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Saturday, July 24, 2021

Adolescent sexuality

From Wikipedia, the free encyclopedia

Adolescent sexuality is a stage of human development in which adolescents experience and explore sexual feelings. Interest in sexuality intensifies during the onset of puberty, and sexuality is often a vital aspect of teenagers' lives. Sexual interest may be expressed in a number of ways, such as flirting, kissing, masturbation, or having sex with a partner. Sexual interest among adolescents, as among adults, can vary greatly, and is influenced by cultural norms and mores, sex education, as well as comprehensive sexuality education provided, sexual orientation, and social controls such as age-of-consent laws.

Sexual activity in general is associated with various risks. The risks of sexual intercourse include unwanted pregnancy and contracting a sexually transmitted infection such as HIV/AIDS, which can be reduced with availability and use of a condom or adopting other safe sex practices. Contraceptives specifically reduce the chance of pregnancy.

The risks are higher for young adolescents because their brains are not neurally mature. Several brain regions in the frontal lobe of the cerebral cortex and in the hypothalamus that are deemed important for self-control, delayed gratification, risk analysis, and appreciation are not fully mature. The prefrontal cortex area of the human brain is not fully developed until the early 20s or about age 25. Partially, because of this, young adolescents are generally less equipped than adults to make sound decisions and anticipate consequences of sexual behavior, although brain imaging and behavioral correlation studies in teens have been criticized for not being causative.

Development of sexuality

Adolescent sexuality begins at puberty. The sexual maturation process produces sexual interest and stimulates thought processes. Subsequent sexual behavior starts with the secretion of hormones from the hypothalamus and anterior pituitary gland. These hormones target the sexual organs and begin their maturation. Increasing levels of androgen and estrogen have an effect on the thought processes of adolescents and have been described as being in the minds "of almost all adolescents a good deal of the time".

Though most female adolescents begin their sexual maturation process in normal, predictable ways, there may be concerns by parents and clinicians if the following become evident:

  • painful menstruation
  • chronic pelvic pain
  • partial vaginal outflow obstruction/imperforate hymen
  • possible anatomical defects

Views on sexual activity

One study from 1996 documented the interviews of a sample of junior high school students in the United States. The girls were less likely to state that they ever had sex than adolescent boys. Among boys and girls who had experienced sexual intercourse, the proportion of girls and boys who had recently had sex and were regularly sexually active was the same. Those conducting the study speculated that fewer girls say they have ever had sex because girls viewed teenage parenthood as more of a problem than boys. Girls were thought to be more restricted in their sexual attitudes; they were more likely than boys to believe that they would be able to control their sexual urges. Girls had a more negative association in how being sexually active could affect their future goals. In general, girls said they felt less pressure from peers to begin having sex, while boys reported feeling more pressure.

A later study questioned the attitudes of adolescents. When asked about abstinence, many girls reported they felt conflicted. They were trying to balance maintaining a good reputation with trying to maintain a romantic relationship and wanting to behave in adult-like ways. Boys viewed having sex as social capital. Many boys believed that their male peers who were abstinent would not as easily climb the social ladder as sexually active boys. Some boys said that for them, the risks that may come from having sex were not as bad as the social risks that could come from remaining abstinent.

Concepts about loss of virginity

In the United States, federally mandated programs started in 1980 and promoted adolescent abstinence from sexual intercourse, which resulted in teens turning to oral sex, which about a third of teens considered a form of abstinence in a study.

Until their first act of sexual intercourse, adolescents generally see virginity in one of the following ways: as a gift, a stigma, or a normal step in development. Girls typically think of virginity as a gift, while boys think of virginity as a stigma. In interviews, girls said that they viewed giving someone their virginity as like giving them a very special gift. Because of this, they often expected something in return such as increased emotional intimacy with their partners or the virginity of their partner. However, they often felt disempowered because of this; they often did not feel like they actually received what they expected in return and this made them feel like they had less power in their relationship. They felt that they had given something up and did not feel like this action was recognized.

Thinking of virginity as a stigma disempowered many boys because they felt deeply ashamed and often tried to hide the fact that they were virgins from their partners, which for some resulted in their partners teasing them and criticizing them about their limited sexual techniques. The girls who viewed virginity as a stigma did not experience this shaming. Even though they privately thought of virginity as a stigma, these girls believed that society valued their virginity because of the stereotype that women are sexually passive. This, they said, made it easier for them to lose their virginity once they wanted to because they felt society had a more positive view on female virgins and that this may have made them sexually attractive. Thinking of losing virginity as part of a natural developmental process resulted in less power imbalance between boys and girls because these individuals felt less affected by other people and were more in control of their individual sexual experience. Adolescent boys, however, were more likely than adolescent girls to view their loss of virginity as a positive aspect of their sexuality because it is more accepted by peers.

Behavior

Prevalence of sexually experienced 15-year-olds
Country Boys (%) Girls (%)
Austria 21.7 17.9
Canada 24.1 23.9
Croatia 21.9 8.3
England 34.9 39.9
Estonia 18.8 14.1
Finland 23.1 32.7
Belgium 24.6 23
France 25.1 17.7
Greece 32.5 9.5
Hungary 25 16.3
Israel 31 8.2
Latvia 19.2 12.4
Lithuania 24.4 9.2
North Macedonia 34.2 2.7
Netherlands 23.3 20.5
Poland 20.5 9.3
Portugal 29.2 19.1
Scotland 32.1 34.1
Slovenia 45.2 23.1
Spain 17.2 13.9
Sweden 24.6 29.9
Switzerland 24.1 20.3
Ukraine 47.1 24
Wales 27.3 38.5

Birth control

In 2002, a survey was conducted in European nations about the sexual behavior of teenagers. In a sample of 15-year-olds from 24 countries, most participants self-reported that they had not experienced sexual intercourse. Among those who were sexually active, the majority (82.3%) had used contraception at last intercourse.

A nationally representative Danish study found that teenage girls who use the most common form of birth control pills, combination birth control pills with both estrogen and progestin, are 80% more likely to be prescribed an antidepressant than girls who were not taking birth control. Girls who take progestin-only pills are 120% more likely. The risk of depression is tripled for teenage girls who use non-oral forms of hormonal contraception.

Adolescent sexual functioning: gender similarities and differences

Lucia O'Sullivan and her colleagues studied adolescent sexual functioning: they compared an adolescent sample with an adult sample and found no significant differences between them. Desire, satisfaction and sexual functioning were generally high among their sample of participants (aged 15–21). Additionally, no significant gender differences were found in the prevalence of sexual dysfunction. In terms of problems with sexual functioning mentioned by participants in this study, the most common problems listed for males were experiencing anxiety about performing sexually (81.4%) and premature ejaculation (74.4%). Other common problems included issues becoming erect and difficulties with ejaculation. Generally, most problems were not experienced on a chronic basis. Common problems for girls included difficulties with sexual climax (86.7%), not feeling sexually interested during a sexual situation (81.2%), unsatisfactory vaginal lubrication (75.8%), anxiety about performing sexually (75.8%) and painful intercourse (25.8%). Most problems listed by the girls were not persistent problems. However, inability to experience orgasm seemed to be an issue that was persistent for some participants.

The authors detected four trends during their interviews: sexual pleasure increased with the amount of sexual experience the participants had; those who had experienced sexual difficulties were typically sex-avoidant; some participants continued to engage in regular sexual activity even if they had low interest; and lastly, many experienced pain when engaging in sexual activity if they experienced low arousal.

Another study found that it was not uncommon for adolescent girls in relationships to report they felt little desire to engage in sexual activity when they were in relationships. However, many girls engaged in sexual activity even if they did not desire it, in order to avoid what they think might place strains on their relationships. The researcher states that this may be because of society's pressure on girls to be "good girls"; the pressure to be "good" may make adolescent girls think they are not supposed to feel desire like boys do. Even when girls said they did feel sexual desire, they said that they felt like they were not supposed to, and often tried to cover up their feelings. This is an example of how societal expectations about gender can impact adolescent sexual functioning.

Gender disparities in oral sex among adolescents

There are gender differences in the giving and receiving of oral sex. One study demonstrated that young men expected to receive oral sex more than young women expected to receive it. With 43% of men and 20% of women expecting to receive it. Additionally more young men reported having oral-penis contact over oral-vulva contact with a different gender. Young men also receive more frequent oral sex than young women. One study with U.S. college students reported 62% of female participants were more likely to report giving oral sex more than they received it. However similar proportions of young men and women report having experienced oral sex.

In Brazil

The average age Brazilians lose their virginity is 17.4 years of age, the second-lowest number in the countries researched (first was Austria), according to the 2007 research finding these results, and they also ranked low at using condoms at their first time, at 47.9% (to the surprise of the researchers, people of lower socioeconomic status were far more likely to do so than those of higher ones). 58.4% of women reported that it was in a committed relationship, versus solely 18.9% of men (traditional Mediterranean cultures-descended mores tend to enforce strongly about male sexual prowess equating virility and female quality being chastity and purity upon marriage), and scored among the countries where people have the most positive feelings about their first time, feeling pleasure and more mature afterwards (versus the most negative attitudes coming from Japan).

In another research, leading the international ranking, 29.6% of Brazilian men lost their virginity before age 15 (versus 8.8% of women), but the average is really losing virginity at age 16.5 and marrying at age 24 for men, and losing virginity at age 18.5 and marrying at age 20 for women. These do not differ much from national figures. In 2005, 80% of then adolescents lost their virginity before their seventeenth birthday, and about 1 in each 5 new children in the country were born to an adolescent mother, where the number of children per women is solely 1.7 in average, below the natural replacement and the third lowest in independent countries of the Americas, after Canada and Cuba.

