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The Lived Experiences of Men Attracted to Minors and Their Therapy-Seeking Behaviors
Abstract
This study explored the lived experiences of men attracted to minors who believed they would
benefit from therapy but did not seek out or attend therapeutic services; and sought to gain an
understanding of how the decision to seek help or not impacted their well-being. Participants
included 7 men who were recruited through the B4U-ACT online forum, which provides peer
support for the minor attracted community. Participants were interviewed over Skype. Data from
these interviews was analyzed and coded according to the interpretative phenomenological
method as outlined by Smith et al. (2012). Five main themes emerged, providing insight as to
why more therapeutic support is not sought. These themes include: emotional distress,
consideration of therapy, actual and perceived stigmatization, expectations of therapist
assumptions, expectations of professionalism, and therapeutic support.
The findings were compared with existing literature to propose ways mental health professionals
can provide easier access to resources and reach the population, which can lead to societal
benefits. Improved access to treatment has the potential to provide the population opportunities
to better cope with stigma, manage their impulses more effectively, lower their feelings of
isolation, and increase their overall well-being. This study helps to fill the current void in the
area of research on help-seeking behaviors and the associated challenges that men attracted to
minors may face.
... Recent years have witnessed a rise in treatment options for this particular group in community settings, often with the primary goal of preventing sexual offending (Beier et al., 2009(Beier et al., , 2021. Although our understanding of the needs and treatment experiences for this population is limited, there is a growing body of research exploring various aspects of sexual attraction to children and treatment from their own perspective (Cacciatori, 2017;Lievesley et al., 2023). A better understanding of their treatment needs, experiences, and barriers is essential for providing effective and tailored interventions. ...
... Although pedohebephilic interest is a risk factor for child sexual abuse (Dombert et al., 2016), it does not mean that pedohebephiles are doomed to commit child sex offences. In fact, there are large communities of people with a sexual interest in children that are aware of their interests and take steps to avoid acting on them (Cacciatori, 2017). ...
... Of the 12 that reported on interest, the majority (n = 7) demonstrated moderate (35-70%) to high (over 70%) incidence while only three reported relatively low (under 35%) levels of interest. The highest scores estimate is unreliable due to the small sample size (Cacciatori, 2017;n = 7). A desire to change their sexuality was considered as interest in treatment due to its perception by participants as being a potential goal of treatment. ...
People with a sexual interest in children face significant barriers to seeking and receiving mental health treatment. This review aims to bridge the gap between the treatment needs and experiences of pedohebephiles, and the services aiming to support them. Reviewers screened 1705 database hits and extracted findings from 22 qualitative, 15 quantitative, and 3 mixed-method studies on the treatment needs and experiences of pedohebephiles. Research suggests that this population experiences significant levels of distress, depression, and anxiety related to their sexual interest. Many individuals belonging to this population would seek (median = 42.3%), or have sought (median = 46.5%), treatment to cope with their sexual interest or with potential related mental health repercussions. Their experiences in treatment have been mixed, with some reporting positive experiences with empathic therapists and others reporting rejection. Most frequently, pedohebephiles report fear of exposure and rejection as barriers to seeking treatment, in addition to fear of the legal repercussions. The current study is the first to summarize and discuss previous findings on the treatment needs and experiences of pedohebephiles. The findings indicate that the treatment needs of pedohebephiles often remain unaddressed. Suggestions to increase the fit between treatment services and the needs of pedohebephiles are put forward.
... Qualitative studies also found that experiences with SIB were common among people attracted to children, even when researchers were not explicitly studying suicidality (Cacciatori, 2017;Shields et al., 2020;Stevens & Wood, 2019;Walker, 2017). Shields (2020) found that, for most participants, the discovery of attraction to their children was accompanied by significant distress; for some participants, this distress led to SIB. ...
... Stevens and Wood (2019) found that references to self-hatred, self-harm, and suicide were the largest theme related to mental health, representing 30% of responses. Cacciatori (2017) and Walker (2017) found that, for some participants, significant suicidal distress was a driving factor in finally seeking help for mental health problems. ...
