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Journal of Forensic Psychiatry & Psychology

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Paedophilia: plague or panic?

Donald West

To cite this Article West, Donald(2000) 'Paedophilia: plague or panic?', Journal of Forensic Psychiatry & Psychology, 11: 3,

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The Journal of Forensic Psychiatry Vol 11 No 3 December 2000

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ARTICLES

Paedophilia: plague or panic?

DONALD WEST
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ABSTRACT A punitive socio- legal policy towards sex offenders against minors has been driven by public demand. The perception of an appallingly high incidence of serious abuse by incorrigible men has been encouraged by press sensationalism, but criminal statistics and recidivism studies fail to con rm either an escalation of sex crimes against minors or the inevitability of recidivism. Retrospective victim studies have given alarming indications of the prevalence of abuse, but they have often included trivial incidents and the experiences of sexually active adolescents that do not involve real paedophiles. Clinical observation demonstrates the devastating effects of child sex abuse, but community surveys suggest that minor incidents have only minor effects, except when accompanied by other stresses. Statutory changes and prison statistics reveal the increasing punitiveness of criminal justice. Exaggerated perception of risk produces undue restrictions on childrens freedom and on their interactions with teachers and other adults. Assumptions of incorrigibility impede the rehabilitation of offenders through vigilantism, stigmatization and barriers to employment. This ampli es deviance and does not protect children. Keywords: paedophilia, sex abuse, socio- legal policy

Questioning the general adult population reveals a high prevalence of recollections of childhood sexual confrontations with older persons. The statistics vary wildly according to how questions are framed and what is counted as abuse. American studies may include incidents up to 18, the legal age of consent in some states. When non- contact cases, such as seeing a asher or being exposed to pornography, indecent talk or adult nudity are included, it can be claimed that a majority of the female population has suffered child sex
The Journal of Forensic Psychiatry ISSN 0958-5184 print/ISSN 1469-9478 online 2000 Taylor & Francis Ltd http://www.tandf.co.uk/journals DOI: 10.1080/0958518001000266 9

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abuse. In one careful research utilizing a UK national sample, it was found that 12% of females and 8% of males recalled having experienced some signi cant, unwanted sexual incident with an older person when they were under 16 (Baker and Duncan, 1985). Clearly, large numbers of people have been exposed to illegal sexual incidents during their childhood, mostly undisclosed to parents, social workers, or police. However, over- inclusive statistics can give an exaggerated impression of seriousness. Inappropriate fondling is a frequently remembered experience, but pre- pubertal sexual penetration is comparatively rare. Persistent, unwanted molestation is less frequent than casual, one- off encounters. Exposure of children to sexual incidents involving both young and older adults may be more common than previously thought, but similar prevalence rates were obtained in Kinseys surveys during the 1940s in the USA (Grubin, 1999: 8). The situation may be unchanged, but current use of the label paedophilia in the context of non- contact activities and the experiences of older adolescents is a change from its psychiatric meaning. Contrary to impressions sometimes given by the media, few sexual molesters of children are life- threatening. Homicide statistics show that 50 children, aged 1 to 15 inclusive, were killed in England and Wales in the year 1997 (Home Of ce, 1998a: Table 4.6). Most child victims are killed by their parents. Each year, the number of known child victims of sex- related killings by strangers is usually in single gures and hard evidence of any increase is lacking. In the USA such crimes are also very rare, despite the high levels of violence in some American cities (Jenkins, 1998: 10). AN INCREASING PROBLEM? Sex offences recorded by the police and published annually by the Home Of ce show a signi cant increase of a quarter (25,154 to 31,165) over the decade 1987 to 1997 (see Table 1). Although substantial, these numbers still amount to less than 1% of all crimes recorded and the rise is less than for non- sexual crimes of violence, which increased by three quarters over the same period. The increases in recorded sex crime do not necessarily re ect a real proliferation. Sex offenders have been built up into modern folk devils by the popular press (Sampson, 1994: x) and the menace from them has been magni ed in the tabloids (Soothill and Walby, 1991). Reporting of incidents and suspects has been encouraged and the police are required to take all rape complaints seriously and to deal with victims sympathetically and supportively (Temkin, 1999). Reports of rapes have more than doubled since 1987. Home Of ce research (Lloyd, 1991; Harris and Grace, 1999) shows that the increase is attributable to rapes by acquaintances or intimates. Numbers of rapes by

PA E D OP H IL IA Table 1 Trends in crimes and convictions Offence category 1987 Offences Persons recorded found guilty1 2,471 13,340 312 2,699 511 831 2,425 1,127 929 25,154 198,829 425 2,348 102 349 194 248 507 951 257 6,231 1997 Offences Persons recorded found guilty2 6,281 576 18,674 2,484 148 44 1,112 199 183 42 1,629 167 3,503 479 520 237 647 (347)* 120 33,165 4,523 347,064

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Rape of a female Indecent assault on a female Unlawful sex under 13 Unlawful sex under 16 Incest Indecency with a child Indecent assault on a male Male indecency Buggery Total sex3 offences Total violent crimes

