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Stigmatization restricts people's opportunities in life and has severe consequences on mental health and psychological well-being. This article focuses on stigmatization research on pedophilia. Based on an extensive literature search, it reviews studies that have empirically determined lay theories, stereotypes, prejudices, and discrimination against people with pedophilia, as well as the effect of stigma on this group. The review reveals a scarcity of empirical studies on the subject (11). Although the majority of studies give at least an indication that stigma against people with pedophilia is highly prevalent, we also identified severe methodological limitations and a lack of a unifying and systematic research agenda. We discuss the need for more theory-driven, rigorous, and representative empirical studies and propose perspectives and requirements for the scientific study of stigma against people with pedophilia.
Stigmatization of People with Pedophilia: A Blind Spot in Stigma Research
Sara Jahnke1 and Prof. Dr. Juergen Hoyer1
1Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
This article may not exactly replicate the final version published in the journal
"International Journal of Sexual Health. The final article is available at
Correspondence concerning this article should be addressed to Sara Jahnke,
Technische Universität Dresden, Klinische Psychologie und Psychotherapie, Hohe Str. 53,
01187 Dresden, Germany.
Fax: ++49-351-463-36955
Phone number: ++49-351-463-36978
Second author‘s address: Prof. Dr. Juergen Hoyer, Technische Universität Dresden,
Klinische Psychologie und Psychotherapie, Hohe Str. 53, 01187 Dresden, Germany
Fax: ++49-351-463-36955
Phone number: ++49-351-463-36978
Acknowledgements: This publication was realized within the MiKADO project, funded by
the German Federal Ministry of Family Affairs, Senior Citizens, Women and Youth.
Stigmatization restricts people’s opportunities in life and has severe consequences on mental
health and psychological well-being. This article focuses on stigmatization research on
pedophilia. Based on an extensive literature search, it reviews studies that have empirically
determined lay theories, stereotypes, prejudices, and discrimination against people with
pedophilia, as well as the effect of stigma on this group. The review reveals a scarcity of
empirical studies on the subject (11). While the majority of studies give at least an indication
that stigma against people with pedophilia is highly prevalent, we also identified severe
methodological limitations and a lack of a unifying and systematic research agenda.
We discuss the need for more theory-driven, rigorous, and representative empirical studies
and propose perspectives and requirements for the scientific study of stigma against people
with pedophilia.
Detrimental effects of stigma have been known and discussed for decades. In his
seminal work, Goffman (1963) defines stigma as an undesirable attribute that makes its
carrier “different from others, […] in the extreme, a person who is quite thoroughly bad, or
dangerous, or weak. He is thus reduced in our minds from a whole and usual person to a
tainted, discounted one” (p. 3). When this deeply discrediting attribute becomes known, it
“spoils the social identity of the person carrying it and cuts him off from society and from
himself so that he stands a discredited person facing an unaccepting world” (p. 19).
The initial accounts on stigma have fostered a long-standing empirical research
tradition (Heatherton, Kleck, Hebl, & Hull, 2003). The amount of stigma and its negative
impact on stigmatized individuals has been comprehensively documented for ethnic
minorities (Bogardus, 1925; Gillen-O'Neel, Ruble, & Fuligni, 2011), obesity (Puhl & Heuer,
2009), gender (Spencer, Steele, & Quinn, 1999), social status (Croizet & Claire, 1998),
diseases (Lebel & Devins, 2008; Leiker, Taub, & Gast, 1995), and mental disorders
(Angermeyer & Dietrich, 2006). Stigmatization has also been investigated with regards to
bisexual people, lesbians, and gay men (Ahmad & Bhugra, 2010; Bhugra, 1987; Herek, 2002,
2009; Steffens & Wagner, 2004) and, to a lesser degree, other sexual minorities like
transgender people (King, Winter, & Webster, 2009).
The stigma process starts with the labeling of a person or group as deviant or
fundamentally different from oneself (Link & Phelan, 2001). Therefore, many stigma
researchers take an interest in naïve or lay theories of mental disorders (Angermeyer &
Dietrich, 2006; Gaebel, Zaske, & Baumann, 2006; Phelan, 2005) or other stigmas (Hodson &
Esses, 2005). Lay theories can be defined as theories (e.g., about causes and management of
mental disorders) that people without expert knowledge use in an everyday context. Although
lay theories don’t necessarily lead to stigma, they might help “clarify the psychological basis
of stigma” (Haslam, 2005, p. 42). Public stigma (i.e., the negative reaction of the public
towards a discredited minority) consists of three aspects: stereotypes, prejudices, and
discrimination (Rusch, Angermeyer, & Corrigan, 2005). Stereotypes are beliefs about
perceived or assumed characteristics of a social group (Ashmore & Del Boca, 1981), such as,
e.g., the notion that homosexual men are effeminate and work as hairdressers (Madon, 1997).
Being aware of stereotypes about other social groups does not imply agreeing with them
(Corrigan & Watson, 2002). However, when an individual member of the community adopts
discrediting consensual stereotypes (e.g., that members of the group are dangerous), prejudice
ensues (Rusch et al., 2005). Empirical research further demonstrated that agreement with
stereotypes and strong evaluative reactions can promote discrimination against stigmatized
groups (Corrigan, Thompson, Lambert, Sangster, Noel, & Campbell, 2003; Page, 1977), and
reduce the likelihood of helping behavior (Corrigan & Watson, 2002).
However, not all potentially stigmatizing characteristics are obvious, and some are
easier to conceal than others. When an individual who (knowingly) possesses a stigmatized
attribute that is not readily apparent to others manages to keep it secret (e.g., by avoiding
situations where others might discover it), this might be referred-to as a “hidden stigma”
(Corrigan & O'Shaughnessy, 2007). People with a minority sexual orientation or a mild
mental illness can decide whether or not to disclose their status to other people, while people
with, e.g., a cleft lip are easily identifiable as stigmatized and may become a target of
discrimination, regardless of their behavior. However, even people with a hidden stigma may
experience threat when confronted with stressors such as “having to make decisions to
disclose one’s hidden status, anxiously anticipating the possibility of being found out, being
isolated from similarly stigmatized others and being detached from one’s true self”
(Pachankis, 2007, p. 328). To explain higher rates of mental disorders among gay men,
lesbians, and the bisexual population, Meyer’s (2003) minority stress theory convincingly
argues that multiple processes besides the direct experience of prejudice and discrimination
may act as further sources of stress, such as expectations of rejection and the heightened
vigilance it entails, efforts to hide and conceal the stigma and internalization of stigmatizing
views. Thus, belonging to a stigmatized group may not only reduce the quality of life but
might also lead to self-harm, including drug abuse (Baiocco, D'Alessio, & Laghi, 2010;
Lehavot & Simoni, 2011), suicidal behavior (Haas et al., 2011; Liu & Mustanski, 2012;
Mustanski, Garofalo, & Emerson, 2010), and reluctance to seek help if it includes being
labeled as a member of a stigmatized group (Ben-Zeev, Young, & Corrigan, 2010; Vogel &
Wade, 2009). While stigma against sexual minority orientations or mental illnesses such as
depression or schizophrenia is widely recognized as an important problem of modern society,
research will need to explore whether the above mentioned consequences of stigma also
apply to other relatively hidden stigmas, such as pedophilia.
