Objective: The aim of this study was to critically review the literature concerning the nature ane prevalence of paedophilia.
Method: The literature of the past 30 years was examined in relation to the author's clinical experience and with emphasis on methodologically appropriate empirical studies.
Results: Concern and reporting of child-adult sexual activity has increased markedly in the last decade, although its prevalence has not increased at least since the 1960s. The prevalence in women can be as high as 60%, depending on the definition and method of enquiry used, and female compared to male victims report more negative effects, although a percentage of both men and women report the experience as positive. Validation of effects requires multivariate statistical analysis. Current pro-active procedures to identify paedophiles detect those who victimise boys but do not detect the much greater number of paedophiles who victimise girls. Perpetrators are known to the majority of their female and male victims, and those reported are almost all male; most boys do not consider their prepubertal experiences with older women abusive. Relapse prevention, the current most popular treatment, has been shown to be ineffective for incarcerated child molesters.
Conclusions: Child-adult sexual activity should be opposed as an infringement of children's rights rather than requiring a false belief that it is invariably harmful; whether it should be mandatory for therapists to report it requires examination. Scientifically appropriate evaluation should be an essential component of current treatment programs.