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Robert A. Prentky, Ph.D.,
Justice Resource Institute, Massachusetts Treatment Center,
30 Administration Rd., POB 554, Bridewater, Massachusetts 02324
(e-mail: firstname.lastname@example.org )
Schmidt's essay revisits the boundary lines of morality and social custom with regard to the proper age of onset of human sexuality. As Schmidt points out, although there are identifiable "outside limits" to what is not permissible (e.g., the presence of coercion or violence), discourse generally focuses on the moral gray zone, where customs, attitudes, and mores shift over time and across cultures.
Schmidt focuses on two central questions within this moral gray zone:
|(1) How young is too young to make an informed, competent decision to be sexual with a partner;
|(2) What are boundary lines for manipulation and grooming relative to the age of the partner (i.e., what is grooming for young adolescents may appear to be flirting for adults)?
The role of society in defining what is "normative" and what is "deviant" is perhaps more evident with paraphilias such as voyeurism or exhibitionism than with pedophilia. For most paraphilias, we estimate the base rates for given sexual behaviors. If relatively few people "do it," then "it" can be classified as deviant, which is to say non-normative.
Pedophilia, however, poses a more difficult problem. Base rates cannot be inferred until we decide where to impose age cut-offs (i.e., precisely when is pedophilia "present"). From any perspective -- anthropological, developmental, legal, or religious -- there appears to be no consensus when it comes to such questions as the minimum age for consenting sexual activity or marriage, a point clearly made by Green.
The second question about manipulation and grooming is merely a partial operationalization of Schmidt's "sexual self-determination." It is, of course, not merely an imbalance of power that threatens sexual self-determination but an abuse of power as well. There are untold instances of emotionally and physically abusive men effectively nullifying their partner's sexual self-determination.
All discourse on sexuality would appear to be inherently tainted by our attitudes and emotional responses to sexuality. I am not nearly as sanguine as Schmidt about the "enlightened, democratic discourse on morality that
prevails today." Such discourse would appear to prevail only in a few morally enlightened countries.
Otherwise, we can rely on the dictum that societies with the most conservative, strict adherence to the tenets of religion are the most sexually repressive and, conversely, societies that are more lax in their observance of and devotion to religion tend to be the most permissive with respect to sexuality.
Thus, degree of "enlightenment" may simply be a function of degree of secularity.
One unobtrusive measure of our degree of enlightenment around human sexuality would seem to be the quality and quantity of our scholarship with respect to normative sexual behavior in childhood and adolescence. This bears rather importantly, after all, on the subject of Schmidt's article.
I find it noteworthy that, other than the exceptional work of Friedrich and colleagues
(Friedrich et al., 1992, 2001; Friedrich, Fisher, Broughton, Houston, & Shafran, 1998; Friedrich, Grambsch, Broughton, Kuiper, & Beilke, 1991),
there is virtually no empirical research on normative sexual behavior in children and adolescents.
The foregoing observations notwithstanding, I believe that we could summon a general consensus around markedly age-discordant sexual activity (i.e., between adults and young children). For the same reasons that children are neither expected nor permitted to engage in a host of different activities, from operating motor vehicles to casting ballots in elections, we do not permit (by law) or condone (by social custom) developmentally inappropriate sexual activity.
In all instances, the rationale centers around the child's immaturity. In the case of sexual activity, the child's immaturity precludes any ability to give valid consent to such activity.
Although there is most certainly consensus around this cardinal principle that children cannot ethically or legally give valid consent to sexual activity with adults, the waters remain muddy.
When, after all, is a child no longer a child? In England, as Green pointed out, the magic age was 10 until about 100 years ago. We will forever be stymied by the fact that, unlike the onset of physical maturity, the age of emotional maturity is highly variable, leaving us with the dubious conclusion that there undoubtedly are some 12-year-olds who are mature enough to make decisions about sexual activity and there are many more 18-year-olds who are too immature to be making such decisions.
The nosological question posed by Green is whether in any context -- legal, psychiatric, biological, cultural -- pedophilia can be classified as a mental disorder.
