Pedophilia: Definition, Causes & Sexual Orientation

What Is Pedophilia?

Pedophilia is a paraphilic disorder involving pervasive sexual fantasies, urges, or behaviors involving a prepubescent girl or boy, generally younger than 13 years of age.¹ In order to be diagnosed with pedophilia, a person must be at least 16 years-old and at least 5 years older than the children to whom they are attracted.

In order to fit the criteria for diagnosis, someone must also report significant distress or interpersonal challenges caused by their pedophilic sexually intrusive thoughts.¹ Research indicates that people with pedophilic interests may or may not commit a sexual crime against a child. Many choose to live a non-offending lifestyle and seek the support of a helping professional.²

“Why some adults have pedophilia is unknown. Researchers assume it is a combination of genes and environment, as everything else, but have very little information of what specific genes or what specific environmental factors. Most likely the processes that lead to pedophilia take place early, long before the individual becomes aware of his or her pedophilia, which usually happens in the late teens. One popular theory is the neurodevelopmental model, which states that pedophilia is formed by prenatal factors, such as androgen levels in utero.” – Christoffer Rahm, M.D., Ph.D., Chief Psychiatrist at Psychiatry South Stockholm, researcher at Karolinska Institute and Principal Investigator at Prevent It, an online CBT therapy program for minor-attracted individuals³¹

Is Pedophilia a Sexual Orientation?

Some research suggests that pedophilia reflects an age-specific sexual orientation.³ Similar to a gender-based orientation (e.g. heterosexuality), awareness of pedophilic interests usually begins in early adolescence.⁴ Most keep this secret due to fear and sexual shame, resulting in significant psychological and emotional distress.⁵

Some scholars believe that sexual attraction to children can change; however, most scientific investigations indicate that pedophilic interests remain stable over time, which is consistent with gender-based sexual orientation experiences.^3,5 Rather than attempting to convert an individual’s age-specific sexual orientation to socially acceptable standards of sexual attraction, treatment should primarily focus on helping minor-attracted individuals to cope with their sexual urges, work through internalized stigma, and achieve self-acceptance.⁵

The Stigma of Pedophilia

At the root of stigma are stereotypes, myths, and misinformation; and this is particularly true with regard to individuals who experience an attraction to children.^6,7 Sources of public information such as media outlets tend to perpetuate myths about minor-attracted individuals, precipitating widespread social condemnation toward this population.⁸

Common misrepresentations about minor-attracted individuals include that they choose to be attracted to children, that they are dangerous, and that they will inevitably sexually offend against a child, among others.⁷ Hostility against this population can be witnessed in professional contexts, including therapeutic communities, scientific publications, and academic institutions.⁹ While many people with an attraction to children wish to participate in treatment, very few are able to locate a practitioner willing to view them beyond the labels and stigma attached to them.⁷

“The stigma around pedophilia causes individuals with sexual attraction to children to be viewed as destined to abuse a child. But attractions don’t equal behaviors. Many of us don’t act on our attractions. Not all individuals with sexual attraction to children are pedophiles and many people who engage in child sexual abuse don’t have a sexual attraction to children. There are actually many people with an attraction to children who are committed to keeping children safe; however, the stigma can cause emotional distress, lack of hope for the future, and fears of being reported or rejected that make reaching out for support extremely difficult.” – Amanda Ruzicka, MA, Director of Research Operations for the Moore Center for the Prevention of Child Sexual Abuse and Senior Research Associate at the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health³²

Rahm notes, “The stigma around pedophilia is a double-edged sword. It communicates effectively that any kind of sexual contact between an adult and a child, or any other form of sexual exploitation of children, is wrong. In that way it may help to prevent some child sexual abuse. On the other hand it is also so strong that, because of fear for the reactions they would meet, individuals who realize they have this sexual attraction often do not dare to talk about it, not even with their closest friends or family, or their therapist. This keeps people from the help they need.”

It is essential that helping professionals educate themselves about this population and their experiences of stigma in order to offer responsible and humane therapeutic services.¹⁰ By doing so, helping professionals are indeed participating in the prevention of childhood sexual abuse and trauma. In contrast, denying minor-attracted individuals access to services based on erroneous beliefs and unfounded biases may inadvertently result in further victimization of children.⁷

Relevant Pedophilia Statistics

Here are several relevant statistics concerning pedophilia:

• Research indicates that approximately 3-5% of the population experience pedophilic attraction¹²
• The vast majority of people experiencing pedophilia are male, with only 3% of women exhibiting sexual interests in children¹¹
• Studies have documented that the majority of individuals who commit sexual offenses against children do not necessarily experience a romantic or sexual attraction to them¹²
• Approximately 46% of individuals with pedophilic interests consider suicide: 32% report having a plan and 13% attempt suicide¹³
• About 41% of minor-attracted individuals who consider suicide do so before the age of 18¹²
• Approximately 85% of people with pedophilic interests expect to be misunderstood by treatment providers; 89% expect to be judged’ and 76% fear that their confidentiality will be compromised¹³

What Causes Pedophilia?

