B4U-ACT

B4U-ACT conducted an online survey of minor-attracted people over a 14-week period from July to October, 2011. Responses were received from 209 people. Most were male, but six identified themselves as female and three as transgender. Respondents ranged in age from under 18 to over 70, with about 75% of them evenly distributed between ages 18 and 50. Major findings were:

Over half had wanted to see a mental health professional at some time but did not do so due to fear that a professional would react negatively, report them to others, or lack necessary knowledge. Details.
About 40% of those who wanted services but did not receive them said they were discouraged from doing so by something said by a mental health professional or organization. About the same number were not discouraged in this way. Details.
About half of those who wanted services but did not receive them said they experienced negative consequences as a result; most of the rest were uncertain. Details.
About a quarter of all respondents saw professionals voluntarily, while 1 out of 10 were mandated to treatment. Details.
Those who saw professionals did so primarily to address a wide variety of issues other than controlling sexual feelings—most often, to improve self-concept. In about half of all cases, the professional’s goals were compatible with the client’s; in about one third, they were not. Details.
Half of the respondents who saw professionals experienced one who made incorrect and unjustified assumptions about them consistent with stereotypes found in the DSM-IV-TR. In two thirds of such cases, these assumptions interfered with the therapeutic process. Details.
The majority of respondents felt that the description of pedophilia from a non-forensic study was accurate and helpful in promoting mental health care, but did not represent the beliefs of typical professionals. Details.
A majority of respondents felt that a recent professional article about pedophilia represented the beliefs of most professionals, but was inaccurate and encouraged inadequate, adversarial, and unethical treatment. However, those who received care were divided over whether such articles contributed to harmful treatment for them. Details.
The majority of respondents felt that DSM-related literature about pedophilia represented the beliefs of most professionals, but was inaccurate and encouraged inadequate, adversarial, and unethical treatment. Details.

1. Over half had wanted to see a mental health professional at some time but did not do so due to fear that a professional would react negatively, report them to others, or lack necessary knowledge. (n = 205)

Question: Have you ever wanted to see a mental health professional about an issue related to your attraction to boys or girls, but did not do so? (n = 205)
Results: Yes: 58% No: 42%

Question: What would have been your goal(s) in seeing a mental health professional? Check all that apply.

Goal	Percent (n = 120)
Figure out how to live in society with this attraction	73%
Deal with society's negative response to my attraction	68%
Understand the cause of the attraction	52%
Deal with sexual frustration	51%
Improve my self-concept	48%
Learn to control the sexual feelings	32%
Extinguish or reduce the attraction to boys or girls	27%
Develop or increase an attraction to adults	23%
Other	13%

Question: Why did you not see mental health professional? Check all that apply.

Reason	Percent (n = 120)
Fear of negative reaction by the professional	78%
Fear of being reported to law enforcement	78%
Fear of being reported to family, employer, or community	68%
Uncertain how to find a knowledgeable professional	54%
Profeesionals are not knowledgeable about attraction to minors	43%
I was a minor and could not tell my parent(s)/guardian	9%
No professional in my area	7%
I could not afford the fee	4%
Other	9%

2. About 40% of those who wanted services but did not receive them said they were discouraged from doing so by something said by a mental health professional or organization. About the same number were not discouraged in this way.

Question: Did you read or hear anything by a mental health professional or organization that contributed to you not seeing a mental health professional about this issue? (n = 120)
Results: Yes: 40% No: 38% Uncertain: 23%

Question: If you answered "Yes" to the question above, what did it say? (n = 49)

Information suggested MAPs would be reported (just for feelings: 8%)	18%
Information was inaccurate/perpetuated stereotypes	16%
Information was completely negative	14%
Information said MAPs are criminals	12%
Information demonized MAPs	8%
Information was about social control, not helping MAPs	8%
Information was condemning/adversarial/ judgmental/hostile	8%
Information was insulting	6%
Information showed no compassion or empathy	6%
Information described treatment that sounded inhumane	6%
Professional made judgmental/derogatory statement about me	6%
Professional showed hostility toward me	6%
Professional lacked knowledge	6%

3. About half of those who wanted services but did not receive them said they experienced negative consequences as a result; most of the rest were uncertain.

Question: Were there any negative consequences of your not receiving services? (n = 115)
Results: Yes: 48% No: 16% Uncertain: 37%

Question: If there were negative consequences, or you believe there may have been, please describe them briefly.

Consequence	Percent (n = 102)
Depression	19%
Self-hatred/low self-esteem	12%
Suicidal thoughts/attempts	10%
Isolation/withdrawal/loneliness	10%
Lost productivity in work/school	9%
Frustration/anger	9%
Fear/anxiety/paranoia	7%
Family estrangement	7%
Difficulty controlling self	5%
Pain/suffering/unhappiness	4%
Criminal conviction	4%
Substance abuse	3%
Hopelessness/pessimism	3%
Continuation/growth of attraction	3%

4. About a quarter of all respondents saw professionals voluntarily, while one out of ten were mandated to treatment.

Question: Have you ever seen a mental health professional for an issue related to your attraction to boys or girls? (n = 185
Results: Yes, voluntarily: 23% Yes, involuntarily: 10% No: 71%

Note: Voluntarily includes under pressure from family or friends. The total is over 100% because some received both voluntary and involuntary treatment.