... Research shows that people attracted to children face intense stigma, even when they have not committed sexual crimes involving children (Imhoff, 2014). The stigma associated with navigating an attraction to children can lead to stressors such as internalization of negative stereotypes (i.e., internalized stigma/self-stigma) and anticipation of rejection (B4U- ACT, 2011aACT, , 2011bCacciatori, 2017;Cash, 2016;Shields et al., 2020;Walker, 2017). This stigmarelated stress increases the risk of negative mental health and interpersonal outcomes among people attracted to children (Cantor & McPhail, 2016). ...
Suicide represents a significant public health problem, with around 800,000 deaths per year worldwide and up to 20 times as many episodes of self-harm and suicide attempts. Members of stigmatized groups may experience increased risk of suicide due in part to stigma-related factors, such as expectations of rejection, internalization of negative stereotypes, or potential for greater social isolation. Research suggests that adults who are attracted to children face extreme stigma, even those who do not commit sexual crimes involving children. Adults who are attracted to children also experience significantly increased risk for suicidal ideation and behavior (SIB) compared to general population samples. The current study sought to explore experiences with SIB among adults attracted to children to better understand factors underlying suicidality in this population. The lead author conducted semi-structured interviews in a community sample of 15 adults attracted to children who self-reported some form of SIB in their lifetime. Using interpretative phenomenological analysis, the lead author explored and interpreted interview data to generate themes driven by respondents’ characterizations of their SIB. Superordinate themes related to suicidality in this sample included low self-esteem or self-worth, cumulative impacts of the attraction and other stressors, and concerns about the ability to have a positive future due to the attraction. Findings underscore the importance of addressing internalized stigma, treating problems like depression and social isolation, and instilling hope for the future to promote mental health and prevent SIB among adults attracted to children.
... For example, individuals may exhibit low treatment motivation for a variety of reasons yet engage in help-seeking behavior due to encouragement or ultimatums from loved ones, employers, or the legal system (see Drieschner et al., 2004). The 1 Of note, many people who are sexually attracted to children choose not to seek treatment because they felt they are able to manage their sexual interest and do not express concern about their ability to refrain from childhood sexual abuse perpetration (e.g., Bailey et al., 2016a;Cacciatori, 2017;Goode, 2010;Grady et al., 2018;Houtepen et al., 2016;Levenson & Grady, 2019;Levenson et al., 2017). present study aims to provide a more nuanced examination of the correlates of treatment motivation among individuals who are sexually attracted to children. ...
... Visions of Alice (https://alicelovers.net), GirlChat (https://www.annabelleigh.net), and BoyChat (https://www.boychat.org). Previous research studies on individuals who are sexually attracted to children in the community have been successful utilizing this recruitment strategy (e.g., Bailey et al., 2016aBailey et al., , 2016bCacciatori, 2017;Lievesley et al., 2020). ...
There is a need for community treatment programs for people who are sexually attracted to children, but individuals report difficulty accessing services. Individuals who are sexually attracted to children (n = 293) completed an online anonymous survey that revealed a significant positive association between maladaptive coping and two factors of the treatment motivation measures. The association between maladaptive coping and treatment motivation was attenuated at higher levels of ego dystonic distress/aversion. Results highlight the importance of targeting stigma toward those who are sexually attracted to children to increase treatment seeking behavior.
... Notably, anticipated discrimination was a pervasive concern, with many participants fearing rejection from others and avoidance by therapists. This aligns with existing literature, which indicates that individuals with stigmatized identities often avoid help-seeking behaviors due to the anticipated negative reactions they might encounter (Cacciatori, 2017;Levenson & Grady, 2018;Link & Phelan, 2001). Inferential statistics revealed significantly higher levels of depression, anxiety, and stress in this sample compared to the general population. ...
