Sexual preference for 14-year-olds as a mental disorder: you can't be serious!!

This letter addresses two papers by the DSM-V Sexual and Gender Identity Disorders Workgroup member Ray Blanchard published in this Journal (Blanchard, 2009; Blanchard et al., 2009). Having been active in the 1970s struggle to remove homosexuality from the DSM (Green, 1972), a success that cured millions of their mental disorder, I am appalled that the ranks of the disordered may swell, once more in consequence of sexual orientation. As a psychiatry professor and graduate of Yale Law School, I hope I understand the domain of both disciplines. The DSM proposal trespasses their boundary. Concern is expressed that‘‘the current definition of pedophilia is excluding from specific diagnosis a considerable proportion of men who have a persistent preference for humans at an incomplete stage of physical development’’(Blanchard et al., 2009). Whence the 11th commandment, Thou shalt not have sex with those not fully mature? The Commandment could have been carved: Thou shalt not have sex with those before reproductive capacity. This would permit sex with some 13-year-olds. In several European countries, the age of legal consent to have sex falls within the range proposed for the DSM as signifying mental disorder for the older participant. The age of consent is 14 in Albania, Austria, Bulgaria, Croatia, Estonia, Germany, Hungary, Italy, Lithuania, and Serbia and 13 in Spain (www.avert.org). If the general culture is accepting of participation by the younger party, but psychiatry pathologizes participation by the older party, then the mental health profession pronounces a moralistic standard and, if successful, becomes an agent of social control (Moser & Kleinplatz, 2005). The American Psychiatric Association (APA) is an organization representing a profession still striving for scientific respectability. The parody of science masquerading as democracy made a laughing stock of psychiatry and the APA when it held a popular vote by its membership on whether homosexuality should remain a mental disorder (Bayer, 1981). Decreeing in a few years time that 19-year-olds who prefer sex with 14-year-olds (5 years their junior) have a mental disorder, as proposed for DSM-V (Blanchard, 2009), will not enhance psychiatry’s scientific credibility. A series of biased terms or logically frail arguments are provided for including hebephilia as a mental disorder. First, the terminology stamped on younger participants in sexual interactions loads the dice in favor of criminalizing (though not pathologizing) sex with early teens.‘‘The modal age of victims of sexual offences in the United States is 14 years; therefore, the modal age of victims falls within the time frame of puberty’’ (Blanchard, 2009). What constitutes victimhood? Is a victim a person who experienced trauma consequent to a sexual interaction or a willing participant who did not experience an untoward reaction but could not consent legally? Logical slippage is demonstrated: ‘‘In anonymous surveys of social organizations of persons who acknowledge having an erotic interest in children, attraction to children of pubescent ages is more frequently reported than is attraction to those of prepubescent ages’’(Blanchard, 2009) So? This does not show that the attraction is a mental disorder. Further,‘‘In samples of sexual offenders recruited from clinics and correctional facilities, men whose offense histories or assessment results suggest erotic interests in pubescents sometimes outnumber those whose data suggest erotic interest in prepubertal children’’ (Blanchard, 2009). So? This, too, does not show that the attractions or interactions reflect mental disorder, though contact is a R. Green (&) Department of Psychological Medicine, Imperial College, London W6 8RF, UK e-mail: [email protected]