What makes people sexually aroused by...well, whatever they are aroused by? I don't know if I'll get to see a complete answer in my lifetime, but it's certainly a fascinating way to spend one's research career!
When I got started (in the 1990's), all the major research on atypical sexualities was about homosexuality—specifically, about gay men. Being openly gay myself, I had a pretty natural curiosity about what made me different. Although the idea that men are essentially born gay (or straight) is now pretty much taken for granted, it was still a hotly contested idea back then, and only a small handful of scientists were doing research to figure it out. Out of more luck than anything else, I got to meet and become a student of one of them: Ray Blanchard. (Among his other scientific achievements, he figured out that homosexuality in men follows from interactions before birth between male fetuses and the immune system of the mother.)
Research on what makes gay men gay is still on-going, but, to me, we had (and still have!) the next, even bigger question: What about all the rest of sexual diversity? Blanchard checked where possible, but the immune system research did not explain other atypical sexualities.
When I got started (in the 1990's), all the major research on atypical sexualities was about homosexuality—specifically, about gay men. Being openly gay myself, I had a pretty natural curiosity about what made me different. Although the idea that men are essentially born gay (or straight) is now pretty much taken for granted, it was still a hotly contested idea back then, and only a small handful of scientists were doing research to figure it out. Out of more luck than anything else, I got to meet and become a student of one of them: Ray Blanchard. (Among his other scientific achievements, he figured out that homosexuality in men follows from interactions before birth between male fetuses and the immune system of the mother.)
Research on what makes gay men gay is still on-going, but, to me, we had (and still have!) the next, even bigger question: What about all the rest of sexual diversity? Blanchard checked where possible, but the immune system research did not explain other atypical sexualities.
Pedophilia
After finishing my PhD, I got a job in the forensic department of a large psychiatric hospital: That department contained a sexual behavior clinic and phallometric laboratory for assessing and treating (mostly) men who committed sexual offences against children. That gave me the chance to study another atypical sexuality--pedophilia.
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Although pedophilia is unrelated to ho-mosexuality, it had in common that many people (including professionals) believed it to be the result of childhood events rather than the result of biology. Speci-fically, it was widely believed that being the victim of sexual abuse in childhood led to one becoming a pedophile in adult-hood. (The idea is still nick-named the "abused-abuser hypothesis.")
Despite its popularity, the abused-abuser hypothesis never made much sense to me. In almost all of cases, pedophiles are men. (Even when there is a report about a woman sexually abusing a child, there |
is usually a man in the picture, goading her into the behavior to please him.) Despite pedophiles being mostly men, the majority of the victims are female. If being the victim of sexual abuse were the central factor, then these proportions should be close to each other, rather than almost opposites. To a scientist, a puzzle like that is pretty irresistible.
Doing research on pedophilia is no straight-forward task. It isn't as if we can conduct surveys. Plus, even if we could think of a way to examine a sample typical pedophiles (whatever that might mean), people can't just think back and tell us what biological things were going on before they were born. Plus, other than being sexually interested in children, pedophiles are pretty much like everyone else. We could look for evidence only indirectly.
To be convincing evidence, we had to think of potential clues that were not only already known to relate to brain structure, but also could be measured objectively (so we wouldn't accidentally see only what we hoped to see), could not be easily faked (so a pedophile couldn't easily manipulate our results), and was something that both develops early in life and does not change later in life (to rule out the possibility that any differences were caused by being a pedophile instead of the other way around). All this was in addition to a long list of practical considerations: The work had to be inexpensive enough to fit in (very!) small research budgets, had to be ethical and safe for the people volunteering to participate in our research (no dissecting of brains...), and had to be feasible to complete in a few months or years. A very tall order, yes; but not quite impossible...
One by one, the clues emerged. Together with an amazing team of students, research assistants, and no small amount of guidance from Ray Blanchard as my mentor, the pedophiles showed important differences from non-pedophiles---and the only explanation of the differences we found was that pedophilia is an innate and probably immutable feature. People do not choose to be sexual attracted to children.
Doing research on pedophilia is no straight-forward task. It isn't as if we can conduct surveys. Plus, even if we could think of a way to examine a sample typical pedophiles (whatever that might mean), people can't just think back and tell us what biological things were going on before they were born. Plus, other than being sexually interested in children, pedophiles are pretty much like everyone else. We could look for evidence only indirectly.
