuse from a psychological – not criminological – framework, the consequences of your work take on an entirely new meaning.

What types of consequences do I mean? Cancel culture and the effects of being silenced. If I were to study the effects of victimization, I would most likely be better funded (well, maybe. Grant writing is a skill I am still mastering) and my child would be able to grow up in relative safety. However, since I research pedophilia and its role in sexual abuse perpetration, I am more likely to be singled out as being a “pedo-lover,” “pedo-apologist,” or just downright accused of being a pedophile myself. Look no further than what has happened to my colleagues such as Dr. Walker and organizations like Prostasia Foundation. The mob mentality is real and has very real consequences for those of us who work in this field. Please bear in mind that this is not meant as an “oh woe is me” post; I do this work willingly and I understand the risks. Doesn’t mean I enjoy the potential harm, nor does it mean I will ever accept harm coming toward my family or child.

My child did not ask for this. My child did not ask to have a mother who specialized in sex research and chose to focus on a critically underserved population. They did not ask for the bullying, the hatred, the abuse coming from adults who do not understand that if we want to prevent sexual abuse, we must work with all of it, not just the parts with good optics.

Let’s all work together to eradicate sexual abuse! We can do it if we join together, support each other, and bring our diverse experiences and points of view to the table of sexual abuse prevention. Let’s work to keep all kids safe!

Minor Attraction and Pedophilia: Why Should You Know About Them?

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!

Child Sexual Abuse Prevention is Important.

Something we can all agree on, yes?

…or maybe not. Before I dive into the meat of this piece, I’d like to ask you to do something. Answer the following questions: what does child sexual abuse prevention look like for you? What does it mean to you? What kind of images does it conjure up in your mind’s eye?

Does it include images of prisons?

Programs designed to help children and families after they’ve experienced the worst nightmare imaginable?

Therapy?

Laws to make it easier for children and families to come forward with abuse allegations and have their testimonies taken seriously?

Intervention initiatives to educate child caregivers (e.g. teachers, coaches, daycare providers, parents, babysitters, bus drivers, to name a few) about the signs of abuse so they can intervene as early as possible?

If you answered yes to any of the above options, then this post is for you.

This post will be one of several pieces about child sexual abuse prevention and how we get there. It is not meant to advocate for any particular position nor am I an advocate (I’m just a scientist speaking out). It is meant to challenge some widespread assumptions about child sexual abuse prevention that are (in themselves) preventing us from success. I don’t think I’ll manage this in only one post – scholars (myself included) have been writing about this for years – and the issue still isn’t completely resolved. Why is that? Well, keep reading and let’s find out.

So where do we begin? Perhaps a good start might be to define the term “prevention.” According to the CDC, prevention has 3 levels, namely primary prevention, secondary prevention, and tertiary prevention. Here are some details:

  1. Primary prevention is acting to stop behavioral health consequences from happening, usually through programs designed to address known risk factors;
  2. Secondary prevention is acting to identify problematic behaviors in their earliest stages and to stop them from escalating;
  3. Tertiary prevention is long-term condition management after a diagnosis or disease state has progressed.

The Association for the Treatment of Sexual Abusers (ATSA) – an international organization whose purpose is to “make society safe” by advocating for the prevention, intervention, and treatment of sexually offensive behaviors – has adapted the CDC guidelines to reflect the type of work we do more adequately. Their guidelines are:

  1. Primary prevention: uses approaches that take place prior to sexual violence has occurred to prevent initial perpetration or victimization;
  2. Secondary prevention: responds immediately after sexual violence has occurred to deal with immediate effects of violence;
  3. Tertiary prevention: uses long-term strategies after the sexual violence has occurred to address long-term consequences of violence and sex offender treatment interventions.

Let’s talk about how we can more effectively prevent childhood sexual abuse. It can be done – really! But it might take some patience and a willingly open mind to get there. Are we ready?

So, you’ve already conjured up images of what child sexual abuse prevention looks like to you. If you imagined (as I did too before I worked in this field) sex offender treatment or imprisonment as a form of prevention, you’re not wrong. That’s what we (in the field) consider tertiary prevention. It’s necessary, but does not do anything related to primary prevention (it only comes in after the abuse has happened). Maybe you’re thinking of the sex offender registry, where specialists ensure we keep track of those who may pose a risk to children in their environments and should be monitored for safety. Yup, that’s tertiary prevention too – and while questions remain about its effectiveness, it’s still a method of tertiary prevention that we employ. But what if I told you that nearly 95% of those individuals in New York State (where I live and work) who are convicted of a sexual offense against a child are not on the sex offender registry? What does that mean?

