Sex Offenders

I was recently asked a question about 'sex offenders'. My friend was initially perplexed by my response that this was a 'legal' and 'political' term and not a 'psychiatric' or 'medical' term. As a medical doctor and psychiatrist I can speak about sexuality and even 'offensive' sexual behavior.

"You know what I mean, pedophiles, priest, guys like Tiger Woods and Clinton, " said my friend who was truly interested in the subject academically, and mostly asking if there was some sort of 'epidemic' or 'pandemic' situation. I was tempted to respond as a comedian did, 'that indoor plumbling, cleanliness, and in door heating has contributed as much to modern day sexual abuse as increasingly 'leisure time' has.

Politics, the media and the legal system groups these very disparate entities under this one heading, "Sex Offender". A sex offender can be anything from a violent sadistic rapist to a person who keeps calling an ex after a restraining order. The term is a bit of a moving target too so that only lawyers or perhaps judges know what it really means from week to week. Within the category there are clearly 'specific' legal entities and sometimes these 'legal entitities' overlap with medical and psychiatric diagnosis.

1. Pedophiles are specifically people who have prefer sex with under aged, pre pubescent, ie children. It's a medical and psychiatric term. If a person has sex with a menstruating 12 year old with breasts or a hair 11 year old boy, medically and psychiatrically this person wouldn't be termed a 'pedophile'. They would have a very different condition. Biologically, our sexual reproductive apparatus is arranged with hormones and pheromes to have sex with 'fertile' people. While a 12 year old menstruating female with breasts and secondary sexual development wouldn't be an 'adult' in our society, and wouldn't be an 'adult' capable of raising children, she would be 'adult' from a biological basis and capable of reproduction. In so called "primitive" cultures it was not uncommon for what would e considered 'teen ager's today to mate, have children, and those children would be raised by the parents and grandparents. In primitive society the # of people in the 'tribe' was often critical to the tribes 'survival' as all work was human and winning and losing in war was often a matter of numbers. Pedophiles, those who have sex with children biologically, are a specific clinical and medical entity. Both may be 'morally' wrong but they are distinct categories clinically.
   
2. Patrick Wall, an ex priest legal advisor, states that most of the priests are heterosexual and most of the "sexual abuse" in the Catholic church is heterosexual with young women. The media has sensationalized the 'altar boy'. Teen ager girls are most vulnerable because of their lack of sexual awareness. An adult woman would not come into a priests room to have a rest beside him whereas a lonely teen age girl would be a risk for such a ploy. Protestant ministers and rabbis are as likely to offend as priests though 'confessional' booths and the exchanges perhaps give priests for access. The recent 'witchhunt' of the priests is not so much about the sex offenders and the pedophiles (priests who have sex with altar boys and prebuscent girls) but the institutional 'cover up'. The same is true for rabbis and the protestant churchs as well. The trauma associated with 'residential schools' , teachers, principals, ministers, priests was made worst by the authorities denial and cover up. As for pedophiles, it's common for the real thing, to have 150 to 200 'victims' before they are 'caught'. It's not uncommon for them to have been sexually abused themselves as children and repeating learned behavior but doing it knowingly and increasingly as an 'addictive' or 'compulsive behaviour'.
   
3. Adultery is what Tiger Woods and Clinton are guilty of. Jesus said of the crowd ready to 'stone' the adulteress in the Bible, "he without sin should throw the first stone'. Do not commit adultery is one of 10 commandments, up there with lying and bearing false witness (gossiping etc) , stealing (including institutional kinds), etc. What is significant about Woods and Clinton is the 'availability' factor. Daily men or women in high position in society have 'access' to sex in a way in which most of us, who would gladly judge them from partaking, when we ourselves don't have their 'power and beauty'. The ugly are the quickest to condemn sexual sins by the likes of Clinton and Woods or Madonna. The ugly however wouldn't turn a blind eye to their own 'sins' of say, 'blasphemy', or most importantly not respecting their parents. Rocks stars are commonly followed by groupie women who take men sexually as 'trophies' in the same way that some men 'score'. It's shallow and it's superficial and it may represent some underlying psychiatric disorder, say a mood disorder, commonly an addiction or sometimes just a personality disorder. However, the fact remains , 'power corrupts' and 'absolute power corrupts absolutely'
   
4. Robert Hare, PHD the leading authority on Psychopaths and Sociopaths would see many of the "sex offenders" as expressing their 'antisocial' and 'manipulative' traits in the 'sexual realm' just as they express these deviant traits in a variety of other areas of their lives. They lack 'empathy' or they consider the 'victim' as 'beneath them'.
   
5. The final comment I'd say on 'sex offenders' is that it is a very broad group and that most are amenable to treatment. Psychopaths aren't really amenable to treatment and pedophiles aren't readily amenable to treatment. Thanks to the courts these aberrant behaviours can be treated when they are required. There is most limited success without the 'control' being taken out of the hands of the 'offenders'. The same has been seen with drug addict and the increasingly successful Drug Courts. Sex addiction as a model is one of the newer kids on the block and certainly has it's place in the thinking surrounding these disorders. People are not 'monsters' but their 'behaviours' can be 'monstrous'. Today we would stop the behavior externally and work to have the person develop the internal restraints.
   
6. Increasingly there are areas where the legal and psychiatric systems work very well together. The risk though is that there is a history of these 'alliances' increasing the 'power' of intervention however not necessarily respecting such profound factors as 'cultural differences'. It's far too easy to forget that the vast majority of people are muddling along in the right direction. Just because the majority of sexual abuse is done by women doesn't mean that most women sexually abuse their children. The very vast majority of mothers and fathers simply don't do that. The media sells with sensation and the politicians get votes by appearing tough on whatever while the police and courts and even the psychological services have their own invested interests which might well be in conflict with the needs of the greater society. Thankfully there are groups of people, specialists and lay persons, struggling with these hard questions of 'ethical' behavior and what is 'sick' and what may not be 'sick' but still is 'just plain wrong' . No one alone and on one group has the only answer.