Key 1Source: Criminal Statistics 1987, suppl., Vol. 1, Tables S1, 1A; Vol. 2, Tables S2, 1A. 2Source: Criminal Statistics 1997, suppl., Vol. 2, Annexe A, p. 3. 3The total includes a few unusual offences (procuration, bigamy, abduction) that do not appear in the table. *Figure for non- consensual buggery, now counted as male rape, shown in parentheses.

strangers remained virtually constant between 1985 and 1996, but declined as a proportion of the total from 30% to 12%. Rapes during dates or encounters with friends were less likely to be reported in the past when women were so often blamed for putting themselves in compromising situations (Wright, 1980). As the table shows, the number of persons found guilty of rape has increased only slightly. Only 9% of incidents now lead to a conviction for rape, less than half the proportion in 1985. The increased attrition is largely due to the dif culty in establishing absence of consent when, in 82% of reported incidents, there was some degree of consensual contact immediately prior to the attack (Harris and Grace, 1999: Table 2.4). Following all the publicity given to sex abuse of children, increasing readiness to report could also account for the increase in these cases recorded by the police. The annual statistics do not display the age of victims. However, the table shows that reported cases of indecency towards children, which by legal de nition means those under 14, doubled between 1987 and 1997. Offences of indecent assault on males mostly concern boys under 16; so do many offences of buggery (now classed as male rape), and a substantial proportion of indecent assaults on females refer to girls under 16 (in up to 70%

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of cases leading to a conviction, according to previous Home Of ce research; Walmsley and White, 1978: Table B2). All three of these offences have very signi cantly increased, yet the table shows a substantial decline in persons convicted. As with rape, the increase in recorded offences appears largely attributable to greater readiness to report cases unlikely to lead to conviction, which would previously have gone unnoti ed. Some contribution to the decreasing ratio of persons convicted to offences reported is made by the current practice of seeking out anyone with whom a molester may have had indecent contact over a whole lifetime, so that a single offender can generate numerous offences from years ago. Reports of certain sex crimes have actually decreased. The table shows that unlawful sexual intercourse with a girl under 16 but over 13 (which is consensual behaviour; otherwise it would be chargeable as rape) was reduced by more than half. Given the increase in pregnancies among girls of this age (reaching 9.4 per 1,000 in 1996, according to the Of ce for National Statistics) sexual activity among the young can hardly have diminished. The change must be caused by parents and other adults becoming less inclined to complain to the police about the sexual behaviour of young people. The reduction in recorded indecency between males (in effect, homosexual acts in public places) presumably re ects a lessening in the proactive policing needed to detect the behaviour. The reduction in crimes of incest and unlawful sexual intercourse with girls under 13, both very serious offences, is probably a procedural artefact, as sexual penetration of young children is nowadays more realistically counted as rape. It seems that the increase in of cially recorded sex crimes does not establish a real increase in serious sex offences against children. PERSISTENCE OF OFFENDING Among both the public and clinicians, sex offenders, particularly offenders against children, have a reputation for extreme persistence and incorrigibility. In reality, sex offenders generally have relatively low reconviction rates. In one of the largest surveys ever conducted, in which 3,000 Danish sex offenders conviction records were followed for 12 to 24 years, just 10% were reconvicted (Christiansen, 1965). Among prisoners released in 1994 in England and Wales, 56% were reconvicted within 2 years, whereas only 16% of released sex offenders were reconvicted and only about 2% had their rst reconviction for another sex offence (Home Of ce, 1998b: Table 9.8). Longer periods of follow- up produce more reconvictions, 7% over 4 years following release from imprisonment for a sex offence, according to an earlier study (Marshall, 1994). Unlike most other offenders, who are unlikely to be reconvicted after a lapse of more than 4 years or after attaining middle age, sex

