CHILD ABUSE & NEGLECT | Volume 105 | https://doi.org/10.1016/j.chiabu.2020.104416
Ryan T. Shields, Sarah M. Murray, Amanda E. Ruzicka, Cierra Buckman, Geoff Kahn, Aniss Benelmouffok, Elizabeth J. Letourneau
ABSTRACT
Background
Adolescents and young adults with a sexual interest in young children represent an underserved population. The needs of this group, and their implications for child sexual abuse prevention program development, are not well understood.
Objective
The objective of this research is to advance knowledge about adolescents and young adults with a sexual interest in children to better inform the development of effective prevention and mental health efforts.
Participants and setting
The sample consisted of 30 young adults, ages 18–30, from North America, South America, Europe, and Australia.
Methods
Researchers conducted telephone interviews with participants, and asked about when their interest in children emerged, how they responded to this sexual interest, and what resources could have been helpful during this process. Participants also completed a brief, online survey. Interviews were transcribed and analyzed using Dedoose software.
Results
Participants reported that their sexual interest in children emerged during adolescence, and as part of that process, they experienced a variety of emotions, including fear, shame, and feelings of isolation. Participants also noted the need for role models who are sexually interested in children and successfully navigating life, positive messaging, and support from families and the community.
Conclusions
Young people with a sexual interest in children are largely hidden, vulnerable, and looking for help. Findings from this research can be used to direct the development of the prevention and mental health programs that are responsive to the needs of this community.
INTRODUCTION
Child sexual abuse remains a significant contributor to the global burden of disease (Krug, Mercy, Dahlberg, & Zwi, 2002; Mathers, Stevens, & Mascarenhas, 2009). In the United States (U.S.), approximately 15–25 % of girls and 5 % of boys experience child sexual abuse (Finkelhor, Shattuck, Turner, & Hamby, 2014), and the consequences of these experiences can be substantial. Child sexual abuse increases the likelihood of severe physical, mental, and behavioral health problems across the life course, as well as confers additional risk for subsequent sexual and nonsexual victimization and perpetration (Dong, Giles, Felittie, Dube, & Anda, 2004; Finkelhor, Turner, Shattuck, & Hamby, 2013; Molnar, Buka, & Kessler, 2001; Noll, Horowitz, Bonanno, Trickett, & Putnam, 2003; Noll, Zeller, Trickett, & Putnam, 2007; Ogloff, Cutajar, Mann, & Mullen, 2012; Putnam, 2003). Accordingly, public health scholars and practitioners have issued calls to increase resources for the development, evaluation, and dissemination of targeted child sexual abuse prevention programs (Letourneau, Eaton, Bass, Berlin, & Moore, 2014; Letourneau, Schaeffer, Bradshaw, & Feder, 2017), as have national and international organizations (Institute of Medicine, 2013; Krug et al., 2002; Radford, Allnock, & Hynes, 2015).
Adolescents at risk of, or engaging in, harmful sexual behavior are an important target for broad prevention efforts, yet little intervention development has been conducted for this population. This gap in prevention efforts is notable given that approximately one-third to one-half of child sexual abuse incidents involve adolescents as perpetrators (Finkelhor, Ormord, & Chaffin, 2009, 2014). Youth who commit sexual offenses are a heterogeneous population and engage in harmful sexual behavior for a variety of reasons (Fox & DeLisi, 2018; Letourneau et al., 2017; McCuish & Lussier, 2017), including, but not limited to, lack of sexual knowledge, insufficient supervision, and acting out their own experiences. In addition, for a small proportion of youth, engaging in child sexual abuse may be influenced by an emerging sexual interest in children. It is important to note that not all individuals who commit sexual offenses against children are preferentially sexually interested in children, and not all individuals who are sexually interested in children necessarily engage in child sexual abuse. Still, prior research has identified atypical sexual interests as a leading risk factor for child sexual abuse perpetration and sexual recidivism (Robertiello & Terry, 2007; Seto & Lalumière, 2010; Seto, 2004). Sexual interest in children, specifically, remains a logical but currently understudied potential risk factor for engaging in sexual abuse.
Estimates of adults’ sexual interest in children vary and are definition specific. Research sampling college students has identified some level of sexual interest in up to 20 % of men (Briere & Runtz, 1989). In a population-based cohort study of Finnish male twins, approximately 1 % of subjects reported being sexually interested in, or had fantasized about, children (Alanko, Salo, Mokros, & Santtila, 2013). In a cross-sectional survey of 367 German men, 10 % reported pedophilic fantasies while 6 % reported pedophilic fantasy during masturbation (Ahlers et al., 2011). An online study of 8718 German men found that 5.5 % of respondents reported some level of sexual interest in prepubescent children, while 4 % reported having sexual fantasies involving children (Dombert et al., 2016). Throughout this paper, we generally use the broader term sexual interest in prepubescent children to be more inclusive of a full range of experiences, including sexual attraction to children, as well as non-exclusive and exclusive sexual preference for children.
