There is no cure, so the focus is on protecting children.
Pedophilia, the sexual attraction to children who have not yet reached puberty, remains a vexing challenge for clinicians. Classified as a paraphilia, an abnormal sexual behavior, researchers have found no effective treatment. Like other sexual orientations, pedophilia is unlikely to change. The goal of treatment, therefore, is to prevent someone from acting on pedophilic urges – either by decreasing sexual arousal around children or increasing the ability to manage that arousal. But neither is as effective for reducing harm as preventing access to children, or providing close supervision.

The exact causes of pedophilia have not been conclusively established. Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies

• No intervention is likely to work on its own; outcomes may be better when the patient is motivated and treatment combines psychotherapy and medication.
• Parents should be aware that in most sexual abuse cases involving children, the perpetrator is someone the child knows.

Nearly all people with pedophilic tendencies are male. Studies of child molesters have reported that only 1% to 6% of perpetrators are female. Co-occurring disorders, such as personality disorders or mood disorders, are common in people with pedophilic tendencies. And about 50% to 70% of people with pedophilic tendencies are also diagnosed with another paraphilia, such as exhibitionism, voyeurism, or sadism.

Most psychotherapies used to treat pedophilia incorporate the principles and techniques of cognitive behavioral therapy. The focus of therapy is to enable the patient to recognize and overcome rationalizations about his behavior. In addition, therapy may involve empathy training and techniques in sexual impulse control. Most important behaviour therapy used is Relapse prevention

• Relapse prevention is intended to help the patient anticipate situations that increase the risk of sexually abusing or assaulting a child, and to find ways to avoid or more productively respond to them

• testosterone suppression offers advantages such as the need for follow-up visits (which aids in monitoring behavior). It may take 3 to 10 months for testosterone suppression to reduce sexual desire.

• SSRIs may be a useful adjunct to other treatments, because they not only subdue sexual ruminations and urges but also help with impulse control.

Finally I’m in favor of treatment to spare kids the physical and psychological trauma. It doesn’t matter whether it is nature or nurture unless it helps in quality treatment.

Dr Sharmila Majumdar
MS Human Sexuality, PhD cbt
Fellowship from Ichan school of Medicine, Mount Sinai, USA
Director and Chief Sexologist
Sexual and mental health clinic , Avis Hospital

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