Pedophilia is a diagnostic term applied to people who are sexually interested in pre-
pubescent children (APA, 2000). However, according to a recent article (Seto, 2012),
pedophilia also fulfills criteria of a sexual orientation with respect to the age of the desired
partners (as opposed to their sex). Taking position on this controversial issue is beyond the
focus of this paper. However, regardless of whether or not pedophilia should be considered a
sexual orientation, we believe that stigma against people with pedophilia could be informed
by the literature on the experiences of sexual minorities.
While there is evidence that child sex offenders with a deviant sexual preference are
more likely to re-offend than nonparaphilic sex offenders (Hanson & Bussiere, 1998),
pedophilia is neither a necessary nor a sufficient condition for child sex offenses. People
with pedophilia make up for only 50 % (or less) of the offender population (Seto, 2008), and
there are those with pedophilia who cope with their sexual urges without committing sexual
offenses or harming children (Feelgood & Hoyer, 2008; Hall & Hall, 2007).
In the general public however, it is to be expected that sexually abusive behavior
towards children is often confused with pedophilia as a sexual preference. In the media,
people with pedophile or other paraphile interests are often stereotypically portrayed as
violent criminals (Diefenbach, 1997; Kitzinger, 2004). The public’s view of sexual offenders
is extremely negative (Fortney, Levenson, Brannon, & Baker, 2007). Agreement with the
stereotype that pedophilia often or always coincides with child sex offenses is likely to
prompt a high degree of discrimination against people with pedophilia, regardless of their
actual behavior. This may have a negative impact on the mental health of a person suffering
from pedophilia, and unwanted indirect effects on the likelihood of this person seeking
therapy when needed. Both potential consequences may, presumably, put children at risk of
child sexual abuse.
In this article, we will systematically review and summarize research on lay theories
and public stigma regarding people with pedophilia. We will also search for indications on
the consequences of public stigma on the beliefs and attitudes of a person with pedophilia
towards himself. Additionally, we will build on the results of our review by developing ideas
and perspectives for a more theory-driven and methodologically rigorous empirical study of
stigma against people with pedophilia.
Studies were considered for review when they were dealing with (1) lay theories
about pedophilia, (2) stereotypes about or prejudice towards people with pedophilia, (3)
discrimination of people with pedophilia, and (4) the effect of stigma on individuals with
pedophilia. The articles were also required to be quantitative studies and to be published in
English, German, or French. Recent research on pedophilia and sexual abuse has shown a
questionable trend to confuse sociolegal and psychopathological classifications (Feelgood &
Hoyer, 2008). To avoid this pitfall, we excluded papers dealing with public perception of
sexual offenders in general (Fortney et al., 2007) or sex offender registration (Kernsmith,
Craun, & Foster, 2009), unless they actually featured pedophilia as a psychopathological
category. Studies were excluded in which participants were solely and unambiguously
questioned about adult people engaging in sex with children (i.e., sex offenders), even though
the authors used the term “pedophile” in their study description (e.g., Marzillier & Davey,
2004; Russell & Giner-Sorolla, 2011).
We searched the Web of Knowledge and PubMed databases, using a combination of
the terms “attitude*”, “perception”, “stereotyp*”, “prejudice”, “social distance”,
“discrimination”, “stigma*”, “lay theor*”, “implicit theor*”, “opinion”, “media”, “public”,
“label*”, “disgust” and the words “pedophil*”, “paedophil*”, “paraphil*” or “sexual*
devian*”. Web of Science and PubMed are among the most reliable and acknowledged
search engines for their respective fields (Falagas, Pitsouni, Malietzis, & Pappas, 2008).
However, like most academic search engines, they have the disadvantage of only searching
bibliographic records (Jacso, 2005). Therefore, we additionally conducted a full-text search
via Google Scholar, using the search terms “stigmatization” and “pedophilia” and limited
further inspection to the 100 most relevant findings, including nonperiodical web documents.
Five hundred and thirty one publications in Web of Science and 655 in PubMed were
identified, but only seven studies met the aforementioned criteria (note that two studies
reported in a single article were counted individually). Based on an additional full-text search
via Google Scholar, three more studies could be identified. An eleventh study was retrieved
via checking reference lists. Ten studies were published in English and one study in German.
Although we decided to restrict the focus of the present paper to quantitative research,
we would like to add that well-structured and carefully analyzed qualitative work can be
illuminating and worth seeking out both for its own intrinsic value and as a means of
generating well focused quantitative research.
Overview of the reviewed studies
Table 1 summarizes the studies that fulfilled inclusion criteria. In the following, we
briefly summarize their goals and methodology.
1) Feldman and Crandall (2007) investigated which characteristics across mental
disorders lead to stigmatization. They collected social distance ratings (modified by Crandall,
1991) of 40 vignettes, each describing a typical case of a mental disorder listed in the DSM-
IV-TR (American Psychiatric Association, 2000) including alcoholism, paranoid
schizophrenia, depression and pedophilia. Each participant rated 13.5 disorders on average
(range: 9 - 17).
2) Furnham and Haraldsen (1998) conducted a study to explore the structure,
determinants, and relationship between participant’s beliefs about the causes and cures for
fetishism, sexual sadism, voyeurism and pedophilia. Participants rated the importance of 16
possible causes and 14 treatments.
3) Kramer (2011, August 17) authored two online surveys for people who self-
identify as being sexually attracted to children. The first survey investigated the development
of pedophilic interests, suicidal ideation, and attitudes towards seeking help. The second
survey aimed at further investigating the experiences of people with pedophilia in the public
health system, as well as assessing whether people with pedophilia felt stigmatized by
professional writings about them. Both surveys were conducted by B4U-ACT, a Maryland-
based patient advocacy group to promote health care resources for people with pedophilia.
