Can Pedophilies Change?

The mental health community has long been interested in developing treatments for persons who are attracted to prepubescent children with the goal of preventing sexual offenses. In fact, if you search for “pedophilia treatments” or “pedophile therapy” on Google Scholar, you’ll get thousands of hits.

Numerous treatment approaches have been tested, with many focusing on finding a “cure.” For example, some studies have explored use of aversion therapy, in which something unpleasant (such as a very bad smell) is paired with child stimuli with the goal of reducing pedophilic desires. Others have looked at orgasmic reconditioning, which involves thinking about or speaking aloud socially appropriate fantasies while masturbating to orgasm in an attempt to learn new fantasies that are pleasurable.

While researchers have touted success for some of these techniques in terms of lessening pedophilic attraction and/or increasing adult attraction, there are a lot of caveats. For one thing, they’re often based on clinical case reports of a single subject, one who is may be highly motivated to demonstrate change. So, for the most part, we’re not dealing with experiments with control conditions, which tempers the conclusions we can draw considerably.

Importantly, larger-scale studies and reviews of the literature have concluded that pedophilic attractions tend to be pretty stable and are largely resistant to change, which is part of the reason that some in the field have begun to argue that pedophilia is a sexual orientation.

However, controversy over whether pedophiles can be cured persists. Case in point: the journal Current Sexual Health Reports just published a back-and-forth series of papers in which two researchers argue different sides of this issue. This debate is the subject of a recent column I wrote over at TONIC.

On one side is Dr. Paul Fedoroff, who argues that pedophilia is changeable—in fact, he says it’s as changeable as “interest in vegetarianism, or kale or oysters.” He points to a range of evidence that he believes offers support for his views.

On the other side is Dr. James Cantor, who interprets the same exact evidence that Fedoroff cites in a very different way—one that doesn’t support the notion that pedophilia is changeable.

For example, Fedoroff cites the fact that pedophiles’ risk of reoffending decreases over time as evidence that their sexual attractions and interests are changing, whereas Cantor suggests that their lower risk over time stems from the fact that sexual desire decreases with age, thereby making pedophilic attractions less difficult to manage.

The full debate is fascinating and well worth a read. For more, check out my analysis of it over at TONIC.

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