“Nothing can be changed until it is faced” – Break the taboo!

Let’s talk about Paedophilia and Child abuse

(Written by: Naveen Ariadurai, Faculty of Medicine, University of Colombo)

‘Paedophile’, a word that often brings disgust among those who encounter it, has become synonymous with the word ‘child abuser’ to many. However, what do these words actually mean? How could anyone possibly have these thoughts? Do all Paedophiles abuse children? These are questions that need to be asked and answered. Unfortunately, these conversations do not take place in our societies as they are often regarded as taboo. The social stigma that surrounds sex education and mental disorders further contribute to the lack of conversation and growing misconceptions about these topics. This article intends to give an insight on what paedophilia is and how it contributes to the increasing prevalence of child abuse in today’s world.

The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) by the American Psychiatric Association defines Paedophilia as “recurrent and intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child (male or female)—generally aged 13 years or younger—over a period of at least six months”. It also requires that the individual has either acted upon these sexual urges or has marked distress or interpersonal difficulty such as difficulties in maintaining meaningful relationships, due to these fantasies. The individual should at least be 16 years of age and at least 5 years older than the children that the individual is fantasizing about. Thus, it is evident that paedophilia is not considered to be a normal phenomenon and is rather viewed as a mental disorder, a type of paraphilia, which are abnormal sexual preferences. These paraphilias can range from seemingly benign disorders such as fetishism to rather serious disorders such as paedophilia. However, the DSM-V differentiates ‘paedophilic sexual orientation’ from ‘paedophilic disorder’. It says that if these individuals who experience these fantasies do not report feelings of guilt, shame or anxiety and have not acted upon their impulses they would not be diagnosed as having the disorder itself but would rather be classified as having a paedophilic sexual orientation. Paedophilia should also be differentiated from sexual intercourse with young people who have attained puberty but have not yet reached the legal age of consent, this although is a crime, is not paedophilia.

Paedophilia is most commonly seen among men, with a highest possible prevalence of about three to five percent among the total male population. Although female cases have been recognized, it is thought to be a small fraction when compared to the male prevalence.

The possible causative or risk factors that could lead to paedophilia are not well understood. However, there is some evidence that it may be familial, though it is not entirely certain if this is due to genetics or learned behaviour. Males that experience these fantasies and act on it have often reported that they were sexually abused as children, which is known as the “victim-to-abuser cycle”. However, it must be noted that although abused individuals are most likely to abuse others, most individuals who are abused do not perpetuate the cycle. There have also been reports of paraphilic behaviour secondary to organic brain pathologies, with a recent emergence of paedophilia in late life and brain disease.

Are all paedophiles child abusers? Sexual child abuse is when an adult has sexual contact with an underage minor. This is a criminal act, and the perpetrator of that crime is a ‘child abuser’. As seen earlier not all those with paedophilic sexual orientation act on their fantasies. A paedophile becomes a sexual offender or a child abuser when they act upon their sexual urges, by viewing child pornography, or sexually abusing children. It should also be noted that not every child abuser is a paedophile. Only about 40% of convicted sex offenders meet the diagnostic criteria for paedophilic disorder.

Why is this distinction between child abusers and paedophiles so important? Categorizing the two as one gives us a sense that offenders are easier to identify, as they show grooming behaviors or they actively prey on children, thus targeting and apprehending those who prey on children may eradicate child abuse. It also gives us a false understanding that all offenders have a psychiatric sexual disorder that can’t be cured. However, most child abusers are situational offenders, who do not necessarily seek out an opportunity to abuse a child, but rather, find themselves in a situation that enables them to abuse a child and so make use of the situation. Most offenders have been identified to be a known person to the child or family, such as a family friend or relative. Situational offenders most likely abuse children when they are either feeling stressed or depressed due to perhaps the loss of a job or divorce, or are morally and sexually indiscriminate, or when they are considered as social outcasts; putting them at a position where they cannot form intimate relationships with their peers. On the other hand, Paedophiles that are child abusers actively seek out children. The internet has become one such hunting ground where pedophiles prey on children. Social networking sites are common tools that they use to “catfish” innocent children. Which is where they pretend to be someone they are not, such as a classmate or a peer and form friendships and then arrange meetings to carry out their sexual desires. Research also shows that paedophilic offenders have significantly higher rates of reoffending than situational offenders.

Most child abusers create and reinforce “thinking errors” to rationalize and minimize the impact of their abuse. For example, they may convince themselves that if the child is young enough that he/she won’t understand or remember, that the relationship is loving – that they are filling an emotional need for the child, that they are ‘teaching’ the child about sex, or that if the child consents to the abuse, it isn’t abuse.

If someone has these feelings or is suffering from a paedophilic sexual orientation what should he/she do? There are treatment options available in Sri Lanka, and so it is recommended that they seek help. Those who experience these urges rarely seek help on their own, and most of them are referred to counseling or a psychiatric facility following a court order for a crime that they have committed against an innocent child, at which point it is too late. Early diagnosis and therapy will help to reduce and prevent the occurrence of child abuse. Extensive use of child pornography is a useful indicator to know if a person is struggling with these desires. So, if you are someone that does feel this way, please do seek professional help, you will be helping a child from potentially falling victim to something that he/she does not deserve.


  1. Diagnostic Statistical Manual of mental disorders 5th edition (DSM-V) by the American Psychiatric Association
  2. Shorter Oxford Textbook of Psychiatry
  3. https://neuroanthropology.net/2010/05/10/inside-the-mind-of-a-pedophile/
  4. https://themamabeareffect.org/think-all-child-molesters-are-pedophiles-think-again/
  5. https://blogs.bmj.com/medical-ethics/2017/11/11/pedophilia-and-child-sexual-abuse-are-two-different-things-confusing-them-is-harmful-to-children/
  6. https://www.psychologytoday.com/us/conditions/pedophilia
  7. https://theconversation.com/the-causes-of-paedophilia-and-child-sexual-abuse-are-more- complex-than-the-public-believes-94915
  8. https://theconversation.com/we-need-to-support-paedophiles-to-prevent-child-sex-offending- 44845
  9. https://www.webmd.com/mental-health/features/explaining-pedophilia#2

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