More detailed information about the results of both studies could be obtained from their
website (B4U-ACT, Inc., 2011, June 22 for study one, and B4U-ACT, Inc., 2011, December
30 for study 2).
4) Lam, Mitchell and Seto (2010) conducted two studies on how different offense-
and offender-related characteristics (such as perceived likelihood of pedophilia, among
others) influenced the student’s perceptions of child pornography offenses. Both studies used
vignettes which varied with respect to age and gender of the depicted minor (study one) and
the offender (study two).
5) McCartan (2004) sought to determine the relationship between the media and
opinions concerning people with pedophilia in a small UK-based opportunistic sample. The
author administered a self-developed questionnaire (22 items) to collect data about the
respondents’ opinions on various subjects concerning pedophilia (including the treatment of
people with pedophilia, and the role of the media).
6) McCartan (2010) collected responses to two open-ended questions (“What is a
paedophile?” and “What attitudes and behaviours do paedophiles typically display?”) and
summarized answers thematically.
7) Stiels-Glenn (2010) examined the availability of outpatient psychotherapy for
people with pedophilia. The author sent questionnaires to all licensed psychotherapists in the
German city of Essen, asking them whether they were willing to work with different types of
offenders and individuals with pedophilia. About half of the respondents made annotations
that allow further insights about their standpoint towards treating members of the
aforementioned groups.
8) Twohig and Furnham (1998) investigated lay theories about overcoming each of
the four paraphilias fetishism, sexual sadism, voyeurism and pedophilia by asking
participants to rate how important they considered 24 coping strategies for each of the
9) Wilson and Cox (1983) used a self-developed questionnaire to assess various
aspects of psychosexual development, personality, sexuality, and attitudes towards their
condition among members of a London-based self-help group for people with pedophilia.
The leaders of the organization distributed the questionnaires via mail . The authors
thematically summarized the responses obtained.
Lay theories about pedophilia
In this section, we describe lay theories about the causes and treatment of pedophilia
based on the above listed publications.
With reference to lay concepts of possible causes of paraphilia, a factor analysis
carried out for the items in Furnham and Haraldsen’s (1998) study revealed four factors, a)
Early Relationships (e.g., being beaten or sexually abused as children); b) Repressed
Emotions; c) Lack of Guidance; and d) Biology. Regarding the potential cures, a factor
analysis revealed the three factors: a) Therapy; b) External Control (e.g., belief in God,
medication), and c) Internal Control (will-power, self-efficacy). For pedophilia, participants
considered Early Relationships the most important etiological factor, followed by Repressed
Emotions, Lack of Guidance and Biology (F(3, 12) = 3.59, p < .05). They saw Internal
Control and Therapy as more effective cures than External Control (F(2, 11) = 28.76, p <
.05). The authors mentioned in a side-note that, despite a high degree of tolerance expressed
towards paraphilias in their sample, this liberal attitude did not apply to pedophilia, which
“can almost be regarded as belonging to a different genre of paraphilias” (p. 699).
A factor analysis of Twohig and Furnham’s (1998) coping items revealed three
factors a) Self-Reliance, b) Seeking Help, and c) External Control. While participants
perceived Self-Reliance to be important in the cure of fetishism, sadism and voyeurism, they
saw Seeking Help as the most important factor in dealing with pedophilia, followed by Self-
Summary: Lay theories indicate that pedophilia is mostly attributed to unusual early
relationship experiences and inadequate ways of dealing with emotions (Furnham &
Haraldsen, 1998). The emphasis on internal factors in curing pedophilia suggests that it is
seen as a problem that is coming from within the person. However, whether or not pedophilia
is actually caused specifically by early adverse experiences, it continues to be a topic of
debate in scientific literature (Freund & Kuban, 1994; Jespersen, Lalumiere, & Seto, 2009).
Moreover, the questioned samples viewed external sources of help and self-reliance as the
most important therapeutic means for sexual deviance (Twohig & Furnham, 1998).
Stereotypes and prejudices concerning people with pedophilia
Here, stereotypes and prejudices towards people with pedophilia will be listed, as they
occurred within the above mentioned publications.
McCartan (2004) found that most participants agreed that an individual with
pedophilia partakes in a variety of sexual (e.g., kissing 61%, fondling 90%, masturbation
86%, sex 76%) and nonsexual (e.g., spending time 70%, talking 76%) activities with the
child. Seventy-nine percent disagreed that pedophiles are mad, while a majority of 58%
agreed that pedophiles are evil. Also, only 21% agreed that pedophilia can be successfully
treated. The perceived re-offense risk was high (with 68% believing that pedophile sex
offenders are more likely to re-offend than other offenders). The majority (58%) also agreed
that the press has created a “witch hunt” in relation to pedophiles.
McCartan (2010) reported that when asked about which typical traits come to mind
when they think of a pedophile, most students mentioned “sexually abusing children”
(68.6%). Only a small minority suggested that this might not necessarily be the case (11.8%).
Some stated that pedophiles were “not normal” (7.8%) "criminal" (9.8%), “mentally
disordered” (15.7%) and "disgusting" (9.8%). No positive traits were mentioned. Answers to
the question regarding typical behaviors or attitudes for this group included notions like, e.g.,
“appear normal” (25.5%), "secretive" (21.6%), and “spends time near kids” (21.6%).
Summary: In both studies by McCartan (2004, 2010), participants mentioned many
very negative and judgmental traits, such as pedophiles being “evil” or “disgusting.
Furthermore, the literature does not support the assumption that sexual (re-)offense rates
committed by persons with pedophilia are excruciatingly high (McCartan, 2004, 2010), as
recidivism rates in extra-familiar boy-victim sexual offenders both characteristics indicative
of pedophilic sexual interests (Seto & Lalumière, 2001) were only 35% after 15 years
(Harris & Hanson, 2004). Additionally, many participants expressed pessimistic beliefs about
the treatability of pedophilia (McCartan, 2004).
Discrimination of people with pedophilia
In prison, child sex offenders and people with pedophilia are outcasts prone to
victimization at the hands of their fellow inmates (Jewkes, 2005, Vaughn & Sapp, 1989).
Though some authors (e.g., Seto, 2008) reported anecdotes of actual and sometimes even
extreme forms of discriminating behavior against people who were supposedly or actually
sexually attracted to children, we found no quantitative study dealing with this topic. At this
point, we would like to acknowledge that there are experts who speak out for a more
accepting stance towards people with pedophilia among health care professionals in order to
avoid sexual abusive behavior towards children (e.g., Beier et al., 2009; Ward, Mann, &
Gannon, 2007). However, there are no studies investigating whether this group or the general
public would actually be willing to show prosocial behavior towards people with pedophilia
(e.g., the intent to help them to not act upon their sexual impulses involving children).
