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Paraphilic disorders are characterised by abnormalities and disturbances in ones sexual behaviour and attraction which causes significant distress and impairment to personal functioning. Paedophilia is a psychosexual paraphilic disorder involving sexual attraction towards children below the age of consent. Paedophilic attraction is mistakenly used synonymously with child molestation, this is present in the diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 diagnosis criteria for paedophilia requires the occurrence of sexual behaviour towards children for more than 6 months, even if the person does not have sexual fantasies or urges towards children. This criteria is problematic as there are non-offending paedophiles and 43% of offenders are indeed paedophiles. The seemingly automatic link between offenders and paedophilic attraction reiterates the stigma the disorder faces, possibly discouraging paedophiles of seeking medical help. Paedophilia itself is not inherently harmful, child sexual offences are, especially regarding psychological damage. Whilst there are non-offending paedophiles and a differentiation is important, research shows that paedophilia remains a disorder not an orientation.
Current research supports the statement that paedophilia is a disorder (DSM-5). The 2014 meta-analysis paper featured research which linked paedophilia with neurological abnormalities, the paper featured 3 independent voxel-based morphometry (VBM) studies which through MRIs found a reduced volume of the amygdala in paedophiles. The 2007 study by Schiltz analysed MRIs of 15 male offending paedophiles and 15 controls without the disorder, 13 of the offenders were solely attracted to children and were not on medication; the data suggested that the structural abnormalities found could interfere with sexual maturation. However, the study did not specify whether the paedophiles had dealt with neurodevelopmental problems, previous brain injury or. On the other hand, the findings are supported by a previous study which linked brain irregularities and lesions with anomalous sexual attractions. The 1993 study found that as one reaches puberty there is a decrease in child sexual interest, data from that study showed that loss of sexual interest for children peaked at the age of 12, however this is not the case for paedophiles. Some may argue that this is proof of paedophilia being an orientation as sexual orientation develops around puberty.
However, differently to non-paedophiles, research indicates that paedophiles develop this paraphilic attraction due to brain structural anomalies which prohibits the loss of child sexual attraction, which normally occurs around puberty. The second study featured in the 2014 paper featured 18 inpatient paedophiles who were only attracted to children and were unmedicated as well as 24 controls. 50% of the total 42 participants were solely attracted to males, the other 50% was solely attracted to females. This study also found reduced volume of the amygdala in paedophiles. From the results the authors inferred a relation between obsessive-compulsive disorder and paedophilia. Reduced amygdala volume has also been linked with psychopathic traits such as aggression, emotional apathy as well as lack of empathy. The shared neurological abnormalities found in other psychological disorders further suggests that paedophilia is a disorder also. The third study compared 9 unmedicated offending paedophiles with 11 non offending paedophiles, the study also found volume reductions in the amygdala in their participants. Whilst the 3 VBM studies had small sample sizes their research showed matching results across the studies. The amygdala has been linked in sexual arousal processing; it is likely the amygdala irregularity could be a definitive trait of paedophilic disorder. Overall, the combined corresponding results between the 3 studies draws a considerable link between amygdala irregularities and paedophiles, since it indicates there is a neurodevelopmental irregularity regarding sexual arousal processing present. Further research should be conducted regarding these findings as they may provide new diagnosis tools and therapies to better help paedophiles understand their condition and prevent offenses. Overall, these brain irregularities have not been expressively linked to the healthy controls of which many were heterosexual and homosexual, therefore paedophilia is clearly a disorder not an orientation.
Lastly, it is understood that paedophilia has a lifelong duration. Since paedophilic age of onset matches that of other sexual orientations and paedophiles deal with their paraphilic attraction for upwards of 40 years some may argue that it is a lifelong attraction and therefore orientation, as it cannot be changed. On the other hand, the Klein Sexual Orientation Grid (KSOG) does not include age preference as a component of sexual orientation. The KSOG is deemed an admissible research tool. However, the KSOG is arguably outdated, Setos 2012 study is a more contemporary outlook and uses parameters, including age onset which would allow paedophilia to be deemed a sexual orientation. Although, as previously stated age of onset shows a disturbance within the paedophiles neurological structure due to structural abnormalities in the brain, it is not evidence of paedophilia being an orientation.
Studies show a strong link between being a childhood victim to later developing and perpetrating paedophilic sexual disorder. The study retrospectively reviews the clinical cases of 843 patients. Whilst the 2001 study featured a large sample size it consisted of a clinical population; the sample was large but arguably not representative of the wider population. However, the results were conclusively drawn from a large sample size which does make the found link likely to be true. Since it is more likely for paedophilia victims to become perpetrators it seems that it is not innate like sexual orientation is. Since being a child sexual assault victim leads to psychological trauma and mental health issues it is possible that paedophilic disorder is an extension of mental health trauma faced in early years.
Current research concludes that paedophilia cannot be an orientation. Not only is it defined as a disorder by the DSM-5, it is also not included as an orientation in the KSOG. Furthermore, studies show that paedophiles tend to have a reduced volume of the amygdala; the amygdala has been implicated with sexual arousal and processing; therefore, the irregularity likely results in paedophilic disorder. Research shows that victims of child sexual abuse are more likely to become perpetrators of paedophilia, these findings further indicate that paedophilia is not an orientation but a psychological disorder. Since paedophilia is a disorder it is important to understand that paedophiles cannot be blamed for their paraphilic sexual attractions, they should be held responsible for their actions not for having the disorder. Understanding paedophilia as a disorder is likely to have positive societal outcomes, perhaps paedophiles will be more likely to seek help and will feel less shame since research shows they are not at fault for their disorder.
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