To be brief, it means that sex offender treatment, imprisonment, and the registry are only affecting a small percentage of the total number of individuals who are engaging in these behaviors. It means that a lot of individuals are not identified until after something happens – after abuse occurs. I’m not sure about you, but I know that particular statistic bothers me. It means that all of our methods so far are limited to individuals who have already acted; we’re dealing with at best secondary and typically tertiary prevention methods. This means we are allowing children to become victims in the first place. We can do better; we must do better. How do we accomplish this?

This calls for the inclusion of primary prevention measures. To be sure, many different prevention measures fill this category and we have several incredible ones here in the US. For example, “Erin’s Law” is a law that would require all states to mandate schools to teach students body safety and how to tell (and speak up) if they have been victimized. So far Erin’s Law has been passed in 37 states, with New York passed in 2019. “Darkness to Light” is another resource that helps caregivers, teachers, and parents identify the signs of abuse in this children (or those they work with). This is just a small sample, but you get the idea. The goal with programs like these is to facilitate easier outcries from children and help their caregivers intervene with appropriate resources. But even with these programs, we still face a shortage. Why?

The short answer is that we don’t include all groups under the prevention umbrella. There is one key group that is traditionally ignored here – those individuals who might be more likely to engage in problematic behaviors but who have not done so (yet; perhaps never will). Remember above when I said that about 95% of individuals caught for these behaviors are not on the registry? That means they are engaging in offense-related behaviors for the first time. Now stick with me here, don’t give up yet. It means we have a place to intervene, a moment right before the person acted during which we can do something to prevent that behavior from ever occurring. Sounds good, right? Seems like something we should be doing and doing frequently, yes? I know I would love to see this happening in programs all over the US because it means we are doing something to lower the number of children harmed and we are improving the quality of life of residents of all ages. We already see programs of this nature rolling out (with success) abroad, for example the Prevention Project Dunkelfeld in Germany, Talking for Change in Canada, and other related initiatives such as the Lucy Faithfull Foundation in the UK. The question I find myself asking is why we don’t have such programs and initiatives here in the US? In our own backyard? The answer to this is simple and I will explain it over the next few posts. It all has to do with our priorities as parents and as a society.

The challenge with primary prevention of this nature is that it requires us, as residents and citizens, to be willing to include individuals who might be likely to engage in this behaviors in our discussions. There are many terms that get bounced around here that often confuse the conversation so let’s narrow the focus to these: person with potential to offend (or potential offender), person who has committed a sexual abuse offense (sexual offender), and person who has not engaged in sexual offense behaviors (non-offender). I will use person-first language because at the end of the day, we’re working with humans and even though our urge to condemn and forget about them and throw away the key may be strong, we should not sacrifice our humanity in the process. I don’t want to get further than this in my first few posts because too much detail without context with simply make for a boring read.

Simply put, we are all aware of the ugly feeling we get when we think about people who do sexual things with children and our gut reaction is to hate the thought and then hate the people. But if we want to understand why this is happening and how we can keep our children safe, it’s important to understand these individuals. We have to include them. And what we will learn is that they are people too – and they often want our help.

I encourage you as readers to simply challenge the idea of how we do prevention here in the US and find ways to improve it. The solution starts at home by talking about this issue. Get information, reach out to organizations that are involved in this kind of work, talk to others. Be willing to learn about the work that goes into this and maybe become a volunteer (if you are so inclined!). I’ll include some links at the bottom to sources used in this article as well as resources for further information.

Keep up with my next posts where I dive into the nitty-gritty of primary prevention and how it works both here in the US and abroad. We’ll talk about pedophilia and minor attraction, prevention of behavior, and different programs that exist to do this with information on how you can support them. See you soon!

Resources

Erin’s Law Website with information on how to get it in your state (if it’s not already).

Darkness to Light Program

Stop it Now! (US) with information on what sexual abuse is, how to report it, and support measures.

New York State Alliance for the Prevention of Sexual Abuse

Association for the Treatment of Sexual Abusers

Dr. T: Who Am I and Why Am I Talking About Minor Attraction?

It helps to know who’s talking.

