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A Dissenting Opinion on DSM-5 Pedophilic Disorder

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Notes

  1. DSM-IV-TR lists three diagnostic criteria for pedophilia. The one relevant to this Letter is Criterion A, which describes the nature of the paraphilia: “Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger)” (American Psychiatric Association, 2000, p. 572).

  2. There are five Tanner stages of physical development, with Tanner Stage 1 indicating prepuberty and Tanner Stage 5 indicating full maturation (Marshall & Tanner, 1969, 1970; Tanner, 1978). Tanner stages pertain to breast development and pubic hair growth in females, and to genital development and pubic hair growth in males. The stages of present relevance may be briefly described as follows. Tanner Stage 1: girls, no palpable breast tissue; boys, genitals similar to early childhood; both sexes, no pubic hair at all. Tanner Stage 2: girls, breast bud stage; boys, enlargement of scrotum and testes, with change in the color and texture of scrotal skin; both sexes, sparse growth of long, slightly pigmented downy hair, appearing mainly along the labia or base of the penis. Tanner Stage 3: girls, further enlargement of breast and areola with no separation of their contours; boys, growth of the penis and testes to half adult size or less; both sexes, pubic hair is darker and coarser, but lesser in quantity and different in quality from adult type.

  3. The average age at which the onset of puberty occurs has been dropping for at least 150 years, and research indicates that it has continued to drop over the last few decades (e.g., Biro et al., 2010). In a multi-site study, for example, Biro et al. found that 18.3 % of white girls, 42.9 % of Black non-Hispanic girls, and 30.9 % of Hispanic girls had started puberty by the age of 8 years. A study on boys (Herman-Giddens et al., 2012) found comparable results for boys at age 9. By this age, 26.1 % of white boys, 43.4 % of African-American boys, and 44.4 % of Hispanic boys had started puberty, as indicated by Tanner Stage 2 (or higher) of genital development.

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Blanchard, R. A Dissenting Opinion on DSM-5 Pedophilic Disorder. Arch Sex Behav 42, 675–678 (2013). https://doi.org/10.1007/s10508-013-0117-x

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