To be convincing evidence, we had to think of potential clues that were not only already known to relate to brain structure, but also could be measured objectively (so we wouldn't accidentally see only what we hoped to see), could not be easily faked (so a pedophile couldn't easily manipulate our results), and was something that both develops early in life and does not change later in life (to rule out the possibility that any differences were caused by being a pedophile instead of the other way around). All this was in addition to a long list of practical considerations: The work had to be inexpensive enough to fit in (very!) small research budgets, had to be ethical and safe for the people volunteering to participate in our research (no dissecting of brains...), and had to be feasible to complete in a few months or years. A very tall order, yes; but not quite impossible...
One by one, the clues emerged. Together with an amazing team of students, research assistants, and no small amount of guidance from Ray Blanchard as my mentor, the pedophiles showed important differences from non-pedophiles---and the only explanation of the differences we found was that pedophilia is an innate and probably immutable feature. People do not choose to be sexual attracted to children.
Hypersexuality (sex addiction)
Despite the enormous amount of discussion among professionals as well as the public, only very little actual research has been done with people who think they might be addicted to sex. People with different theories use different labels from sex addiction to compulsive sexuality to hypersexual disorder, and many others.
The research projects I have started now, however, suggests that hypersexuality is not a condition by itself. Instead: (1) It is a symptom of something else, and (2) there are several, completely different conditions that can have hypersexuality as a symptom. That is, in order to help people who think they might be hypersexual, we need to figure out what that condition is for that specific person, and to provide the treatment(s) most appropriate for that specific condition.
This line of research is still in its early stages, but, so far, these are what those conditions appear to be:
The research projects I have started now, however, suggests that hypersexuality is not a condition by itself. Instead: (1) It is a symptom of something else, and (2) there are several, completely different conditions that can have hypersexuality as a symptom. That is, in order to help people who think they might be hypersexual, we need to figure out what that condition is for that specific person, and to provide the treatment(s) most appropriate for that specific condition.
This line of research is still in its early stages, but, so far, these are what those conditions appear to be:
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Paraphilic Hypersexuality. People with this type of hyper-sexuality are almost always men and have two key features: First, they show very high frequencies of one or more sexual behaviors, such as repeated instances of adultery, many hours every day watching pornography or seeking sexual partners (usually over the Internet), and very frequent solicitation of prostitutes. Second, people in this group have an extremely wide range of (often unusual) sexual stimuli. They often have had sex not only with both men and women, but also are turned on by people who look female, but have a penis. (There are male-to-female transsexuals who decide to transition only part way and keep their penis. They often refer to themselves as "she-males," but, there are other transgender activists who find that word offensive.) Unlike most other men, who have a very clear idea of what excites them sexually, men in this group can be much more tentative and experimental about what they like, and say that their interests have changed over their lives.
Avoidant Masturbation. The main complaint from people in this type (almost if not always men) is that they spend enormous amounts of time watching pornography and mastur-bating. Although there is no line between healthy and un-healthy amounts of masturbation, people in this group spend enough time surfing the web for porn and masturbating to have been fired from jobs, failed classes, and ignored other important life activities (social relationships, hobbies, etc.) to spend the time masturbating. Unlike the paraphilic hyper-sexuals (who also masturbate very frequently), avoidant mas-turbation have otherwise typical sexual interests, regardless of whether they are straight or gay. (I have not yet seen a bisexual man in this category.) Some avoidant masturbators are inter-ested in mild and consensual bondage or discipline, the level of their interest is much lower than that for people who are para-philic hypersexuals. Sexual Guilt. Not everybody seeking help for hypersexuality actually engages in very frequent sexual behavior. That is, even though the people in this group want to decrease how often they engage in some sexual behavior, they already engage in it less frequently than do most other people. Both men and women have asked for help with this, but sexual orientation is not always clear. That is, there are people who want to live heterosexual lives, but believe they are “addicted” to gay/ lesbian sex or pornography. Similarly, there are people who have fetishes or other atypical sexual interests that they want to be rid of. |
Chronic Adultery. Although they often get labeled “hyper-sexual,” the people in this group generally have very typical frequencies of sex and masturbation. They are unusual only in their numbers of extramarital sex partners. Their affairs include one-time encounters, on-going sexual relationships, and the solicitation of prostitutes. (This group would not, however, apply to openly non-monogamous or other non-traditional relationships wherein no relationship agreement is violated. Nor does it apply to situations with a single, on-going or long-term extramarital relationship, even though the affair might include many episodes of sexual behavior.) People who want help with this kind of problem (almost always male, and almost always heterosexual) have very typical sexual interests, oftentimes including sex toys, costumes, or mild (mostly symbolic) bondage. Even though it is the husband who usually goes into therapy for the problem, these situations usually require both members of the couple to participate.
