DSM-IVRecently there was a stir about something in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. A couple of headlines were saying that this fifth and latest version was identifying pedophilia as a “sexual orientation.” Not long after those headlines registered their requisite shock and response, the APA issued a retraction and clarification.

Watching this unfold I was reminded again how seemingly confusing is the use of terminology by this group, especially when it comes to key words like “orientation,” “identity” and “disorder.” A first principle of critical thinking is the clear and precise use of important terms. Failure to define these words with clarity and consistency in this case includes an ominous potential to carry our society down a moral and logical river that runs straight into a sewage pond. To see what I mean, consider more carefully the definition and use of each of these strategic words.


The APA & similar organizations describe “sexual orientation” as persistent attraction to those of a particular type or group. The attraction is of a sexual (in some cases they add “emotional” or “romantic”) nature. Sometimes you see, along with “attraction,” other words such as “tendency,” “proclivity,” “interest” & “preference.” So in essence a person’s sexual orientation, according to this characterization, amounts to his or her feelings of attraction toward a given group.

Usually the emphasis of the ‘group’ to which a person is attracted is along the lines of gender (i.e., attracted to males, females, or both), but there is nothing in the definition to prevent other things besides gender from defining the parameters of the group. There is no reason given, for example, why such an orientation would not instead have to do with age (e.g., attraction to the elderly or to children), body type (e.g., attraction to the obese or to “little people”), or something else.

Clearly a person who does experience one of these peculiar kinds of sexual attraction (or interest or preference) based on something other than gender would have a legitimate case for his or her attraction being an “orientation” by the definition commonly used. So the description of pedophilia as an “orientation,” for all of the reaction it evoked, would nevertheless, by the reasoning of the APA, be perfectly sensible. I don’t see any argument they could make against that application of the word as it has been loosely defined.


Now a safe bet for why many people were so uncomfortable with notion that pedophilic attraction could be an “orientation” is that there is another (seemingly added on) aspect of “orientation” that is often mentioned when the term is being discussed and explained. This aspect is basically a sense of one’s identity being in some way tied to the sexual attraction one feels toward the given group. Like the feelings of attraction themselves, this sense of personal identity is entirely 1st person  and subjective. I have the specific orientation if I say that I do, and thus it is part of my identity if I say that it is.

And of course if identity is tied to orientation in this way, it would give people a reason not to want to grant that  something like pedophilia is an orientation, since to call it an orientation would then be to make it part of that person’s identity, and that is an idea we generally don’t want to countenance. Unfortunately this is where the confusion begins to wreak its initial havoc. The association of identity with orientation has served the homosexual cause precisely for the reason that it gives a kind of deeply rooted and fixed permanence to the attraction. In other words, by making the orientation an identity, we make it more than merely a preference or attraction. We make it part of the very nature of the person him/herself. And as such, it is unchangeable and natural. The use of the word “identity” conjures up notions like DNA or genetic make-up, making sexual orientation something nobody should question nor dare attempt to alter. This has been a key element in the case for same-sex orientation/identity.

BUT, if the pedophile gets the logical right to use the word “orientation” for his persistent preference, and therefore also gets – as part of the rights to that term – the use of the word “identity” to describe it, then he too can lay claim to the idea that this is part of the fabric of his being, the nature of who he is, something people should not question and cannot be changed by any kind of therapy. And if you say to the pedophile, “But your preference/orientation is bad this implies that some preferences are immoral, and he can merely reply, “How can I be called ‘bad’ for something that is an inherent part of my identity?” Perhaps at that point a kind of concession will be granted and the pedophile will be told, “OK, your preference or attraction is technically not immoral, but acting upon it is.” This, in fact, appears to be something like the approach the American Psychiatric Association has chosen to take.


The recent DSM has begun using the term “disorder” to refer to various kinds of sexual behavior based on what it calls “atypical sexual interests.” These “paraphilic disorders” as it calls them, include, according to their website: exhibitionistic disorder, fetishistic disorder, frotteuristic disorder (from the French for “to rub” – basically groping or fondling), pedophilic disorder, sexual masochism disorder, sexual sadism disorder, transvestic disorder, & voyeuristic disorder (see www.dsm5.org).

To qualify as having a disorder, the DSM says that those persons with the “atypical sexual interest” of one of these kinds listed above would need to:

(a)    “feel personal distress about their interest, not merely distress resulting from society’s disapproval;


(b)   “have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.”

The DSM then explains that this “subtle but crucial difference … makes it possible for an individual to engage in consensual atypical sexual behavior without … being labeled with a mental disorder.”

