Pedophilia

===Debate regarding criteria===
There was discussion on the DSM-IV-TR being overinclusive and underinclusive. Its criterion A concerns sexual fantasies or sexual urges regarding prepubescent children, and its criterion B concerns acting on those urges or the urges causing marked distress or interpersonal difficulty. Several researchers discussed whether or not a "contented pedophile"—an individual who fantasizes about having sex with a child and masturbates to these fantasies, but does not commit child sexual abuse, and who does not feel subjectively distressed afterward—met the DSM-IV-TR criteria for pedophilia since this person did not meet criterion B.<ref name=SetoReview/><ref>{{cite journal | vauthors = O'Donohue W, Regev LG, Hagstrom A | title = Problems with the DSM-IV diagnosis of pedophilia | journal = Sex Abuse | volume = 12 | issue = 2 | pages = 95–105 | year = 2000 | pmid = 10872239 | doi = 10.1023/A:1009586023326 | s2cid = 195287902 }}</ref><ref name="greenpedo">{{cite journal | author = Green R | year = 2002 | title = Is pedophilia a mental disorder? | url = http://www2.hu-berlin.de/sexology/BIB/pedophilia.htm | journal = [[Archives of Sexual Behavior]] | volume = 31 | issue = 6 | pages = 467–471 | doi = 10.1023/a:1020699013309 | pmid = 12462476 | s2cid = 7774415 | url-status = dead | archive-url = https://web.archive.org/web/20101012005114/http://www2.hu-berlin.de/sexology/BIB/pedophilia.htm | archive-date = 2010-10-12 }}</ref><ref name=DiagnosticCompare>{{cite journal | vauthors = Moulden HM, Firestone P, Kingston D, Bradford J | year = 2009 | title = Recidivism in pedophiles: an investigation using different diagnostic methods | journal = Journal of Forensic Psychiatry & Psychology | volume = 20 | issue = 5 | pages = 680–701 | doi=10.1080/14789940903174055 | s2cid = 144622835 }}</ref> Criticism also concerned someone who met criterion B, but did not meet criterion A. A large-scale survey about usage of different classification systems showed that the DSM classification is only rarely used. As an explanation, it was suggested that the underinclusiveness, as well as a lack of validity, reliability and clarity might have led to the rejection of the DSM classification.<ref name="feelgood">{{cite journal | vauthors = Feelgood S, Hoyer J | year = 2008 | title = Child molester or paedophile? Sociolegal versus psychopathological classification of sexual offenders against children | journal = Journal of Sexual Aggression | volume = 14 | issue = 1 | pages = 33–43 | doi=10.1080/13552600802133860 | s2cid = 145471750 }}</ref>

