Should pedophilia be treated as mental illness? MAN: Talking about pedophilia is not easy. The child-sex-abuse scandal that continues to plague the Catholic Church has put the word in global headlines and dinner-table conversations. It's especially hard to talk about pedophilia in detached clinical terms. It sort of feels insensitive to victims, but it is instructive to do so and could lead to better solutions perhaps. When treating patients, every therapist in the United States uses the DSM. That's the Diagnostic and Statistical Manual of Mental Disorders. And it categorizes the illnesses and creates a customized treatment plan. In the DSM, pedophilia is what's called a paraphilia. That's a condition in which a person's sexual arousal depends on fantasizing about or engaging in behavior that is atypical. It's not culturally acceptable. In this same section, you're going to find exhibitionism and voyeurism. Pedophilia is an ongoing sexual attraction in a person, usually 16 years or older, toward prepubescent children, generally 13 years or younger. Simply feeling that attraction is not a crime. And it's not all that rare. Studies suggest that between 3% and 5% of the general population are pedophiles. Most are men. A fraction are women. Pedophilia becomes a paedophilic disorder when the person experiences, personal distress and impairment because of the ongoing burden of the fantasies and urges regarding children. Now, even this is still not a crime. Pedophilia also becomes a paedophilic disorder when there's related behavior, like looking at child pornography or sexually abusing a child. Now, that's obviously a crime, a serious one. In cases of abuse, it's a crime that leaves victims emotionally scarred for life, it can result in a prison sentence, the offender's name on a registry, enforced treatment. Here's a point that probably is surprising to a lot of people. Experts believe only 50% of people who sexually abuse children are pedophiles. The other 50% are not specifically sexually attracted to children. They might lack the social skills to maintain appropriate emotional and sexual relationships and then look to children as a sexual surrogate. Abusers who are not attracted to children are said to suffer from an impulse-control disorder. As with most mental disorders, pedophiles can be treated, but not cured. Some can learn to control their urges through things like therapy, sometimes medication. But the attraction to children won't go away. There is preliminary research that shows pedophiles have less gray matter in their brains and a different brain structure than most other people. In other words, the preference for children might be in some ways hardwired. It's clear that pedophilia cannot explain all the cases of child sexual abuse, but it still poses a giant concern. If society applied the standards used for other mental-health conditions, would more pedophiles seek treatment before offending? It just might reduce the number of sexual-abuse cases. Of course, the question remains of how to handle the other offenders also, whether born of impulse-control deficits or cultures of silence.