The bottom line is that the “interests” they list (which we could justifiably call “orientations” by the definition previously given), while “atypical,” are not “disorders” so long as those with such atypical interests feel no distress, and cause nobody else distress or injury. According to the DSM, then, telling the person it is wrong to act upon his “interest” is too harsh per se;  the DSM says that each of the things listed (from fetishes to masochism to transvestitism to sadism to voyeurism) CAN be acted upon and practiced without it being considered a disorder (again so long as there’s no “distress” to the person or anyone else). Pedophilia, it is presumed, is unique among those things listed in that it cannot be practiced without violating (b) of the criteria above, thus those with that “interest” (“orientation/identity”?) are out of luck. For on the assumption that any sexual act with a minor causes distress or injury to that minor, the pedophilic “interest” becomes a “disorder” by definition the moment it is practiced (to say nothing of the legal problems such an action faces).

Minor-Attracted Persons

This situation of inequality for a particular group with a particular preference (“orientation/identity”?) has not been lost on those who in fact possess it. Due to the pedophiles getting the short end of the stick in this way, a few advocacy groups have taken up for their cause. For example, “B4U-ACT” (b4uact.org) is a non-profit organization based in Maryland that exists on behalf of “Minor-Attracted Persons” (MAPs), as it calls them. Anyone notice the typical tweaking of terminology for the sake of moral legitimacy? Anybody sense a dangerous direction here based on the confusion our society has created?

The website for B4U-ACT describes the “extraordinary stigma” that those with this attraction deal with, and why they seldom admit it. It speaks a lot of “mental health services” and “therapies” for them but never specifies the goals or aims of such therapy outside of helping them deal with the stresses of their condition. One wonders if they attempt anything at all in the way of “reversion” therapy or treatment aimed at helping someone no longer experience those attractions. There is no mention of any such treatment on the pages where therapies are discussed.

The website talks about the ill-treatment of those with “minor-attraction” in our society and how even traditional therapists do not understand or properly empathize with “MAPs” but instead often merely judge or stereotype them (or treat them as criminals). It points out that these people do not “choose” to have their attractions, that each MAP is a unique individual & that as a whole they are a diverse group, from all walks of life. They should not be lumped together into one category, it says. People should not paint them with the same brush as those who have committed brutal crimes against children, it insists. And furthermore it chides society for fostering the idea that MAPs are “deviants” since, the website assures us, they are not.

A spokesperson for B4U-ACT named Paul Christiano talked in an interview (http://www.neontommy.com/news/2013/10/pedophilia-sexual-orientation) about wanting the APA to help “de-stigmatize” the condition (or orientation) of minor-attraction, since, as he said, “negative societal attitudes toward minor-attracted persons trickle down to policy-making …”  I wonder what he might mean by that exactly. Anybody feeling a little queasy about where he may be going with this idea of policy-making?

When asked specifically about treatment for MAPs, Christiano seemed to indicate that so long as their preferences were not acted upon, there is no problem with their having the attraction (orientation) to minors, and furthermore that they “must be allowed to fantasize about minors, as long as such acts are never consummated.” It should be noted that Christiano is himself a registered sex offender & that this senior thesis in graduate school argued for the “sexual autonomy” of children. Whooboy.

To Recap …

The proposed experts describe “sexual orientation” as essentially attraction (interest, preference), then add the questionable notion of “sexual identity” to the equation whereby that attraction/interest is seen as fixed part of the person who has it. But then when attempting to deal with “atypical” attractions/interests, the experts refrain (somewhat arbitrarily) from using the word “orientation,” likely because they do not want to legitimize the atypical attractions as a fixed part of the identities of those who have them.

Moreover, the experts then use the term “disorder” of those atypical interests only if those who have them happen to feel personally distressed about it OR act upon it in such a way as to cause injury to somebody. If those with the atypical interests (including, mind you, pedophiles) do not feel distress about it, they do not have a disorder. And if they cause no injury to anyone else, they can practice it without having a disorder. For pedophiles, if it were determined that those with this interest could engage in relations with minors without distress or injury being caused to those minors, the experts who provide this confusion would still have to say that it is not a disorder. The worst they could say of that is that it is currently illegal. But as we’ve all seen, laws can change as fast as public opinion can.

What seems at first like a little bit of confusion over definitions of words like “orientation,” “identity,” and “disorder,” turns out to be catastrophic if in the long run such confusion opens wide the door to arguments that ultimately justify, legitimize and normalize something like pedophilia (er, I mean “minor-attraction”).

Our culture, in order to accomplish fast sweeping changes in the collective public mind (as well as the law) regarding the ethics of sexual behavior, has foolishly butchered common sense on its alter. And without that long-standing guardian, dangerous deviants can be expected to seize the opportunity of a morally and logically discombobulated cultural landscape for the sake of further changes in the muddled public mind, followed by further changes in the law – changes that will serve their specific “interests” (or should we say, “orientations” and thus “identities”?).

