Is Pedophilia a Mental Disorder?
Originally published in: Archives of Sexual Behavior, Vol. 31, No. 6, December 2002, pp. 467–471
Richard Green, M.D., J.D.
Imperial College School of Medicine, Gender Identity Clinic, Department of Psychiatry, Charing Cross Hospital, London, England, Institute of Criminology, University of Cambridge, Cambridge, England
Nearly 30 years ago, I was embroiled in the historic battle within the American Psychiatric Association (APA) over whether homosexuality per se was rightfully deemed a mental illness, as included in the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II; American Psychiatric Association, 1968). During the controversy, several topics were examined: historical and cross-cultural groundings in homosexual expression, associated psychiatric features accompanying a homosexual orientation, the emotional consequences to the homosexual of societal condemnation, and behaviors of other species. I argued vigorously for removal of homosexuality from the DSM (Green, 1972; see also Stoller, 1973). The Task Force on Nomenclature and Statistics voted to delete homosexuality. Ludicrously, that decision led to a shotgun marriage between science and democracy. It was put to popular vote—a referendum by the entire APA membership. We cannot track precisely the 1970s model here. Consensual same-sex adult–adult sexuality does not suggest the element of harm to one participant as in child–adult sex or an age barrier to informed consent. But these concerns are within the domain of the law and penal enforcement. What follows here does not address whether pedophilia should be deemed criminal.
HISTORICAL AND CROSS-CULTURAL CONSIDERATIONSSeveral quotes illustrate the range of acceptance of sexual contact between children and adults:
"The diversity of sexual behavior in a cross-cultural perspective is amazing to those who assume that their own society’s moral standards are somehow laws of nature. Yet it is a fact that almost every sort of sexual activity : : : has been considered normal and acceptable in some society at some time: : : . Man-boy relationships are no exception to this rule of diversity: : : . Although they are roundly condemned by many segments of Western society as inherently abusive and exploitive, there have been (and still are) many societies that do not share this viewpoint." (Bauserman, 1997, p. 120) Substantial differences are found between the legal, social, and biological definitions of pedophilia. In Western society, definitions of childhood have been based largely on arbitrary dates, milestones marking progress into adulthood. Biological change may not correspond closely to these, and are insignificant in social and legal definitions. (Howitt, 1998, p. 17) At this point in our history, a very real conundrum exists for the researchers of adult/child sex. The problem is reflected in the question of what truly marks the point beyond which sexual interaction with a child is pathological and not just criminal. (Ames & Houston, 1990, p. 339)
In the DSM-IV (American Psychiatric Association, 2000), puberty is the boundary for pedophilia. The younger person is to be prepubertal. But, the designation of puberty as the bright line age boundary for erotic attraction to be a mental illness is arbitrary. It does not consider the mental development of the child. Further, puberty varies between individuals and may be changing over generations. And, for sexual proscription, it is not the marker necessarily grounded historically or cross-culturally.
Ford and Beach (1951) described cross-cultural examples of child–adult sex from the Human Relation Area files at Yale University. Among the Siwans (Siwa Valley, North Africa), “All men and boys engage in anal intercourse. Males are singled out as peculiar if they did not do so. Prominent Siwan men lend their sons to each other for this purpose” (pp. 131–132). Among the Aranda aborigines (Central Australia), “Pederasty is a recognized custom: : : . Commonly a man, who is fully initiated but not yet married, takes a boy ten or twelve years old, who lives with him as his wife for several years, until the older man marries” (p. 132). Diamond (1990) reviewed child–adult sex in Hawaiian history and Polynesia. In the eighteenth century, Cook (1773) reported copulation in public in Hawaii between an adult male and a female estimated to be 11 or 12 “without the least sense of it being indecent or improper” (cited in Diamond, 1990). Sexual interactions between adult and child were seen as benefitting the child, rather than as gratifying the adult. The sexual desire by an adult for a nonadult, heterosexual or homosexual, was accepted (Pukui, Haertig, & Lee, 1972, cited in Diamond, 1990). Suggs (1966), studying Marquesan society, reported considerable childhood sexual behavior with adults (cited in Diamond, 1990). He reported many examples of heterosexual intercourse in public between adults and prepubertal children in Polynesia. The crews of visiting ships were typically involved and assisted by adult natives. Occasions were recorded of elders assisting youngsters in having sex with other elders. In many cultures of Oceania, prepubertal females were publicly sexually active with adults (Oliver, 1974). In Tahiti, in 1832, the missionary Orsmond observed that “in all Tahitians as well as officers who come in ships there is a cry for little girls” (Oliver, 1974, pp. 458–459, cited in Diamond, 1990). Among the Etoro of New Guinea, from about age 10 years, boys would have regular oral sex with older men, swallowing their semen to facilitate growth (Bauserman, 1997). Amongthe neighboring Kaluli, when a boy reached age 10 or 11, his father would select a man to inseminate him for a period of months to years. In addition, ceremonial hunting lodges would be organized where boys could voluntarily form relationships with men who would have sexual relations with them (Bauserman, 1997).
These cross-cultural examples are not cited to argue for similar practices in Los Angeles or London. But are we to conclude that all the adults engaged in these practices were mentally ill? If arguably they were not pedophiles, but following cultural or religious tradition, why is frequent sex with a child not a mental illness under those circumstances? For skeptics of the relevance of these cited exotic examples, for three centuries the age of sexual consent in England was 10. This was not in some loin cloth clad tribe living on the side of a volcano, but the nation that for six centuries was already graduating students from Oxford and Cambridge. Further, the time when age of consent was 10 was not in a period contemporaneous with Cromagnon Man, but continued to within 38 years of World War I. The impetus to raise the age of sexual consent in England from 10 years was fueled not by an outrage over pedophilia per se but concerns over child prostitution. Changes in employment law during the nineteenth century were protecting children from long hours of factory labor, leaving them more accessible for sexual service as the only means of support. Child prostitution was rampant (Bullough, 1990). Were all customers pedophiles? Were they all mentally ill?
I will make one obligatory reference to nonhuman primates. Observations concern a near relative of Man, the bonobo, where these “pigmy chimps” are allowed free access to any other bonobo for sexual contact at the San Diego Zoo. Nonfertile combinations (same-sex or juvenile–adult combinations) were as frequent as potentially fertile, adult male–female combinations. Further, one third of sociosexual contacts by an adult with an infant were initiated by the infant (De Waal, 1990).