Being Sexually Attracted to Minors: Sexual Development, Coping With Forbidden Feelings, and Relieving Sexual Arousal in Self-Identified Pedophiles

The Treatment Needs and Experiences of Pedohebephiles: A Systematic Review

People with a sexual interest in children face significant barriers to seeking and receiving mental health treatment. This review aims to bridge the gap between the treatment needs and experiences of pedohebephiles, and the services aiming to support them. Reviewers screened 1705 database hits and extracted findings from 22 qualitative, 15 quantitative, and 3 mixed-method studies on the treatment needs and experiences of pedohebephiles. Research suggests that this population experiences significant levels of distress, depression, and anxiety related to their sexual interest. Many individuals belonging to this population would seek (median = 42.3%), or have sought (median = 46.5%), treatment to cope with their sexual interest or with potential related mental health repercussions. Their experiences in treatment have been mixed, with some reporting positive experiences with empathic therapists and others reporting rejection. Most frequently, pedohebephiles report fear of exposure and rejection as barriers to seeking treatment, in addition to fear of the legal repercussions. The current study is the first to summarize and discuss previous findings on the treatment needs and experiences of pedohebephiles. The findings indicate that the treatment needs of pedohebephiles often remain unaddressed. Suggestions to increase the fit between treatment services and the needs of pedohebephiles are put forward.

Development and Initial Validation of Measures of Proximal Stigmas and Experiences of Discrimination for Minor Attracted People

Stigma-related stressors are central to understanding psychopathology, distress, and coping in stigmatized groups; individuals who experience attractions to children are a highly stigmatized group. Currently, few validated self-report measures exist to assess stigma-related stressors in minor attracted people (MAPs) and the current research describes the development and initial validation of two measures of internalized stigma and experiences of discrimination. A sample of MAPs (n = 289; mean age = 31.8 years, SD = 12.2) was recruited online and completed a set of self-report measures assessing stigma-related stress, negative mental health outcomes, substance use, and coping. Exploratory factor analyses of the two newly developed stigma-related stress measures were conducted and convergent associations with other constructs were examined for validity evidence. Exploratory factor analyses indicated a two-factor solution to both the measure of internalized stigma and experiences of discrimination. The total scale scores and factors scores generally demonstrated the anticipated patterns of correlations with mental health concerns, distress, coping, and substance use. Clinical intervention with MAPs may benefit from an exploration of stigma-related stressors in clients' lives to improve mental health outcomes. The relatively large sample that was recruited from multiple online forums is a strength of the current study. The use of a self-report measurement modality for all measures used in the study weakens that strength of the validation evidence presented here. These results provide initial validity evidence for the measures of stigma-related stress in MAPs and the promise of stigma processes in understanding negative outcomes in this population.

The Reintegration of Men into Society after a Sexual Offense: A Hermeneutic Phenomenology Study

The purpose of this study was to describe the lived experience and meaning of being a 'sex offender' for the individual who is reintegrating into society, considering issues associated with self-perception, perception of others, stigma and humanization. Fourteen male adults were invited to participate in this hermeneutic phenomenological study. Data analysis was completed using an iterative process as described by van Manen. Five major themes were identified: exposed secret leads to humiliation; being considered a sex offender is living in fear of the unknown; stigma and shame consume the identity of the individual charged with a sexual offense; reframing and "leveling" of the crime are coping strategies; and the path toward healing and forgiveness is complex. Contextualizing individuals' experiences and examining barriers and motivators post-charge are essential to minimize stigma and risk factors linked to recidivism, as well as to facilitate recovery and healing.

Online Communities for Child-Attracted Persons as Informal Mental Health Care: Exploring Self-Reported Wellbeing Outcomes

Online support communities are gaining attention among child-attracted persons (CAPs). Though research has largely focused on the negative consequences these environments create for potential offending, they may also provide a beneficial alternative to more formal treatment settings. To assess the utility for clinical and therapeutic purposes, this analysis focused on subcultural dynamics to examine self-reported wellbeing outcomes of participation in a Dutch forum for CAPs. A total of 15 semi-structured interviews were conducted with moderators, members and mental health professionals involved in the community. Thematic analyses demonstrated that by means of informal social control, bonds of trust and social relational education, the network aims to regulate the behavior and enhance the wellbeing of its marginalized participants. Key outcomes include a decreased sense of loneliness and better coping with stigma, to the point that participants experience less suicidal thoughts. Association with prosocial peers also helps to set moral boundaries regarding behavior towards children, although we cannot fully rule out potential adverse influences. Online support networks offer a stepping stone to professional care that fits individual needs of CAPs, while also providing an informal environment that overcomes limitations of physical therapy and that extents principles of existing prevention and desistance approaches.

Developmental factors associated with inappropriate coping strategies among sexual aggressors of children

BACKGROUND

Many studies in the field of sexual offending focus on the presence of inadequate coping strategies prior to sexual offending, and the role these strategies play in the sequence of the offense. However, little is known about the development of strategies-such as substance abuse and, especially, deviant sexual fantasies-to manage daily difficulties.

