First, I would like to know if the following would be considered sexual abuse. A boy’s uncle likes to wrestle with him, and often grabs the boy’s testicles and squeezes them very hard. He walks around the house naked and makes the boy look at his penis, sometimes putting his penis close to the boys face (but never touching). Other times, he makes the boy walk around naked while he laughs at him and makes fun of how small his penis is.

My second question is this. If someone is aroused by fantasies of being a child and having sex with adults and other children, but not by fantasies of being an adult with children, are they a pedophile?

And my last question: Can someone be a pedophile and have POCD at the same time?

Thank you very much for your time and response.

A: Yes. The uncle is abusing the boy and should be immediately reported to child protective services. Abuse isn’t limited to penetration. The uncle is stimulating himself at the boy’s expense and may be causing long-lasting psychological harm. As the adult in the situation, he has all the power and control. The boy is not at an age where he can give consent. The uncle is violating the boy’s trust and counting on the boy’s confusion and innocence to get away with what he is doing. His taunts are diminishing the boy’s self-esteem and may be skewing his idea of masculinity.

The fantasies you describe reflect some confusion about boundaries between children and adults. They are only dangerous if they lead to behavior. As long as they stay in the realm of fantasy – and the person is able to have sex with appropriate partners – it probably doesn’t mean that the person is a pedophile. But I clearly don’t have enough information to say that definitively.

As for your last question, you might find this previous column to be helpful.

I wish you well.
Dr. Marie