Article

Sexual Interest in Children Among Women in Two Nonclinical and Nonrepresentative Online Samples

Abstract

Introduction Regarding women, little research is available about the prevalence of sexual interest in children (SIC), especially in nonclinical samples. Aim The present study aimed to investigate the extent to which adult women from 2 nonclinical and nonrepresentative samples indicate sexual interest in prepubescent and/or pubescent children. Methods Participants took part in an online survey either via general websites or via websites directed toward individuals with a SIC. Main Outcome Measures The self-report survey included questions about the use of online abuse material including children and teenagers as well as about sexual fantasies involving prepubescent and pubescent children. Both measures were included as main outcome measures. Results Results showed that few women reported having used online abuse material including children (total sample: n = 7 [0.8%], general websites: n = 3 [0.4%], SIC websites: n = 4 [9.5%]) or teenagers (total sample: n = 44 [5.0%], general websites: n = 37 [4.4%], SIC websites: n = 7 [16.7%]). Results further revealed that some women reported sexual fantasies involving prepubescent (total sample: n = 98 [7.0%], general websites: n = 92 [6.8%], SIC websites: n = 6 [11.1%]) or pubescent children (total sample: n = 136 [9.6%], general websites: n = 129 [9.5%], SIC websites: n = 7 [13.0%]). Conclusions The samples included are nonrepresentative and therefore not generalizable to the female population. Nevertheless, they strongly suggest that SIC is a phenomenon also found in women. We therefore recommend professionals in the field of sexual medicine to increase their attention and engagement for women with SIC. Based on the present results, the development of preventive treatment services specifically tailored to women with a SIC has to be strongly encouraged in the near future. Tozdan S, Dekker A, Neutze J, et al. Sexual Interest in Children Among Women in Two Nonclinical and Nonrepresentative Online Samples. Sex Med 2020; XX:XXX–XXX.
ORIGINAL RESEARCH & REVIEWS
Sexual Interest in Children Among Women in Two Nonclinical and
Nonrepresentative Online Samples
Saye Tozdan, PhD,
1
Arne Dekker, Dr Phil,
1
Janina Neutze, PhD,
2,3
Pekka Santtila, PhD,
4
and Peer Briken, MD
1
ABSTRACT
Introduction: Regarding women, little research is available about the prevalence of sexual interest in children
(SIC), especially in nonclinical samples.
Aim: The present study aimed to investigate the extent to which adult women from 2 nonclinical and
nonrepresentative samples indicate sexual interest in prepubescent and/or pubescent children.
Methods: Participants took part in an online survey either via general websites or via websites directed toward
individuals with a SIC.
Main Outcome Measures: The self-report survey included questions about the use of online abuse material
including children and teenagers as well as about sexual fantasies involving prepubescent and pubescent children.
Both measures were included as main outcome measures.
Results: Results showed that few women reported having used online abuse material including children (total
sample: n ¼7 [0.8%], general websites: n ¼3 [0.4%], SIC websites: n ¼4 [9.5%]) or teenagers (total sample:
n¼44 [5.0%], general websites: n ¼37 [4.4%], SIC websites: n ¼7 [16.7%]). Results further revealed that
some women reported sexual fantasies involving prepubescent (total sample: n ¼98 [7.0%], general websites:
n¼92 [6.8%], SIC websites: n ¼6 [11.1%]) or pubescent children (total sample: n ¼136 [9.6%], general
websites: n ¼129 [9.5%], SIC websites: n ¼7 [13.0%]).
Conclusions: The samples included are nonrepresentative and therefore not generalizable to the female pop-
ulation. Nevertheless, they strongly suggest that SIC is a phenomenon also found in women. We therefore
recommend professionals in the eld of sexual medicine to increase their attention and engagement for women
with SIC. Based on the present results, the development of preventive treatment services specically tailored to
women with a SIC has to be strongly encouraged in the near future. Tozdan S, Dekker A, Neutze J, et al.
Sexual Interest in Children Among Women in Two Nonclinical and Nonrepresentative Online Samples.
Sex Med 2020; XX:XXXeXXX.
Copyright 2020, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Key Words: Female Pedophilia; Female Hebephilia; Online Abuse Material; Sexual Fantasies Involving
Children
INTRODUCTION
Sexual Interest in Children
In the Diagnostic and Statistical Manual of Mental Disor-
ders,
1
pedophilic disorder is described as recurrent, intense
sexually arousing fantasies, sexual urges, or behaviors involving
sexual activity with a prepubescent child or children. This means
that the diagnosis is intended for individuals who are sexually
attracted to children generally aged 11 years or younger. In
contrast, sexual interest in pubescent children (ie, aged 11e14) is
called hebephilia.
2
Currently, hebephilia is not included in
diagnostic classication systems. In the present study, the term
sexual interest in childrenincludes both pedophilic and
Received November 8, 2019. Accepted January 27, 2020.
1
Institute for Sex Research and Forensic Psychiatry, University Medical
Center Hamburg-Eppendorf, Hamburg, Germany;
2
Department of Forensic Psychiatry and Psychotherapy, School of Medicine
University of Regensburg, District Hospital Regensburg, Regensburg,
Germany;
3
Forensic Psychiatry, Ansbach District Hospital, Ansbach, Germany;
4
Psychology, New York University Shanghai, Shanghai, China
Copyright ª2020, The Authors. Published by Elsevier Inc. on behalf of
the International Society for Sexual Medicine. This is an open access
article under the CC BY-NC-ND license (http://creativecommons.org/
licenses/by-nc-nd/4.0/).
https://doi.org/10.1016/j.esxm.2020.01.007
Sex Med 2020;-:1e14 1
hebephilic sexual interest but does not necessarily imply that
diagnostic criteria are met.
Most empirical research on sexual interest in children has been
conducted with men who have sexually offended against children
and detected, and, consequently, incarcerated. Only few studies have
investigated the prevalence of sexual interest in children in the general
population. Also, most of these studies have only included men.
3e6
Focusing only on men is probably based on the widely accepted
notion of sexual interest in children being an exclusively male phe-
nomenon. However, the fact that research has hardly included
women compared to men may reinforce this view in the absence of
actual empirical data on the lack of female sexual interest in children.
Recently, studies have examined the extent to which women in
general population report any sexual interest in children.
7,8
The
present study adds to this new line of research by providing empirical
data from an online survey assessing the prevalence of sexual interest
in children among adult women in nonclinical online samples.
Sexual Interest in Children vs Child Sexual Abuse
As mentioned previously, most of what is known about sexual
interest in children among adults is based on studies with child
sexual abusers detected by the criminal justice system.
9
These
samples consist mostly of men.
10
Such forensic samples are not
necessarily representative for the population of adults who have
sexual interest in children, and they are not helpful in assessing the
prevalence of the phenomenon. In fact, research has consistently
demonstrated that men who sexually abuse children are not
necessarily sexually attracted to children meaning they would have a
pedophilic or hebephilic sexual preference (for a review, refer to the
article by Seto
11
). Child sexual abusers sometimes have a preference
for adult sex partners but choose to act on their sexual desires by
abusing children because they are available and vulnerable(p.
221).
12
Because of these problems, recent research on pedophilia
and hebephilia has focused on samples of individuals with a self-
identied sexual interest in children.
13e18
From this research, it is
now evident thatthere are individuals who are sexually interested in
children but report abstaining from acting upon their sexual in-
terests by committing sexual offenses against children. For such
individuals, a rare example of a treatment program designed to help
the participants cope with a sexual interest in children is the German
Dunkelfeld Project (www.dont-offend.org). The primary goal of
the project is to hinder potential future sexual offences.
13
In sum, even though sexual interest in children contributes to
child sexual abuse
19
and has been proven to be the most important
risk factor for sexual offence recidivism,
20
sexually offending against
children cannot be regarded as a reliable indicator of pedophilic or
hebephilic sexual interest.
21
Individuals with sexual interest in
children were shown to be a stigmatized group who risk being the
target of intense discrimination.
22
Thus, we clearly separated be-
tween child sexual abuse and sexual interest in children as the former
is a criminal act while the latter is not. We consciously decided to not
go into further detail on the topic of child sexual abuse.
Prevalence of Sexual Interest on Children in the
General Population
Research has so far arrived at differing estimates of the preva-
lence of sexual interest in children among men. The prevalence
estimates may differ as a function of the type of question partici-
pants are asked. For example, Wurtele et al
8
found differences
between responses to questions referring to sexual fantasies,
masturbation, and sexual attraction involving children, the likeli-
hood of having sex with a child if participants were guaranteed they
would not be caught or punished as well as the likelihood of using
online abuse material.
8
Among their online sample, men reported
prevalence rates ranging from a low of 3.5% to a high of 9.2%.
1
Another reason for differing prevalence estimates may be that
studies vary regarding the age at which a person is dened as a
child. Wurtele et al
8
did not report their survey including a clear
denition of what is meant by the term child. Participants may
differ in their interpretation of undened terms that probably
affect prevalence estimates. As a result, the authors were not able
to report separate prevalence rates for pedophilic and hebephilic
interest. Owing to recent research on the differences between
pedophilia and hebephilia,
2
this might be considered relevant.
Within an online-sample of 8,718 German men, Dombert et al
4
specied children as persons aged 12 or younger and found that
358 (4.1%) men reported sexual fantasies including prepubes-
cent children, whereas only 0.1% specied that they had a
pedophilic sexual preference.
4
Santtila et al
5
provided a
population-based estimate of the incidence of sexual interest in
children among adult men by investigating 1,310 Finnish male
twins. Sexual interest in children aged 12 or younger was re-
ported by 0.2% (n¼3) participants. Children aged 15 or
younger were sexually interesting to 3.3% (n¼43).
5
As preva-
lence estimates depend on sample composition as well, other
nonrepresentative studies, in contrast, suggest a prevalence of up
to 5% for pedophilia in the general population (for a review, see
the article by Seto
11
). In sum, research results on the prevalence
of sexual interest in children among adult men from nonclinical
samples range from 0.1 to 5%.
4,11,23e25
Regarding women, little research is available about the prev-
alence of sexual interest in children. Early studies asking women
about their sexual interest in children revealed prevalence rates
ranging from 1 to 4%.
3,26,27
Recent research also demonstrates
variety. Baur et al
7
investigated 3,898 Finish women (twins aged
18e33 years) including questions about sexual interests,
masturbation fantasies, and sexual partners across 2 specic age
groups (0e6, 7e12 years). Results showed that only 17 females
(0.4%) reported pedophilic sexual interest. Wurtele et al
8
investigated 262 females of whom 0.8% reported some likeli-
hood of masturbation and sexual attraction regarding children,
1.5% reported some likelihood of having sex with a child if they
were guaranteed they would not be caught or punished, and
3.4% stated some likelihood of viewing child pornography on
the Internet. Overall, 4.2% of 262 women responded positively
to at least one of the sexual interest in children items.