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offenders carry some risk of reoffending into their later years. Among persons over 50 sentenced to imprisonment in 1997, 21% were sex offenders, compared with only 4% among the totality of sentenced prisoners (Home Of ce, 1998b: Table 4.5). In a majority of cases, convictions for sex offences involve persons under 16. Among the 125,000 persons born in 1953, who acquired a conviction history by age 40 for what would now be a registrable sex offence, a large majority, 110,000, had been convicted for an offence involving a child (Marshall, 1997). Recidivism among offenders against children follows the pattern of sex offences in general, namely relatively low rates of reconviction persisting over many years. Based on a cohort of offenders aged 20 or more convicted in 1973 for sex offences against children under 16, Soothill et al. (1998) found the percentage reconvicted for a further sex offence, even after a follow- up as long as 21 years, was still only 20%, with fewer, 16%, being reconvicted for a sex offence involving someone under 16. Offenders against boys were more often reconvicted of a further sex offence than offenders against girls (26% of those guilty of indecent assault against boys compared with 15% of similar offenders against girls, and a corresponding contrast, 24% v 16%, for those guilty of indecency towards boys or girls respectively). Even allowing for a low detection rate, it was surprising that ve out of six convicted sex offenders against children, who are generally known to local police and often subject to surveillance, were never reconvicted for a similar offence. The authors conclude that many seem to do better than the current moral panic seems to suggest. This view is supported by a Home Of ce study (Grubin, 1999) that cites as the last word on the topic a large metaanalysis of a collection of studies showing that about 13% of child molesters are reconvicted over 5 years of follow- up, which contrasts with 50% of nonsex offenders reconvicted within 2 years of release from prison (Hanson and Bussiere, 1999). Nevertheless, a minority of molesters are very persistent. Reconviction rates are higher among men with strong and continuing erotic attachment to young children (i.e. the true paedophiles) and higher among offenders who target only boys. They are lowest among those who target children in their own family circle (McGrath, 1991), which is in conformity with evidence that these offenders are least likely to have predominantly paedophilic sex arousal patterns (Quinsey et al., 1979). Recidivism among child molesters can be much greater than their conviction histories suggest. Offenders under treatment sometimes confess to unreported contacts with large numbers of different children. A frequently cited research by Abel et al. (1987) found that among non- incestuous paedophiles, men who had targeted boys claimed an average of 150.2 different victim/partners and men who contacted girls an average of 19.8. However, they also noted that the median numbers were much less (4.4 and 1.3 respectively), showing that the high averages were due to a minority of offenders

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claiming extremely large numbers of contacts. The ages of the victim/participants were not given, so many may have been adolescents rather than children. Incestuous (i.e. intra- familial) offenders claimed to have had contacts with only one or two victims (mean 1.8). Offenders against boys outside the home predominated among the promiscuous minority. Such surveys tend to concentrate on samples of the worst offenders. Weinrott and Saylor (1991) questioned molesters diagnosed as psychopaths. Abel et al., though examining volunteer, non- incarcerated subjects, still used a selected sample. One of the criteria for inclusion was that he had fantasies or participated in behaviors that were persistently and involuntarily repetitive. Many had been repeatedly arrested and many had been persuaded to participate by relatives, lawyers and mental health professionals. Reconviction records may not be as de cient a means of identifying the more persistent offenders as is sometimes assumed. Even with a low detection rate, offenders who pursue numerous children outside the home are likely to be arrested sooner or later and so to be included in any long- term follow- up of reconviction records. Known recidivists are necessarily overrepresented among clients of social workers and clinicians and in prison populations. Recidivism is not necessarily linked to seriousness. The less dangerous behaviours, such as ritualistic indecent exposure from a safe distance, can be the most repetitive. Physically violent sex offenders are often also aggressively antisocial and criminal in non- sexual contexts. Men who kill for sex tend to be social and emotional isolates strikingly lacking in empathy (Grubin, 1997). Some are homicidal sadists of psychopathic disposition, who tend to target victims of any age. They are a far cry from the typical xated paedophile inappropriately in love with a child. THE EFFECTS OF CHILD ABUSE Clinical evidence amply demonstrates that sexual molestation of children can cause immediate distress followed by severe, long- term psychological damage. Limitless mental health problems, from psychosis to eating disorders and multiple personality, from depression to delinquency, from sexual inhibitions to sexual offending, have been linked to sexual abuse, which has come to be seen as more noxious than violence, cruelty or neglect. Stories from the Third World of starving children, forced labour and the gunning down of street urchins receive less emotive commentary in the media than sex tourists patronage of child prostitutes. Clinicians deal with the worst cases, but a wide range of experiences are classed as abuse. To discover how often they cause lasting damage, victimization studies based on samples drawn from the general population are

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needed. Given the very large number of adults recalling such experiences, they cannot all have been badly affected. Most studies agree that violent, coercive assaults are likely to lead to longterm damage, but damage attributed to apparently minor sexual abuse in childhood is often due to the accompanying abnormal family situation as much as to the sexual acts themselves (Nash et al., 1993). A large population sample of New Zealand women was surveyed by means of postal questionnaires (Mullen et al., 1993). All who recalled childhood sexual abuse and a random selection of those who did not were given psychiatric interviews and tests. There was a substantial statistical association of abuse with subsequent psychopathology. However: When the full range of abuse experiences is considered, the risks of women victims who came from stable and satisfactory home backgrounds developing signi cant adult psychopathology were not signi cantly higher than controls from similar backgrounds. Nevertheless, the minority who reported severe abuse, de ned as penetration, did show increased psychopathology, even when from a reasonably good background. This result con rms that seriously abusive incidents often produce lasting damage, as clinicians have observed, but when relatively minor incidents appear to do so the cause is likely to be due as much to other accompanying stresses as to the sexual incidents themselves. A substantially similar result emerged from an analytical review of seven careful surveys based on national population samples by two American researchers (Rind and Tromovitch, 1997). They concluded that, although correlations between adult sexual and social maladjustment and histories of childhood sexual involvements with adults were statistically signi cant, they were on the whole quite small, indicating that, in the long term, many had not been measurably affected. This was doubtless because of the inclusion of so many minor incidents in the surveys in question. Adverse effects were more likely when the sexual abuse was linked with physical abuse or with other indications of disturbed family background. Boys were less likely to be affected than girls, possibly because of their more robust attitudes to sex or, more likely, because most of their experiences are casual, one- off encounters with an outsider rather than continued molestation by a family member who cannot be avoided. A further meta- analysis based on college samples (Rind et al., 1998) con rmed the Mullen ndings, that family environment makes a substantial contribution to the effects attributable to sexual abuse. It also con rmed that males are not always upset by their experiences and that they less frequently suffer long- term effects. This result contrasts with the clinical observation that abused boys can show at least as much disturbance as girls. They may fear that they may be suspected of collaboration or that their experiences cast doubt upon their masculinity or their heterosexuality (Mezey and King, 2000). Abused males are also found to be at risk of becoming abusers themselves (Bentovim and

