Unconventional harm reduction interventions for Minor-attracted persons

Minor-attracted persons raise some of the most complex and taboo challenges in both psychiatric ethics and contemporary society. A recent American study suggested that “nearly 10% of males and 4% of females reported some likelihood of having sex with children or viewing child pornography” if they were free from repercussions. ¹ Data for men from Germany (4.1%), Sweden (4.2%) and Finland (3.5%) indicate the phenomenon is widespread.^2,3,4 The conduct of minor-attracted persons is likely responsible for the molestation of a substantial plurality of the approximately 60,000 children who fall victims to sexual abuse in the United States each year.^5,6 Although many minor-attracted individuals do not act upon their feelings, those who do pose a significant danger to children.^7,8 While abstract arguments have occasionally been advanced that children might not be damaged by such conduct in societies with fundamentally different social structures from those of contemporary society, and meaningful debate exists regarding the appropriate age of consent—both matters beyond the scope of this paper—it is widely accepted that sexual contact between children and adults in our society is usually highly and often irreversibly detrimental to the welfare of the minors involved. ⁹ As nearly all scholars agree that there should be an age of consent, although there may be disagreement on the cutoff, pinpointing a precise age has little bearing on the harm reduction proposals that follow.^10,11 A range of negative medical, psychological and social outcomes have been associated with adult-child sexual contact—enough for this author to believe that such conduct should be prohibited.^12,13 At the same time, in light of these deleterious effects and the related criminal consequences, it is hard to imagine any rational adult willfully choosing to be attracted to minors. Widespread consensus now exists that while acting on such attractions may be a choice, the attraction itself is likely biologically determined by a combination of genetics, congenital factors and early childhood experiences.^14,15 It might be thought of as a sexual orientation, but one that poses a grave danger to others, so that acting upon it is reasonably forbidden. ¹⁶ Whether or not such proclivities are predetermined does not bear dispositively upon whether they are ethical.

The term “minor attracted person” is itself contested, but has increasingly come to replace such misleading terms as “pedophile,” “child abuser” and “sex offender” in the scientific literature when describing individuals who harbor sexual attraction toward children but do not act upon those feelings or desires. ¹⁷ Although the term, which was originally coined by journalist Heather E. Peterson in 1998, was initially popularized by an organization known as B4U-ACT, established by a convicted sex offender to encourage abstinence among others with similar proclivities, it has since become a widely used, and possibly preferred, term in the literature. ¹⁸ Among the leading scholars in the field who have embraced this terminology are Abramowitz, Cohen, Grady, Levenson, Lapworth, Lievesly, Sorrentino, and Tenbergen.^{18,19,20,21,22} In contrast to minor attracted persons, individuals who act upon those desires in contravention of moral norms may be thought of as “child abusers,” while those whose actions are illegal may also be thought of as “sex offenders.” The terms “child abuser” and “sex offender,” while distinct, will often describe the same behavior from different vantage points (i.e. moral and legal). However, not all minor attracted persons act upon their feelings—in fact, many do not—and the purpose of this paper is to generate alternative methods to keep them from doing so. As important, individuals who are not attracted to minors may nonetheless engage in child sexual abuse and often do so. (By analogy, males attracted to females may sexually assault males, and vice versa, for reasons having nothing to do with attraction.) Pedophilic disorder, as defined by the DSM-IV, is a psychiatric diagnosis that describes individuals who over “a period of at least 6 months” experience “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger)” and have “acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.” ²³ Although some individuals who are attracted to minors also meet the criteria for pedophilic disorder, many others do not—because they either do not meet the age and time-period parameters or they have not acted on their sexual urges or experienced the required distress. It is crucial to emphasize pedophilia and child molestation are not synonymous. ²⁴ The term pedophile, while technically accurate in some cases, has been so widely used—albeit inaccurately—to describe both child abusers and non-abusing minor attracted persons, often in a stigmatizing manner, that it is of little use as a term to describe either desires or behavior with any precision.