OBJECTIVE

To better understand the antecedents of the development of inadequate coping strategies, we conducted a series of structural equation modeling (SEM) analyses.

PARTICIPANTS AND SETTINGS

Based on 274 sexual aggressors of children, these analyses were based on components of Maniglio (2011a) theoretical model, in which victimization before the age of 18 leads to the development of psychological problems and, ultimately, the reliance on deviant sexual fantasies as a coping strategy.

METHODS

Two models were created through exploratory factorial analysis: the first model comprised 19 manifest variables, while the second model consisted of 15 manifest variables. All the retained variables were related to Maniglio's (2011a) hypothesis.

RESULTS

The analyses not only confirm Maniglio's hypothesis but also produced two statistically significant models (RMSEA = 0.069, CFI = 0.93 and TLI = 0.92 for Model 1 & RMSEA = 0.074, CFI = 0.93 and TLI = 0.91 for Model 2) composed of three indirect trajectories and one direct trajectory on the one hand, and four indirect trajectories and one direct trajectory on the other hand.

CONCLUSIONS

These results are consistent with those of studies that have highlighted the heterogeneity of sexual aggressors of children.

Physical and Psychological Child and Adult Sex Cues and Their Association with Sexual Age Preferences

This study combined research on human mate preferences and attraction to physical and psychological features of children. Specifically, we used the Ideals Standards Model (ISM) as a conceptual framework to investigate the sexual relevance of adult and child sex cues within the general population. A sample of 589 men (mean age 30.6 years, SD = 16.6) answered questions about their sexual age preferences as well as different child and adult sex cues. The sample showed the full gamut of sexual age preferences (i.e. ranging from prepubescent children to adults over sixty years of age). A principal component analysis revealed five dimensions of adult and child sex cues. Sexual interest in children was positively related to the two dimensions of attraction to neotenous innocence and attraction to neotenous physical appearance while being negatively related to the factor of agency. In contrast, sexual interest in adults was indicated by the dimension of vitality. The fifth dimension of warmth-truthfulness was neither related to sexual interest in children nor sexual interest in adults. We argue that attraction to neotenous innocence and attraction to neotenous physical appearance can be used as an indicator of sexual interest in children. Moreover, we discuss how our results fit in with theoretical notions from the ISM.

Secret-keeping in therapy by clients who are sexually attracted to children

Objective This study investigated the reasons why pedohebephilic clients disclose their sexual attraction to children in therapy and the experiences associated with this decision among English-speaking samples. Method: The pre-registered online survey combined (1) quantitative correlational data of self-reported improvement, alliance, therapist reaction to disclosure, and the belief that mandatory reporting laws were in place, and (2) qualitative data about reasons for disclosure or no disclosure as well as perceived consequences. The sample consisted of pedohebephilic people who have been clients in therapy and have disclosed (n = 96) or not disclosed (n = 40). Results: While the disclosure and no disclosure groups did not differ in improvement or beliefs about mandatory reporting, those who had disclosed reported a stronger alliance. Clients who did not perceive the therapist's reaction as supportive reported less improvement than the no disclosure group. Thematic analysis of qualitative data identified three themes concerning motives for disclosing or not disclosing and a fourth regarding differential impacts of disclosure. Discussion: This study indicates that disclosing pedohebephilia does not in and of itself lead to improvement but is contingent on a therapist's reaction.

"Falling Through the Cracks": A Retrospective Exploration of the Barriers to Help-Seeking Among Men Convicted of Sexual Crimes

The prevalence and impact of sexual abuse is of global concern, and the alarming rates of victimization have inspired a focus on its prevention. Whilst research has begun to explore the experiences of non-offending individuals to inform prevention initiatives, there is limited exploration of those who have struggled with their sexual interests and go on to commit sexual crime. Arguably these individuals hold key information about gaps in service provision, which may inform approaches to crime prevention. This study aimed to provide a phenomenological exploration of the pre-offense experiences of convicted individuals' beliefs about help-seeking, their desires for support, and any barriers that might have prevented them from coming forward for help. Semi-structured interviews were conducted with 14 individuals convicted of sexual offenses (n = 13 against children; n = 1 sexually motivated violence), and interpretative phenomenological analysis elicited three superordinate themes: Desperation, Barriers to Help-seeking and A Way Forward. The findings shed light on the distressing experience of living with sexual interests that are so openly rejected by society and the many ways participants attempted to cope with this, including multiple failed attempts to seek help. Implications and limitations are discussed.

Fantasy Sexual Material Use by People with Attractions to Children

PURPOSE OF REVIEW

With the Internet allowing consumers easy access to fantasy and fictional sexual materials (FSM), it is becoming increasingly important to understand the context of their use among specific populations. Of particular, social, clinical, and legal interest is FSM use by people who are attracted to children and whether this may have a risk-enhancing or protective impact on their likelihood of committing a contact or non-contact sexual offence.