Question: If you voluntarily saw a professional for an issue related to your attraction to boys or girls, describe the factors that encouraged you to see him or her. (n = 37)

Own initiative to address issues related to attraction	51%
Was in therapy for other issues possibly related to sexuality (depression, anxiety, suicidal thoughts)	27%
Recommendation by others (professional, MAP, girlfriend)	11%
Pressure from others (family, school)	11%

5. Those who saw professionals did so primarily to address a wide variety of issues other than controlling sexual feelings—most often, to improve self-concept. In about half of all cases, the professional’s goals were compatible with the client’s; in about one third, they were not.

Question: When you saw the professional(s), whether voluntarily or involuntarily, what were your goals? What were the professional’s goals?

Goal	Percent of MAPs (n = 53)	Percent of professionals (n = 51)
To improve my self-concept	67%	51%
To deal with society’s negative response to my attraction	60%	30%
To figure out how to live in society with this attraction	57%	33%
To understand the cause of the attraction	45%	31%
To deal with sexual frustration	36%	20%
To learn to control the sexual feelings	30%	45%
To develop or increase an attraction to adults	21%	35%
To extinguish or reduce the attraction to boys or girls	17%	43%
To treat depression	9%	2%
To feel happier/at peace	0%	6%
Other	11%	22%
None/unclear/unknown	11%	11%

Question: How compatible were your goals and those of the professional(s)? (n = 53)

Very compatible	19%
Somewhat compatible	30%
Neutral or uncertain	17%
Somewhat incompatible	13%
Very incompatible	21%

6. Half of the respondents who saw professionals said professionals made incorrect and unjustified assumptions about them consistent with stereotypes found in the DSM-IV-TR. In two thirds of such cases, these assumptions interfered with the therapeutic process.

Percent of MAPs voluntarily seeking therapy whose therapists made such assumptions	43% (n = 42)
Percent of MAPs mandated to treatment whose therapists made such assumptions	67% (n = 18)
Overall percent of MAPs in treatment whose therapists made such assumptions	50% (n = 54)

MAPs whose therapists made inaccurate, unjustified assumptions about them:

Inaccurate and Unjustified Assumption (taken from DSM-IV accompanying text on pedophilia)	In voluntary therapy (n=42)	In mandated treatment (n=18)
That the client engaged or would engage in sexual activity with a child	38%	61%
That the client interacted or would interact with a child only for gratification of sexual desires rather than for love or relationship	29%	61%
That the client was or would be attentive to a child’s needs for the purpose of interacting with him or her sexually	29%	50%
That the client did or would coerce or pressure a child into sexual behavior	21%	67%
That the client was or would be attentive to a child’s needs for the purpose of preventing disclosure of sexual behavior	17%	50%
That the client posed or would pose a danger to society unless under supervision or surveillance	17%	50%
That the client engaged or would engage in sexual behavior with a child in his immediate or extended family	7%	33%
That the client threatened or would threaten a child to prevent disclosure of sexual behavior	7%	44%
That the client gained or would gain access to children for sexual purposes by marrying or befriending their parents, taking in foster children, or trading children with other adults	7%	28%
That the client abducted or would abduct a child for sexual purposes	2%	22%

Question: When a mental health professional made any of the above incorrect assumptions, did it make you less likely to go back for further sessions? (n = 27)
Results: Yes: 63% No: 22% Uncertain: 15%

Question: When a mental health professional made any of these incorrect assumptions, did it interfere with reaching any of your or the therapist’s goals? (n = 27)

Results: Yes: 67% No: 15% Uncertain: 19%

7. The majority of respondents felt that the description of pedophilia from a non-forensic study was accurate and helpful in promoting mental health care but did not represent the beliefs of typical professionals.

After reading an excerpt from the conclusions of a particular non-forensic study of pedophilia, respondents were asked to rate the degree to which they agreed with each of the following statements.

Statement	Agree	Uncertain/ Neutral	Disagree
Information like this is commonly written by mental health professionals and researchers (n = 141).	2%	29%	64%
Information like this reflects the understanding held by the typical mental health professional (n = 142).	8%	26%	66%
Information like this is accurate (n = 144).	73%	19%	8%
The writers seem to want to understand people who are attracted to boys or girls (n = 142).	85%	9%	6%
Information like this encourages mental health professionals to focus on the psychological well being of people who are attracted to boys or girls (n = 140).	76%	18%	7%
Information like this contributes to an adversarial relationship between the mental health professional and the minor-attracted person (n = 141).	9%	19%	72%
Information like this encourages mental health professionals to treat minor-attracted people unethically (n = 138).	12%	17%	71%
I would seek help from a mental health professional who believed information like this (n = 142).	70%	23%	8%
I received treatment that was beneficial to me due to information like this (completed by those who received treatment, n = 38).	26%	45%	29%
I received treatment that was harmful to me due to information like this (completed by those who received treatment, n = 43).	2%	30%	67%

Some comments:

“A positive feature of the text is the way it seeks to remove the 'them verses us' world view.”
“[T]he attitude represented here would be a non-negotiable factor if I ever felt a need for professional help.”