Who is Dr. T? It’s me – the author, and I would like to take a brief moment to tell you about myself and how I got into this field of sexual abuse prevention and treatment. I’m writing this broadly for anyone who is interested, but also for students who may happen across this and are wondering to themselves – how do I get involved? It’s also for those students who are panicking that they “don’t know what they want to do yet,” because hey, I was that student once too. You are not alone!

Once upon a time I was a naive psychology undergraduate student in the US. I knew I liked psychology and my friends always thought of me as the “group therapist.” You know, the one you can talk to! It’s really no surprise I wound up in psychology and discovered there a passion for understanding human sexuality. Of all the specialties I could have followed, it was in my nature from the beginning to study the thing everyone does but no one talks about (that’s right, SEX). I eventually completed a Bachelor’s honors thesis on the topic and decided the next step should be graduate study in psychology – since everyone tells you that you can’t do anything in psychology without a graduate degree (more true in my time, less so now for my current students).

By this time (ca. 2008), neuroscience and neuroscientific-based graduate programs were all the rage. I knew I wanted something that would challenge me and also help me develop the skills for a successful career, whatever that would be (I didn’t know at the time in 2008 that a PhD would be in my future). What was unique was that I would be living in Europe at the time of graduate study, so any program I applied to would need to be located near Germany (where I was living with my then-fiance-now-husband). This brought me to Maastricht University – a thriving new university in the southern part of the Netherlands known for its Research Master program in Cognitive and Clinical Neuroscience. I applied and thanks to a lot of external support (from faculty in the US), was successful and started their Research Master program in Psychopathology. Two years, two internships, and a serious dabbling in addictions research later, I graduated. I still didn’t know exactly what I wanted to do for a career, but I knew it would be something related to forensic research/addictions treatment. This led me to applying to PhD positions in Germany.

PhD positions in Germany work a little differently from in the US. For starters, you are not a student in a program. You are a paid employee working for a university as a (Doctoral) Research Associate. That means you are paid as a project employee and are responsible for varying degrees of project completion for the particular professor who is running the project. Sometimes you’ll have classes to teach and students to supervise, sometimes not (it really depends on the university and its regulations about PhD student workload). In your spare time (sometimes during working hours) you make progress on your PhD research. Benefit? Because you are an employee, you get paid, you get health insurance, AND you get paid time off. I highly recommend this path if you can learn German!

I interviewed for a project that was looking for a PhD associate with a background in neuroscience and neuropsychology (the study of how the brain influences behavior). Just so happens, my Master’s degree was all about that! So I applied, was hired, and began a journey that has led me to this point: talking to you about child sexual abuse prevention and treatment!

This project was called NeMUP (short for Neurobiological Mechanisms Underlying Pedophilia and Child Sexual Abuse). You can check out what we did in this project here. The purpose of the project was to identify the neuro-(brain) biology links that give rise to pedophilia and its associated behaviors (child sexual abuse) so that researchers and treatment providers could use this information to develop better prevention and treatment programs. I worked with this project for nearly 5 years total and earned my PhD through it. Working for and with my German colleagues provided me opportunities to learn about things I never thought were open for scientific inquiry. As a typical American, what I knew about pedophilia at the time (ca. 2012) was the same as what anyone else knew: all pedophiles were abusers and should be sent to jail. Period. Working on this project opened my eyes to a world of knowledge that I truly had no idea existed.

This project involved me working with individuals with pedophilia to collect data. This means I sat in the same room with these persons, listened to their stories, and had them complete tasks, and kept in touch with them about study results. Some had histories of engaging in sexually abusive behaviors, some did not. The first major epiphany (if you want to call it that) I had while working in Germany was the realization that not every individual with pedophilia engages in sexually abusive behaviors! I’m not entirely sure why this thought had not occurred to me before I worked on this project; I suppose it had something to do with simply not giving the topic any actual thought. I would watch my favorite crime shows (e.g. Law and Order: SVU and Criminal Minds), assume that what they told me about a topic was true, and move on. Never questioning a thing. Now I know better.

Eventually my time in Germany came to an end and my husband and I returned to the US to pursue faculty positions here. I landed at my alma mater, SUNY Oswego, as a Visiting Assistant Professor. I have since transitioned to life on the tenure track as an Assistant Professor (3rd year out of 6 at the time of writing). By the end of my PhD, I knew I wanted to keep working in this field because I had developed a passion for alternative methods for child sexual abuse prevention thanks to working on the NeMUP project. But it did not take me long to realize the nature and scope of my German research was simply not possible in the US. For example, in Germany I had colleagues and a team of scholars to support me – I was not alone. In the US, I was alone (at least at first). I didn’t know any of the major players here, I did not know what funding sources were available to support my work, and I needed to establish a research lab on campus to recruit students and volunteers for the studies I would run. It took a lot of work and trial and error, but eventually I found my niche and went back to work. Thankfully it was during this time I found friends and colleagues in NYS and set out to pursue research into minor attraction and child sexual abuse prevention with the support of SUNY Oswego.

