This article will cover the following points: 

• What is Pedophilia and why is it different from child sexual offending?
• The importance of language in the stigmatization and misconception of Pedophilia
• How stigma influences cognitive, social and emotional functioning in people with pedophilic tendencies.
• How stigma influences help-seeking behaviour in people with pedophilic tendencies.
• Finally, can stigma actually increase the risk for child sexual offending? 

What is Pedophilia? Why is it different from Child Sexual Offending? 

Pedophilia is a mental disorder which involves having sexual urges towards prepubescent children[2]. The DSM-5, the central manual for diagnosing mental disorders, makes clear that sexual offending is not a requirement for the diagnosis[2]. Still, in day to day language we use the word “pedophile” and “child sexual offender” interchangeably and this only increases the stigma around this disorder[6].  In spite of popular belief, the two are not equivalent: there are people with pedophilic interests who have never, and will never, commit sexual offense[4] and child sexual molesters who do not have pedophilic interests. In fact, only 25 to 50% of child sexual abusers have actually been approximated to have pedophilic tendencies[9]. 

Nonetheless, media and informal conversations repeatedly represent pedophiles as criminals who should be isolated from society.  Equating pedophiles to child sexual offenders also promotes the idea that people with such disorder have impulses that are uncontrollable, which is a dangerous misconception[7]. 

But why is this important? 

First of all, people with pedophilia often live in a constant state of anxiety known as “minority stress”. Stigma and prejudices about sexual minorities create a tense environment which has negative effects on their mental state[7]. We recognize it is often hard to see the human side of people who are affected with stigmatized disorders and to empathize with them. Still, minority stress has been shown to have much larger implications than just for the minority itself.  In 2015, researcher Sara Jahnke and her colleagues[7] proposed a model (seen in the diagram below), which hypothesizes that stress due to stigmatization impacts the cognitive, social, emotional and behavioural functioning of people with pedophilia, and ultimately may increase the risk of sexual offense [7]. Being a stigmatized group makes it harder for individuals to understand their condition, seek treatment and learn to control their impulses.  Therefore, knowing more about the stigma that surrounds the pedophilic disorder is of critical importance, not only for the detrimental effects on the quality of life of people with pedophilia, but because it may be of extreme relevance for the prevention of child sexual offenses. 

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Effects on Cognitive Functioning 

Stigma surrounding pedophilia has been suggested to affect the minority’s cognitive functioning by enhancing the chances of having cognitive distortions [7]. Cognitive distortions are imprecise beliefs and perceptions [2] which are a well-known risk factor of sexual assault[10]. Jahnke and her colleagues[7] proposed that people with pedophilia internalize common public misconceptions created by stigma, for example that they are incapable of controlling their urges. Ultimately, this may influence their belief in their ability to inhibit their impulses and lead them to give in to them.

Unfortunately, up to now, no study has been able to confirm this proposed link between stigma, cognitive distortions and child sexual offending. Still, this does not mean that it is to be fully disregarded [7]. 

Effects on Social and Emotional Functioning

Fear of discovery and perceived social distance, two major components of stigma-related stress, have been proposed to have significant impacts on the social and emotional aspects of the lives of people with pedophilia [7]. Perceiving a sense of isolation could trigger feelings of loneliness which have been found to be common in child sexual abusers[11]. 

In addition, Jahnke proposed that due to fear of discovery, people with pedophilia might avoid confronting non-pedophiles and interact only with people with their same disorder. This may lead to a mutual encouragement of acting upon their urges [7]. 

Indeed, in their questionnaire Jahnke and her colleagues[7] found a positive correlation between levels of dread of discovery and social and emotional dysfunctions. Specifically regarding social dysfunctions, results demonstrated their hypothesized positive relationship between stigma-related stress and loneliness. Similarly, the answers to the questionnaires show that the stronger the fear of people finding out the lower were the levels of emotional coping and self-esteem. 

Help-Seeking Behaviour 

Perhaps the most concrete consequence of stigma is the one on behavioural functioning, specifically on help-seeking behaviour. In fact, it is very uncommon for people with pedophilia to engage in treatment before committing a sexual offense. This was hypothesized to be because of fear of expressions of stigmatization, such as negative reactance, by professionals involved in treatment[8].

This assumption was confirmed by the B4UAct  which created an online survey investigating awareness of sexuality in pedophiles. Results strongly supported what was hypothesized: 54% of respondents believed that professionals would disrespect them, 62% expected to be judged by them and 51% doubted their statement would remain confidential[3]. Most importantly, 75% of the participants admitted that their negative expectation of mental care services derived from public social attitudes towards them[3].