RECENT FINDINGS

There is a lack of data currently available in relation to the use of FSM by those with sexual attractions to children. Evidence from allied areas appears to show no meaningful associations between FSM use and sexual aggression. We propose a novel research program and some initial research questions that provide a theoretical framework for more evidence-based inquiry on FSM use by people who experience attractions to children.

The Hamburg Youth Prevention Project (HYPP) for adolescents with sexual interest in children

Paedophilic sexual interest is often linked to an emergence during adolescence, but concrete empirical knowledge on its development and early viable treatments remains scarce. The aim of this article is to provide an overview about the current state of research on juveniles with sexual interest in children as well as to introduce the Hamburg Youth Prevention Project (HYPP). The HYPP aims to better comprehend the development of sexual interests in adolescents and seeks to find a basis for improved treatment strategies during this critical developmental period. In this perspective, we outline the framework, goals, and treatment approach for this project. It addresses adolescents who are sexually attracted to younger children or engage in sexual acts with children and who have not yet been in contact with the justice system. The project offers a diagnostic process, anonymous counselling, and treatment. It is grounded in a biopsychosocial perspective on psychosexual development and an integrative family-centred approach. The project is based on the core assumption that in adolescent participants, there is still great flexibility for development, including their sexual interests.

Public Stigmatizing Reactions Toward Nonoffending Pedophilic Individuals Seeking to Relieve Sexual Arousal

People with pedophilia (PWP) can deal with their sexual desires by relieving sexual arousal without sexually exploiting children. Study 1 investigated whether public reactions toward nonoffending pedophilic men are affected by their strategies to relieve sexual arousal (nonsexual pictures vs. child sex dolls) or to reduce their sex drive via testosterone lowering medication in legally nonproblematic ways. A sample of German-speaking participants (N = 143) read three vignettes describing PWP using either of these strategies. Participants' (59.4% females) mean age was 39.7 (SD = 15.6). Although no significant difference was detected between the nonsexual pictures and sex dolls conditions on cognitive (except for dangerousness), affective, and behavioral levels, both consistently elicited more stigmatizing reactions than the testosterone-lowering medication condition. To investigate if this effect was driven by disapproving any relief of sexual arousal or the use of actual child stimuli in particular, Study 2 (N = 151) added two conditions with PWP using adult child-like stimuli to relieve sexual arousal: adult-as-schoolgirl porn and adult partner with childlike appearance. Here, Participants' (57.6% females) mean age was 28.0 (SD = 13.3). Results indicate that stigmatization was driven by disapproving the use of child stimuli rather than the relief of sexual arousal in general. Individuals with a sexual interest in children face strong stigmatizing reactions, which are only alleviated when they are described as undergoing treatment lowering sex drive or - to a lesser extent - being able to mate with an adult partner or using porn with adult actors posing as schoolgirls.

Pedohebephilia and Perceived Non-coercive Childhood Sexual Experiences: Two Non-matched Case-Control Studies

Research on the link between childhood sexual abuse experiences (CSAE) and pedohebephilia is limited by its focus on events that the respondents rate as abusive. We asked 199 German-speaking (Study 1) and 632 English-speaking (Study 2) men with and without self-reported pedohebephilia to complete the Childhood Trauma Questionnaire (CTQ) and scales to assess perceived non-coercive childhood sexual experiences with adults (PNCSE-A), and peers (PNCSE-P, only Study 2). A substantial number of participants with PNCSE-A disagreed with all items of the CTQ Sexual Abuse subscale (e.g., 35% and 26% of pedohebephilic men in Studies 1 and 2, 38% of teleiophilic men in Study 2). While pedohebephilic men reported more CSAE than teleiophilic men, the effects for PNCSE-A did not consistently point in the expected direction. In Study 2, conviction status for sexual offenses among pedohebephilic men was linked to higher rates of CSAE, PNCSE-A, PNCSE-P, physical neglect, and physical abuse. Pedohebephilic men in Study 2 also reported more PNCSE-P than teleiophilic men. Our results highlight the importance of assessing different (positive or neutral) perceptions of CSAE. Better controlled designs (e.g., matched case-control studies) are needed to substantiate whether and how perceived non-coercive childhood sexual experiences relate to pedohebephilia and sexual offending.

Realization, Self-View, and Disclosure of Pedophilia: A Content Analysis of Online Posts

In order to treat individuals with pedophilia¹ who are at risk of committing offenses, disclosure of the attraction must first take place. The aim of this study was to understand processes of initial recognition of pedophilic attraction, disclosure, and help-seeking. We conducted a qualitative content analysis of online posts from self-identified individuals with pedophilia, finding four categories: (1) Awareness and Initial Self-View (with emotions including denial, shame, and fear), (2) Disclosure (typically made to family, friends, or therapists, but also done online in an anonymous way), (3) People's Reactions to Disclosure (ranging from rejection to support), and (4) Current Self-View (including minimization, distortions, despair, resignation, and non-offending/anti-contact commitment). Our findings highlight the internal process experienced by individuals with pedophilia when first recognizing their attraction to minors, what is involved in disclosure, the importance of others' reactions after disclosure, and the factors that can reinforce a non-offending commitment. Clinical and social implications are discussed.