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Williams, 1998). But clinicians are not dealing with the large number of male incidents that are unreported, one- off casual encounters of minor emotional signi cance uncomplicated by subsequent inquisitions. Surveys do not support claims made by paedophiles that children generally welcome their attentions. Most women recall such incidents as being unpleasant at the time. Even the minority who experienced pleasure may look back on the event with distaste or anger (Nash and West, 1985). Men who were molested by persons of either sex when they were young boys tend to recall anxiety and bewilderment; those who were at or post puberty when approached by adult men typically recall annoyance and determined evasive action. However, if they were already homosexually inclined they might look upon the experience positively, just as do many male heterosexuals who have had contact with a woman when they were adolescents (West and Woodhouse, 1990). Sexualized friendships between pubertal children and older people, especially the homosexual relationships likened to Greek love (Geraci, 1997), are idealized in paedophile literature. Benign, if not bene cial, relationships can occur and have been documented (Brongersma, 1986; Sandfort, 1987), especially where compensation for emotional or material deprivation is provided, but this is not the usual outcome of lustful adult approaches. In summary: the concept of abusers has spread beyond paedophiles who pursue pre- pubertal children. Research points to a need to discriminate between undesirable but psychologically unimportant incidents and the serious situations that can cause great damage. CRIMINAL JUSTICE TRENDS In his recently published memoirs the veteran criminologist Leon Radzinowicz (1998: Ch. 17) deplores the grim penal outlook, the increasingly authoritative trend of criminal justice and the ever more frequent resort to imprisonment. The trend is most obvious in relation to sex offenders. Hebenton and Thomas (1996: Table 1) note the toughening of sentencing practice towards sex offenders since the 1980s, shown by a steady increase in the proportion of persons found guilty of an indictable sex offence who receive immediate custody. Over the period 19927, the number of persons convicted for indictable sex offences has not increased, but the chances of immediate imprisonment following conviction have increased twice as much for indictable sex offences as for the generality of indictable offences (16% versus 8%; Home Of ce, 1998a: Table 7B). Sentence lengths have also increased. Over the decade from 30 June 1987 to 30 June 1997, males in prison under sentence in England and Wales increased by 23% (from 37,916 to 46,739), but the number under sentence for sex offences increased by 75% (from 2,317 to 4,069) (Home Of ce, 1998b: Table 1.6).

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Changes in the criminal law, although in many respects bene cial, have nevertheless widened the range of sex offences and increased the use of imprisonment. New offences have been created and maximum punishments augmented. For example, the possession of indecent photographs of children, rst criminalized by s.16 of the Criminal Justice Act 1988, and the making of obscene telephone calls in breach of the Telecommunications Act 1984, were both made imprisonable offences under the Criminal Justice and Public Order Act 1994, ss.86 and 92. Stalking of sexually targeted individuals was criminalized under the Protection from Harassment Act 1997. Under the Sex Offences Act 1985 kerb crawling, that is, soliciting prostitutes from slowly cruising vehicles, became a criminal offence. Under the same Act, maximum terms of imprisonment for indecent assault on a female and for indecency towards a child under 14, both previously set at 2 years, were increased to 10 years and 7 years respectively. The House of Lords decision in R. v Brown [1993], subsequently upheld by the European Court of Human Rights, reafrmed the criminalization of sado- masochism, on the principle that the consent of a sexual partner is no defence to the imprisonable offence of causing actual bodily harm. Husbands traditional immunity from prosecution for rape of their wives was removed by the House of Lords in R. v R [1991]. The presumption that a boy under 14 is incapable of sexual intercourse was abolished by the Sexual Offences Act 1993. Boys as young as 10 can now be charged with rape. In June 1999 a boy of 10, whose victim was 8, was so charged. Young boys, but not girls, can also be charged with unlawful sexual intercourse with a consenting partner who is under 16, even if the girl is older than the boy. The Criminal Justice Act 1991, s.2, allowed longer terms than the normal tariff to be imposed on sex offenders when the court considers this necessary for the protection of the public from serious harm (which can include psychological harm). In case the offender is released on parole, the same Act (s.44) allowed the court to extend the period of supervision, beyond the customary two- thirds point to the very end of the sentence. The Crime and Disorder Act 1998, s.58, further provided for the sentencing court to impose extended periods on licence, following release, for whatever length of time is considered necessary to prevent reoffending and secure rehabilitation, up to the maximum allowable sentence for the crime. These measures were clearly intended to counteract criticism that serious sex offenders, who have supposedly paid their debt to society, can go free without restriction, even if they are manifestly still dangerous. The Court of Appeal in Mansell [1994] upheld rm application of the 1991 Act on a man of 40 convicted for what seems indecent horseplay. He jumped on (presumably unwilling) young men of 18 and 22, thrusting and rubbing himself against them in a sexual way while both he and they were clothed. The sentencer recognized 30 months as an appropriate tariff, but doubled this

