Thoughts about Pedophilia and the DSM-5 · 5:20am Feb 28th, 2015
The topic was raised recently among the comments of Fallen Angels, and I thought I'd share my understanding and thoughts, so here they are.
Pedophilia and Mental Health:
The most recent version (5) of the Diagnostic and Statistical Manual of Mental Disorders has recently replaced the diagnostic terms pedophilia and pedophile. Instead, the DSM-5 favors the terms pedophilic sexual orientation (later corrected to interests instead of orientation) and the term pedophilic disorder. Individuals that have the orientation/interest are still referred to shorthand as pedophile, or someone with pedophilia, but a pedophile is clearly distinguished apart from someone who has pedophilic disorder. I.e., to be sexually attracted to minors is not classified as an illness as some might think. The sexual interest and the disorder are kept explicitly separate in the manual because, for some, being attracted to prepubescent children does not manifest with the other necessary symptoms of the disorder. Here is the actual section before it was corrected to say interest.
Essentially, pedophiles who don't act on their impulses nor experience any negative impact for their attractions and urges lack the necessary requirements to be diagnosed with pedophilic disorder.
The Politics:
As far as U.S. law is concerned, all sexual orientations receive equal protection under the law. When the DSM made it clear that pedophilic interest may be identified as an orientation, it upset a lot of people. For reasons that I assume are purely non-scientific, but political, the DSM-V was "corrected" to remove most or all instances of the word orientation as it related to paraphilias, as seen, for example, in these few paragraphs:
http://www.dsm5.org/Documents/Paraphilias_103113.pdf
For the law's sake, the DSM-V went as far as to say that ...
[P]edophilic disorder does not imply that an individual with such a condition meets legal criteria for the presence of a mental disorder or a specified legal standard (e.g., for competence, criminal responsibility, or disability). For the latter, additional information is usually required beyond that contained in the DSM-5 diagnosis, which might include information about the individual's functional impairments and how these impairments affect the particular abilities in question.
This seems fair, but it still wasn't enough, apparently, to satisfy folks who knew that the classification of pedophilia as an orientation would mean protection for pedophiles from things like hate crimes or job loss based on their sexuality.
Still, it's fairly safe to assume that simply being attracted to children isn't against the law, or the use of the term orientation might never have been applied in the first case. Even before the "correction" the DSM-V explained that someone attracted to children might not act on their impulses.
Common Speech:
Someone who is simply attracted to children (whether they call themselves a pedophile or not) without acting on the attraction is not considered to have any disorder unless the attraction causes the person undue stress, emotional pain, or impairs their functioning.
Simply put, not all pedophiles are molesters, nor do they necessarily have a disorder.
Meanwhile, according to the DSM-V, an adult who repeatedly molests children under 12 or 13 years old over the course of 6 months is a person with pedophilic disorder, whether or not they admit to finding children attractive. Not all repeat child molesters are attracted to children sexually, nor are they all, as the DSM says they must be, "at least age 16 years and at least 5 years older than the child," where the child is prepubescent (younger than 12). This means that someone diagnosed with pedophilic disorder for repeat molestation might not actually be attracted to children (despite their actions), and therefore, might not be a pedophile.
Simply put, not all child molesters are pedophiles.
Furthermore, some might claim that acting on sexual urges toward children with their agreement ought not to be a considered harmful, something that chapters 23-24 of Fallen Angels discusses, based on Twilight's Notes (i.e. the Rind meta-analysis). In spite of the law, therefore, many question whether acting on pedophilic urges ought to be considered valid criterion for the disorder. They argue that only mental distress and impaired functioning ought to be considered criteria.
In other words, if it seems to cause no mental harm, calling adult-child sex a sign of mental disorder makes no sense. This is to say nothing of whether I believe the same, mind you, but it is what it is.
This is true (the first portion of your post, about the DSM-V criteria), and technically it's always been this way since the DSM-III, but they made the wording super-clear here which was a rather liberal spin that I am pleased to see. (I have a degree in psychology.)
More generally still, a disorder isn't a disorder until it is encountered in the clinic. To be a disorder, all three of these things must be true:
0) it's weird (atypical)
1) it causes you distress or interferes with your social (or job) life
2) the problem would be the same in the wide majority of US communities
If you have a deep belief in religious things it might meet 1 and 2 but fail to meet 0. If you're weird because you collect buttons, that might meet 0 and 2 but fail to meet 1. If you're suffering because you're gay and live in the South, that might meet 0 and 1 but not 2.