A 2013 report through national statistics of students of the last grade before high school, aged generally (86%) 13–15, found out 28.7% of them already had lost their virginity, with both demographics of 40.1% of boys and 18.3% of girls having reduced their rate since the last research, in 2009, that found the results as 30.5% overall, 43.7% for boys and 18.7% for girls. Further about the 2013 research, 30.9% of those studying in public schools were already sexually initiated, versus 18% in private ones; 24.7% of sexually initiated adolescents did not use a condom in their most recent sexual activity (22.9% of boys, 28.2% of girls), in spite of at the school environment 89.1% of them receiving orientation about STDs, 69.7% receiving orientation of where to acquire condoms for free (as part of a public health campaign from the Brazilian government) and 82.9% had heard of other forms of contraceptive methods.

In Canada

One group of Canadian researchers found a relationship between self-esteem and sexual activity. They found that students, especially girls, who were verbally abused by teachers or rejected by their peers were more likely than other students to have sex by the end of the Grade 7. The researchers speculate that low self-esteem increases the likelihood of sexual activity: "low self-esteem seemed to explain the link between peer rejection and early sex. Girls with a poor self-image may see sex as a way to become 'popular', according to the researchers".

In India

In India there is growing evidence that adolescents are becoming more sexually active. It is feared that this will lead to an increase in spread of HIV/AIDS among adolescents, increase the number of unwanted pregnancies and abortions, and give rise to conflict between contemporary social values. Adolescents have relatively poor access to health care and education. With cultural norms opposing extramarital sexual behavior, R.S. Goyal fears "these implications may acquire threatening dimensions for the society and the nation".

Motivation and frequency

Sexual relationships outside marriage are not uncommon among teenage boys and girls in India. In a random study of 100 couples, the best predictor of whether or not a girl would be having sex is if her friends were engaging in the same activities. For those girls whose friends were having a physical relationship with a boy, 84.4% were engaging in the same behavior. Only 24.8% of girls whose friends were not having a physical relationship had one themselves. In urban areas, 25.2% of girls have had intercourse and in rural areas 20.9% have. Better indicators of whether or not girls were having sex were their employment and school status. Girls who were not attending school were 14.2% (17.4% v. 31.6%) more likely to be having sex; for girls who were employed this number was 14.4% (36.0% v. 21.6%).

In the Indian sociocultural milieu girls have less access to parental love, schools, opportunities for self-development and freedom of movement than boys do. It has been argued that they may rebel against this lack of access or seek out affection through physical relationships with boys. While the data reflects trends to support this theory, it is inconclusive. The freedom to communicate with adolescent boys was restricted for girls regardless of whether they lived in an urban or rural setting, and regardless of whether they went to school or not. More urban girls than rural girls discussed sex with their friends. Those who did not may have felt "the subject of sexuality in itself is considered an 'adult issue' and a taboo or it may be that some respondents were wary of revealing such personal information."

Contraceptive use

Among Indian girls, Goyal claims that "misconceptions about sex, sexuality and sexual health were large. However, adolescents having sex relationships were somewhat better informed about the sources of spread of STDs and HIV/AIDS." While 40% of sexually active girls were aware that condoms could help prevent the spread of HIV/AIDS and reduce the likelihood of pregnancy, only 10.5% used a condom during the last time they had intercourse.

In The Netherlands

According to Advocates for Youth, the United States' teen pregnancy rate is over four times as much as it is in the Netherlands. In comparison, in the documentary, Let's Talk About Sex, a photographer named James Houston travels from Los Angeles to D.C. and to the Netherlands. In the Netherlands, he contrasts European and American attitudes about sex. From the HIV rates to the contemplations of teen parenthood in America, Houston depicts a society in which America and the Netherlands differ.

Most Dutch parents practice vigilant leniency, in which they have a strong familial bond and are open to letting their children make their own decisions.

Gezelligheid is a term used by many Dutch adolescents to describe their relationship with their family. The atmosphere is open and there is little that is not discussed between parents and children.

Amy Schalet, author of Not Under My Roof: Parents, Teens, and the Culture of Sex discusses in her book how the practices of Dutch parents strengthen their bonds with their children. Teenagers feel more comfortable about their sexuality and engage in discussion with their parents about it. A majority of Dutch parents feel comfortable allowing their teenagers to have their significant other spend the night.

Same-sex attractions among adolescents

Adolescent girls and boys who are attracted to others of the same sex are strongly affected by their surroundings in that adolescents often decide to express their sexualities or keep them secret depending on certain factors in their societies. These factors affect girls and boys differently. If girls’ schools and religions are against same sex attractions, they pose the greatest obstacles to girls who experience same sex attractions. These factors were not listed as affecting boys as much. The researchers suggest that maybe this is because not only are some religions against same-sex attraction, but they also encourage traditional roles for women and do not believe that women can carry out these roles as lesbians. Schools may affect girls more than boys because strong emphasis is placed on girls to date boys, and many school activities place high importance on heterosexuality (such as cheerleading). Additionally, the idea of not conforming to typical male gender roles inhibited many boys from openly expressing their same-sex attraction. The worry of conforming to gender roles did not inhibit girls from expressing their same-gender preferences as much, because society is generally more flexible about their gender expression.

Researchers such as Lisa Diamond are interested in how some adolescents depart from the socially constructed norms of gender and sexuality. She found that some girls, when faced with the option of choosing "heterosexual", "same-sex attracted" or "bisexual", preferred not to choose a label because their feelings do not fit into any of those categories.

Sexually transmitted infections

Adolescents have the highest rates of sexually transmitted infections (STIs) when compared to older groups. Sexually active adolescents are more likely to believe that they will not contract a sexually transmitted infection than adults. Adolescents are more likely to have an infected partner and less likely to receive health care when an STI is suspected. They are also less likely to comply with the treatment for an STI. Coinfection is common among adolescents.

An STI can have a large negative physiological and psychological effect on an adolescent. The goal of the pediatrician is for early diagnosis and treatment. Early treatment is important for preventing medical complications and infertility. Prevention of STIs should be a priority for all health care providers for adolescents. Diagnosis of an STI begins the evaluation of concomitant STIs and the notification and treatment of sexual partners. Some states in the US require the reporting of STIs to the state's health department.

Media influence

Modern media contains more sexual messages than was true in the past and the effects on teen sexual behavior remain relatively unknown. Only 9% of the sex scenes on 1,300 of cable network programming discusses and deals with the potentially negative consequences of sexual behavior. The internet may further provide adolescents with poor information on health issues, sexuality, and sexual violence.

A study on examining sexual messages in popular TV shows found that 2 out of 3 programs contained sexually related actions. 1 out of 15 shows included scenes of sexual intercourse itself. Shows featured a variety of sexual messages, including characters talking about when they wanted to have sex and how to use sex to keep a relationship alive. Some researchers believe that adolescents can use these messages as well as the sexual actions they see on TV in their own sexual lives.

The results of a study by Deborah Tolman and her colleagues indicated that adolescent exposure to sexuality on television in general does not directly affect their sexual behaviors, rather it is the type of message they view that has the most impact. Gender stereotypes enacted in sexual scenes on TV were seen to have a large effect on adolescents. Girls felt they had less control over their sexuality when they saw men objectifying women and not valuing commitment. The study discussed the risk of women internalizing this message and spreading the idea that it is okay to be weak and answer to men all the time. However, girls who saw women on TV who refuted men's sexual advances usually felt more comfortable talking about their own sexual needs in their sexual experiences as well as standing up for themselves. They were comfortable setting sexual limits and therefore held more control over their sexuality. Findings for boys were less clear; those who saw dominant and aggressive men actually had fewer sexual experiences.

However some scholars have argued that such claims of media effects have been premature. Furthermore, according to US government health statistics, teens have delayed the onset of sexual intercourse in recent years, despite increasing amounts of sexual media.

A 2008 study wanted to find out if there was any correlation between sexual content shown in the media and teenage pregnancy. Research showed that teens who viewed high levels of sexual content were twice as likely to get pregnant within three years compared to those teens who were not exposed to as much sexual content. The study concluded that the way media portrays sex has a huge effect on adolescent sexuality.

Teenage pregnancy

Adolescent girls become fertile following the menarche (first menstrual period), which normally occurs between age 11 to 12. After menarche, sexual intercourse (especially without contraception) can lead to pregnancy. The pregnant teenager may then miscarry, have an abortion, or carry the child to full term.

Pregnant teenagers face many of the same issues of childbirth as women in their 20s and 30s. However, there are additional medical concerns for younger mothers, particularly those under 15 and those living in developing countries. For example, obstetric fistula is a particular issue for very young mothers in poorer regions. For mothers between 15 and 19, risks are associated more with socioeconomic factors than with the biological effects of age. However, research has shown that the risk of low birth weight is connected to the biological age itself, as it was observed in teen births even after controlling for other risk factors (such as utilisation of antenatal care etc.).

Worldwide, rates of teenage births range widely. For example, sub-Saharan Africa has a high proportion of teenage mothers whereas industrialized Asian countries such as South Korea and Japan have very low rates. Teenage pregnancy in developed countries is usually outside of marriage, and carries a social stigma; teenage mothers and their children in developed countries show lower educational levels, higher rates of poverty, and other poorer "life outcomes" compared with older mothers and their children. In the developing world, teenage pregnancy is usually within marriage and does not carry such a stigma.