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to 5 years imprisonment for public protection, a decision which the Court of Appeal upheld. In the same year, the court, in Groves (1994), in response to an Attorney- Generals reference, increased a sentence from 6 years to 9 years because the sentencing judge had not had regard to the provisions of the 1991 Act. The offender had committed sex acts with boys he was said to have befriended. In White [1996], for an offence of indecent assault, initially charged as attempted rape, the court upheld the extension of the sentence from 5 to 9 years. It remains to be seen whether the Appeal Court will be equally supportive of rm decisions under the 1997 and 1998 Acts. In an echo of the American notion of three strikes and youre out, the Crime (Sentences) Act 1997 set a mandatory punishment of life imprisonment for a second serious offence of violence or sex (the latter is de ned as rape, attempted rape or intercourse with a girl under 13). When offenders are sentenced to life imprisonment, the trial judge can advise on a date before which the offender should not be granted release on licence. This can be extended by the Home Secretary, who may decide on detention until death, which he has done for a number of sex offenders and sex killers, most notoriously for Myra Hindley, convicted for participating in the murders of children in the early 1960s. In its intensity and persistence her vili cation in the media is unique. It seems that the public perception of a serious and worsening problem has led to sex offenders being singled out for increasingly severe punishment. SEX OFFENDER REGISTRATION AND SEX OFFENDER ORDERS Many states in America have a so- called Megans Law, hastily enacted after a child of that name was killed by a rapist in 1994. These permit, and in some places require, that names and addresses of convicted sex offenders be published in newspapers, posted on the internet or made available on a telephone line. The systems have been criticized for encouraging vigilantism and hate crimes, disregarding civil rights, driving offenders underground and having little demonstrable protective effect (Petrosino and Petrosino, 1999). Recent UK legislation has gone some way along a similar path. The Sex Offenders Act 1997 established the sex offender register, popularly referred to as a paedophile register. All persons of any age who are convicted or cautioned for a sex offence must notify the police of their current address so that their movements can be monitored. The duration of the obligation is without limit for an adult receiving more than 30 months imprisonment, but 7 years or less for shorter or non- custodial sentences or for young persons. Failure to comply is an imprisonable offence. The

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requirement to register applies to a wide range of offences, not only to the very serious, such as rape, but to lesser crimes, such as the possession of indecent photographs of children, consensual intercourse with a girl under 16 by a man over 20 and homosexual indecency between males, where the offender is over 20 and the other party under 18. The police have discretion to release information about anyone on the register. Heads of local schools, employers and even neighbours might be informed, although current guidance suggests that dissemination of information beyond public authorities should be exceptional. In the rst year of operation, over 6,000 registered, amounting to 96% compliance. This presents overstretched police forces with a daunting task if they are to monitor more than a minority at all closely. Had the legislation been retrospective, requiring everyone with past sexual convictions and cautions to register, at least 125,000 (of the people over 20 in 1993) would have been included (Marshall, 1997). The Crime and Disorder Act 1998, s.2, introduced the sex offender order, which can be applied to anyone with a sex conviction history, including those who have committed an offence abroad. The order, imposed by magistrates on application from the police, places restrictions on the movements and activities of sex offenders in the community whose behaviour suggests they might do serious harm. They do not have to commit an offence, an apparent risk suf ces. The order operates for a minimum of 5 years or as long as the court decides. A breach of the order attracts a maximum penalty of 5 years imprisonment (Power, 1999). There is an obvious potential for further augmentation of the number of sex offenders in prison or under restriction in the community. In December 1998 the Home Secretary announced that, in accordance with the Police Act 1997, a Criminal Records Bureau is to be set up to issue certi cates displaying a persons criminal convictions, or the absence of them, which employers would be allowed to ask job applicants to produce. He said the measure would be an important step towards preventing dangerous people from working with children. Many men will be affected since over a third have a criminal conviction at some time. For employment in sensitive areas or professions, or involving regular contact with persons under 18, the required certi cate will include cautions and old spent convictions. For work involving regular care or sole charge of persons under 18, an enhanced certi cate will be needed that also includes relevant information from con dential police records. The effect of recent legal changes will depend upon the discretion of the authorities operating them, but the over- inclusiveness of the sex offender category could mean detrimental measures being applied to individuals who present no real risk.