Qualitative Analysis of Minor Attracted Persons' Subjective Experience: Implications for Treatment

Treatment for Minor Attracted Persons is inadequate and difficult to access. This qualitative study examined community-based MAPs' responses to narrative questions about their experiences and what they want society to understand, using an iterative thematic analysis. Notable responses from the participants included: 1) sexual attraction does not equal action; 2) minor attraction is immutable; 3) stigma leads to psychological burden; 4) therapy should aim to reduce distress, not change sexual feelings; and 5) sexual behavior can be controlled and remain within legal parameters. Further understanding of MAPs' experiences is key for developing more efficacious treatment modalities to help them live meaningful lives without endangering children.

Identifying and working with appropriate treatment targets with people who are sexually attracted to children

Research has shown that people within society experience sexual attractions to children, and a substantial number of these seek support related to this. However, professional practices around working with minor-attracted persons (MAPs) are variable. Clinicians possess low levels of knowledge about this population and are unclear about the correct treatment goals. In this work we explored the prioritization of different treatment goals by MAPs (n = 150), before investigating the demographic, sexuality-related, and psychological predictors of treatment target prioritization. Self-compassion drove many treatment targets among MAPs. We offer recommendations about how professionals might work collaboratively and effectively with this population.

10 years later: Revisiting Seto’s (2012) conceptualization of orientation to sexual maturity among pedohebephilic persons

Emerging research has examined the experiences of individuals who are sexually attracted to children. This study collected both quantitative and qualitative data from individuals with self-identified pedohebephilic attractions ( n = 116). Several analyses were used to assess whether the sample characteristics followed Seto’s (2012) conceptual outline of pedophilia as an orientation to sexual maturity. The three developmental characteristics of gender-based sexual orientation were explored using survey and interview data. Overlapping patterns with relation to the age of onset, expressions of both sexual and romantic attractions, and stability of such attraction over time were found. As noted by researchers and clinicians in this area, there are clear clinical implications associated with a shift in the conceptualization of sexual attraction to children. Such etiological conceptualizations are often poorly understood and/or conflated with sociocultural understandings and reactions. Despite resistance to such conceptualizations, the findings indicate that orientation to sexual maturity closely mirrors the developmental trajectory of gender sexual orientation, as outlined in Seto’s seminal paper.

Media Coverage of Pedophilia and Its Impact on Help-Seeking Persons with Pedophilia in Germany—A Focus Group Study

The public stigma associated with pedophilia, the sexual attraction to prepubescent children, is tremendous. Previous research indicates that undifferentiated media coverage plays an essential role in perpetuating the public stigma by falsely equating pedophilia and child sexual abuse (CSA) and thus may stop persons suffering from a pedophilic disorder from seeking professional help. Until now, a comprehensive examination of positive as well as negative media effects on affected individuals is missing. Therefore, the present study explores if and how media coverage impacts the lives of help-seeking persons with pedophilia by conducting four qualitative focus group discussions with a clinical sample (N = 20) from the German Prevention Network “Kein Täter werden”. Present results demonstrate that media coverage of pedophilia was perceived as mostly undifferentiated, even though participants observed an increase in fact-based reporting over the years. Moreover, it seems that media coverage has strong emotional and behavioral consequences for patients (e.g., negative reporting reduced self-esteem). In sum, our results highlight that differentiated media coverage could play a key role in supporting help-seeking persons with pedophilic disorder, while the impact of undifferentiated media coverage appears to be mostly negative. Therefore, our results point to the need to reframe pedophilia using differentiated media coverage to help affected persons receive treatment efficiently and thereby prevent CSA.

Challenges and Solutions to Implementing a Community-Based Wellness Program for Non-Offending Minor Attracted Persons

Child sexual abuse is a significant public health concern that has long-lasting consequences for victims and their families and poses a significant financial cost to the public. Prevention efforts, including sex offender treatment programs, are intended to prevent further instances of sexual abuse. Most sexual offenses, however, are committed by individuals who are not yet known as sexual offenders, and therefore traditional sex offender treatment programs fall short of this goal. It is crucial to provide services to people who may be at risk for committing a sexual offense and those who have not offended, including those individuals who are attracted to children. While primary prevention programs such as Prevention Project Dunkelfeld and Talking for Change have begun to address this issue internationally, there are significant barriers to providing preventive services of this nature to non-offending minor attracted persons (NOMAPs) in the United States. Barriers include concerns about mandated reporting laws, stigmatization, and lack of knowledge by therapists about MAPs. This paper explores these barriers and provides solutions for practitioners to offer services to this population. This paper includes the development of specific programming for non-offenders and specialized training for clinicians who work with non-offenders as used by The Global Prevention Project.

