Sins of the Fathers
Is child molestation a sickness or a crime?
By Thomas Szasz
We use words to label and help us comprehend the world
around us. At the same time, many of the words we use are
like distorting lenses: They make us misperceive and hence
misjudge the object we look at. As Sir James Fitzjames
Stephen, the great 19th-century English jurist, aptly put it,
"Men have an all but incurable propensity to prejudge all the
great questions which interest them by stamping their
prejudices upon their language."
Consider the ongoing scandal involving Roman Catholic
priests accused of molesting boys. American law defines
sexual congress between an adult and a child as a crime. The
American Psychiatric Association defines it as a disease called
Crimes are acts we commit. Diseases are biological processes
that happen to our bodies. Mixing these two concepts by
defining behaviors we disapprove of as diseases is a
bottomless source of confusion and corruption.
That confusion was illustrated by a February 8 letter to The
Boston Globe in which the Rev. John F. Burns defended
Boston Cardinal Bernard Law against critics who said he
ought to resign. As an archbishop, Law had transferred the
Rev. John J. Geoghan to a new parish despite allegations of
sexual abuse. Geoghan eventually was accused of molesting
more than 100 children over three decades.
"It should be noted that neither Cardinal Bernard Law nor
Father John Geoghan was aware early on of the etiology or
pathology of the disease of pedophilia," Burns wrote. "The
cardinal did what an archbishop does best. He showed
kindness and love to an apparent errant priest. Father Geoghan
also did what more recent knowledge shows pedophiles do:
namely, be in total denial, with hardly any remembrance or
remorse for their diseased acts. Calling for the cardinal™s
resignation is absurd. Let the healing begin and the law take its
The law is taking its course not only in the suits filed against
the church by the victims of Geoghan and other abusive
priests. Geoghan himself has been convicted of molestation in
one case and faces trial in another. But if his behavior was
caused by "the disease of pedophilia," a condition that not only
compelled him to fondle boys but erased his memory of those
"diseased acts," how can it be just to punish him? The
uncertainty introduced by viewing sexual abuse as the
symptom of a disease played an important role in the church™s
failure to protect congregants from priests like Geoghan. In a
May 8 deposition, Cardinal Law was asked how he
approached molestation charges. "I viewed this as a pathology,
as a psychological pathology, as an illness," he said.
"Obviously, I viewed it as something that had a moral
component. It was, objectively speaking, a gravely sinful act."
The combination of these two irreconcilable views, medical
and moral, was a recipe for inaction.
Medical Penal Establishment
Today virtually any unwanted behavior, from shopaholism and
kleptomania to sexaholism and pedophilia, may be defined as
a disease whose diagnosis and treatment belong in the
province of the medical system. Disease-making thus has
become similar to lawmaking. Politicians, responsive to
tradition and popular opinion, can define any act, from
teaching slaves to read to the cold-blooded murder of a bank
guard, as a crime whose control belongs in the province of the
criminal justice system.
Applied to behavior, especially sexual behavior, the disease
label combines a description with a covert value judgment.
Masturbation, homosexuality, and the use of nongenital body
parts (especially the mouth and anus) for sexual gratification
have, at one time or place, all been considered sins, crimes,
diseases, normal behaviors, and even therapeutic measures.
For many years psychiatrists imprisoned homosexuals and
tried to "cure" them; now they self-righteously proclaim that
homosexuality is normal and diagnose people who oppose that
view as "homophobic." Psychiatrists diagnose the person who
eats too much as suffering from "bulimia" and the person who
eats too little as suffering from "anorexia nervosa." Similarly,
the person who has too much sex suffers from "sex addiction,"
while the person who shows too little interest in sex suffers
from "sexual aversion disorder." Yet psychiatrists do not
consider celibacy a form of mental illness; celibate persons are
not said to suffer from "anerotica nervosa."
Why not? Because psychiatrists, politicians, and the media
respect the Roman Catholic Church™s definition of celibacy as
a virtue, a "gift from God," even though celibacy is at least as
"abnormal" as homosexuality, which the church continues to
define as a grievous sin -- an "intrinsic evil," in the words of
Cardinal Anthony Bevilacqua. Regardless of how unnatural or
socially destructive a pattern of sexual behavior might be, if
the church declares it to be virtuous -- as with celibacy or
abstinence from nonprocreative sexual acts -- psychiatrists do
not classify it as a disease. Thus a religion™s moral teachings
shape what is ostensibly a scientific judgment.
Conversely, psychiatric diagnoses affect moral judgments.
Fred Berlin, founder of the Johns Hopkins Sexual Disorders
Clinic and a professor of psychiatry at the Johns Hopkins
School of Medicine, declares: "Some research suggests that
some genetic and hormonal abnormalities may play a role [in
pedophilia]....We now recognize that it™s not just a moral
issue, and that nobody chooses to be sexually attracted to
young people." Yet an action that affects other people is
always, by definition, a moral issue, regardless of whether the
actor chooses the proclivity to engage in it.