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SOME ADVERSE CONSEQUENCES OF OVERREACTION Once a climate of panic has been generated, it tends to feed upon itself. The tabloid press now regularly employs such terms as beast, monster and sex end. Professionals have developed a vocabulary peculiar to sex offences involving children, with frequent employment of the catch- all label sex abuse and such words as disclosure, perpetrator and survivor used in contexts where allegation, accused or complainant might be more accurate. The effect is insidious, for the deployment of either negative or neutral terminology has been shown to induce different reactions to the same sexual incident (Rind and Bauserman, 1993). Media- generated fears about the proximity of paedophiles can trigger local disturbances. The Daily Mail (1998) devoted a whole page to the revelation that, according to police statistics (doubtless including many long past and less serious offences) the seaside resort of Bournemouth was harbouring more than 600 child sex perverts who were walking freely around. (Actually, the number of persons with a sex offence history was not unusual for the size of the area surveyed.) The following day the Guardian (1998a) quoted visitors as thinking twice about bringing their children to Bournemouth. The paper went on to describe what had happened elsewhere when a 65- year- old man, who had spent 6 years in prison for paedophile offences, was due to return to the village house he owned, near to his former victims. With police collaboration, local people were putting up window stickers in selected houses and shops offering refuge to children fearing attack. The NSPCC had expressed reservations, pointing out the danger of stickers being copied by child molesters. Mob passions can be lethal, as when vigilantes burnt down a paedophiles house killing a girl of 14 who was inside (Guardian, 1997). The prospect of continued persecution, both in prison and after release, creates a risk of children being murdered to avoid detection. The terrifying social consequences of conviction for even relatively minor offences provoke desperate denials which oblige child victims to testify in court. The of cial tracking and public harassment of released offenders cause some who are indeed dangerous to try to ee from supervision. Others seek police protection which brings expense and embarrassment to the authorities who have set up a supervised refuge in secure accommodation next to Nottingham Prison. Parental fears are stimulated by crusading moral ideologues who depict paedophiles as highly predatory, prone to violence, incurably recidivistic and lacking in any concern for their victims. Contrary views become both politically incorrect and morally suspect. In America, and to a lesser extent in Britain, fundamentalist religion has in uenced some social workers and therapists to give credence to stories, since discredited, of sexual abuse and

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murder of babies in the course of satanic ritual sacri ces (LaFontaine, 1998). Dubious claims that memories of abusive incidents in childhood, forgotten for many years, can be recovered through hypnosis or psychotherapy have proliferated (Brandon et al., 1998). Although sometimes scarcely more reliable than similarly recovered memories of previous lives or of encounters with aliens, such claims have destroyed families and devastated innocent parents or grandparents (Pendergrast, 1996). It has become dangerous for academics to publish politically incorrect conclusions. Bruce Rinds nding that much of the abuse reported in community surveys had minimal long- term consequences was followed by attacks from media and politicians on the American Psychological Association (APA) for publishing the paper. The US House of Representatives passed a vote condemning Rinds study as seriously awed and commending the APA for having resolved to evaluate the scienti c articles it publishes in the light of their potential social, legal and political implications (Congress Record, 12 July 1999, CRH 5341). A year or two earlier the author of a Cambridge University doctoral thesis, who had interviewed paedophiles and analysed their rationalizations, was attacked in the press and reported to the British Psychological Association on the basis of statements taken out of context and wrongly supposed to be supportive of sex with minors. Too many anxious precautions damage children. Social learning is affected if children can never play with their peers out of sight of their parents. Parents can be made self- conscious about ordinary domestic situations, such as fathers bathing children. Following some notorious prosecutions, including one of a TV celebrity who attracted much public sympathy, parents must now have second thoughts about taking photographs of their infants in the nude. Parental nudity in the home can also arouse suspicion during child custody disputes. Children sometimes make up stories of sexual abuse out of malice or to satisfy intimidating interrogators. Some notorious incidents (in Orkney and Cleveland, for instance) in which children were abruptly snatched in dawn raids by social services acting on uncon rmed suspicions of sexual abuse, should have alerted authorities to the danger that children, desperate for release, may agree to any suggestions put to them. Relations between young children and teachers can be inhibited if one- toone situations have to be avoided and comforting hugs banned. In the heatwave of August 1998 the Local Government Association advised primary school teachers to refuse parental requests to apply barrier cream to young pupils limbs. The ruling seems less absurd in the light of the prevalence of malicious accusations of sexual impropriety by disaffected pupils which, regardless of the outcome of an investigation, result in automatic suspension and sullied reputation. At a meeting of the National Union of Schoolmasters and Women Teachers, it was reported that of 974 recent allegations there had