Hostility toward sexual offenders and individuals who manufacture or consume child pornography runs extremely deep in contemporary western culture and has only been fueled by disturbing and scandalous histories of abuse and cover-up in the Catholic Church, the Boy Scouts, exclusive private schools, and other powerful institutions. ²⁵ A wide range of plausible reasons might be mustered to prohibit minor-attracted persons from acting upon their desires. Some of these have little to do with child welfare: enforcing majority norms proscribing sex outside marriage, fostering the moral wellbeing of minor-attracted persons themselves, encouraging minor-attracted adults to mate with other adults and so bear offspring in order to increase population size, etc. This essay embraces the premise that the overriding and most important justification for such prohibitions is the protection of children. (It is outside the scope of this paper to discuss other potential justifications, beyond acknowledging that additional moral claims against sexual contact between adults and children may exist, but none can trump the importance of the need to protect children's welfare.) Minor attracted persons do have a range of medical and psychiatric options available to them to help prevent them from offending. These generally include various modalities of psychotherapy, including cognitive behavioral therapy and acceptance commitment therapy, and, in some instances, pharmaceuticals that reduce libido. ²⁶ Unfortunately, the data supporting the efficacy of these interventions remains weak. ²⁷ In light of the high stakes involved, efforts should be made to consider alternative interventions.

At present, unconventional efforts to protect children from minor-attracted persons are likely constrained by factors such as moral disgust or vengeance. These sentiments prevent the consideration of novel and potentially efficacious interventions that might protect children from exploitation. This essay proposes a harm reduction model for minor-attracted persons, reviews the ethical issues surrounding such an approach, and then considers several potential—albeit controversial—harm reduction interventions that advancing technologies may render possible if society proves willing to accept them. Other commentators, such as Moen and Sterri, have focused upon the ethics of minor-attracted persons engaging in the use of such alternative technologies. They have written, “Arguably, the production, distribution, and use of computer-generated graphics, child sex dolls, and child sex robots should be made legal in some form” with appropriate safeguards. ²⁸ How to operationalize this prospect in a safe and ethical manner remains an open question. Building upon their earlier work, this essay focuses on the role and ethical obligations of society in creating access and acceptance for them. ²⁸

One might reasonably ask whether such harm reduction approaches are necessary. If effective interventions existed that were able to engage most potential offenders before they engaged in sexual conduct with minors, then alternative measures would not be needed; arguably, the risk entailed could not possibly justify such measures. However, the efficacy of measures to reduce adult sexual misconduct against minors is limited, and, at best, reduces recidivism among some offenders some of the time.^29,30 As important, such interventions generally strive to prevent recidivism after an initial offense. While data on efficacy of therapy for minor attracted persons prior to engaging in sexual conduct with children is limited, the leading study on the subject found that fewer than half of those individuals seeking such therapy found it helpful. ²⁰

This paper first considers the subjects of harm reduction and disgust It then explores four potential harm reduction interventions—child sex robots, artificial virtual reality interactions, synthetic child pornography, and destigmatization measures—and proposes an argument for how they might be operationalized in a risk-mitigating manner.

Ethical considerations

Harm reduction: Harm reduction is an approach to public health that was initially developed in the 1980s as an alternative to abstinence-only solutions for illicit drug use. ³¹ Grounded in the belief that abstinence-only interventions were not realistic for many patients, harm reduction focused upon minimizing risk through such measures as methadone maintenance therapy and free needle exchanges. Similar methods have since been adopted in other areas including “wet shelters” for individuals with alcohol use disorder, safer sex programs in schools, and the decriminalization and regulation of paid sex work. The underlying principle is that if the problematic behavior cannot realistically be prevented, efforts should be made to minimize the damage it causes. Significant evidence supports the effectiveness of harm reduction policies across many domains.^32,33 On initial consideration, sexual abuse does not appear to lend itself easily to harm reduction. For instance, allowing minor-attracted persons to abuse fewer children, but to do so with impunity, strikes all but the extreme utilitarian as deeply disturbing and immoral. (Several dystopian short stories, such as Ursula Le Guin's “The Ones Who Walk Away from Omelas” (1973) and Jacob M. Appel's “The Children's Lottery” (2015), do depict such societies, but not in a favorable light.) Yet while traditional methods of harm reduction might not work, affording alternative outlets for minor-attracted persons to find fulfillment without harming children would constitute harm reduction—even if doing so led to other disturbing consequences, but ones that did not injure children. The most basic of such interventions would be destigmatizing adult attraction to minors, while continuing to stigmatize and penalize acting upon such attractions—much as society has learned to destigmatize alcoholism while continuing to punish individuals who run over children while intoxicated. Arguably, both the harm and benefit of such destigmatization is limited. That is one of the reasons that this paper proposes several more radical forms of harm reduction. The goal of these harm reduction measures is to reduce the risk to minors from minor attracted individuals through abstinence from unlawful or abusive conduct against such minors.