Attraction to Physical and Psychological Features of Children in Child-Attracted Persons

In an online survey of 274 self-identified child-attracted persons (CAPs), we examined the attraction ratings given to sets of 9 physical and 12 psychological features of children, and asked CAPs to identify additional features that were not listed. We also examined the relationships between these attraction ratings and attraction to children dimensions (age mono-/polymorphism, exclusivity of attraction to children, and gender attraction), history of falling in love with a child, and detected sexual offending history. There was relatively little differentiation across physical features and psychological features; all averages were approximately 4 or higher on a 5-point scale. Attraction ratings were mostly weakly and inconsistently related to our other study variables. The exception was that CAPs who had fallen in love with a child rated 11 out of 12 psychological features as more attractive than CAPs who had not fallen in love with a child, with small to moderate effect sizes. These two groups did not differ in ratings for physical features. Our qualitative content analysis of participant-suggested features revealed six physical themes (inter alia, face and head, children's bodies) and five psychological themes (inter alia, personality, harmlessness) that were important to CAPs' attraction to children.

Primary Health Professionals' Beliefs, Experiences, and Willingness to Treat Minor-Attracted Persons

There is a desire and need among minor-attracted persons (MAPs) to access support within the community, and this often begins with an approach to healthcare providers working in general medical/mental health settings. However, little is known about the experiences of these non-specialist professionals in relation to their beliefs, knowledge, and decision-making processes when working with patients who disclose sexual attractions to children. Using an online survey, this study explored the knowledge, comfort, competence, and treatment willingness of 220 non-specialist healthcare providers when faced with patients who disclose sexual attractions to children. We investigated how often such disclosures were made, clinician stigma, treatment priorities, and professionals' willingness to report MAPs to external agencies because of their sexual attractions. Some key differences were found when comparing primary medical vs. mental health professionals, including increased likelihood to view MAPs as dangerous, unable to control behaviors and that sexual attractions are an avoidable choice, in the former group. Both groups prioritized mental health treatment targets above controlling attractions and living with stigmatized attractions, although controlling or changing attractions were still relatively high priorities. Results indicated a need for further training, focusing on increasing comfort around working with MAPs, as this was associated with a greater willingness to work with this group. We identify current gaps in service provision for MAPs seeking professional support and discuss recommendations for professional training.

"I Would Report It Even If They Have Not Committed Anything": Social Service Students' Attitudes Toward Minor-Attracted People

This study explores future mental health providers' assumptions about minor-attracted people, using data from a survey of 200 students preparing for entry into social service professions at a public university in the state of Utah. Survey results show that more than half of the students believe clients who identify themselves as pedophiles must be automatically reported to the police, which has implications for providers' understandings about the term "pedophile," as well as their knowledge of guidelines for when clinicians may break client confidentiality. This belief was not significantly affected by taking ethics courses, nor courses that discussed mandated reporting guidelines. Despite this finding, 91% of students did not believe that they would need to report a client who had attractions to children, but who had never committed a sexual offense against a child. The majority of students indicated a willingness to work with minor-attracted clients, and commonly indicated in comments that they wanted more information about MAPs and when to break client confidentiality in their programs of study. Study results indicate a need for education among social service students about these issues.

"We Do Exist": The Experiences of Women Living with a Sexual Interest in Minors

The current body of the literature studying minor-attracted persons (MAPs) predominantly focuses on the experiences of men who experience sexual attractions to children. To shed more light on the experiences of women within this population, we conducted anonymous semi-structured interviews with six self-identified female MAPs, who were recruited through online support forums for individuals with sexual attractions to children. Interpretative phenomenological analysis (IPA) was used to analyze the interview transcripts. Two superordinate themes were identified from the dataset that highlighted the uniqueness of the experience of being a woman within the MAP community ("A minority within a minority") and themes of social isolation and the effects of this on identity ("A lonely secret existence"). The findings reported here highlight how the experiences of female MAPs both converge with and diverge from their male counterparts in important ways. We discuss the implications of these experiences in relation to more effective service provision for women who are sexually attracted to children.

Identifying the Coping Strategies of Nonoffending Pedophilic and Hebephilic Individuals From Their Online Forum Posts

Individuals who identify as pedophilic or hebephilic, and who do not offend, are increasingly visible in online discourse and as a focus of research. Developing knowledge about this population will offer insights into their psychological needs and, potentially, into the mechanisms and strategies individuals use to live offense-free lives. This study examined coping strategies among members of an online forum supporting pedohebephilic individuals who do not wish to offend. Forum users' posts were analyzed using thematic analysis. Eleven themes emerged, which were classifiable into three superordinate themes around (a) the acceptance of pedophilia, (b) strategies to stay safe, and (c) dealing with sexual arousal. These themes offer insight into the varying strategies used by these individuals to cope with stress and/or to remain offense-free. Understanding whether these strategies are adaptive or maladaptive may help develop better support services for those who have not offended and may inform prevention efforts.

