Overview of Sex Offenders and the Paraphilias

• Author: Howard Barbaree, David Greenberg, and Renée Fugère
• Pages: 765-782

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CHAPTER 36

Overview of Sex Of‌fenders

and the Paraphilias

Howard Barbaree, David Greenberg, and Renée Fugère

I. INTRODUCTION

is chapter begins by dening several related terms, namely, sexual deviance, sexual abuse, and sexual

crime. is discussion, originally presented in Barbaree and Langton (2006), is included as a background

to the important distinction in forensic psychiatry between the diagnostic and legal characterization of

sex oenders. (A similar, but more detailed, discussion is contained in Chapter 45 to assist in under-

standing the distinction between adolescent sexual activity and juvenile sex oending.) e chapter

goes on to review the family and psychiatric histories that are commonly found in sex oenders, and

we present the criminogenic features that distinguish these individuals, including antisocial orienta-

tion, sexual deviance, social ski ll decits, and cognitive distortions such as denial and minimization of

responsibility for oending. We make the important distinction between sex oender subtypes, rapists,

and child molesters, and we then describe the paraphilias as laid out in the Diagnostic and Statistical

Manual (DS M-I V-T R) (APA, 2000). Finally, we describe what is known regarding the epidemiology of

the paraphilias and the legal dispositions that are usually applied to sex oenders. e paraphilic patient

or sex oender will be referred to as “he” or “him,” in recognition of the fact that the vast majority of

these individuals are male.

A. Deviant Sexual Behaviour

e study of deviant sexual (paraphilic) behaviour has its roots in the late nineteenth century, with

extensive work carried out by von Kra-Ebing (1886) and Ellis (1897), amongst others. “Deviance” is

a statistical term, denoting the tendency in a distribution of scores of any quantiable variable for the

values of individual observations to disperse from the average value or mid-point. Accordingly, sexual

behaviour is said to be deviant when it is outside the norm for a particular population of individuals.

Sexual deviation is oen used as a synonym for sexual perversion (Travin & Protter, 1993). In colloquial

usage, the term sexual deviance has acquired a pejorative connotation and conveys at least a tone of

moral disapproval, more oen outright condemnation. Using the obvious example, the world’s religions

have condemned homosexual behaviour throughout history.

B. Sexual Abuse

A signicant subset of deviant sexual behaviours is abusive. In order to properly dene sexual abuse, we

must rst dene consent to sexual relations. While there are obvious pleasurable aspects of sexual activ-

ity, it can pose signicant risks to participants, such as the acquisition of sexually transmitted diseases,

including HIV, or an unwanted pregnancy. If the pregnancy is not terminated nor the child given up for

adoption, the woman faces the prospect of raising a child in possibly dicult circumstances with sign i-

cant long-term lifestyle changes and nancial challenges. Less permanent risks of sexual activity include

Howard Barbaree, David Greenberg, and Renée Fugère

feelings of jealousy, rejection, and abandonment if the relationship doesn’t work out. On the other hand,

sex can have a number of benets as well, besides immediate pleasure, including increased psychological

well-being, the solidication of human partnerships, the formation of family units, and procreation.

Considering the potential risks and rewards of sexual relations, the decision to engage in sexual ac-

tivity can be a critica lly important decision with long-term consequences. Adults have the right to make

autonomous decisions concerning their participation in sexual relations by weighing for themselves the

balance between the potential risks and rewards of any sexual relationship. When sexual interactions

are forced on a non-consenting person, the sexual interactions are, by this denition, abusive. e per-

son who forces sex is referred to as a “sexual abuser” while the non-consenting person is recognized as a

victim of sexual abuse. e word “force” here is used in its broadest sense, meaning physical force, and

also the use of verbal threats and intimidation, the use of the imbalance of power (as is present in the

relationship between a teacher and a pupil, a coach and a player, etc.), and the exploitation of situations

in which the victim is particularly vulnerable due to intoxication or a handicap.

Sex between an adult and a child is inherently abusive because children are unable to provide true

consent. Finkelhor (1979) articulated two preconditions to true consent: (1) full knowledge regarding

what is being consented to, and (2) absolute freedom to accept or decline. Young children have not de-

veloped the capacity to give consent to sexual relations because (1) they have not developed the intellec-

tual ability or the knowledge to properly weigh the risks and rewards of sexual relations, and (2) children

are susceptible to inuence by adults, who, by virtue of their maturity and greater experience easily exert

control over children. Adults who have sexual contact with children commit child sexual abuse (CSA)

(Ondersma, Chan, Berliner, Cordon, Goodman, & Barnett, 2001).

C. Sexual Crime

Criminal laws against sexual abuse have been enacted to protect the individual’s right to autonomy and

self-determination in sexual relations. In Canada, laws protecting adult persons from sexual abuse refer

to “sexual assault” and are contained (along with laws pertaining to non-sexual assault) in section 265 of

the Criminal Code. e Code denes sexual assault as sexual contact (dened broadly to include sexual

touching as well as sexual intercourse) with another person without that other person’s consent. Consent

is dened in section 273.1(1) as “the voluntary agreement of the complainant to engage in the sexual ac-

tivity in question.” Section 271 pertains to “sexual assault,” section 272 to “sexual assault with a weapon,

(makes) threats to a third party or caus(es) bodily harm,” and section 273 to “aggravated sexual assault”

resulting in the wounding, maiming, disg urement, or the endangerment of the life of the complainant.

When sexual assault involves sexual intercourse it is sometimes referred to colloquially as “rape,” but

rape is a term that is no longer used in the Code.

Additionally, in every jurisdiction in modern western society, criminal laws specically protect chil-

dren from sexual victimization by adults. Laws against CSA require the establishment of an age below

which the individual is considered to be unable to provide consent to sexual relations. is is oen

referred to as the “age of consent.” In 2006, the Parliament of Canada raised the age of consent from

fourteen to sixteen.

In Canada, laws protecting children from sexual abuse are included in sections 151 to 153 and refer

to sexual interference, invitation to sexual touching, and sexual exploitation. Section 151 (of the Code)

denes “sexual interference” as an act of “every person who, for a sexual purpose, touches, directly or

indirectly, with a part of the body or with an object, any part of the body of a person under the age of

sixteen years.” Section 152 denes “invitation to sexual touching” as an act of

every person who, for a sexual purpose, invites, counsels or incites a person under the age of 16 years to

touch, directly or indirectly, with a par t of the body or with an object, the body of any person, including