Pedophilia is defined as a primary, exclusive, or sustained sexual interest in children under age 13. 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.” This distinction between impulse and action is disturbing to many, still some men claim they have never acted on their desires.

What separates those who violate children from those who have urges but do not act?  In some cases, the difference may be a matter of receiving treatment, commonly referred to as “chemical castration.”

What Most Believe

You’d be hard-pressed to find someone who has never watched at least a single episode of Law and Order or one of its sibling shows, the televised portrayal of ripped-from-the-headlines urban horror stories that first aired in 1990. TV crime shows are popular and influential, shaping public opinion on all matters of the law. It could be argued, in fact, that these shows directly influence the way society thinks about crime in general and sex crimes in particular.

Many people, for instance, believe child sex offenders must have once been violated themselves as children. While this is true of some (if not many) offenders, research suggests a large number of people who sexually abuse children have never been victimized themselves. A related misperception is also false. Adults who were once sexually abused as children do not automatically go on to victimize children; in fact, the majority will never mistreat a child.

Another everyday belief is that convicted offenders, once released, will hurt other children. Here, we arrive at the crossroads of sexual statistics, where the truth is difficult, if not impossible to discern.

The Center for Sex Offender Management notes only 12 to 24 percent of child sex offenders are repeat offenders. This statistic, it is important to note, includes other crimes — even non-violent, non-sexual crimes. At the same time, Yello Dyno quotes studies reporting that more than 90 percent of convicted pedophiles, following release from prison, are arrested again for the same offense.  

Any true number of offenders, offenses, and re-offenses may be unclear since many child molesters are never caught and convicted to begin with — according to the Department of Justice, only 30 percent of all types of sexual assault cases, including those where children become victims, are even reported. There are other instances as well where offenders plea bargain down to lesser crimes. On the other hand, some sex offenders are closely watched once released from prison by probation officers and local law enforcement who keep current on the registered offenders list. Whether they may hope or even plan to re-offend, some convicted child molesters may never gain a ripe opportunity.

Since abusing a child is the most heinous crime most of us can ever imagine, it seems natural to prefer to stick with the Law and Order worldview and err on the side of caution. Consider, for a moment, the widely reported facts about these crimes.

Registered... Or Not

One in four girls and one in six boys are sexually abused before the age of 18, according to the Centers for Disease Control and Prevention, while the average age of first abuse is between ages 9 and 10. Typically, abuse occurs within an on-going relationship between the offender and child victim, lasting, on average, for four years. In the past year alone, one in five youth received a sexual approach or solicitation over the Internet.

Only a minority, just 10 percent, of perpetrators are strangers to the child: about a third are family members, while nearly 60 percent are acquaintances. Most perpetrators are male and most are adults, though roughly 20 percent are under the age of 18.

As of March 31, 2016, the total number of people registered as sex offenders in the United States is 805,781. With many offenders able to evade detection and many offenses unknown, the actual number of child molesters remains unknown. Similarly, the potential cause of their impulses remains elusive.

A recent study finds sex offenders, in general, do not suffer from higher levels of testosterone than those who do not commit sexual aggressions. Instead of hormones, the brain may be the culprit or so says Dr. James Cantor, a clinical psychologist who studies the psychology behind people’s sexual interests and sexual perversions. Based on brain imaging research, Cantor and other scientists theorize pedophilia could be caused by a developmental disorder, resulting in mis-wired neural connections in the brain.

That said, the attraction to prepubescent children may be more commonplace than most of us think.

One disturbing 2006 study of 531 male students found 7 percent reporting some sexual attraction to children while 3 percent confessed they’d consider sexual contact with a child if they knew no one would find out. Other unrelated analyses estimate 5 percent of men may be, to some extent, sexually attracted to prepubertal children, though the author of one such study, Dr. Michael Seto, a clinical and forensic psychologist, recently revised his estimate and currently suggests the number is only 1 to 2 percent.

Possible Treatments

While no cure exists for pedophilia, limited treatments do exist. European doctors introduced oral hormonal treatments, such as estrogen pills, in the 1940s, while in the 1960s, Dr. John Money, a Johns Hopkins professor, began to prescribe medroxyprogesterone acetate, the base drug in the commonly used contraceptive Depo Provera. Depo Provera and other hormonal drugs have been used in the United States, Canada, and Europe to “chemically castrate” pedophiles and other sexual deviants.

Recently, Asian countries have adopted these techniques. The Star reports that under new regulations by the Indonesian government, those who commit sexual violence against children will be punished with chemical castration in addition to their prison and house arrest sentencing. Prior to these new Indonesian regulations, Korea enacted chemical castration laws, while India has reportedly drafted though not yet passed legislation as well.

Overall, hormonal treatments appear to be effective for some offenders and other people who suffer from unwanted urges. In a 1991 Johns Hopkins study, less than 10 percent of 626 “chemically castrated” patients had committed sexual offenses five years after treatment. A Korean study of 38 chemical castration patients discovered reductions in frequency and intensity of sexual drive, frequency of masturbation and sexual fantasies, yet, during the first two months after cessation of treatment, the patients experienced an unexpected upsurge of testosterone levels and intense sexual drive and fantasy. Another Korean study found chemical castration reduced the frequency and intensity of sexual thoughts in the majority though not all patients.

What does chemical castration feel like? As Renee Sorrentino, a Boston University- and Harvard-trained forensic psychiatrist, explained in Boston Magazine, Lupron reduces the sex drive and mitigates deviant desires; while the feelings remain, they’re less obsessive. Sorrentino, who treats convicted pedophiles, rapists, exhibitionists, and voyeurs in her Boston clinic, likens Lupron’s effects to the volume being lowered on a radio. One of her patients, a sex-addict, told New York Magazine, “Before I went on Lupron I was thinking about having sex with a prostitute over 30 times a day. After six months I would only have the thoughts a few times a day.”

Along with less mental noise, patients may also experience side effects including weight gain, hair loss, and development of breasts. Lupron may also lead to osteoporosis in men. Despite side effects and health risks, Sorrentino’s patients tell her they prefer shots of medication to feeling uninvited urges and, in their own words, "living in a dark place."