The American Family Association, the American Psychiatric Association, and the “Pedophile Orientation” Fiasco: Update

Back to Charisma News:

Accuracy of AFA’s Report on Pedophilia Classification Questioned

The American Family Association (AFA) sounded an alarm on Wednesday, pointing to a shocking announcement from the American Psychiatric Association (APA) in its latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). But was the report accurate?

Charisma News started digging a little deeper on Thursday morning into the AFA’s claims that the APA now classifies pedophilia as a sexual orientation or preference instead of a disorder.

The AFA’s Cindy Roberts told Charisma News that its public relations firm, Hamilton Strategies, conducted the initial research on its claim. The PR firm has not responded to our requests for more information…

A caption under a stock photo adds:

The American Family Association appears to have offered misinformation about the APA’s classification of pedophilia.

As I noted yesterday, the origins of the controversy go back to a paragraph in the new (fifth) edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), concerning the paraphilia of sexual attraction to children:

 if [individuals] report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic impulses (according to self-report, objective assessment, or both), and their self-reported and legally recorded histories indicate that they have never acted on their impulses, then these individuals have a pedophilic orientation but not pedophilic disorder.

A document on the APA website gives further context:

…Most people with atypical sexual interests do not have a mental disorder. To be diagnosed with a paraphilic disorder, DSM-5 requires that people with these interests:

• feel personal distress about their interest, not merely distress resulting from society’s disapproval;

or

• have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.

…In the case of pedophilic disorder, the notable detail is what wasn’t revised in the new manual. Although proposals were discussed throughout the DSM-5 development process, diagnostic criteria ultimately remained the same as in DSM-IV TR. Only the disorder name will be changed from pedophilia to pedophilic disorder to maintain consistency with the chapter’s other listings.

I assume the word “orientation” was used in DSM-5 because this particular paraphilia concerns attraction to a kind of person (i.e. children) rather than to a kind of act (e.g. voyeurism). However, the word does not appear to have been theorized or explained any further in the text, and it seems to me that it was infelicitous; there are legal protections against discrimination on grounds of “sexual orientation”, and even though these obviously don’t refer to paedophiles, the notion of a medically recognised “pedophilic orientation” would muddy the water. Might a self-described but non-practising paedophile apply for an unsuitable job and demand equal consideration? And for anti-gay elements, the phrase could be cited as a reason why anti-discrimination measures should be repealed, and as spurious evidence that this what anti-discrimination activists really want, and that gay people are actually paedophiles.

As I also noted yesterday, reports about the DSM-5 became progressively distorted. Misleading headlines suggested that the notion of paedophilia as a disorder was being scrapped altogether, and the end result was the lurid suggestion from the  American Family Association that the change was being made at the behest of “pedophile activists”. According to the AFA’s Sandy Rios, in the original report carried by Charisma:

Just as the APA declared homosexuality an ‘orientation’ under tremendous pressure from homosexual activists in the mid-’70s, now, under pressure from pedophile activists, they have declared the desire for sex with children an ‘orientation,’ too.

An extra element of confusion here was that the AFA and Charisma initially referred to the American Psychological Association rather than the American Psychiatric Association; the American Psychological Association has since issued a statement:

A news release sent Oct. 30 on behalf of the American Family Association mischaracterized the position of the American Psychological Association with respect to pedophilia. The American Psychological Association does not classify mental disorders or publish the Diagnostic and Statistical Manual, as the release incorrectly stated.

The American Psychological Association maintains that pedophilia is a mental disorder; that sex between adults and children is always wrong; and that acting on pedophilic impulses is and should be a criminal act. The American Psychological Association has worked for many years to prevent child sexual abuse and will continue to do so.

Charisma News corrected its original report on the subject, but we’re still left wondering about which organisation Sandy Rios had in mind when she referred to “the APA”. If her specific contextualized allegations were meant to refer to the American Psychological Association, how can it be valid simply to substitute the article with the words “American Psychiatric Association”? It’s not a small point – the American Psychological Association has been vocal for many years on anti-discrimination and the need to distinguish between mental illness and sexual orientation, and it’s obvious that Rios and the AFA hoped to discredit the American Psychological Association’s position by refering to the DSM-5.

Meanwhile, the American Psychiatric Association has also now issued a statement, as reported in the Washington Times:

The APA said in its statement that “‘sexual orientation’ is not a term used in the diagnostic criteria for pedophilic disorder and its use in the DSM-5 text discussion is an error and should read ‘sexual interest.'”

“In fact, APA considers pedophilic disorder a ‘paraphilia,’ not a ‘sexual orientation.’ This error will be corrected in the electronic version of DSM-5 and the next printing of the manual,” the organization said. The error appeared on page 698, said a spokeswoman.

It added: “APA stands firmly behind efforts to criminally prosecute those who sexually abuse and exploit children and adolescents. We also support continued efforts to develop treatments for those with pedophilic disorder with the goal of preventing future acts of abuse.”

The new reading, then, will be: “…these individuals have a pedophilic interest but not pedophilic disorder.” That will probably continue to upset a lot of people: how can an “interest” here not also be a “disorder” in any circumstances, even if it doesn’t manifest in illegal behaviour? For instance, someone who collects non-pornographic images of children for sexual reasons may not be breaking any laws or causing any harm to others, but it’s reasonable to be concerned that this abnormal behaviour may be a sign that such a person is a potential danger to children. However, it should be remembered that the DSM-5 is a technical document dealing with medical classifications; “disorder” in this context has a particularly circumscribed meaning.

UPDATE (2 November): Seizing on the American Psychiatric Association’s statement, Charisma now adds:

The APA has clarified its text mistake. Pedophilia has not been classified as a sexual orientation, but the AFA report was not fabricated or fear-mongering. Click here for the resolution to this issue.

Well, not fear-mongering apart from the small matter of invoking shadowy “pedophile activists” and linking the story to the American Psychological Society’s position on homosexuality.

(Thanks to commentators on yesterday’s post for some points to consider and for some links)

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