Feldman and Crandall (2007) assessed behavioral intentions with the social distance
scale, which is considered a proxy for actual discrimination by some authors (e.g., Corrigan,
Edwards, Green, Diwan, & Penn, 2001). Participants indicated lower willingness to interact
with people with pedophilia than with people suffering from all the other presented disorders,
except antisocial personality disorder.
In Stiels-Glenn’s (2010) study of German psychotherapists, 12.8% of the participants
indicated to be willing to accept sexual offenders for treatment. However, only 4.7% would
treat patients with pedophilia, and only 3.5% would treat child sex offenders. Some therapists
specified the reasons for their responses with a lack of knowledge (20% of all who provided
additional information), a focus on fields of work other than psychotherapy (13.3%) or
further reasons that were unrelated to stigmatization. Other participants justified their refusal
with negative feelings towards the aforementioned groups (13.3%), negative experiences they
had had with them in the past (13.3%) or doubts regarding their motivation for therapy
(11.7%). A few therapists expressed doubts regarding the appropriateness of the therapeutic
setting (6.7%), which hints at fears and uncertainties concerning the treatment of people with
Summary: Based on the few studies we could identify, evidence suggests that people
with pedophilia are perceived as a threat that must be avoided. Feldman and Crandall (2007)
discovered that individuals with pedophilia were more strongly rejected by students than
other mentally ill patients (except for people diagnosed with antisocial personality disorder).
In addition, psychotherapists do not seem inclined to accept people with pedophilia for
treatment (Stiels-Glenn, 2010). Studies examining the general public’s behavioral intentions
or actual behavior towards people with pedophilia are still missing.
Factors predicting lay theories, stereotypes, prejudices and behaviors
The following studies investigated which socio-demographic and psychological
characteristics predict lay theories about and public stigma towards people with pedophilia in
the broadest sense. Due to the scarcity of studies, they will be summarized here, although
their focus and aims differed considerably.
Furnham and Haraldsen (1998) examined beliefs about the causes and cures of
paraphilias and found the factor psychoticism of the Eysenck Personality Questionnaire
(Eysenck, Eysenck, & Barrett, 1985) tested in study participants to be associated with a
weaker belief in the effectiveness of therapy (r = −.40). Psychoticism is a personality
dimension that is related to traits such as antisociality, unemotionality, and unhelpfulness
(Eysenck & Eysenck, 1976). The more religious the participants rated themselves, the less
they believed in the importance of biological and external factors in the cure of paraphilias (r
= .25, p < .05). There was no link between gender or other tested sociodemographic and
personality variables and the proposed “cures” for paraphilia.
In both parts of their study into the assumed links between child pornography and
pedophilia, Lam et al. (2010) showed a significant effect (p < .05) of participants’ sex on the
perceived likelihood that the child pornography offender had pedophilia (F(1, 230) = 4.17 in
the first part, F(1, 245) = 5.3 in the second part), with female participants (67.5% and 67.4%,
respectively) being more likely to rate him as such than male participants (58.9% and 58.2%).
Lam et al. (2010) reported that the likelihood of the described child pornography
offenders to be perceived as pedophile was 63.6 % (Study one). In their two studies, they
found significant correlations (p < .05) between the perceived likelihood of pedophilia and
the perceived severity of the crime (r = .24 in study one, r = .14 in study two), the
recommended sentence length (not significant in study one, r = .30 in study two), the
probability of the same re-offense (r = .26 in study one; r =.34 in study two), the probability
of past sexual contact with a child (r = .54 in study one, r = .26 in study two), and the
probability of future sexual contact with a child (r = .56 in study one, r = .48 in study two).
Stiels-Glenn (2010) found that, of the few psychotherapists who would agree to work
with patients with pedophilia (13.3%), none was female.
In Twohig and Furnham’s (1998) study, the participant’s ratings of the importance of
Seeking Help as a way of coping with paraphilia was predicted by gender (t = 2.33, p < .05)
and psychoticism (t = -3.17, p < .01). Men (t = -2.29, p < .05), and a low self-perceived
religiousness (t = -2.05, p < .05) were more likely to stress the importance of External
Control. Religiousness was furthermore correlated with the factor Self-reliance (t = 1.98, p <
.05). Neither attitudes to sex (Eysenck, 1970), political beliefs, siblings, nor the factors of the
Eysenck Personality Questionnaire had an effect on the ratings of the cure factors.
Summary: Information on how personal or demographic variables relate to lay beliefs
about and public stigma towards people with pedophilia are few, scattered, and inconsistent.
Researchers have yet to put classic” traits of stigma research that have repeatedly been
shown to affect public attitudes like authoritarianism (Cohen & Struening, 1962) or
familiarity with stigmatized people (Link & Cullen, 1986) to the test. In line with the
empirical literature on the subject (Seto, Cantor, & Blanchard, 2006), students mostly see
child pornography offenses as a valid indicator for sexual interest in children (Lam et al.,
2010). They demanded higher sentencing the more they were convinced that the child
pornography offender is pedophilic (Lam et al., 2010), suggesting that child pornography
offenders with pedophilia might be socially disadvantaged compared to offenders without
pedophilia. Though this assumption is highly speculative at this point, it deserves to be
investigated in more detail in future studies. All therapists who stated their willingness to
treat patients with pedophilia were male (Stiels-Glenn, 2010). However, the results only refer
to self-reports and do not document actual decisions of therapists to treat (or reject) patients
with pedophilia.
Consequences of public stigma on a person with pedophilia
Pedophilia has been shown to be associated with higher rates of mood, anxiety and/or
substance abuse disorders compared to the general population (Raymond, Coleman,
Ohlerking, Christenson, & Miner, 1999; Schaefer et al., 2010). However, as the evidence for
links between pedophilia and mental illness is cross-sectional, it is not clear whether higher
rates of mental illness in pedophile samples should be interpreted as a psychopathology being
a precursor of the condition, or a consequence of stigma. Among the articles that satisfied our
search criteria, only three surveys investigated stigma experiences of people who self-identify
as being attracted to minors (Kramer, 2011, August 17; Wilson & Cox, 1983).