8
In other
Sex Med 2020;-:1e14
2Tozdan et al
online surveys, between 3.4% and 5.5% of female respondents
admitted the use of online abuse material including persons
under the age of 18 years.
28,29
Most of the studies on women cited previously aimed at
assessing sexual interest in children aged 12 years or younger,
which implies a pedophilic interest (ie, sexual interest in children
up to 11 years), or did not provide a clear denition of what is
meant by the term child.
The Present Study
The present study aimed to investigate the extent to which
adult women from 2 nonclinical and nonrepresentative samples
indicate sexual interest in prepubescent and/or pubescent chil-
dren. We analyzed data from an online self-report survey con-
ducted in Germany, Finland, and Sweden that aimed to
investigate social and sexual online behaviors among adults.
30,31
The survey included questions about the use of online abuse
material including children or adolescents as well as about sexual
fantasies involving prepubescent and pubescent children.
METHOD
Participants
A total of 1,808 adult women completed the online survey, of
which 50.7% were located in Germany, 45.5% in Finland, and
3.9% in Sweden. A total of 874 women (48.3%) provided in-
formation on the use or nonuse of online abuse material
including children or adolescents. Assessment of sexual fantasies
involving prepubescent and/or pubescent children were made by
1,411 women (78.0%). The overlapping subsample includes 871
women (48.2%) who answered questions on both online abuse
Table 1. Sample characteristics and use of online abuse material including children or adolescents among female participants who provided
information on the use of online abuse material (n ¼874) including results of comparisons between participants recruited among general
websites (general website) and those who were recruited on websites directed to individuals with sexual interest in children (SIC website)
using t-test for interval scaled variables and chi-square test or Fishers exact test for nominal and binary variables
Variables
Total (n ¼874, 100%)
General website
(n ¼832, 95.2%)
SIC website
(n ¼42, 4.8%)
Sig.M (SD) Range M (SD) Range M (SD) Range
Age (in years)*26.6 (7.6) 18e67 26.6 (7.6) 18e67 26.1 (7.0) 18e45 n.s.
Relationship status N (%) N (%) N (%) Sig.
In a relationship 541 (61.9) 515 (61.9) 26 (61.9) n.s.
Currently single 333 (38.1) 317 (38.1) 16 (38.1)
Sexual orientation N (%) N (%) N (%) Sig.
Heterosexual 631 (72.2) 606 (72.8) 25 (59.5) n.s.
Homosexual 48 (5.5) 43 (5.2) 5 (11.9)
Bisexual 193 (22.1) 181 (21.8) 12 (28.6)
Not specied
§
2 (0.2) 2 (0.2) e
Use of online abuse
material including children
N (%) N (%) N (%) Sig.
No 867 (99.2) 829 (99.6) 38 (90.5) ***
Yes 7 (0.8) 3 (0.4) 4 (9.5)
Use of online abuse material
including adolescents
N (%) N (%) N (%) Sig.
No 830 (95.0) 795 (95.6) 35 (83.3) **
Ye s 4 4
{
(5.0) 37
k
(4.4) 7** (16.7)
Use of online abuse material
including any minor
N (%) N (%) N (%) Sig.
No 829 (94.9) 795 (95.6) 34 (81.0) **
Ye s 4 5
††
(5.1) 37
††
(4.4) 8
††
(19.0)
M¼mean value; N (%) ¼absolute share (percentage share) in the sample; SD ¼standard deviation; SIC ¼sexual interest in children; Sig. ¼Signicance
level of the group comparison analysis.
**P<.01 ***P<.001.
*Age at data collection.
Result from t-Test.
Results from chi-square test.
§
Participants did not provide information on these questions.
{
Including 6 females who reported on using material involving both children and adolescents.
k
Including 3 females who reported on using material involving both children and adolescents.
**Including 3 females who reported on using material involving both children and adolescents.
††
Participants who reported both the use of online material including children and adolescents were taken into account only once.
Sex Med 2020;-:1e14
Sexual Interest in Children Among Women 3
Table 2. Sample characteristics and sexual fantasies involving prepubescent or pubescent children among female participants who
provided information on their sexual fantasies (n ¼1,411) including results of comparisons between participants recruited among general
websites (general website) and those who were recruited on websites directed to individuals with sexual interest in children (SIC website)
using t-test for interval scaled variables, U-test for ordinal scaled variables, and chi-square test or Fishers exact test for nominal and binary
variables
Variables
Total (n ¼1,411, 100%)
General website
(n ¼1,357, 96.2%)
SIC website
(n ¼54, 3.8%)
Sig.M (SD) Range M (SD) Range M (SD) Range
Age (in years)*27.5 (8.8) 18e69 27.5 (8.8) 18e69 28.2 (9.5) 18e58 n.s.
Relationship status N (%) N (%) N (%) Sig.
In a relationship 908 (64.4) 874 (64.4) 34 (63.0) n.s.
Currently single 503 (35.6) 483 (35.6) 20 (37.0)
Sexual orientation N (%) N (%) N (%) Sig.
Heterosexual 1,096 (77.7) 1,062 (78.3) 34 (63.0) *
§
Homosexual 73 (5.2) 68 (5.0) 5 (9.2)
Bisexual 236 (16.7) 221 (16.3) 15 (27.8)
Not specied
{
6 (0.4) 6 (0.4) - (-)
Sexual fantasies involving
k
.
Prepubescent girls
N (%) N (%) N (%) Sig.
Not at all 1,320 (93.6) 1,273 (93.8) 47 (87.0) ***
(2) 59 (4.2) 57 (4.2) 2 (3.7)
(3) 22 (1.6) 20 (1.5) 2 (3.7)
(4) 7 (0.5) 6 (0.4) 1 (1.9)
Absolutely 3 (0.2) 1 (0.1) 2 (3.7)
Dichotomized
††
N (%) N (%) N (%) Sig.
No 1,379 (97.7) 1,330 (98.0) 49 (90.7) **
Yes 32 (2.3) 27 (2.0) 5 (9.3)
Prepubescent boys N (%) N (%) N (%) Sig.
Not at all 1,159 (82.1) 1,113 (82.0) 46 (85.2) n.s.**
(2) 175 (12.4) 171 (12.6) 4 (7.4)
(3) 61 (4.3) 59 (4.3) 2 (3.7)
(4) 15 (1.1) 13 (1.0) 2 (3.7)
Absolutely 1 (0.1) 1 (0.1) 0 (0.0)
Dichotomized
††
N (%) N (%) N (%) Sig.
No 1,334 (94.5) 1,284 (94.6) 50 (92.6) n.s.
§
Ye s 7 7
{
(5.5) 73 (5.4) 4 (7.7)
Sexual fantasies involving
k
.
Prepubescent children
N (%) N (%) N (%) Sig.
No 1,313 (93.1) 1,265 (93.2) 48 (88.9) n.s.
Yes 98 (7.0) 92 (6.8) 6 (11.1)
Sexual fantasies involving
‡‡
.
Pubescent girls
N (%) N (%) N (%) Sig.
Not at all 1,208 (85.6) 1,165 (85.9) 43 (79.6) n.s.**
(2) 138 (9.8) 134 (9.9) 4 (7.4)
(3) 49 (3.5) 46 (3.4) 3 (5.6)
(4) 13 (0.9) 11 (0.8) 2 (3.7)
Absolutely 3 (0.2) 1 (0.1) 2 (3.7)
Dichotomized
††
N (%) N (%) N (%) Sig.
No 1,346 (95.4) 1,299 (95.7) 47 (87.0) *
Yes 65 (4.6) 58 (4.3) 7 (13.0)
Pubescent boys N (%) N (%) N (%) Sig.
Not at all 1,121 (79.4) 1,080 (79.6) 41 (75.9) n.s.**
(2) 203 (14.4) 196 (14.4) 7 (13.0)
(3) 66 (4.7) 63 (4.6) 3 (5.6)
(continued)
Sex Med 2020;-:1e14
4Tozdan et al
material and sexual fantasies involving children. The sample
characteristics for the 3 subsamples are presented in Tables 1e3.
In all subsamples, a subgroup of women participated via one of 2
German websites associated with individuals with a self-
identied sexual interest in children (SIC websites). One web-
site is directed to individuals with a self-identied sexual interest
in children offering anonymous treatment opportunities (www.
kein-taeter-werden.de, online since 2005). The other website is
a forum for individuals with a self-identied sexual interest in
children with no other specied thematic focus (www.
krumme13.org, online since 2003).
30
Differences between par-
ticipants who took part in the survey via one of the general websites
and those who participated via websites directed to individuals
with sexual interest in children were expected.
31
We, therefore,
present all variables for the total sample as well as for the 2 groups
(general websites and SIC websites) including tests of comparison
between them. Among participants who completed the assessment
of sexual fantasies involving prepubescent and/or pubescent chil-
dren, comparison tests showed differences in sexual orientation
between the general websitesgroup and SIC websitesgroup
(Table 2). Women who participated via a general website reported
less frequently a homosexual or bisexual orientation than those
who participated via a SIC websites.
Procedure
The online survey was conducted between July and December
2012. The study link was spread on general websites, that is,
social media platforms (eg, Facebook, Twitter) and other online
forums (eg, concerning lifestyle, hobbies, or interests) in Sweden,
Finland, and Germany, as well as via email lists for students
at universities and vocational universities in Finland. This con-
stitutes the rst sample. In addition, participants were recruited
via 2 German websites directed toward individuals with a self-
identied sexual interest in children. These participants consti-
tute the second sample. On all websites, information about the
study including the study link was posted to promote the study.
To ensure ongoing visibility, posts on all websites were checked
Table 2. Continued
Variables
Total (n ¼1,411, 100%)
General website
(n ¼1,357, 96.2%)
SIC website
(n ¼54, 3.8%)
Sig.M (SD) Range M (SD) Range M (SD) Range
(4) 18 (1.3) 16 (1.2) 2 (3.7)
Absolutely 3 (0.2) 2 (0.1) 1 (1.9)
Dichotomized
††
N (%) N (%) N (%) Sig.
No 1,324 (93.8) 1,276 (94.0) 48 (88.9) n.s.
Ye s 8 7
k
(6.2) 81 (6.0) 6 (11.1)
Sexual fantasies involving
‡‡
.
Pubescent children
N (%) N (%) N (%) Sig.
No 1,275 (90.4) 1,228 (90.5) 47 (87.0) n.s.
Yes 136
§§
(9.6) 129
{{
(9.5) 7
kk
(13.0)
Sexual fantasies involving
any children***
N (%) N (%) N (%) Sig.
No 1,231 (87.2) 1,184 (87.3) 47 (87.0) n.s.
Yes 180
†††
(12.7) 173
†††
(12.7) 7
†††
(13.0)
M¼mean value; N (%) ¼absolute share (percentage share) in the sample; SD ¼standard deviation; SIC ¼sexual interest in children; Sig. ¼signicance
level of the group comparison analysis.