Twenty-five years ago, Spitzer, a prominent neo-Kraepelinian, provided criteria for classifying mental disorder. Spitzer and Wilson (1975) decreed that mental disorders are conditions
|(1) which "are primarily psychological and involve alteration in behavior,"
| (2) which, in their
"full blown state are regularly and intrinsically associated with
|(3) that are "distinct from other con ditions in terms of the clinical picture and, ideally, followup, family studies, and response to treatment" (p. 829).
It is historically noteworthy that Spitzer's attempts at formulating criteria for mental disorder coincided with, and were at least in part prompted by, the swirling controversy of the day over whether homosexuality was classifiable as a mental disorder.
Spitzer (1973) argued that homosexuality could not be classified as a mental disorder, because it failed to meet the second criterion noted above. If the client did indeed experience "subjective distress" over his or her same-sex sexual attraction, then presumably that individual could be classified as having a mental disorder.
Since the DSM-III-R and DSM-IV no longer included Ego-Dystonic Homosexuality as a diagnosis, as did the DSM-III, the distressed individual would most likely have to be classified with an anxiety disorder or Sexual Disorder Not Otherwise Specified.
Applying those same criteria to pedophilia, we encounter a similar problem with the second criterion, as Green clearly pointed out. Although there are many pedophiles who evidence "generalized impairment in social effectiveness or functioning," and still other pedophiles who experience true "subjective distress," there are many pedophiles who experience no distress, their sexual interest in children is ego-syntonic, and their social functioning and effectiveness is not demonstrably impaired.
One solution, of course, would be to classify, de facto, all individuals who do not sustain co-habiting relationships with same-age partners as impaired in social effectiveness or functioning. Such blanket categorization, however, would inevitably yield many false positives.
A dramatic, and admittedly atypical, example is Charles Lutwidge Dodgson (Lewis Carroll). Throughout his entire life, marriage was never a consideration and the only objects of his love were young girls. Despite his clear pedophilic orientation, he taught mathematics at Oxford for almost 30 years, was an ordained deacon in the Church of England, and a prominent member of the Tory Party.
Another equally dramatic example is James Matthew Barrie. Barrie was the lord rector of St. Andrews University, appointed to the Order of Merit, elected president of the Society of Authors, served as chancellor of Edinburgh University and was made a baronet. Despite these remarkable accomplishments, the only objects of his love were young boys, two of whom inspired the early tales of Peter Pan.
Although Dodgson and Barrie clearly were pedophiles, it is questionable whether their extraordinary life accomplishments and their positions of considerable responsibility in
an adult world would permit us to conclude that there was evidence of "generalized impairment in social effectiveness or functioning."
Green reserved his harshest criticism for the sophistical reasoning in the DSM that an individual must have acted on his pedophilic urges or be markedly distressed by them in order to be classified as a pedophile.
Hence, an individual can masturbate exclusively to thoughts of children and, as long as he is not distressed by his masturbatory thoughts, he "does not have a mental illness without more."
The "without more" refers to the language "acted on" in the DSM, language that is never defined.
Although one could argue that masturbation qualifies as "acting on" one's urges, the intent of the language more likely refers to seeking out a potential victim.
Although downloading child pornography would probably not apply, falling in the same category as masturbation, leaving your computer and traveling to meet a child that you encountered in a chat room presumably would apply.
Ultimately, the distinction that the DSM seems to be making is one of self-control. This is the same distinction that legislators make in crafting civil commitment statutes, referred to in that context as volitional impairment. This distinction is also fundamental to the principle in criminal law that every crime consists of two elements or components:
|actus reus (the physical act or behavior associated with the crime) and
|mens rea (the mental state, or degree of intent, associated with the crime).
The acted on language in the DSM seems to suggest that, absent evidence of the first component (actus reus) and absent "distress," an individual cannot be classified as a pedophile.
Green concluded that this state of taxonomic affairs is "logically incoherent" and that the DSM has left us in Wonderland. Wonderland is appropriate, I suppose, given my earlier reference to Lewis Carroll but unsatisfying from any epistemological perspective. Although admittedly nihilistic, it appears to me that the black box hiding the secrets of pedophilia remains impenetrable, and that we have little more credible, empirically corroborated knowledge about the origins of pedophilia today than we did a 100 years ago.
Given that state of affairs, the DSM could not be expected to do much better
(although I agree with Green that it makes no sense to yoke psychiatric criteria to the statutory requirements of criminal law).