Berlin misleadingly talks about the involuntariness of being
"sexually attracted to young people." The issue is not sexual
attraction; it is sexual action. A healthy 20-year-old male with
heterosexual interests is likely to be powerfully attracted to
every halfway pretty woman he sees. This does not mean that
he has, or attempts to have, sexual congress with these
women, especially against their will. The entire psychiatric
literature on what used to be called "sexual perversions" is
permeated by the unfounded idea -- always implied,
sometimes asserted -- that "abnormal" sexual impulses are
harder to resist than "normal" ones.
The acceptance of this notion helps explain the widespread
belief that sex offenders are more likely than other criminals
to commit new crimes, an assumption that is not supported by
the evidence. Tracking a sample of state prisoners who were
released in 1983, the Bureau of Justice Statistics found that 52
percent of rapists and 48 percent of other sex offenders were
arrested for a new crime within three years, compared to 60
percent of all violent offenders. The recidivism rates for
nonviolent crimes were even higher: 70 percent for burglary
and 78 percent for car theft, for example.
These numbers suggest that pedophiles resist their impulses
more often than car thieves do. In any case, it is impossible to
verify empirically whether an impulse is resistible. We can
only say whether it was in fact resisted. But that doesn™t
matter, because the purpose of such a pseudomedical claim is
to excuse the actor of moral and legal responsibility.
Catholic officials took advantage of this psychiatric absolution
to avoid dealing decisively with priests who were guilty of
sexual abuse. What do church authorities do when a priest is
accused of molesting children? They send him to a prestigious
psychiatric hospital -- Johns Hopkins in Baltimore, the
Institute of Living in Hartford, the Menninger Foundation in
Topeka -- for "treatment." In practice, the psychiatric hospital
is a safe house for the sexually misbehaving priest, a place
where he can be hidden until he is quietly reassigned to
continue his abuse elsewhere. Berlin claims such priests are
closely watched after being discharged. But a priest who
commits sexual abuse is a criminal who should be imprisoned,
not a patient who should be monitored by psychiatrists in the
Sex with minors was not always considered a disease. In
ancient Greece, sexual relationships between men and boys
were a normal part of life. Such relations, called "pederastic,"
typically occurred between a 20-to-30-year-old man and a 12-
to-17-year-old boy. The man pursued the boy, and the boy
submitted to him as the passive partner in anal sex. The man
also played the role of mentor to his pupil. With the arrival of
heavy pubic hair, usually at age 18, the younger man found a
boy to mentor and get sexual satisfaction from. Sexual
relations between men and young children played no part in
Greek pederasty. Judaism and Christianity redefined same-sex
relations as unnatural and condemned them as sinful. Then, as
criminal laws supplemented or replaced ecclesiastical laws,
same-sex relations became crimes as well. That understanding
governed popular opinion until the rise of secularism and
The first person to propose redefining "pederasty," which in
the 18th century became the term for what we call
homosexuality, appears to have been the French physician
Ambroise Tardieu (1818“1879). In 1857 Tardieu published a
forensic-medical study to assist courts in cases involving
pederasty. Tardieu believed that the penises of active
homosexuals were anatomically different from the penises of
passive homosexuals and "normal" men, that the anuses of
passive homosexuals were anatomically different from the
anuses of active homosexuals and normals, and that physicians
could examine individuals and diagnose homosexuality by
observing these alleged markers.
It remained for Karl Friedrich Otto Westphal (1833“1890), a
famous German neurologist, to convert homosexuality from a
disease identifiable by examining the subject™s body into a
mental illness identifiable by examining the subject™s mind.
Westphal renamed pederasty "sexual inversion" (in German,
"contrary sexual feeling"), a term that was widely used well
into the 20th century. It was also Westphal who popularized
the erroneous idea, still held by many people, that male
homosexuals are effeminate and female homosexuals are
masculine. He argued that since sexual inversion was a disease
it should be treated by doctors rather than punished by law.
A Return to Athens
Creating diseases by coining pseudomedical terms was raised
to the level of art by Baron Richard von Krafft-Ebing
(1840“1902), a German-born professor of psychiatry at the
Universities of Strasbourg, Graz, and Vienna. In his
Psychopathia Sexualis (1886), which made him world famous,
Krafft-Ebing authoritatively renamed sexual sins and crimes
"sexual perversions" and declared them to be "cerebral
neuroses." Lawyers, politicians, and the public embraced this
transformation as the progress of science, instead of
dismissing it as medical megalomania based on nothing more
than the manipulation of language. "Sexology" became an
integral part of medicine and the new science of psychiatry.
We have come a long way from Krafft-Ebing. In July 1998
Temple University psychologist Bruce Rind and two
colleagues published their research on pedophilia in the
Psychological Bulletin, a journal of the American
Psychological Association. The authors concluded that the
deleterious effects on a child of sexual relations with an adult
"were neither pervasive nor typically intense." They
recommended that a child™s "willing encounter with positive
reactions" be called "adult-child sex" instead of "abuse."