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been no grounds for action in 792 and that 3 members had committed suicide following false allegations (Guardian, 1999a). Recruitment of men to teachertraining has been affected (Guardian , 1998b). Volunteers for charitable youth work are also likely to be discouraged by inquisitorial screening and reference to police records. Men working as coaches for boys and girls in sports training are now subject to careful scrutiny. A 24- hour Swimline telephone service has been set up recently to help young swimmers exposed to sex abuse by instructors or others and to advise coaches and parents on safer practices in clubs. Similar cautionary guidelines operate in tennis and other sports. Homosexual men working with young people are under particular suspicion because of an undeserved reputation for being prone to child- molesting. Plethysmographic research has failed to show that sexual arousal to young children is any more prevalent among homosexual than heterosexual males, rather the reverse, but the idea is reinforced through the persistent promiscuity of a small minority of practising homosexual paedophiles and by the inclusion in forensic samples of men whose partners are not young boys, but sexually mature and willing male adolescents. Modern Western sensibilities have moved on from the time of classical antiquity when homosexuality between men and youths was more readily accepted than sex between adult men, an attitude that lingers on in some cultures today, where the idea of men adopting a sexually receptive, non- macho sexual role arouses greater censure than pederasty. Molestation of children in residential homes by their carers is a revolting breach of trust. Former staff from these establishments have been justi ably prosecuted in a spate of well- publicized trials many years after the alleged events. However, as one investigative journalist pointed out, most of the supporting witnesses have been male, many of them disgruntled adolescent delinquents rather than children at the time they were allegedly abused, who came forward only after approaches from police pointing out the prospect of compensation from the Criminal Injuries Compensation Authority, a ploy unlikely to be used for other types of injurious crimes (Webster, 1998). Sex law has become over- inclusive, embracing a large grey area of sexual activity that is not paedophilia in a psychiatric sense. Whatever their age or habitual sexuality, anyone who has any kind of sexual interaction with someone under 16 commits an indecent assault. Many young people are sexually active before 16. The popularity of nubile adolescents as pin- ups and prostitutes testi es to their attractiveness to normal adults. Early in the twentieth century girls could marry at 12. Now, with mandatory reporting of sexualized behaviour in American schools, juveniles are charged or sent to therapists for activities their parents used to engage in with impunity (Jenkins, 1998: 288). Mandatory rules risk producing odd consequences. Early in 1998, a number of men in Bolton were reported to police for having gay sex together

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in a private house. They were convicted and placed on the Sex Offender Register because one of them was a few months below 18, the age of consent for male homosexuality. He protested in vain that he was a willing participant and not a victim. In October 1998, a judge criticized the Children (Protection from Offenders) (Miscellaneous Amendments Regulations) 1997, which prevented him from allowing the children of a pair of drug abusers to be fostered by otherwise very suitable grandparents. The grandfather had been convicted 36 years previously for sex with a girl of 15 (Guardian, 1998c). The inclusion on the register of women who have had sexual affairs with under- age males stretches most peoples notion of a sex offender.
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TREATMENT Inappropriate sexual behaviour with children can be the expression of an aberrant attraction that most of us do not experience, but treatment that might reduce the chances of further child victimization rarely takes precedence over the urge to punish. Alienation by long imprisonment and subsequent social rejection reduces offenders motivation to conform. Treatment and rehabilitation are humane and practically advantageous, but ef cacy, measured by reduced reconviction rates, is dif cult to establish. Reconviction rates being low, a long follow- up period and substantial samples are needed to yield a clear result. Random allocation to treatment or no treatment is rarely possible, so obtaining an adequate comparison group is problematic. Evaluations have been fraught with methodological problems and have had uncertain outcomes (Furby et al., 1989). Larger- scale and methodologically superior evaluations carried out in America have yielded some impressive evidence of bene t. For example, Marshall and Barbaree (1988), using cognitive behavioural methods with sex offenders, found very signi cant reductions in sexual recidivism (assessed over a long- term follow- up with a variety of of cial and unof cial measures). The effect was especially marked among child molesters, with incestuous offenders having, as usual, the lowest reconviction rates. In a more recent project in Vermont, a sample of sex offenders, the great majority paedophiles, participated in a determined application of cognitive behavioural treatment, supplemented when necessary by additional interventions such as job training and attendance at Alcoholics Anonymous. The treatment continued for an average of just under 4 years until suf cient change was observed. A follow- up of offence records over 5 years began when most had completed the programme. Only 1.5% were detected in a further sex offence, as opposed to 15.6% in a comparable sample enlisted in more varied and sometimes shorter programmes (McGrath et al., 1998). The men were treated while under correctional supervision in the community, so