Legal issues

Worldwide ages of consent for heterosexual sex by country

  – puberty
  – less than 12
  – 12
  – 13
  – 14
  – 15
  – 16
  – 17
  – 18
  – 19
  – 20
  – 21+
  – varies by state/province/region/territory
  – must be married
  – no law
  – no data available

Sexual conduct between adults/adolescents and adolescents younger than the local age of consent is generally illegal, aside from close-in-age exemptions or in jurisdictions where only sex between married couples is legal, such as those in some Islamic countries. In many jurisdictions, sexual intercourse between adolescents with a close age difference is not prohibited. Around the world, the average age-of-consent is 16, but this varies from being age 13 in Sudan, age 16 in Spain and Canada, and age 16–18 in the United States. In some jurisdictions, the age-of-consent for homosexual acts may be different from that for heterosexual acts. The age-of-consent in a particular jurisdiction is typically the same as the age of majority or several years younger. The age at which one can legally marry is also sometimes different from the legal age-of-consent.

Sexual relations with a person under the age-of-consent are generally a criminal offense in the jurisdiction in which the act was committed, with punishments ranging from token fines to life imprisonment. Many different terms exist for the charges laid and include statutory rape, illegal carnal knowledge, or corruption of a minor. In some jurisdictions, sexual activity with someone above the legal age-of-consent but beneath the age of majority can be punishable under laws against contributing to the delinquency of a minor.

In some countries marrying a person under the age of consent may make sex with that person legal regardless of the age of consent.

Societal influence

Social constructionist perspective

The social constructionist perspective (see social constructionism for a general definition) on adolescent sexuality examines how power, culture, meaning and gender interact to affect the sexualities of adolescents. This perspective is closely tied to feminism and queer theory. Those who believe in the social constructionist perspective state that the current meanings most people in our society tie to female and male sexuality are actually a social construction to keep heterosexual and privileged people in power.

Researchers interested in exploring adolescent sexuality using this perspective typically investigates how gender, race, culture, socioeconomic status and sexual orientation affect how adolescent understand their own sexuality. An example of how gender affects sexuality is when young adolescent girls state that they believe sex is a method used to maintain relationships when boys are emotionally unavailable. Because they are girls, they believe they ought to engage in sexual behavior in order to please their boyfriends.

Developmental feminist perspective

The developmental feminist perspective is closely tied to the social constructionist perspective. It is specifically interested in how society's gender norms affect adolescent development, especially for girls. For example, some researchers on the topic hold the view that adolescent girls are still strongly affected by gender roles imposed on them by society and that this in turn affects their sexuality and sexual behavior. Deborah Tolman is an advocate for this viewpoint and states that societal pressures to be "good" cause girls to pay more attention to what they think others expect of them than looking within themselves to understand their own sexuality. Tolman states that young girls learn to objectify their own bodies and end up thinking of themselves as objects of desire. This causes them to often see their own bodies as others see it, which causes them to feel a sense of detachment from their bodies and their sexualities. Tolman calls this a process of disembodiment. This process leaves young girls unassertive about their own sexual desires and needs because they focus so much on what other people expect of them rather than on what they feel inside.

Another way gender roles affect adolescent sexuality is thought the sexual double standard. This double standard occurs when others judge women for engaging in premarital sex and for embracing their sexualities, while men are rewarded for the same behavior. It is a double standard because the genders are behaving similarly, but are being judged differently for their actions because of their gender. An example of this can be seen in Tolman's research when she interviews girls about their experiences with their sexualities. In Tolman's interviews, girls who sought sex because they desired it felt like they had to cover it up in order (for example, they blamed their sexual behavior on drinking) to not be judged by others in their school. They were afraid of being viewed negatively for enjoying their sexuality. Many girls were thus trying to make their own solutions (like blaming their sexual behavior on something else or silencing their own desires and choosing to not engage in sexual behavior) to a problem that is actually caused by power imbalances between the genders within our societies. Other research showed that girls were tired of being judged for their sexual behavior because of their gender. However, even these girls were strongly affected by societal gender roles and rarely talked about their own desires and instead talked about how "being ready" (rather than experiencing desire) would determine their sexual encounters.

O'Sullivan and her colleagues assessed 180 girls between the ages of 12 and 14 on their perceptions on what their first sexual encounters would be like; many girls reported feeling negative emotions towards sex before their first time. The researchers think this is because adolescent girls are taught that society views adolescent pre-marital sex in negative terms. When they reported positive feelings, the most commonly listed one was feeling attractive. This shows how many girls objectify their own bodies and often think about this before they think of their own sexual desires and needs.

Researchers found that having an older sibling, especially an older brother, affected how girls viewed sex and sexuality. Girls with older brothers held more traditional views about sexuality and said they were less interested in seeking sex, as well as less interested responding to the sexual advances of boys compared with girls with no older siblings. Researchers believe this is because older siblings model gender roles, so girls with older siblings (especially brothers) may have more traditional views of what society says girls and boys should be like; girls with older brothers may believe that sexual intercourse is mostly for having children, rather than for gaining sexual pleasure. This traditional view can inhibit them from focusing on their own sexualities and desires, and may keep them constrained to society's prescribed gender roles.

Social learning and the sexual self-concept

Developing a sexual self-concept is an important developmental step during adolescence. This is when adolescents try to make sense and organize their sexual experiences so that they understand the structures and underlying motivations for their sexual behavior. This sexual self-concept helps adolescents organize their past experiences, but also gives them information to draw on for their current and future sexual thoughts and experiences. Sexual self-concept affects sexual behavior for both men and women, but it also affects relationship development for women. Development of one's sexual self-concept can occur even before sexual experiences begin. An important part of sexual self-concept is sexual esteem, which includes how one evaluates their sexuality (including their thoughts, emotions and sexual activities). Another aspect is sexual anxiety; this includes one's negative evaluations of sex and sexuality. Sexual self-concept is not only developed from sexual experiences; both girls and boys can learn from a variety of social interactions such as their family, sexual education programs, depictions in the media and from their friends and peers. Girls with a positive self-schema are more likely to be liberal in their attitudes about sex, are more likely to view themselves as passionate and open to sexual experience and are more likely to rate sexual experiences as positive. Their views towards relationships show that they place high importance on romance, love and intimacy. Girls who have a more negative view often say they feel self-conscious about their sexuality and view sexual encounters more negatively. The sexual self-concept of girls with more negative views are highly influenced by other people; those of girls who hold more positive views are less so.

Boys are less willing to state they have negative feelings about sex than girls when they describe their sexual self-schemas. Boys are not divided into positive and negative sexual self-concepts; they are divided into schematic and non-schematic (a schema is a cluster of ideas about a process or aspect of the world; see schema). Boys who are sexually schematic are more sexually experienced, have higher levels of sexual arousal, and are more able to experience romantic feelings. Boys who are not schematic have fewer sexual partners, a smaller range of sexual experiences and are much less likely than schematic men to be in a romantic relationship.

When comparing the sexual self-concepts of adolescent girls and boys, researchers found that boys experienced lower sexual self-esteem and higher sexual anxiety. The boys stated they were less able to refuse or resist sex at a greater rate than the girls reported having difficulty with this. The authors state that this may be because society places so much emphasis on teaching girls how to be resistant towards sex, that boys do not learn these skills and are less able to use them when they want to say no to sex. They also explain how society's stereotype that boys are always ready to desire sex and be aroused may contribute to the fact that many boys may not feel comfortable resisting sex, because it is something society tells them they should want. Because society expects adolescent boys to be assertive, dominant and in control, they are limited in how they feel it is appropriate to act within a romantic relationship. Many boys feel lower self-esteem when they cannot attain these hyper-masculine ideals that society says they should. Additionally, there is not much guidance on how boys should act within relationships and many boys do not know how to retain their masculinity while being authentic and reciprocating affection in their relationships. This difficult dilemma is called the double-edged sword of masculinity by some researchers.

Hensel and colleagues conducted a study with 387 female participants between the ages of 14 and 17 and found that as the girls got older (and learned more about their sexual self-concept), they experienced less anxiety, greater comfort with sexuality and experienced more instances of sexual activity. Additionally, across the four years (from 14 to 17), sexual self-esteem increased, and sexual anxiety lessened. The researchers stated that this may indicate that the more sexual experiences the adolescent girls have had, the more confidence they hold in their sexual behavior and sexuality. Additionally, it may mean that for girls who have not yet had intercourse, they become more confident and ready to participate in an encounter for the first time. Researchers state that these patterns indicate that adolescent sexual behavior is not at all sporadic and impulsive, rather that it is strongly affected by the adolescent girls' sexual self-concept and changes and expands through time.

Sex education

Sex education, also called "Sexuality Education" or informally "Sex Ed" is education about human sexual anatomy, sexual reproduction, sexual intercourse, human sexual behavior, and other aspects of sexuality, such as body image, sexual orientation, dating, and relationships. Common avenues for sex education are parents, caregivers, friends, school programs, religious groups, popular media, and public health campaigns.

Sexual education is not always taught the same in every country. For example, in France sex education has been part of school curricula since 1973. Schools are expected to provide 30 to 40 hours of sex education, and pass out condoms to students in grades eight and nine. In January, 2000, the French government launched an information campaign on contraception with TV and radio spots and the distribution of five million leaflets on contraception to high school students.

In Germany, sex education has been part of school curricula since 1970. Since 1992 sex education is by law a governmental duty. A survey by the World Health Organization concerning the habits of European teenagers in 2006 revealed that German teenagers care about contraception. The birth rate among German 15- to 19-year-olds is 11.7 per 1000 population, compared to 2.9 per 1000 population in Korea, and 55.6 per 1000 population in US.

According to SIECUS, the Sexuality Information and Education Council of the United States, in most families, parents are the primary sex educators of their adolescents. They found 93% of adults they surveyed support sexuality education in high school and 84% support it in junior high school. In fact, 88% of parents of junior high school students and 80% of parents of high school students believe that sex education in school makes it easier for them to talk to their adolescents about sex. Also, 92% of adolescents report that they want both to talk to their parents about sex and to have comprehensive in-school sex education.

