Introduction Few psychological disorders are as stigmatized as pedophilia. From the Greek meaning “love of children,” pedophilia is defined in the Diagnostic and Statistical Manual as “recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children,” (Muller, 2016, p. 1). The media perpetuates stigma by semantically linking pedophilia with child sexual abuse or child molestation. In fact, pedophilia refers only to the desire or fantasy, but not to the behavior. Differentiating between pedophilia and child molestation is important both for dispelling myths and for promoting effective interventions for people with pedophilia.

What is Pedophilia?

Pedophilia literally meals love of children, but more specifically refers to having a sexual attracting to children. The Diagnostic and Statistical Manual describes pedophilia as “recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children,” (Muller, 2016, p. 1). For a brief time the American Psychiatric Association defined pedophilia as a “sexual orientation,” but quickly backpedaled due to public outcry (Whitney, 2015). As Berlin (2014) points out, the APA and other professional organizations that set standards for diagnosis, treatment, and public health policy should revert to a definition of pedophilia that does refer to sexual orientation. Doing so would reduce stigma, showing that having sexual urges or fantasies about children is something that is beyond the person’s control; essentially the pedophile was born that way. In fact, emerging evidence has been showing that pedophilia may be a “biologically based neurodevelopmental disorder,” (Fazio, Dyshniku, Lykins, et al, 2015, p. 1). Neurological tests also show that structural alterations in the brain “account for common affective and neurocognitive impairments in pedophilia,” (Poeppl, Eickhoff, Fox, et al, 2015, p. 2374). Therefore, it is reasonable to classify pedophilia as a sexual orientation.

By definition, pedophiliacs experience serious emotional and psychological distress. The DSM-V includes as part of its clinical definition the parameter that “to be diagnosed with pedophilia, the person must experience these symptoms for at least six months, and feel serious distress from the sexual urges and fantasies,” (Muller, 2016, p. 1). The distress pedophiles feel can be serious, making comorbidity with other psychological disorders, such as depression or anxiety disorders, a high likelihood. In fact, pedophilia has been associated with “agonizing self-hatred” and suicidal ideation (Muller, 2016). Treating pedophilia as a psychological disorder is an appropriate and sensible response.

Unfortunately, research on pedophilia is scant. Treatment interventions are also scarce, which increases the likelihood that some pedophiliacs might act on their urges, placing children in serious danger. It is crucial to remember that pedophiles are not inherently dangerous; their urges are not necessarily going to be translated into action. “The great majority of pedophiles may never offend against children, and choose to keep their attractions a secret,” (CBC Firsthand Productions, 2016). A pedophile is not a child molester; a child molester is also not necessarily a pedophile but just a sexual predator (CBC Firsthand Productions, 2016). Differentiating between pedophilia and child molestation is the most important first step towards improving prognosis for pedophiles, improving public health, and improving public safety and the welfare of children.

Prevalence

Because of measurement discrepancies and difficulties relying on self-reports, t is hard to know how many pedophiliacs there are in the general population or overall prevalence rates. Muller (2016) claims, “it is now believed that approximately 1 to 5 percent of men identify as a pedophile,” (p. 1). Population research substantiates the estimate of “0.5–1% lifetime prevalence in men,” (Poeppl, Eickhoff, Fox, et al, 2015, p. 2374). Research on the prevalence, types, and effects of stigmatization of people with pedophilia is in fact difficult to acquire in part because of stigma and reluctance to frankly address the taboo topic.

Support groups for pedophiles are mostly online affairs because of the shame, stigma and lack of established or formal social services. The online support group Virtuous Pedophile has over 1200 registered members (CBC Firsthand Productions, 2016). Both men and women can be pedophiles, but males are “far more likely than females to commit child sexual abuse,” (Pittaro, 2016, p. 301). Again due to stigma related to pedophilia, there are no precise numbers of the prevalence of pedophilia among adult women. As Pittaro (2016) points out, female pedophiles are “uncommon,” but being uncommon does not mean it is acceptable to ignore this small subset of the population and provide appropriate treatment intervention to reduce harm (p. 301).

