Subjective causes of SIC

A total of 86.0% answered the question on the assumed cause of their SIC. Table 2 shows all response categories and how often they occurred. The largest category consists of assumed causes that lie in the participants’ own childhood or at least in their past. For example, the answer

“Because of my own trauma history.”

Table 2 Response categories for the subjective cause of SIC in female participants (n = 43).

was categorized as own victimization. This subjective estimation adds to environmental theories among researchers claiming that SIC develops in the course of a social learning process (e.g., [14]). It is assumed that individuals who were sexually abused during their childhood become sexually attracted to children during adulthood and may have the desire to sexually offend against children because they repeat the abuse they experienced as children. At least, self-experienced sexual abuse is more common among men with SIC than among others (e.g., [15]). Some participants in the present study reported non-abusive sexual experiences as the reason for their SIC. For example, one participant referred to her past sexual experiences with her younger brother that helped both of them to survive sexual abuse:

“With my little brother I had a wonderful innocent tendered love and sexual relationship that helped us and strengthened us for the world to survive against sexual abuse, school anxiety, bullying…”

Another participant described jointly masturbation with her older sister as the reason for her SIC stating that this experience is the most intense and most positive memory of her childhood. She further explained that a few years later she did the same with her younger cousin and then with the little sister of a friend. She was sexually aroused by the fact that she acted as a kind of teacher showing the younger girls how their body works. Finally she stated:

“…that pattern remained although I grew older. You cannot tell a 20-year old how their body functions.”

These responses are in line with considerations grounded on learning theories assuming that during first sexual experiences with children of the same age there might be a conditioned coupling of previously neutral stimuli (e.g., a child’s body schema) with unconditioned sexual satisfaction which causes a SIC [16]. Four participants named other past experiences that were not explicitly sexual or abusive, e.g.:

“An early puberty triggered by steroids from asthma breathing treatments.”

Nine participants referred to characteristics of children/adolescents as the cause for their SIC, e.g.:

“… I found boys/young men beautiful”

or described an emotional affiliation with children/the childish world, e.g.:

“… I envy the beautiful way that children see the world without sexuality clouding their vision. I hate the adult world for trying to pervert them. I want to be a child again,…”

Such features remind of the concept of emotional congruence with children which is associated with an exaggerated cognitive and emotional affiliation with childhood, child-like characteristics, strong non-sexual liking of children, and positive views of children and childhood [17]. It has been shown that emotional congruence with children is related to pedophilic interest and sexual recidivism risk among men who sexually offended against children [18]. Future research should find out to what degree the concept of emotional congruence with children is also important in women with SIC. Some participants specified that their SIC is a disposition, e.g.:

“I was born with it.”

which fits the assumption that a genetic component has an influence on the development of sexual interest and masturbation fantasies. In fact, Alanko et al. [19] reported that among participants with a SIC a non-additive genetic component could explain 14.6% of the total variance in the data. In contrast, environmental influences that were not shared by the twins explained 85.4% of the total variance indicating that the environment has a greater influence on SIC then genes [19].

Four participants reported that their general sexual desire is the reason for their SIC, e.g.:

“Because I like sex and because it is beautiful/awesome to me.”

Research has shown that a sexual interest in children can occur in the context of compulsive sexual behavior [20]. Thus, these participants may not have a sexual interest in children in terms of pedophilia but rather might show indicators for sexual preoccupation or compulsive sexual behavior. Finally, one woman stated that external pressure caused her SIC:

“I was persuaded by my boyfriend at the beginning. But it was good for me and then I was attracted to it.”

Some participants of the present study mentioned more than one reason for their SIC, e.g.:

“I think that the major cause is disposition… Eventually the emotional abuse and mental violence during my childhood contributed to the anchoring of the preference during puberty because I felt emotionally closer to children and I partly still do today.”

This participant reported both a disposition and past experiences causing her SIC and additionally addressed an emotional affiliation with children/the childish world.

Ten participants answered that they had no idea why they have a SIC.

Experiences with disclosure

A total of 56.0% disclosed to another person and answered the question on the reactions to their disclosure (Table 3). Most participants reported positive reactions after disclosing. Both results are in line with those by Wagner et al. [21] who reported that about half of their male sample directly disclosed to another person which was rather associated with positive consequences, such as social acceptance. On the one hand, it might be that people rather react positive to a known person who admits to be sexually interest in children. This would imply that individuals with SIC should be encouraged to open up to the people around them in order to overcome the feeling of isolation. On the other hand, and more likely, individuals with SIC may anticipate how the people around them will react and obviously rather disclose to people whose reaction are expectedly positive. One participant reported unspecified positive reactions and support:

“Reactions have been uniformly positive and supportive. I am careful about who I confide in.”