In America, not only do U.S. students receive sex education within school or religious programs, but they are also educated by their parents. American parents are less prone to influencing their children's actual sexual experiences than they are simply telling their children what they should not do. Generally, they promote abstinence while educating their children with things that may make their adolescents not want to engage in sexual activity.

Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics as early as grade 5 or 6. However, what students learn varies widely, because curriculum decisions are quite decentralized. Two main forms of sex education are taught in American schools: comprehensive and abstinence-only. A 2002 study conducted by the Kaiser Family Foundation found that 58% of secondary school principals describe their sex education curriculum as comprehensive, while 34% said their school's main message was abstinence-only. The difference between these two approaches, and their impact on teen behavior, remains a controversial subject in the U.S. Some studies have shown abstinence-only programs to have no positive effects. Other studies have shown specific programs to result in more than 2/3 of students maintaining that they will remain abstinent until marriage months after completing such a program; such virginity pledges, however, are statistically ineffective, and over 95% of Americans do, in fact, have sex before marriage.

In Asia the state of sex education programs are at various stages of development. Indonesia, Mongolia, South Korea and Sri Lanka have a systematic policy framework for teaching about sex within schools. Malaysia, the Philippines and Thailand have assessed adolescent reproductive health needs with a view to developing adolescent-specific training, messages and materials. India has programs that specifically aim at school children at the age group of nine to sixteen years. These are included as subjects in the curriculum and generally involved open and frank interaction with the teachers. Bangladesh, Nepal and Pakistan have no coordinated sex education programs.

Some educators hold the view that sexuality is equated with violence. These educators think that not talking about sexuality will decrease the rate of adolescent sexuality. However, not having access to sexual education has been found to have negative effects upon students, especially groups such as adolescent girls who come from low-income families. Not receiving appropriate sexual health education increases teenage pregnancy, sexual victimization and high school dropout rates. Researchers state that it is important to educate students about all aspects of sexuality and sexual health to reduce the risk of these issues.

The view that sexuality is victimization teaches girls to be careful of being sexually victimized and taken advantage of. Educators who hold this perspective encourage sexual education, but focus on teaching girls how to say no, teaching them of the risks of being victims and educate them about risks and diseases of being sexually active. This perspective teaches adolescents that boys are predators and that girls are victims of sexual victimization. Researchers state that this perspective does not address the existence of desire within girls, does not address the societal variables that influence sexual violence and teaches girls to view sex as dangerous only before marriage. In reality, sexual violence can be very prevalent within marriages too.

Another perspective includes the idea that sexuality is individual morality; this encourages girls to make their own decisions, as long as their decision is to say no to sex before marriage. This education encourages self-control and chastity.

Lastly, the sexual education perspective of the discourse of desire is very rare in U.S. high schools. This perspective encourages adolescents to learn more about their desires, gaining pleasure and feeling confident in their sexualities. Researchers state that this view would empower girls because it would place less emphasis on them as the victims and encourage them to have more control over their sexuality.

Research on how gender stereotypes affect adolescent sexuality is important because researchers believe it can show sexual health educators how they can improve their programming to more accurately attend to the needs of adolescents. For example, studies have shown how the social constructed idea that girls are "supposed to" not be interested in sex have actually made it more difficult for girls to have their voices heard when they want to have safer sex. At the same time, sexual educators continuously tell girls to make choices that will lead them to safer sex, but do not always tell them ‘how’ they should go about doing this. Instances such as these show the difficulties that can arise from not exploring how society's perspective of gender and sexuality affect adolescent sexuality.

Brain maturity

Brain imaging and behavioral correlation studies on teenagers that characterize them as immature have been criticized for not being causative, thus possibly reaffirming cultural biases. Robert Epstein argues that "teen turmoil," which is blamed on differences in brain structure and function between adolescents and adults, is a relatively recent western phenomenon that is largely absent in pre-industrial societies and is a result of infantilization of teenagers rather than inherent brain differences. He reasons that if such incompetence and irresponsibility were truly a result of inherent brain differences, then it would be present in all societies and cultures.

Historical research

In 1988, two researchers from the University of North Carolina, Ronald Rindfuss and J. Richard Udry, submitted a proposal to The National Institute of Child Health and Human Development (NICHD) to study the health-related risk behaviors of adolescents. The study was intended to collect data on the patterns of adolescent sexual behavior that could expose teenagers to sexually transmitted diseases. The researchers designed the study to capture data on a national sample of 24,000 youth from the seventh to the eleventh grade. The American Teen Study had initially been approved by both the National Advisory Council of the NICHD and by other NICHD officials, granting the study funding up to $2.5 million for the first year commencing in May 1991.

One month after the approval start date of the study, Secretary Louis Sullivan of Health and Human Services (HHS) cancelled the research study after having been questioned and berated by those that did not believe that research on adolescent sexual behaviors would be beneficial. According to Charrow (1991), this may have been the first time that a previously awarded amount of funding had been revoked. The American Teen Study sought to reveal the importance of investigating the health-related risk-taking behaviors of youth by gathering data across various social contexts such as at home and school. Countless critics had condemned the study by insisting that the issue of teen sex behaviors had been studied excessively.

Center for Disease control (1991) show that the age of first intercourse for American girls began to decrease from 1985 to 1989. The number of Massachusetts teens who reported engaging in sexual intercourse increased from 55% to 61% between the years 1986–1988. Moreover, it was found that the utilization of condoms by teenagers may decrease when they have multiple sexual partners.  The authors (1993) state that the mathematical theory of epidemics reveals two factors about the rate of increasing infections during an epidemic: the first is the probability of an uninfected person contracting aids from an infected person. The transmission of a sexually-transmitted disease such as HIV will depend on the sexual behaviors of individuals, their personal safety practices when engaging in sexual intercourse, and how often they are in contact with sexual partners.

The second factor is the number of uninfected individuals that are in the population. At the beginning of an epidemic, a sexually-transmitted disease spreads when the uninfected partner of an infected person becomes highly sexually-active within the population, leading to an increase in the amount of those infected. As the population becomes more infected, an infected person will be less likely to encounter an uninfected one, leading to a decline in new infections. However, although the rate of new infections of HIV among older gay males has decreased, it is dangerous to say that the same pattern has been observed for gay adolescents. Similarly, data suggests that heterosexual adolescents also engage in anal intercourse which can lead to an increase in the number of infected persons. 10% of women at an adolescent planning center, 19% of female Canadian college students, and 25% of Black and Hispanic women at a family planning center all reported engaging in anal-intercourse with their partners.

The statistics suggest that there is an increasing need for research on the sexual risk-behaviors of adolescents.  The current research on adolescent risk-taking sexual behaviors lack three fundamentals conditions that would give sufficient and generalizable data on the current sexual-behaviors of adolescents. The first is that the research studies need to have large samples and thorough designs to cover the diverse populations of adolescents that range from various genders, sexual orientations, ethnicities, races, and cultures. Second, there needs to be research that studies the interaction between various social contexts, such as riding in cars for enjoyment, and adolescent sexual-behaviors that leave youth susceptible to engaging in sexual-intercourse. Lastly, it would be necessary for repeated longitudinal studies on the sexual behaviors of adolescents as behaviors are constantly changing and may be open to different interpretations.

The American Teen Study would have been utilized to conduct the type of research that would be needed to investigate the increasing rate of sexually-transmitted diseases among adolescents. The authors (1993) suggest that the cancellation of The American Teen Study was politically motivated as evidenced by Louis Sullivan's rushed rejection of the study without providing adequate reasoning for why the study should not take have taken place. Without data from the study, it can be difficult for scientists to monitor the spread of sexually-transmitted diseases such as HIV and to develop techniques to decrease the increasing rate of infections

Child sexuality

From Wikipedia, the free encyclopedia

Development of sexuality is an integral part of the development and maturation of children. A range of sensational, emotional, and consequent sexual activities that may occur before or during early puberty, but before full sexual maturity is established. The development of child sexuality and the perception of child sexuality by adults is influenced by social and cultural aspects. The concept of child sexuality also played an important role in psychoanalysis.

History of research

Freud

Until Sigmund Freud published his Three Essays on the Theory of Sexuality in 1905, children were often regarded as asexual, having no sexuality until later development. Freud was one of the first researchers to seriously study child sexuality, and his acknowledgment of its existence was a significant change. Children are naturally curious about their bodies and sexual functions – they wonder where babies come from, they notice anatomical differences between males and females, and many engage in genital play or masturbation. Child sex play includes exhibiting or inspecting the genitals. Many children take part in some sex play, typically with siblings or friends. Sex play with others usually decreases as children go through their elementary school years, yet they still may possess romantic interest in their peers. Curiosity levels remain high during these years, escalating in puberty (roughly the teenage years) when the main surge in sexual interest occurs.

Kinsey

Alfred Kinsey in the Kinsey Reports (1948 and 1953) included research on the physical sexual response of children, including pre-pubescent children (though the main focus of the reports was adults). While there were initially concerns that some of the data in his reports could not have been obtained without observation of or participation in child sexual abuse, the data was revealed much later in the 1990s to have been gathered from the diary of a single pedophile who had been molesting children since 1917. This effectively rendered the data-set nearly worthless, not only because it relied entirely on a single source, but the data was hearsay reported by a highly unreliable observer. In 2000, Swedish researcher Ing-Beth Larsson noted, "It is quite common for references still to cite Alfred Kinsey", due to the scarcity of subsequent large-scale studies of child sexual behavior.