*P<.05, **P<.01.
*Age at data collection.
Result from t-Test.
Results from Chi-Square-Test.
§
Results from Fischers Exact Test.
{
Participants did not provide information on these questions.
k
Indicated by the self-reported extent to which female and male children at Tanner stage 1 (prepubescent girls and boys) are involved in participantssexual
fantasies.
**Results from U-Test.
††
Response categories were dichotomized by computing not at alland (2)into noand (3),(4), and absolutelyinto yes.
‡‡
Indicated by the self-reported extent to which female and male children at Tanner stage 2 (pubescent girls and boys) are involved in participantssexual
fantasies.
§§
Including 11 females who reported on having sexual fantasies involving prepubescent girls.
{{
Including 16 females who reported on having sexual fantasies involving pubescent girls.
kk
Including 54 females who reported on having sexual fantasies involving prepubescent children (Tanner stage 1).
***Indicated by the self-reported sexual fantasies which at least partly involves female and/or male children at Tanner stage 1 and/or 2 (prepubescent and
pubescent girls and boys).
†††
Participants who responded positive to more than one of the 4 pictures were taken into account only once.
Sex Med 2020;-:1e14
Sexual Interest in Children Among Women 5
regularly. To monitor participation, study links on all websites
were distinct.
31
Participants were informed that the survey would
assess their social and sexual online behavior. Before beginning
the survey, informed consent was obtained from all participants.
The survey was approved by the ethics committees of Deutsche
Gesellschaft für Psychologie and Abo Akademi University,
Finland.
31
The survey was programmed using the program
SoSci Survey
32
from the company SoSci Survey GmbH (www.
soscisurvey.de).
Measures
Sample Characteristics
To describe the samplescharacteristics, single-item questions
on age, relationship status, and sexual orientation were included
in the study.
Use of Online Abuse Material Including Children or
Adolescents
Online abuse material including children or adolescents
involves sexual online material (ie, videos, pictures, or texts)
representing child sexual abuse. The use of online abuse material
including children or adolescents has been suggested to be a
reliable indicator of sexual interest in prepubescent and/or
pubescent children.
33
Participants in the present study were
asked how often they have used different types of general sexual
online material within the last year, that is, videos, pictures, or
texts. For each type of material, participants rated the frequency
of use on a 4-point Likert scale from neverto very often.
Afterward, participants were asked what kind of sexual online
material they had been interested in within the last year.
Multiple-choice response categories included involving chil-
drenand involving teenagers. Both categories were included
as binary variables.
Sexual Fantasies Involving Prepubescent or Pubescent
Children
Self-report measures of sexual fantasy can be viewed as direct in-
dications of ones level of sexual interest.
34
Although self-report is
considered susceptible to socially desirable responding, it is often
used for theassessment of sexual interest in children
35e37
probably
due to its simple and economical implementation. In addition, it can
be assumed that guaranteeing anonymity (eg, within an online
survey) enhances truthful responding.
38
In the present study, participants were presented with 10
pictures showing different undressed bodies. The pictures were
computer-generated stimuli validated for the assessment of
Table 3. Sample characteristics and the overall indication of any sexual interest in children among female participants who provided
information on the use of online abuse material as well as on their sexual fantasies (n ¼871) including results of comparisons between
participants recruited among general websites (general website) and those who were recruited on websites directed to individuals with
sexual interest in children (SIC website) using t-test for interval scaled variables and chi-square test or Fishers exact test for nominal and
binary variables
Variables
Total (n ¼871, 100%)
General website
(n ¼829, 95.2%)
SIC website
(n ¼42, 4.8%)
Sig.M (SD) Range M (SD) Range M (SD) Range
Age (in years)*26.6 (7.6) 18e67 26.6 (7.6) 18e67 26.1 (7.0) 18e45 n.s.
Relationship status N (%) N (%) N (%) Sig.
In a relationship 539 (61.9) 513 (61.9) 26 (61.9) n.s.
Currently single 332 (38.1) 316 (38.1) 16 (38.1)
Sexual orientation N (%) N (%) N (%) Sig.
Heterosexual 628 (72.1) 603 (72.7) 25 (59.5) n.s.
§
Homosexual 48 (5.5) 43 (5.2) 5 (11.9)
Bisexual 193 (22.2) 181 (21.9) 12 (28.6)
Not specied
{
2 (0.2) 2 (0.2) - (-)
Any sexual interest in children
k
N (%) N (%) N (%) Sig.
No 717 (82.3) 684 (82.5) 33 (87.6) n.s.
Yes 154** (17.7) 145** (17.5) 9** (21.4)
M¼mean value; N (%) ¼absolute share (percentage share) in the sample; SD ¼standard deviation; SIC ¼sexual interest in children; Sig. ¼signicance
level of the group comparison analysis.
*Age at data collection.
Result from t-test.
Results from chi-square test.
§
Result from Fischers exact test.
{
Participants did not provide information on these questions.
k
Indicated by the self-reported use of online abuse material including children and/or adolescents and/or the self-reported sexual fantasies which at least
partly involves female and/or male children at Tanner stage 1 and/or 2 (prepubescent and pubescent girls and boys).
**Participants who reported both the use of online abuse material and sexual fantasies involving children were taken into account only once.
Sex Med 2020;-:1e14
6Tozdan et al
pedophilic interest.
39
Each of the bodies represented a Caucasian
person in 1 of 5 female and male Tanner stages of secondary sex
characteristic development.
40
Tanner stage 1 indicates a prepu-
bescent developmental stage with no secondary sex characteris-
tics. Tanner stages 2 and 3 represent a pubescent status with the
beginning of pubic hair growth in girls and boys and the start of
breast development in girls. Tanner stages 4 and 5 indicate
maturity of secondary sex characteristics.
40
The use of Tanners
stages helps clinicians and researchers to accurately assess sexual
interest in prepubescent or pubescent children by providing clear
criterions based on the developmental stages of children and
adolescents. Owing to wide variation in the age of onset of pu-
berty, for example,
41
a 12-year-old girl might look much more or
less mature than her age. Therefore, age is an imperfect indica-
tion of sex characteristic development and does not necessarily be
valid when assessing pedophilic and hebephilic interest.
42
For each of the 10 Tanner pictures, participants were asked to
assess to which extent the body on the picture corresponds with
bodies they have sexual fantasies about. There was no specied
time period for participants to respond to the images. Instead,
participants have chosen by themselves when they rated each
picture. The 5-point assessment scale ranged from 1 (not at all) to 5
(absolutely). As an indication of sexual interest in children, we
included the assessments of prepubescent and pubescent girls and
boys, that is, 4 pictures showing female and male bodies at Tanner
stage 1 and 2. Pictures were presented in a randomized order.
Data Analyses and Presentation
Data analyses were conducted using IBM SPSS Statistics 22.
43
Group comparisons between participants recruited among gen-
eral websites (general websites) and those who were recruited on
websites directed to individuals with sexual interest in children
(SIC websites) were computed using t-test for interval scaled
variables,
44
U-test for ordinal scaled variables,
45
and chi-square
test for nominal and binary variables or Fishers exact test
when one of the cells had less than 5 observations.
46
For the calculation of the use of online abuse material
including any minor, we summarized the use of online abuse
material including children and the use of online abuse material
including adolescents. Participants who responded positively to
both variables were taken into account only once. This approach
enables the presentation of all women who reported the use of
online abuse material including either children or adolescents or
both preventing the double counting of those who are present in
both variables. Simultaneously, by reporting all frequencies for
both variables separately, we provide all information necessary for
a comprehensive understanding of the present data.
Regarding the assessment of Tanner stages, we only included
trials with reaction times equal or longer than 150 milliseconds
to ensure that cognitive information processing was possible.
47,48
For the purpose of better clarity and understanding, we present
the frequencies of the 5 original response categories as well as
dichotomized categories for the assessment of Tanner stages 1
and 2. Dichotomization was conducted by computing not at
alland (2)into the category noand (3),(4), and
absolutelyinto the category yes. In addition, we summarized
the dichotomized assessments for female and male pictures at
Tanner stage 1 and 2 to present a dichotomized assessment for
prepubescent and pubescent children. Finally, we summarized
the dichotomized assessment for prepubescent and pubescent
children to present a dichotomized assessment for any children.
Participants, who reported sexual fantasies involving both pre-
pubescent and pubescent children, were taken into account only
once. Again, this approach enables the presentation of all women
who reported sexual fantasies involving either prepubescent or
pubescent children or both preventing the double counting of
those who are present in both categories.
To calculate an overall indicator of any sexual interest in
children, we summarized the use of online abuse material
including any minor and sexual fantasies involving any children.
If participants were present in both variables, they were taken
into account only once. By this, we aim at presenting all women
who reported either the use of online abuse material including
any minor or sexual fantasies involving any children or both
preventing the double counting of women who indicated sexual
interest in children by both measures.
Additional Analyses
As both use of online abuse material and sexual fantasies
involving children are intended to assess the same construct, that
is, sexual interest in children, statistical relations between these 2
variables can be reasonably assumed. Such statistical relations
would demonstrate consistency of the present data which suggest
validity of the measures. We therefore generate a correlation
matrix including the 2 binary variables for the use of online abuse
material (including children, including teenagers) as well as the 4
variables for sexual fantasies involving children (prepubescent
girls, prepubescent boys, pubescent girls, pubescent boys) in their
original 5-point scale. We conducted the correlation analyses
using the Pearson product moment correlation coefcient.
49
In
cases of signicant differences between the subgroups (general
websites vs SIC websites) in both variables whose statistical
relation was tested, we used partial correlation coefcients with
subgroup (general websites, SIC websites) as control variable.
49
We expected signicantly positive correlations between all 6
indications of sexual interest in children with at least small sizes.
RESULTS
Use of Online Abuse Material Including Children or
Adolescents
The subsample including female participants who answered
the questions on the use of online abuse material (n ¼874) had a
mean age of 26.6 (standard deviation [SD] ¼7.6) years and, on
average, mainly reported being heterosexual and in a relationship
Sex Med 2020;-:1e14
Sexual Interest in Children Among Women 7
(Table 1). They mainly indicated the use of sexual online videos
(83%) and reported less frequently the use of sexual online
pictures (51%) and sexual online texts (64%). A proportion of
0.4% (n ¼3) of those women who participated via general
websites stated that they use online abuse material including
children within the last year, whereas 9.5% (n ¼4) of those
women who participated via websites that were directed at in-
dividuals with a sexual interest in children (SIC websites) did so.
The use of online abuse material including adolescents was re-
ported by 4.4% (n ¼37) of women from general websites and
by 16.7% (n ¼7) of women from SIC websites. Taking
together, 4.4% (n ¼37) of women from general websites indi-
cated the use of online abuse material including any minor,
whereas 19.0% (n ¼8) of women from SIC websites reported
doing so. Group comparison revealed signicant differences be-
tween women from SIC websites and those from general websites
in all of the 3 variables (Table 1).