B4U-ACT, Inc. (2011, June 22) found that 46% of the respondents conveyed having
seriously considered suicide; 32% had plans to carry out suicide; and 13% have actually
attempted suicide for reasons related to their pedophile sexual interests. Of the participants
who reported suicide ideation, 67% responded that they were not able to talk about it to
another person. Forty percent stated that they had wanted mental health care for a reason
related to pedophilia, but did not obtain it. While a high number (82%) agreed that sometimes
other people with pedophilia may profit from mental health care, 88% disagreed that mental
health professionals had a good understanding of pedophilia, and 59% disagreed that they
would seek help from a mental health professional if they had a problem related to their
sexual preferences. Furthermore, about half of the participants doubted that a mental health
professional would treat them ethically (46%), with respect (54%) or non-judgmentally
(62%), or would keep confidentiality (51%). Forty-two percent of the sample reported having
received mental health care for reasons related to their pedophilia sexual interests. Among
this subgroup, therapy satisfaction was mixed (39% satisfied, 39% not satisfied).
In the second survey of the B4U-ACT group (2011, December 30), 58% of the
participants agreed that they had once wanted to see a mental health professional for a reason
related to their pedophile sexual interests (i.e., coping with the stigma), but failed to do so,
mostly for fear that the professional would react negatively, report them or misunderstand
their problems. Forty percent indicated that something they had heard or read a mental health
professional say had discouraged them from seeking professional help, the majority of
complaints relating to stigma. A number of 48% (37% uncertain) revealed that not receiving
mental health care resulted in negative consequences, e.g., depression, low self-esteem,
suicide attempts and isolation. More than half of those who received health care services
reported to have hoped to improve their self-concept (67%), deal with public stigma (60%)
and figure out ways to live in society as a person with pedophilia (57%). In the client’s
opinion, the professional less often attempted to address these issues (51%, 30% and 33%
respectively), while putting more emphasis on learning to control sexual urges (45%) and
reduce or extinguish pedophile attraction (43%). These goals were seen as important by only
a minority of patients (30% and 17% respectively). Especially clients in mandated treatments
reported to have been confronted with assumptions they considered inaccurate and
stereotyped (67% vs. 43% among clients voluntarily seeking treatment), such as believing the
client to have or have had sex with a child, or only seeking sexual gratification from children
rather than fulfilling romantic goals. Clients who reported to have been confronted with these
statements usually felt that they impeded successful therapy. The majority of the participants
agreed that the presented excerpts from a recent article on pedophilia (“Pessimism about
pedophilia,” 2010), the current DSM-IV-TR definition (APA, 2000), and an article in favor
of the DSM-Fifth Edition changes with respect to pedophilia (Blanchard, 2010) reflected
current trends in professional writing. However, many also felt that these texts were
inaccurate and promoted unethical treatment that did not befit a good clientprofessional
relationship. In contrast, an article on the subject written about a non-forensic sample of
persons with a sexual interest in children that will also be featured in this review (Wilson &
Cox, 1983) was considered accurate and encouraging an ethical and beneficial treatment of
clients with pedophilia.
In Wilson and Cox’s (1983) survey, participants were divided in their feelings
towards their pedophile preference: Some mentioned positive feelings (35% happy, proud,
positive, 6% reconciled), but many responses were clearly negative (27% disturbed, 17%
frustrated, 14% puzzled, 6% sad/hopeless/depressed, 5% guilty/ashamed and 4% bitter or
angry with society). The authors describe that “it was quite often the attitude of society that
was the cause of their disturbance or puzzlement rather than their paedophilia per se” (p. 28).
Summary: A majority of people with pedophilia appear to have very negative attitudes
towards their condition due to public stigma (Wilson & Cox, 1983). As the results of two
online surveys indicate (Kramer, 2011, August 17), many people with pedophilia would not
seek professional help for problems related to their sexual interests despite widespread belief
that mental health care could sometimes be beneficial. Whether perceived stigmatization
increases social isolation or other risk factors for committing offenses besides therapy
motivation remains unclear.
Based on an extensive literature review in medical and social science journals, we can
argue that stigma research has a blind spot on pedophilia. Although the studies we found
were too scarce, heterogeneous, and unsystematic to provide more than preliminary evidence,
they seem to coalesce around the notion that pedophilia is among the most stigmatized human
characteristics. In the following sections, we will discuss methodological problems of the
studies and empirical and theoretical requirements for future research.
Only about half of the articles or book chapters that could be identified in this review
made pedophilia their main focus (Kramer, 2011, August 17; McCartan, 2004, 2010; Stiels-
Glenn, 2010; Wilson & Cox, 1983). More importantly, only one of these used a well-
established stigma measure, i.e., the social distance scale (finding that discrimination of
people with pedophilia might compare to that of persons with antisocial personality disorder,
Feldman & Crandall, 2007). Generally, sample sizes were too small to draw conclusions
about lay theories of pedophilia or stigma against individuals with pedophilia in the general
public. Also, most samples were biased in favor of young and/or well-educated participants.
As stigma research suggests, more educated people tend to express less stigmatizing views
towards people suffering from mental illness (Angermeyer & Dietrich, 2006) and towards
sexual minorities (Lambert, Ventura, Hall, & Cluse-Tolar, 2006). Thus, a testing of the
general population is likely to find even more negative opinions and a more severe
discrimination of people with pedophilia. All studies but one (Stiels-Glenn, 2010) were
conducted by British or North American researchers, and their generalizability to cultures
that are not Western is unclear, as the acceptance of pedophilia and adult child sex differs
across cultures (Green, 2002). Hence, larger and more representative samples are needed to
put stigmatization of people with pedophilia on the map.
Moreover, no single study explicitly asked participants how they would perceive and
judge non-offending people with pedophilia or persons with pedophilia enrolled in preventive
treatment programs like the Dunkelfeld project (Beier et al., 2009). It is possible that when
people are questioned about their attitudes towards people with pedophilia, many will give
information on what they think and feel about child sex offenders, and none of the studies
made an effort to counteract this confusion of terms (e.g., by giving a clear definition of the
two distinct phenomena). It is uncertain if and how much the label paraphilia influences
people’s perception of individuals tainted with it when other personality traits of a “whole
person” (Hayward & Bright, 1997) are brought into play. Students react more favorably to
people whom they believe not to pose a danger to the community (Feldman & Crandall,
2007). Hence, offense related characteristics of the person with pedophilia, such as attitudes
towards adult-child sex, self-control and motivation for therapy, are likely to have an effect
on the public’s opinion. However, this can only be true if the community is well-informed
about the conceptual differences of pedophilia and child sex offences, and also willing to
differentiate between the two.