"Designated Patients." Not everybody who comes in for help actually believes he or she needs help: Instead, their romantic partner does. Sometimes, this is after the discovery that one partner is having an affair, which is attributed to sex addiction. Other times, it is associated with one or both members of the couple who have a zero tolerance for mastur-bation, pornography, or non-procreative sex, religious or political reasons (such as the belief that pornography is harmful to women). The common thread within this type is that the client is seeking therapy, not because the client believes sex addiction is the issue, but because the client’s partner does. Despite these cases being called hypersexual or sex-addicted (etc.), people in this group have typical rates of sexual behaviors. Although it is usually the case that one partner sends the other partner to get treatment, these cases generally require both to enter therapy. Symptom of another psychiatric diagnosis. Although these types represent most of the people who come to sex therapists for help with hypersexuality, there also exist other known problems that have hypersexuality as a symptom. The best known of these are bipolar disorder, with elevated sex drives occurring during manic phases, and certain personality disorders. Some head injuries and neurological diseases can also result in hypersexuality or difficulty in controlling one’s impulses. In situations such as these, the best course of action is often to target the overarching problem, rather than to target the hypersexuality itself. |
Publications
- Cantor, J. M. (2015). In his own words: Response to Moser. Journal of Sexual Medicine, 12, 2502–2503.
- Cantor, J. M. (2015). Milestones in sex research: What causes pedophilia? In J. S. Hyde, J. D. DeLamater, & E. S. Byers (Eds.), Understanding human sexuality (6th Canadian ed.) (pp. 452–453). Toronto: McGraw-Hill Ryerson.
- Cantor, J. M. (2015). Pedophilia. In R. Cautin & S. Lilienfeld (Eds.), Encyclopedia of clinical psychology. Malden, MA: Wiley-Blackwell. doi: 10.1002/9781118625392.wbecp184
- Cantor, J. M. (2015). Purported changes in pedophilia as statistical artifacts: Comment on Müller et al. (2014). Archives of Sexual Behavior, 44, 253–254. doi: 10.1007/s10508-014-0343-x
- Cantor, J. M. (2015). Research methods, statistical analysis, and the phallometric test for hebephilia: Response to Fedoroff. Journal of Sexual Medicine, 12, 2499–2500.
- Cantor, J. M., Lafaille, S., Soh, D. W., Moayedi, M., Mikulis, D. M., & Girard, T. A. (2015). Diffusion Tensor Imaging of pedophilia. Archives of Sexual Behavior, 44, 2161–2172. doi: 10.1007/s10508-015-0599-9
- Cantor, J. M., & McPhail, I. V. (2015). Sensitivity and specificity for the phallometric test of hebephilia. Journal of Sexual Medicine, 12, 1940–1950. doi: 10.1111/jsm12970
- Dyshniku, F., Murray, M. E., Fazio, R. L., Lykins, A. D., & Cantor, J. M. (2015). Minor physical anomalies as a window into the prenatal origins of pedophilia. Archives of Sexual Behavior, 44, 2151–2159. doi: 10.1007/s10508-015-0564-7
- Fazio, R. L., & Cantor, J. M. (2015). Factor structure of the Edinburgh Handedness Inventory versus the Fazio Laterality Inventory in a population with established atypical handedness. Applied Neuropsychology, 22, 156–160. doi: 10.1080/23279095.2014.940043
- Lykins, A. D., Robinson, J. J., LeBlanc, S., & Cantor, J. M. (2015). The effects of common medications on volumetric phallometry. Journal of Sexual Aggression, 21, 385–393. doi: 10.1080/13552600.2014.900121
- McPhail, I. V., & Cantor, J. M. (2015). Pedophilia, height, and the magnitude of the association: A research note. Deviant Behavior, 36, 288–292. doi: 10.1080/01639625.2014.935644
- Nunes, K. L., & Cantor, J. M. (2015). Sex offenders. In P. Whelehan & A. Bolin (Eds.), International encyclopedia of human sexuality. Malden, MA: Wiley-Blackwell.