Sexual Fantasies Involving Prepubescent or
Pubescent Children
Female participants who were willing to assess the male and
female bodies at Tanner stages 1 and 2 (n ¼1,411) had an
average age of 27.5 (SD ¼8.8) and were mostly in a relationship
(Table 2). Although all women mainly reported being hetero-
sexual, women from SIC websites demonstrated a higher pro-
portion of homosexual and bisexual orientation than women
from general websites. Group comparison only demonstrated
signicant differences between women from SIC websites and
women from general websites regarding sexual fantasies involving
prepubescent girls (general websites: n ¼27 [2.0%], SIC web-
sites: n ¼5 [9.3%]) and pubescent girls (general websites:
n¼58 [4.3%], SIC websites: n ¼7 [13.0%]). Among the total
sample, the proportion of women who reported having sexual
fantasies involving prepubescent children (n ¼98 [7%], general
websites: n ¼92 [6.8%], SIC websites: n ¼6 [11.1%]) was
slightly smaller than the proportion of women who reported
having sexual fantasies involving pubescent children (n ¼136
[9.6%], general websites: n ¼129 [9.5%], SIC websites: n ¼7
[13.0%]). As the overlapping group among these 2 variables only
included 54 women who reported on having sexual fantasies
involving both prepubescent and pubescent children, the pro-
portion of women among the total sample who indicated having
sexual fantasies involving any children (ie, girls or boys at Tanner
stage 1 or 2) reached 12.7% (n ¼180, general websites: n ¼173
[12.7%], SIC websites: n ¼7 [13.0%]; Table 2).
Overall Indicator of Any Sexual Interest in Children
Women in the present study who provided data on both the
use of online abuse material and the assessment of pictures
presenting female and male children at Tanner stage 1 and 2
(n ¼871) aged 26.6 (SD ¼7.6) on average were mostly het-
erosexual and in a relationship (Table 3). Almost 18% (n ¼154)
of this subsample specied at least some sexual interest in chil-
dren by responding positive to at least one of the variables
included in the present study (general websites: n ¼145
[17.5%], SIC websites: n ¼9 [21.4%]; Table 3).
Table 4. Results of 2-tailed tested Pearson product moment correlations as well as partial correlations including subgroup (general
website, SIC website) as control variable between 6 indications of sexual interest in children for the total subsample of female participants
who provided information on all 6 indications of sexual interest in children (n ¼871)
Indications of sexual interest in children 1. 2. 3. 4. 5. 6.
1. Use of online abuse material
including children
r*-
P
-
2. Use of online abuse material
including teenagers
r
xy
.32*** -
P.000 -
3. Sexual fantasies involving
prepubescent girls
§
r
xy
.58*** .24*** -
P.000 .000 -
4. Sexual fantasies involving
prepubescent boys
{
r
xy
.20*** .12** .36*** -
P.000 .001 .000 -
5. Sexual fantasies involving
pubescent girls
k
r .34*** .21*** .51*** .30*** -
P.000 .000 .000 .000 -
6. Sexual fantasies involving
pubescent boys**
r .24*** .14*** .36*** .57*** .34*** -
P.000 .000 .000 .000 .000 -
**P<.01, ***P<.001.
*Pearsons product-moment correlation coefcient.
Pvalue of the correlation coefcient.
Partial correlation coefcient with subgroup (general website, SIC website) as control variable.
§
Indicated by the self-reported extent to which female children at Tanner stage 1 (prepubescent girls) are involved in participantssexual fantasies.
{
Indicated by the self-reported extent to which male children at Tanner stage 1 (prepubescent boys) are involved in participantssexual fantasies.
k
Indicated by the self-reported extent to which female children at Tanner stage 2 (pubescent girls) are involved in participantssexual fantasies.
**Indicated by the self-reported extent to which male children at Tanner stage 2 (pubescent boys) are involved in participantssexual fantasies.
Sex Med 2020;-:1e14
8Tozdan et al
Correlation Analyses
All the 6 indications of sexual interest in children are positively
correlated to each other (Table 4). The strongest correlation is
between sexual fantasies involving prepubescent girls and the use
of online abuse material including children (r
xy
¼0.58,
P<.001); the weakest between sexual fantasies involving pre-
pubescent boys and the use of online abuse material including
teenagers (r ¼0.12, P<.01).
DISCUSSION
The present study aimed to examine sexual interest in children
among adult women in 2 types of nonclinical and nonrepresen-
tative samples. Data analyses included variables from an online
self-report survey conducted among adults in Germany, Finland,
and Sweden by spreading the link on social media platforms and
other online forums (general websites) as well as 2 German online
platforms that directly address individuals with a self-identied
sexual interest in children (SIC websites). The survey included
questions about the use of online abuse material including children
or adolescents as well as about sexual fantasies involving prepu-
bescent and pubescent children. Both variables were used as in-
dicators of sexual interest in children among the female
participants. Results showed that 7 women of the total sample
(0.8%) report using online abuse material including children
(general websites: 0.4%, SIC websites: 9.5%; Table 1) indicating a
sexual interest in children.
33
Compared with women from general
websites, women from SIC websites stated a higher proportion of
using online abuse material including children (0.4% vs 9.5%;
Table 1). Table 1 further demonstrates that more women reported
using online abuse material including children or adolescents (total
sample: 5.1%, general websites: 4.4%, SIC websites: 19.0%;
Table 1), indicating a sexual interest in children or adolescents.
33
Compared with general websites participants, SIC websites par-
ticipants revealed a higher proportion of using online abuse ma-
terial including children or adolescents (4.4% vs 19.0%; Table 1).
Such differences were expected and probably reect a difference in
the amount of sexual interest in children in these 2 samples.
Our results also show (Table 2) that 180 female participants of the
total sample (12.7%, general websites: 12.7%, SIC websites:
13.0%) have sexual fantasies involving prepubescent children at
Tanner stage 1 (no secondary sex characteristics) or pubescent
children at Tanner stage 2 (beginning of pubic hair growth in girls
and boys and the start of breast development in girls). Compared
with general websites participants, SIC website participants showed
a higher proportion of having sexual fantasies involving prepubes-
cent (2.0% vs 9.3%; Table 2) and pubescent girls (4.3% vs 13.0%;
Table 2). This difference is quite likely the result of the differences in
sexual orientation between these 2 groups. SIC website participants
specied almost twice as frequently as general websites participants
on being homosexual (9.2% vs 5.0%; Table 2)orbisexual(27.8%vs
16.3%; Table 2). As general websites participants indicated a higher
proportion of heterosexual orientation than SIC website participants
(87.3% vs 63%; Table 2), they reported less frequently that they
have sexual fantasies involving girls. Indeed, the differences in sexual
fantasies involving prepubescent or pubescent girls vanished when
summarizing the gender-specic items into the variables sexual
fantasies involving prepubescent childrenand sexual fantasies
involving pubescent children(Table 2). Finally, results from
Table 3 revealed that 154 female participants of the total sample
(17.7%, general websites: 17.5%, SIC websites: 21.4%; Table 3)
specied any sexual interest in children as indicated by the use of
online abuse material including children and/or adolescents and/or
by sexual fantasies involving prepubescent and/or pubescent girls
and/or boys.
The present study design offers some advantages that enhance
the reliability and validity of results. Most importantly, the present
study is based on a relatively large sample of female adults
(N¼1,808) leading to a more precise estimation of sample sta-
tistics and a greater statistical power.
50
In addition, data analyses
included multiple indicators of sexual interest in children (use of
online abuse material and sexual fantasies involving children)
which implies a certain degree of triangulation and facilitates
validation of data.
51
Indeed, correlation analyses revealed signi-
cant relationships between the different indications of sexual in-
terest in children (Table 4). That is, women who indicated that
they use online abuse material including children more likely
indicated that they use online abuse material including teenagers
(r
xy
¼0.32, P<.001) and that they have sexual fantasies involving
prepubescent (girls: r
xy
¼0.58, P<.001; boys: r
xy
¼0.20,
P<.001) or pubescent children (girls: r¼0.34, P<.001; boys:
r¼0.24, P<.001) than did women who did not report the use of
online abuse material including children. In addition, we found
signicant relationships between sexual fantasies involving pre-
pubescent girls and boys (r
xy
¼0.36, P<.001), prepubescent girls
and pubescent girls (r¼0.51, P<.001), prepubescent boys and
pubescent boys (r¼0.57, P<.001), as well as pubescent girls and
boys (r¼0.34, P<.001). This indicates that women who re-
ported that their sexual fantasies are at least partly about prepu-
bescent children (Tanner stage 1) likely reported that sexual
fantasies are at least partly about pubescent children (Tanner stage
2). Moreover, women who reported that their sexual fantasies are
involving prepubescent or pubescent girls likely reported that their
sexual fantasies are involving prepubescent or pubescent boys. The
rather weak correlations between the use of online abuse material
including teenagers and sexual fantasies involving both prepu-
bescent (girls: r
xy
¼0.24, P<.001; boys: r
xy
¼0.12, P<.01) and
pubescent children (girls: r¼0.21, P<.001; boys: r ¼0.14,
P<.001) seem to be reasonable because the term teenagers
commonly implies adolescents aged 14e17 years, whereas Tanner
stages 1 and 2 represent earlier developmental stages, that is, before
puberty (aged up to 10 years) and beginning of puberty (aged
11e14 years). In sum, the correlation pattern gives reason to as-
sume consistency of the present data.
A further advantage of the present study was that data were
collected online which implies a high degree of anonymity. This
Sex Med 2020;-:1e14
Sexual Interest in Children Among Women 9
may have foster participantsreadiness to respond truthfully.
Finally, we chose a rather conservative approach when solely
including the assessments of Tanner stages 2 as an indication of
sexual interest in pubescent children. Actually, a pubescent status
is represented by Tanner stages 2 and 3. Post hoc analyses of the
present data indicated that the prevalence of sexual interest in
children among female participants in the present study would
have been much higher when taken into account the assessments
of pictures showing children at Tanner stage 3 (approximately
30%). The fact that the prevalence of sexual interest in children
among women reached almost 18% despite a conservative pro-
cedure justies the assumption that pedophilic and hebephilic
sexual interest may not be a phenomenon exclusive to men.
Previous studies on the prevalence of sexual interest in chil-
dren among female adults in the general population reported
rates up to 4%.
