Pedophilic disorder

Pedophilic disorder is a diagnosis in DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders) and ICD-11 (International Classification of Diseases). Its diagnostic criteria include attraction to children and young adolescents and either a history of acting on this attraction or a sense of strong distress about the attraction. At present, both DSM and ICD differentiate between having pedophilic disorder and being a pedophile.

Legitimacy of this diagnosis is questionable.

DSM

Diagnostic Criteria F65.4

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sex­ual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).

B. The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

C. The individual is at least age 16 years and at least 5 years older than the child or chil­dren in Criterion A.

Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old.

Specify whether:
Exclusive type (attracted only to children)
Nonexclusive type

Specify if:
Sexually attracted to males
Sexually attracted to females
Sexually attracted to both

Specify if:

Limited to incest

- DSM-5-TR

The diagnosis "pedophilic disorder" has appeared in the DSM in 2013, replacing an older diagnosis "pedophilia", which did not require distress as a criterion and did not make a clear difference between just plain attraction and acting on it. This change was a part of a bigger shift towards depathologizing all paraphilias. The first edition of DSM-5 included the words "pedophilic sexual orientation", and after accusations from the public, the word "orientation" has been changed to "interest", which was later copied to DSM-5-TR. Changing a correct term to a nearly synonymous, yet less thought-provoking one was referred to as a mistake by researchers.

However, if they 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 sexual orientation but not pedophilic disorder.

- DSM-5 at the moment of release

However, if they 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 sexual interest but not pedophilic disorder.

- DSM-5-TR at present

ICD

Description

Pedophilic disorder is characterised by a sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children. In addition, in order for Pedophilic Disorder to be diagnosed, the individual must have acted on these thoughts, fantasies or urges or be markedly distressed by them. This diagnosis does not apply to sexual behaviours among pre- or post-pubertal children with peers who are close in age.

Diagnostic Requirements

Essential (Required) Features:

• A sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children.
  

• The individual must have acted on these thoughts, fantasies or urges or be markedly distressed by them.
  

• The diagnosis does not apply to sexual arousal and accompanying behaviour between pre- or post-pubertal children who are close in age.
  

- ICD-11

ICD-11 was established in 2019 and has officially replaced ICD-10 on January 1, 2022. The older version of this document included the diagnosis "paedophilia", which applied only to the attraction. It's important to note that while DSM is used within the United States of America, ICD has worldwide significance. 

Misconceptions

The main misconception is conflating pedophilic disorder and pedophilia. This is done by Wikipedia, which states that "Pedophilia is termed pedophilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11).". This leads to many people assuming that the attraction itself is a mental illness. Conceptualizing the attraction as pathological results in wide promotion of conversion therapy and an erroneous belief that any map who considers mapness an inherent identity is uneducated and mislead.

People who understand the nature of this disorder poorly often claim that distress and guilt about being a map is a symptom of POCD, and that "clients who have pedophilic disorder enjoy and are aroused by sexualized thoughts and images of children, clients with P-OCD fear that they may actually enjoy or find pleasure in these images".

In addition to that, mapmisiacs often use ableist stereotypes against maps, such as assuming poor self control, low self awareness, violent behavior.

Criticism

Both DSM and ICD treat the act of sexual abuse, perpetrated by a pedophile, as a sign of a mental disorder, while no conclusion like this is made about non-pedophilic sexual abusers.

The distressed feelings maps experience about their attraction can be rather well explained by the minority stress model, which describes internalized stigma and guilt members of hated minorities may develop.

For example, LGBTQ+ youth and adults who have experienced prejudice about their sexual orientation sometimes choose to conceal their sexual identity from others. Concealing such personal information causes significant psychological distress, including intrusive thoughts about the secret, shame and guilt, anxiety, and isolation from other members of the minority group. Internalized homophobia is another proximal stressor prevalent among LGBT individuals. It refers to the internalization of negative social views about homosexuality, which leads to self-hatred and poor self-regard.

- Wikipedia

For me, it comes with intense feelings of guilt and disgust, self loathing, and even suicidal ideation and tendencies. It does come with urges, but not in the sense that you may think. Instead, I find myself constantly and consistently thinking about being a minor attracted person and how much it impacts my life and my outlook.

- Midsummer's Quest, "What does Pedophilic Disorder feel like? Well..."

The parallels between these two conditions were noticed not only by maps themselves, but also some researchers.