The effect of stigma on the psychological well-being of the person with pedophilia
has only been tested in three surveys, with one of them dating back as far as the early 1980s
(Kramer, 2011, August 17; Wilson & Cox, 1983). Their results strongly suggest that many
persons with pedophilia struggle with public stigma, and suffer from negative emotional and
behavioral problems as a result. Stigma research on people with pedophilia is likely to
produce highly different results depending on whether participants were sampled in
clinical/forensic settings, self-help or patient advocacy groups, or independently from
aforementioned clusters. All people with pedophilia who participated in the three surveys
were recruited via self-help networks/patient advocacy organizations. This strategy might
have resulted in a severe sampling bias, as it is possible that these groups disproportionately
attract members who are particularly frustrated with the publics’ or health professionals’
attitudes. Furthermore, self-reports might have been biased due to hidden political agendas
among participants recruited by said initiatives. This is not to say that recruiting people with
pedophilia in clinical or forensic settings would lead to more reliable or representative results.
In fact, people with psychiatric problems or a criminal history involving child sexual abuse
might have an even greater motivation to give biased accounts (Gannon, Keown, &
Polaschek, 2007).
More research is clearly warranted to determine whether there is a link between
public stigma and adverse health and behavioral outcomes in diverse samples of people with
pedophilia. Yet, a theoretical framework to derive hypotheses about the causes,
characteristics, and consequences of stigma against pedophiles is currently missing. Such a
framework would be indispensable to help researchers move forward in this under-researched
area. In order to fill this gap in the literature, we suggest using ideas and concepts from
stigma research on people with a mental illness (Corrigan & Watson, 2002) or sexual
minority orientation (Meyer, 2003) as sophisticated ‘templates’ that might prove to be useful
for the study of stigma against pedophiles as well. Despite differences relating to stereotype
content, people with either pedophilia, mental illness, or a gay, lesbian or bisexual orientation
appear to be faced with similar conflicts with society at large. All three groups are clearly
stigmatized, and (in the case of mental illness and pedophilia) may refrain from seeking
treatment to avoid being labeled. All have a hidden stigma that they may choose to reveal or
keep a secret from others. Hence, it is to be expected that they undergo similar psychological
processes in response to stigma, and are confronted with similar problems when they consider
disclosing their stigma. Based on these considerations, we are presently developing such a
theoretical framework (working title: Framework for the Effects of Stigma Against People
With Pedophilia), which we plan to test within a sample of people with pedophilia.
While we do in no way wish to downplay or legitimize the severe crime that is child
sexual abuse, we have reasonable grounds to believe that stigma against people with
pedophilia is doing a disservice to the prevention of this particular form of violence. Firstly,
public stigma is likely to discourage individuals who perceive themselves at risk of
committing sexual offenses from seeking help among health professionals or their friends and
family (Kramer, 2011, August 17; Seto, 2012), cutting them off from sources of social
control and support. Furthermore, a lack of positive identification models (Fog, 1992),
reduced self-esteem, or other problems resulting from or maintained by stigmatization (e.g.,
social phobia; Hoyer, Kunst, & Schmidt, 2001) could lead to less efficient attempts to deal
with deviant sexual impulses (Ward, Hudson, & Marshall, 1995). Therefore, stigmatization is
likely to not only contribute to higher risks of social, emotional and cognitive problems
among persons with pedophilia, but also to higher risks of abusive behavior.
Studies exploring the reaction of individuals with pedophilia to stigma would need to
devise a research strategy, in which participants not having yet been identified as people with
pedophilia by forensic or non-forensic clinical institutions can partake without risking
juridical investigations or other adverse effects. Nevertheless, as complicated as the study
designing may become, the personal dignity of every respondent is a core element of the rules
for Good Scientific Practice.
An important barrier for research on stigmatization of people with pedophilia is the
secretiveness of the phenomenon. However, the hidden nature of conceivable stigmas was not
an insurmountable barrier for research on stigma against homosexual, mentally ill or HIV-
infected people. This can be taken as a hint towards an obstacle that seems to lie in the expert
community itself. Beyond a few notable exceptions (e.g., Green, 2002; Seto, 2012), many
researchers appear to be hesitant to attribute victim status to individuals with pedophilia and
reluctant to approach their experiences from a stigma research perspective. At best, people
with pedophilia are considered potential offenders (Schaefer et al., 2010), or offenders who
have at one point in the past been victims of sexual abuse as well. This apparent lack of
openness towards the effects of ostracism on individuals with pedophilia may partially be
explained by biased sampling. People who have committed child sex crimes are arguably
harder to empathize with than people who deal with their pedophile needs in ways that are
not illegal or harmful to children. However, child sex offenders with pedophilia are virtually
the only source of information about people with pedophiles in general (Hall & Hall, 2007).
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controversial or unusual to construe "the pedophile" as a victim of stigmatization instead of a
priori labeling the person as an actual or potential offender, let alone as someone who does
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Table 1 Description of empirical studies referring to stigmatization of pedophiles
Samples and sampling strategy
Feldman & Crandall (2007)
Undergraduate Students (Psychology)
in the US
Discrimination: Social distance
Furnham & Haraldsen
18 39
Mostly (85.7%) Students in London,
Lay theories: Causes, cures
Covariates: Personality, gender, religiousness
B4U-ACT, Inc. (2011, June
Self-identified people with
pedophilia, online, 48 % in the US,
10% Germany, 8% Canada, 8% the
Netherlands and 7% UK, 98% male
Reaction to public stigma: Suicide ideation and suicide
attempts in relation to pedophilia, beliefs about and
experiences with health care professionals
B4U-ACT, Inc. (2011,
December 30).
Self-identified people with
pedophilia, 3% female, 1 %
Reaction to public stigma: Beliefs about and experiences
with health care professionals, opinions about professional
writings about people with pedophilia
Lam, Mitchell, & Seto
(2010) - 1st Study
N = 142 participants from an
introductory criminology course, N =
Factors predicting lay theories and public stigma: Child
pornography offender’s sexual interests, severity, sentence
98 on university campus, Toronto,
length, probability of same re-offense, probability of past
and future sexual contact
Lam, Mitchell, & Seto
(2010) - 2nd Study
Undergraduate psychology students
Factors predicting lay theories and public stigma: See 1st
McCartan (2004)
People in public places, e.g.,
restaurants, cafes, work places, in
Leicester and Belfast, UK
Stereotypes: Pedophile activities, treatment of pedophiles,
pedophilia in the media
McCartan (2010)
21 58
Criminology postgraduate students in
Leicester, UK
Stereotypes: Pedophile activities, pedophile personality
Stiels-Glenn (2010)
Psychotherapists in public health
insurance system in Essen, Germany
(56.6% of the targeted group)
Discrimination: Willingness to treat pedophiles
Covariates: Gender
Twohig & Furnham (1998)
17 35
Mostly (91%) Students in London,
Lay theories: Coping strategies for overcoming paraphilias
Covariates: Personality, attitudes to sex, siblings, gender,
Wilson & Cox (1983)
> 20
Self-identified people with
pedophilia, members of a self-help
group (representing estimably 50% of
the targeted group)
Reaction to public stigma: feelings towards sexual
* modal age range
... This is notably pernicious as MAPS encounter a high amount of emotional distress and suicidal ideation (Cohen, et al. 2019). Jahnke and Hoyer (2013), argue many MAPS fail to return to counselling if they have a negative experience, thus provoking undesirable consequences for example a CSO or attempted suicide. ...