Interestingly, however, in Jahnke’s[7] results the motivation behind hesitancy to seek help was not related to any component of stigma-related stress. 

Nonetheless, in other examined studies participants revealed they feared that professionals would comply with the public attitudes towards them. Therefore, stigma can be considered a valid reason for not engaging in therapy and preventing the pedophilic disorder to progress to the point that individuals are brought to act upon their urges.[8]

In Conclusion, 

We can say that stigma influences the social, emotional and behavioural functioning of people with pedophilia and that this may increase the risk of sexual offending, although this has not yet been demonstrated by current research. In fact, there is a proper dead-spot in research in this area, which can also be traced back to the stigmatization[7]. We hope that, in the future, more research will be directed in trying to demonstrate what was proposed by Jahnke, because it has frightening implications. In countries such as the United States, 1 out of 5 children is victim of sexual abuse before the age of 18[1].  One cannot ignore these numbers and if taboos regarding pedophilia are possibly a part of the problem, we all have to contribute to de-stigmatizing this mental illness. 

Here at Shrink it Out we believe the first step to de-stigmatization is talking about it, which is one of the major purposes of this article. We encourage you to open this debate with your family and friends. 

We are curious to know what you think :)

Here are some other interesting resources on the topic: 

1. A Podcast Interview to a person with Pedophilia: https://www.thisamericanlife.org/522/tarred-and-feathered/act-two-0
2. Article on the Dunkelfeld Project, only prevention program in the world specialized in non-offending Pedophiles: https://dl.uswr.ac.ir/bitstream/Hannan/73773/1/2018%20JSM%20Volume%2015%20Issue%208%20August%20%2813%29.pdf

3. “Don’t Offend” German Commercial: https://www.youtube.com/watch?v=ck3uOCyWB50 

References 

1. Anda, R. F., Butchart, A., Felitti, V. J., & Brown, D. W. (2010). Building a framework for global surveillance of the public health implications of adverse childhood experiences. American Journal of Preventive Medicine, 39(1), 93–98
2. American Psychiatric Association. (2013). Diagnostic criteria and codes. In Diagnostic and statistical manual of mental disorders (5th ed.). http://dx.doi.org/10.1176/appi.books.9780890425596.316088 
3. B4UAct. (2011). Youth, suicidality, and seeking care. Retrieved from http://www.b4uact.org/ research/survey-results/youth-suicidality-and-seeking-care/ 
4. Dombert, B., Schmidt, A. F., Banse, R., Briken, P., Hoyer, J., Neutze, J., & Osterheider, M. (in press). How common is males’ self-reported sexual interest in prepubescent children? Journal of Sex Research. doi:10.1080/00224499.2015.1020108.
5. Jahnke, S., & Hoyer, J. (2013) Stigmatization of people with pedophilia: A blind spot in stigma research, International Journal of Sexual Health, 25(3), 169-184. doi:10.1080/19317611.2013.795921 
6. Jahnke, S., Imhoff, R., & Hoyer, J. (2015a). Stigmatization of people with pedophilia: Two comparative surveys. Archives of Sexual Behavior, 44(1), 21-34. doi:10.1007/s10508-014-0312-4
7. Jahnke, S., Schmidt, A. F., Geradt, M., & Hoyer, J. (2015b). Stigma-related stress and its correlates among men with pedophilic sexual interests. Archives of Sexual Behavior, 44(8), 2173-2187. doi:10.1007/s10508-015-0503-7
8. Levenson, J. S., Willis, G. M. &, Vicencio, C.P. (2017). Obstacles to help-seeking for sexual offenders: Implications for prevention of sexual abuse. Journal of Child Sexual Abuse, 26(2), 99-120. doi: 10.1080/10538712.2016.1276116
9. Schmidt, A. F., Mokros, A., & Banse, R. (2013). Is pedophilic sexual preference continuous? A taxometric analysis based on direct and indirect measures. Psychological Assessment, 25, 1146–1153. doi:10.1037/A003 332
10. Ward, T., & Keenan, T. (1999). Child molesters' implicit theories. Journal of Interpersonal Violence, 14(8), 821-838. doi: 10.1007/s11194-005-8053-5
11. Whitaker, D. J., Le, B., Hanson, R. K., Baker, C. K., McMahon, P. M., Ryan, G., ... Rice, D. D. (2008). Risk factors for the perpetration of child sexual abuse: A review and meta-analysis. Child Abuse & Neglect, 32, 529–548. doi:10.1016/j.chiabu.2007.08.005.