In other words, "disorder" is a value judgment that depends entirely on societal norms.
Also, there is one disorder that doesn't meet 0: female inorgasmia. I suspect it's still in the DSM-V. Many psychologists have questioned its inclusion, since too many people have it. If it's that common (a very large share of women), calling it a "disorder" borders on social engineering rather than diagnostics.
2837221
Super thanks for the clarification and added perspective. I'm glad I got that part right.
Those examples are really interesting to see, especially when I think about how the puritans came to the new land for religious freedom. Being religious isn't always a life-improving thing, yet religious freedom is an important part of the U.S.'s origin and identity. If the DSM had existed back then, the puritans might have had a disorder for the fact that their lifestyle got in the way of their social functioning. Gradually, more groups than the religious have seen their time for fair treatment come, and homosexual activists declassified themselves as "weird" so that they're no longer in the DSM. Unfortunately, the groups that are protected now (religious, women, homosexuals) are sometimes more at odds than ever and often blame each other for their repression and accuse one another of bigotry on all sides (eg. the removal of prayer from school and resistance to gay marriage).
As a Christian converted during preadolescence, raised in a household where my non-Christian mother had a series of lesbian partners, and as a pedophile myself, I wish we could see an end to the vitriol. Just within the pedophile community, I see many pedophiles vehemently accuse feminists of persecuting them for their sexuality. I see some pedophiles that put down homosexuals. Others, instead, put down the religious and look to homosexuals as allies. A rare few seem to simply acknowledge the conflict and move on to strive for peace and fair treatment for everybody.
I'd love to contribute something more helpful to this post, but I don't know much more on the topic, than what I've read in Fallen Angles, and this blog. I do find this interesting though. I am a Christian as well and don't see why people argue so insistently about Pedophilia, or gays/lesbians. To me they are an existing part of this world. We can't force them to feel differently. The arguing is unnecessary and uncalled for, on the topic you mentioned especially. People need to learn to Love and Tolorate each other. We can't all be the same, and just because you are different doesn't mean you're better or worse than anyone else.
Well that's my opinion anyway.
Insightful.
Insightful indeed.
As a terrified adolescent that has planned to chemically castrate himself, should he actually go on (or go very near to) and do the deed on a child in real life, this soothes me. I mean, at least I know that I'm not scum, if I restrain myself like the (attempted but failed) Liberal (in the Latin sense of the word) Man I am.
2846521 I'm really glad this could help. I knew a pedophile who chemically castrated himself, but it didn't help him quite as much as you might think. I've been offered free therapy by, supposedly, the best professionals in my state, to be paid for by my church, with the guarantee that they could erase my attractions to children, but it didn't feel right, and I declined. I don't doubt some would jump at the chance.
I might not be able to live like other people live in the presence of children, and it breaks my heart, but, whether or not I ever do, at least I'll do everything in my power to fight isolation for myself and others like me. You're not alone, and, for what it's worth, I don't believe you've any reason to be ashamed of yourself, whatever your thoughts are toward children. Of course, thoughts turn into more than just thoughts, so caution is really essential, but self-loathing never helped anyone tame or refine their impulses. Usually, that sort of mentality only makes things much worse.
2837221 Apparently, there's a contradiction between documents. Can you make sense of which is correct? The image from the DSM-5 above explicitly states in the last shown sentence there that there may be pedophilic sexual interests without a disorder, yet the bulleted points in this official-looking document seem to say otherwise:
http://www.dsm5.org/Documents/Paraphilic%20Disorders%20Fact%20Sheet.pdf
Is there a newer version of the DSM-5 that eliminates or changes the statement at the end of the first paragraph under Diagnostic Features beyond simply replacing the term "orientation" or any other information you could provide?
2862902
I believe "a sexual desire or behavior that involves another person’s psychological distress" means the attraction is to the effects of abuse itself, and "a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent" means the individual actually wants to engage in those behaviors in real life. I don't think either of these suggest that it is a disorder to have fantasies of children being able to consent for which the person does not intend to engage in real life.
2862995 Brilliant. That makes so much more sense.
For reference...
NY Times article about pedophilia being classified as an orientation (link)
Note: The article is misleading in that it attributes the orientation mostly to men while there's still very little research about pedophile women. It also draws conclusions based on research done on a clinical or prison population which heavily skews things like IQ and cerebral white matter.