Table 3 Response categories for the reactions to disclosure of SIC of the female participants (n = 28).

This response not only shows that the women made positive experiences with her disclosure but also reflects that she saw the need of being aware who she tells about her SIC. As society overestimates the relation between SIC and sexual offending against children, at least, men with SIC are generally seen as dangerous [22]. The stereotype of dangerousness is strongly connected to desires to punish or to avoid the men with SIC. As a consequence, men with SIC fear the disclosure of their SIC and make efforts to cover it up since they are afraid of negative social consequences [22]. Although these results need to be validated in female samples, it can be assumed that women with SIC also anticipate negative reactions and thus decide to not disclose. Some participants mentioned that they experienced acceptance by the other persons, e.g.:

“…They accept me regardless.”

or stated that they were supported by the people around them, e.g.:

“She has been supportive.

Four participants reported that the other person agreed with the SIC:

“My partner is pedophilic himself and therefore reacted calmly.”

Three participants claimed that the person reacted by understanding, e.g.:

“Showed a lot of understanding.”

Few participants mentioned negative reactions of the other person including disbelief, e.g.:

“Restrained, I was only taken seriously to a limited degree. I have a husband and an active sex life. It has to be imagination.”

It can be assumed that people generally think that SIC is a male phenomenon. Thus, when a women mentions having a SIC people probably tend to minimize that statement and do not take the women seriously. The six women with SIC that were interviewed by Lievesley and Lapworth [6] claimed that women with SIC are a ‘minority within a minority’. They felt overlooked in social discussions about SIC as people do not recognize that women with SIC exist [6]. Furthermore, as far as we know so far it seems to be common for women with SIC to have an adult partner and a sex life as most women with SIC from the current sample also reported a sexual interest in adults [7]. Thereby their SIC mays not be detectable from the outside.

Two participants stated that the person they disclosed to responded by contact termination, e.g.:

“Frightened in the first instance—she sealed herself off and did not want to have contact for a while (3 month)…“,

And one answer included shame and disgust:

“Mother cried and was speechless. Asked many questions. Said she would feel shame and disgust…”

This woman further revealed that her mother later searched for information on the internet regarding a prevention program where the woman participated. Her brother expressed his need for communication with another person:

“…Brother …asked me for permission to speak with a trusted person.”

One participant mentioned an unspecified negative reaction:

Finally, five participants mentioned neutral reactions, e.g.:

“Predominantly positive or neutral.”

At least for men, research has shown that negative social consequences after disclosing that one is sexually attracted to children, such as social ostracism, can lead to more emotional and social problems which may in turn even increase the risk of offending against children [23]. The participant mentioned above who experienced contact termination for three months further described that later she was able to explain everything to the person and that they became friends. However, the narrative indicates that she experienced the three month of non-contact as negative before she became friend with the other person. It appears to be relevant to investigate the long-term effects of negative consequences after disclosing that one has a SIC among females.

Reasons for non-disclosure

A total of 44.0% of participants stated that they did not disclose to anyone mainly due to the fear of certain consequences (Table 4). This confirms research on stigma in men with SIC mentioned above (e.g., [22]). One participant described her fear of rejection of her best friend:

“I could never talk about it to anyone, not even to my best friend, because I have great fear that she finds me repulsive or that I cannot see her anymore.”

Table 4 Response categories for the reasons for non-disclosure (n = 22).

Another participant specified her fear of rejection and her fear of stigmatization and other negative consequences as follows:

“Fear of getting stigmatized and ostracized; and of police investigations, although I have never done anything. It could harm my family when others know. I do not want to be bullied or to get physically attacked.”

Some participants referred to unspecified fears, e.g.:

Similar to our participants, the women examined by Lievesley and Lapworth [6] indicated that they perceive risks associated with disclosure of their SIC. The authors refer to the possible consequences of internalizing a social stigma that can be observed in sexual minority adults including depression, anxiety, substance abuse, and suicidality (e.g., [24]). It can be presumed that such consequences may be also relevant for women with SIC. In line, 40.0% of our participants reported that they have been diagnosed with a mental illness and mainly specified that it was the diagnosis depression.

