I’m not aware of any solid evidence regarding a genetic basis for pedophilia. The closest I’ve seen is a Finnish study led by Katarina Olanko, published in 2013, that found evidence for a modest genetic influence on sexual interest in children and youth up to age 16. That age range includes pedophilia, but it also includes pubescent children and postpubescent teens.

We make a distinction clinically and in research between people with an exclusive sexual interest in children and people with a nonexclusive interest, where they might be attracted to adolescents or adults as well.

In my motivation-facilitation model of sexual offending against children, I distinguish between motivations for offending, such as pedophilia and factors that can facilitate acting on that motivation. In particular, I think the research evidence is strong that people with antisocial personality traits such as impulsivity and callousness are more likely to act. We also have multiple studies that have shown that people who endorse particular attitudes and beliefs (e.g., that children are not harmed by sexual contact with an adult) are more likely to act. Last, there are again multiple studies that show that people who emotionally identify with children or fall in love with children are more likely to act.

For me, a warning flag would be the prior relationship between the adult and minor. I think most adults do not knowingly engage in ongoing personal conversations with someone they know or learn is a minor when they don’t have a prior relationship. They might have an online conversation about a shared interest, such as a video game, but would not persist in asking personal questions such as whether the minor is dating or what they look like. The challenge in terms of flagging suspicious interactions is that online sexual interactions can and sometimes are initiated by someone the minor already knows, whether it’s a relative, friend of an older sibling, or a trusted adult (e.g., coach or tutor).

One difference between pedophilia and obsessive-compulsive disorder where the person is concerned they have pedophilia is the person’s emotional reaction: Some people with pedophilia are distressed by their sexual interest in children, but others are not; in contrast, all the people with OCD are significantly distressed. Perhaps the biggest difference is in the sexual salience of thoughts or urges regarding children. People with pedophilia are sexually attracted to children, by definition, and this attraction might be manifested in pleasurable sexual fantasies about children, subjective and physical sexual arousal to children, and masturbation while thinking about children or looking at images of children. People with OCD do not find sexual thoughts about children to be pleasurable, are not sexually aroused by these thoughts (though they may misinterpret signs of anxiety as signs of arousal), and do not masturbate while thinking about children.

I agree with Brené Brown that there’s an important difference between feelings of guilt and shame. Guilt is a feeling centered on behaviour, as when we feel bad because we realize we’ve done something wrong. Shame, on the other hand, is a feeling centered on the person, as when someone feels ashamed of themselves for something they’ve done. Guilt can motivate rehabilitation by motivating the person to change their behavior, whereas shame might actually interfere with rehabilitation because the person thinks they cannot change, because it’s part of themselves, or copes with the feelings of shame by avoiding anything related to it.

In my review of studies with self-reported as well as officially detected offending (, we found that about half of those who committed child sexual exploitation image offenses had sexual contact with a child.

(Seto, M. C., Karl Hanson, R., & Babchishin, K. M. (2011). Contact Sexual Offending by Men With Online Sexual Offenses. Sexual Abuse, 23(1), 124–145.)

In our research, we have found that a majority of men who view child sexual exploitation images have pedophilia and were seeking content that matched their sexual interests. There is some newer research that does suggest that a minority of individuals show an escalation of pornography use from conventional adult content to more taboo or extreme adult content, and then to illegal content such as depictions of children.

We don’t have any long-term outcome research for pedophilic people. The closest we come are long-term outcome studies for treatment of men who have sexually offended against children, but not all of them are pedophilic.

I think the general consensus is that we cannot change pedophilia through psychological therapy. The goals of therapy instead are to help the person cope with having such a stigmatized sexual interest, and teaching skills that help them better manage this sexual interest. This typically includes cognitive-behavioral techniques to identify situations associated with urges to use child sexual content or to have sexual contact with children, and then developing coping strategies.

Chronophilias is a term used to refer to the entire spectrum of age-related paraphilias. This includes pedophilia (prepubescent children) but also includes nepiophilia (infants/toddlers), hebephilia (pubescent children), and older adults (mesophilia: middle-aged adults; gerontophilia: elderly).