Not surprisingly, this conclusion created a furor, which led to
a retraction and apology. Raymond Fowler, chief executive
officer of the American Psychological Association,
acknowledged that the journal™s editors should have evaluated
"the article based on its potential for misinforming the public
policy process, but failed to do so."
Apparently no one noticed that, according to the fourth edition
of the American Psychiatric Association™s Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV, published in
1994), a person meets the criteria for pedophilia only if his
"fantasies, sexual urges, or behaviors cause clinically
significant distress or impairment in social, occupational, or
other important areas of functioning." In short, pedophilia is a
mental illness only if the actor is distressed by his actions.
Psychiatrists had likewise classified homosexuality as a
disease if the individual was dissatisfied with his sexual
orientation ("ego-dystonic homosexuality"), but not if he was
satisfied with it ("ego-syntonic homosexuality"). Bending to
the wind, the American Psychiatric Association later
backtracked. In DSM-IV-TR, published in 2000, the
requirement of "clinically significant distress or impairment"
was omitted from the criteria for pedophilia.
Mental health professionals are not the only "progressives"
eager to legitimize adult-child sex by portraying opposition to
it as old-fashioned antisexual prejudice. In a 1999 article,
Harris Mirkin, a professor of political science at the University
of Missouri-Kansas City, stated that "children are the last
bastion of the old sexual morality." As summarized by The
New York Times, he argued that "the notion of the innocent
child was a social construct, that all intergenerational sex
should not be lumped into one ugly pile and that the panic
over pedophilia fit a pattern of public response to female
sexuality and homosexuality, both of which were once
considered deviant." Mirkin cited precedents such as Greek
pederasty. "Though Americans consider intergenerational sex
to be evil," he wrote, "it has been permissible or obligatory in
many cultures and periods of history." He told the Times: "I
don™t think it™s something where we should just clamp our
heads in horror....In 1900, everybody assumed that
masturbation had grave physical consequences; that didn™t
make it true."
The analogy is fatally flawed. Autoerotic acts differ radically
from heteroerotic acts. Masturbation is something the child
does for himself; it satisfies one of his biological urges. In that
sense, masturbation is similar to urination or defecation. That
is why we do not call masturbation a "sexual relationship," a
term that implies the involvement of two (or more) persons,
one of whom may be an involuntary participant. Masturbation
(in private) is an amoral act: Strictly speaking, it falls outside
the scope of moral considerations. In contrast, every sexual
relationship is intrinsically a moral matter; medical (or
pseudomedical-psychiatric) considerations ought to play no
role in our judgments of such acts. The religiously enlightened
person may view same-sex relations as evil. The
psychologically enlightened person may view any consensual
sex relations as good. Society must decide which sexual acts
are permissible, and individuals must decide which sexual acts
they condemn, condone, or wish to engage in.
The Legal Line
The criminal law defines sex between adults and minors as a
crime. But the law is a blunt instrument. Technically, an 18-
year-old male who has a consensual sexual relationship with a
17-year-old female is committing a criminal act (statutory
rape), even though he might be only one day older than his
partner. Such "crimes" generally are not prosecuted.
Sexual contact between a priest and a 10-year-old boy is quite
another matter, and here is where the medicalization of
unwanted or prohibited behaviors hinders our understanding.
To impress the laity, physicians long ago took to using Greek
and Latin words to describe diseases. For example, they called
inflammation of the lung "pneumonia" and kidney failure
"uremia." The result is that people now think that any Greco-
Latin word ending in ia -- or with the suffix philia or phobia --
is a bona fide disease. This credulity would be humorous if it
were not tragic.
Bibliophilia means the excessive love of books. It does not
mean stealing books from libraries. Pedophilia means the
excessive (sexual) love of children. It does not mean having
sex with them, although that is what people generally have in
mind when they use the term. Because children cannot legally
consent to anything, an adult using a child as a sexual object is
engaging in a wrongful act. Such an act is wrongful because it
entails the use of physical coercion, the threat of such
coercion, or (what comes to the same thing in a relationship
between an adult and a child) the abuse of the adult™s status as
a trusted authority. The outcome of the act -- whether it is
beneficial or detrimental for the child -- is irrelevant for
judging its permissibility.
Saying that a priest who takes sexual advantage of a child
entrusted to his care "suffers from pedophilia" implies that
there is something wrong with his sexual functioning, just as
saying that he suffers from pernicious anemia implies that
there something wrong with the functioning of his
hematopoietic system. If that were the issue, it would be his
problem, not ours. Our problem is that there is something
wrong with him as a moral agent. We ought to focus on his
immorality, and forget about his sexuality.
A priest who has sex with a child commits a grave moral
wrong and also violates the criminal law. He does not treat
himself as if he has a disease before he is apprehended, and we
ought not to treat him that way afterward.
Contributing Editor Thomas Szasz, a professor of psychiatry
emeritus at the SUNY Upstate Medical University in Syracuse,
is the author, most recently, of Liberation by Oppression: A
Comparative Study of Slavery and Psychiatry (Transaction).
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