What’s the goal with treatments for Pedophilic Disorder?

By David S. Prescott, LICSW

A recent media storm focused on attempts to modernize laws relating to sexuality, including the Take Pride Act in Minnesota (https://tinyurl.com/4sm8jure). Here is the relevant text from the law. It seems to remove attraction to children as part of the definition of sexual orientation.

“Subd. 44. Sexual orientation. "Sexual orientation" means having or being perceived as having an emotional, physical, or sexual attachment to another person without regard to the sex of that person or having or being perceived as having an orientation for such attachment...”

Whatever one thinks about that definition, what was taken out of the law was:

“…or having or being perceived as having a self-image or identity not traditionally associated with one's biological maleness or femaleness. "Sexual orientation" does not include a physical or sexual attachment to children by an adult.”

Where the definition of sexual orientation once excluded a sexual attraction to children, this seems to remove that exclusion, leaving open the possibility that sexual attraction to children could be interpreted as an orientation. Multiple media outlets described this as “normalizing” pedophilia, while others said that it was nothing more than removing language. It’s no wonder media pundits get confused (especially with double-negative language involved).

The predictably polarized media coverage has led to private conversations with some professionals expressing doubts about the scope of their practice in the future. The sponsor(s) of the bill have been vocal that they don’t intend to open the door to pedophilia as an orientation, but the law is not written with our field in mind. At a time when conversion therapy continues to be reviled, is it possible that some providers may be liable for helping their clients with sexual attraction to children? In many ways, this seems completely far-fetched since treatment providers in our field typically try to help people manage their urges and have long recognized that they likely can’t change someone’s innate sexuality. In the absence of any universally agreed-upon definition of “orientation,” perhaps there is a lawsuit waiting to happen.

 On the one hand, we might argue that we are helping people who have consented to treatment manage (not change) their sexual interests and urges. On the other hand, some may argue that the mandated nature of treatment or even the social climate of treating these individuals raises questions about truly informed consent given freely. If anything, though, it seems many professionals will want to be clearer than ever on the aims of treatment.

I believe that lawsuits against professionals or agencies for practicing conversion therapy with clients who are attracted to children would be a losing endeavor under almost all circumstances. Most people can understand the difference between helping clients in treatment manage their behavior and attempting to change their innate sexual orientation. Still, lawsuits are expensive and stressful, and I respect the opinions and concerns of those in our field who want to do the work of helping people build healthier and offense-free lives.

As the saying goes, an ounce of prevention is worth a pound of cure. It might be worthwhile for professionals to revisit their policies and clarify in writing and with their clients that using treatment approaches with people with pedophilic disorders is about managing urges and behaviors and not an attempt to change the innate qualities of someone’s sexual orientation. One colleague aptly referred to treatment approaches in this area as similar to techniques others might use to manage anger. Whatever the case, ongoing attempts to clarify informed consent with clients at every turn will be vital.