The Association between Maladaptive Coping and Treatment Motivation in Individuals who are Sexually Attracted to Children Living in the Community

There is a need for community treatment programs for people who are sexually attracted to children, but individuals report difficulty accessing services. Individuals who are sexually attracted to children (n = 293) completed an online anonymous survey that revealed a significant positive association between maladaptive coping and two factors of the treatment motivation measure. The association between maladaptive coping and treatment motivation was attenuated at higher levels of ego dystonic distress/aversion. Results highlight the importance of targeting stigma toward those who are sexually attracted to children to increase treatment seeking behavior.

Understanding and Challenging Stigma Associated With Sexual Interest in Children: A Systematic Review

The stigmatization of people with pedophilia was previously identified as a "blind spot" in stigma research. This systematic review updates and expands on Jahnke and Hoyer's 2013 review to understand (1) factors contributing to stigma toward people with sexual interest in children, (2) experiences of stigma, and (3) how stigma can be challenged and reduced. Thematic synthesis was used to analyze data from 35 studies from the United Kingdom, United States, The Netherlands, Germany, Canada, Norway, Australia, and New Zealand. Overarching themes were (1) misperceptions and stereotypes, (2) negative affective responses, (3) discrimination, (4) mental distress, (5) internalized public stigma, (6) negative effects of disclosure, and (7 and 8) informative and humanizing interventions. Findings highlighted substantial prevalence of stigma toward and amongst people with sexual interest in children, and methodological limitations of extant research. An agenda for future research is discussed, emphasizing how stigma can be challenged.

Help wanted: Lessons on prevention from young adults with a sexual interest in prepubescent children

BACKGROUND

Adolescents and young adults with a sexual interest in young children represent an underserved population. The needs of this group, and their implications for child sexual abuse prevention program development, are not well understood.

OBJECTIVE

The objective of this research is to advance knowledge about adolescents and young adults with a sexual interest in children to better inform the development of effective prevention and mental health efforts.

PARTICIPANTS AND SETTING

The sample consisted of 30 young adults, ages 18-30, from North America, South America, Europe, and Australia.

METHODS

Researchers conducted telephone interviews with participants, and asked about when their interest in children emerged, how they responded to this sexual interest, and what resources could have been helpful during this process. Participants also completed a brief, online survey. Interviews were transcribed and analyzed using Dedoose software.

RESULTS

Participants reported that their sexual interest in children emerged during adolescence, and as part of that process, they experienced a variety of emotions, including fear, shame, and feelings of isolation. Participants also noted the need for role models who are sexually interested in children and successfully navigating life, positive messaging, and support from families and the community.

CONCLUSIONS

Young people with a sexual interest in children are largely hidden, vulnerable, and looking for help. Findings from this research can be used to direct the development of the prevention and mental health programs that are responsive to the needs of this community.

Sexual Attraction and Falling in Love in Persons with Pedohebephilia

Few studies of pedophilia or hebephilia have included questions about romantic attraction. We conducted an anonymous online survey of 306 men who self-reported as sexually attracted to children. The majority (72%) of participants reported they had fallen in love with a child in their lifetime. Participants reported greater feelings of attachment to children than feelings of infatuation. Though sexual attraction and falling in love were strongly correlated, they were not synonymous. Participants who reported pedohebephilia (defined in this study as attraction to prepubescent and pubescent children) were more likely to have fallen in love with a child than participants who reported pedohebe-ephebophilia (defined as attraction to prepubescent, pubescent, and post-pubescent minors). Also, participants with an exclusive attraction to children were more likely to have fallen in love with a child than participants who were equally attracted to children and adults. The results of this study were consistent with the suggestion of Seto (2012) that pedohebephilia could be considered a form of sexual orientation for age, which includes both sexual and romantic attraction.

Correlates of Chronic Suicidal Ideation Among Community-Based Minor-Attracted Persons

Elevated suicidal risk has been documented in adults who are sexually attracted to minors but the topic has not been adequately investigated, particularly outside the context of the criminal justice system. In this study, risk factors for chronic suicidal ideation were assessed in 333 community-based minor-attracted persons (95% male) via an online survey. Chronic suicidal ideation was endorsed by 38.1% of the participants but was associated neither to history of sexually engaging with a child nor to prior contact with the criminal justice system. In bivariate logistic regression analyses, significant unadjusted correlates included young age, less education, prior mental health treatment, weaker attraction to adult women, history of sexual abuse in the participants' own childhood, and the psychosocial effect of perceived stigma against pedophilia. In multivariable analysis, all these factors except education were uniquely associated with suicidal ideation. These results identify meaningful clinical risk factors and treatment targets in this population.