The causes of pedophilic attraction remain largely misunderstood by the general public and the scientific community.¹⁴ While no direct causal relationship can be determined, researchers have linked the development of pedophilic interests to a number of environmental and neurobiological factors. For example, some early investigations document a higher prevalence of childhood sexual abuse among people with pedophilic interests.

Factors linked to pedophilia include:

• Pathological or dysfunctional family systems
• Absence of social support in childhood
• Developmental disruptions
• Certain neurobiological factors
• Certain biological factors

Biological Factors of Pedophilia

Recent developments in neurobiology are increasingly leading to an expansion of scientific knowledge regarding the potential causes of pedophilia, but there still are no definitive answers as to what exactly causes this condition.^15,16

Here are some of the prominent findings from investigations on neurological and biological factors associated with the development of sexual attraction to children:

• According to research, early brain development seems to play a crucial role in the development of pedophilic interests^17,18
• Temporal lobe and frontal cortex abnormalities have been observed among pedophilic individuals. These regions of the brain are critical for sexual and behavioral regulation, impulse control, and executive functions¹⁵
• Reduction of gray matter in the amygdala and hypothalamus have been found in pedophilic populations. These regions of the brain are responsible for sexual development¹⁹
• Atypical physiological development before birth has been found in large samples of men exhibiting attraction to children²⁰
• Anatomical differences such as left-handedness and other superficial deviations from typical physiological development have been implicated in the development of pedophilic interests^20,21
• Research has reported an association between intelligence and pedophilia. Specifically, lower IQ levels have been found in samples of pedophilic individuals¹⁷
• Genetic alterations that are linked to androgen, estrogen, prolactin, oxytocin, corticotropin, and serotonin have been implicated in the development of sexual behavior problems in pedophilic individuals¹⁴

Symptoms of Pedophilia

A diagnosis of pedophilia should specify whether someone is exclusively attracted to children or if they also experience attraction to same-age individuals. Additional specifications should consider the gender of children and if the person’s sexual interest or behavior is limited to incest (sexual attraction or behavior toward a young family member).¹

The three official symptoms of pedophilia are:¹

1. Persistent and recurrent sexually arousing fantasies, urges, or behaviors involving a prepubescent child experienced for at least six months
2. Significant distress or interpersonal challenges caused by sexual fantasies and urges involving a prepubescent child
3. Having committed an actual sexual offense against a child.

How Is Pedophilia Diagnosed?

The initial step to diagnosis involves an assessment with a qualified licensed helping professional, such as a clinical social worker, professional counselor, psychologist, or psychiatrist. Preferably, the practitioner has also received formal training in human sexuality and holds a specialized certification in sex therapy.

Note that a diagnosis of pedophilia should not be given to anyone 16 or younger. Diagnosis should also be avoided when an individual in late adolescence (16 or 17 years-old) is involved in an ongoing sexual relationship with a peer approximately four years younger.

When Might a Practitioner Hold Off on Diagnosing Pedophilia?

Some practitioners rely on diagnosing in order to treat their clients, but others may focus on targeting specific symptoms without the use of labeling.²² This may be an important method of client engagement considering that pedophilia carries with it the weight of social stigma.⁷ Starting with a diagnosis of pedophilia without carefully assessing clients as whole individuals may lead to further shaming them. It may also prevent therapists from establishing a strong therapeutic alliance and effectively building rapport, both of which are key elements of successful treatment engagement.²³

Treatment for Pedophilia

Ethical, compassionate, and competent treatment for minor-attracted individuals should focus on both sexual abuse prevention and client well-being.²³ Although no single treatment exists that offers a cure for pedophilia, several interventions have shown promise at reducing the intensity of sexual urges, improving psychosocial functioning, and decreasing risk of sexual offending.¹⁹

Ruzicka mentions, “There is no ‘one size fits all’ treatment for individuals with an attraction to children. Not everyone with an attraction to children has a hard time managing their attraction. Many would like support in dealing with the emotional distress and challenges that the stigma surrounding an attraction to children can cause.”

Cognitive-behavioral Therapy (CBT)

CBT is one of the most researched interventions for addressing problematic patterns of sexual arousal, and it has demonstrated some effectiveness at reducing sexual offending risk.²⁴ Treatment focuses on identifying cognitive distortions associated with someone’s pedophilic interests, particularly those that may increase risk of sexually offending (e.g. believing that children can consent to sex with an adult). These distortions are substituted with socially-acceptable thought processes that encourage prosocial and responsible behaviors.²⁵

Cognitive-behavioral therapists rely on techniques such as conditioning and reinforcement to stimulate adaptive and healthy behaviors, as well as social skills and empathy training to enhance interpersonal experiences.²⁶ 

Psychodynamic Therapy

Psychodynamic therapy may be a more appropriate option for people wishing to explore childhood traumas, early sexual development, and personality structures.¹⁹ From this perspective, pedophilic interests reflect unresolved conflicts that stem from disruptions during the period of psychosexual development (infancy through prepuberty).