Stigmatizing

1). Sexually molesting children is grossly unethical and illegal, and needs to remain a highly stigmatized behavior. However, pedophilia is not equal to child sexual abuse any more than suicidal ideation is the same thing as suicide. The whole point of trying to remove stigma about pedophilia is actually to prevent harm to children, not to normalize child sexual abuse.
Stigma is systematic negative attribution, linked to labeling, and results in social isolation (Jahnke, Imhoff & Hoyer, 2015). Shaming excluding the person from mainstream society can exacerbate the original condition, leading to symptom deterioration or the emergence of comorbid disorders. A stigma can also be challenging to overcome, and takes a while to change the public perceptions of the problems. Taking a more balanced approach to pedophilia would be far more productive than stigmatizing, and yet stigmatizing persists due to prevailing misconceptions about pedophilia.

Misconceptions are perpetuated by the media and popular culture, and embedded in laws like Canada’s mandatory reporting laws (Muller, 2016). The media continues to equate pedophilia with child sexual abuse, calling abusers “pedophiles,” instead of calling abusers child molesters. Mandatory reporting laws can apply just as well to pedophiles who have never harmed a child as they do to child molesters. These types of laws and the social support of those laws underscore how deeply entrenched stigma against pedophilia is. The stigma leads to lack of treatment options, lack of research, and lack of policy that can keep children safe.

Research also shows how deeply negative the stigmas against pedophilia are. Jahnke, Imhoff & Hoyer (2015) conducted two separate surveys in two different populations and found “nearly all reactions to people with pedophilia were more negative than those to alcoholics, “sexual sadists,” or “people with antisocial tendencies,” (p. 21). Furthermore, as many as 28% percent of people surveyed expressed the belief that “people with pedophilia should better be dead, even if they never had committed criminal acts,” (Jahnke, Imhoff & Hoyer, 2015, p. 21). These are extremist views, views that leave no room for sensible dialogue about wht to do about pedophilia, how to prevent pedophilia from becoming child molestation, or how to help people with pedophilia to live healthy lives. People with “right-wing authoritarian” qualities were shown to be more likely to exhibit strong feelings of stigma against pedophilia (Jahnke, Imhoff & Hoyer, 2015, p. 21). However, stigmatization is pervasive.

Stigma About Female Pedophilia

Stigma against female pedophiles may in fact be worse than stigma against male pedophiles. Even though male pedophilia receives far more media attention, “it is just too heinous and counterintuitive an idea to contemplate that a female, whose traditional identity has included giving life, nurturing, and protecting the young, could molest a child,” but it does happen (Pittaro, 2016, p. 301). Female pedophiles may suffer even more stigma than males due to gender norms related to appropriate sexual urges; “pedophilia, especially female pedophilia, is improperly stigmatized by modern society,” (Carroll, 2015, p. 26). Henry James’s Turn of the Screw included a poignant theme related to female pedophilia, contributing to the “overall horror and dreadfulness” of the novel (Carroll, 2015, p. 28). Female pedophilia is perceived as being so demonic that it is considered almost supernaturally horrific; “most people in modernity consider female pedophilia to be the ‘most perverse act against nature’” (Carroll, 2015, p. 28).

Effects of Stigma

While norming is an important way to ensure important ethical boundaries are not crossed, stigmatizing psychological disorders like pedophilia can easily backfire. The most important problem with stigma is that it may prevent pedophiles from seeking help or support. Seeking help is the only way to prevent further harm, as the pedophile might be a potential harm to themselves or to children if the urges are acted upon. In fact, being stigmatized can potentially increase the likelihood of acting on impulse: “people with pedophilic sexual interests use societal thinking to self-stigmatize, which in turn may actually serve to increase their risk of committing a sexual offense,” (Harper, Bartels & Hogue, 2016, p. 1). Stigma causes social isolation, which can contribute to depression and suicidal thoughts or behaviors (Muller, 2016). A pedophile is unlikely to confide in even those closest to them, for fear of being forever socially scorned or worse, for fear of being arrested. In some jurisdictions, mandatory reporting laws are preventing pedophiles from being able to access mental health services.

Contributing to the problem are professional psychologists,…