Preventing Sexual Abuse: Perspectives of Minor-Attracted Persons About Seeking Help

The primary aim of this exploratory research was to gain information from minor-attracted persons (MAPs) about their (a) formal and informal experiences with help-seeking for minor attraction, (b) perceived barriers to seeking help for concerns about minor attraction, and (c) treatment priorities as identified by consumers of these services. A nonrandom, purposive sample of MAPs (n = 293, 154 completed all questions) was recruited via an online survey. Results show that 75% of participants did seek formal help from a professional; however, just less than half of them found the experience to be helpful. Characteristics of helpful therapeutic encounters included nonjudgmental attitudes, knowledge about minor attraction, and viewing clients in a person-centered and holistic way. Barriers to help seeking included uncertainty about confidentiality, fear of negative reaction or judgment, difficulties finding a therapist knowledgeable about MAPs, and financial constraints. Understanding or reducing attraction to minors were common treatment goals, but participants also prioritized addressing general mental health and well-being related to depression, anxiety, loneliness, and low self-esteem. Implications for effective and ethical counseling and preventive interventions for MAPs are discussed.

"I Despise Myself for Thinking about Them." A Thematic Analysis of the Mental Health Implications and Employed Coping Mechanisms of Self-Reported Non-Offending Minor Attracted Persons

'Non-offending pedophiles' or 'minor attracted persons' are individuals who suppress an attraction to children. Previous analyses of this population's mental illness employed overt self-report methods, limited by social desirability. Additionally, studies assessing the coping mechanisms employed to remain offense-free are underpowered; understanding of these would facilitate the rehabilitation of prior offenders. A thematic analysis of coping mechanisms and mental illness was conducted on 5,210 posts on the 'Virtuous Pedophiles' forum. Four themes emerged for coping mechanisms: Managing risk and attraction to children, Managing mood, Managing preferences prosocially and Friends, family and relationships, with 13 subthemes. Five themes emerged for mental ill-health, including: Addiction, Anxiety, Depression, Self-hatred/Self-harm/Suicide and Other. Self-hatred/Self-harm/Suicide accounted for almost a third of discussed mental ill-health. These results highlight the severity of mental ill-health amongst this population and the coping mechanisms employed to remain offense-free.

Understanding Men's Self-Reported Sexual Interest in Children

A few studies have found that even in the general population, a minority of adults-men as well as women-report some sexual interest in a young age group. The purpose of the present study was to identify factors associated with self-reported sexual interest in children among a community-based sample of men. Using an online survey methodology, we examined the extent to which different types of childhood adversities (witnessing parental violence, sexual, physical, and emotional abuse), atypical childhood sexual experiences, and participants' self-reported likelihood of engaging in a variety of sexual behaviors (heightened sexual interest) were related to sexual interest in children (SIC) reported by a non-forensic/non-clinical sample of 173 men. Data were analyzed using hierarchical multiple regression. After controlling for physical and emotional abuse and witnessing parental violence, self-reported experiences of childhood sexual abuse (CSA) significantly increased the amount of variance explained in SIC scores. However, only early masturbation and current heightened sexual interests contributed significantly to the final model. Total variance explained by the model as a whole was 24% (adjusted R² = 20%). Early masturbation and heightened sexual interests significantly mediated the relationship between CSA and SIC scores. Findings add to the small but growing body of literature examining the etiology of pedophilic sexual interests in non-clinical samples.

Attraction Versus Action in Pedophilic Desire: The Role of Personality Traits and Childhood Experience

OBJECTIVE

Comparison of pedophilic individuals who do and do not refrain from sexually engaging with children may offer critically important information regarding the differential contributors to pedophilic attraction versus behavior. This study compared 5 traits that are potentially contributory to pedophilic attraction or behavior in both minor-attracted persons (MAPs) who refrain from sexually engaging with minors (nonacting MAPs) and those who have acted on pedophilic attractions and subsequently entered the criminal justice system (forensic MAPs).

METHODS

Subjects included 195 nonacting MAPs, 50 forensic MAPs, and 60 healthy controls. Data on nonacting MAPs were drawn from an online survey, and data on the other 2 groups were based on prior in-person evaluations. Measures included the Millon Clinical Multiaxial Inventory-II (MCMI-II), Barratt Impulsiveness Scale (BIS-11), the MAP Questionnaire, and the Sexual History Questionnaire (SHQ).

RESULTS

Both MAP groups scored higher than healthy controls on the domains of socially inhibited personality traits, propensity toward cognitive distortions, and subjects' own childhood sexual abuse (CSA). Forensic MAPs scored higher than nonacting MAPs on the CSA domain, but the 2 MAP groups differed little on the other 2 domains. Forensic MAPs also scored higher than the other 2 groups on the antisocial domain, whereas nonacting MAPs did not differ from controls on this measure. Nonacting MAPs scored higher than controls on impulsivity.

CONCLUSIONS

Antisocial personality traits may be a primary driver of pedophilic behavior that is unrelated to pedophilic attraction. Socially inhibited personality traits and propensity toward cognitive distortions are associated with pedophilic attraction, although the direction of causation is not clear. CSA seems to increase the risk of both attraction and behavior.

