The long read: They have committed unspeakable crimes that demand harsh punishment. But most will eventually be set free. Are we prepared to support efforts to rehabilitate them?
A photograph of Aaron Collis regularly appeared in the press while he was on trial. It showed a young man in a crowd of friends, whose faces have been pixelated to preserve their anonymity, and it appears to capture a moment of celebration. The group are bunched together, arms in the air, all wearing the same white shirts and roughly knotted blue-and-red striped ties. They could be in school uniform, or party costume. Collis is looking up at the camera, a wide smile exposing a top row of pointed teeth. The photo was taken in a dark room with the flash on, so his face is starkly lit and every pock and mole visible. His eyes are narrowed to slits and his nose seems abnormally large. You can see why the image was used: Colliss face is distorted, and disturbing. It is a fitting portrait of a paedophile.
In October 2009, Collis, then 24 years old, was convicted of committing 11 offences of sexual abuse against five children. He was given an indeterminate sentence, with a minimum five-year term. In March 2012, he was sentenced to a further fiveyears, to run concurrently, after admitting to offences against another 13 children. The youngest of his victims was 18 months old. At the original sentencing, the judge, Gareth Hawkesworth, told Collis that he would only be released from prison once he no longer posed a threat to life and limb. Thehurt you have done to these young children and their families is incalculable, he said. These were evil and repulsive offences which any right-minded member of society can barely comprehend.
After sentencing, Collis went to prison at HMP Parkhurst, on the Isle of Wight. From there he contributed to the February 2014 issue of Inside Time, the prisoners newspaper: I am a 28-year-old sex offender who has always openly admitted his crimes from the word go, he wrote. I hate what I have done and for four-and-a-half years now Ive been in the prison system trying to find a cure for the incurable. I found a solution a while back and have been exploring it ever since, but for some reason I am finding it nearly impossible to convince people that chemical castration is the best thing for me. Collis said he had appealed to doctors, nurses and psychologists but had so far failed to gain access to the medication he desired. Ithought they would jump at the chance to take away my sex drive, but I was very wrong. They all seem to be trying to talk me out of it, telling me Im young and its not necessary. Well, Im sorry, but its my body and my messed-up brain which is dangerous and this is my decision.
Colliss plea for help to take away his sex drive raises a number of uncomfortable questions. Paedophiles occupy an unambiguous position in society: they are the lowest of the low, the authors of unspeakable crimes not only evil and repulsive, as the judge said, but incomprehensible. For some, the very idea of rehabilitation is questionable: do these individuals deserve to be helped? Can someone who has abused a child be forgiven or changed? Most uncomfortable of all, does a medical intervention in the form of drugs that eliminate sexual desire imply that there is a cure, that paedophilia is a sickness rather than the worst possible crime?
Last summer, after coming across Colliss letter to Inside Time, I wrote to him in prison. Our correspondence lasted for several months and raised its own concerns. To what extent could Colliss version of himself be trusted? He admitted that though he owned up to his crimes, he had fabricated all sorts of rubbish in police interviews. But writing to him was part of an attempt to answer two questions that, given the disgust that naturally attaches to these crimes, have become difficult even to ask: what makes someone a paedophile? And what should we, as a society, do about them?
When Collis arrived at Parkhurst in 2009, he took part in the Sex Offenders Treatment Programme (SOTP) courses devised by psychologists and run to minimise an inmates risk, and help them develop healthy sexual behaviours. But he found the programme ineffective. I learned absolutely nothing on the SOTP, he wrote in one of his first letters to me, last July. All they do is overanalyse irrelevant parts of our lives, and make up random risk factors to work on. Over his years of incarceration Collis said he had met hundreds of sex offenders who had taken part in the programme and got good reports. In his view, they were playing the system. Not one of them was honest.
Collis traced his attraction to children back to puberty. To begin with I was hoping it was just a phase I was going through, he wrote. I soon realised that I was a paedophile and that was never going to change. His early childhood had been happy, he said, but at the age of seven he was abused by a stranger and then by a teacher. At school he was bullied and became socially isolated. As he went through his teenage years, he felt unable to form relationships with his peers and so befriended younger children. From the age of 14, he knew that his feelings towards these children were inappropriate, and sexual.
Not long after his arrival in prison, Collis watched an episode of ITVs This Morning in which a convicted rapist talked about being chemically castrated. The man said he had been prescribed a course of anti-libidinal drugs that had drastically reduced his sex drive. Then Collis met a fellow inmate and sex offender who had been in and out of prison for 20 years. He had done all the Mickey Mouse courses, Collis wrote. After reoffending and being sectioned, the inmate was sent to hospital and later prescribed medication: And he has never thought about sex since. Its no longer part of his life.