Of course, non-disclosure can protect affected individuals from stigma and discrimination. However, concealing can also make it difficult to find social support [25] and may lead to isolation and loneliness in women with SIC [6]. Therefore, women with SIC should be encouraged to disclose to persons they trust and/or to professionals as most women in the present study experienced positive consequences from doing so. Nevertheless, our results also demonstrated that there are risks associated with the disclosure of SIC. Additionally, research has proven that people in general wish to punish or to avoid men with SIC [22]. Ultimately, there probably is no general rule in terms of disclosure of SIC. Affected women need to make an individual decision and at best, they are supported by professionals who have experience in treating individuals with SIC. Three participants further mentioned taboo as the reason why they do not disclose, e.g.;

Two participants named shame as the reason for their non-disclosure which in one case seems to be related to the stigmatization of SIC:

“I feel ashamed to admit this to a trusted person. After all, it is a delicate and stigmatized topic.”

Another participant claimed no need for disclosure of her SIC by writing:

„ I don’t want to, it’s private, like my sexuality (bisexual)…”

She further explained that a disclosure would have negative consequences:

“…And I know it would be very dangerous, and they would never accept it.”

which indicates that her shame may be based on her fear of other negative consequences.

Two participants indicated that they had no idea why they do not disclose to another person.

Experiences with professional help

A total of 30.0% of participants reported having sought help due to their SIC and most experiences with professional help appear to be negative (Table 5). This result is in line with research showing men with SIC mostly report negative consequences (e.g., inappropriate treatment methods and stigmatization) when they disclose to general professionals in the health care system [21]. Five participants in the present study reported that the professionals were not helpful, e.g.:

“No help for coping.”

Table 5 Response categories for experiences with professional help (n = 15).

Some participants described that the professionals’ reaction included disbelief, e.g.:

“They try to convince me it’s a phase.”

This result indicates that there are professionals in the health care system who think that SIC cannot exist in females. Obviously there has to be more information among professionals regarding SIC in women. Although SIC does not necessarily lead to child sexual abuse, research on male samples demonstrated that SIC contributes to child sexual abuse [26] and has been proven to be one of the most important risk factors for sexual recidivism among men [27]. As it cannot be assumed that this male-based finding applies to women, research to that effect is needed. Two participants stated that they had no courage/no trust in professionals, e.g.:

“…Trying to start therapy again but it’s so difficult to trust again. I just want help and to make good choices…”

One participant also mentioned that she felt her therapist was disgusted:

“My outpatient therapist was not a big help to me. She condoned the topic but we hardly talked about it. During the last session, I felt like I could grab her disgust.”

In another context she even experienced rejection by the health care system:

“When I brought up the topic during a hospital stay, they had a team meeting discussing whether it is still possible that I was further treated on that ward.”

This outlines how important it is that general professionals in the health care system are well educated concerning SIC. As they are part of the society they may also believe that people with SIC automatically conduct child sexual abuse and cannot imagine that part of them decide to not act on their SIC. However, the same participant also reported positive experiences with professionals in other contexts:

„The psychologist at my last hospital stay was very calm and never seemed to be disgusted or emotional; I could talk about it to her without having the feeling to be judged.”

This participant highlighted that she did felt no judgment due to her SIC indicating that she felt accepted. Since SIC is a highly stigmatized topic (e.g., [22]), it seems plausible that the feeling of being accepted and not judged may be of high importance when treating women with SIC. Compared to men, it might be even more relevant for women to feel accepted given their greater need for affiliation [28]. Two women reported that their experiences were helpful, e.g.:

“…Therapist was not specialized in this area, but could give me some helpful exercises I can apply in everyday life…”

The same participant stated that her therapist shows genuine interest and empathy. A further participant mentioned:

“Good: I am not alone.”

This quote indicates that the good experience of this participant was that she felt not alone. Similar to acceptance, the feeling of not being alone may be highly relevant in the treatment of women with SIC as they possibly carry a sense of isolation and loneliness [6]. One participant reported unspecified positive experiences after a period of disbelief:

“Negative experiences at the beginning since I was not taken seriously because I was so young. Afterwards positive experiences, but then I was older.”

Finally, one participant claimed neutral experiences:

“Therapists predominantly reacted neutral…”

We consider the consequences these experiences—either positive, nor negative, nor neutral – may have on the individual course of women with SIC to be relevant. It seems at least reasonable that the women in the present study who made negative experiences possibly tend to avoid further contacts to professionals regarding their SIC. Positive experiences on the other hand may encourage women with SIC to stay in treatment which might be a protective factor against child sexual abuse. Future research should address the question which impact such experiences can have on women with SIC and on their possible risk to sexually abuse children.