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the project also demonstrated that, given suf cient time and effort, a good outcome could often be achieved without resort to costly and damaging imprisonment. The fact that paedophiles typically prefer seduction to force and have fewer convictions for non- sexual violence than other types of offender (Grubin, 1999: 15), makes community treatment feasible. Although on a much smaller scale, work in England has yielded promising indications of a reduction in reconvictions among sex offenders in community treatment programmes while on probation (Hedderman and Sugg, 1996). Treatment in prison is more problematic, given the anti- therapeutic atmosphere, competition for limited resources, hostility from other inmates, fear that confessing sexual problems may delay discharge and dif culty in arranging continuity of treatment at the critical period of release. It is too soon to be able to use reconviction statistics to judge the outcome of the national system for sex offender treatment in English prisons, but bene cial changes in measured attitude have been recorded among a substantial proportion of treated men (Beech et al., 1998). Some paedophiles will not enter treatment except under pressure, but there is a legal mechanism to persuade them, namely the probation order with a requirement to undergo treatment by a doctor. This is little used because there are few willing doctors or facilities within the health service to deal with them and the courts increasingly opt for imprisonment. The Mental Health Act 1983 speci cally excludes sexual deviation or other immoral conduct as justi cation for compulsory detention in a psychiatric hospital, so for the less co- operative paedophiles prison is the only option. The lack of National Health Service facilities cannot be justi ed by an absence of available treatments. Cognitive behavioural methods, which are admittedly more like re- education than a conventional medico- psychological approach, sometimes need supplementing with individual psychotherapy. Clinical psychologists have developed reconditioning methods for modifying deviant sexual arousal and sophisticated techniques of penile plethysmography to monitor results. Libido- suppressant drugs also have their uses. Adequate matching of individual needs to appropriate therapies and realistic assessment of treatment outcomes require specialized mental health skills and training that are beyond the scope of an ordinary prison. A small minority of paedophiles have severe personality disorders and express their sexual proclivities in uncontrolled and dangerously predatory or violent sexual behaviour, the consequences of which can be as disastrous to themselves as to their victims. For such offenders, often rightly diagnosed psychopaths, detention under conditions of high security is essential, but admission to secure psychiatric hospitals is hampered again by the Mental Health Act, which requires that persons detained on grounds of psychopathy must be treatable. Since such patients are usually long- term and dif cult to manage, psychiatrists are tempted to consider them untreatable, which

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means they go to prison. The concept of being too severely disordered to be looked after humanely in a hospital setting is dubious and would not be considered for a physical illness. Nevertheless, the government is proposing to set up units for the indeterminate detention of individuals with severe personality disorder who are dangerous and untreatable under present arrangements. They would be assessed, if necessary, without waiting for a current or repeat offence (Home Of ce and Department of Health, 1999). Once such facilities become available it is to be expected that known paedophiles will be given this diagnosis more readily.
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CONCLUSIONS Serious sexual abuse, re ected in pregnancies, prostitution and venereal infection among slum children, was well recognized in the nineteenth century in the UK by such moral activists as Josephine Butler and W. T. Stead and in the USA by such organizations as the American Vigilance Association (Goldberg and Goldberg, 1935). Interest has waxed and waned since, but at present public concern shows no sign of abating. According to Jenkins (1998) it is a moral panic, originating in America, spreading globally and fuelled by selfserving interests. Feminists reinforce their case against male oppression, social workers gain more resources, therapists nd more clients, psychologists and psychiatrists expand their role as experts, religious morality gains credibility, media circulation is promoted, lawyers are given new tasks and politicians nd a vote- catching cause. Sexual contact between children and adults is illegal and undesirable, but there are different degrees of offensiveness, and a blurred boundary lies between children incapable of informed consent and the sexually sophisticated young. The Home Of ce is undertaking a review of sex law, but the terms of reference are limited and do not include age of consent issues (Rutherford, 1999). Whether well- intentioned recent legislation proves bene cial will depend on the new powers and responsibilities given to police, probation, social services and sentencers being used with discretion and without attention to popular clamour. The public needs educating to prevent such labels as paedophile, predator and incurable being used indiscriminately. Existing possibilities of diversion from criminal justice to effective treatment and welfare should be utilized fully, particularly for sexual problems arising within families. For the minority of offenders who are dangerously deviant and uncontrolled, hospitalization remains a more constructive response than imprisonment. Many children sustain lasting damage from repetitive, coercive and sometimes brutal sexual assaults, but such grave crimes are less frequent than minor indecencies without dire consequences. Exclusive therapeutic concentration

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on childhood sexual incidents risks neglect of other important coexisting traumatic factors. Professional overstatement of harm, seen in the past in regard to masturbation, cannabis and homosexuality, is unhelpful. Disproportionate reaction to an exaggerated menace has costly side- effects, blunting justice, alienating offenders instead of rehabilitating them, limiting childrens freedom and inhibiting their interactions with adult males. It also discourages independent research or professional judgements that con ict with fashionable opinion. But such considerations provide no reason to neglect the very real problems of serious abuse.
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Donald J. West, MD, LittD, FRCPsych, emeritus professor of clinical criminology, University Institute of Criminology, 7 West Road, Cambridge CB3 9DT

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LEGAL CASES
R. v Brown [1993] 2 All ER 75. R. v Groves [1994] 16 Cr App R (S) 366. R. v Mansell [1994] 15 Cr App R (S) 771. R. v R [1991] 4 All ER 481. R. v White [1996] 2 Cr App R (S) 40.

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