Disgust: One of the historical challenges to harm reduction interventions has been societal “disgust” toward the underlying conduct to be mitigated. The rise of “disgust” as a significant principle in modern ethics can be traced back to responses to John Stuart Mill's “harm principle,” such as Patrick Devlin's The Enforcement of Morals (1965). ³⁴ In its contemporary form, the viewpoint is strongly associated with Leon Kass’ seminal 1997 article, “The Wisdom of Repugnance,” in which the former chairman of the President's Council on Bioethics claimed that “repugnance is the emotional expression of deep wisdom … beyond reason's power fully to articulate it.” ³⁵ He cited as examples of acts for which one cannot “give an argument fully adequate to [their] horror” as including corpse mutilation, consensual father-daughter incest, bestiality, cannibalism and human cloning. ³⁵ Key to repugnance theorists such as Kass is the belief that opposition to such acts need not be grounded in reasoned analysis, but “because we intuit and feel, immediately and without argument, the violation of things that we rightfully hold dear.” ³⁵ Critics have derided Kass’ theory as “a grand piece of anti-intellectualism and a pseudo-intellectual defense of ‘yuck’ reactions” worthy of “eye-rolling.” ³⁶ Yet disgust also has its defenders, such as Alexandria Plakias, who has noted that “disgust is not uniquely untrustworthy—that the same features that the disgust skeptics cite as grounds for suspicion of disgust are present in other emotions and affective and cognitive processes as well.” ³⁷ Disgust, which varies in intensity among individuals, might correlate with conservative values and preferences for the status quo, which certainly could prove socially beneficial in some contexts. ³⁸ What does not follow is that disgust should be used as a basis for law or policy absent other justifications.

Two key points need to be emphasized at this juncture. First, the distinction between harboring sexual attraction toward minors and acting upon that attraction is of high moral significance. As noted above, a widespread consensus, with which this author concurs, opposes sexual conduct with minors because doing so poses a longstanding, documented harm to the latter—at least, in the context of our current civilization, which is what matters here. However, it does not follow that harboring sexual feelings toward minors without acting upon them is immoral. By comparison, murdering one's employer for the insurance money is clearly immoral, but wishing to do so, without acting upon this wish, is not necessarily so. An argument can be made, of course, that even such wishes are immoral. Such “thought crimes” existed in early English law. ³⁹ Sins of thought have also been recognized historically by various Christian denominations. ⁴⁰ Whether thoughts of sexual conduct with children are immoral, independent of action, need not be decided in order to support harm reduction. Rather, all one must accept is that acting upon such thoughts has societal consequences so much more severe that such thoughts must be tolerated if doing so can prevent action. In other words, if by allowing people to fantasize about killing their employers, one could reduce the murder rate, the moral harm done by the former would surely be outweighed by the societal benefit of the latter. The same is true of regarding thoughts and actions regarding sexual conduct with minors.

The second key point is that sexual conduct between adults and children has been shown to cause significant psychological damage and often physical injury to the latter. That deleterious impact certainly justifies both moral opprobrium and legal proscription. Such conduct also provokes disgust in many people. These are two distinct phenomena. This paper argues that it is the negative impact upon children, not the moral state of the adults nor the disgust that the majority may harbor toward these adults, that justifies criminalization. In the counterfactual hypothetical where sexual conduct between adults and minors did not harm the latter—and it is important to emphasize that this is a counterfactual hypothetical—then the arguments for proscribing such conduct would prove far weaker. It need not be established here that such arguments would not exist at all, merely that they should prove subordinate to policies that do protect minors.

Certain harm reduction measures related to minor-attracted persons, such as synthetic child pornography and child sex robots, may provoke such disgust without doing harm to children. In theory, such interventions might protect real children. Whether disgust has any intrinsic value in formulating policy—and this author generally believes it does not—this essay proposes that preventing disgust should never take precedence over preventing actual damage. Even if disgust can alert us to harms—a debatable claim—it seems illogical to prioritize preventing disgust over the harms to which it alerts us. What wisdom is there, after all, in a form of disgust that might actually lead to increased harm to children?