3,7,8,26,27
The present results demonstrate an even
higher proportion of women who appear to be at least partly
sexually attracted to children and/or adolescents with prevalence
rates up to 17.5% for women who participated via general
websites which have not been associated with the topic of sexual
interest in children (Table 3). Our higher rates compared to
previous studies may have been due to the fact that previous
studies mainly focused on indicators for pedophilic interest. That
is, most studies on the prevalence of sexual interest in children
among women aimed at assessing sexual interest in children aged
12 years or younger which rather implies a pedophilic interest (ie,
sexual interest in children aged up to 11 years). The present
study aimed at assessing sexual interest in children and adoles-
cents which implies a pedophilic or a hebephilic interest (ie,
sexual interest in children up to 14 years). Thus, the broader
range of ages might have revealed further groups of females being
interested in older children that might have been neglected in
other studies by limiting the age range to 12 years. In addition,
previous studies mainly included direct questions on the sexual
interest in children,
3,7,8,26,27
for example, I am sexually attracted
to little children. Our methodological approach included the
assessment of sexual interest in children by rating the extent to
which naked bodies of prepubescent and pubescent children
corresponds with bodies participants have sexual fantasies about.
This methodological difference might have led to different re-
sults. A direct question on sexual interest in children may be
more difcult to afrm than a picture of a naked children as the
former implies a clear consciousness about ones own sexual in-
terest in children, whereas the latter may not necessarily do so.
Nevertheless, there are other possible explanations for the
discrepancy between previous research and the present results.
Some of them are discussed in the following as limitations of the
present study implicating further research questions.
Limitations and Further Research Questions
Although the study was not meant to be representative,
31
the
fact that the present data were not population-based has to be
mentioned as a strong limitation. Indeed, the present online
recruitment seems to be an economic and practicable approach
to focus on deviant online behavior, such as the use of online
abuse material including children or adolescents. Moreover, the
present sample includes users of websites that were identied as
directly addressing individuals with a sexual interest in children
(SIC websites). Thus, the results for the total sample are probably
distorted by a higher rate of individuals being sexually attracted
to children which is represented by the differences between
general and website participants in using of online abuse material
(Table 1). However, in all the 3 subsamples (Tables 1e3), the
proportion of the SIC websites participants was below 5%
indicating that their impact on the total subsamplesresults is
obviously not very substantial. Consequently, the proportions of
sexual interest in children for the total samples are quite similar
to those of the general websites subgroups (eg, total sample:
17.7%, general websites: 17.5, Table 3). In addition, in most
variables concerning sexual fantasies involving prepubescent or
pubescent children, women who participated among general
websites and women from SIC websites did not differ from each
other. As mentioned previously, the higher proportion of using
online abuse material including children or adolescents among
SIC websites participants might be partly caused by a general
difference in online behavior. However, it is more likely that
there is a real difference in being sexually interested in children
between women from general websites and women from SIC
websites. In fact, it might be assumed that most participants from
the SIC websites would indicate a sexual interest in children as
they are visiting a website that is explicitly directed toward in-
dividuals with sexual interest in children. There are many
possible reasons why only a minority of SIC websites participants
specied a sexual interest in children. One reason might be that
participants did not feel safe about the protection of their
identity and therefore were not willing to disclose a sexual in-
terest in children that is highly stigmatized in society.
22
Another
reason might be that participants have called up the website as
relatives of persons with sexual interest in children, therapists,
or other interested parties and even though participated in the
study.
Mentioned previously as an advantage of the present study,
data were collected online implying a high degree of anonymity.
From a different perspective, this anonymity may be regarded as
a limitation because there is a certain degree of unknowingness
about participants. For instance, it might be that male partici-
pants pretended to be female, especially those from SIC websites,
or that participants generally did not respond honestly as they
might have not taken the survey seriously. Moreover, we
collected data from 2 German SIC websites. It is possible that
individuals who visited one of these websites also know the other
website. Therefore, participants of the SIC websites might have
had access to both study links and the possibility to participate
more than one time in our study without our awareness. How-
ever, this is also the case for the general websites as well as online
studies in general.
Sex Med 2020;-:1e14
10 Tozdan et al
A further limitation of the present data is that all measures are
based on participantsself-reports. A social desirability scale was
not applied. Thus, distortion of the present data owing to social
desirability cannot be excluded. In addition, participants were
offered with the opportunity to skip questions they did not wish
to answer. The use of online abuse material is a criminal behavior
in all the 3 countries participants came from, that is, in Ger-
many, Sweden, and Finland. As participants might not dare to
report criminal activities, this have possibly led to a systematic
bias in the data. Compared to the proportion of sexual fantasies
involving prepubescent or pubescent children in the present
study, the reports on using online abuse material including
children or adolescents were less frequent. This may indicate that
having sexual fantasies about children is easier to disclose as it
does not imply the anticipation of criminal prosecution.
Furthermore, sexual interest in children is strongly stigmatized
by public
52
and therefore possibly difcult to disclose by affected
individuals. Consequently, the present results might underesti-
mate the prevalence of sexual interest among adult women.
Finally, it might be that participants misunderstood the meaning
of the category involving teenagerswhen assessing the content
of sexual online material. Among legal pornographic material,
there is a category called teenwhich includes adult female
actors portraying teenagers.
53
As the response category involving
teenagershad not been specied by an exact age of actors (eg,
14e17 years), participants might have not reported the use of
online abuse material including adolescents but the use of legal
pornographic material from the category teen. This would have
led to an overestimation of the prevalence of sexual interest among
adult females. Nevertheless, as the category involving teenager
was placed next to the category involving children, we assume the
probability of such misunderstanding to be rather low.
Another uncertainty relates the fact that the present study did
not include precise questions about the exact content of the
sexual online material that included children or adolescents. In
the present study, we considered every sexual online material that
included children or adolescents to be online abuse material.
The use of online abuse material has been shown to be an
indicator not only of sexual interest in children but also of
compulsive sexual behavior.
54
From our clinical experience, there
are persons who report their use of sexual online material
compulsively turned to images of underage persons to increase
arousal. In fact, post-hoc analyses of the present data revealed a
statistical relation between the use of online abuse material
including any minor and the frequency of the general use of
sexual online material. This means that women who reported the
use of online abuse material including any minor were more
likely to report a more frequent use of sexual online material
(videos: Fishers exact ¼47.9, P<.001; pictures: Fishers
exact ¼36.3, P<.001; texts: Fishers exact ¼8.2, P<.05) in
general. Thus, it might be that the women in the present study
who reported the use of online abuse material including children
or adolescents do not have a sexual interest in children but need
online abuse material because ordinary sexual online material lost
its effect.
To reach better clarity and understanding of the data, we
dichotomized the sexual fantasy categories by computing the
response categories not at alland (2)into the category no
and (3),(4), and absolutelyinto the category yes. This
specic methodological approach need to be taken into account
when interpreting the present data. This means, other ways of
dichotomization are indeed possible changing the percentages of
women indicating a sexual interest in children, for example,
computing not at all,(2), and (3)into the category no
and (4)and absolutelyinto the category yes. Compared to
this methodological approach, our approach clearly led us to a
higher rate of women with sexual fantasies involving children.
Yet, as we provided the reader with all information necessary for
a comprehensive understanding of our data, the reader is enabled
to develop own interpretations and conclusions from the present
data. Our methodological approach only represents one possi-
bility of data presentation.
Moreover, research so far suggests that pedophilia and hebe-
philia are 2 relatively distinct but also overlapping constructs.
2
Strictly speaking, individuals with pedophilic interest and those
with hebephilic interest should not be considered as one ho-
mogeneous group when investigating individualsspecic char-
acteristics. As the present study was not intended to investigate
specic characteristics but to examine the amount to which
women indicate pedophilic or hebephilic interests, we combined
the 2 constructs of pedophilia and hebephilia. In addition, as said
previously, results of the measures for pedophilic and hebephilic
interests were presented separately and in detail and were not a
priori merged.
Owing to these limitations, the validity and generalizability of
the present results are presumably restricted to a certain degree.
Further empirical research on how common sexual interest is
among adult females is deemed necessary, especially in
population-based samples. Although being sexually attracted to
children cannot be equated with sexually abusing children,
research among men has shown that sexual interest in children
constitutes a risk factor for sexual child abuse.
20
In particular, the
use of online abuse material has been demonstrated to be related
to sexual offences against children in male perpetrators.
55
Even if
male and female perpetrators were shown to have different risk
factors for committing child sexual abuse,
56e58
future research
proposals need to be focused on using online abuse material as a
risk factor that might also lead female adults with a sexual interest
in children to sexually offend against children. As women who
sexually abuse children have always been a powerful social
taboo
59
even in professionals in the health-care systemthey
are surrounded by a societal culture of denial.
60
Also, there is a
huge discrepancy between prevalence rates of female and male
child sexual offenders from ofcial criminal statistics and
victimization surveys. One possibility is that female child sexual
offenders are more likely to go underreported.
61,62
The results of
Sex Med 2020;-:1e14
Sexual Interest in Children Among Women 11
the present study suggest that quite a few women are, at least to
some extent, sexually interested in children and may be at a risk for
abusing children and/or maybe are in need of professional help. We
suggest that women with sexual interest in children and/or ado-
lescents are surrounded by a quite similar social taboo as are women
who sexually offend against children. Thus, scientic data on
women with a sexual interest in children are missing. We therefore
consider the overcome of that social taboo by professionals in the
health-care system particularly important.
62
CONCLUSION
The present sample is nonrepresentative, and the present re-
sults are therefore not generalizable. However, the results clearly
demonstrate that there are women who report using online abuse
material and having sexual fantasies about children. Thus, pro-
fessionals in the health-care system need to be aware that sexual
interest in children may be a phenomenon also found in adult
females. We strongly advise professionals in the health-care sys-
tem to increase their attention and engagement for women with
sexual interest in children. A stronger representation of the ex-
istence of such women in the professionals mind is deemed
necessary to prevent adult females who are perhaps even strug-
gling with their sexual interest in children from remaining un-
seen. We recommend clinicians and researchers in the eld of
sexual medicine not to wait until women seek help in the health-
care system to cope with their sexual interest in children. Instead,
we suggest pursuing an active approach toward women who are
sexually attracted to children and might be at risk to sexually
offend against them. Projects such as the German Dunkelfeld
Project
13
appear to be directed toward male individuals with a
sexual interest in children. Based on the present results, the
founding of preventive treatment services specically tailored to
female individuals with a sexual interest in children has to be
strongly encouraged in the near future.
ACKNOWLEDGMENTS
The authors take responsibility for the integrity of the data
and the accuracy of the data analyses and have made every effort
to avoid inating statistically signicant results.
Corresponding Author: Saye Tozdan, PhD, Institute for Sex
Research and Forensic Psychiatry, University Medical Center
Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Ger-
many. Tel: þ49(0)40 7410-57622; Fax: þ49(0)40 7410-57921;
E-mail: s.tozdan@uke.de
Conicts of Interest: The authors declare no conict of interest.
Funding: This study was realized within the MiKADO project,
63
funded by the German Federal Ministry of Family Affairs, Senior
Citizens, Women and Youth (Bundesministerium für Familie,
Senioren, Frauen und Jugend, GZ: II A 7 - 2510091004).
Research is also funded by the German Federal Ministry of
Education and Research (Bundesministerium für Bildung und
Forschung, 01SR1602).