... Participant 11 suggested the importance of disclosing Michaels attraction to protect Willingness is also associated with the ability to be non-judgemental and consider clients symptoms and feelings rather than their attraction. leading to the further deterioration of their mental-wellbeing (Cohen et al., 2018;Jahnke & Hoyer, 2013;Levenson & Grady, 2018;Morrissey, 2017). ...
Full-text available
Minor Attracted Persons (MAPS) are individuals who have a sexual interest towards minors but suppress this attraction; understanding the impact it would have on a child’s life. MAPS are a highly stigmatised and isolated population with many developing various mental health disorders including suicidal ideation. MAPS face significant challenges when attempting to pursue professional support for their mental health, such as judgmental attitudes and confidentiality breaches. MAPS are more likely to access counsellors for support, however, there is a lack of pre-existing research exploring UK counsellors opinions, understandings, and attitudes of the MAP population. Twelve counsellors completed a semi-structured skype interview, answering questions surrounding a vignette based on a hypothetical MAP. Eleven interviews were included in the final analysis. A critical realist thematic analysis was conducted. Four themes and four subthemes emerged, Theme 1, ‘An Understanding Response’ with he Subthemes 'Feeling Empathy and Sympathy' and 'Offering an Empathetic & Non-Judgemental Space, Theme 2, ‘Barriers to Counselling’, Theme 3, ‘Handling the Disclosure’ with the Subthemes 'Assessing Risk' and 'Maintaining Sensitivity' and Theme 4, '‘A Need for Training’. Themes encompassed participants feelings towards the client, their approach to counselling, participants willingness and knowledge of working with MAPS and barriers encountered by the participant and MAPS during counselling. Findings are discussed in relation to current research and strengths, limitations, and future recommendations were explored.
... that they are controllable and, therefore, the fault of the individual experiencing them (Pachankis et al. 2018). Such is the case for mental illness (Michaels et al. 2012) and associated behaviors, such as alcohol and drug dependence (Corrigan, Kuwabara, and O'Shaughnessy 2009;Schomerus et al. 2011), sexual deviance (Jahnke and Hoyer 2013), and self-injury (Staniland et al. 2021). ...
Despite significant impacts to mental health and support-seeking, non-suicidal self-injury (NSSI) stigma remains under-studied and poorly understood. Recently, the NSSI Stigma Framework was proposed, conceptualizing NSSI stigma as comprising six constructs (origin, concealability, course, peril, aesthetics, disruptiveness) that manifest across four perspectives (public, self, anticipated, enacted). The present study investigated the extent to which this framework can account for individuals’ NSSI stigma experiences using a directed content analysis. Written responses from 99 university undergraduates (Mage = 21.5, SD = 3.7; 83.8% female) generated 731 data units for analysis, of which 299 (40.9%) were coded. Results demonstrated support for the public and enacted perspectives, with participants describing stigma experiences within friendships, families, schools, and workplaces. Data pointed to both direct and indirect experiences of public stigma, suggesting a more nuanced understanding of this perspective is required. While there was sufficient support for a majority of elements, more work is needed to verify the applicability of the self and anticipated perspectives. Our findings contribute to a growing body of research investigating NSSI stigma, and provide preliminary support for the utility of the NSSI Stigma Framework in identifying multiple facets of NSSI stigma. Implications for intervention and future research are discussed.
... Onder het brede publiek, maar ook onder hulpverleners bestaan er nog al te vaak vooroordelen omtrent MAPs, omdat deze seksuele voorkeurstoornis vaak verward wordt met seksueel kindermisbruik. Ook de misvatting dat MAPs geen hulp zouden willen zoeken wanneer ze dat nodig hebben, draagt bij tot de stigma's over deze groep (Jahnke & Hoyer, 2013). Deze negatieve overtuigingen hebben niet alleen impact op het sociale en maatschappelijke leven en het psychosociale welzijn van MAPs, het heeft ook invloed op hun hulpzoekende gedrag (Levenson, Willis, & Vicencio, 2017). ...
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Pedofilie is een maatschappelijk gevoelig thema, waarover verschillende misvattingen en stigma’s circuleren. Ook binnen de klinische praktijk blijft het een taboeonderwerp. Veel te vaak wordt pedofilie gelijkgesteld met kindermisbruik. Onderzoek toont echter aan dat heel wat mensen seksuele interesses voor minderjarigen ervaren zonder tot seksueel kindermisbruik over te gaan. De negatieve opvattingen hebben niet alleen impact op het sociale leven en het psychosociaal welzijn van personen met een seksuele voorkeur voor minderjarigen ̶ in het Engels minor-attracted persons (MAPs) genoemd ̶ , het heeft ook invloed op het hulpzoekend gedrag van deze personen. De huidige studie beoogt meer inzicht te verwerven in het hulpzoekend gedrag van MAPs. Uit de resultaten blijkt dat slechts een minderheid hulp heeft gezocht. Vooral formele hulpbronnen of hulp door professionals lijken van belang in hun zoektocht naar hulp, maar de drempel ernaartoe blijft groot. Niet alleen duidelijkheid rond de toegang en de beschikbaarheid van formele hulpbronnen zijn noodzakelijk om de zoektocht naar gepaste hulp te faciliteren, ook de houding en attitude van hulpverleners ten aanzien van MAPs spelen een belangrijke rol. In deze bijdrage wordt besproken hoe bestaande initiatieven hier reeds op anticiperen, ook worden aanbevelingen geformuleerd over de wijze waarop het bestaande hulpaanbod beter kan aansluiten bij de noden van MAPs.
