Today in Baltimore, Maryland, B4U-ACT brought together a range of clinicians, researchers, academics, and minor-attracted persons to discuss key issues regarding the entry for pedophilia in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. The purpose of the meeting was to promote a more comprehensive and accurate DSM. This first symposium of its kind was a success, as 38 people participated in discussion of stimulating presentations by nine distinguished speakers.

The foundation of the symposium was B4U-ACT’s position that the DSM should be based on accurate information about people in the general population. It should be “sensitive to the needs of clinicians and their patients” (as advocated by the APA). Minor-attracted people should be involved in its revision (also advocated by the APA).

B4U-ACT believes that everyone benefits when a variety of reasoned perspectives is heard. Therefore, speakers were allowed to express their views freely and openly. B4U-ACT does not necessarily endorse all of the views expressed. Our policy of free and open expression is in support of the APA’s position that DSM revisions should involve input from “diverse perspectives, disciplines, and areas of expertise,” and that “patient and family” groups be involved. Speakers and attendees specialized in psychiatry, ethics, psychology, philosophy, social work, linguistics, and gender studies.

This kind of scholarly interaction is necessary in light of the numerous unresolved issues raised about the proposed DSM revisions by scholars, researchers, and minor-attracted people. Controversy has arisen over scientific issues, conceptual issues, the purpose of the DSM (to promote mental health vs. social control), and consequences of the DSM entry for society and the people being diagnosed. Information about these controversies can be found at:

www.b4uact.org/science/symp/2011/refs.htm#crit and
www.asexualexplorations.net/home/paraphilia_bibliography

Speakers addressed a diverse range of crucial issues related to the DSM, and discussion was lively. Keynote speaker Dr. Fred Berlin (of Johns Hopkins University) provided a conceptual overview of pedophilia from a psychiatric viewpoint, and argued in favor of acceptance of and compassion for people who are attracted to minors, while at the same time rejecting adult-minor sexual activity. Dr. John Sadler (University of Texas) argued that diagnostic criteria for mental disorders should not be based on concepts of vice since such concepts are subject to shifting social attitudes and doing so diverts mental-health professionals from their role as healers. Dr. Nancy Potter (University of Louisville) analyzed the concept of “uptake” — that is, genuine listening — and argued that by giving uptake to minor-attracted people, those revising the DSM would strengthen DSM-5 and contribute to more ethical treatment, but that minor-attracted people must exhibit accuracy and sincerity in their testimony. Dr. Lisa Cohen (Albert Einstein College of Medicine) presented data on the psychological correlates of pedophilia based on forensic samples, and argued that use of non-forensic samples would help researchers separate factors related to feelings of attraction from those related to behavior, and support the development of improved diagnostic systems.

In the afternoon, Dr. Renee Sorrentino (Harvard Medical School) discussed legal, ethical, and medical consequences of the proposed DSM-5 entry for pedohebephilia. Andrew Hinderliter (University of Illinois) argued that the medicalization of social deviance blurs the boundary between the helping professions and the criminal justice system, creating the potential for psychiatry to become a means of controlling undesirables, rather than an agent of healing. Jacob Breslow (London School of Economics and Political Science) challenged assumptions about minors and sexuality which currently underlie policymaking and the DSM. Richard Kramer (the only speaker representing B4U-ACT), analyzed sources of stigma in the DSM, presented survey data regarding MAPs’ feelings of stigma, and provided recommendations for revising the DSM to reduce stigma.

B4U-ACT is a 501(c)(3) organization that promotes communication and collaboration among minor-attracted persons, mental health professionals, and researchers. Its mission is to increase the availability of accurate information about minor-attracted persons and mental health services that focus on their mental health needs. Inaccurate negative stereotypes force minor-attracted people into hiding, leave young adolescents who are attracted to children hopeless with nowhere to turn, and do nothing to protect children. We have received emails from teenagers as young as 15 who were engaged in self-harming behavior or threatening suicide, and could talk to no one about it, because they were attracted to children. Making welcoming, informed, and empathetic mental health services available is the goal of B4U-ACT.

For more details about the symposium, see https://www.b4uact.org/research/past-symposium/. Please direct any questions to B4U-ACT director of operations Richard Kramer at rkramer@b4uact.org.

July 25, 2011 — B4U-ACT has sent an open letter to the Board of Trustees of the American Psychiatric Association (APA) notifying the organization of the inaccuracies and misleading information contained in the current draft of its Diagnostic and Statistical Manual of Mental Disorders (DSM), currently under revision.

The letter requests the establishment of a working relationship between B4U-ACT and the APA’s work group in charge of revising the diagnostic criteria for pedophilia. B4U-ACT is a 501(c)(3) organization that promotes dialog between mental health professionals and people with a sexual attraction to children or adolescents.

The Diagnostic and Statistical Manual is the authoritative publication of the psychological sciences that provides the profession’s descriptions of mental disorders and their symptoms.

“The current revision of the DSM is full of inaccurate and misleading information on people who are attracted to children or adolescents,” said Howard Kline, science director of B4U-ACT. “It is based on data from prison studies, which completely ignore the existence of those who are law-abiding. The proposed new diagnostic criteria specify ages and frequencies with no scientific basis whatsoever. The DSM should meet a higher standard than that. We can help them, because we are the people they are writing about.”