STATEMENT OF AUTHORSHIP
Category 1
(a) Conception and Design
Janina Neutze; Pekka Santtila
(b) Acquisition of Data
Janina Neutze; Pekka Santtila
(c) Analysis and Interpretation of Data
Saye Tozdan
Category 2
(a) Drafting the Article
Saye Tozdan
(b) Revising It for Intellectual Content
Saye Tozdan; Arne Dekker; Peer Briken; Janina Neutze; Pekka
Santtila
Category 3
(a) Final Approval of the Completed Article
Saye Tozdan; Arne Dekker; Peer Briken; Janina Neutze; Pekka
Santtila
REFERENCES
1. American Psychiatric Association. Diagnostic and statistical
manual of mental disorders. 5th ed. Arlington, VA: American
Psychiatric Association; 2013.
2. Blanchard R, Lykins AD, Wherrett D, et al. Pedophilia, hebe-
philia, and the DSM-V. Arch Sex Behav 2009;38:335-350.
3. Briere J, Henschel D, Smiljanich K. Attitude toward sexual
abuse: sex differences and construct validity. J Res Pers 1992;
26:398-406.
4. Dombert B, Schmidt AF, Banse R, et al. How common is
mens self-reported sexual interest in prepubescent children?
J Sex Res 2016;53:214-223.
5. Santtila P, Antfolk J, Räfså A, et al. Mens sexual interest in
children: one-year incidence and correlates in a population-
based sample of Finnish male twins. J Child Sex Abus
2005;24:115-134.
6. Williams KM, Cooper BS, Howell TM, et al. Inferring sexually
deviant behavior from corresponding fantasies: the role of
personality and pornography consumption. Crim Justice
Behav 2009;36:198-222.
7. Baur E, Forsman M, Santtila P, et al. Paraphilic sexual interests
and sexually coercive behavior: a population-based twin study.
Arch Sex Behav 2016;45:1163-1172.
8. Wurtele SK, Simons DA, Moreno T. Sexual interest in children
among an online sample of men and women: prevalence and
correlates. Sex Abuse 2014;26:546-568.
9. Seto MC, Eke AW. Correlates of admitted sexual interest in
children among individuals convicted of child pornography
offenses. Law Hum Behav 2017;41:305-313.
10. Cortoni F, Hanson RK, Coache ME. Les délinquantes sexuelles:
prévalence et récidive [Female sexual offenders: prevalence
Sex Med 2020;-:1e14
12 Tozdan et al
and recidivism]. Rev Int Criminol Police Tech Sci 2009;
LXII:319-336.
11. Seto MC. Pedophilia and sexual offending against children:
theory, assessment and intervention. Washington, DC:
American Psychological Association; 2008.
12. Murray JB. Psychological prole of pedophiles and child mo-
lesters. J Psychol 2000;134:3221-3225.
13. Beier KM, Ahlers CJ, Goecker D, et al. Can pedophiles be
reached for primary prevention of child sexual abuse? First
results of the Berlin Prevention Project Dunkelfeld (PPD).
J Forensic Psychiatr Psychol 2009;20:851-867.
14. Neutze J, Seto MC, Schaefer GA, et al. Predictors of child
pornography offenses and child sexual abuse in a community
sample of pedophiles and hebephiles. Sex Abuse 2011;23:212-
242.
15. Tozdan S, Briken P. The earlier, the worse? eage of onset of
sexual interest in children. J Sex Med 2015;12:1602-1608.
16. Tozdan S, Briken P. Age of onset and its correlates in men with
sexual interest in children. Sex Med 2019;7:61-71.
17. Tozdan S, Kalt A, Dekker A, et al. Why information matters - a
randomized controlled trial on the consequences of suggesting
that pedophilia is immutable. Int J Offender Ther Comp
Criminol 2016. https://doi.org/10.1177/0306624X16676547.
18. Tozdan S, Kalt A, Keller LB, et al. Keep faith in yourself! ea
pilot study on the relevance of specic self-efcacy for
modifying sexual interest in children among men with a risk to
sexually abuse children. J Sex Marital Ther 2018;44:591-
604.
19. Ward T, Beech A. An integrated theory of sexual offending.
Aggress Violent Behav 2006;11:44-63.
20. Hanson RK, Morton-Bourgon KE. The characteristics of
persistent sexual offenders: a meta-analysis of recidivism
studies. J Consult Clin Psychol 2005;73:1154-1163.
21. Wollert R, Cramer E. Sampling extreme groups invalidates
research on the paraphilias: implications for DSM-5 and sex
offender risk assessments. Behav Sci Law 2011;29:554-565.
22. Jahnke S, Imhoff R, Hoyer J. Stigmatization of people with
pedophilia: two comparative surveys. Arch Sex Behav 2015;
44:21-34.
23. McClintock MK, Herdt G. Rethinking puberty: the development
of sexual attraction. Curr Dir Psychol Sci 1996;5:178-183.
24. Seto MC. Is pedophilia a sexual orientation? Arch Sex Behav
2012;41:231-236.
25. Smith TP. Effects of the childs relative age appearance and
attractiveness on vulnerability to pedosexual interactions. Diss
Abstr Int 1994;54:6472.
26. Fromuth ME, Conn VE. Hidden perpetrators: sexual molesta-
tion in a nonclinical sample of college women. J Interpers
Violence 1997;12:456-465.
27. Smiljanich K, Briere J. Self-reported sexual interest in children:
sex differences and psychosocial correlates in a university
sample. Violence Vict 1996;11:39-50.
28. Seigfried KC, Lovely RW, Rogers MK. Self-reported online child
pornography behavior: a psychological analysis. Int J Cyber
Criminol 2008;2:286-297.
29. Seigfried-Spellar K, Rogers M. Does deviant pornography use
follow a Guttman-like progression? Comput Hum Behav
2013;29:1997-2003.
30. Bergen E, Davidson J, Schulz A, et al. The effects of using
identity deception and suggesting secrecy on the outcomes of
adult-adult and adult-child or -adolescent online sexual in-
teractions. Vict Offenders 2014;9:276-298.
31. Schulz A, Bergen E, Schuhmann P, et al. Online sexual solici-
tation of minors: how often and between whom does it occur?
J Res Crime Delinquen 2015;53:1-24.
32. Leiner DJ. SoSci survey (version 3.1.06) [computer software];
Available at: https://www.soscisurvey.de. Accessed December
17, 2019.
33. Seto MC, Cantor JM, Blanchard R. Child pornography offenses
are a valid diagnostic indicator of pedophilia. J Abnorm Psy-
chol 2006;115:610-615.
34. Bartels RM, Beech AR, Harkins L, et al. Assessing sexual in-
terest in children using the go/no-go association test. Sex
Abuse 2018;30:593-614.
35. Allan M, Grace RC, Rutherford B, et al. Psychometric
assessment of dynamic risk factors for child molesters. Sex
Abuse 2007;19:347-367.
36. Beggs SM, Grace RC. Treatment gain for sexual offenders
against children predicts reduced recidivism: a comparative
validity. J Consult Clin Psychol 2011;79:182-192.
37. Gannon T, Terriere R, Leader T. Ward and Siegerts Pathways
Model of child sexual offending: a cluster analysis evaluation.
Psychol Crime Law 2012;18:129-153.
38. Ong AD, Weiss DJ. The impact of anonymity on responses to
sensitive questions. J Appl Soc Psychol 2000;30:1691-1708.
39. Dombert B, Mokros A, Brückner E, et al. The virtual people set:
developing computer-generated stimuli for the assessment of
pedophilic sexual interest. Sex Abuse 2013;25:557-582.
40. Tanner JM. Foetus into man: physical growth from conception
to maturity. Cambridge, MA: Harvard University Press; 1978.
41. Herman-Giddens ME, Slora EJ, Wasserman RC, et al. Sec-
ondary sexual characteristics and menses in young girls seen
in ofce practice: a study from the pediatric research in ofce
settings network. Pediatrics 1997;99:505-512.
42. Stephens S, Seto MC, Goodwill AM, et al. Evidence of
construct validity in the assessment of hebephilia. Arch Sex
Behav 2017;46:301-309.
43. International Business Machines Corp. IBM SPSS statistics for
windows, version 22.0. Armonk, NY: IBM Corp; 2013.
44. Kim TK. T-test as a parametric statistic. Korean J Anesthesiol
2015;68:540-546.
45. Conover WJ. Practical nonparametric statistics. 2nd ed. New
York: John Wiley & Sons; 1980.
46. Kim HY. Statistical notes for clinical researchers: chi-squared
test and Fishers exact test. Restor Dent Endod 2017;
42:152-155.
Sex Med 2020;-:1e14
Sexual Interest in Children Among Women 13
47. Grüsser OJ, Grüsser-Cornehls U. Gesichtssinn und Okulomo-
torik [Sense of sight and oculomotor system]. In: Schmidt RF,
ed. Physiologie des Menschen: Mit Pathophysiologie, 28. Au.
[Human physiology: including pathophysiology, 28th ed.].
Heidelberg, Germany: Springer; 2000. p. 278-315.
48. Underwood GP, Chapmann KB, Crundall D. Visual search while
driving: skill and awareness during inspection of the scene.
Transport Res F Trafc Psychol Behav 2002;5:87-97.
49. Kornbrot D. Pearson product moment correlation. Encyclo-
pedia of statistics in behavioral science. New York: Wiley;
2005.
50. Kish L. Survey sampling. London, GB: John Wiley & Sons, Inc
New York; 1965.
51. Bogdan RC, Biklen SK. Qualitative research in education: an
introduction to theory and methods. Boston, MA: Allyn &
Bacon; 2006.
52. Jahnke S. The stigma of pedophilia eclinical and forensic
implications. Eur Psychol 2018;23:144-153.
53. Allison S. Overlap between child porn and teensobsession.
Youth Stud Aust. Available at: http://link-1galegroup-1com-1
00cb2a630147.emedien3.sub.uni-hamburg.de/apps/doc/A
126357396/AONE?u¼hamburg&sid¼AONE&xid¼c4867
e5b. Accessed December 17, 2019.
54. Engel J, Veit M, Sinke C, et al. Same same but different: a
clinical characterization of men with hypersexual disorder in
the Sex@Brain study. J Clin Med 2019;8:E157.
55. Houtepen JABM, Sijtsema JJ, Bogaerts S. From child
pornography offending to child sexual abuse: a review of child
pornography offender characteristics and risks for cross-over.
Aggress Violent Behav 2014;19:466-473.
56. Gannon TA, Rose MR. Female child sexual offenders: towards
integrating theory and practice. Aggress Violent Behav
2008;13:442-461.
57. Miccio-Fonseca LC. Adult and adolescent female sex of-
fenders: experiences compared to other female and male sex
offenders. J Psychol Hum Sex 2000;11:75-88.