Sexual development

Before puberty

The National Child Traumatic Stress Network issued a report in 2009 on child sexual development in the United States. The report asserted that children have a natural curiosity about their own bodies and the bodies of others that ought to be addressed in an age-appropriate manner. According to the report:

  • Children less than four years old will normally touch their own private parts, look at the private parts of others, and remove their clothes wanting to be naked;
  • Between ages four and six, children will be more actively curious. They will attempt to see others dressing or undressing, or will perhaps "play doctor"; and
  • Between ages six and twelve, children will expand their curiosity to images of undressed people available in the media. They will develop a need for privacy regarding their own bodies and begin to be sexually attracted to peers.

The report recommended that parents learn what is normal in regard to nudity and sexuality at each stage of a child's development and refrain from overreacting to their children's nudity-related behaviors unless there are signs of a problem (e.g. anxiety, aggression, or sexual interactions between children not of the same age or stage of development).

Children can discover the pleasure of genital stimulation naturally at an early age. Boys often lie on their stomachs and girls may sit and rock. Manual stimulation occurs about the time of adolescence and mutual masturbation or other sexual experimentation between adolescents of similar ages may also occur, though cultural or religious coercion may inhibit or occult such activity if there is negative peer pressure or if authority figures are likely to disapprove.

From the ages of three to seven, the following behaviors are normal among children:

  • Children are curious about where babies come from.
  • Children may explore other children's and adults' bodies out of curiosity.
  • By age four, children may show significant attachment to the opposite-sex parent.
  • Children begin to have a sense of learned modesty and of the differences between private and public behaviors.
  • For some children, genital touching increases, especially when they are tired or upset.

Early school age covers approximately ages five to seven, and masturbation is common at these ages. Children become more aware of gender differences, and tend to choose same-sex friends and playmates, even disparaging the opposite sex. Children may drop their close attachment to their opposite-sex parent and become more attached to their same-sex parent.

During this time, children, especially girls, show increased awareness of social norms regarding sex, nudity, and privacy. Children may use sexual terms to test adult reaction. "Bathroom humor" (jokes and conversation relating to excretory functions), present in earlier stages, continues.

"Middle childhood" covers the ages from about six to eleven, depending on the methodology and the behavior being studied, individual development varies considerably.

As this stage progresses, the choices of children picking same-sex friends becomes more marked and extending to disparagement of the opposite sex.

By the age of 8 or 9 children become aware that sexual arousal is a specific type of erotic sensation and will seek these pleasurable experiences through various sights, self-touches, and fantasy.

Although there are variations between individual children, children are generally curious about their bodies and those of others, and explore their bodies through explorative sex play. "Playing doctor" is one example of such childhood exploration; such games are generally considered to be normal in young children. Child sexuality is considered fundamentally different from adult sexual behavior, which is more goal-driven. Among children, genital penetration and oral-genital contact are very uncommon, and may be perceived as imitations of adult behaviors. Such behaviors are more common among children who have been sexually abused.

A 1997 study based on limited variables found no correlation between early childhood (age 6 and under) peer sexual play and later adjustment. The study notes that its results do not demonstrate conclusively that no such correlation exists. The study also does not address the question of consequences of intense sexual experiences or aggressive or unwanted experiences.

Between puberty and adulthood

Contemporary issues

In the latter part of the 20th century, sexual liberation probably arose in the context of a massive cultural explosion in the United States of America following the upheaval of the Second World War, and the vast quantity of audiovisual media distributed worldwide by the new electronic and information technology. Children are apt to gain access and be influenced by material, despite censorship and content-control software.

Sex education

The extent of sex education in public schools varies widely around the world, and within countries such as the United States where course content is determined by individual school districts.

A series of sex education videos from Norway, intended for 8–12 year olds, includes explicit information and images of reproduction, anatomy, and the changes that are normal with the approach of puberty. Rather than diagrams or photos, the videos are shot in a locker room with live nude people of all ages. The presenter, a physician, is relaxed about close examination and touching of relevant body parts, including genitals. While the videos note that the age of consent in Norway is 16, abstinence is not emphasized. As of 2015, however, 37 U.S. states required that sex education curricula include lessons on abstinence and 25 required that a "just say no" approach be stressed. Studies show that early and complete sex education does not increase the likelihood of becoming sexually active, but leads to better health outcomes overall.

Sexualization of children

Some cultural critics in the Western world have postulated that over recent decades, children have been subject to a premature sexualization, as indicated by a level of sexual knowledge or sexual behavior inappropriate for their age group. The causes of this premature sexualization that have been cited include portrayals in the media of sex and related issues, especially in media aimed at children; the marketing of products with sexual connotations to children, including clothing; the lack of parental oversight and discipline; access to adult culture via the internet; and the lack of comprehensive school sex education programs. For girls and young women in particular, studies have found that sexualization has a negative impact on their "self-image and healthy development".

Child sexual abuse

Child sexual abuse is defined as an adult or older adolescent having a sexual relationship with a child. Effects of child sexual abuse include clinical depression, post-traumatic stress disorder, anxiety, propensity to further victimization in adulthood, and physical injury to the child, among other problems.

Child sexual abuse by a family member is a form of incest, and can result in more serious and long-term psychological trauma, especially in the case of parental incest.

Children who have been the victim of child sexual abuse sometimes display overly sexualized behavior, which may be defined as expressed behavior that is non-normative for the culture. Typical symptomatic behaviors may include excessive or public masturbation and coercing, manipulating or tricking other children into non-consensual or unwanted sexual activities, also referred to as "child-on-child sexual abuse". Sexualized behavior is thought to constitute the best indication that a child has been sexually abused.

Children who exhibit sexualized behavior may also have other behavioral problems. Other symptoms of child sexual abuse may include manifestations of post-traumatic stress in younger children; fear, aggression, and nightmares in young school-age children; and depression in older children.

Among siblings

In 1980, a survey of 796 undergraduates, 15 percent of females and 10 percent of males reported some form of sexual experience involving a sibling; most of these fell short of actual intercourse. Approximately one quarter of these experiences were described as abusive or exploitative. A 1989 paper reported the results of a questionnaire with responses from 526 undergraduate college students in which 17 percent of the respondents stated that they had preadolescent sexual experiences with a sibling.

Methodological issues

Empirical knowledge about child sexual behavior is not usually gathered by direct interviews of children, partly due to ethical consideration. Information about child sexual behavior is gathered by the following methods:

  • Observing children being treated for problematic behavior, such as use of force in sex play, often using anatomically correct dolls;
  • Recollections by adults;
  • Observation by caregivers.

Most published sexual research material emanates from the Western World, and a great deal of dramatic audio-visual material which might influence social attitudes to child sexuality are generated either in the United States of America or else for that audience. "Normative" may therefore relate to Western culture rather than to the general complexity of human experience.

Pedophilia

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Pedophilia

Pedophilia (alternatively spelt paedophilia) is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. Although girls typically begin the process of puberty at age 10 or 11, and boys at age 11 or 12, criteria for pedophilia extend the cut-off point for prepubescence to age 13.[4] A person must be at least 16 years old, and at least five years older than the prepubescent child, for the attraction to be diagnosed as pedophilia.

Pedophilia is termed pedophilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the manual defines it as a paraphilia involving intense and recurrent sexual urges towards and fantasies about prepubescent children that have either been acted upon or which cause the person with the attraction distress or interpersonal difficulty. The International Classification of Diseases (ICD-11) defines it as a "sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children."

In popular usage, the word pedophilia is often applied to any sexual interest in children or the act of child sexual abuse. This use conflates the sexual attraction to prepubescent children with the act of child sexual abuse and fails to distinguish between attraction to prepubescent and pubescent or post-pubescent minors. Researchers recommend that these imprecise uses be avoided, because although some people who commit child sexual abuse are pedophiles, child sexual abuse offenders are not pedophiles unless they have a primary or exclusive sexual interest in prepubescent children, and some pedophiles do not molest children.

Pedophilia was first formally recognized and named in the late 19th century. A significant amount of research in the area has taken place since the 1980s. Although mostly documented in men, there are also women who exhibit the disorder, and researchers assume available estimates underrepresent the true number of female pedophiles. No cure for pedophilia has been developed, but there are therapies that can reduce the incidence of a person committing child sexual abuse. The exact causes of pedophilia have not been conclusively established. Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies. In the United States, following Kansas v. Hendricks in 1997, sex offenders who are diagnosed with certain mental disorders, particularly pedophilia, can be subject to indefinite involuntary commitment.

Definitions

The word pedophilia comes from the Greek παῖς, παιδός (paîs, paidós), meaning "child", and φιλία (philía), "friendly love" or "friendship". Pedophilia is used for individuals with a primary or exclusive sexual interest in prepubescent children aged 13 or younger. Infantophilia is a sub-type of pedophilia; it is used to refer to a sexual preference for children under the age of 5 (especially infants and toddlers). This is sometimes referred to as nepiophilia (from the Greek: νήπιος (népios) meaning "infant" or "child," which in turn derives from "ne-" and "epos" meaning "not speaking"), though this term is rarely used in academic sources. Hebephilia is defined as individuals with a primary or exclusive sexual interest in 11- to 14-year-old pubescents. The DSM-5 does not list hebephilia among the diagnoses; while evidence suggests that hebephilia is separate from pedophilia, the ICD-10 includes early pubertal age (an aspect of hebephilia) in its pedophilia definition, covering the physical development overlap between the two philias. In addition to hebephilia, some clinicians have proposed other categories that are somewhat or completely distinguished from pedophilia; these include pedohebephilia (a combination of pedophilia and hebephilia) and ephebophilia (though ephebophilia is not considered pathological).