Recently my work has expanded to include two ongoing projects, the first of which is a pilot 1-year treatment evaluation project with my collaborators at The Global Prevention Project. They have a specific curriculum meant to work with individuals who are minor attracted and seek support to help cope with it or to work on accompanying mental health issues (such as depression, anxiety, substance use, etc.). We replicated their group format in New York and one of my colleagues here (who is licensed to treat humans – sadly I am not) is running the group. Data collection is on-going and we hope to have some interesting results to report here in the future. All things data-related that come from my lab will be posted to my lab’s blog account – that will be up and running once I have things to write about and have this blog running successfully!

The other project is new and just started data collection recently. This project is also the one getting my name into a bit of hot water, since the project topic is rather controversial. Fantasy sexual materials (FSM) are something most of us never think about, but surprisingly it’s a relevant research field in human sexuality. Given my lab’s focus on minor attraction research, understanding how minor attracted persons interact and use FSM is incredibly important, since there might be treatment and prevention tools in them. That, and it helps to understand how sexual fantasy works more broadly, to help us answer the question of why some people can engage in prolonged and detailed fantasies without acting out behaviorally, whereas some cannot (and wind up possibly engaging in illegal behaviors as a result). Wouldn’t it be so helpful to understand this so we could use it in prevention services? I think so and hope our project will shed some light on the issue.

I suppose that’s it for now. I don’t want to keep you here forever! But it seemed relevant to share my story so that you would have a better idea of why I’m choosing to blog about this topic and from where my knowledge comes. I don’t propose to know everything, I certainly do not. But I do know this field and want to share my knowledge in a way that promotes mutual understanding and perhaps compassion. So this is me – Dr. T, an Assistant Professor of Psychology at SUNY Oswego in NY, director of the Sexual Neuroendocrinology Lab, and your resident expert in child sexual abuse prevention and minor attraction.

Greetings and Welcome!

Hello there!
I’m Dr. T and welcome to my blog. I plan to use this space to write generally about the topic of sexual abuse prevention, with specific posts dedicated to relevant – and often misconstrued – subtopics. This is one of my passion topics and I hope that with some time and patience, maybe we can all get to know one another. But first things first, it might help to know who I am and why I am writing about sexual abuse prevention.

If you google my name, you’ll find plenty of links to different articles I’ve written, my current employment, and probably this very page (if not my website itself). I am the director of the Sexual Neuroendocrinology Lab in Upstate NY, a scholar in the field of sexual abuse prevention and while other are perhaps more frequently giving public interviews, my passion lies in outreach and science communication. You can read about my academic history on my main website page and about the work my lab does, if you are so inclined to know more about me. I have published scholarly work on the topic of pedophilia and the prevention of sexual abuse, the reaction to which has pushed me to start blogging. My primary research question is “Where does pedophilia come from?” – that is, what mechanisms (specifically neurobiological, or brain-based ones) give rise to a person developing this form of sexual preference? As a follow-up to this question, I research how we use this information to improve sexual abuse prevention services. My approach has always been this: how can we prevent something if we don’t know what we’re preventing? Nothing is more important that our promise as a society to keep children safe, and I believe the best way to keep them safe is to make sure no one offends in the first place.

Here’s the thing – I’m here to write about sexual abuse prevention from the perspective of someone who does it and to promote a reasonable, objective, and informed response to it. I’ll take a few different approaches to this goal, for example writing about scientific studies in a more open language (because let’s face it, scientific jargon just complicates things), describing studies out of my lab and others that are of interest to the public, and (perhaps less often) writing opinion pieces on current events in the world of sexual abuse prevention.

I will caution readers that I don’t sugar coat the science and I am writing about topics that are controversial, emotionally charged, and incredibly nuanced in their detail. If you don’t want to read this, that’s fine – no one is forcing you to stay. I encourage you to stay long enough to read a bit and maybe understanding something today that you didn’t yesterday. Serious comments are welcome, but anything hateful, violent, harmful, or otherwise intending to inflict damage will be deleted. Let’s keep the conversation polite, shall we?