Goals: The primary and overriding purpose of harm reduction programs for minor-attracted persons should be to protect children from sexual abuse and exploitation. Of course, such programs might also accrue ancillary advantages to the minor-attracted persons themselves. These benefits might include increased sexual fulfillment, lower risks of incarceration, less stigmatization and an opportunity to lead more productive lives. Society could benefit in other ways as well, such as conserving resources that would otherwise be expended upon trying and imprisoning offenders. If computer-generated pornography gains traction, public and private sector employees charged with reviewing potentially indecent child images might find some comfort in knowing that most of the material that they review is synthetic. These incidental benefits may be of considerable value, but it is important to emphasize that they are not dispositive. If harm reduction policies on average protect more children than they endanger, then such programs are ethically justified; if they fail to protect children, no concomitant benefit to minor-attracted persons themselves or to society more broadly would likely justify such measures. In other words, this paper does not advocate for a cost-benefit analysis of the welfare of children against that of minor-attracted persons, but rather a cost-benefit analysis of harm reduction programs in relation to—and only in relation to—the welfare of potential child abuse victims themselves. Finally, some scholars suggest that certain technological advances such as child sex robots are inevitable, so steps should be taken to minimize their negative impact. ⁴¹ While this essay does not object to that as an ancillary goal of management, it does not accept inevitability alone as grounds for adopting these harm reduction interventions.

Safeguards: Any harm reduction program for minor-attracted persons must occur with extreme safeguards to protect against child abuse. These safeguards are particularly necessary because of the risk of irreparable damage to young victims, such as occurred during a German program run by Helmut Kentler from the 1960s to the 1990s in which foster children were knowingly placed in the homes of pedophiles. ⁴² Inadequate monitoring leading to child abuse could also have the long-term effect of dampening other harm reduction efforts that might protect children. Needless to say, harm reduction measures should initially be studied on a small scale with stringently careful oversight to ensure that subjects do not abuse minors while enrolled; enhanced supervision might even be a legitimate requirement for participants. At the same time, such harm reduction programs should occur with complete transparency. While the optics of some of the interventions discussed below may prove politically unpalatable, the hope is that pitching them as measures to protect real children from actual harm may generate public acceptance.

Interventions

Approaches: What follows are three different proposals for harm reduction technologies that may reduce the likelihood of minor-attracted persons to sexually abuse or exploit children. The key word here is “may”: Numerous theories have been advanced to link exposure to sexual content with subsequent aberrant behavior, but evidence of causality remains highly contested and debated. ⁴³ In the absence of clear evidence, this paper advocates for further, controlled exploration of interventions that might reduce the risk of harm to children. While the technology for these potential interventions already exists, they are generally not readily available to non-offending minor attracted persons. For example, while it is possible to create synthetic images of children of a sexual nature, as discussed below, no easy mechanism exists for a minor attracted person to verify that such images are indeed synthetic or to obtain such images without inadvertently acquiring actual images of children—with the negative moral and legal implications of doing so.

Sex Robots: The history of sex dolls is likely as old as the history of human sexuality itself with so-called “Dutch wives” becoming staples of sailors’ lives during the sixteenth century. Yet the rise of modern electronics, computers and artificial intelligence has opened the door to sex robots that are increasingly lifelike and responsive. Progressively sophisticated robots such as “Samantha” and “Harmony” can engage in rudimentary conversation, generate facial expressions and simulate orgasm. Without legal restrictions, such creations can only be expected to become more complex with time and might even someday be able to pass for human. Supporters champion these dolls are potential tools in sex therapy or as cures for loneliness. ⁴⁴ Sterri and Earp have advanced the argument that they should be regarded similarly to other mechanisms of harm reduction such as those found in addressing substance addiction. ⁴⁵ Critics have asserted that these robots are “inspired by a non-empathetic form of encounter that is manifest in the sex trade” and may further the objectification of actual women and girls. ⁴⁶ Some commentators have even raised the prospect that the robots themselves have intrinsic rights; yet if that were the case, it would still be incumbent upon robot-rights advocates to demonstrate that such rights should take priority over child welfare. ⁴⁷ Lifelike child sex robots, which are currently manufactured in Asia, are particularly contentious. Opponents raise concerns that such robots could “increase the likelihood of child sexual abuse by desensitizing the doll user to the physical, emotional and psychological harm caused by child sexual abuse and normalizing the behavior in the mind of the abuser”—although they acknowledge the absence of empirical evidence at present. ⁴⁸ Their concern is the risk of “escalation” from relatively benign interactions with the robot to malignant actions in society. ⁴⁸ These fears led Australia to ban such dolls through the Combatting Child Sexual Exploitation Legislation Amendment Act 2019; Canadian authorities have prosecuted ownership as child pornography, while Great Britain has proscribed importing on the grounds of obscenity. In the United States, a criminalization bill titled Curbing Realistic Exploitative Electronic Pedophilic Robots (CREEPER) passed the House of Representatives in 2018 but has not received a vote in the Senate. Sex robots are illegal in several American states including Florida, Tennessee and Kentucky. ⁴⁹ Whether or not such robots lead to escalation or reduce harm is an open question for which data is largely absent. In theory, such robots might even lead to a reduction in child sex trafficking as would-be abusers might choose to meet their needs entirely through the use of dolls. Alternatively, these would-be abusers might be able to meet only some of their needs through the use of dolls, but even this limited satisfaction might move enough to persuade them not to risk of harming or trafficking actual children and its legal and moral consequences. These possibilities, of course, are speculative. But to the degree they are potentially effective, they should be investigated. The intensity of opposition to such robots may be grounded in a desire to protect children from the users of such robots, but some evidence suggests that it is also grounded in disgust at the use of robots themselves. One of the leading Congressional advocates for criminalization in the United States, Bob Goodlatte, justified the ban on the grounds that the “very thought makes me nauseous.” ⁵⁰ In an editorial, the chief sponsor of the bill, Representative Daniel Donovan, acknowledged that his objections to sex robots go beyond protecting real children. He objected to the view that “it's on us to decide whether we prefer [minor-attracted persons] use inanimate dolls or our sons and daughters.” ⁵¹ Yet if such dolls actually do reduce the danger to real children—a matter yet unresolved—then that is precisely the question society must ask.