Signs and symptoms

Development

Pedophilia emerges before or during puberty, and is stable over time. It is self-discovered, not chosen. For these reasons, pedophilia has been described as a disorder of sexual preference, phenomenologically similar to a heterosexual or homosexual orientation. These observations, however, do not exclude pedophilia from being classified as a mental disorder as pedophilic acts cause harm, and mental health professionals can sometimes help pedophiles to refrain from harming children.

In response to misinterpretations that the American Psychiatric Association considers pedophilia a sexual orientation because of wording in its printed DSM-5 manual, which distinguishes between paraphilia and what it calls "paraphilic disorder", subsequently forming a division of "pedophilia" and "pedophilic disorder", the association commented: "'[S]exual orientation' is not a term used in the diagnostic criteria for pedophilic disorder and its use in the DSM-5 text discussion is an error and should read 'sexual interest.'" They added, "In fact, APA considers pedophilic disorder a 'paraphilia,' not a 'sexual orientation.' This error will be corrected in the electronic version of DSM-5 and the next printing of the manual." They said they strongly support efforts to criminally prosecute those who sexually abuse and exploit children and adolescents, and "also support continued efforts to develop treatments for those with pedophilic disorder with the goal of preventing future acts of abuse."

Comorbidity and personality traits

Studies of pedophilia in child sex offenders often report that it co-occurs with other psychopathologies, such as low self-esteem, depression, anxiety, and personality problems. It is not clear whether these are features of the disorder itself, artifacts of sampling bias, or consequences of being identified as a sex offender. One review of the literature concluded that research on personality correlates and psychopathology in pedophiles is rarely methodologically correct, in part owing to confusion between pedophiles and child sex offenders, as well as the difficulty of obtaining a representative, community sample of pedophiles. Seto (2004) points out that pedophiles who are available from a clinical setting are likely there because of distress over their sexual preference or pressure from others. This increases the likelihood that they will show psychological problems. Similarly, pedophiles recruited from a correctional setting have been convicted of a crime, making it more likely that they will show anti-social characteristics.

Impaired self-concept and interpersonal functioning were reported in a sample of child sex offenders who met the diagnostic criteria for pedophilia by Cohen et al. (2002), which the authors suggested could contribute to motivation for pedophilic acts. The pedophilic offenders in the study had elevated psychopathy and cognitive distortions compared to healthy community controls. This was interpreted as underlying their failure to inhibit their criminal behavior. Studies in 2009 and 2012 found that non-pedophilic child sex offenders exhibited psychopathy, but pedophiles did not.

Wilson and Cox (1983) studied the characteristics of a group of pedophile club members. The most marked differences between pedophiles and controls were on the introversion scale, with pedophiles showing elevated shyness, sensitivity and depression. The pedophiles scored higher on neuroticism and psychoticism, but not enough to be considered pathological as a group. The authors caution that "there is a difficulty in untangling cause and effect. We cannot tell whether paedophiles gravitate towards children because, being highly introverted, they find the company of children less threatening than that of adults, or whether the social withdrawal implied by their introversion is a result of the isolation engendered by their preference i.e., awareness of the social [dis]approbation and hostility that it evokes" (p. 324). In a non-clinical survey, 46% of pedophiles reported that they had seriously considered suicide for reasons related to their sexual interest, 32% planned to carry it out, and 13% had already attempted it.

A review of qualitative research studies published between 1982 and 2001 concluded that child sexual abusers use cognitive distortions to meet personal needs, justifying abuse by making excuses, redefining their actions as love and mutuality, and exploiting the power imbalance inherent in all adult–child relationships. Other cognitive distortions include the idea of "children as sexual beings", uncontrollability of sexual behavior, and "sexual entitlement-bias".

Child pornography

Consumption of child pornography is a more reliable indicator of pedophilia than molesting a child, although some non-pedophiles also view child pornography. Child pornography may be used for a variety of purposes, ranging from private sexual gratification or trading with other collectors, to preparing children for sexual abuse as part of the child grooming process.

Pedophilic viewers of child pornography are often obsessive about collecting, organizing, categorizing, and labeling their child pornography collection according to age, gender, sex act and fantasy. According to FBI agent Ken Lanning, "collecting" pornography does not mean that they merely view pornography, but that they save it, and "it comes to define, fuel, and validate their most cherished sexual fantasies". Lanning states that the collection is the single best indicator of what the offender wants to do, but not necessarily of what has been or will be done. Researchers Taylor and Quayle reported that pedophilic collectors of child pornography are often involved in anonymous internet communities dedicated to extending their collections.

Causes

Although what causes pedophilia is not yet known, researchers began reporting a series of findings linking pedophilia with brain structure and function, beginning in 2002. Testing individuals from a variety of referral sources inside and outside the criminal justice system as well as controls, these studies found associations between pedophilia and lower IQs, poorer scores on memory tests, greater rates of non-right-handedness, greater rates of school grade failure over and above the IQ differences, lesser physical height, greater probability of having suffered childhood head injuries resulting in unconsciousness, and several differences in MRI-detected brain structures.

Such studies suggest that there are one or more neurological characteristics present at birth that cause or increase the likelihood of being pedophilic. Some studies have found that pedophiles are less cognitively impaired than non-pedophilic child molesters. A 2011 study reported that pedophilic child molesters had deficits in response inhibition, but no deficits in memory or cognitive flexibility. Evidence of familial transmittability "suggests, but does not prove that genetic factors are responsible" for the development of pedophilia. A 2015 study indicated that pedophilic offenders have a normal IQ.

Another study, using structural MRI, indicated that male pedophiles have a lower volume of white matter than a control group. Functional magnetic resonance imaging (fMRI) has indicated that child molesters diagnosed with pedophilia have reduced activation of the hypothalamus as compared with non-pedophilic persons when viewing sexually arousing pictures of adults. A 2008 functional neuroimaging study notes that central processing of sexual stimuli in heterosexual "paedophile forensic inpatients" may be altered by a disturbance in the prefrontal networks, which "may be associated with stimulus-controlled behaviours, such as sexual compulsive behaviours". The findings may also suggest "a dysfunction at the cognitive stage of sexual arousal processing".

Blanchard, Cantor, and Robichaud (2006) reviewed the research that attempted to identify hormonal aspects of pedophiles. They concluded that there is some evidence that pedophilic men have less testosterone than controls, but that the research is of poor quality and that it is difficult to draw any firm conclusion from it.

While not causes of pedophilia themselves, childhood abuse by adults or comorbid psychiatric illnesses—such as personality disorders and substance abuse—are risk factors for acting on pedophilic urges. Blanchard, Cantor, and Robichaud addressed comorbid psychiatric illnesses that, "The theoretical implications are not so clear. Do particular genes or noxious factors in the prenatal environment predispose a male to develop both affective disorders and pedophilia, or do the frustration, danger, and isolation engendered by unacceptable sexual desires—or their occasional furtive satisfaction—lead to anxiety and despair?" They indicated that, because they previously found mothers of pedophiles to be more likely to have undergone psychiatric treatment, the genetic possibility is more likely.

A study analyzing the sexual fantasies of 200 heterosexual men by using the Wilson Sex Fantasy Questionnaire exam determined that males with a pronounced degree of paraphilic interest (including pedophilia) had a greater number of older brothers, a high 2D:4D digit ratio (which would indicate low prenatal androgen exposure), and an elevated probability of being left-handed, suggesting that disturbed hemispheric brain lateralization may play a role in deviant attractions.

Diagnosis

DSM and ICD-11

The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) has a significantly larger diagnostic features section for pedophilia than the previous DSM version, the DSM-IV-TR, and states, "The diagnostic criteria for pedophilic disorder are intended to apply both to individuals who freely disclose this paraphilia and to individuals who deny any sexual attraction to prepubertal children (generally age 13 years or younger), despite substantial objective evidence to the contrary." Like the DSM-IV-TR, the manual outlines specific criteria for use in the diagnosis of this disorder. These include the presence of sexually arousing fantasies, behaviors or urges that involve some kind of sexual activity with a prepubescent child (with the diagnostic criteria for the disorder extending the cut-off point for prepubescence to age 13) for six months or more, or that the subject has acted on these urges or suffers from distress as a result of having these feelings. The criteria also indicate that the subject should be 16 or older and that the child or children they fantasize about are at least five years younger than them, though ongoing sexual relationships between a 12- to 13-year-old and a late adolescent are advised to be excluded. A diagnosis is further specified by the sex of the children the person is attracted to, if the impulses or acts are limited to incest, and if the attraction is "exclusive" or "nonexclusive".

The ICD-10 defines pedophilia as "a sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age". Like the DSM, this system's criteria require that the person be at least 16 years of age or older before being diagnosed as a pedophile. The person must also have a persistent or predominant sexual preference for prepubescent children at least five years younger than them. The ICD-11 defines pedophilic disorder as a "sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children." It also states that for a diagnosis of pedophilic disorder, "the individual must have acted on these thoughts, fantasies or urges or be markedly distressed by them. This diagnosis does not apply to sexual behaviours among pre- or post-pubertal children with peers who are close in age."

Several terms have been used to distinguish "true pedophiles" from non-pedophilic and non-exclusive offenders, or to distinguish among types of offenders on a continuum according to strength and exclusivity of pedophilic interest, and motivation for the offense. Exclusive pedophiles are sometimes referred to as true pedophiles. They are sexually attracted to prepubescent children, and only prepubescent children. Showing no erotic interest in adults, they can only become sexually aroused while fantasizing about or being in the presence of prepubescent children, or both. Non-exclusive offenders—or "non-exclusive pedophiles"—may at times be referred to as non-pedophilic offenders, but the two terms are not always synonymous. Non-exclusive offenders are sexually attracted to both children and adults, and can be sexually aroused by both, though a sexual preference for one over the other in this case may also exist. If the attraction is a sexual preference for prepubescent children, such offenders are considered pedophiles in the same vein as exclusive offenders.