To our knowledge, there are no estimates of the proportion of adolescents with a sexual interest in prepubescent children. However, individuals with a sexual interest in children typically report that their attraction emerged during adolescence (Goode, 2010; Houtepen, Sijtsema, & Bogaerts, 2016); we anticipate that the rates of sexual interest in young children identified in adult men might be similar for adolescent boys, indicating that a considerable number of youth may benefit from prevention services.
Individuals with a sexual interest in children may also require services for a range of concerns, which vary by individual. Broadly, these concerns include managing their own experiences of trauma, current sexual behavioral issues, and general health concerns (Cantor & McPhail, 2016). Commonly, these services are unavailable, inaccessible to individuals with a sexual interest in children (Goode, 2010), or difficult to access due to fears of judgement and/or mandatory reporting by providers (Grady, Levenson, Mesias, Kavanagh, & Charles, 2019; Jahnke, 2018). Further, services vary widely by geography. For example, in the U.S., resources for this population are scarce. Stop It Now!—a U.S.-based organization offering an anonymous helpline, information, and safety plan development support—serves as a notable exception (Donovon Rice, Hafner, & Pollard, 2010). There are also Stop It Now! initiatives in Belgium, Germany, the Netherlands, and the United Kingdom (Eisenberg, Mulder, van Horn, & Stam, 2014; Van Horn et al., 2015). The Specialist Treatment Organization for Perpetrators and Survivors of Sexual Offending (STOPSO) provides therapy to individuals in the United Kingdom who are concerned about their sexual interest in children (www.stopso.org.uk). Germany also houses the Prevention Project Dunkelfeld, a sexual abuse prevention campaign and treatment intervention for individuals with a sexual interest in children, whether or not they have ever acted on that interest (Beier, Ahlers et al., 2009). After the first three years of the project, 808 individuals expressed interest in participating, and nearly half (45 %) appeared for full assessment (Beier, Neutze et al., 2009).
Free and accessible resources for young people with a sexual interest in children are particularly rare. Instead, access to therapeutic services often becomes available only after a child is harmed (Piché, Mathesius, Lussier, & Schweighofer, 2018). Apart from a recent offshoot of Prevention Project Dunkelfeld, Prevention Project Juveniles, we are unaware of any other programs that provide free support and treatment for adolescents with a sexual interest in children (Beier et al., 2016).
There are several reasons why these gaps in service may exist. For one, the specific needs of adolescents and young adults with a sexual interest in children have not been thoroughly explored. It is also likely that young people experience additional barriers to obtaining available services. Young people may lack the cognitive development or coping skills to process sexual interest children, have fewer resources under their direct control, and must rely on parents, caregivers, or other adults to identify services, coordinate transportation to providers, and facilitate payment for these services. Consequently, young people who are sexually interested in young children represent an especially vulnerable, marginalized, and underserved population.
Scholarly attention to individuals with a sexual interest in children in the community (i.e., in non-forensic settings) has gained momentum in recent years. Still, much of the knowledge regarding those with a sexual interest in children comes from studies of adults involved with the criminal justice system and/or treatment settings. The experiences of adolescents and young adults, as well as perspectives from individuals who have not engaged in child sexual abuse, have not been sufficiently explored in the literature. Further, designing effective, evidence-based primary prevention programs for young people with a sexual interest in children remains a necessary but overlooked component of comprehensive child sexual abuse prevention strategies (Letourneau & Shields, 2016; Letourneau et al., 2017; Rothman, 2016).
To address these gaps, this study reports findings from interviews with a non-forensic sample of young adults with a sexual interest in children. This study advances scholarship on individuals with a sexual interest in children in three key ways. First, particular emphasis was placed on participant experiences of their sexual interest during adolescence. This focus advances scholarship on individuals with a sexual interest in children because much of the existing literature is centered on adult experiences. Second, participants were directly questioned about the kinds of resources that would have been helpful had they been available during their adolescence. Third, though not expressly required for participation in the study, seven participants (24 %) self-identified as “non-offending,” while 12 participants (41 %) reported that they do not view themselves as at risk of abusing a child. Thus, our findings include a non-offending perspective that has not typically been represented in research.
