This Letter describes how the proposed DSM-5 criteria for pedohebephilia have been developed without following four key guidelines specified by the American Psychiatric Association (APA) and to point out significant flaws that have resulted. It also proposes solutions. First, the paraphilias subworkgroup apparently ignored the DSM research agenda development process, which addressed developmental issues, questions of disability and impairment, potential contributions from neuroscience, and cross-cultural and gender considerations (American Psychiatric Association, 2010e). Developmental issues are crucial for determining the ages at which pedohebephilic disorder can be diagnosed and the bases for diagnosis at various ages, since attraction to children develops during childhood (Farella, 2002; Freund & Kuban, 1993). The other considerations would inform ongoing debates over impairment and distress in diagnosing pedophilia (e.g., Green, 2002; O’Donohue, Reger, & Hagstrom, 2000) and over whetherpedohebephilicdisorder isagenuinepsychiatricdisorder or solely a taboo in current Western culture (Bullough, 1990; Green, 2002). Additionally, they might help us understand why pedohebephilia is rarely diagnosed among women. However, neither the literature review on pedohebephilia (Blanchard, 2010) nor the rationale on the DSM-5 website acknowledges these issues. Second, the paraphilias were ignored by the APA/NIHorganized conference series designed to address problematic diagnostic questions in particular categories and ‘‘to stimulate the empirical research necessary to allow informed decision making’’(American Psychiatric Association, 2010f). If any category is in need of such attention, surely it is the paraphilias. There have been continuing controversies over conceptual validity, logical consistency, and terminology; in the absence of reliable scientific data, it has been easy for critics to claim that conceptualizations and criteria have been determined by law and morality rather than science (Franklin, 2009; Green, 2002; Moser & Kleinplatz, 2005). The lack of research interest in pedohebephilia is breathtaking in light of the extreme societal concern over adults and adolescents who interact sexually with children, and considering that 5% or more of males (over 5 million adults and 600,000 teenagers in the U.S.) may be preferentially attracted to children (Abel & Harlow, 2001; Farella, 2002; Hall, Hirschman, & Oliver, 1995). Yet, none of the 10 APA/NIH conferences or resulting white papers, which‘‘played a key role in establishing the evidence base for DSM-V,’’ addressed pedohebephilia (American Psychiatric Association, 2010d). Third, the paraphilias subworkgroup ignored the APA’s statement that‘‘to ensure that those involved in the revision process represent diverse perspectives, disciplines, and areas of expertise, the Task Force and work groups represent a variety of clinical and scientific disciplines...’’ (American Psychiatric Association, 2010a). A full understanding of pedohebephilia would require consulting experts and research from psychol ogy, sexology, evolutionary biology, ethology, anthropology, and sociology.Butall fourmembersof theparaphilia subworkgroup are specialists whose perspective on pedohebephilia is limited to that of controlling sex offenders. Of the 34 studies cited in Blanchard’s (2010) literature review, 31 were from a sex offender management perspective, including 10 co-authored by Blanchard himself. Although relevant literature from other fields is not plentiful, it does exist. Fourth, the subworkgroup failed to heed APA guidance that DSM work groups should represent‘‘patient and family groups’’ (American Psychiatric Association, 2010a). Researchers have long criticized research on pedophilia for its reliance on unrepresentative correctional samples (e.g., Okami & Goldberg, R. Kramer (&) B4U ACT, POB 1754, Westminster, MD 21158, USA e mail: rkramer@b4uact.org