Virtual Reality: Immersive virtual reality is a technology that has evolved since the 1990s to allow users to inhabit computer-generated sensory universes. Such technology can be harnessed for a wide range of purposes from entertainment to training physicians. ⁵² Closely related are haptic appliances known as teledildonic devices that enable users to engage in simulated sex acts with each other in what is known as “spatially separated sexual intercourse.^53,54 Increasingly, technologies are rendering such encounters highly authentic. Both of these related technologies offer harm reduction opportunities for minor-attracted persons. First, computerized sex simulations with computer avatars might be designed for minor-attracted persons to engage in sex acts with virtual minors that would be immoral if indulged in real life. Second, either government employees or privately hired individuals might assume the identities of children to engage in haptic sexual interactions with minor-attracted persons. Regrettably, the individuals charged with diverting minor-attracted persons in this manner might find the experience disturbing or even traumatic. It is hoped that the knowledge that they are acting to protect real children might mitigate this negative impact. Even if it did not do so, the voluntary, compensated virtual trauma of these adults is ethically justified if it can be shown to protect real children from abuse.

Synthetic Child Pornography: The majority of nations prohibit the production or possession of imagines of children engaged in sexually explicit conduct. While the most frequent justification for such laws is protection of children from exploitation in the manufacture of such images, some nations such as Great Britain and Canada prohibit even fictional depictions of such conduct whose creation did not involve child exploitation. In the United States, which has some of the most draconian penalties for obscene depictions of children, the national PROTECT Act of 2003 prohibited virtual child pornography. ⁵⁵ In 2016, a Michigan man was sentenced to seven years in prison for possessing for his own personal use a self-generated, hand-drawn image and a self-authored short story that depicted illegal sexual conduct with minors. ⁵⁶ The two most probable motives for such prohibitions are either fear of “escalation” or moral disgust Whether or not consuming—as opposed to producing—child pornography leads to escalation and abuse remains an unresolved question. If it does not, and the primary harm to children occurs through the production of the pornography itself (rather than acts by consumers inspired by the images), then the increasing realism of computer-generated synthetic pornography raises the possibility of using artificial child pornography to combat real child pornography. For instance, governments might eliminate the economic viability of producing real child pornography by flooding the market with synthetic, specially watermarked child pornography indistinguishable to the naked eye. The result might be a concomitant reduction in the supply of child abuse imagery in favor of synthetic depictions for whose production no child was harmed. Easy access to such synthetic materials might even generate less interest in real materials offered freely. Knowledge that consuming synthetic materials involves no penalties, while consuming real penalties risks imprisonment, could easily skew consumer interest toward the former. Alternatively, the government might charge a low fee for such synthetic materials and use the funds to compensate victims of childhood sexual exploitation. Such synthetic images would have to be indistinguishable from real images and, by necessity, would have to depict graphic acts that many individuals view as horrific. To shy away from that is to ignore the serious implications of such an intervention. Failing to cater to the needs of potential abusers would also fail to ward off abuse. Such a tradeoff may prove unpalatable to many, in light of widespread disgust toward such imagery, but that alone would not justify sanitizing such images if they might prove effective at mitigating harm.

