How Do Doctors Help a Self-Identified Pedophile?

"My name is Adam," the post read. "I'm 18 and non-exclusively attracted to boys and girls of all ages (particularly very young ones). I am the leader of a support group for non-offending pedophiles around my age… I would be very happy to talk with you."

That's how Luke Malone, researching an article for Medium, first came in contact with a teenage pedophile. For more than two years, Malone worked on a story about people like Adam, now 20, and new treatments that show promise in treating pedophiles. It's disturbing, captivating and difficult material to read. Malone writes,

[Adam] first noticed his attraction toward young children when he was 11. He'd developed a crush on a kindergartener at school, a boy, his desire fueled by brief, furtive glimpses of him in the halls. By the time he reached 16, his sexual interest in kids had become more defined. He found himself attracted primarily to boys between three and seven and girls aged five to eight.

"Adam" goes on to describe to Malone his struggle to keep himself from viewing child pornography. (Warning: There are graphic descriptions of the pornography Adam viewed, so be advised if you want to check out the sourced link.) He asked his mother for help (with what he described as "depression") who then took him to see a therapist. Adam said the therapist's mood changed drastically the minute he told her about his sexual urges.

She just became extremely cold and harsh," he said. "She even, a few times, almost got to the level of shouting." She suggested that he was simply nervous around kids his own age — a reaction I've learned is common among therapists with limited experience in this area. She told him she wasn't trained to deal with the situation, but she would ask around for information on how to help him and scheduled a second session for a couple of weeks later.

That's when Adam realized what a lot of other pedophiles who attempt to seek help realize—the medical community isn't a place that is quite ready to treat and cure pedophiles. For one thing, mandatory reporting laws require some medical health professionals to report suspected child abuse, which might scare pedophiles who haven't sought treatment away from admitting their urges. But just because health care doesn't have a place to treat them doesn't mean people who need treatment are not out there.

Studies suggest that up to 9 percent of men have fantasized about having sex with a prepubescent child, and 3 percent of all men have gone on to sexually offend. (Not all of them would meet the diagnostic criteria for pedophilia. The latter figure includes situational offenders, men who abuse children if the opportunity arises but who otherwise have no pre-existing attraction to kids.) Michael Seto, director of the University of Ottawa's Forensic Research Unit and associate editor of Sexual Abuse: A Journal of Research and Treatment, believes that the prevalence of male pedophiles sits closer to 1 percent of the population, which would equate to at least 1.2 million in the U.S. alone. (Female pedophiles exist, but in smaller numbers.)

Keep in mind, Adam wasn't even adult himself at the time. Faced with wanting to find a way to treat himself (or least manage his urges) and no suitable treatment options, he did what most people do when they need help. He Googled it.

One day he typed the words "young pedophile" into Google, and his original thread on the mental health board was the first entry to come up. But when he started to scroll down he saw similar entries on other boards, ones with headlines like "I'm a young pedophile and I need some help" and "How can I get free counseling? I'm a teenage pedophile."

"I know that pedophiles don't choose to be pedophiles," he shared in an introductory message to one of the first forums where he sought help. "I didn't want my attraction. I don't want my attraction. But the attraction is there, and all I can do is try to curb it." Adam told Malone he eventually made friends online who helped distract him from his urges to look at child porn.

Distinct from the idea of a malevolent pedophile ring, these young men — and occasionally young women — said they didn't want to hurt children and were trying find a way to make sure they never would. Some messaged back and forth before dropping off ("They probably got scared that it was a sting operation," said Adam), but one by one a cluster of regulars formed.

If the idea of a group of pedophiles getting together to "network" on the Internet disturbs you, you're not alone. Even while trying to understand and be objective about the story, I found myself horrified at the very idea. Throughout the article, Malone cites specific examples of how the community reaches out to one another when they feel overwhelmed by what they know are inappropriate urges. I had a hard time reading a lot of it, to be honest. (Malone profiles one man named "Mike" who works with children and wants to study child development.)

However, if we're going to find a way to stop children from being abused — the end goal and the most important thing we care about here — we have to acknowledge the fact that we need to study and understand this disorder, which means understanding the people who have it.

That's how adolescent pedophiles who recognize their condition early in life can play a major role. Elizabeth Letourneau, founding director of the Moore Center for the Prevention of Child Sexual Abuse. Their mission is "to try to change the way the nation views child sexual abuse, as something that is preventable." Letourneau wants to create a new program outside of the center, focused on preventive treatment in adolescent pedophiles just like Adam.

"We say we're really concerned about sex offending and we really don't want children to be sexually offended and we don't want adults to be raped, but we don't do anything to prevent it," Letourneau said. "We put most of our energy into criminal justice, which means that the offense has already happened and often many offenses have already happened." Letourneau calls the historically favored technique of "arousal reconditioning," — which basically dictates that men try to alter the way they think while they masturbate— "archaic" and has called for a new technique that's more modern and, you know, helpful.

Another program similar to the one Letearneau proposes is the Prevention Project Dunkelfeld in Germany. "In my view, it's not the inclination that's a problem," Dr. Klaus Beier, head of the PPD, said. "And I wouldn't condemn the inclination, I'd condemn the behavior."

The program consists of weekly therapy sessions for up to 12 months. They favor cognitive behavioral therapy, but also offer libido-reducing medication, otherwise known as chemical castration, if a patient needs to reduce his sexual drive in order to benefit from treatment.

Beier and other researchers with the program said one of the keys to the program is maintaining the confidentiality of the patients. (Germany does not have the same mandated reporting laws as the U.S.) But there is one possible workaround for researchers who want to understand pedophiles without scaring away their test subjects by exposing them to law enforcement.

In the United States, researchers can apply for a Certificate of Confidentiality. These federal certificates, if granted, protect the privacy of research study participants and can offer temporary exemptions from mandatory reporting laws. But there has been only one certificate granted in the area of pedophilia research. Between 1977 and 1985, Dr. Gene Abel interviewed 561 unidentified sex offenders in order to better understand this under-researched population. No one has been given one since.

"I'd like to be able to include youth who have offended but who are undetected, and the reason for that is that if they're undetected they're gonna stay undetected," Letourneau told Malone. "Do you want them to get help or not? For my money, you really want to be working with the kids who have already started offending, because those are the ones most likely to offend again."

Our society is a punitive culture. We are curative, not preventative. We place a lopsided amount of resources into fixing (or punishing) as opposed to stopping horrible things before they happen. But treatments like Letourneau's put the focus back on the offender. It puts the emphasis on helping a person who knowingly harbors feelings that make most of us either want to vomit, cry or rage. We don't want to "treat" and "help" people who we think could hurt children. We want to punish them and make an example of them, because in this culture, satisfying a blood lust for justice is more satiating than spending decades studying and researching to try and help people who are pedophiles. Even the word "help" next to "pedophile" is too much for some to bear. Because that ultimately requires some level of understanding, which is dangerously close to compassion.

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