Clint Roberts
Clint Roberts

Clint Roberts has taught Philosophy, Religion, Ethics, Critical Thinking, Apologetics, and a few less interesting subjects over the last decade or so. He likes the Credo House because he once launched a similar non-profit establishment in a different state. His Masters is from a fine theological institution and his doctorate focused on famed arguments by Clive Staples Lewis. He and Wanda lived in Texas a little while, then Idaho very briefly, then Salt Lake City for several years prior to coming to the prairie lands of Oklahoma. They had four kids along the way, and later adopted two more humans, a few goats and chickens, and a pony.

    14 replies to "Orientations, Identities, Disorders, and Future Possibilities that Might Make you Squirm a Little"

    • Sexual deviation has been going on since the Fall of Adam, and we are living more and more in just the adamic sin in our own hedonistic and now more narcissistic culture! Mostly surely humanity is ripening fast for the global tribulations and judgments that are coming at the Eschatological End! Come Lord Jesus! (Note Rev. 22: 10-16, etc.)

    • Detroit

      Very interesting, and I couldn’t agree more. Unfortunately, because of the uncomfortable nature of the logical conclusions you have drawn, many will try to dismiss it as ludicrous. But without consistent definitions and thinking, these things are unavoidable. Furthermore, it is not outside the realm of human capability if you look at some other cultures around the world, as well as history. Very well articulated.

    • Truth Unites... and Divides

      “Our culture, in order to accomplish fast sweeping changes in the collective public mind (as well as the law) regarding the ethics of sexual behavior, has foolishly butchered common sense on its alter.”

      Christians have to be willing to be mocked, scoffed, derided, laughed at, ridiculed, and marginalized for upholding and affirming God’s Word.

      Christian Courage. No courage, no Salt, no Light, no Witness, no Holiness. Just cowardice.

    • theoldadam

      And the great downward pull continues.

    • Derek Knighten

      Glad somebody did this post so that there is a lot of base information to think about these things.

    • william

      It (DSM) has already been ditched by the NIMH (National Institute of Mental Health).
      I wouldn’t worry about it too much.

    • William

      Though I don’t mean to sound flippant and say that it is nothing to worry about at all, rather that it appears to be the case that the industry practitioners are becoming less enthusiastic about the influence of those financing such works and that DSM in particular does not enjoy the status it once did. My point was that if official organizations are abandoning DSM these days, then that may be an indication that it is not quite the institution it once was and therefore not that much to be concerned about.
      There is a cultural trend to accept what was once unacceptable or taboo. The cultural shift is such that this ‘I’m not thinking logically’ logic that many people seem to employ these days when discerning what is right from wrong is almost like a poison being forced upon all our children from preschool onwards. As they grow up they never learn that what happens when you delete premordernism is you get modernism. But as Robert W. Jensen put it so beautifully
      “Walter Lippmann spoke of “the acids of modernity”; as it turns out, the stones attacked by this acid have been those on which the modern world was itself erected.”
      Postmodernism is the vacuum left behind by the slow death of modernism and there is nothing left to fill it; so obviously anything goes, even molesting children.

    • Win

      I read some paragraphs taken from the report of a debate in the House of Commons, which made me doubt my eyesight, with respect to the age at which female children should be answerable for their own ruin. I could not help the blood rushing to my temples with indignant shame. I could not help rubbing my eyes and reading again and saying, do my eyes deceive me? Could this ever have happened in the House of Commons in England? Oh! my God, are we come to this? I did not think we were so low as this—that one member should suggest that the age of these innocents should be heightened to 14, and that another suggested it should be not so high. Another that it should be reduced to 10, and oh! my God, pleaded that it was hard for a man—HARD—for a man!—having a charge brought against him, not to be able to plead the consent of a child like that. I would not tell what, but for the grace of God, I should feel like doing to the man who brought that argument to bear on my child. (Applause.) I have a sweet innocent little girl—many of you have also—of 14, as innocent as an infant of any such things—what, if a man should make an application of this doctrine to her. Well may the higher classes take such care of their little girls? Well may they be so careful never to let them go out without efficient protectors. But what is to become of the little girls of poor unprotected widows? Of the little girls of the working classes of this country? I do not know who these men were who discussed this matter of ages. … I think in view of such discussions and their consequences, it is time that we women had some kind of capacity bestowed upon us for looking after ourselves, and after our children!!

      Catherine Booth 1884

    • lotharson

      “Sexual deviation has been going on since the Fall of Adam, and we are living more and more in just the adamic sin in our own hedonistic and now more narcissistic culture!”