Psychodynamic interventions address early life disturbances by targeting unconscious components of an individuals’ sexual fantasies and urges.²⁵ Therapy may involve an exploration of parental figures and familial patterns of behavior, as these are believed to potentially play a role in the genesis of sexual deviance. By confronting childhood adversity, unresolved emotional conflicts or childhood traumas, and disturbances to psychosexual development, someone can be better equipped to manage their pedophilic interests and establish healthier coping mechanisms.¹⁹

Relapse Prevention

Relapse prevention is generally used in treatment for people who have already committed sexual offenses. This approach focuses on eliminating risk factors associated with sexual abuse of children.²⁵ Individuals learn to anticipate emotional and behavioral triggers, as well as risk situations (e.g., viewing child pornography) that could precipitate sexual offending.

Such awareness allows people to establish effective coping strategies to counter risk factors and triggers as they appear.²⁴ Relapse prevention requires that someone is highly motivated to avoid sexual offending behaviors, thus it encourages self-help techniques and empathy building through education on the effects of sexual abuse on children.²⁵

Strengths-Based Approaches to Therapy

Strengths-based therapists are trained to understand and appreciate the influence of the environment in identity development. Strengths-based therapy with minor-attracted individuals fosters discussions about social stigma and its impact on their emotional and psychosocial well-being.²⁷ While a strengths-based perspective can be integrated into most types of psychotherapies, some are more naturally suited to this approach, such as narrative therapy and compassion-focused therapy.

SSRIs

Selective Serotonin Reuptake Inhibitors (SSRIs) are often prescribed to help decrease sexual desire, sexual urges, and compulsive sexual behavior. This method is most commonly used with individuals who have been convicted of a sexual crime, aligning with the main objective to reduce sexual recidivism risk.²⁸ Minor-attracted individuals may choose to take SSRIs to treat anxiety or depression symptoms, as well as to contain sexual urges or reduce risk of sexual high-risk behaviors.²⁵

Antiandrogens

Though controversial, chemical castration is another judicial response to manage severe cases of sexual offending. It intends to lower testosterone levels through administration of antiandrogen steroid hormones. Some states have specific laws that require individuals convicted of serious sexual crimes to receive this treatment.²⁸

Minor-attracted individuals without a history of serious sexual offending are recommended against chemical castration due to its serious side effects.

Medications are usually accompanied by behavioral or other types of psychotherapeutic treatments, and must always be monitored by a medical provider.²⁵

How to Get Help For Pedophilia

There are a few national and international organizations that connect minor-attracted individuals with trained mental health practitioners and other services. These organizations typically screen their referral sources to ensure that each professional is properly qualified to work with this population.

Here is a short list of organizations that offer help for pedophilia:

• B4U-ACT: Provides resources for adolescents and adults experiencing minor-attraction and offers educational opportunities for providers interested in working with this population
• Virtuous Pedophiles: Online community offering social support for pedophiles who are committed to non-offending living
• Stop It Now: International organization committed to the prevention of childhood sexual abuse through education and support for individuals at risk of pepetrating sexual abuse
• Association for the Treatment of Sexual Abusers (ATSA): International organization for the prevention of childhood sexual abuse through research and education
• Help Wanted: Online course providing tools for individuals who are attracted to children
• The Global Prevention Project: Organization/podcast promoting mental wellness and prevention of childhood sexual abuse through intervention.

Coping Strategies for Individuals With Pedophilia

There is no cure for pedophilia; however, people can acquire tools to manage their pedophilic attraction and concurrent sexual urges.⁶ Appropriate and healthy coping enables minor-attracted individuals to improve their self-esteem and achieve acceptance of their condition. As a result, they may experience healthier relationships, have access to more resources, and create a life for themselves that isn’t consumed by shame.²³

Coping strategies should be personalized whenever possible. While adopting conventional tools to manage stress and crisis situations is generally helpful, it is best that people unearth their own strengths and develop skills that are customized according to their personal values and needs.^29,27 Because shame, anxiety, and hopelessness often take control of a minor-attracted individual’s cognitive and emotional experiences, it is recommended for them to remain active and engaged in various aspects of their lives.⁷

Here are eight coping strategies for minor-attracted individuals:^6,23,29,30

1. Self-education (learning about pedophilia from appropriate sources)
2. Joining online peer support groups
3. Participating in research, helping advance scientific knowledge can provide a sense of accomplishment and agency
4. Practicing healthy relationship skills with same-age friends
5. Journaling to externalize feelings of shame and other emotional difficulties
6. Embracing movement, creating or engaging in new projects that expand sense of self and identity
7. Participating in activities to keep occupied and motivated
8. Some individuals benefit from involvement in religious and faith communities

Final Thoughts on Pedophilia

People with pedophilia experience significant social and interpersonal barriers due to their own shame and social stigma. This frequently prevents them from accessing treatment. Regardless of specialization, helping professionals should be willing to share relevant resources when needed. Helping minor-attracted individuals maintain their commitment to a non-offending lifestyle is prevention against childhood sexual abuse. For minor-attracted individuals who are seeking help: don’t give up, help is out there.