A plague on both your APA houses

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Young pedophile commits suicide

Heretic TOC’s first anniversary blog promised something important was on the way. The life-threatening mental anguish of minor-attracted teenagers to which today’s shocking photos draw attention surely measures up to that criterion. This blog has had a strict no photos policy until now, explicitly to avoid any possible association with images of child abuse.

Ironically, it is precisely such abuse that Heretic TOC now feels an urgent need to expose: abuse not by adult molesters or rapists but by two organisations that ought to be helping young people instead of making their lives unbearable. These are the American Psychiatric Association and the American Psychological Association, two of the most important organisations in the world in the field of mental health. A plague on both their houses for failing to measure up!

The photos tell their own story very powerfully, so I will try to keep this reasonably brief. Showing them is part of a wider effort to draw attention to the present scandalous situation and to put pressure on these organisations to mend their ways. That is why Fight Back recently launched their message into the public arena.

As Fightback says, “both APAs have recently released press releases in response to right wing fundamentalist complaints that the new DSM 5 classifies pedophilia as a sexual orientation. The press releases ignore the mental health of people with the diagnosis and instead advocate their prosecution.”

Peter Hooper, occasionally a commentator here, was quick off the mark with his own excellent blog on this theme a couple of days ago, Mistakes can have a very high price. Rather than me reinventing the wheel, you can read his analysis. His website is called Take A Risk NZ.

I will just add that recognising paedophilia as a sexual orientation is a really big deal. The scientists have been moving towards a consensus in recent years that paedophilia is indeed a sexual orientation; the problem lies with the organisations’ politically minded “leadership”, who really amount to a craven followership of whichever lobby they are most scared of offending. The issue is important because there are already laws against discrimination based on sexual orientation. Paedophiles of any age who stay within the law would benefit hugely if discrimination against them in employment, housing, access to sports and leisure facilities, engagement in community activities, etc., were to be made illegal via logical application of current law to a newly recognised orientation.

Such a development could have a massive impact in lifting the psychological pressure now bearing down on MAPs, and especially on young ones. Those of us who have survived a decade or more of adult life may find the going tough, but at least we have gained some experience of how to get by and even thrive, despite the worst society can throw at us. Without such experience the young are more vulnerable: it can easily appear to them that the future will be utterly, permanently, relentlessly bleak. Being brought under the protection of anti-discrimination laws would reduce depression, suicidality and other manifestations of poor mental health among MAPs so that the young and the rest of us would have less need for therapy. Having said that, the APAs should be working much harder towards delivering better mental health provision than the “treatment” currently meted out, which is often hostile, oppressive and punitive.

Young teen pedophile commits suicide

As for whether Heretic TOC’s contribution will do any good, yes it can, especially as it is part of a wider effort. Richard Kramer, of B4U-ACT, has been vigorous in his critique of the two APAs in a recent debate at the influential Sexnet scientific and clinical forum, and I have put in my own two penn’orth there as well, and so has one of this blog’s contributors, Peter Loudon – well, at least 10 penn’orth in his case! Additionally, you other heretics here can all do your own bit by tweeting links to the photos and blog info, plus networking in any other way you can think of: Facebook, links on other relevant sites, etc. It will be great if this goes viral.

Tromovitch sets a poser on prevalence

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I promised (or threatened !) more about the Cambridge conference on DSM-5. Groan ye not, though, dear heretics, as this week’s despatch will be a tad less arcane.

Turning to the poster presentations, in particular, several of these were lively sessions, with subject matter of wider potential interest than the knotty diagnostic concerns that constituted the main business of the event. Three stand out: Noëmi Willemen, from the Catholic University of Louvain in Belgium, speaking on “Liberating the paedophile: a discursive analysis”; Diederik Janssen, editor of Culture, Society & Masculinities, on “Specification of the perverted: anthropologizing bad sex”, and Philip Tromovitch, of Doshisha University, Japan, on “The prevalence of pedophilia: What little we know”.

Liberating the paedophile! Wow, we don’t hear that kind of talk much these days. Unfortunately, interesting though it was, Willemen’s poster was an analysis of the rhetoric of paedophile liberation in the Olden Days several decades ago, rather than a rousing call for liberation right now. Janssen’s work, by contrast, is far more radical than his use of expressions like “perverted” and “bad sex” might suggest. For colourful, provocative mischief, though, I must hand the palm on this occasion to Tromovitch, and thus will focus on his contribution.

