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Even the confidentiality of the psychiatrist's office is not enough to ensure that an incipient pedophile who notices his stirrings and seeks to get them treated won't be punished for trying. Laws vary state by state, but in 48 of them, plus the District of Columbia, a therapist who merely suspects that a patient has molested a child is required to contact the police and therapists often advise the patient to consult an attorney before starting treatment. "What lawyer is going to advise a client to incriminate himself?" asks Berlin. "We need to find a way to help people, but we don't accomplish that by deterring them from identifying themselves in the first place."
The real shame is that treatment does work. The overwhelming majority of research concludes that pedophilia is an innate — thus unchosen — condition, one that produces more suffering than pleasure, but that can be controlled. Berlin and others working with pedophiles use a combination of talk therapy, abstinence training based on the Alcohol Anonymous model and, when necessary, libido-suppressing drugs. In one study of 400 of Berlin's patients, less than 3% who fully cooperated with treatment relapsed after five years. Other studies show that when pedophiles are not treated, nearly 18% of them offend again within three to five years.
The answer, of course, will never be as simple as merely reminding ourselves of the pedophile's essential humanity and showing him safely to the doctor's door. No rational person would deny a potential offender treatment, but no rational parent with a child to protect would not also want to tie a bell around the pedophile's neck before a potential offense can become a real one. It's in that clash of strategies that the tension lies, but it's a tension we'd best resolve soon. The tragedy in Pennsylvania is a terrible reminder of the price of waiting.
—With reporting by Deirdre van Dyk/New York