While sex is still one of the biggest taboos in society, it is accepted that most sex between consenting adults is moral but any act that takes place without consent, be it rape or paedophilia, is wrong.
But what if you physically cannot control your compulsions, even if you know what you are doing is immoral?
This is the position that a 40-year-old man found himself struggling with in 2000. Three years later he was the, albeit unnamed, subject of international headlines after doctors concluded that a brain tumour had caused him to become a paedophile.
In a stable, happy marriage for two years prior, the man enjoyed good health and lived with his second wife and his stepdaughter in the US.
While he harboured a strong interest in pornography since his teen years, he said he had never been attracted to children and had never behaved in a sexually deviant way.
In fact, he had worked as a corrections officer before taking a master’s degree in education and becoming a school teacher in 1998.
But during the year 2000, his tastes began to change. For the first time in his life, he visited prostitutes at brothels disguised as massage parlours. Fully aware that his feelings were immoral, he built a secret collection of pornographic magazines and websites which focused on paedophilia.
Soon, he was unable to contain his urges and started making sexual advances towards his prepubescent stepdaughter. After a few weeks the girl told her mother, who discovered her husband's preoccupation with child pornography.
He was kicked out of his home, diagnosed with paedophilia and prescribed Medroxyprogesterone – a drug usually used to regulate women’s period but that is also prescribed to patients with sexual disorders.
A judge later found him guilty of child molestation and ordered him to complete a 12-step rehabilitation programme for sexual addiction or go to jail.
But the threat of incarceration didn’t stop his sexual urges – and he was kicked off the programme for making advances at staff members and other clients, knowing his only option was prison.
The night before his prison sentencing, he was rushed to the emergency department at the University of Virginia, suffering from a headache after complaining that he had lost his balance.
There, he admitted to psychiatrists that he had experienced suicidal thoughts and feared he would rape his landlady. During tests at the hospital, he solicited female members of staff for sexual favours and was unconcerned when he urinated on himself.
Doctors also noticed that his gait had changed, and he twitched his head has he walked, and lost the ability to write.
Scouring his medical history for answers, doctors found that the man had injured his head in 1984 and was knocked unconscious for two minutes.
Scans later revealed that he had a brain tumour, which may or may not have been related to the injury. Days after it was removed, the man’s life was transformed.
Hours later he regained bladder control and his gait returned to normal. Seven months later, he has completed a Sexaholics Anonymous programme, and was allowed to return home to his wife and stepdaughter.
But he became concerned when he started to develop persistent headaches and started to collect pornography again. The tumour that had caused his paedophilia had returned. When it was removed, he was once again cured.
Scientists concluded that the tumour interfered with the orbifrontal cortex which helps to regulate social behaviour and likely exacerbated his pre-existing interest in pornography, and “manifesting sexual deviancy and paedophilia”.
Doctors said that this was the first known case of paedophilia being caused by a tumour.
The tumour had cast him into the fraught situation where he lost control of his sexual impulses, while his knowledge of wrong and right was preserved. His only focus was short-term sexual reward, despite being accutely aware of the long-term consequences.
Canadian psychologist and sex behaviour scientist Dr James Cantor, who was not involved in the case, said that the man’s is one of a handful of reports where people have carried out sexual crimes against children because of a head injury or brain disorder. He added that his cause would likely no longer be regarded as paedophilia having been caused by a tumour.
“Although these cases can be an important clue, I would not conclude that they represent someone who became paedophilic or became non-paedophilic again. Rather, the evidence suggests that someone who was already paedophilic all along lost the ability to hide it after the injury, and then regained the ability to suppress it as the neurological problem was treated.”
He added that he believes the man’s attitude towards the females around him, including his young stepdaughter, revealed how his tumour had affected his sexual self-control rather than causing him to become a paedophile.
Dr Sarah Goode, a sociologist and the acting CEO of the StopSO specialist therapy organisation, agreed with Dr Cantor.
Dr Goode, who has authored two books on paedophilia, explained: “Many people with paedophilia say that they 'always knew' they were paedophiles; others say they grow into awareness of their sexual attraction during adolescence, when the age of those they find attractive does not increase as it does with their non-paedophile peers. A smaller number say they realise their sexual attraction to children later in life, but as far as I know this is not accompanied by any neurological symptoms and is not due to any organic cause such as a lesion.”
She went on to stress that the way paedophiles are treated medically must change, and they should feel that they are able to reach out for help in order to prevent children from being harmed.
“An important aspect of paedophilia for many people is that point when they first realise they have this involuntary sexual attraction. It is a great shock for many young people, who feel horrified, shamed, disgusted by themselves, and suicidally desperate and lonely. They feel unable to reach out for help.
"This is the point at which society needs to ensure they have the key messages that help is available, they are not alone, and they are not doomed to become abusers but can always make moral choices to stay law-abiding."
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