- Soh, D. W., & Cantor, J. M. (2015). A peek inside a furry convention. Archives of Sexual Behavior, 44, 1–2. doi: 10.1007/s10508-014-0423-y
- Sutton, K. S., Stratton, N., Pytyck, J., Kolla, N. J., & Cantor, J. M. (2015). Patient characteristics by type of hypersexuality referral: A quantitative chart review of 115 consecutive male cases. Journal of Sex and Marital Therapy, 41, 563−580. doi: 10.1080/0092623X.2014.935539
- Cantor, J. M. (2014). Gold star pedophiles in general sex therapy practice. In Y. M. Binik and K. Hall (Eds.), Principles and practice of sex therapy (5th ed.) (pp. 219–234). New York: Guilford.
- Cantor, J. M., & Sutton, K. S. (2014). Paraphilia, gender dysphoria, and hypersexuality. In P. H. Blaney & T. Millon (Eds.), Oxford textbook of psychopathology (3rd ed.) (pp. 589–614). New York: Oxford University Press.
- Chivers, M. L., Roy, C., Grimbos, T., Cantor, J. M., & Seto, M. C. (2014). Specificity of sexual arousal for sexual activities in men and women with conventional and masochistic sexual interests. Archives of Sexual Behavior, 43, 931−940. doi: 10.1007/s10508-013-0174-1
- Fazio, R. L., Lykins, A. D., & Cantor, J. M. (2014). Elevated rates of atypical-handedness in pedophilia: Theory and implications. Laterality, 19, 690−704. doi: 10.1080/1357650X.2014.898648
- Lykins, A. D., & Cantor, J. M. (2014). Vorarephilia: A case study in masochism and erotic consumption. Archives of Sexual Behavior, 43, 181–186. doi: 10.1007/s10508‑013‑0185‑y
- Cantor, J. M., Klein, C., Lykins, A., Rullo, J. E., Thaler, L., & Walling, B. R. (2013). A treatment-oriented typology of self-identified hypersexuality referrals. Archives of Sexual Behavior, 42, 883–893. doi: 10.1007/s10508-013-0085-1
- Blanchard, R., Kuban, M. E., Blak, T., Klassen, P. E., Dickey, R., & Cantor, J. M. (2012). Sexual attraction to others: A comparison of two models of alloerotic responding in men. Archives of Sexual Behavior, 41, 13–29. doi: 10.1007/s10508-010-9675-3
- Cantor, J. M. (2012). Reply to Italiano’s (2012) comment on Cantor (2011). Archives of Sexual Behavior, 41, 1081–1082. doi: 10.1007/s10508-012-0011-y
- Cantor, J. M. (2012). Brain research and pedophilia: What it says and what it means. Sex Offender Law Report, 13, 81,84,89–91.
