Interview | Klaus Beier Health

‘To do nothing is not the answer’

Portrait Professor Klaus, Beier

Portrait Professor Klaus, Beier   | Photo Credit: Thomas Farr

Primary prevention approach targeted at paedophiles can reduce risk factors for child sexual abuse

Dr. Klaus Beier, director, Institute of Sexology and Sexual Medicine at the Charite University, Berlin, is a pioneer in research on paedophiles. He will deliver a lecture in Chennai on Monday on ‘Paedophilia and Sexual Offending against Children: How to Prevent Child Sexual Abuse and the Use of Child Abusive Images.’ Earlier, he spoke to The Hindu in Mumbai about his work.

You run the only programme in the world with a targeted approach to treating paedophiles. How did it start?

Official statistics account for only a fraction of all child sexual abuse (CSA) and the use of child abusive images (so-called ‘child pornography offences’, or CPO). The cases not reported constitute a large part of sexual offences against children and are referred to as dunkelfeld (dark field) in German. Consequently, preventive efforts must consider primary prevention in the case of potential offenders in the dunkelfeld.

According to empirical data, there are two groups of child sexual offenders: those showing no sexual preference disorder, but who, for different reasons, sexually abuse children. These are mentally handicapped perpetrators, offenders with antisocial personality disorder and within generally traumatising family constellations, including physical, emotional and sexual abuse. This group comprises approximately 60% of officially-known offenders. The second group comprises those showing a sexual preference disorder, namely paedophilia or hebephilia (erotic preference for early pubescent minors). These account for approximately 40% of officially-known offenders.

Sexual preference, in general, manifests itself during adolescence and remains unchanged thereafter. Thus, paedophiles and hebephiles will always be at risk of offending and/or re-offending, mainly in the dunkelfeld. For that reason, at the Institute of Sexology and Sexual Medicine in Berlin, a prevention approach was developed by generating a media campaign to encourage self-identified (but officially unregistered) paedophiles and hebephiles to seek professional help and avoid committing CSA and CPO.

What is your approach to treating paedophilia, given that there is no permanent cure?

Paedophilia manifests like any other sexual orientation during puberty and remains stable during [the paedophile’s] lifetime. All sexual orientations endure and are not changeable. There has never been any evidence of sexual orientation change using different therapy techniques. So the treatment focuses on behaviour control.

In a specialised one-year treatment programme, participants learn to ensure impulse control by using cognitive-behavioural techniques, sexological tools like integrating sexual preference into their self-concept and pharmaceutical options, mostly androgene deprivation therapy. The project’s evaluation was done in a non-randomised waiting list-control design with multiple assessments for 75 participants. It revealed that primary prevention approach reduces risk factors for child sexual abuse, prevents sexual offences against minors and reduces the number of contact offences.

In most cases, paedophiles commit offences before treatment. Would identifying early signs and awareness make a difference?

Empirical data suggests paedophiles and hebephiles reveal high levels of co-morbidity and distress because of the problems associated with their sexual preference. As a result, they are more likely than other sexual offenders to seek treatment. Mostly, a man inclined to paedophilia wants a way out but has no option. This is where we come in. These people suffer from low self-esteem, depression, lack of concentration, anxiety and loss of strength, among other symptoms. However, community-based specialised diagnostic and therapeutic programmes for these individuals remain scarce.

Are there plans to roll out your programme in India?

There are plans to roll out the programme internationally. Paedophilia is a part of human sexuality and we can assume that it is to be found in every culture, in every country. According to the World Health Organisation and their International Classification of Diseases (ICD), paedophilia is a diagnosis, not a crime. Child pornography is a topic of international concern, because of the internet and accessibility in nearly every country. All over the world, a huge dunkelfeld can be assumed. To do nothing is just not the answer. The use of child abusive images in one country leads to more availability of child pornography in other countries. There should be no contradiction between law enforcement and the promotion of preventive strategies, and both can be done.

Is there a need to tweak the approach for India?

Definitely. It is always necessary to take the cultural particularities into account. This is true for every country. There are legal aspects to be aware of like the mandatory report law in India, and the strong systems of social layers, castes and families embedded in historical roots of enormous power.

Quoting a report by the Ministry of Women and Child development, India has a high prevalence of child sexual abuse: about 20% of the children [are victims] and it is one of the rare countries where boys are more abused than girls. This is a huge public health issue. It is well-established that childhood adversity, including sexual abuse, dramatically increases the risk for developing a wide range of psychiatric disorders and certain medical diseases. This fact should stimulate our mutual efforts concerning primary prevention.

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Printable version | Feb 17, 2020 5:49:29 AM | https://www.thehindu.com/sci-tech/health/to-do-nothing-is-not-the-answer/article17416101.ece

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