"One a Day Keeps the Prison Away": Understanding the Experiences of Individuals Convicted of Sexual Offences Receiving Anti-Androgens for the Treatment of Problematic Sexual Arousal.

Problematic sexual arousal (PSA) is an umbrella term to describe a range of clinical presentations related to excessive sexual thinking (e.g., sexual preoccupation) and sexual behavior (e.g., hypersexuality). Although such concepts are known to affect sexual recidivism among individuals convicted of sexual offences, PSA is not routinely or directly targeted in offending behavior programs in England and Wales. However, in recent years, there have been moves to incorporate pharmacological interventions for addressing this among people with sexual offence histories. Although some work to understand the experiences of those taking SSRI medication for this purpose has emerged, little is known about the experiences of service users taking anti-androgen medication. In this study, we interviewed all individuals in prison taking anti-androgens for the treatment of problematic sexual arousal following convictions for sexual offences in England at the time of data collection (N = 10). Using a phenomenologically oriented thematic analysis, we established themes pertaining to "Differing needs: Motivations for treatment," "Medication as a risk management strategy," and how the medication helped the men in their pursuit of "Discovering a 'new me'." This work contributes important knowledge to inform the development of ethical and effective prescribing of anti-androgen medication with this population and offer recommendations for both future research and the development of clinical practice.

Fantasy Sexual Material Use by People with Attractions to Children.

PURPOSE OF REVIEW: With the Internet allowing consumers easy access to fantasy and fictional sexual materials (FSM), it is becoming increasingly important to understand the context of their use among specific populations. Of particular, social, clinical, and legal interest is FSM use by people who are attracted to children and whether this may have a risk-enhancing or protective impact on their likelihood of committing a contact or non-contact sexual offence. RECENT FINDINGS: There is a lack of data currently available in relation to the use of FSM by those with sexual attractions to children. Evidence from allied areas appears to show no meaningful associations between FSM use and sexual aggression. We propose a novel research program and some initial research questions that provide a theoretical framework for more evidence-based inquiry on FSM use by people who experience attractions to children.

Exploring the Psychological Characteristics and Risk-related Cognitions of Individuals Who Own Sex Dolls.

The ownership of sex dolls has become an increasingly controversial social issue over the last five to ten years, with many in society (and academia) calling for the criminalization of such dolls. At the root of these calls is the implicit (and often explicit) assumption that sex doll ownership contributes to increases in negative social attitudes toward women, and sexual offense risk among doll owners. However, there are yet to be any empirical examinations of these claims. In this work we compared the psychological characteristics and comparative sexual aggression proclivities of sex doll owners (n = 158) and a non-owner comparison group (n = 135). We found no substantive differences in most psychological traits. Doll owners scored lower than comparators in relation to sexual aggression proclivity. They were, however, more likely to see women as unknowable, the world as dangerous, and have lower sexual self-esteem. They also had more obsessive and emotionally stable personality styles. We conclude that there is no evidence that sex doll owners pose a greater sexual risk than a non-owning comparison group, before highlighting the need for more evidence-informed social debates about the use of sex dolls in modern society.

"Falling Through the Cracks": A Retrospective Exploration of the Barriers to Help-Seeking Among Men Convicted of Sexual Crimes.

The prevalence and impact of sexual abuse is of global concern, and the alarming rates of victimization have inspired a focus on its prevention. Whilst research has begun to explore the experiences of non-offending individuals to inform prevention initiatives, there is limited exploration of those who have struggled with their sexual interests and go on to commit sexual crime. Arguably these individuals hold key information about gaps in service provision, which may inform approaches to crime prevention. This study aimed to provide a phenomenological exploration of the pre-offense experiences of convicted individuals' beliefs about help-seeking, their desires for support, and any barriers that might have prevented them from coming forward for help. Semi-structured interviews were conducted with 14 individuals convicted of sexual offenses (n = 13 against children; n = 1 sexually motivated violence), and interpretative phenomenological analysis elicited three superordinate themes: Desperation, Barriers to Help-seeking and A Way Forward. The findings shed light on the distressing experience of living with sexual interests that are so openly rejected by society and the many ways participants attempted to cope with this, including multiple failed attempts to seek help. Implications and limitations are discussed.

Identifying and working with appropriate treatment targets with people who are sexually attracted to children.

Research has shown that people within society experience sexual attractions to children, and a substantial number of these seek support related to this. However, professional practices around working with minor-attracted persons (MAPs) are variable. Clinicians possess low levels of knowledge about this population and are unclear about the correct treatment goals. In this work we explored the prioritization of different treatment goals by MAPs (n = 150), before investigating the demographic, sexuality-related, and psychological predictors of treatment target prioritization. Self-compassion drove many treatment targets among MAPs. We offer recommendations about how professionals might work collaboratively and effectively with this population.

Exploring the Ownership of Child-Like Sex Dolls.

There is a fervent social debate ongoing that relates to the ownership of child-like sex dolls. On the one hand, some proponents of dolls suggest that they offer a safe sexual outlet for minor-attracted people (MAPs) and could be used in efforts to prevent the sexual abuse of children. On the other side of the debate, child-like dolls are seen as articles that sexualize children, encourage deviant fantasies, and increase offending risk. To date, no empirical analyses have been undertaken with people who own such dolls. In this paper, we present data from child-like sex doll owners (n = 85) and MAPs who do not own dolls (n = 120) recruited from online forums visited by people who own sex dolls or forums for people with sexual attractions to children. Specifically, we compared their psychological characteristics and proclivities for sexual aggression. Among non-owners, 79.2% of participants declared an interest in owning a sex doll, which is higher than the 20-40% rate reported in adult-attracted samples of non-owners. We found few differences between the groups on most personality variables, with doll owners being less antisocial and anxiously attached than non-owners, but exhibiting more schizotypal traits. Related to offending proclivities, doll ownership was associated with lower levels of sexual preoccupation and self-reported arousal to hypothetical abuse scenarios, but higher levels of sexually objectifying behaviors and anticipated enjoyment of sexual encounters with children. We discuss these data in relation to a functional model of child-like sex doll ownership among MAPs.