Individuals with a sexual preference for minors are subject to significant stigma in society, even in the absence of any criminal behavior, which can profoundly affect their psychological well-being. This stigma can contribute to the development of internalizing psychopathology (e.g., anxiety, depression, and stress), which is also recognized as dynamic risk factor for child sexual abuse. This cross-sectional questionnaire study (N = 92) aimed to examine the psychological distress experienced by this population. Specifically, we: (1) investigated the occurrence of internalizing complaints among individuals with a sexual preference for minors; (2) examined associations between cognitive processes (e.g., rumination, emotional attentional control), self-stigma, and internalizing psychopathology; and (3) explored the mediating role of rumination, specifically brooding, in linking self-stigma and internalizing psychopathology. The results indicate that individuals with a sexual preference for minors experience significantly higher levels of anxiety, depression, and stress compared to the general population. Furthermore, several hypothesized associations were confirmed, including associations between self-stigma, poor emotional attentional control, brooding and internalizing psychopathology. Mediation analyses further revealed that brooding mediates the effect of self-stigma on internalizing complaints, albeit with small effect sizes. Follow-up longitudinal studies are necessary to validate these findings and explore their implications. Ultimately, these insights aim to inform targeted interventions and support strategies for this population, which could help to prevent child sexual abuse.
... While the prevention of child sexual abuse is undoubtedly a legitimate goal, the risk-management approach has been criticized for perpetuating social and self-stigma around minor attraction, which implies that individuals attracted to children are inevitably destined to offend unless preventive measures are taken (Jahnke, 2018;Lievesley & Harper, 2021). Some clients may perceive such efforts as incongruent with their needs and expectations, leading them to avoid seeking support to distance themselves from suspicions of being treated as potential offenders 1 (Cacciatori, 2017;Grady et al., 2019;Lievesley & Harper, 2021). ...
The provision of effective mental health services to individuals attracted to children is rapidly expanding. However, these services have not yet been integrated into general mental healthcare systems and are mainly offered by organizations that predominantly provide services to child sexual abuse perpetrators. Little is known about the perspective, treatment goals, and approaches employed by prevention-specialist mental health professionals when working with clients attracted to children. To address this gap, we used purposive sampling to recruit 10 practitioners who had experience of working in prevention settings with clients attracted to children. After conducting semi-structured interviews and analyzing data through interpretative phenomenological analysis, we identified three main themes and four subthemes within the data. While most participants believed that attraction to minors is unmodifiable or doubted the possibility of modifiability, this belief did not necessarily manifest in their practice. Participants stressed the importance of finding safe alternatives for clients and highlighted the significance of accessing evidence-based information on alternative sexual outlets, such as sex dolls. One overarching theme that emerged across all themes and within participants' accounts was the concern of escalation, indicating a fear that pedophilic fantasies or alternative sexual outlets such as sex dolls could potentially lead to sexual offenses. The findings shed light on the approach of prevention-specialist mental health professionals in working with clients attracted to children and may be used to inform future intervention plans to facilitate service provision to this population.
... Almost 20% of respondents noted that this information suggested that services would report paedophilic clients to law enforcement, employers, family, or their community (B4U-Act, 2011). Samples of non-offending paedophilic men have reported distrust of professionals due to feared prejudicial behaviour and concerns about being reported to authorities as primary factors preventing them from accessing treatment (Cacciatori, 2017;Dymond & Duff, 2020). ...
Child sexual abuse (CSA) is pervasive internationally, and has significant impacts on victim-survivors into adulthood. The most appropriate way to address this problem is prevention and early intervention of perpetration. Stigma experienced by people with paedophilia (PWP) is associated with refusal to seek and engage in therapeutic care, and nonadherence to treatment plans. Fear of rejection or unfair practice by healthcare professionals is a specific barrier. This scoping review aims to examine stigmatisation of individuals with a sexual interest in children or adolescents (paedophilia), and how stigma may impact (a) the help-seeking behaviour and disclosure, and (b) treatment professionals' willingness to treat this population. The influence of stigma on therapeutic outcomes and effectiveness was further explored to illuminate barriers and facilitators to treatment for PWP. In line with the Systematic Reviews and Meta-Analysis for Scoping Review (PRISMA-ScR) guidelines, relevant databases were searched (e.g., PsycInfo, EbscoHost) and screened independently. Eligible studies were focused on the impact of stigma on help-seeking and disclosure, published between 2000 and 2022, and English-language. Themes reflect experiences of internalised stigma, public and familial stigmatisation, professional stigma, and how these function as barriers to accessing help or disclosing one's sexual attraction to informal (e.g., close friends, family) and formal (e.g., mental health professionals, GPs, religious leaders) supports. As demonstrated by the papers reviewed, there is a clear and timely need for increased intervention and treatment. Specialist training for treatment professionals is needed to improve service accessibility and competences in treating clients who disclose this attraction. http://mc.manuscriptcentral.com/sajrt Sexual Abuse F o r P e e r R e v i e w Abstract Child sexual abuse (CSA) is pervasive internationally, and has significant impacts on victim-survivors
... To our knowledge the work presented in this paper is the first formal examination of the lived experiences of women with sexual attractions to children. Previous work has either only included men as participants (Cacciatori, 2017;Dymond & Duff, 2020;Freimond, 2013;Houtepen et al., 2016), has involved larger quantitative analyses of surveys wherein women make up only a minority of each sample (Cohen et al., 2018;Elchuk et al., 2021;Lievesley et al., 2020;McPhail & Stephens, 2020), or has only studied descriptive sexological features of sexual attractions to children among female MAPs Tozdan et al., 2020). This lack of focus on minor attraction across the gender spectrum seemingly risks alienating women within the MAP community, while simultaneously limiting our understanding of this population at a broader level (Goode, 2010). ...
