There’s a lot of confusion about pedophilic disorder, often referred to as pedophilia, and what exactly it entails.
The topic of pedophilic disorder can be a controversial one, especially for those who don’t know what it is and how it’s treated in the mental health community.
Though pedophilia is widely associated with child molestation, one does not necessarily lead to the other. You may live with this mental health condition and never harm another person.
Clarity and understanding of the signs and symptoms can make all the difference in your treatment plan.
Pedophilic disorder is classified as a type of paraphilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the primary diagnostic tool of mental health professionals in the United States.
Paraphilic disorders are intense, recurrent urges, fantasies, or behaviors that:
- lead someone to feel distress about their interest (not merely distress resulting from society’s disapproval)
- include a sexual desire or behavior that involves another person’s psychological distress, injury, or death
- include a desire for sexual behavior involving unwilling persons or persons unable to give legal consent
Living with pedophilic disorder isn’t your choice. Some causes may include poor adult social development, past personal abuse, or brain abnormalities.
Is it a sexual orientation?
“It is important for people to understand that there are many stereotypes about pedophiles that we need to debunk,” explains Dr. Thomas Plante, a psychology professor at Santa Clara University in Santa Clara, California. “Most people think of creepy and disheveled strangers that snatch innocent children off the streets.”
If you’re living with pedophilic disorder, you may feel aroused by children, but you’ll also feel extreme distress at the same time. This can stop you from participating in events or daily routines. You often have a sense of anxiety and guilt.
For these reasons, pedophilic disorder is not a sexual orientation. As a type of paraphilic disorder, it’s a condition that causes impairment or distress for the person living with it.
Pedophilic sexual orientation, on the other hand, involves the absence of anxiety, shame, or guilt at being sexually attracted to children.
Pedophilia vs. ephebophiles
“We need to remember that pedophilia, really, is folks who target or are sexually interested in pre-pubescent children,” Plante says.
“Some people are primarily interested in teenagers, but we call them ‘ephebophiles,’ and their diagnostic profile and treatment approach really differ from pedophiles.”
A licensed mental health professional or medical doctor can help diagnosis pedophilic disorder.
While the DSM-5 cites extensive use of child pornography as a reliable indicator of pedophilic disorder, some clinicians may also use the Abel Assessment for Sexual Interest (AASI-3).
The AASI-3 can be used to help evaluate both men and women. It can shed light on sexual interests in children as well as your probability of past child sexual abuse.
Additional diagnostic tools may be used. These include penile plethysmography in men and vaginal photoplethysmography in women. This is a way to measure blood flow to your genitals as an arousal response while images of children are shown, varying on a spectrum from “normal” photos to more sexualized images.
Someone who lives with clinical pedophilic disorder will, for a period of at least 6 months, experience sexual attraction and arousal toward prepubescent children, which generally refers to children under the age of 13.
To achieve a diagnosis per the DSM-5, you must also:
- have acted on, or experienced interpersonal distress or difficulty related to, your urges or fantasies
- be at least 16 years of age and be at least 5 years older than the child you’re focused on
Pedophilic disorder may present as:
- Exclusive. Attraction is only toward children.
- Nonexclusive. You’re attracted to both children and adults.
Other specifiers for diagnosis include:
- sexual attraction toward females
- sexual attraction toward males
- sexual attraction toward both females and males
- sexual attraction limited to incest
Acting on a pedophilic urge could mean engaging in various sex acts with children, viewing child pornography, or fantasizing about or masturbating to images of children, either real or imaged.
Some signs that you’re living with pedophilic disorder include being sexually aroused by prepubescent children and experiencing any of the following symptoms as a result:
- extensive use of child pornography
- feelings of shame or guilt
- psychosocial impairment
- sexual frustration
Often, the fear and anxiety about living with pedophilic disorder can cause you to deny that you have sexual urges toward children.
You may try to justify your thoughts or behaviors, or call inappropriate interactions accidental or unintentional.
Extensive use of child pornography
The extensive use of child pornography is often seen as a reliable means of diagnosing pedophilic disorder.
Feelings of shame or guilt
If you’re living with pedophilic disorder, you may experience anxiety and despair when you feel sexual urges toward children. The shame and guilt may prevent you from seeking treatment.
For some, pedophilic disorder can prevent a satisfying sex life.
For example, if you’re in an adult partnered relationship and engaging in consensual sex, you may feel sexually frustrated or dissatisfied because you would prefer to be engaging in some type of sexual contact with a child.
The anxiety and stress from living with pedophilic disorder may cause you to avoid social events or family gatherings, particularly if children are present.
A general fear of being “found out” and exposed may also prevent you from attending adult-only interactions.
Preferring the company of children to adults
If you live with pedophilic disorder, the company of children may feel more accepting than the company of adults. For example, you may leave important adult conversations behind in favor of interacting with a child.
Children may not be as threatening to you or may make you feel important or empowered.
Simply enjoying the company of children, however, doesn’t mean you are experiencing pedophilic disorder.
Living with pedophilic disorder does not make you a “child molester.” This is a toxic term that elicits stigma and shame.
To be clear, this term refers to any adult who inappropriately touches a child or forces a child to touch them. If this is the case, you’ve engaged in child sexual abuse and, by definition, molested a child.
It’s likely that someone who acts on their feelings and molests a child is also living with pedophilic disorder. However, some people who live with pedophilic disorder do not molest children.
Pedophilic disorder focuses on sexual arousal. If you live with this condition, you may fantasize about children but never act on it.
“Pedophilia is a psychiatric condition that means adults are attracted to young prepubescent children. They may or may not act on their impulses and desires. Child molestation is sexually abusing children and/or teens,” Plante says.
“Child molestation is always a behavior, whereas pedophilia is not necessarily a behavior at all but it could be only a desire,” he says.
Pedophilic disorder is a mental health condition where sexual attraction to children can cause someone to have clinical distress or impairment.
If you live with this condition, you may feel extreme stress, anxiety, or despair related to your sexual urges.
The presence of impairment and stress is what makes pedophilic disorder different from pedophilia sexual orientation.
Pedophilic disorder is not synonymous with child molestation. You may experience intense distress about having a sexual attraction toward children yet never act on it.
Treatment is available for this mental health condition.
It’s important to know up front that there are many variables to address and consider in managing these types of thoughts, feelings, and behaviors. Experts are still trying to figure out how to make treatment more effective.
Medication and psychotherapy can help create a framework for managing sexual desires toward prepubescent children. In some cases, cognitive restructuring therapy and aversion therapy may prove helpful.