8. A majority of respondents felt that a recent professional article about pedophilia represented the beliefs of most professionals, but was inaccurate and encouraged inadequate, adversarial, and unethical treatment. However, those who received care were divided over whether such articles contributed to harmful treatment for them.

After reading an excerpt from an article about pedophilia published in the Harvard Mental Health Letter, respondents were asked to rate the degree to which they agreed with each of the following statements.

Statement	Agree	Uncertain/ Neutral	Disagree
Information like this is commonly written by mental health professionals and researchers (n = 124).	72%	20%	8%
Information like this reflects the understanding held by the typical mental health professional (n = 127).	69%	28%	4%
Information like this is accurate (n = 123).	14%	16%	70%
The writers seem to want to understand people who are attracted to boys or girls (n = 124).	12%	10%	78%
Information like this encourages mental health professionals to focus on the psychological well being of people who are attracted to boys or girls (n = 124).	6%	10%	84%
Information like this contributes to an adversarial relationship between the mental health professional and the minor-attracted person (n = 123).	81%	8%	11%
Information like this encourages mental health professionals to treat minor-attracted people unethically (n = 125).	74%	15%	11%
I would seek help from a mental health professional who believed information like this (n = 123).	9%	9%	82%
I received treatment that was beneficial to me due to information like this (completed by those who received treatment, n = 32).	9%	22%	69%
I received treatment that was harmful to me due to information like this (completed by those who received treatment, n = 34).	38%	27%	35%

Some comments:

“It refers to ‘pedophiles’ as if they were some kind of dangerous animal, or a threat by default. It is quite offensive.”
“[I]n short, the focus should be on treating individuals, not punishing criminals.”
“[T]he author clearly sees pedophiles as the enemy.”
“Information like this is intended to dehumanize us.”

9. The majority of respondents felt that DSM-related literature about pedophilia represented the beliefs of most professionals, but was inaccurate and encouraged inadequate, adversarial, and unethical treatment.

After reading the description of pedophilia in DSM-IV-TR, respondents were asked to rate the degree to which they agreed with each of the following statements.

Statement	Agree	Uncertain/ Neutral	Disagree
Information like this is commonly written by mental health professionals and researchers (n = 152).	75%	18%	7%
Information like this reflects the understanding held by the typical mental health professional (n = 151).	70%	22%	9%
Information like this is accurate (n = 156).	18%	21%	61%
The writers seem to want to understand people who are attracted to boys or girls (n = 153).	12%	16%	73%
Information like this encourages mental health professionals to focus on the psychological well being of people who are attracted to boys or girls (n = 152).	12%	8%	80%
Information like this contributes to an adversarial relationship between the mental health professional and the minor-attracted person (n = 149).	77%	13%	10%
Information like this encourages mental health professionals to treat minor-attracted people unethically (n = 151).	72%	20%	9%
I would seek help from a mental health professional who believed information like this (n = 150).	10%	15%	75%
I received treatment that was beneficial to me due to information like this (completed by those who received treatment, n = 48).	4%	23%	73%
I received treatment that was harmful to me due to information like this (completed by those who received treatment, n = 43).	37%	30%	33%

Some comments:

“This only serves to strengthen the misunderstanding and hate society at large has for us...”
“What would be the point in seeking out a professional likely to traumatize me with these prejudices?”
“This passage has nothing to do with mental health…It does not assist a mental health provider in providing treatment for a minor attracted person, only in identifying the minor attracted person’s illegal activities with the presumption that they exist.”
“It has little to no focus on pedophiles as human beings.”

After reading an excerpt from the recent literature review supporting DSM-5 revisions, respondents were asked to rate the degree to which they agreed with each of the following statements.

Statement	Agree	Uncertain/ Neutral	Disagree
The recommendations of this article will encourage mental health professionals to focus on the psychological well-being of people who are attracted to minors (n = 129).	10%	27%	63%
The recommendations of this article will contribute to an adversarial relationship between the mental health professional and the minor attracted person (n = 128).	59%	27%	14%
The recommendations of this article will encourage mental health professionals to treat minor attracted people unethically (n = 128).	49%	31%	20%
The recommendations of this article encourage me to seek help from a mental health professional (n = 129).	5%	17%	78%
The author accepts the use of phallometry to accurately diagnose the patient in order to help him achieve mental health (n = 129).	53%	21%	26%
The author accepts the use of phallometry against the patient’s will to discover his attraction to boys or girls (n = 129).	56%	33%	12%

Some comments:

“The article is…buying into the idea that MAPs should be punished as harshly as possible.”
“Isn't the goal of therapy for the person to feel comfortable enough to open up to the therapist about his/her attractions rather than using what amounts to a sexual lie detector?”
“[The article] dehumanizes the pedophile. The phallometric test in this instance is unethical and morally reprehensible. The study is meant to prove something, not to help anyone…”