Pedophiles may be attracted to young boys, young girls, or both, and they may be attracted only to children or to children and adults.
Doctors diagnose pedophilia when people feel greatly distressed or become less able to function well because of their attraction to children or when they have acted on their urges.
Treatment involves long-term psychotherapy and drugs that alter the sex drive and reduce testosterone levels.
(See also Overview of Paraphilias and Paraphilic Disorders Overview of Paraphilias and Paraphilic Disorders Paraphilias are frequent, intense, sexually arousing fantasies or behaviors that involve inanimate objects, children or nonconsenting adults, or suffering or humiliation of oneself or the partner... read more and Overview of Child Neglect and Abuse Overview of Child Neglect and Abuse Child maltreatment includes all types of abuse and neglect of a child under the age of 18 by a parent, caregiver, or another person in a custodial role (for example, clergy, coach, or teacher)... read more .)
Pedophilia is a form of paraphilia. Because it causes harm to others, it is considered a disorder.
Whether sexual interest or involvement between two people is considered pedophilic disorder depends on the age of the people involved. In Western societies, a diagnosis of a pedophilic disorder requires that the person be 16 years old or older and at least 5 years older than the child who is the object of the sexual fantasies or activity. However, sexual involvement of an older adolescent (aged 17 to 18) with a 12- or 13-year-old may not be considered a disorder. The age criteria used to identify when such activity is considered a crime may differ.
Although state laws vary in the United States, the law generally considers a person older than 18 to be committing statutory rape if the victim is 16 or younger. Statutory rape cases often do not meet the definition of pedophilia, highlighting the somewhat arbitrary nature of selecting a specific age cutoff point in a medical or legal definition. In many places (including in some states in the United States), children as young as 12 to 14 can legally marry, further complicating the definition of pedophilia and statutory rape.
Pedophilia is much more common among men than among women.
Pedophiles may be attracted to young boys, young girls, or both. Whether girls or boys are more likely to be the victims of pedophiles is unclear, although girls seem much more likely to be the victims of sexual abuse in general.
Usually, the adult is known to the child and may be a family member, stepparent, or a person with authority (such as a teacher or coach). Some are attracted only to children within their own family (incest). Some pedophiles are attracted only to children, often of a specific age range or developmental stage. Others are attracted to both children and adults.
Looking or general touching seems more common than touching the genitals or having sexual intercourse.
Predatory pedophiles may use force or coercion to engage children sexually and may threaten to harm the child or the child's pets if the child tells anyone. Many of these pedophiles have antisocial personality disorder Antisocial Personality Disorder Antisocial personality disorder is characterized by a pervasive pattern of disregard for consequences and for the rights of others. People with antisocial personality disorder go after what... read more .
Many pedophiles have or develop a substance use disorder or dependence Overview of Substance-Related Disorders Medications and other substances, whether used for legitimate medical purposes, as a habit (for example, caffeine), or recreationally, are an integral part of everyday life for many people ... read more and depression Depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more . They often come from dysfunctional families, and marital conflict is common. Many were sexually abused as children.
Diagnosis of Pedophilia
A doctor's evaluation, based on specific criteria
Doctors diagnose pedophilia when
People have had repeated, intense sexually arousing fantasies, urges, or behaviors involving a child or children (usually aged 13 years or under).
People feel greatly distressed or become less able to function well (at work, in their family, or in interactions with friends), or they have acted on their urges.
People are aged 16 years old or older and are 5 or more years older than the child who is the object of the fantasies or behaviors. (An exception is an older adolescent who has an ongoing relationship with a 12- or 13-year-old.)
They have had the condition for 6 months or more.
Treatment of Pedophilia
Pedophilia can be treated with long-term individual or group psychotherapy and drugs that alter the sex drive and reduce testosterone levels.
Results of treatment vary. Outcome is best when participation is voluntary and the person receives training in social skills and treatment of other problems, such as drug abuse or depression. Treatment that is sought only after criminal apprehension and legal action may be less effective.
Simply putting pedophiles in prison or another institution, even for a long time, does not change pedophilic desires or fantasies. However, some imprisoned pedophiles who are committed to long-term, monitored treatment (usually including drugs) can refrain from pedophilic activity and be reintegrated into society.
Doctors in the United States usually use the following drug:
Medroxyprogesterone acetate, which is injected into a muscle
Medroxyprogesterone (a progestin) is similar to the female hormone progesterone.
An alternative is leuprolide.
Medroxyprogesterone and leuprolide stop the pituitary gland Overview of the Pituitary Gland The pituitary is a pea-sized gland that is housed within a bony structure (sella turcica) at the base of the brain. The sella turcica protects the pituitary but allows very little room for expansion... read more from signaling the testicles to produce testosterone. They thus reduce testosterone levels and the sex drive. Doctors periodically do blood tests to monitor the effects of these drugs on liver function, as well as other tests (including bone density tests and blood tests to measure testosterone levels). It is not clear how useful these drugs are in women who are pedophiles.
Antidepressants called selective serotonin reuptake inhibitors Selective serotonin reuptake inhibitors (SSRIs) Agomelatine, a new type of antidepressant, is a possible treatment for major depressive episodes. Several types of drugs can be used to treat depression: Selective serotonin reuptake inhibitors... read more (SSRIs) may also be helpful. They may help control sexual urges and fantasies. They also decrease the sex drive and may cause erectile dysfunction.
Drug treatment is more effective when it is combined with psychotherapy and training in social skills.