58. Peter T. Exploring taboos comparing male- and female-
perpetrated child sexual abuse. J Interpers Violence 2009;
24:1111-1128.
59. Hayes S, Baker B. Female sex offenders and pariah feminin-
ities: rewriting the sexual scripts. J Criminol 2014;1:1-8.
60. Denov MS. Perspectives on female sex offending: a culture of
denial. Aldershot, UK: Ashgate; 2004.
61. Cortoni F, Babchishin KM, Rat C. The proportion of sexual
offenders who are female is higher than thought: a meta-
analysis. Crim Justice Behav 2017;44:145-162.
62. Tozdan S, Briken P, Dekker A. Uncovering female child sexual
offenders-needs and challenges for practice and research.
J Clin Med 2019;8:401-412.
63. Osterheider M, Banse R, Briken P, et al. Frequency, etiological
models and consequences of child and adolescent sexual
abuse: aims and goals of the nationwide MiKADO project. Sex
Offender Treat 2012;6.
Sex Med 2020;-:1e14
14 Tozdan et al
... In recent years, researchers attempted to assess the prevalence of sexual interest in children in females among non-clinical samples and reported varying rates ranging from 0.4 to 9.6% (Baur et al., 2016;Tozdan, Dekker, Neutze, Santtila, & Briken, 2020;Wurtele, Simons, & Moreno, 2014). Baur et al. (2016) investigated 3,898 Finish women (twins aged 18-33 years) from a population-based sample and found that only 17 females (0.4%) reported pedophilic sexual interest measured by sexual interests, masturbation fantasies, and sexual partners across two specific age groups (0-6, 7-12 years). ...
... Wurtele et al. (2014) examined 262 females from a convenience sample of whom 0.8% reported some likelihood of masturbation and sexual attraction regarding children, 1.5% reported some likelihood of having sex with a child if they were guaranteed they would not be caught or punished, and 3.4% stated some likelihood of viewing child pornography on the Internet. Tozdan et al. (2020) aimed to investigate the extent to which adult women indicate sexual interest in prepubescent and/or pubescent children by their use of online abuse material (directly measured) and their sexual fantasies involving prepubescent and pubescent children indirectly measured by the assessment of pictures showing different undressed bodies among a non-representative online sample. Results showed that women who indicated a sexual interest in children rather reported consuming abuse material involving adolescents (total sample: 5%) than child actors (total sample: 0.8%) and rather indicated that they sexually fantasize about pubescent (total sample: 9.6%) than prepubescent children (total sample: 7.0%; Tozdan et al., 2020). ...
... Tozdan et al. (2020) aimed to investigate the extent to which adult women indicate sexual interest in prepubescent and/or pubescent children by their use of online abuse material (directly measured) and their sexual fantasies involving prepubescent and pubescent children indirectly measured by the assessment of pictures showing different undressed bodies among a non-representative online sample. Results showed that women who indicated a sexual interest in children rather reported consuming abuse material involving adolescents (total sample: 5%) than child actors (total sample: 0.8%) and rather indicated that they sexually fantasize about pubescent (total sample: 9.6%) than prepubescent children (total sample: 7.0%; Tozdan et al., 2020). These results are in contrast to results found in men who have a sexual interest in children but have not been known to justice for sexual offenses against children (i.e., non-forensic male samples) since they indicated a sexual attraction to both prepubescent and pubescent children (Tozdan & Briken, 2015. ...
Article
Little research has examined adult women’s sexual interest in children, particularly in non-forensic samples. We aimed to describe characteristics of women with sexual interest in children by recruiting 52 women (mean age: 33.2 years) who have a self-identified sexual interest in children under the age of 14 years into an anonymous online self-report study. Measures of interest referred to general characteristics (e.g., age, education level), general sexuality (e.g., sexual orientation, masturbation), and sexual interest in children (e.g., exclusivity, motivation to change). Results showed that women with sexual interest in children are similar to non-forensic samples of men with sexual interest in children in previous studies and rather differ from women from the general population regarding the investigated characteristics in this study. Our results clearly indicate that women with sexual interest in children need to be taken into account in future research and clinical practice. Treatment programs preventing sexual offenses against children or the consumption of abuse material need to explicitly address females as well.
... There are currently two published studies that report data from women who identify as MAPs, with these both presenting frequency analyses of sexual attraction patterns, the content of sexual fantasies, and female MAPs' engagement with child abuse imagery. For example, Tozdan et al. (2020) compared a sample of 42 female MAPs to a control sample of 832 community-based women and found no differences between the groups in terms of self-reported sexual orientation (i.e., heterosexual vs. homosexual vs. bisexual), relationship status, or age. However, the MAP subsample was more likely to have engaged with child abuse imagery involving children and teenagers and had a significantly higher level of sexual fantasizing about children (with the largest between-groups difference being in relation to fantasies involving girls). ...
... In a similar vein, we do not intend to compare women with and without sexual attractions to children. Early sexological analyses of these kinds have already been presented by and Tozdan et al. (2020), respectively. Instead, our principal aim is to offer an initial exploratory account of the lived experiences of female MAPs to inform future research studies and to provide recommendations about how to best support this group to both maximize their mental wellbeing and, where risks might exist, to prevent sexual offending. ...
... 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). ...
Article
Full-text available
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.
... but the rate data reported by victims up to 24.4% (Cortoni et al., 2017). Furthermore, as if that were not enough, professionals perceptions involved in services regarding cases of child sexual victimization conceive the female sex offenses as harmless, minimized, discarded, or indicate sexual interest toward prepubescent and pubescent children, but not adults, whose interest arose during adolescence among women (Stephens & McPhail, 2021;Tozdan et al., 2020). An interview series with six female minor-attracted persons explains the interpersonal and psychological difficulties among females participants, such as lonely secret existence (e.g., loneliness and alienation, hidden part of identity, disclosure deterrent) and a minority within a minority (e.g., questioning existence and ambivalent experience of their sexual interests) (Lievesley & Lapworth, 2021). ...
Preprint
Full-text available
In the light of the understanding of pedophilia, several disciplines have been an effort to analyze distinct levels of sexual attraction toward children but also sexual attraction toward children plus sexual offenses. Most recent evidence indicates a potential role of the biological sphere in sexual interest toward children and susceptibility to sexual offenses. In general, genetics is involved in the sexual interest of children. In addition, several neuroimage studies indicate a different brain structure among persons with pedophilia in comparison with persons with attraction toward adults and also considering the history of sexual crimes against children. Also, persons with pedophilia have physical features such as height, leg length, and congenital malformations. It suggests a different ontogeny process during gestation. The 2D:4D length ratio, a biomarker of prenatal androgenization in utero, has been linked with sexual offending against children and brain structure among persons with the pedophilic disorder. In contrast, theories of learning indicate that sexual victimization in childhood is associated with the risk of committing sexual offenses against children in later life. In contrast, some studies have had discrepancies if this adverse experience facilitates the development of pedophilic attraction. In women, recent studies indicate the presence of female minor-attracted persons and their social and psychological difficulties for their interests. Finally, evidence of pedophilic-like behaviors facilitated by altered brain mechanisms is associated with the propensity to commit sexual offending rather than sexual attraction. This review provides state of the art from the biological sphere of pedophilia considering criminal behavior.
... In recent years, researchers focused on estimating the prevalence of SIC in females among non-clinical samples. Results revealed rates ranging from 0.4 to 9.6% and proving that a phenomenon like SIC does not only exist in men (Baur et al., 2016;Tozdan et al., 2020;Wurtele et al., 2014). Most recently, Lievesley and Lapworth (2022) conducted interviews with six women who had self-identi ed SIC. ...
Preprint
Full-text available
Research on women with sexual interest in children (SIC) is still rare. Especially little is known about women’s own theories about the cause of their SIC, their experiences with disclosure, non-disclosure, and professional help. We therefore aimed at investigating women with SIC using a qualitative research approach. We provided women with SIC with open questions regarding their own theories about what causes their SIC, experiences with disclosure as well as non-disclosure, and experiences with and opinions about professional help. Analyses were conducted using a qualitative content analysis method. Results revealed that participants mainly think that past experiences caused their SIC, e.g., abusive or non-abusive sexual experiences during childhood. Disclose of SIC was reported by 56% of the present sample and lead to rather positive consequences. Those who did not disclose mainly did so due to fear of rejection and/or stigmatization. A total of 30% already sought help due to their SIC and frequently reported negative experiences. One of the major reasons participants stated on how to reach women with SIC in order to offer professional help was the destigmatization of SIC. We recommend that women with SIC should be taken more seriously among research and in prevention measure.
... However, not all deviant sexual fantasies are "high risk", and not all "high risk" fantasies lead to sexual offenses. In fact, sexual fantasies involving deviant behaviors with adults are common in the general population (Bartels & Gannon, 2011;Joyal, Cossette, & Lapierre, 2015), and the prevalence of child-related sexual fantasies ranges from 1.8% to 13% in men (Dombert et al., 2016;Joyal et al., 2015) and 0.4% to 7% in women (Bartova et al., 2021;Tozdan et al., 2020). The question raised, then, is what distinguishes "high risk" sexual fantasies that might lead to actual offenses from those that are a part of "normal" human experience? ...
Article
Although deviant sexual fantasizing has been found to be an etiological factor for sexual offending, not all deviant sexual fantasies increase risk equally. The aim of the present overview is to provide readers with an introduction to key terminology, a primer on central clinical theories, and a summary of the research literature on “high risk” sexual fantasies over the past 50 years. First, the important difference between “sexual fantasy” and “sexual fantasizing” is described. Second, the link between sexual fantasizing and sexual offending is discussed, with a focus on principle moderators such as physiological reaction, personality profile, and offense-supportive beliefs. Third, the different methods used to assess sexual fantasies are discussed. Fourth, the principles and techniques behind four evidence-based approaches to treating “high risk” sexual fantasies are discussed: (1) the behavioral approach, (2) the cognitive approach, (3) the imagination approach, and (4) the mindfulness-based approach. Finally, a call is issued for practice-based quantitative and qualitative research to further explore this clinical phenomenon. The findings of such investigations would advance the field’s understanding of assessment, management, and monitoring best practices for this important forensic population.
... More male users than female users (and nonbinary users) accessed Troubled Desire. This indeed coincides with the findings in existing literature showing that sexual interest in children is more common in men than in women [48,49]. At the same time, this also underlines the fact that sexual interest in children is also found in women. ...