... This is of particular importance, because as a field there is an emerging trend of trying to communicate openly about the state of the science with regard to pedophilia in a bid to reduce stigmatization and encourage such individuals to actively seek support prior to committing sexual offences. In light of the existing literature on the stigmatization of people with pedophilic interests (Jahnke, 2018a;Jahnke & Hoyer, 2013;Jahnke, Schmidt et al., 2015), there is a risk that even this well-meaning scientific communication could translate into internalized stigma, with people with pedophilic sexual interests either taking on this 'doomed to deviance' script, or enhancing the feeling that professionals are likely to view them through the lens of their sexual interests first, and not address broader treatment needs (B4U-ACT, 2011). A subsequent risk in this process is that people with pedophilic sexual interests avoid experiencing this stigma and decline to access the mental health support that they may require. ...
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The stigmatization of people with pedophilic sexual interests is the topic of growing academic and professional consideration, owing to its potential role in moderating pedophiles' emotional wellbeing, and motivation and engagement in child abuse prevention schemes. Thus, improving attitudes and reducing stigmatization toward this group is of paramount importance. Prior research has suggested that narrative humanization-presenting personal stories of self-identified non-offending pedophiles-could be one route to doing this. However, this work has only been conducted with students or trainee psychotherapists, meaning the public generalizability of this method is still unknown. In this study, we compared two stigma interventions to test whether narratives reduce stigma toward people with pedophilic interests more effectively than an informative alternative (scientific information about pedophilia). Using a longitudinal experimental design with a lack of non-intervention control (initial N = 950; final N = 539), we found that narratives had consistently positive effects on all measured aspects of stigmatization (dangerousness, intentionality), whereas an informative alternative had mixed results, and actually increased perceptions of pedophiles' levels of deviance. These effects were also still present four months after the initial presentation. We discuss these data in relation to ongoing debates about treating pedophilia as a public health issue requiring a broad societal approach to wellbeing and child abuse prevention.
In order to treat individuals with pedophilia ¹ who are at risk of committing offenses, disclosure of the attraction must first take place. The aim of this study was to understand processes of initial recognition of pedophilic attraction, disclosure, and help-seeking. We conducted a qualitative content analysis of online posts from self-identified individuals with pedophilia, finding four categories: (1) Awareness and Initial Self-View (with emotions including denial, shame, and fear), (2) Disclosure (typically made to family, friends, or therapists, but also done online in an anonymous way), (3) People’s Reactions to Disclosure (ranging from rejection to support), and (4) Current Self-View (including minimization, distortions, despair, resignation, and non-offending/anti-contact commitment). Our findings highlight the internal process experienced by individuals with pedophilia when first recognizing their attraction to minors, what is involved in disclosure, the importance of others’ reactions after disclosure, and the factors that can reinforce a non-offending commitment. Clinical and social implications are discussed.
Child sexual abuse is a significant public health concern that has long-lasting consequences for victims and their families and poses a significant financial cost to the public. Prevention efforts, including sex offender treatment programs, are intended to prevent further instances of sexual abuse. Most sexual offenses, however, are committed by individuals who are not yet known as sexual offenders, and therefore traditional sex offender treatment programs fall short of this goal. It is crucial to provide services to people who may be at risk for committing a sexual offense and those who have not offended, including those individuals who are attracted to children. While primary prevention programs such as Prevention Project Dunkelfeld and Talking for Change have begun to address this issue internationally, there are significant barriers to providing preventive services of this nature to non-offending minor attracted persons (NOMAPs) in the United States. Barriers include concerns about mandated reporting laws, stigmatization, and lack of knowledge by therapists about MAPs. This paper explores these barriers and provides solutions for practitioners to offer services to this population. This paper includes the development of specific programming for non-offenders and specialized training for clinicians who work with non-offenders as used by The Global Prevention Project.
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People with paedophilia are a highly stigmatised group-even more so over recent years in which reports of child sexual abuse have risen, and sensationalist media coverage intensified. For people with paedophilia, whom many assume to also be sex offenders, the risk of exposure to prejudice-driven crime is high. In this article, I pose the question of whether people with paedophilia should be included in hate crime legislation across the world. I conclude that they should be included under the so-called vulnerability-and-deinvididualisation approach that I suggest in this paper. According to this approach, groups should be protected by hate crime legislation, if they are discriminated against significantly more often than groups who only experience prejudice-driven crimes on a rare basis (vulnerability). Furthermore, they should only be protected if the crime is targeted towards a whole group instead of a specific individual (deinvidualisation). However, via a subclause, this approach excludes certain groups who would fall under the two outlined premises but whose attributes harm the ideals of a pluralistic society that hate crime legislation seeks to foster. I conclude with broader implications on victim inclusion criteria. The boundaries of victim protection criteria 2
Objective: According to research participants, those who come out with their pedophilia are less likely to abuse children. Method: This study builds on qualitative research with 16 participants/members of a self-help group for people with pedophilic orientation. Results: Individuals who come out are better equipped mentally to cope with their pedophilia and coming out makes possible support from their social environment. Coming out is, however, extremely difficult, since it is associated with the label ‘child abuser’. Conclusion: An understanding approach to people with pedophilia who do not want to abuse children may help prevent child sexual abuse by allowing for more access to resources, treatment, and education.
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In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress— explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
There are doubts about the availability of outpatient treatment for sexual offenders, especially for paedophiles. In this survey, all psychotherapists working in the public health insurance system based in Essen (Germany) were asked, whether they were willing to treat sexual offenders. Although a high percentage of questionnaires were returned, the author found very little willingness to treat these patients. Half of those therapists who replied justified their refusal to some degree. The results challenge the professional community for ethical and practical consequences.
Social science research on stigma has grown dramatically over the past two decades, particularly in social psychology, where researchers have elucidated the ways in which people construct cognitive categories and link those categories to stereotyped beliefs. In the midst of this growth, the stigma concept has been criticized as being too vaguely defined and individually focused. In response to these criticisms, we define stigma as the co-occurrence of its components-labeling, stereotyping, separation, status loss, and discrimination-and further indicate that for stigmatization to occur, power must be exercised. The stigma concept we construct has implications for understanding several core issues in stigma research, ranging from the definition of the concept to the reasons stigma sometimes represents a very persistent predicament in the lives of persons affected by it. Finally, because there are so many stigmatized circumstances and because stigmatizing processes can affect multiple domains of people's lives, stigmatization probably has a dramatic bearing on the distribution of life chances in such areas as earnings, housing, criminal involvement, health, and life itself. It follows that social scientists who are interested in understanding the distribution of such life chances should also be interested in stigma.