Suggestions for how to reach women with SIC

A total of 78.0% of participants answered the question on how to reach women with SIC who are in need of professional help (Table 6) indicating that the stigmatization of individuals with SIC appears to be the biggest barrier for reaching women with SIC. In addition to the destigmatization, some also mentioned the assurance of anonymity as important, e.g.:

“Internet, anonymously, without stigmatization and fear of punishment.”

Table 6 Response categories for the question on how to reach women with SIC to offer help (n = 39).

Based on our results, it appears that women with SIC struggle with the same problems as men with SIC regarding stigmatization [22] and fear of negative consequences [21]. Some participants also stated that there need to be more aware that women with SIC exist, e.g.:

„First of all there is a need for more enlightenment regarding this topic. In people’s minds men are still the ones that have a sexual interest in children/adolescents…”

She further explained that females might already be reached at school when they are adolescents who eventually develop a SIC. The students should be enlightened about prevention programs so that they know where to find help in the future. The participant added that special treatment programs for women with SIC are necessary:

„…An additional program would make sense addressing women. I think men and women should not be mixed up here.”

One participant stated that self-acceptance is needed:

“…The most important step is to be honest with you and to accept yourself, so that you can talk about it and work on it…”

Eight women suggested using media and advertising to reach out for women with SIC, e.g.:

“…flyers at pediatricians?…”

or

“Raise awareness through TV and internet ads…”

Our results show that women with SIC appear to be aware of the social stigma that surrounds pedophilia. Many females in the present study clearly mentioned the need for destigmatization of people with SIC. They considered a feeling of acceptance relevant in order to reach women with SIC to offer help and partly highlighted that special treatment program for women should be implemented. It seems to be necessary to raise awareness for this topic among the general public and targeted professional groups. Regarding treatment features, one participant underlined the importance of supportive therapists referring again to the negative experiences she made during her last treatment:

“…I wish therapists understood that the best thing for everyone is to actually be supportive instead of abusive. I’m seriously hurting about this last therapist I trusted.”

And one participant spoke out against the enforcement to sex with adults:

“Don’t encourage us to have sex with adults to change things bc it is traumatic for us and makes us feel like we are being raped.”

At least five participants claimed that the legalization of sexual contacts with children would help women with SIC, e.g.:

„Tenderness and consensual sex and motherly love should be decriminalize, that would be better for all and a better protection for children of exploitative and violent sexual relationships.”

This participant described her relationship with her daughter as more intimate then the relationship to her husband. It might be assumed that she conduct sexual acts with her daughter as she seems to be convinced that “consensual sex and motherly love” with children is supposed to protect children from sexual violence. Some research results indicate that cognitive distortions found in men regarding sexual acts with children also are relevant in women who sexually offended against children. For example, Beech et al. [29] analyzed interviews among 15 women who were incarcerated for child sexual abuse. The authors found that implicit theories underlying men’s cognitions who sexually offended against children for the most part could be identified in women. One of these implicit theories implies seeing children as sexual objects and being sexually attracted to or aroused by the abused children. The abused children are considered to enjoy the sexual offending behavior and actively seek to repeat the experiences [29]. Other research results indicate that women who sexually offend against children are less likely than men to be characterized by motivations and cognitions associated with the sexualization of children (e.g., [30]). Cognitive distortions have been demonstrated to be a risk factor for recidivism in men who sexually abused children [31]. Further research is needed to determine whether this male-based finding applies to women. Three participants mentioned that reaching out for women with SIC is not possible, e.g.:

“…Unless a pedo reaches out to you, there’s no way you can know and reach out to them…”

Nine participants specified that they had no idea how to reach women with SIC.

Limitations

The major limitation of the present study is that the sample is small and not representative. Moreover, ten participants entered the study via the English study link. The English version of the study was translated by someone whose first language is English from a translation company. The translation and cultural adaptation of a questionnaire should include a forward-backward translation by qualified translators as well as subsequent validation and harmonization processes. In addition, one participant entered the survey via a German study link, but appears to be not German-speaking. Free text fields showed that this participant answered in English. However, the response pattern of this participant was fully comprehensible and consistent. We were additionally not able to identify and exclude females with obsessive–compulsive disorder including obsessions related to children that do not indicate a SIC in the sense of pedophilia [32]. At least, two participants reported that they were given the diagnosis obsessive compulsive behavior during their life time. Finally, it has to be mentioned that the present results were partly discussed referring to findings on men with SIC or men who sexually abused children that were not validated on female samples. As previous research revealed that there are remarkable differences between men and women in terms of sexuality (e.g., [8]), findings in men are not necessarily transferable to women regarding SIC. In summary, the validity and generalizability of the present results are therefore limited.