How do I cure my pedophilia?

I also just ran into that question on Yahoo, and thought it too was worth repeating..:

I am 16, and for years now I have been lusting after girls much younger than me.....Recently, I started lusting after little boys, too....When I see little girls' feet in public, I go back home and masturbate while fantasizing about molesting them.... I would never molest a child, but I want to get rid of these feelings....what should I do?

First, I want to congratulate you on confronting this. It's probably the most difficult type of 'coming out' that there is.

The answer to your question, however, is that there is no known way of turning a pedophile into a nonpedophile. Although there is the occasional claim, there has never been any decent evidence of it. Rather, pedophilia appears to be like a sexual orientation: innate and immutable. 

The best that can be done, and what I recommend for anyone with atypical sexual interests, is to find ways of integrating it into your life in as healthy and safe a way as possible that poses no risks to anyone. 

The male sex drive is a very powerful motivator, and it has led very many people (not just pedophiles) to make very many bad decisions. For some people, sex drive reducing medications (testosterone blockers) can be helpful. That is, some people find that dampening their sex drives is preferable to being constantly distracting by it. For other people, having a professional therapist to debrief with is a great relief. But there is no evidence that we can change the pedophilia itself. 

To help find a therapist experienced in these issues, a referral list is maintained by the Association for the Treatment of Sexual Abusers (www.atsa.com). Although the focus of that group is on people who have committed crimes, the people on their referral list are the best qualified to work with folks who have not. 

You may also find support and great advice from the Virtuous Pedophiles group, at virped.org. They are an organization of people who acknowledge their pedophilia and support each other in never committing offences and in dealing with the extreme stigma that pedophiles face in our society. 

I wish you the best of luck. 

What's the difference between autogynephilia and trans women?

I saw that question on Yahoo, and thought readers here might also be interested in the answer:

First the politics: There are extremists among trans activists who oppose the very idea of autogynephilia, despite all the scientific evidence for it. They believe that it makes their desire to live as female less genuine, and they attack (sometimes quite viciously) anyone who endorses the idea. 

Now, for the actual distinction between autogynephilia and being a transwoman: Autogynephilia is when someone born male experiences sexual arousal to the image of being female. Some people express their autogynephilia through cross-dressing, and some people express it only during sexual arousal and masturbation. Some people express it through clothes and relatively visible means, and some people want to express it permanently and opt for genital surgery in addition to whatever cosmetic changes help them be perceived as female.

Autogynephilia is not the only thing that can motivate a bio male to want to live as female. The other can be thought of as extreme homosexuality...sort of like gay men who are so gay, they are actually happier living as female. These are the folks who were very obviously feminine boys during childhood, unlike the autogynephiles, who were unremarkably masculine boys in childhood.

So, that's the difference: Autogynephilia is a desire that can motivate (some) bio males to want to live as female, and trans women are those who are living as female (regardless of what motivated them). 

Unfortunately, the internalized autogynephobia in the trans community has made it nearly impossible for people to come out as autogynephilic, even within their own communities and to other autogynephiles. As a political movement, activists do not want to be recognized as living as women; they will accept only those ideas that validate that they actually were women all along. It's understandable politically, but not accurate, scientifically.

Dear Dr. James: A 15 year old male who takes his mother's and sister's underwear...

I am working with a 15 year old male who has issues of taking his mother and sisters underwear to masturbate in.  He has not acted out sexually in any other way.  His mother is insistent that she wants to let him buy his own female underwear.  I have been working with this young man to replace this fetish with appropriate masturbation and fantasies.  Any suggestions?

—R.W.

It’s easy to forget how little we know about paraphilias

On a listserv I belong to, mostly of psychologists, someone described a man who was sexually aroused by touching the plaster cast of persons with a broken limb. The psychologist wondered whether the patient’s behavior should be called toucherism (sexual interest in touching an unsuspecting stranger), whereas other psychologists in the discussion argued for acrotomophilia (sexual preference for amputees).

Similar debates are often had for the boundaries of other paraphilias.  I find most such debates to be uninformative, however.  With only few exceptions, such as pedophilia, the state of the scientific literatures on the paraphilias is not sufficiently advanced for making any clear demarcations around them.

Although it is rarely made explicit, opinions about whether a case fits in one or another category follow from what the clinician sees as the most important feature (or, more typically, the most dramatic feature) that makes the paraphilic interest distinct from typical sexual interests: To the toucherism-thinker in the above debate, it was the touching of the an unsuspecting stranger that was the defining feature of the patient’s sexual interest; to the acrotomophilia-thinkers, it was the lack of a healthy limb that was the defining feature. In truth, however, we do not know which behavioral feature of a paraphilia is its defining one, if any at all.

Depathologize! A follow-up

If I had to pick the top theme that sexologists and sexuality interest groups were discussing in the lead up to the proposed DSM changes, that would be it: Depathologize, depathologize, depathologize.  From blogs to letters to editors of research journals, there have been demands that the DSM declare as officially normal various sexual phenomena, ranging from purely consensual situations (like transsexualism and BDSM) to those that motivate sexual offenses (such as pedophilia and hebephilia). With the release of the DSM5 proposals from their various workgroups, I thought it was worth revisiting.  I was actually quite surprised by which of the DSM committees did and did not remove the label mental illness and from whom:
  

Dear Dr. James,

Is there a professional term for one who derives sexual pleasure from watching himself masturbate in the mirror?  I assume I’m not the only one who sees cases like this (albeit only 2 over the last 5 years—both with totally different personality disorders and sex crimes). Does anyone have a reference for literature on the phenomenon?

Thanks, David