- Cantor, J. M. (2012). Is homosexuality a paraphilia? The evidence for and against. Archives of Sexual Behavior, 41, 237–247. doi: 10.1007/s10508-012-9900-3
- Cantor, J. M. (2012). The errors of Karen Franklin’s Pretextuality. International Journal of Forensic Mental Health, 11, 59–62. doi: 10.1080/14999013.2012.672945
- Cantor, J. M., & Blanchard, R. (2012). White matter volumes in pedophiles, hebephiles, and teleiophiles. Archives of Sexual Behavior, 41, 749–752. doi: 10.1007/s10508-012-9954-2
- Cantor, J. M. (2011). New MRI studies support the Blanchard typology of male-to-female transsexualism. Archives of Sexual Behavior, 40, 863–864. doi: 10.1007/s10508-011-9805-6
- Lykins, A. D., Cantor, J. M., Kuban, M. E., Blak, T., Dickey, R., Klassen, P. E., & Blanchard, R. (2010). Sexual arousal to female children in gynephilic men. Sexual Abuse: A Journal of Research and Treatment, 22, 279–289. doi: 10.1177/1079063210372141
- Lykins, A. D., Cantor, J. M., Kuban, M. E., Blak, T., Dickey, R., Klassen, P. E., & Blanchard, R. (2010). The relation between peak response magnitudes and agreement in diagnoses obtained from two different phallometric tests for pedophilia. Sexual Abuse: A Journal of Research and Treatment, 22, 42–57. doi: 10.1177/1079063209352094
- Barbaree, H. E., Langton, C. M., Blanchard, R., & Cantor, J. M. (2009). Aging versus stable enduring traits as explanatory constructs in sex offender recidivism: Partitioning actuarial prediction into conceptually meaningful components. Criminal Justice and Behavior: An International Journal, 36, 443–465. doi: 10.1177/0093854809332283
- Blanchard, R., Kuban, M. E., Blak, T., Cantor, J. M., Klassen, P. E., & Dickey, R. (2009). Absolute versus relative ascertainment of pedophilia in men. Sexual Abuse: A Journal of Research and Treatment, 21, 431–441. doi: 10.1177/1079063209347906
- Blanchard, R., Lykins, A. D., Wherrett, D., Kuban, M. E., Cantor, J. M., Blak, T., Dickey, R., & Klassen, P. E. (2009). Pedophilia, hebephilia, and the DSM–V. Archives of Sexual Behavior, 38, 335–350. doi: 10.1007/s10508-008-9399-9.
- Cantor, J. M., Blanchard, R., & Barbaree, H. E. (2009). Sexual disorders. In P. H. Blaney & T. Millon (Eds.), Oxford textbook of psychopathology (2nd ed.) (pp. 527–548). New York: Oxford University Press.
- Cantor, J. M. (2008). MRI research on pedophilia: What ATSA members should know. ATSA Forum, 20(4), 6–10.
- Cantor, J. M., Kabani, N., Christensen, B. K., Zipursky, R. B., Barbaree, H. E., Dickey, R., Klassen, P. E., Mikulis, D. J., Kuban, M. E., Blak, T., Richards, B. A., Hanratty, M. K., & Blanchard, R. (2008). Cerebral white matter deficiencies in pedophilic men. Journal of Psychiatric Research, 42, 167–183. doi: 10.1016/j.jpsychires.2007.10.013
- Zucker, K. J., Bradley, S. J., Own-Anderson, A., Kibblewhite, S. J., & Cantor, J. M. (2008). Is gender identity disorder in adolescents coming out of the closet? Journal of Sex and Marital Therapy, 34, 287–290.
- Blanchard, R., Kolla, N. J., Cantor, J. M., Klassen, P. E., Dickey, R., Kuban, M. E., & Blak, T. (2007). IQ, handedness, and pedophilia in adult male patients stratified by referral source. Sexual Abuse: A Journal of Research and Treatment, 19, 285–309. doi: 10.1007/s11194‑007-9049-0
- Cantor, J. M., Kuban, M. E., Blak, T., Klassen, P. E., Dickey, R., & Blanchard, R. (2007). Physical height in pedophilia and hebephilia. Sexual Abuse: A Journal of Research and Treatment, 19, 395–407. doi: 10.1007/s11194-007-9060-5
- Blanchard, R., Cantor, J. M., & Robichaud, L. K. (2006). Biological factors in the development of sexual deviance and aggression in males. In H. E. Barbaree & W. L. Marshall (Eds.), The juvenile sex offender (2nd ed., pp. 77–104). New York: Guilford.