Primary Health Professionals' Beliefs, Experiences, and Willingness to Treat Minor-Attracted Persons.

There is a desire and need among minor-attracted persons (MAPs) to access support within the community, and this often begins with an approach to healthcare providers working in general medical/mental health settings. However, little is known about the experiences of these non-specialist professionals in relation to their beliefs, knowledge, and decision-making processes when working with patients who disclose sexual attractions to children. Using an online survey, this study explored the knowledge, comfort, competence, and treatment willingness of 220 non-specialist healthcare providers when faced with patients who disclose sexual attractions to children. We investigated how often such disclosures were made, clinician stigma, treatment priorities, and professionals' willingness to report MAPs to external agencies because of their sexual attractions. Some key differences were found when comparing primary medical vs. mental health professionals, including increased likelihood to view MAPs as dangerous, unable to control behaviors and that sexual attractions are an avoidable choice, in the former group. Both groups prioritized mental health treatment targets above controlling attractions and living with stigmatized attractions, although controlling or changing attractions were still relatively high priorities. Results indicated a need for further training, focusing on increasing comfort around working with MAPs, as this was associated with a greater willingness to work with this group. We identify current gaps in service provision for MAPs seeking professional support and discuss recommendations for professional training.

Humanizing Pedophilia as Stigma Reduction: A Large-Scale Intervention Study.

The stigmatization of people with pedophilic sexual interests is a topic of growing academic and professional consideration, owing to its potential role in moderating pedophiles' emotional well-being, and motivation and engagement in child abuse prevention schemes. Thus, improving attitudes and reducing stigmatization toward this group is of paramount importance. Prior research has suggested that narrative humanization-presenting personal stories of self-identified non-offending pedophiles-could be one route to doing this. However, this work has only been conducted with students or trainee psychotherapists, meaning the public generalizability of this method is still unknown. In this study, we compared two stigma interventions to test whether narratives reduce stigma toward people with pedophilic interests more effectively than an informative alternative (scientific information about pedophilia). Using a longitudinal experimental design with a lack of non-intervention control (initial N = 950; final N = 539), we found that narratives had consistently positive effects on all measured aspects of stigmatization (dangerousness, intentionality), whereas an informative alternative had mixed results, and actually increased perceptions of pedophiles' levels of deviance. These effects were still present four months after the initial presentation. We discuss these data in relation to ongoing debates about treating pedophilia as a public health issue requiring a broad societal approach to well-being and child abuse prevention.

"We Do Exist": The Experiences of Women Living with a Sexual Interest in Minors.

The current body of the literature studying minor-attracted persons (MAPs) predominantly focuses on the experiences of men who experience sexual attractions to children. To shed more light on the experiences of women within this population, we conducted anonymous semi-structured interviews with six self-identified female MAPs, who were recruited through online support forums for individuals with sexual attractions to children. Interpretative phenomenological analysis (IPA) was used to analyze the interview transcripts. Two superordinate themes were identified from the dataset that highlighted the uniqueness of the experience of being a woman within the MAP community ("A minority within a minority") and themes of social isolation and the effects of this on identity ("A lonely secret existence"). The findings reported here highlight how the experiences of female MAPs both converge with and diverge from their male counterparts in important ways. We discuss the implications of these experiences in relation to more effective service provision for women who are sexually attracted to children.

Sex Doll Ownership: An Agenda for Research.

PURPOSE OF REVIEW: The topic of sex doll ownership is becoming an increasingly discussed issue from both a social and legal perspective. This review aims to examine the veracity of the existing psychological, sexological, and legal literature in relation to doll ownership. RECENT FINDINGS: Strong views exist across the spectrum of potential socio-legal positions on sex doll ownership. However, there is an almost total lack of empirical analyses of the psychological characteristics or behavioral implications of doll ownership. As such, existing arguments appear to represent the philosophical positions of those scholars expressing them, rather than being rooted in any objective evidence base. Despite an absence of empirical data on the characteristics and subsequent effects of doll ownership, discussions about the ethical and legal status of doll ownership continue. This highlights a real and urgent need for a coherent research agenda to be advanced in this area of work.

The Internalization of Social Stigma Among Minor-Attracted Persons: Implications for Treatment.

In this article, we sought to build on existing stigmatization research by examining the extent to which internalized stigmatization (i.e., the personal adoption and incorporation of social views, operationalized as thought suppression-an avoidant coping strategy-and low psychological well-being) among minor-attracted persons (MAPs) may impact upon help-seeking behaviors and their avoidance of children. We adopted a cross-sectional anonymous survey design to recruit a sample of self-identified MAPs (N = 183) from prominent online support fora. We found that increased levels of suppression and lower levels of psychological well-being were associated with lower levels of hope about the future, but higher levels of both shame and guilt about having a sexual interest in minors. Thought suppression was not significantly associated with outcomes related to help-seeking behaviors, but did significantly predict higher rates of actively avoiding children, even after controlling for psychological well-being and other emotional variables. Independently, lower levels of self-reported psychological well-being were associated with a desire for more support and higher rates of actively avoiding children. We explore the potential implications of our data in relation to treating and supporting MAPs within the community, increasing their well-being, and encouraging help-seeking behavior.