What if the Child Appears to Enjoy It? Moral Attitudes Toward Adult-Child Sex Among Men With and Without Pedohebephilia

This study attempted to measure cognitions about adult-child sex by approaching the issue from a perspective of moral attitudes. We assessed ratings regarding direct and indirect harmfulness, nonconsent, exploitation, and differences in adults' and children's sexualities based on a description of adult-child sex without apparent child discomfort among an online sample of 120 pedohebephilic and 89 nonpedohebephilic German-speaking men. The results showed that only 7.5% among pedohebephilic men had equal or less permissive attitudes than the average control, while 4.5% of nonpedohebephilic men had equal or more permissive attitudes than the average pedohebephilic man. Both groups did not, however, differ in their appraisal that children may suffer indirect harm via stigmatization. The findings also indicate that the moral perception of adult-child sex shows little differentiation among German-speaking laypeople. We discuss the relevance of these findings for clinical practice and propose ideas for subsequent research.

Qualitative Analysis of Attitudes Toward Adult-Child Sexual Activity Among Minor-Attracted Persons

This study uses qualitative methodology to explore narrative responses to a question regarding the harmful versus beneficial effects of adult-child sex on children. Data were gathered from a survey of self-identified minor-attracted persons (MAPs). Two hundred and sixty-seven survey participants provided narrative responses. Results indicated a significant amount of variability in perceptions of harm and of mitigating or aggravating factors. Understanding the subjective perspectives of MAPs, the range of their attitudes, and the issues that they identify as pertinent is critically important for clinical efficacy in the treatment of pedophilia.

The Stigma of Pedophilia

Abstract. There is an emerging consensus among researchers that having pedophilic interests is not synonymous with child sexual abuse or other amoral behavior. Nevertheless, misconceptions about pedophilia are highly prevalent among the general public and mental health practitioners. This article provides an overview of recent findings on the stigma of pedophilia and derives guidelines for mental health practitioners based on these results. We argue that stigmatization of people with pedophilic sexual interests has undesired indirect effects on risk factors for child sexual abuse, particularly on an emotional and social level. Also, fear of being rejected or treated unethically may prevent pedophilic individuals at risk for sexual offending from confiding in medical practitioners or psychotherapists. Psychologists working with pedophilic individuals in forensic or clinical settings should be aware that stigmatizing people with pedophilia may increase their risk of sexual offending, and provide help to deal with potential stigma-related repercussions.

Is Contact with Children Related to Legitimizing Beliefs Toward Sex with Children Among Men with Pedophilia?

Among pedophilic men, social contact with children has been discussed as creating a risk situation for sexual abuse. Also, pedophilic men searching for such contact are seen as harboring more beliefs legitimizing sexual contact with children. However, social contact may also decrease false beliefs. We tested these competing views in an anonymous Internet survey with a non-forensic, non-clinical sample of 104 self-classified pedophilic men. Results showed that both increased social and physical contact were significantly linked to fewer legitimizing beliefs toward sex with children, even when controlling for past psychotherapy, educational level, social desirability, and age. Controlling for previous conviction for child sexual offenses reduced the effect for physical contact, but not for social contact. Exploratory analyses showed that either type of contact had no significant effect on total self-perceived risk of offending. However, pedophilic men with physical contact with children perceived a higher risk of more direct (i.e., child abuse) than indirect offenses (i.e., child pornography offenses) compared to pedophilic men without physical contact. Despite limitations of the correlational design and the only small to moderate effects, the results challenge the assumption that complete avoidance of contact with children is necessary for persons with pedophilia to reduce the risk of abusive behavior.

Obstacles to Help-Seeking for Sexual Offenders: Implications for Prevention of Sexual Abuse

Persons with potentially harmful sexual interests such as attraction to minors are unlikely to seek or receive treatment before a sexual offense has been committed. The current study explored barriers to help-seeking in a sample of 372 individuals in treatment for sexual offending. Results revealed that the shame and secrecy resulting from stigma associated with pedophilic interests often prevented our respondents from seeking professional counseling, and only about 20% tried to talk to anyone about their sexual interests prior to their arrest. Barriers to seeking and receiving psychological services included concerns about confidentiality, fears of social and legal consequences, personal shame or confusion about the problem, affordability, and challenges finding competent therapists who were adequately equipped to help them. Understanding and ultimately reducing obstacles to help-seeking can improve the quality of life for people with harmful sexual interests and potentially prevent sexual abuse of children or other vulnerable individuals.

Prevention of Child Sexual Abuse by Targeting Pre-Offenders Before First Offense

The population of potential child abuse offenders has largely been unstudied. In the current study, we examine whether a six-component model used for primary diabetes prevention could be adapted to child sexual abuse pre-offenders, whereby individuals who are prone to sexual abuse but have not yet committed an offense can be prevented from committing a first offense. The six components include: define and track the magnitude of the problem, delineate a well-established risk factor profile so that at-risk persons can be identified, define valid screening tests to correctly rule in those with the disease and rule out those without disease, test effectiveness of interventions-the Dunkelfeld Project is an example, produce and disseminate reliable outcome data so that widespread application can be justified, and establish a system for continuous improvement. By using the diabetes primary prevention model as a model, the number of victims of child sexual abuse might be diminished.