The current body of the literature studying minor-attracted persons (MAPs) predominantly focuses on the experiences of men who experience sexual attractions to children. To shed more light on the experiences of women within this population, we conducted anonymous semi-structured interviews with six self-identified female MAPs, who were recruited through online support forums for individuals with sexual attractions to children. Interpretative phenomenological analysis (IPA) was used to analyze the interview transcripts. Two superordinate themes were identified from the dataset that highlighted the uniqueness of the experience of being a woman within the MAP community (“A minority within a minority”) and themes of social isolation and the effects of this on identity (“A lonely secret existence”). The findings reported here highlight how the experiences of female MAPs both converge with and diverge from their male counterparts in important ways. We discuss the implications of these experiences in relation to more effective service provision for women who are sexually attracted to children.
... MAPs. Previous work has either only included men as participants (Cacciatori, 2017;Dymond & Duff, 2020;Freimond, 2013;Houtepen et al., 2016), or has involved larger quantitative analyses of surveys wherein females make up only a minority of each sample (Cohen et al., 2018;Elchuk et al., 2021;Lievesley et al., 2020;McPhail & Stephens, 2020). This lack of focus on minor attraction across the gender spectrum seemingly risks alienating females within the MAP community, while simultaneously limiting our understanding of this population at a broader level (Goode, 2010). ...
The current body of literature studying minor-attracted persons (MAPs) predominantly focuses on the experiences of men who experience sexual attractions to children. To shed more light on the experiences of women within this population, we conducted anonymous semi-structured interviews with six self-identified female MAPs, who were recruited through online support forums for individuals with sexual attractions to children. Interpretative phenomenological analysis (IPA) was used to analyze the interview transcripts. Two superordinate themes were elicited from the dataset that identified themes of social isolation and the effects of this on identity (“A lonely secret existence”) and the uniqueness of the experience of being a woman within the MAP community (“A minority within a minority”). The findings reported here highlight how the experiences of female MAPs both converge with and diverge from their male counterparts in important ways. We discuss the implications of these experiences in relation to more effective service provision for female MAPs.
There has been an increase in research using online forums for individuals who are attracted to children. This research is beneficial because it allows the study of individuals attracted to children recruited from the community, in contrast to individuals recruited from clinical or forensic samples. The aim of the present review was to explore who researchers are recruiting from online forums and how they are recruiting these participants. We conducted a systematic review of 71 studies with participants recruited from online forums for people attracted to children. We considered sample homogeneity, evidence of data and sample overlap, and the use of community-based research principles that aid in participant recruitment and retention. The majority of participants were White men, between the ages of 18 and 35, living in North America or Europe. Forty percent of publications had some data overlap. Virtuous Pedophiles and B4U-ACT were the two most common forums for recruitment. Just over onethird of publications mentioned community-based research principles. Our results suggest a high degree of homogeneity across online samples of individuals attracted to children, with most participants being recruited from two forums. Results from publications recruiting narrowly are less generalizable and may give an inaccurate impression of replication. Conducting research with participants recruited from the community is important, but researchers should diversify recruitment methods, ask about previous study participation, and employ community-based research principles to increase participation.
