Adult Sexual Attraction to Early-Stage Adolescents: Phallometry Doesn’t Equal Pathology

Abstract

The finding of Blanchard et al. (2008) that adult self-reports of sexual preference for early-stage adolescents generally matched their phallometric responses to such adolescents does not justify the broad and startling conclusion of these researchers that ‘‘hebephilia exists as a discriminable erotic age-preference’’ so as to justify an expansion of the DSM diagnostic category of Pedophilia to include early-stage adolescents. DSM-IV-TR draws the distinction between pathological and non-pathological age-related sexual arousal at the onset of pubescence: adult arousal to prepubescents is considered pathological and adult arousal to pubescents and post-pubescents is considered non-pathological. This distinction is more than academic. It has serious, real world implications, given that, in the U.S., a diagnosis of Pedophilia can result in the diagnosed individual being subject to potential lifetime confinement pursuant to so-called ‘‘sexually violent predator’’ civil commitment laws (Zander, 2005). There are at least three major reasons why the Blanchard et al. proposal to extend the diagnostic criteria for Pedophilia to include adult sexual attraction to early-stage adolescents is a leap that is insufficiently supported by their data. First, as conceded in their article, ‘‘The main methodological limitation of the present study was the absence of models age 15–18 (midto late-adolescence) among the phallometric stimuli.’’ This means that we do not know if men who were aroused to early-stage adolescents—whom Blanchard et al. would now classify as paraphilic—might not also be equally or more aroused to midto late-stage adolescents, with respect to which they acknowledge, ‘‘Few would want to label erotic interest in late-or even mid-adolescents as psychopathology.’’ Yet, their proposal may do just that by pathologizing men attracted to early-stage adolescents as part of an overall arousal pattern to adolescents in all stages of sexual development. In other words, conspicuous by their absence are any data to refute the alternative hypothesis that sexual attraction to adolescents at all stages of sexual development is a discriminable, but not pathological, erotic preference. Second, the proposal to extend the already problematic diagnosis of Pedophilia to include early-stage adolescents would complicate the diagnosis further by exacerbating the problem of the diagnostic discriminability that Blanchard et al. aptly and punningly identify by pointing out that ‘‘[T]he onset of puberty varies from child to child and.. the boundaries of puberty are fuzzy to begin with.’’ Clinicians already wrestle with the line of demarcation between pre-pubescence and pubescence in the current diagnostic criteria, given: (1) the many definitions of pubertal onset (e.g., for girls is it menarche [mean age, 12.1 years, for African-American girls] or thelarche/pubarche [mean age, 9 years, for AfricanAmerican girls]); (2) the wide variability of individual pubertal onset age; and (3) the overall decreasing age of pubertal onset (Herman-Giddens, 2006). Imagine how much more impractical it would be to require forensic evaluators to determine the existence of Pedophilia based on the stage of adolescence of the examinee’s victim. Such determinations could literally devolve into a splitting of pubic hairs— resulting in an interrater reliability for the expanded diagnosis of Pedophilia that is even worse than is the case with the current version (Wollert, 2007). Their proposal to have diagnosticians specify the examinee’s preferred age to which he is aroused does little to solve the problem of discriminating early-stage adolescents from midto late-adolescents given the aforementioned diagnostic ambiguities resulting from variable and decreasing age of puberty. T. K. Zander (&) 10936 N. Port Washington Rd. #285, Mequon, WI 53092-5031, USA e-mail: DrTomZander@aol.com