[[Ray Blanchard]], an [[Canadians of American origin|American-Canadian]] [[Sexology|sexologist]] known for his research studies on pedophilia, addressed (in his literature review for the DSM-5) the objections to the overinclusiveness and under underinclusiveness of the DSM-IV-TR, and proposed a general solution applicable to all paraphilias. This meant namely a distinction between ''paraphilia'' and ''paraphilic disorder''. The latter term is proposed to identify the diagnosable mental disorder which meets Criterion A and B, whereas an individual who does not meet Criterion B can be ascertained but ''not'' diagnosed as having a paraphilia.<ref name="pmid19757012">{{cite journal | author = Blanchard R | title = The DSM diagnostic criteria for pedophilia | url = https://archive.org/details/sim_archives-of-sexual-behavior_2010-04_39_2/page/304 | journal = Arch Sex Behav | volume = 39 | issue = 2 | pages = 304–16 | date = April 2010 | pmid = 19757012 | doi = 10.1007/s10508-009-9536-0 | s2cid = 20213586 }}</ref> Blanchard and a number of his colleagues also proposed that hebephilia become a diagnosable mental disorder under the DSM-5 to resolve the physical development overlap between pedophilia and hebephilia by combining the categories under ''pedophilic disorder'', but with specifiers on which age range (or both) is the primary interest.<ref name="dsm5.org"/><ref name=Blanchard>{{cite journal | vauthors = Blanchard R, Lykins AD, Wherrett D, Kuban ME, Cantor JM, Blak T, Dickey R, Klassen PE | title = Pedophilia, Hebephilia, and the DSM-V | journal = Archives of Sexual Behavior | volume = 38 | issue = 3 | pages = 335–350 | year = 2009 | pmid = 18686026 | doi = 10.1007/s10508-008-9399-9 | s2cid = 14957904 }}</ref> The proposal for hebephilia was rejected by the American Psychiatric Association,<ref name=prnsdhebephilia>{{cite magazine | url = http://www.psychologytoday.com/blog/witness/201212/psychiatry-rejects-novel-sexual-disorder-hebephilia | title = Psychiatry Rejects Novel Sexual Disorder "Hebephilia" | author = Karen Franklin | date = 2 December 2012 | magazine = Psychology Today | location = USA | access-date = 7 December 2012 }}</ref> but the distinction between ''paraphilia'' and ''paraphilic disorder'' was implemented.<ref name="dsm5.org Fact Sheet">{{cite web | title = Paraphilic Disorders | year = 2013 | access-date = July 8, 2013 | publisher = [[American Psychiatric Association|American Psychiatric Publishing]] | url = http://www.dsm5.org/Documents/Paraphilic%20Disorders%20Fact%20Sheet.pdf | url-status = dead | archive-url = https://web.archive.org/web/20160724010712/https://www.dsm5.org/Documents/Paraphilic%20Disorders%20Fact%20Sheet.pdf | archive-date = July 24, 2016 }}</ref>

The American Psychiatric Association stated that "[i]n the case of pedophilic disorder, the notable detail is what wasn't revised in the new manual. Although proposals were discussed throughout the DSM-5 development process, diagnostic criteria ultimately remained the same as in DSM-IV TR" and that "[o]nly the disorder name will be changed from pedophilia to pedophilic disorder to maintain consistency with the chapter's other listings."<ref name="dsm5.org Fact Sheet"/> If hebephilia had been accepted as a DSM-5 diagnosable disorder, it would have been similar to the ICD-10 definition of pedophilia that already includes early pubescents,<ref name=SetoReview/> and would have raised the minimum age required for a person to be able to be diagnosed with pedophilia from 16 years to 18 years (with the individual needing to be at least 5 years older than the minor).<ref name="dsm5.org"/>

O'Donohue, however, suggests that the diagnostic criteria for pedophilia be simplified to the attraction to children alone if ascertained by self-report, laboratory findings, or past behavior. He states that any sexual attraction to children is pathological and that distress is irrelevant, noting "this sexual attraction has the potential to cause significant harm to others and is also not in the best interests of the individual."<ref>{{cite journal | author = O'Donohue W | title = A critique of the proposed DSM-V diagnosis of pedophilia | url = https://archive.org/details/sim_archives-of-sexual-behavior_2010-06_39_3/page/587 | journal = Arch Sex Behav | volume = 39 | issue = 3 | pages = 587–90 | date = Jun 2010 | pmid = 20204487 | doi = 10.1007/s10508-010-9604-5 | s2cid = 30900698 }}</ref> Also arguing for behavioral criteria in defining pedophilia, Howard E. Barbaree and [[Michael C. Seto]] disagreed with the American Psychiatric Association's approach in 1997 and instead recommended the use of actions as the sole criterion for the diagnosis of pedophilia, as a means of [[taxonomy (biology)|taxonomic]] simplification.<ref name="barbaree-seto">Barbaree, H. E., and Seto, M. C. (1997). Pedophilia: Assessment and Treatment. ''Sexual Deviance: Theory, Assessment, and Treatment''. 175–193.</ref>