      Yeah but according to Calvinism God Himself caused the fall of Adam:

      God predetermined fags to be fags.
      So after having bashed them, consistent Calvinists should praise God for his secret will and the plan of eternal suffering He has with them.

    • Francis

      I believe that we have given undue attention to DSM V. DSM as a catalog of mental disorders only aims to discern between adaptive vs. maladaptive psychological conditions, as such its concern is less sociological but more individual.

      For example, in DSM IV (I’ve never studied DSM V), any condition that is diagnosed as “disorder” needs to demonstrate that the inflicted has experienced significant personal distress (admittedly quite subjective) or problems functioning within the confines of the society (admittedly quite secular) — and this is what mandates treatment (medications, therapies etc.). As such someone who experiences melancholia isn’t necessarily clinically depressed, but only when significant distress/dysfunction is resulted does that person need treatment.

      With this framework in mind, any sexual tendency, be it pedophilia or otherwise, that an inflicted individual experiences, but that does not cause significant personal distress or problem with functioning (usually by behavioral repression), cannot be regarded as an “disorder”. On the other hand, if it either causes a person to grieve over their sexual attraction, or even step outside the bounds of societal law, then a “tendency” becomes “disorder”. To put this in the context of homosexuality (in a way acceptable to Christians but not to those in the field of psychiatry/psychology): a male person who experiences attraction to another male can be referred to as someone with homosexual tendency/orientation/interest, but only by engaging in homosexual acts or to experience significant personal distress can one diagnose him with “disorder”.

      In a clinical setting where the psychiatrist/psychologist needs to refrain from moral judgment/stereotyping (as it’s usually expressed behaviorally), while discerning between who needs treatment and who doesn’t, “disorder” vs. “non-disorder” is important. However, this in no way replaces/displaces moral judgment in a societal context.

    • Francis

      It’s important to note that pedophilia as a sexual attraction has not been removed from paraphilia (classified as abnormal) in DSM V, as homosexuality had been. That said, since psychological disorders are defined as “causing distress or dysfunction”, both of which are moving targets, what constitutes a disorder will change over time.

      I predict that with secularization of the society at large, some current paraphilias will eventually be removed from the paraphilia category. From a societal standpoint, more and more atypical social arrangement between males and females will also become legalized as valid forms of civil union.

    • William

      In respect of your last paragraph, would you limit that prediction to union of humans only or do you think human to animal union will also become legalized? Grim question I know.
      My feeling is that this is the way things are going. I do not see a limit to this.
      It is important to look at the societal conditions under which previous taboo issues became legalized, since this may give us some clues as to what to look for with the possible legalization of child abuse and how best to combat it. I think this issue is important for the church to address, I am sorry that so few people have commented on it. So these ‘MAP’ people are going to try an pull a civil rights movement in the future eh?
      “Christian Courage. No courage, no Salt, no Light, no Witness, no Holiness. Just cowardice.”
      That seems to ring true in the west.
      Not me in regards to this issue. This would be an issue upon which I may be willing to give my life.
      I know of several people who have and still do commit civil unrest on the issue of abortion. I have thought about this a lot too, but my wife will not allow me to commit any actions for which I would be arrested. Sadly.

    • Francis

      It’s not hard to detect the general trend in which old social taboos become legitimized.

      Physical or sexual abuse (e.g. domestic violence, child abuse) will not become socially acceptable in the foreseeable future, but polygamy and open relationships likely will (just check out the recent CNN article).

      Age of sexual consent will be reduced, but probably won’t go below 14 or 15 years of age unless human physiology changes drastically. More and more illicit drugs (mostly psychedelics) will become legalized.

      The society will remain obsessed about individual rights so long as individual freedom isn’t perceived to directly infringe on other people’s rights. This will be the measuring stick by which old ethics are questioned/thrown out and new moral values are instilled.

      Christians truly have an uphill battle in front of them, one that they will ultimately lose.

      Until the Judgment Day.

    • William

      “The society will remain obsessed about individual rights so long as individual freedom isn’t perceived to directly infringe on other people’s rights.”
      Was this not the case with abortion until the preborn child was redefined in legal terms? Would there not be a situation in which some movement could be made for the pro-MAP view? I say this because the argument (with faulty logic) I have heard seems to confuse peoples order of rights. That is that some people think that they would have a greater right to abuse a person than that persons right to not be abused.
      A slight conflation here I admit but I heard a song on he radio recently in which lady GAGA is singing something like ‘do what you want with my body’ to which R-KELLY!!!! responds ‘do what I want with your body’
      I was shocked. Was it not him who was arrested for having relations with his underage niece??Here we have a convicted pedophile singing about doing what he wants with another persons body!? How on earth must his victim feel about this, and what is it exactly that Lady gaga is promoting here?

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