But first, a fanfare is in order. Tromovitch will be revered by many here as part of a team, Rind, Tromovitch & Bauserman, whose valorous deeds set them among the immortals of heresy over a decade ago.  Their work had the temerity to challenge the term “child sexual abuse” (CSA) as unscientific, and demonstrated through careful statistical analysis that the psychological harm thought to be caused by child-adult sexual contacts is instead far more strongly associated with non-sexual factors such a poor family background, including issues such as violence and neglect. Their meta-analysis published in the Psychological Bulletin in 1998 was so powerful, so high-profile, and so threatening to the entrenched interests of the abuse industry that it was condemned in a resolution passed by both house of the United States Congress – the first and only time any academic paper has been thus attacked in the nation’s history, in a move many have compared to the Pope having Galileo tried for heresy in the 17th century based on his “heretical” view that the earth orbits the sun.

After more than three hundred years the Catholic Church finally admitted that Galileo was right. While it is to be doubted that the US Congress will ever rescind its vote against Rind, Tromovitch & Bauserman, even in a thousand years, the tremendous trio, a veritable holy trinity of heresy, can at least take satisfaction from the fact that in the academic world, at least, their work has earned lasting respect and is widely cited.

There is a price to be paid for heresy, though. Work in cancer research, say, or particle physics, of a similar quality to Rind et al.’s contribution, might lead to a Nobel prize, or at the very least a top professorship in a world famous university. The careers of Rind, Tromovitch & Bauserman, by contrast, have all suffered, and getting further work published has been a struggle. So it should not have come as a surprise to me that Tromovitch’s role at Cambridge was relatively modest. Presenting a poster is a fairly humble task, whereas he might have been invited to give the keynote speech in more favourable political circumstances.

Never mind, the modest status of the presentation was more than made up for by the punch it packed: in its way, the claim put forward was just as shocking and sensational as the paper denounced by Congress. Put it this way: What proportion of the male population do you think are paedophiles? One percent? Five? Surely it has to be less than the number of adult-orientated gays, right, a figure variously estimated at between five and ten percent?

Well, no, it ain’t necessarily so. According to Tromovitch – and I quote directly from his poster – “the majority of men are probably pedophiles and hebephiles”. Of course, much depends on precisely how those terms are defined, but it has certainly long been known that when so-called normal men are used as control group subjects in laboratory research they will typically show arousal (usually measured by increase in penis volume) when exposed to sexual stimuli featuring children, such as erotic pictures or stories. Startlingly, as Tromovitch points out, “89% of community males exhibited some sexual arousal while viewing slides of female children” (Hall et al., 1995).

Whether a small degree of arousal to children is significant is open to doubt, but Tromovitch’s presentation brought together a range of research data which together introduced startling evidence that around 20-25% of men actually test as paedophiles, by which he appears to mean significantly or preferentially so, although this would need further elaboration. What is more, these figures are supported by self-report studies, of which Tromovitch cites a good few, including these:  22% of male students reported that they were sometimes attracted to little children (Briere et al., 1996); 19% of male students reported unwanted, personally unacceptable, sexually intrusive thoughts involving sexual acts with a child or minor (Byers et al., 1998). Perhaps most strikingly, based on a number of studies, Tromovitch reveals that “Approximately 10% of normal men report that they would have sex with a child if no one would know and there would be no punishment”.

All this, says Tromovitch, need not surprise us if we think about the characteristics of different age categories and their likelihood of either eliciting or inhibiting sexual arousal in adult men. Older children (pubescent, 8-12), he points out, and young biological adults (adolescent 11-15) are the only groups in seven age categories, from infants to the elderly, whose characteristics comprise no factors usually regarded as off-putting (such as sagging breasts and blemished skin) along with the positive presence of factors usually regarded as sexy (arousing body shape, high libido, not too hairy).

Is he right? Well, you can check out the details of his poster, Page 1 and Page 2, and decide for yourself. I would just note that in his authoritative book Pedophilia and Sexual Offending Against Children, Michael Seto puts preferential or exclusive attraction to prepubescent children at around 4% or less. The most obvious reason for scepticism, though, seems to me to be this: If such a high proportion of men really are significantly or preferentially attracted to children, how come our political presence is so feeble? Why don’t we organise and fight the oppression against us far more powerfully, like the massively successful gay movement? Is it just fear of the majority’s ferocity? Or is it mainly, as I suspect, that most minor-attracted adults have fallen prey to all the moralistic propaganda that so besets our ears on a daily basis?

But, hey, enough of the heavy stuff. Who’s ready for some tittle tattle about personalities?

