Broadening the understanding of pedophilia and its complex roots could enable more people to connect with treatment.

Pedophilia, or pedophilic disorder, is a difficult topic for many to discuss.

It’s also a somewhat misunderstood topic, with confusion about what it does and doesn’t mean, possibly because of people’s reluctance to talk about it at all. This lack of clarity extends to beliefs about what causes pedophilic disorder.

For example, some might believe that sexual abuse in childhood could be responsible for causing pedophilia. While this might play a role in developing the condition, many other environmental and genetic factors could also be involved.

As experts continue to investigate the causes of pedophilic disorder, the understanding of treatment options may grow.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) categorizes pedophilia as a paraphilic disorder, which involves a nontypical sexual interest that causes distress or harm to you or others.

If you have pedophilic disorder, you might experience:

  • sexual attraction, fantasies, and urges toward children who aren’t sexually mature
  • behaviors that involve sexual activity with a child who isn’t sexually mature
  • feelings of distress, shame, and guilt about these urges and fantasies
  • feelings of sexual frustration and isolation due to these urges
  • interest in child pornography

These symptoms must be present for at least 6 months to meet the criteria for pedophilic disorder.

A common misconception is that all people with pedophilic disorder have abused a child. But some people with the condition never act out pedophilic behaviors. An estimated 50% of those who have sexually abused a child don’t meet the criteria for pedophilia.

In addition, the DSM-5 makes a distinction between pedophilic disorder and pedophilic sexual orientation. While pedophilic disorder comes with strong anxieties about these urges, someone with pedophilic sexual orientation might not experience feelings of shame about these thoughts.

While the DSM-5 indicates that pedophilic disorder might be a lifelong condition, symptoms can change or decrease with age. Treatment is also possible and could help you gain relief from these urges without acting on them.

Also, having sexual thoughts involving children doesn’t necessarily mean having pedophilic disorder. For instance, a type of obsessive-compulsive disorder (OCD) could also cause unwanted and intrusive thoughts such as worries about being attracted to children.

Many factors could play a role in the development of pedophilic disorder, such as:

  • genetics and epigenetics
  • differences in brain structure
  • hormones
  • developmental differences
  • childhood experiences

While they likely don’t cause pedophilia, certain factors could also be linked to it, according to a 2015 study. For example:

  • Males might be more likely to receive a diagnosis of pedophilic disorder.
  • People with antisocial personality disorder might be more likely to fit the diagnostic criteria for pedophilic disorder.

Since many studies involve only people who have acted out pedophilic behaviors and are in the legal system as a result, research on those with pedophilia who don’t act on their thoughts is still limited.

This means that the research we do have might still represent a skewed view of those with pedophilic disorder.

A 2021 theory paper highlights the possibility that pedophilic disorder could run in families. However, it didn’t account for how environmental factors such as childhood abuse might have contributed.

A 2015 review also reports that according to older twin studies, pedophilia might be heritable — but it’s been found to be at least two times less heritable than many other mental health conditions.

Experts suggest that while genes might play a small role in causing pedophilic disorder, the influence of factors such as development and upbringing might be stronger.

Epigenetics, or the way your environment acts on your genes, might also play a role — this could be because aspects of both brain development and sexual development could be tied to epigenetics.

Epigenetic changes could influence the development of pedophilic disorder by acting on genes involved with the serotonin system, according to a 2022 study.

Serotonin is a neurotransmitter, or brain chemical, that plays many key roles in bodily functioning — including regulating behavior.

A 2021 study found that low serotonin levels could be linked to impulsivity and aggression, but more research is needed to confirm the connection between these epigenetic changes and pedophilia.

A 2015 literature review found that brain differences could play a role in developing pedophilic disorder.

Frontal lobe differences

Pedophilia might cause differences in the function of the prefrontal cortex, located in the frontal lobe of the brain.

Parts of the frontal lobe and prefrontal cortex regulate impulse control and sexual behavior.

Because of this, differences in the frontal lobe could be more strongly connected to acting on pedophilic thoughts, according to this study.

Temporal lobe differences

Differences in the temporal lobe of the brain were also connected to an increase in both nontypical sexual interests and behaviors involving pedophilia.

A 2013 study points specifically to a lower volume of the amygdala, a part of the temporal lobe responsible for processing emotions.

Experts in the 2015 review suggest that these differences in the temporal lobe could be more strongly connected to attraction to children rather than acting on that attraction.

White matter function

A 2015 paper found a connection between differences in the white matter of the brain, but not gray matter, and pedophilic disorder. Specifically, injured or dysfunctional white matter was connected to pedophilia.

A 2020 study connects higher fetal exposure to androgens, or male sex hormones, with pedophilic disorder. In particular, high levels of the hormone testosterone could have this effect.

Exposure to high testosterone levels could also change the volumes of different parts of the brain in ways that might increase the likelihood of pedophilia.

A 2020 clinical trial on hormone treatments for pedophilia could help shine a light on how hormones might cause the condition. For instance, a medication that lowered testosterone in study participants seeking help for pedophilic disorder reduced the number of pedophilic thoughts that they experienced as well as the risk of related behaviors.

A 2020 study linked the developmental roots of pedophilia with neurodevelopmental conditions such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

This study found a lower intelligence quotient (IQ) in people with pedophilic disorder as well as a bigger difference between the lengths of their second and fourth fingers. According to experts, these features could be signs of developmental conditions.

Those with pedophilic disorder could also have higher rates of left-handedness than the rest of the population, another feature connected with some developmental conditions.

Environmental factors, specifically head and brain injury, could also contribute to pedophilia.

A 2015 literature review reports that men in prison with pedophilic disorder experienced significant head injuries before age 13 at twice the typical rate.

Brain injuries from tumors or a stroke could be linked to cases of pedophilic abuse, according to the 2021 theory paper.

It’s still unclear, however, whether the brain injury caused pedophilia itself or just led to the behavior.

One theory proposes that social conditioning, another environmental factor, could cause pedophilia. This conditioning might come in the form of child abuse, such as:

  • exposure to pornography
  • exposure to sexually inappropriate conversations
  • physical sexual abuse

A 2020 study suggests that a strong link could exist between childhood sexual abuse and pedophilic interests later in life. It found that past abuse could also impact a person’s ability to take part in mutually beneficial sexual experiences, causing them to lean on forceful or objectifying ways of relating instead.

The past abuse might also make it more difficult to empathize with a child they’re abusing.

In addition to sexual abuse, a 2020 study found a connection between emotional abuse in childhood and pedophilic disorder.

It’s unlikely that one single factor could cause pedophilic disorder. Instead, its causes are probably made up of a complex set of factors that interact with each other.

For example, a history of abuse or exposure to specific hormones as a fetus might switch “on” certain genes associated with pedophilia through epigenetics.

If you think you might have pedophilic disorder, it could help to remember that this doesn’t mean acting on your thoughts is inevitable.

Seeking help for pedophilic disorder could be a daunting prospect since people who have acted on their thoughts are overrepresented in many treatment situations.

Still, treatment options do exist — and there’s no shame in seeking professional support for thoughts or urges that could cause you and others harm if left unaddressed.