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Psychiatric Association Debates Reclassifying Pedophilia

By Lawrence Morahan, CNSNews.com Senior Staff Writer, June 11, 2003

1st Add: Includes additional language from report

(CNSNews.com) - In a step critics charge could result in decriminalizing sexual contact between adults and children, the American Psychiatric Association (APA) recently sponsored a symposium in which participants discussed the removal of pedophilia from an upcoming edition of the psychiatric manual of mental disorders.

Psychiatrists attending an annual APA convention May 19 in San Francisco proposed removing several long-recognized categories of mental illness - including pedophilia, exhibitionism, fetishism, transvestism, voyeurism and sadomasochism - from the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Most of the mental illnesses being considered for removal are known as "paraphilias."

Psychiatrist Charles Moser of San Francisco's Institute for the Advanced Study of Human Sexuality and co-author Peggy Kleinplatz of the University of Ottawa presented conferees with a paper entitled "DSM-IV-TR and the Paraphilias: An Argument for Removal."

People whose sexual interests are atypical, culturally forbidden or religiously proscribed should not necessarily be labeled mentally ill, they argued.

Different societies stigmatize different sexual behaviors, and since the existing research could not distinguish people with paraphilias from so-called "normophilics," there is no reason to diagnose paraphilics as either a distinct group or psychologically unhealthy, Moser and Kleinplatz stated.

Participants also debated gender-identity disorder, a condition in which a person feels discomfort with his or her biological sex. Homosexual activists have long argued that gender identity disorder should not be assumed to be abnormal.

"The situation of the paraphilias at present parallels that of homosexuality in the early 1970s. Without the support or political astuteness of those who fought for the removal of homosexuality, the paraphilias continue to be listed in the DSM," Moser and Kleinplatz wrote.

In a section of the report entitled 'The Special Case of Pedophilia,' Moser and Kleinplatz wrote, "our suggestion to remove the paraphilias, which includes pedophilia, from the DSM does not mean that sexual acts with children are not crimes. We would argue that the removal of pedophilia from the DSM would focus attention on the criminal aspect of these acts, and not allow the perpetrators to claim mental illness as a defense or use it to mitigate responsibility for their crimes."

Moser and Kleinplatz also noted, "individuals convicted of these crimes should be punished as provided by the laws in the jurisdiction in which the crime occurred. Any interpretation of our work as supporting adult-child sexual interactions is misguided and wrong."

A. Dean Byrd, vice president of the National Association for Research and Therapy of Homosexuality (NARTH) and a clinical professor of medicine at the University of Utah, condemned the debate. Taking the paraphilias out of the DSM without research would have negative consequences, he said.

"What this does, in essence, is it has a chilling effect on research," Byrd said. "That is, once you declassify it, there's no reason to continue studying it. What we know is that the paraphilias really impair interpersonal sexual behavior...and to suggest that it could be 'normalized' simply takes away from the science, but more importantly, has a chilling effect on research."

"Normalizing" pedophilia would have enormous implications, especially since civil laws closely follow the scientific community on social-moral matters, said Linda Ames Nicolosi, NARTH publications director.

"If pedophilia is deemed normal by psychiatrists, then how can it remain illegal?" Nicolosi asked. "It will be a tough fight to prove in the courts that it should still be against the law."

In previous articles, psychiatrists have argued that there is little or no proof that sex with adults is necessarily harmful to minors. Indeed, some have argued that many sexually molested children later look back on their experience as positive, Nicolosi said.

"And other psychiatrists have written, again in scientific journals, that if children can be forced to go to church, why should 'consent' be the defining moral issue when it comes to sex?" she said.

But whether pedophilia should be judged "normal and healthy" is as much a moral question as a scientific one, according to Nicolosi.

"The courts are so afraid of 'legislating someone's privately held religious beliefs' that if pedophilia is normalized, we will be hard put to defend the retention of laws against child molestation," Nicolosi noted.

In a fact sheet on pedophilia, the APA calls the behavior "criminal and immoral."

"An adult who engages in sexual activity with a child is performing a criminal and immoral act that never can be considered normal or socially acceptable behavior," the APA said.

However, the APA failed to address whether it considers a person with a pedophile orientation to have a mental disorder.

"That is the question that is being actively debated at this time within the APA, and that is the question they have not answered when they respond that such relationships are 'immoral and illegal,'" Nicolosi said.

Dr. Darrel A. Regier, director of research for the APA, said there were "no plans and there is no process set up that would lead to the removal of the paraphilias from their consideration as legitimate mental disorders."

Some years ago, the APA considered the question of whether a person who had such attractions but did not act on them should still be labeled with a disorder.

"We clarified in the DSM-IV-TR...that if a person acted on those urges, we considered it a disorder," Regier said.

Dr. Robert Spitzer, author of a study on change of sexual orientation that he presented at the 2001 APA convention, took part in the symposium in San Francisco in May.

Spitzer said the debate on removing gender identity disorder from the DSM was generated by people in the homosexual activist community "who are troubled by gender identity disorder in particular."

Spitzer added: "I happen to think that's a big mistake."

What Spitzer considered the most outrageous proposal, to get rid of the paraphilias, "doesn't have the same support that the gender-identity rethinking does." And he said he considers it unlikely that changes would be made regarding the paraphilias.

"Getting rid of the paraphilias, which would mean getting rid of pedophilia, that would not happen in a million years. I think there might be some compromise about gender-identity disorder," he said.

Dr. Frederick Berlin, founder of the Sexual Disorders Clinic at the Johns Hopkins Hospital, said people who are sexually attracted to children should learn not to feel ashamed of their condition.

"I have no problem accepting the fact that someone, through no fault of his own, is attracted to children. But certainly, such an individual has a responsibility...not to act on it," Berlin said.

"Many of these people need help in not acting on these very intense desires in the same way that a drug addict or alcoholic may need help. Again, we don't for the most part blame someone these days for their alcoholism; we don't see it simply as a moral weakness," he added.

"We do believe that these people have a disease or a disorder, but we also recognize that in having it that it impairs their function, that it causes them suffering that they need to turn for help," Berlin said.

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