- Blanchard, R., Cantor, J. M., Bogaert, A. F., Breedlove, S. M., & Ellis, L. (2006). Interaction of fraternal birth order and handedness in the development of male homosexuality. Hormones and Behavior, 49, 405–414. doi: 10.1016/j.yhbeh.2005.09.002
- Blanchard, R., Kuban, M. E., Blak, T., Cantor, J. M., Klassen, P., & Dickey, R. (2006). Phallometric comparison of pedophilic interest in nonadmitting sexual offenders against stepdaughters, biological daughters, other biologically related girls, and unrelated girls. Sexual Abuse: A Journal of Research and Treatment, 18, 1–14. doi: 10.1007/s11194‑006‑9000-9
- Cantor, J. M., Kuban, M. E., Blak, T., Klassen, P. E., Dickey, R., & Blanchard, R. (2006). Grade failure and special education placement in sexual offenders’ educational histories. Archives of Sexual Behavior, 35, 743–751. doi: 10.1007/s10508-006-9018-6
- Seto, M. C., Cantor, J. M., & Blanchard, R. (2006). Child pornography offenses are a valid diagnostic indicator of pedophilia. Journal of Abnormal Psychology, 115, 610–615. doi: 10.1037/0021-843X.115.3.610
- Zucker, K. J., Mitchell, J. N., Bradley, S. J., Tkachuk, J., Cantor, J. M., & Allin, S. M. (2006). The Recalled Childhood Gender Identity/Gender Role Questionnaire: Psychometric properties. Sex Roles, 54, 469–483. doi 10.1007/s11199-006-9019-x
- Cantor, J. M., Blanchard, R., Robichaud, L. K., & Christensen, B. K. (2005). Quantitative reanalysis of aggregate data on IQ in sexual offenders. Psychological Bulletin, 131, 555–568. doi: 10.1037/0033-2909.131.4.555
- Cantor, J. M., Klassen, P. E., Dickey, R., Christensen, B. K., Kuban, M. E., Blak, T., Williams, N. S., & Blanchard, R. (2005). Handedness in pedophilia and hebephilia. Archives of Sexual Behavior, 34, 447–459. doi: 10.1007/s10508-005-4344-7
- Cantor, J. M., Blanchard, R., Christensen, B. K., Dickey, R., Klassen, P. E., Beckstead, A. L., Blak, T., & Kuban, M. E. (2004). Intelligence, memory, and handedness in pedophilia. Neuropsychology, 18, 3–14. doi: 10.1037/0894-4105.18.1.3
- Blanchard, R., Kuban, M. E., Klassen, P., Dickey, R., Christensen, B. K., Cantor, J. M., & Blak, T. (2003). Self-reported injuries before and after age 13 in pedophilic and non-pedophilic men referred for clinical assessment. Archives of Sexual Behavior, 32, 573–581.
- Cantor, J. M. (2003, Summer). Review of the book The Man Who Would Be Queen by J. Michael Bailey. Newsletter of Division 44 of the American Psychological Association, 19(2), 6.
- Cantor, J. M. (2003, Spring). What are the hot topics in LGBT research in psychology? Newsletter of Division 44 of the American Psychological Association, 19(1), 21–24.
- Blanchard, R., Christensen, B. K., Strong, S. M., Cantor, J. M., Kuban, M. E., Klassen, P., Dickey, R., & Blak, T. (2002). Retrospective self-reports of childhood accidents causing unconsciousness in phallometrically diagnosed pedophiles. Archives of Sexual Behavior, 31, 511–526.
- Cantor, J. M. (2002, Fall). Male homosexuality, science, and pedophilia. Newsletter of Division 44 of the American Psychological Association, 18(3), 5–8.
- Cantor, J. M., Blanchard, R., Paterson, A. D., Bogaert, A. F. (2002). How many gay men owe their sexual orientation to fraternal birth order? Archives of Sexual Behavior, 31, 63–71.
- Cantor, J. M. (2000). Review of the book Sexual Addiction: An Integrated Approach. Journal of Sex and Marital Therapy, 26, 107–109.
- Cantor, J. M., Binik, Y. M., & Pfaus, J. G. (1999). Chronic fluoxetine inhibits sexual behavior in the male rat: Reversal with oxytocin. Psychopharmacology, 144, 355–362.
- Johnson, M. K., O’Connor, M., & Cantor, J. (1997). Confabulation, memory deficits, and frontal dysfunction. Brain and Cognition, 34, 189–206.
- Binik, Y. M., Cantor, J., Ochs, E., & Meana, M. (1997). From the couch to the keyboard: Psychotherapy in cyberspace. In S. Kiesler (Ed.), Culture of the internet (pp. 71–100). Mahwah, NJ: Lawrence Erlbaum.
- Keane, M. M., Gabrieli, J. D. E., Monti, L. A., Fleischman, D. A., Cantor, J. M., & Nolan, J. S. (1997). Intact and impaired conceptual memory processes in amnesia. Neuropsychology, 11, 59–69.
- Pilkington, N. W., & Cantor, J. M. (1996). Perceptions of heterosexual bias in professional psychology programs: A survey of graduate students. Professional Psychology: Research and Practice, 27, 604–612.
(Courtesy Cogent-Brenner)