Collis began to research the treatment and decided that it was essential to his rehabilitation. He believes he was born a paedophile, and that his attraction to children is unchangeable. I did NOT wake up one morning and decide my sexual preference. I am sexually attracted to little girls and have absolutely no interest in sex with adults. Ive only ever done stuff with adults in order to fit in with whats normal. For Collis, therefore, it became a question of how to control this desire and render himself incapable of reoffending.
Collis said he repeatedly put forward requests for assessment to doctors, psychologists and prison officers, but found his efforts thwarted. I kept getting passed on to different departments; no one wanted to take responsibility, he wrote. He became frustrated, and so wrote his letter to Inside Time: For some reason I am finding it nearly impossible to convince people that chemical castration is the best thing for me WHY?
From April this year, a new programme of chemical treatment will be rolled out across the country. For the first time on a national scale, anti-libidinal medication will be made accessible to sex offenders in prisons and through probation services. It has taken a while to get to this point. Don Grubin, a forensic psychiatrist who has spent most of his long career treating sex offenders in Newcastle, first proposed such a programme back in 2007. It was welcomed by John Reid, then home secretary, who got the horses running, according to Grubin.
In 2008, a pilot project was established at HMP Whatton, a prison for sex offenders in Nottinghamshire, and more than 100 inmates and former inmates on parole have since been prescribed anti-libidinal medication. Protracted negotiations followed about how the programme could be scaled up, from an individual project to a nationwide scheme, and about how it would be run and financed. Now, a new national network of clinics will finally be established. Grubin is acting as an adviser, and the programme will be funded and co-managed by NHS England and the National Offender Management System as part of the Offender Personality Disorder Pathway. Forensic psychologist Sarah Skett, who is leading the initiative for the NHS, described its aims as twofold: to give offenders more control over obsessive sexual thoughts and feelings, and to reduce the risk to the public.
Grubin is a short, wiry-haired man, jovial and pragmatic by nature, with an undiluted New Jersey accent despite half a lifetime spent in the north of England. He grew up in Short Hills, a quiet commuter town an hour west of New York City, and was the son of the local doctor. After spending a year of his undergraduate degree at Oxford University, Grubin decided to stay in the UK, began his medical training in 1980, and then, in 1988, decided to specialise in forensic psychiatry, working with mentally disordered offenders. I always thought that minds were more interesting than stomachs or bones, he told me.
Grubin never set out to work with sex offenders. Early in his career, a colleague asked him to help out on a research project in Maidstone prison in Kent, working with offenders in denial. This led to another research post, and soon enough he had established himself among prison psychologists as a rare psychiatrist willing to work with sex offenders.
Many psychiatrists arent interested in it, he said. Many, too, find it morally uncomfortable, believing that psychiatrists should be treating the mentally ill, not criminals. And some do not want to take the risk: what if an offender you treated subsequently committed another crime? Over the years, Grubin became known as an expert on chemical treatment, partly because he was one of few psychiatrists willing to prescribe to offenders. (The only bloody one!, as one ex-probation officer put it to me.) If a sex offender was unable to access treatment in prison, he was often referred to Grubin who, if too far away to treat them himself, would try to find a psychiatrist nearby to take on the case. Some had little experience with sex offenders, and he was never sure of the outcomes of treatment. It was very hit-and-miss, said Grubin.
The plan to make chemical treatment nationally available was born of necessity: Grubins one-man referral agency was not sustainable in the long term. But it was also a logical product of his bracingly practical assessment of the problem of sexual offending. An individual sex offence, Grubin told me, was estimated by the Home Office in 2010 as costing society 36,952 taking into account the costs of police investigation, judicial proceedings and any medical treatment the victim requires, as well as the cost of the profound and often longterm emotional impact on the victim, and their lost output. By comparison, a years worth of sex-drive-reducing selective serotonin reuptake inhibitors (SSRIs) costs around 50, while more intensive anti-androgen medication costs between 300 and 2,000 a year, depending on how it is administered. As Grubin put it: You dont need to prevent very many offences to get your moneys worth.
In recent years, Britain appears to have been gradually and painfully unveiling itself as a nation of paedophiles: Jimmy Savile, Stuart Hall, Yewtree, Rotherham, Rochdale, the ongoing and controversial investigations into an alleged Westminster-based ring of child abusers. Last week, Dame Janet Smiths review of the BBCs mishandling of the Savile case reopened the ferocious debate about this countrys apparently historic inability to prevent these crimes. The ongoing Independent Inquiry into Child Sexual Abuse, established in March last year, is examining what appear to be chronic failures in child protection across almost all the major public institutions in the country: schools, hospitals, the armed forces, the BBC, religious organisations, charities, the police. There is a sense, particularly in a panichungry media, that Britain is in the grip of an epidemic, a country riddled with abuse.