Phil Tromovitch and Diederik Janssen, I am pleased to say, both proved to be “up for it” when I suggested chatting over drinks in a riverside pub garden after the conference ended. Huge guys, both of them – black-clad, shaven-headed, muscleman Janssen, especially, would make a very credible night club bouncer, an image massively at odds with his subtly teasing academic prose – so it felt like I had a couple of body guards. Not that I needed any: the atmosphere in the ancient university city on a lovely English summer’s evening was very relaxed. So was the conversation, which flowed most agreeably, along with the drinks and the beautiful River Cam.

Unsurprisingly, after his defeat, Blanchard himself was not at the conference, but other big-name figures did attend, such as Richard Green, emeritus professor of psychiatry, UCLA, a leading figure behind the declassification of homosexuality as a mental illness thirty years ago, who courageously attempted to do the same with paedophilia early in the new millennium. As President of the International Academy of Sex Research (IASR) he even invited me to address that august body in a symposium on paedophilia.

I guess he had to take some flak for that, some of it quite probably coming from the far more conservative Ken Zucker. As IASR’s conference treasurer at the time, he found himself obliged to hand me a cheque to cover my speaker’s expenses – and judging by his cool demeanour he was none too happy about it.  But Zucker, present in Cambridge having been chair of the DSM-5 work group on sexual and gender identity disorders, has had to take his share of flak too over the years. A psychologist working with children, he has long been under attack by activists for allegedly pushing transgender kids into accepting their biological gender. Transsexuals even demonstrated against him outside the conference building: they included a female-to-male trans guy dressed as a baby and holding a placard saying “Ken Zucker – hands off our kids!” And I learned in Cambridge that a recent journal article published under the auspices of  the British Psychological Society was memorably titled “Zuck off!”

Wonderful! It was a rare few days when I could feel relatively popular!

That was fun, and even more so was the chance to chat to so many folks (including the demonstrators) on a one-to-one basis. Why, I was even able to pin Zucker to the wall over not answering my emails in recent years! He denied it was on account of personal animosity. I don’t believe him but I was too polite to say so. Well, he can read it here!

Approaching gay historian Jeff Weeks for the first time in decades, I was delighted he recognized me but saddened that his speech “Beyond the categories”, which closed the conference, was tired, bland and utterly devoid of the radical edge that characterized his exciting early work. Again, unfortunately, I was too nice to tell him so, although a question I raised from the floor was a pretty big hint. Was the current obsession with crushing paedophilia, I asked, harmfully also leading to the denial of children’s sexuality, and leading to sexually active children themselves being criminalized as sex offenders? His answer was evasive and vacuous. Very disappointing.

Shit! Every week I tell myself I must make these blogs shorter and snappier but I still haven’t delivered on saying I would tell you more about the interesting exchange when I was buttonholed by philosopher Patrick Singy, a conversation also joined to great effect by the delightful Noëmi Willemen. It would take too long to start on that now but I should add a couple of brief and hopefully useful points about my earlier Cambridge blog (11 July):

  1. I have added a paragraph to it (in square brackets and italics) in connection with Singy’s argument.
  2. Also in that same Cambridge blog I mentioned Blanchard’s fraternal birth order effect on sexual orientation in males. A brief, sharp, interview with Blanchard about this, Did having a big brother make me gay?, has just appeared in the Boston Globe online. Recommended.

Stifling but stimulating in sunny Cambridge

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Summer is here at last in England after a long, cold Spring so where better to enjoy the belated sunshine than in the, err, stifling atmosphere of a conference centre with no air conditioning?

Well, call me a masochist but I had a great time last week at Classifying Sex: Debating DSM-5, a two-day conference at Cambridge University. DSM, for the uninitiated, is the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, routinely dubbed the bible of psychiatry, a description often criticised but one which captures the intensity of the religious warfare its various versions and interpretations provoke worldwide, not just in the United States. A quasi-religious aspect is evident, too, not just in the ferocity of debate but also in its labyrinthine theology: grasping what is at stake in all the rhetorical cut and thrust demands close attention to decades of scriptural exegesis since the first edition in 1952 up until the fifth edition launched in May this year. Hence the conference: nothing less than days of lectures from experts will suffice to get one’s head around it.

