Sex Fiends, Perverts, and Pedophiles by Leon Chrysanthi S

Author:Leon, Chrysanthi S. [Leon, Chrysanthi S.]
Language: eng
Format: epub, pdf
Published: 0101-01-01T00:00:00+00:00

wide.20 The medicalization of formal social control in the previous era might have provided the opportunity to remedy this, but rehabilitative experts

yielded too much ground too soon and found themselves demonized. In

place of medicalization, management seems to rule.

In 2003, the Annals of the New York Academy of Sciences devoted a spe-

cial issue to sexual offending. Among the expected articles on etiology, treat-

ment, and legal reform was an article that further demonstrates the unique

position of psych experts in the containment era. Laurie O. Robinson, a U.S.

Department of Justice official, wrote “Sex Offender Management: The Public

Policy Challenges.” It is essentially a plea for giving experts a place at the pol-

icy-making table.21 Robinson describes the “knowledge gap” between experts and everyone else.22 But, recalling Bowman, Robinson underplays the uncertainty among experts in favor of advocating for better “translation” of what

experts already know: “The response by government officials is still too often

driven by anecdote and rhetoric rather than by facts, research, and success-

ful practice”—the monster obscures the ability to view some sex offenders as

reformable deviants.

Experts and Governance

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Challenging Psych Expertise

While psychiatrists might tell the public and policy makers that therapeu-

tic interventions could be justified for the undifferentiated mass of “sex

offenders,” in practice, the offenders selected for treatment have always been

a much smaller pool who fit the treatment being offered. Two contempo-

rary examples also highlight the problems psychiatrists face in protecting

the boundaries of their own jurisdiction—first, involving attempts to rede-

fine mental disorders in the DSM, and, second, involving the prerogative to

empirically test popular orthodoxies.

DSM Contestations

The DSM has moved from an internal document to one that is publicly scru-

tinized, especially as it changes definitions of disorders related to sexual-

ity. Previous chapters described debates about whether homosexuality and

rape were properly included in diagnostic criteria—a 1995 outcry shows the

increasing accountability of psychiatry to nonexperts. Revisions to DSM-IV

attempted to correct a general problem that members of the American Psy-

chological Association had identified with the prior version. DSM-IV applied

a new way of describing mental disorders to almost all of its diagnostic cri-

teria—the finding of “clinical significance. ”23 This phrasing was intended to help clinicians distinguish between what society or others might perceive as

deviance or disorder, but which did not disrupt or disturb the subject.

The uniformly applied “clinical significance” language meant that the defi-

nition of paraphilia in DSM-IV included the phrase “the fantasies, sexual urges,

or behaviors cause clinically significant distress or impairment in social, occu-

pational, or other important areas of functioning. ”24 This definitional change was perceived by the public as “normalizing pedophilia” because it appeared to

exclude child molesters, for example, who suffered no distress or regret.25

The significance of all this is that psychiatry’s internal attempts to resolve

a definitional problem left the discipline open to policy criticism. One

review of the misunderstanding stated, “Admittedly, it is difficult to know

how to draw a boundary between variations in normative sexual fantasies

and behavior and clearly pathological sexual behavior. ”26 But the reaction to this boundary drawing suggested that psych experts had better choose a very

inclusive boundary in the future.

The APA is taking a very long time

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