Key words: Paraphilia Sexual disorder Sexual deviance
This paper is based on Dr. Fedoroff's Academic Lecture to the Canadian Sex Research Forum meeting, Toronto, September, 1997.
Individuals who commit sex crimes present problems for everyone who deals with or is affected by them. Among those who commit such crimes, some are caught, some are convicted, and some are eventually sent to mental health care providers. Although many are never caught and never get help, a growing number seek help through such avenues as: self-help groups like Sex and Love Addicts Anonymous; chat-rooms on the internet; reading books and watching afternoon talk shows; or presenting with vague or unusual complaints (e.g., "Doc, I think I like sex too much"). They are, by definition, criminal and they are always in hiding, despised even by other criminals. They are the subject of increasing media attention which is at once salacious, superficially probing, and almost universally condemning. Victims of sex crimes have become increasingly vocal and have lobbied for the attention of politicians who, in turn, have become convinced that sex crimes are a new epidemic which cries out for corrective legislative countermeasures.
With so many powerful interest groups converging on the issue of sex offenders and what to do with them, it is important that the scientific community be sure of what it is saying. It is important that mental health experts make clear how much of what they are saying is opinion and how much is known scientifically. When a statement is communicated as a fact, it is important that the reasons for believing it and the limitations of evidence supporting the "fact" be stated. The topic of treatment of sex offenders is a "hot potato" that, if not handled correctly, will damage the reputation of the mental health field. Unfortunately, this is among the most complex, controversial, and political topics faced by mental health care professionals. There seems to be something about sex that makes even scientists stop thinking logically. For example, penile plethysmography or phallometry is an experimental procedure used to measure sexual arousal patterns. Virtually every expert who has written about phallometry has cautioned that it is insufficiently sensitive or specific to be used to determine the guilt or innocence of a person accused of a sex crime. A simple mathematical example will indicate the problem. Without knowing the figure, let's assume that 5% of the male population is pedophilic. Assume also that phallometry is 95% accurate (i.e., will correctly identify a pedophile 95% of the time and correctly identify a non-pedophile 95% of the time). Under such circumstances, in a random phallometric testing of the male population, there would be a 50% chance that a man who tested positive was not a pedophile, and hence would be misidentified. [NOTE: of every 100 men tested, 4.75 of the 5 pedophiles would test positive and 4.75 of the 95 non-pedophiles would test positive.] This somewhat counter-intuitive mathematical fact (Savant, 1996) is rarely heard by the courts. Admittedly, the men who find themselves in circumstances where such phallometric testing is done are not a random sample of the population. Nevertheless, courts frequently allow admission of evidence from phallometric testing without an explanation of its limitations.
Similarly, statements that are poorly supported by the scientific literature are made daily about the nature of sex offenders, even by experts. The purpose of this paper is to alert those who deal with sexual offences and sex offenders to some common assumptions that are poorly supported by scientific evidence.
Several currently popular statements about sex offenders are reviewed. For the purpose of this paper, no attempt is made to exhaustively review the literature. Rather, flaws in currently cited literature and/or unacknowledged …