Traditional Harm-Reduction Approaches: Financial incentives have been increasingly used with good effect to motivate individuals with substance use disorders to remain abstinent.^57,58 Whether similar techniques might work with minor-attracted persons is unclear. One potential approach might be to combine the harm reduction methods discussed above with financial incentives. For instance, authorities might pay an individual at high risk of sexually exploiting children to try virtual reality interactions instead—and then reward them if doing so helps them maintain abstinence. While the politics of paying minor-attracted persons to engage with sex robots or not to abuse children may appear unpalatable in the short run, convincing data of their efficacy in protecting children might change public attitudes. Group therapy interventions have also gained considerable traction in harm reduction systems.^59,60 Allowing minor attracted persons to know that they are not alone, so to speak, but in settings that are conducive to safe practices might reduce the risks of offending. Group therapy has been directly connected with the “destigmatization of addiction and the normalization of illicit drug use” in order to help “group … members work on incremental steps toward self-management” ⁶¹ It is possible that group therapy will have the same benefits for minor attracted individuals as well. In fact, destigmatization might be used in conjunction with such methods, normalizing sex robots as alternative outlets for minor-attracted persons. The goal, of course, is not to destigmatize adult-child sexual contact, but rather to destigmatize the desire for such contact independent of action—opening the door to alternative, less harmful means of satisfying those desires. Of course, one might object that the distinction between destigmatizing the desire and destigmatizing the act is a thin one, or that one will invariably lead to the other. Yet this has not proven true in other areas: for instance, destigmatizing alcoholism has not, for instance, destigmatized intoxication driving. In fact, the possibility exists that offering alternative outlets while destigmatizing the desire might even further stigmatize the acts themselves, as even minor attracted persons would have a harder time justifying to themselves the abuse of children.

Objections

As this is a highly controversial topic, an exhaustive list of objections is not feasible, but four likely concerns must be addressed. The first, explored above, relates to the logistical challenges of manufacturing and supplying such harm-reduction tools. The contention of this paper is that while one would seek to minimize the distress caused by this process, even some distress to adults on a voluntary basis can be justified with the aim of protecting children. Internet companies, for example, have long used content moderators to filter real child pornography, and recent methods have been developed to minimize the psychological stress upon these workers. ⁶² Second, the possibility exists that harm reduction will not work with regard to minor attracted persons. That is why such a program should be introduced slowly, on a limited scale, under tight regulations and oversight. If these methods fail to reduce harm to children or recidivism, then society's obligation to further them ends. If they prove deleterious or increase risk to children, they ought to be halted immediately. In the case that they prove neutral, then it is possible they might justifiably remain legal, but certainly not incentivized—any more than any other distasteful but harmless leisure product. Third, there is the possibility that harm reduction is efficacious in preventing child abuse, but generates other tangible and serious harms. For instance, the normalization or destigmatization of such products might traumatize survivors of actual childhood sexual abuse—a real possibility, and not a concern to be dismissed lightly. Yet while such concerns might trump the autonomy of minor attracted persons and override the right to access if these interventions prove neutral, the prevention of actual harm to children, who generally cannot avoid such abuse, should trump the secondary but real interest of those adults who seek to avoid traumatizing exposure, who may take steps to avoid such exposure. Finally, some may argue that there is an abstract or broader harm generated by such harm reduction measures, because they countenance behavior that society perceives to be immoral. Yet this criticism might be made for all harm-reduction measures: The test is not whether the countenancing of immoral behavior is desirable, but whether or not it is less preferable than the underlying social harm of the immoral behavior that the harm reduction measures are intended to reduce.

Conclusions

The high rates of child sexual abuse and exploitation in the western world indicate that current approaches to these disturbing phenomena do not work well. In addition, strong circumstantial evidence suggests that laws in this area are motivated by both moral disgust and a desire to protect children. However, new technologies may place these goals in conflict. Some harm reduction intervention like sex robots and synthetic child pornography may provoke high levels of moral disgust but—and the verdict is still out—reduce danger to real children. Rather than dismiss these technologies outright, our society has an ethical duty to explore their efficacy in carefully monitored interventions and to encourage them if they do in fact protect our most vulnerable from abuse and exploitation.