Stop childhood sexual abuse: How to treat pedophilia.

The Counterintuitive, Distressing but Necessary Way To Stop Childhood Sexual Abuse

The Counterintuitive, Distressing but Necessary Way To Stop Childhood Sexual Abuse

Health and medicine explained.
Sept. 24 2012 2:32 PM

How Can We Stop Pedophiles?

Stop treating them like monsters.

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As Cord Jefferson reported recently in Gawker, new research suggests that pedophilia—the attraction to children, not the act of molesting them—is essentially impossible to change. James Cantor, a senior scientist at the Sexual Behaviors Clinic of the Center of Addiction and Mental Health in Toronto, is at the forefront of neuroimaging studies of pedophiles and has described a kind of crossed wiring in their brains that they’re likely born with. He has expressed hopes that by pinpointing pedophilia’s neurological origins, it may someday lead to a course of prevention.

In the meantime, one way to protect kids may be to reach pedophiles pre-emptively, to give them the therapeutic tools to control themselves and still lead fulfilling lives. A non-offending pedophile like Spencer is preferable to one who’s forced into treatment after committing heinous acts, or even worse, one who is never treated because his acts go undiscovered. The opposite of a non-offending pedophile is not a non-pedophile, which people would obviously prefer, but an offending pedophile.

There is, by now, a sobering familiarity to child sexual abuse scandals, from the Catholic Church and Penn State to Hasidic Brooklyn and Horace Mann. First comes the shocking news. Then there’s a period of mass absorption in the story, a combination of revulsion and chewing over every graphic detail. The perpetrators are decried as monsters. There are investigations and trials. Finally, retribution is sought against anyone who may have known about but not stopped the abuse.


“All of the attention is on known sex offenders and just heaping on the punishment,” Letourneau told me. “This is said to be due to an interest in prevention, but it’s really about retribution. If people are really serious about preventing children from being molested or raped, it may very well necessitate the uncomfortable acknowledgement that some people are born as pedophiles. All we do is drive it underground.”

I’ve thought about this a lot. I have close friends who are rape and sexual assault survivors and have seen how that trauma reverberates through their lives. I’m also a mother of young children, and the notion of pedophilia is as disturbing to me as it is to any parent. I would probably think they were all uncontrollable monsters, too, if it weren’t for Danny.

Danny was a friend I met shortly after graduating college in the late ’90s. He was a scrawny kid from the Bronx, sweet and geeky and neurotic, and he would come over to share beers with me and my then-boyfriend at our apartment in Williamsburg, Brooklyn. One day, he met a 12-year-old girl on the street in the Village, told her he was a photographer and wanted to take her picture, and arranged to meet her again. When he showed up at her parents’ apartment building, the police were there. They discovered rope and scissors in his bag along with a library book about pedophilia. Although the assault he had apparently planned didn’t happen, he confessed that on another occasion, he followed a 10-year-old girl, tied her up and masturbated in front of her. He was convicted of first-degree sexual abuse and sentenced to six years in prison.

I was shocked and appalled, and my heart ached for his victims. But I couldn’t bring myself to abandon him as a friend, and I decided to treat him with the same concern I would any friend who was ill, which was the only way I could make sense of what he had done. I visited him at Riker’s Island while he was awaiting his sentencing, and we exchanged letters during the years that he was imprisoned at Attica and Oswego. I occasionally got a collect call from him. I attended his parole hearing, and when he was released and put on a bus back to the city on a hot summer evening in 2007, I met him at Port Authority. He stepped off the bus dressed in prison-issue jeans, carrying his few belongings in a saggy mesh sack. He walked through Times Square, blinking at the lights and absorbing his new freedom.

Since then, Danny has held a job, hewed to the rules required of him as a registered sex offender, attended group counseling sessions, and gotten married. (Diagnostically, he’s probably a non-exclusive hebephile, meaning that he’s attracted to adult women as well as pubescent girls.) He takes responsibility for what he did and is haunted by shame and guilt over it. His growth in counseling coupled with the terror of returning to jail prevents him from acting on his attraction to young girls. I occasionally worry that he may reoffend. But more than that, I worry about all the other guys like Danny out there, the ones who haven’t been caught and the ones who haven’t even done anything yet.

Fred Berlin, the founder of the Sexual Disorders Clinic at Johns Hopkins University, has studied pedophilia for more than four decades and is leading efforts to consider it a public health issue. “It appears likely that the percentage of people apprehended is just a fraction of those out there who have these attractions, or even act on them,” he said. “We as a society do virtually nothing to reach out to them before the fact.”

Berlin has had success treating pedophiles with therapies similar to those for drug addicts, with an emphasis on taking responsibility for one’s actions, identifying triggers, and resisting cravings, as well as developing empathy for potential victims and addressing cognitive distortions that may support unhealthy behavior. His patients have also had successful outcomes with testosterone-lowering medication, otherwise known as chemical castration.

But these treatments are almost only used on men who have committed offenses, because they’re the ones who show up. Almost nobody comes forward these days without having done something horrible first, which Berlin attributes largely to mandatory reporting statutes. Every state has laws that require health care professionals to report suspected child abuse, laws that are broadened when high profile cases like Penn State occur. Many mental health workers, fearful for their own liability, may rush to report a client who says that he has been thinking about abusing children, concluding that he must be an imminent threat. The result is that men who are grappling with the attraction and other mental health issues that emanate from it—depression is common—have nowhere to go.

Like other clinicians, Berlin compares contemporary attitudes toward pedophilia to old attitudes about alcoholism, before it was understood as a disease that can be managed with proper support. “With pedophilia, we’re still in the pre-Betty Ford era,” he told me. “When do we ever hear, ‘If you’re a 17-year-old worried about being attracted to a younger kid, or worried about having sexual urges you can’t control, for goodness sake, please come in and seek help?’ ”