Recently 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).
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”?).