Article
Background Despite the high prevalence of child sexual offenses and the increasing amounts of available child sexual abuse material, there is a global shortage of preventive interventions focusing on individuals at risk of sexual offending. The web-based app Troubled Desire aims to address this shortage by offering self-assessments and self-management training modules in different languages to individuals with sexual interests in prepubescent and early pubescent children (ie, those with pedophilic and hebephiliac sexual interest, respectively). Objective The aim of this study was to describe the characteristics of the users of the Troubled Desire app. Methods The fully completed self-assessment data gathered within the first 30 months of this study from October 25, 2017 to April 25, 2020 were investigated. The main outcome measures were (1) sociodemographic information and (2) sexual interests and sexual behaviors of the users of Troubled Desire. Results The self-assessment was completed by 4161 users. User accesses were mainly from Germany (2277/4161, 54.7%) and the United States (474/4161, 11.4%). Approximately 78.9% (3281/4161) of the users reported sexual interest in children; these users were significantly more likely to report distress and trouble owing to their sexual interest. Further, child sexual offenses and consumption of child sexual abuse material were significantly more common among users with sexual interest in children than among users with no sexual interest in children. Additionally, the majority of the offenses were not known to legal authorities. Conclusions The Troubled Desire app is useful in reaching out to individuals with sexual interest in prepubescent and early pubescent children. However, future research is warranted to understand the prospective relevance of the Troubled Desire app in the prevention of child sexual offending.
... More male users than female users (and nonbinary users) accessed Troubled Desire. This indeed coincides with the findings in existing literature showing that sexual interest in children is more common in men than in women [48,49]. At the same time, this also underlines the fact that sexual interest in children is also found in women. ...
Preprint
BACKGROUND Despite the high prevalence of child sexual abuse and the increasing amount of available child sexual abuse material, there is a global shortage of preventive interventions focusing on individuals at risk of sexual offending. OBJECTIVE Troubled Desire aims to address this shortage by offering self-assessment and self-management training modules for individuals who feel sexually attracted to prepubescent and early pubescent children (ie, pedophilic and hebephilic sexual interest) in seven different language versions. METHODS The present study analyzed characteristics of users within the first 30 months (25.10.2017-25.04.2020). RESULTS The self-assessment was completed by 4161 users from all over the world. The majority (78.9%, n=3281) reported pedophilic and/or hebephilic sexual interest. Of those with pedophilic and/or hebephilic sexual interest, 72.8% (n=2390) have used child sexual abuse material and 41.5% (n=1363) indicated they had sexually abused a child or children. The vast majority of offenses were committed within the “Dunkelfeld” (ie, not known to legal authorities). CONCLUSIONS These results illustrate the need for expansion and establishment of global preventive interventions for pedophilic and hebephilic individuals.
Article
Background Despite debates on what should constitute sexual interest in children in terms of definition and diagnostic criteria and its strong association with individuals who commit sexual offences against children, research in this area has shown that sexual interest in children is also commonly seen in the general population. Studies in this field have investigated its prevalence and its correlates. However, most research on this topic has focused on men and most particularly sex offender populations. When investigating the general population, again the vast majority of studies used male samples and students. Objective This systematic review aimed to critically evaluate previous research on the prevalence of sexual interest in children across populations and to examine its correlates. Methods A search of relevant databases was conducted as well as a hand search of selected journals to identify eligible papers. Studies meeting the inclusion criteria had their data extracted and were assessed for risk of bias, with a second rater to establish inter-rater reliability. Results A total of 30 studies were reviewed and results indicated a mean prevalence rate of sexual interest in children between 2 %–24 %. Findings also indicated correlates such as the presence of mental health problems and adverse childhood experiences. Most studies showed poor external validity, with the majority of them scoring high on risk of bias. Conclusion Overall, the findings indicate inconsistencies in terms of methodology and definition/diagnostic criteria of sexual interest in children. Further research in this area using recommended methodology to avoid biases is recommended.
Article
Full-text available
This article provides a short literature overview on female child sexual offenders (FCSO) focusing on the discrepancy between prevalence rates from different sources, characteristics of FCSO and their victims, as well as the societal "culture of denial" surrounding these women. FCSO are a powerful social taboo. Even professionals in the healthcare or justice system were shown to respond inappropriately in cases of child sexual abuse committed by women. As a result, offences of FCSO may be underreported and therefore difficult to research. The lack of scientific data on FSCO lowers the quality of child protection and treatment services. We therefore deem it particularly necessary for professionals in health care to break the social taboo that is FCSO and to further stimulate research on the topic of FCSO. We provide some general implications for professionals in health care systems as well as specific recommendations for researchers. We end with an overall conclusion.
Article
Full-text available
Problems arising from hypersexual behavior are often seen in clinical settings. We aimed to extend the knowledge about the clinical characteristics of individuals with hypersexual disorder (HD). A group of people who fulfilled the proposed diagnostic criteria for HD (men with HD, n = 50) was compared to a group of healthy controls (n = 40). We investigated differences in sociodemographic, neurodevelopmental, and family factors based on self-report questionnaires and clinical interviews. Men with HD reported elevated rates of sexual activity, paraphilias, consumption of child abusive images, and sexual coercive behavior compared to healthy controls. Moreover, rates of affective disorders, attachment difficulties, impulsivity, and dysfunctional emotion regulation strategies were higher in men with HD. Men with HD seem to have experienced various forms of adverse childhood experiences, but there were no further differences in sociodemographic, neurodevelopmental factors, and family factors. Regression analyses indicated that attachment-related avoidance and early onset of masturbation differentiated between men with HD and healthy controls. In conclusion, men with HD appear to have the same neurodevelopment, intelligence levels, sociodemographic background, and family factors compared to healthy controls, but they report different and adverse experiences in childhood, problematic sexual behavior, and psychological difficulties.
Article
Full-text available
There is an emerging consensus among researchers that having pedophilic interests is not synonymous with child sexual abuse or other amoral behavior. Nevertheless, misconceptions about pedophilia are highly prevalent among the general public and mental health practitioners. This article provides an overview of recent findings on the stigma of pedophilia and derives guidelines for mental health practitioners based on these results. We argue that stigmatization of people with pedophilic sexual interests has undesired indirect effects on risk factors for child sexual abuse, particularly on an emotional and social level. Also, fear of being rejected or treated unethically may prevent pedophilic individuals at risk for sexual offending from confiding in medical practitioners or psychotherapists. Psychologists working with pedophilic individuals in forensic or clinical settings should be aware that stigmatizing people with pedophilia may increase their risk of sexual offending, and provide help to deal with potential stigma-related repercussions.
Article
Full-text available
Among 26 pedophilic/hebephilic men, we investigated (1) the relationship between ‘specific self-efficacy for modifying a sexual interest in children’ (SSIC) and actual sexual interest in children and (2) whether changes of SSIC are associated with changes of sexual interest in children. Results showed that the more clients believe they are able to influence their sexual interest in children, the less strong they perceive their sexual interest in children. Furthermore, an increase of SSIC is associated with a decrease of the sexual interest in children. We suggest avoiding generalized statements about the immutability of a sexual interest in children.
Article
Introduction Current discussions in the field of sex research concern the age at which sexual interest in children occurred or awareness emerged. Aim To investigate the age of onset (AOO) and its correlates in men with sexual interest in children. Methods Using 2 samples (study 1, patients from an outpatient treatment center, n = 26; study 2, an online survey using 3 recruitment paths, n = 94), we assessed self-reported AOO of sexual interest in children, its flexibility, its exclusiveness, and individuals’ motivation to change it. We further examined the interrelation between these variables. Main Outcome Measure AOO as the self-reported age at which participants retrospectively felt sexually attracted to children for the first time. Results We found broad ranges in AOO (study 1: mean 20.0 ± 10.7; study 2: mean 17.0 ± 8.7), flexibility, and exclusiveness (in studies 1 and 2, 7.7% and 22.3%, respectively, reported that their sexual interest is exclusively in children). The earlier participants felt sexually attracted to children for the first time, the more they were attracted exclusively in children and the less they perceived it to be flexible. Participants who reported rather exclusive sexual interest in children were less likely to perceive it as flexible. The more participants reported on flexibility, the more they were motivated to change it. The earlier participants of study 2 felt sexually attracted to children for the first time, the less they were motivated to change. Clinical Implications The variety of our results indicates the contradiction of overall rules for individuals with sexual interest in children. Strength & Limitations We included individuals with sexual interest in children from different contexts (eg, forensic vs non-forensic). Our results are in line with previous findings. However, both studies included rather small samples, limiting generalizability. There is not yet consent about how to operationalize AOO. Conclusion We recommend a differentiated perspective on individuals with sexual interest in children and on different forms of pedophilia in the diagnostic construct. Tozdan S, Briken P. Age of Onset and Its Correlates in Men with Sexual Interest in Children.Sex Med 2019;7:61–71.
Article
Recent research on a risk assessment tool for child pornography offending suggests that admission of sexual interest in children is a risk factor for any sexual recidivism. Admission is easily vulnerable to lying, however, or to refusals to respond when asked about sexual interests. This may become a particular issue when individuals are concerned about the potential impact of admission of sexual interest on sentencing and other risk-related decisions. In this study, we identified the following behavioral correlates (coded yes/no) of admission of sexual interest in children in the risk tool development sample of 286 men convicted of child pornography offenses: (a) never married (54% of sample), (b) child pornography content included child sexual abuse videos (64%), (c) child pornography content included sex stories involving children (31%), (d) evidence of interest in child pornography spanned 2 or more years (55%), (e) volunteered in a role with high access to children (7%), and (f) engaged in online sexual communication with a minor or officer posing as a minor (10%). When summed, the average score on this Correlates of Admission of Sexual Interest in Children (CASIC) measure was 2.21 (SD = 1.22, range 0-6) out of a possible 6, and the CASIC score was significantly associated with admission of sexual interest in children, area under the curve (AUC) = .71, 95% CI [ .65, .77]. The CASIC had a stronger relationship with admission in a small cross-validation sample of 60 child pornography offenders, AUC = .81, 95% CI [.68, .95]. CASIC scores may substitute for admission of sexual interest in risk assessment involving those with child pornography offenses. (PsycINFO Database Record
Article
To explore the relationship between dynamic risk factors and recidivism in child molesters, we studied a sample of men (N=495) who completed an intensive, prison-based treatment program in New Zealand. During the follow-up period (M=5.8 years), 9.9% were reconvicted for a sexual offense. A self-report psychometric battery was administered at pre-treatment that assessed a range of variables related to sexual attitudes and beliefs, emotional functioning, and interpersonal competency. Factor analysis showed that individual differences in the battery could be described by four dimensions—Social Inadequacy, Sexual Interests, Anger/Hostility, and Pro-Offending Attitudes. Factor scores for each dimension were significantly correlated with sexual recidivism. Logistic regression analyses confirmed that the Sexual Interests and Pro-Offending Attitudes factor scores, as well as an Overall Deviance score which combined the dimensions, provided significant additional validity for predicting recidivism beyond the Static-99 (Hanson and Thornton Law and Human Behavior 24:119-136, 2000). When added to the Static-99, the Overall Deviance score increased the area under the Receiver-Operating Characteristic curve (AUC) from 0.72 to 0.81. These results show that psychometric self-reports can provide valid measures of dynamic risk factors, and that inclusion of such measures can improve risk prediction beyond that achievable by static factors alone.