Speaking of mental disorders, the sanest response might be, why bother? Don’t the shrinks give minor-attracted people a tough enough time as it is, without breaking our heads trying to unravel their precise modes of oppression? Possibly, but that would be to miss an important point: psychiatry is not monolithic; not every oppressive initiative succeeds. A clear example of this is the defeat of the DSM-5 Paraphilias Subworkgroup’s proposal to include hebephilia as a mental disorder, an outcome with potentially huge implications for the lives of sex offenders in the U.S. diagnosed with hebephilia[i]. It could mean the difference between being released at the end of a sentence on the one hand and being confined in a “civil commitment” gulag on the other, with little prospect of ever being freed. The latter fate has increasingly been the desperate lot of those offenders designated paedophiles in recent times: they are supposed to stay behind bars until treatment renders them “safe”, with the Catch 22 that no current treatment can guarantee they will not reoffend, so they cannot get out.

A separate diagnosis along similar lines for hebephiles i.e. those preferentially attracted to early adolescents, as opposed to paedophiles with a pre-pubertal preference, would have drawn in a substantial proportion of the adult population and would have had the strange effect in the case of man-girl and woman-boy love of calling it a mental disorder to be preferentially attracted to a reproductively viable (after menarche or semenarche) early adolescent partner of the opposite sex. It is one thing to criminalise behaviours deemed socially undesirable, but quite another to say a person whose sexual desires are consistent with nature’s imperative to go forth and multiply is mentally disordered. Surely only an idiot would make such a proposal?

Wrong! Try genius instead. Ray Blanchard, perhaps best known for his brilliant and well supported theory that male sexual orientation is affected by fraternal birth order, was described at the conference by another DSM big cheese as “the smartest guy I know”. And one of Blanchard’s smart answers is that it may be true that a high proportion of men (OK, let’s say nearly all of them) find freshly nubile girls a turn-on (and the remainder get hot for young boys!) but the preference, for most, is a more fully mature physique: the truly curvaceous adult female form, with big breasts and butts, is what really does it for them, or the filled-out, muscular frame of a grown man. By contrast, those men whose preference is for pubescent girls (typically aged 11-14) are unlikely to have much reproductive success compared to those whose preference includes women in their twenties and beyond. Therefore, so the reasoning goes, the hebophile’s preference for 11-14 year olds is not what nature intended and accordingly in biological terms it points to a mental disorder.

Coming from Blanchard, of all people, the audacity of this argument is staggering. He is gay! And he has the nerve to pass judgment on people’s mental health based not only on whether their sexual preferences are reproductively viable but whether they are reproductively maximal! On that basis homosexuality should never have ceased to be classified as a mental disorder, but I haven’t seen him campaigning to have gayness restored to the DSM as a psychiatric condition! Nor should this happen: with overpopulation a huge threat these days, not extinction, it makes little sense to define sexual health in crudely reproductive terms, as several speakers at Cambridge noted.

To many minor-attracted people it seems as though all of Blanchard’s research on minor-attraction is hell-bent on dehumanising  paedophiles and hebephiles, making us seem an inferior sub-species: according to his work we are less intelligent, shorter, and are more likely to have suffered head injuries than others.  His research could in theory be used to argue for social policies aimed at helping the minor-attracted overcome any such difficulties if they really exist. But as philosopher of science Patrick Singy eloquently argued in a presentation at Cambridge titled Danger and difference: the stakes of hebephilia, the strategy may be rather less worthy.

Not Blanchard’s personal strategy that is. His motives may be entirely benign as an individual. No, what Singy had discerned is, rather, an unconscious strategy adopted by modern society.  In the liberal democracies that have developed from the 19th century onwards, Singy points out, there is a tension between security and liberty: creating a safe society for the majority can only be achieved by restricting the rights and freedoms of those who present a threat. This cannot be done without a bad conscience by liberally-minded policy makers unless they can first dehumanize offenders, emphasizing their supposedly radical difference from normal people in every possible way: they must be called inferior, or monsters or predators (as in America’s “sexually violent predator” laws), which then enables them (us) to be treated like animals. It is a strategy which preserves as much liberty as possible for the majority by according a radically different, much lower, status, to just a few – with the language of mental disorder coming in very handy for the purpose.

[Added 19 July: The significance in a liberal democracy of claiming supposedly animalistic “predators” are mentally ill is that the individuals thus labelled can be oppressed in ways which superficially appear to be humane: in theory, they are held in civil confinement not as punishment but so they may be treated. The Nazis rhetorically dehumanized their victims before committing acts of genocide, but mass exterminations would obviously be inconsistent with liberal democracy. Such democracies pride themselves on being tolerant and respectful of diversity as far as possible; when there are exceptions, as with “predators” who supposedly must be caged like animals to protect society, the conscience and ethos of liberalism are salved thanks to the availability of medical rather than penal language.]      

