In looking through my blog posts, I don't think I ever specifically addressed the question of how to characterize pedophilia. Sexual orientation? Mental disorder or illness or disease?

When pedophilia is discussed, a frequent debate is whether it is a mental illness or not. Those who especially detest pedophiles are likely to feel passionately it is a disorder, and some pedophiles will insist with equal passion that it is a sexual orientation.

I don't object especially to calling it a mental disorder, and I don't especially mind if people say it isn't an orientation. To me the question isn't what you call it but what you are going to do with the information.

To quote the Virtuous Pedophiles FAQ, "Terms such as mental illness and mental disorder are not precisely defined, and we doubt that they can be defined based on science alone. Values – our opinion of the desirability of a condition – invariably intrude on the decision whether that condition is a mental illness or merely reflects a difference with other people."

The key fact for me is that pedophilia is not a cause for shame. We don't expect people to feel shame for physical ailments such as cancer or diabetes. We mostly don't blame people for getting mental conditions like schizophrenia or manic-depressive illness -- and if we do we shouldn't. Sometimes people have some responsibility for an illness -- perhaps being overweight is a risk factor for diabetes. Many people who are HIV positive engaged in some risky behavior. Drug addicts could have avoided their situation if they had never started using the drug. In comparison, pedophiles are completely innocent. There is nothing we did to bring on the condition and nothing we we could have done to prevent it. There also seems to be nothing we can do to cure it.

Pedophilia is rare (perhaps one percent of the male population), it very often causes distress, it is a risk factor for sexual abuse of children, and it certainly is considered undesirable by society at large and not just a difference from other people. So it's reasonable to call it a disorder -- as long as we are very clear it is not a cause for shame.

Is it a sexual orientation?

Google Ngram viewer confirms my sense that "sexual orientation" came into public awareness recently (roughly 1970). It was for the specific purpose of describing homosexuality in terms other than a disorder. Some scientists might say it specifically concerns the gender  or sex of who you are attracted to and nothing else.

Other scientists might say a "sexual orientation" is a persistent sexual attraction to an entire class of people. And children are certainly an entire class of people. Scientifically, pedophilia shares with homosexuality many things: both are set early in life without regard to life experiences, neither is highly heritable, and no one has found a way to change either one despite decades of serious efforts to do so.

The gender/sex-only position seems to be a popular among LGBT activists. Partly they want nothing whatsoever to do with the stigma that comes with being associated in any way with pedophiles. You could also argue that sexual orientation now has a political meaning that goes beyond the scientific. "Sexual orientation" might have among its implications that it's just fine and perfectly OK to act on your orientation to have sex with willing partners. Pedophilia would not meet that definition.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, the psychiatrist's 'bible', 2013) includes this passage:

“If individuals 'report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic impulses (according to self-report, objective assessment, or both), and their self-reported and legally recorded histories indicate that they have never acted on their impulses, then these individuals have a pedophilic sexual orientation but not pedophilic disorder.'"

They evidently felt that it was either an orientation or a disorder but not both (though why isn't obvious to me). Due to a storm of protest, they changed "sexual orientation" to "sexual interest". I figure this was due mostly to pressure from LGBT activists. But they didn't back down from saying it wasn't (by itself) a disorder. It sounds like "sexual interest" is intended to cover the same scientific ground as the broader definition of sexual orientation.

Another reason to make something a disorder is that insurance won't typically pay for treating something that isn't a disorder. And since pedophiles do frequently feel guilt, shame or anxiety around their attraction, it might help to be able to call it a disorder to get coverage for treating those things.

It's also possible that "sexual orientation" has entered the legal system and has specific associated rights and privileges. In that case, I would say that it is right to exclude pedophilia since those drafting the legislation clearly didn't have pedophilia in mind when they wrote the laws.

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