Spectacular cases of child sexual abuse (CSA) dominate media coverage again and again, shaping our knowledge about a topic that is as sensitive as it is taboo. To date, a scholarly overview of the current state of media coverage of SBC has been lacking. This book attempts to shed light on the connections between SBCs and the media in a variety of ways, incorporating different studies and perspectives from practitioners. It thus provides a comprehensive overview of relevant issues raised in the context of CSA and the media.
The purpose of this entry is twofold. First, it provides a brief examination of the theoretical parameters of Goffman's 1963 Stigma: Notes on the Management of Spoiled Identities. Second, it analyzes the extent to which Goffman's original formulation of stigma is still applicable given the changing social values and ethnic demographic composition of North American society.
Non-offending pedophiles are a unique population of individuals who experience sexual interest in children, but despite common misperceptions, have neither had sexual contact with a child nor have accessed illegal child sexual exploitation material. An emerging body of research has examined the prevalence of pedophilic interests, characteristics of non-offending pedophiles, correlates of pedophilic interests, and stigma associated with pedophilia. Treatment programs are beginning to produce findings regarding the effectiveness of treatment in supporting non-offending pedophiles to remain offence-free. The current review spans these areas of research and discusses potential treatment options for working with non-offending pedophiles based on that research base.
Sexuality-based stigma is associated with increased rates of depression for urban sexual minority persons. However, this relationship has not been explored specifically for rural sexual minority populations. This study examined the association between self-reported external and internal sexuality-based stigma and depression among an online sample of 771 rural sexual minority persons. Two regression outcomes were modeled, representing continuous depression score and clinically significant depression. Anticipated, enacted, and internalized sexuality-based stigma were all significantly associated with increased depression scores and clinically significant depression. Interventions sensitive to the unique stigmas experienced by sexual minority populations in rural areas are needed.
Using selected, contemporaneous illustrations from the reflective journal of a doctoral student undertaking data analysis for the first time, this article examines the relationship between journaling as a learning process when undertaking computer-assisted qualitative data analysis and establishing quality and validity in interpretative phenomenological analysis. The writing of the journal is shown both to enact some potential validity criteria (e.g. in producing an audit trail) whilst also recording and reflectively prompting the process of learning, interpretation and bracketing, thus evidencing transparency. By using a journal inside the software package and alongside the stages of the interpret-ative phenomenological analysis, analysis within the software package, it is argued that quality and validity become dynamic, not static constructs. These constructs are intimately linked to the researcher-learning-process and permit a critical stance to be taken.
This thesis provides a broad and diverse investigation into the field of psychological treatment for child molesters. A range of methods including a systematic review, a single case study and a primary phenomenological investigation were used to explore issues in the field. Following an introduction in Chapter 1, Chapter 2 reviews the effectiveness of psychological treatment for reducing recidivism in child molesters. The results indicate that recidivism among treated and untreated child molesters is yet to consistently and clearly differ and that the treatment outcome literature is obstructed by weak studies using suboptimal scientific designs. In Chapter 3 the aetiology of a child molester’s offending is formulated using the Pathways Model of child abuse (Ward & Siegert, 2002). Treatment sessions addressing areas of criminogenic need are outlined and the impact of the sessions is determined using systems of clinical change on psychometric measures. The results indicate improvements in some of the targeted areas however these were not sufficient to indicate clinically significant changes on both systems used. Chapter 4 explores the lived experience of a sexual preference for children in a sample of five child molesters using the principles of Interpretive Phenomenological Analysis. Four themes were identified. (1) It Creates a Battle for Me, (2) I’m Always Going to Have These Thoughts, (3) There’s No Help Out There and (4) My Interest in Children is More Than Just Sexual. The results have implications for clinical practice and are discussed in the context of directions for further research. Chapter 5 evaluates the Sex with Children scale (Marshall, 1995) which was used as an assessment measure in Chapter 3. Finally, Chapter 6 provides a discussion and close to the thesis drawing together the implications of the research.
Please note that chapter 3, which details a real but anonymised case study is available only in the printed version.