Blanchard, bless him, may not be in love with hebephiles but he does appear to adore hebephilia as a theoretical construct and has done elegant work on the relationship (in terms of preferential and lesser levels of attraction) between paedophilia, hebephilia and teleiophilia (attraction to adults). Perhaps that is why, as chair of the Paraphilias Subworkgroup, he fought a long, bitter, and ultimately losing battle for hebephilia to take its place in DSM: victory would have given hebephilia a higher profile and provided DSM with a diagnosis underpinned by a significant element of scientific research.

Indeed, it is precisely the lack of good research behind most of the DSM’s diagnoses that has been a major and growing cause of embarrassment to the APA and the profession of psychiatry in recent years: the latest edition runs to around a thousand pages, but like earlier efforts it has been criticized as just a rag-bag of symptoms to which labels of often highly dubious medical validity have been attached, with too little attention paid to the underlying nature and causes of the conditions described. As several conference speakers pointed out, what gets labeled as sexually pathological is pretty much all down to politics of one sort or another: if it is not the moralists (who traditionally valorize reproductive sex and pathologize everything else) who are calling the tune, it is insurance companies who need diagnoses in support of legal claims, or big pharma, whose pill-peddling also needs a range of named, medically approved,  dysfunctions, diseases and disorders which they can claim their drugs address, thereby justifying an artificially generated market among  “the worried well”.

The radical psychiatrist Thomas Szasz, who died last year, looms large behind all this. His books The Myth of Mental Illness (1960) and The Manufacture of Madness (1970) argued that mental illnesses are not real in the sense that cancers are real: there are no objective methods for detecting the presence or absence of mental disease. That may change, as medicine becomes more sophisticated. A straw in the wind to this effect came in April, just before the launch of DSM-5, when the American National Institute of Mental Health (NIMH) announced that in future it would be re-orienting its research away from DSM categories. The institute’s director, Thomas Insel, issued a statement titled Transforming Diagnosis. NIMH, he said, “has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.”

Remarkably, unless I was nodding off in the sweltering heat and missed it, not a single word was said in Cambridge about this landmark development. Not that the switched-on, hi-tech new approach by NIMH will take the politics out of sexual psychiatry: it might even give our oppressors more opportunities to blind us with science; but this futuristic ambition to ground mental health diagnosis more deeply in biology (without, one hopes, harking back to reproductive fitness) should at least offer scope for the rational interrogation of any assertions that may be made.

Back to Singy. He contended in his platform speech that whether hebephilia is a mental disorder or not is completely irrelevant to society’s concern about it. What really matters is whether it is dangerous and, if so, how such danger can be assessed reliably. I think he is right, and the same applies to paedophilia. Several speakers from the floor, asking questions, appeared to conflate the harm/danger issue, which at least in theory could be measured objectively, with consent i.e. non-consensual sex is ipso facto harmful. Again, I agree, but the issue of harm is then prejudged by the legalistic fiction that those below a certain age cannot consent. After I pointed out this confusing conflation in a question of my own, Singy approached me in the lunch break for further discussion. I found it an interesting exchange, so I might come back to that and further Cambridge stuff in another post.


[i] It has been claimed that a diagnosis of hebephilia would not in practice necessarily have led to more sex offenders being snared in civil commitment, because it has long been possible to diagnose “Paraphilia NOS” (Not Otherwise Specified), a catch-all category, as an alternative. The NOS diagnosis, which also covers necrophilia and zoophilia, has been used to help label an offender as a “sexual violent predator” in the U.S., thereby providing the legal justification for civil commitment. However, this has only ever been applicable in certain cases, at least in theory, because “the essential features of a paraphilia are recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving nonhuman objects, the suffering or humiliation of oneself or one’s partner, or children or other nonconsenting persons…” (Kafka, 2010). Absent any evidence that the paraphilic (or “perverted”, as would once have been said) offender had any desire to hurt or humiliate a young partner, such a diagnosis would appear to be unjustified. In other words the NOS diagnosis should not ensnare the hebephile who has sex with a willing young partner (statutory rape) but a diagnosis of hebephilia would. However (I warned you this stuff gets complicated!), a simple but bogus (i.e. purely legalistic) diagnosis of “paraphilia nonconsent” has been used frequently in the American courts in support of civil commitment (Frances, 2011).

Frances A, First MB, Paraphilia NOS, nonconsent: not ready for the courtroom, J Am Acad Psychiatry Law. 39(4):555-61 (2011)

Kafka MP, The DSM diagnostic criteria for paraphilia not otherwise specified, Arch Sex Behav. 39(2):373-6 (2010)

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