The community is failing in its duty to protect children, partly because of a lack of treatment options for people with inappropriate sexual attraction, argues Adelaide psychologist Luke Broomhall.

The motivation of individuals who sexually abuse children remains a complex and poorly understood problem in society.

Child sexual abuse is not a new phenomenon, but debate around prevention strategies has been stifled by the combination of misunderstanding, disgust and retribution on behalf of victims.

Strong emotions are inevitable and most often justified when considering the atrocities perpetrated upon innocent children. The problem is, punishment without rehabilitation is variable at best in decreasing future risk of harm; in some cases it may increase risk of perpetrators reoffending. That means society is failing in engaging every possible avenue to protect children from harm caused by sexual abuse.

A significant issue lies in the fact that some individuals who identify their sexual attraction as being inappropriate have few avenues to seek intervention and treatment. As such, many only seek treatment after they have offended. While we will not stop all abuse by providing early identification and intervention, society has a duty to use all available means to reduce the number of children harmed by exposure to sexual abuse. This includes engaging in discussion around the availability of services to individuals, how services are targeted toward different subgroups and the efficacy of these services in reducing direct harm caused to children.

This discussion which must look beyond the understandable emotive, punitive “solutions” the subject invariably inflames. Such “solutions” aim to punish, but mostly miss the true aim, which should be to prevent further harm.

With respect to treatment and rehabilitation, what are the options? Can people be successfully treated?

To answer these questions, it is important to clarify some terms. “Paedophilia” refers (under the Diagnostic Manual of Mental Disorders – Fifth edition) to intense sexual fantasies, urges or behaviours involving pre-pubescent children (under 13 years). This definition leaves a gap: in South Australia, an individual cannot consent to sexual behaviour until they reach 17 years of age. There is no official diagnostic term for sexual attraction to children under the age of consent (13-17 years), although the academic literature refers to this as “hebephilia”. The internationally accepted term is “child sexual abuse”. This term does not allow for justifications, misunderstanding, minimisation or excuses. It also covers all children from 0-17 years of age.

Not all child sexual abusers are paedophiles and not all paedophiles engage in child sexual abuse (given that the definition covers fantasy in addition to downloading and sexual behaviours). This might not seem to make much of a difference to the average person, but it is crucial for those trying to understand and employ strategies to reduce reoffending. Different methods of treatment would be engaged for a person downloading child exploitation material (CEM) to one who would engage in physical acts of abuse, given the differences in these subgroups (note, CEM is the accepted term, not “child porn”, which risks trivialising or legitimising the practice).

How do these sexual “attractions” begin; nature or nurture?

Many perpetrators have histories of developmental trauma: typically an event occurring in early teenage years which halts sexual development and anchors sexual attraction to an age range which doesn’t then advance. Sexual abuse and trauma can be factors here (although clearly not always – the experience of sexual abuse doesn’t always turn the victim into a perpetrator). Others lack the maturity and social skills to engage with their own age group so seek younger company.

There is, however, a group within those who have sexual attraction to children who have no obvious behavioural markers for how they became attracted to children; no abuse, normal development, secure attachment and normal psychosexual development.

The “genetic inheritability” argument (that sexual attraction to children is a “sexual orientation”) is a very morally challenging, confronting possibility. Research in this area hasn’t yet categorically ruled this out as a contributing factor in some (not all) cases of sexual attraction toward children.

One clear fact stands out as an absolute from which no one can deviate or question: regardless of how sexual attraction toward children occurs, children cannot consent to sexual behaviour. Any adult attempting to justify their attraction must be very clear that children are always harmed by sexual abuse. This should seem like a no-brainer, but people with sexual attraction toward children will attempt to convince themselves that no harm will be done by their action through a series of ingrained “cognitive distortions” – thought styles which are never challenged and form part of the pathway to perpetrating abuse behaviours, from downloading material to physical interference.

Sexual behaviour from an adult to a child is non-consensual sexual abuse. End of argument.

It’s our duty to consider best ways to protect children

With the rates of sexual attraction to children among men in western cultures estimated at between 3-5 per cent, we need to have a mature, informed dialogue about the best way to address this serious issue in order to safeguard our children. It just doesn’t matter what our sexual attractions are, all adults have a moral duty to ensure that their behaviour doesn’t infringe the rights of others through non-consensual contact.

When it comes to treatment services however, there are few options available. Even for people who have committed offences.

Does treatment work? This depends on the subgroup within the broad definition. For example, extrafamilial offenders with male victims who meet clinical criteria for paraphilias, such as paedophilia or exhibitionism— do offend with high frequency over long periods and generally have low responsivity to treatment. Such individuals need close monitoring and supervision. However, individuals who download child exploitation material can respond well to treatment and even in some cases re-align their sexual arousal; many have lower rates of offending than general offenders.

The “StopSO” (sexual offending) program in the UK and Dunkelfeld Project in Germany put forward the challenging premise that sexual attraction toward children exists and provides a safe therapeutic environment for men to self-identify and learn to control (ideally re-align) their sexual desires. This is a necessary option to promote in Australia as these services place treatment before offending, rather than waiting until after a child is harmed.

Perpetrators of child sexual abuse are not a homogenous group. Therefore, while some perpetrators of the most serious offences do need to be separated from society, for others, reduction in reoffending can be achieved through greater investment in targeted rehabilitation programs for those who have offended.

Further reduction in potential for harm to children can be achieved by providing early intervention and treatment before offences occur.

As challenging as this might be, we have a duty to consider all available options to protect children from the harm caused by sexual abuse; “lock ‘em up” just won’t work as the only solution.

Luke Broomhall is Director of Broomhall Young Psychology.