Co-founder and chair of the B4U-ACT board, Russell Dick, a licensed social worker with 38 years of experience working with people who are attracted to minors said, “People with this attraction struggle to lead lives consistent with society’s rules. If we want them to succeed, we need to give them a reasonable level of support by providing them with welcoming, informed, and empathetic mental health services. The current revision of the DSM hinders that goal.”

Richard Kramer, director of operations for B4U-ACT, added, “Inaccurate negative stereotypes perpetuated by the DSM force people into hiding, leave young adolescents who are attracted to children hopeless with nowhere to turn, and do nothing to protect children. We have tried every available avenue to get the work group to meet with us and begin addressing this problem. We had a conference call with them last June, where it was apparent that they did not understand the stigmatic effects of the DSM. They then reneged on their promise of follow-up communication. Consequently, our only recourse is to go over their heads to the Board of Trustees of the APA itself.”

B4U-ACT is holding a symposium on pedophilia and the DSM in Baltimore on August 17. One of the ways it suggests the APA work group could start working with them is to send a representative to speak at the symposium. The work group has ignored the invitation.

Read the full text of the letter to the APA trustees at https://staging.b4uact.org/wp-content/uploads/2014/08/b4uact-20110713.pdf.

B4U-ACT sent the e-mail letter below to all members of the DSM Paraphilias Subworkgroup and leading officials of the DSM Task Force, inviting them to come and speak at its upcoming symposium. B4U-ACT suggested this as a way to restart the conversation begun the previous summer with a conference call between DSM officials and B4U-ACT, and thereby take steps “to ensure not only that the DSM is founded in sound science, but also that it does not engender stigma or diminish availability of care, and takes valid patient input into account.”

No reply was received.

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Subject: B4U-ACT Symposium on Pedophilia and the DSM
From: Howard Kline
To: Ray Blanchard, Martin Kafka, Richard Krueger, Niklas Langstrom, Kenneth Zucker, David Kupfer, Darrel Regier, William Narrow
CC: Richard Kramer, Russell Dick, Irving M. Binik, Lori A. Brotto, Peggy T. Cohen-Kettenis, Jack Drescher, Cynthia Graham, Heino F. L. Meyer-Bahlburg, Friedemann Pfäfflin, Robert Taylor Segraves
Date: Tue, 03 May 2011 23:50:21

To Dr. Ray Blanchard, members of Paraphilias Subworkgroup, and APA DSM Task Force officials

Dear Gentlemen:

On August 17, B4U-ACT will hold a symposium on “Pedophilia, Minor-Attracted Persons, and the DSM: Issues and Controversies.” All of you have received the call for proposals for this event, which is also available at www.b4uact.org/callforproposals.htm. The purpose of this e-mail is to reach out to you with a special invitation to participate.

The symposium will be a collaborative exchange of ideas among researchers, scholars, clinicians, and minor-attracted people from a variety of disciplines and with a variety of views. We wish to have all views reflected as accurately and fairly as possible. As such, it would be beneficial to have Dr. Blanchard, other members of the Paraphilias Subworkgroup, and/or other representatives of the DSM Task Force present the perspective under review by the APA on these issues. We would like to have at least two DSM-5 representatives speaking at the symposium in order to ensure that your views are well and accurately represented and that the discussion is fair and meaningful. If none or only one of you is available on the date of the symposium, we’d be interested in your recommendation of others who could speak on your behalf.

There is an important reason for the APA to participate in this symposium. Seven of the recipients of this e-mail took part in a conference call with representatives of B4U-ACT in June 2010. Promises were made of specific follow-up by the APA after that call, however none of that follow-up took place despite numerous attempts by B4U-ACT to obtain it. We are reaching back out to you now in an attempt to restart the conversation. We know how busy you are and understand how various pressures on your time may have interrupted your follow-through last summer. However, we also trust that you are committed to “the best interests of patients and those actually or potentially making use of mental health services” [APA Bylaws] and to enabling care to be provided “with compassion and respect for human dignity and rights” [AMA Ethics]. Therefore, we trust that you want to take all reasonable steps to ensure not only that the DSM is founded in sound science, but also that it does not engender stigma or diminish availability of care, and takes valid patient input into account. These objectives are the key focus areas of the symposium.

If none of you is able to participate in the symposium, and if there is no one else to nominate to represent you, then we urge you to delegate one of you to speak with us about an alternative course of action to resume the conversation started with the conference call last summer.

While this is a matter of professionalism for you, for us it is a matter both of professionalism and of life and limb. Legions of minor-attracted people are suffering daily and reporting inability to find compassionate and respectful mental health services. Most are left to cope by themselves, and some fail. Too many, including many teenagers who find themselves attracted to younger children, take their own lives, or try to. We trust that such outcomes are as unsatisfactory to the APA as they are to us. Please work with us to find solutions that properly diagnose disorder and support its appropriate treatment. Please come and speak at our symposium or get back to us about other ways to get our conversation back on track.

Thank you.

Sincerely,
Howard Kline
Science Director
B4U-ACT, Inc.
www.b4uact.org