Neither the DSM nor the ICD-11 diagnostic criteria require actual sexual activity with a prepubescent youth. The diagnosis can therefore be made based on the presence of fantasies or sexual urges even if they have never been acted upon. On the other hand, a person who acts upon these urges yet experiences no distress about their fantasies or urges can also qualify for the diagnosis. Acting on sexual urges is not limited to overt sex acts for purposes of this diagnosis, and can sometimes include indecent exposure, voyeuristic or frotteuristic behaviors, or masturbating to child pornography. Often, these behaviors need to be considered in-context with an element of clinical judgment before a diagnosis is made. Likewise, when the patient is in late adolescence, the age difference is not specified in hard numbers and instead requires careful consideration of the situation.

Ego-dystonic sexual orientation includes people who acknowledge that they have a sexual preference for prepubertal children, but wish to change it due to the associated psychological or behavioral problems (or both).

Debate regarding criteria

There was discussion on the DSM-IV-TR being overinclusive and underinclusive. Its criterion A concerns sexual fantasies or sexual urges regarding prepubescent children, and its criterion B concerns acting on those urges or the urges causing marked distress or interpersonal difficulty. Several researchers discussed whether or not a "contented pedophile"—an individual who fantasizes about having sex with a child and masturbates to these fantasies, but does not commit child sexual abuse, and who does not feel subjectively distressed afterward—met the DSM-IV-TR criteria for pedophilia since this person did not meet criterion B. Criticism also concerned someone who met criterion B, but did not meet criterion A. A large-scale survey about usage of different classification systems showed that the DSM classification is only rarely used. As an explanation, it was suggested that the underinclusiveness, as well as a lack of validity, reliability and clarity might have led to the rejection of the DSM classification.

Ray Blanchard, an American-Canadian sexologist known for his research studies on pedophilia, addressed (in his literature review for the DSM-5) the objections to the overinclusiveness and under underinclusiveness of the DSM-IV-TR, and proposed a general solution applicable to all paraphilias. This meant namely a distinction between paraphilia and paraphilic disorder. The latter term is proposed to identify the diagnosable mental disorder which meets Criterion A and B, whereas an individual who does not meet Criterion B can be ascertained but not diagnosed as having a paraphilia. Blanchard and a number of his colleagues also proposed that hebephilia become a diagnosable mental disorder under the DSM-5 to resolve the physical development overlap between pedophilia and hebephilia by combining the categories under pedophilic disorder, but with specifiers on which age range (or both) is the primary interest. The proposal for hebephilia was rejected by the American Psychiatric Association, but the distinction between paraphilia and paraphilic disorder was implemented.

The American Psychiatric Association stated that "[i]n the case of pedophilic disorder, the notable detail is what wasn't revised in the new manual. Although proposals were discussed throughout the DSM-5 development process, diagnostic criteria ultimately remained the same as in DSM-IV TR" and that "[o]nly the disorder name will be changed from pedophilia to pedophilic disorder to maintain consistency with the chapter’s other listings." If hebephilia had been accepted as a DSM-5 diagnosable disorder, it would have been similar to the ICD-10 definition of pedophilia that already includes early pubescents, and would have raised the minimum age required for a person to be able to be diagnosed with pedophilia from 16 years to 18 years (with the individual needing to be at least 5 years older than the minor).

O'Donohue, however, suggests that the diagnostic criteria for pedophilia be simplified to the attraction to children alone if ascertained by self-report, laboratory findings, or past behavior. He states that any sexual attraction to children is pathological and that distress is irrelevant, noting "this sexual attraction has the potential to cause significant harm to others and is also not in the best interests of the individual." Also arguing for behavioral criteria in defining pedophilia, Howard E. Barbaree and Michael C. Seto disagreed with the American Psychiatric Association's approach in 1997 and instead recommended the use of actions as the sole criterion for the diagnosis of pedophilia, as a means of taxonomic simplification.

Treatment

General

There is no evidence that pedophilia can be cured. Instead, most therapies focus on helping the pedophile refrain from acting on their desires. Some therapies do attempt to cure pedophilia, but there are no studies showing that they result in a long-term change in sexual preference. Michael Seto suggests that attempts to cure pedophilia in adulthood are unlikely to succeed because its development is influenced by prenatal factors. Pedophilia appears to be difficult to alter but pedophiles can be helped to control their behavior, and future research could develop a method of prevention.

There are several common limitations to studies of treatment effectiveness. Most categorize their participants by behavior rather than erotic age preference, which makes it difficult to know the specific treatment outcome for pedophiles. Many do not select their treatment and control groups randomly. Offenders who refuse or quit treatment are at higher risk of offending, so excluding them from the treated group, while not excluding those who would have refused or quit from the control group, can bias the treated group in favor of those with lower recidivism. The effectiveness of treatment for non-offending pedophiles has not been studied.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) aims to reduce attitudes, beliefs, and behaviors that may increase the likelihood of sexual offenses against children. Its content varies widely between therapists, but a typical program might involve training in self-control, social competence and empathy, and use cognitive restructuring to change views on sex with children. The most common form of this therapy is relapse prevention, where the patient is taught to identify and respond to potentially risky situations based on principles used for treating addictions.

The evidence for cognitive behavioral therapy is mixed. A 2012 Cochrane Review of randomized trials found that CBT had no effect on risk of reoffending for contact sex offenders. Meta-analyses in 2002 and 2005, which included both randomized and non-randomized studies, concluded that CBT reduced recidivism. There is debate over whether non-randomized studies should be considered informative. More research is needed.

Behavioral interventions

Behavioral treatments target sexual arousal to children, using satiation and aversion techniques to suppress sexual arousal to children and covert sensitization (or masturbatory reconditioning) to increase sexual arousal to adults. Behavioral treatments appear to have an effect on sexual arousal patterns during phallometric testing, but it is not known whether the effect represents changes in sexual interests or changes in the ability to control genital arousal during testing, nor whether the effect persists in the long term. For sex offenders with mental disabilities, applied behavior analysis has been used.

Sex drive reduction

Pharmacological interventions are used to lower the sex drive in general, which can ease the management of pedophilic feelings, but does not change sexual preference. Antiandrogens work by interfering with the activity of testosterone. Cyproterone acetate (Androcur) and medroxyprogesterone acetate (Depo-Provera) are the most commonly used. The efficacy of antiantrogens has some support, but few high-quality studies exist. Cyproterone acetate has the strongest evidence for reducing sexual arousal, while findings on medroxyprogesterone acetate have been mixed.

Gonadotropin-releasing hormone analogues such as leuprorelin (Lupron), which last longer and have fewer side-effects, are also used to reduce libido, as are selective serotonin reuptake inhibitors. The evidence for these alternatives is more limited and mostly based on open trials and case studies. All of these treatments, commonly referred to as "chemical castration", are often used in conjunction with cognitive behavioral therapy. According to the Association for the Treatment of Sexual Abusers, when treating child molesters, "anti-androgen treatment should be coupled with appropriate monitoring and counseling within a comprehensive treatment plan." These drugs may have side-effects, such as weight gain, breast development, liver damage and osteoporosis.

Historically, surgical castration was used to lower sex drive by reducing testosterone. The emergence of pharmacological methods of adjusting testosterone has made it largely obsolete, because they are similarly effective and less invasive. It is still occasionally performed in Germany, the Czech Republic, Switzerland, and a few U.S. states. Non-randomized studies have reported that surgical castration reduces recidivism in contact sex offenders. The Association for the Treatment of Sexual Abusers opposes surgical castration and the Council of Europe works to bring the practice to an end in Eastern European countries where it is still applied through the courts.

Epidemiology

Pedophilia and child molestation

The prevalence of pedophilia in the general population is not known, but is estimated to be lower than 5% among adult men. Less is known about the prevalence of pedophilia in women, but there are case reports of women with strong sexual fantasies and urges towards children. Most sexual offenders against children are male. Females may account for 0.4% to 4% of convicted sexual offenders, and one study estimates a 10 to 1 ratio of male-to-female child molesters. The true number of female child molesters may be underrepresented by available estimates, for reasons including a "societal tendency to dismiss the negative impact of sexual relationships between young boys and adult women, as well as women's greater access to very young children who cannot report their abuse", among other explanations.

The term pedophile is commonly used by the public to describe all child sexual abuse offenders. This usage is considered problematic by researchers, because many child molesters do not have a strong sexual interest in prepubescent children, and are consequently not pedophiles. There are motives for child sexual abuse that are unrelated to pedophilia, such as stress, marital problems, the unavailability of an adult partner, general anti-social tendencies, high sex drive or alcohol use. As child sexual abuse is not automatically an indicator that its perpetrator is a pedophile, offenders can be separated into two types: pedophilic and non-pedophilic (or preferential and situational). Estimates for the rate of pedophilia in detected child molesters generally range between 25% and 50%. A 2006 study found that 35% of its sample of child molesters were pedophilic. Pedophilia appears to be less common in incest offenders, especially fathers and step-fathers. According to a U.S. study on 2429 adult male sex offenders who were categorized as "pedophiles", only 7% identified themselves as exclusive; indicating that many or most child sexual abusers may fall into the non-exclusive category.