The actual extent of the problem is hard to pin down. Last year, the National Crime Agency (NCA) estimated that one in 35, or nearly 3%, of men in Britain was a potential paedophile. Figures released by 33 different police forces last year showed that there had been a 60% increase in reported child sexual abuse since 2011. The NSPCC, meanwhile, says that one in 20 children in the UK have been sexually abused, 90% by someone they know and over half by a member of their family. The reality, said deputy director of the NCA, Phil Gormley, in media interviews, is that we are all living not far away from one.
The reality, arguably, is more complicated and an evaluation of the risk depends on how you define paedophilia. The assumption, made frequently in the media, is that anyone who abuses a child is a paedophile. But clinicians use a more stringent definition: someone whose primary sexual interest is in prepubescent children. Using that definition, the Canadian forensic psychologist Michael Seto, who has authored multiple studies of paedophilia, has estimated that fewer than 1% of the population are paedophiles. (This is based on small-scale surveys: a lack of large epidemiological studies mean that there is no accurate prevalence rate.) The number of individuals viewing child abuse images online has risen, but this is not necessarily synonymous with the number of abusing paedophiles. In a paper published in 2011, Seto examined the recidivism data for 2,630 online offenders and revealed that 2% had gone on to commit contact sexual abuse.
Beyond the basic definition, experts diverge in their explanation of paedophilia and its causes. Almost every psychiatrist, psychologist, probation worker and sexologist I spoke to conceptualised the problem in a slightly different way. Crime, illness, sexual orientation all can apply. The debate can perhaps be boiled down to a question: are you born a paedophile, or do you become one?
Many experts support Aaron Colliss self-assessment, that paedophilia is an unchangeable sexual preference. In a 2012 paper, Seto examined three criteria age of onset, sexual and romantic behaviour, and stability over time. In a number of studies, a significant proportion of paedophiles admitted to first experiencing attraction towards children before they had reached adulthood themselves. Many described their feelings for children as being driven by emotional need as well as sexual desire. As for stability over time, most clinicians agreed that paedophilia had a lifelong course: a true paedophile will always be attracted to children. I am certainly of the view, Seto told me, that paedophilia can be thought of as a sexual orientation.
Brain-imaging studies have supported this idea. James Cantor, a psychiatry professor at the University of Toronto, has examined hundreds of MRI scans of the brains of paedophiles, and found that they are statistically more likely to be left-handed, shorter than average, and have a significantly lower density of white matter, the brains connective tissue. The point thats important for society is that paedophilia is in the brain at all, and that the person didnt choose it, Cantor told me. As far as we can tell, they were born with it. (Not that this, he emphasised, should excuse their crimes.)
Heather Wood a psychotherapist and psychologist at the Portman Clinic in London, which specialises in treating violent and sexual offenders prefers to think of paedophilia as a more developmental problem. Drawing on psychoanalysis, she described how she studies an offenders personal history to try and understand why they developed a sexual attraction to children at a particular point in their life. In the normal course of development, Wood said, when youre 11, you fancy 11-year-olds, and when youre 15, you fancy 15-year-olds, and as you mature, the age of the persons to whom youre attracted develops. What we see in some of the patients is that they get stuck in adolescence, so at 11 its 11-year-olds and at 15 its 11-year-olds, and at 18 its 11-year-olds. Their sexual interest doesnt mature.
In the 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American psychiatric classification system used around the world, paedophilia is classed as a paraphilic disorder an atypical sexual interest that either causes distress to the person with the disorder, or makes them a threat to others. Some believe that paedophilia should not be in the DSM at all, such as sexologist Richard Green, who successfully campaigned for homosexuality to be removed from the DSM in 1972, and argued in a controversial 2002 paper (Is paedophilia a mental disorder?) that paedophilia should also be removed. In the paper, Green included an exotic cross-continent tour of places where child-adult sex had historically been the norm (Hawaii, Tahiti, New Guinea), and reminded readers that for three centuries, until the Victorian era, the age of consent in England had been 10. This was not in a period contemporaneous with Cromagnon man, he wrote, but continued to within 38 years of World War I. Greens argument did not suggest that sex with children was acceptable, or should be legal, but that the desire to have it did not necessarily constitute a mental disorder. He cited previous research, which had evaluated non-prisoner, non-patient paedophiles that is, non-abusing, mentally well individuals who were primarily sexually attracted to children. After examining their scores on major personality dimensions, including neuroticism and psychoticism, Green found that it striking how normal the paedophiles appear to be.
For many of those working directly with sex offenders, the definitional wrestling around paedophilia is beside the point: the urgent societal problem is the protection of children. Often people will come to see me and say Ive offended and I just want to know why, I want to know why I did it, said Grubin. And my response is, thats a luxury. The first thing is to stop you doing it again.