Some pedophiles do not molest children. Little is known about this population because most studies of pedophilia use criminal or clinical samples, which may not be representative of pedophiles in general. Researcher Michael Seto suggests that pedophiles who commit child sexual abuse do so because of other anti-social traits in addition to their sexual attraction. He states that pedophiles who are "reflective, sensitive to the feelings of others, averse to risk, abstain from alcohol or drug use, and endorse attitudes and beliefs supportive of norms and the laws" may be unlikely to abuse children. A 2015 study indicates that pedophiles who molested children are neurologically distinct from non-offending pedophiles. The pedophilic molesters had neurological deficits suggestive of disruptions in inhibitory regions of the brain, while non-offending pedophiles had no such deficits.

According to Abel, Mittleman, and Becker (1985) and Ward et al. (1995), there are generally large distinctions between the characteristics of pedophilic and non-pedophilic molesters. They state that non-pedophilic offenders tend to offend at times of stress; have a later onset of offending; and have fewer, often familial, victims, while pedophilic offenders often start offending at an early age; often have a larger number of victims who are frequently extrafamilial; are more inwardly driven to offend; and have values or beliefs that strongly support an offense lifestyle. One study found that pedophilic molesters had a median of 1.3 victims for those with girl victims and 4.4 for those with boy victims. Child molesters, pedophilic or not, employ a variety of methods to gain sexual access to children. Some groom their victims into compliance with attention and gifts, while others use threats, alcohol or drugs, or physical force.

History

Pedophilia is believed to have occurred in humans throughout history, but was not formally named, defined or studied until the late 19th century. The term paedophilia erotica was coined in an 1886 article by the Viennese psychiatrist Richard von Krafft-Ebing but does not enter the author's Psychopathia Sexualis until the 10th German edition. A number of authors anticipated Krafft-Ebing's diagnostic gesture. In Psychopathia Sexualis, the term appears in a section titled "Violation of Individuals Under the Age of Fourteen", which focuses on the forensic psychiatry aspect of child sexual offenders in general. Krafft-Ebing describes several typologies of offender, dividing them into psychopathological and non-psychopathological origins, and hypothesizes several apparent causal factors that may lead to the sexual abuse of children.

Krafft-Ebing mentioned paedophilia erotica in a typology of "psycho-sexual perversion". He wrote that he had only encountered it four times in his career and gave brief descriptions of each case, listing three common traits:

  1. The individual is tainted [by heredity] (hereditär belastete)
  2. The subject's primary attraction is to children, rather than adults.
  3. The acts committed by the subject are typically not intercourse, but rather involve inappropriate touching or manipulating the child into performing an act on the subject.

He mentions several cases of pedophilia among adult women (provided by another physician), and also considered the abuse of boys by homosexual men to be extremely rare. Further clarifying this point, he indicated that cases of adult men who have some medical or neurological disorder and abuse a male child are not true pedophilia and that, in his observation, victims of such men tended to be older and pubescent. He also lists pseudopaedophilia as a related condition wherein "individuals who have lost libido for the adult through masturbation and subsequently turn to children for the gratification of their sexual appetite" and claimed this is much more common.

Austrian neurologist Sigmund Freud briefly wrote about the topic in his 1905 book Three Essays on the Theory of Sexuality in a section titled The Sexually immature and Animals as Sexual objects. He wrote that exclusive pedophilia was rare and only occasionally were prepubescent children exclusive objects. He wrote that they usually were the subject of desire when a weak person "makes use of such substitutes" or when an uncontrollable instinct which will not allow delay seeks immediate gratification and cannot find a more appropriate object.

In 1908, Swiss neuroanatomist and psychiatrist Auguste Forel wrote of the phenomenon, proposing that it be referred to it as "Pederosis", the "Sexual Appetite for Children". Similar to Krafft-Ebing's work, Forel made the distinction between incidental sexual abuse by persons with dementia and other organic brain conditions, and the truly preferential and sometimes exclusive sexual desire for children. However, he disagreed with Krafft-Ebing in that he felt the condition of the latter was largely ingrained and unchangeable.

The term pedophilia became the generally accepted term for the condition and saw widespread adoption in the early 20th century, appearing in many popular medical dictionaries such as the 5th Edition of Stedman's in 1918. In 1952, it was included in the first edition of the Diagnostic and Statistical Manual of Mental Disorders. This edition and the subsequent DSM-II listed the disorder as one subtype of the classification "Sexual Deviation", but no diagnostic criteria were provided. The DSM-III, published in 1980, contained a full description of the disorder and provided a set of guidelines for diagnosis. The revision in 1987, the DSM-III-R, kept the description largely the same, but updated and expanded the diagnostic criteria.

Law and forensic psychology

Definitions

Pedophilia is not a legal term, and having a sexual attraction to children is not illegal. In law enforcement circles, the term pedophile is sometimes used informally to refer to any person who commits one or more sexually-based crimes that relate to legally underage victims. These crimes may include child sexual abuse, statutory rape, offenses involving child pornography, child grooming, stalking, and indecent exposure. One unit of the United Kingdom's Child Abuse Investigation Command is known as the "Paedophile Unit" and specializes in online investigations and enforcement work. Some forensic science texts, such as Holmes (2008), use the term to refer to offenders who target child victims, even when such children are not the primary sexual interest of the offender. FBI agent Kenneth Lanning, however, makes a point of distinguishing between pedophiles and child molesters.

Civil and legal commitment

In the United States, following Kansas v. Hendricks, sex offenders who have certain mental disorders, including pedophilia, can be subject to indefinite civil commitment under various state laws (generically called SVP laws) and the federal Adam Walsh Child Protection and Safety Act of 2006. Similar legislation exists in Canada.

In Kansas v. Hendricks, the US Supreme Court upheld as constitutional a Kansas law, the Sexually Violent Predator Act, under which Hendricks, a pedophile, was found to have a "mental abnormality" defined as a "congenital or acquired condition affecting the emotional or volitional capacity which predisposes the person to commit sexually violent offenses to the degree that such person is a menace to the health and safety of others", which allowed the State to confine Hendricks indefinitely irrespective of whether the State provided any treatment to him. In United States v. Comstock, this type of indefinite confinement was upheld for someone previously convicted on child pornography charges; this time a federal law was involved—the Adam Walsh Child Protection and Safety Act. The Walsh Act does not require a conviction on a sex offense charge, but only that the person be a federal prisoner, and one who "has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others", and who "would have serious difficulty in refraining from sexually violent conduct or child molestation if released".

In the US, offenders with pedophilia are more likely to be recommended for civil commitment than non-pedophilic offenders. About half of committed offenders have a diagnosis of pedophilia. Psychiatrist Michael First writes that, since not all people with a paraphilia have difficulty controlling their behavior, the evaluating clinician must present additional evidence of volitional impairment instead of recommending commitment based on pedophilia alone.

Society and culture

General

Pedophilia is one of the most stigmatized mental disorders. One study reported high levels of anger, fear and social rejection towards pedophiles who have not committed a crime. The authors suggested such attitudes could negatively impact child sexual abuse prevention by reducing pedophiles' mental stability and discouraging them from seeking help. According to sociologists Melanie-Angela Neuilly and Kristen Zgoba, social concern over pedophilia intensified greatly in the 1990s, coinciding with several sensational sex crimes (but a general decline in child sexual abuse rates). They found that the word pedophile appeared only rarely in The New York Times and Le Monde before 1996, with zero mentions in 1991.

Social attitudes towards child sexual abuse are extremely negative, with some surveys ranking it as morally worse than murder. Early research showed that there was a great deal of misunderstanding and unrealistic perceptions in the general public about child sexual abuse and pedophiles. However, a 2004 study concluded that the public was well-informed on some aspects of these subjects.

Misuse of medical terminology

The words pedophile and pedophilia are commonly used informally to describe an adult's sexual interest in pubescent or post-pubescent teenagers. The terms hebephilia or ephebophilia may be more accurate in these cases.

Another common usage of pedophilia is to refer to the act of sexual abuse itself, rather than the medical meaning, which is a preference for prepubescents on the part of the older individual (see above for an explanation of the distinction). There are also situations where the terms are misused to refer to relationships where the younger person is an adult of legal age, but is either considered too young in comparison to their older partner, or the older partner occupies a position of authority over them. Researchers state that the above uses of the term pedophilia are imprecise or suggest that they are best avoided. The Mayo Clinic states that pedophilia "is not a criminal or legal term".

Pedophile advocacy groups

From the late 1950s to early 1990s, several pedophile membership organizations advocated age of consent reform to lower or abolish age of consent laws, as well as for the acceptance of pedophilia as a sexual orientation rather than a psychological disorder, and for the legalization of child pornography. The efforts of pedophile advocacy groups did not gain mainstream acceptance, and today those few groups that have not dissolved have only minimal membership and have ceased their activities other than through a few websites. In contrast to these organizations, members of the support group Virtuous Pedophiles believe that child sexual abuse is wrong and seek to raise awareness that some pedophiles do not offend; this is generally not considered pedophile advocacy, as the Virtuous Pedophiles organization does not approve of the legalization of child pornography and does not support age of consent reform.

Anti-pedophile activism

Anti-pedophile activism encompasses opposition against pedophiles, against pedophile advocacy groups, and against other phenomena that are seen as related to pedophilia, such as child pornography and child sexual abuse. Much of the direct action classified as anti-pedophile involves demonstrations against sex offenders, against pedophiles advocating for the legalization of sexual activity between adults and children, and against Internet users who solicit sex from minors.

High-profile media attention to pedophilia has led to incidents of moral panic, particularly following reports of pedophilia associated with Satanic ritual abuse and day care sex abuse. Instances of vigilantism have also been reported in response to public attention on convicted or suspected child sex offenders. In 2000, following a media campaign of "naming and shaming" suspected pedophiles in the UK, hundreds of residents took to the streets in protest against suspected pedophiles, eventually escalating to violent conduct requiring police intervention.

 

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