|Moving beyond the “sex offender” dialogue:|
How ATSA members can promote person-first language
|Gwenda M. Willis|
School of Psychology, University of Auckland
Elizabeth J. Letourneau
Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
Gwenda M. Willis
Elizabeth J. Letourneau
Gwenda M. Willis,
School of Psychology, University of Auckland.
Correspondence concerning this article should be addressed to Gwenda M.
Willis, School of Psychology, The University of Auckland, Private Bag 92019,
Auckland 1142, New Zealand.
ORCID ID: orcid.org/0000-0001-9827-3397
There is growing recognition that individuals
convicted of sex crimes can and do desist from sexual offending (Caldwell, 2016;
Hanson, Harris, Helmus, & Thornton, 2014; Hanson, Harris, Letourneau,
Helmus, & Thornton, 2018), that people with sexual interest in children often desire help to
avoid acting on their attractions (Beier et al., 2009) and that sexual abuse perpetration is preventable (Letourneau, Eaton,
Bass, Berlin, & Moore, 2014). It would seem
that to some extent, professionals and (to a lesser degree) the public are
moving away from viewing everyone who has engaged in harmful or illegal sexual
behavior and/or who has sexual interest in children as presenting a high risk
of offending. That is, we are slowly
shifting away from viewing people who have or might sexually offend as “monsters”. Yet the labels we use in our professional work
may align more closely with the “monster” label than with a humanistic and
prevention-oriented approach. Many
professionals, organizations and scholarly publications continue to label and
define the people at the center of their work based on their behavior or
attractions (e.g., “sex offender,” “abuser” “pedophile”). ATSA, like its sister organizations NOTA and
IATSO, is no exception, using the “Abuser” label in its name. Similarly, labels appear in the titles and
content of several books currently in circulation for treatment providers (e.g., Carich &
Musack, 2015; Prescott, 2009; Sawyer & Jennings, 2016; Yates, Prescott,
& Ward, 2010), many treatment program names (e.g., “Sex Offender Treatment Program”
or “SOTP”) and in clinicians’ and evaluators’ everyday communication. The frequent use of such labels by subject
matter experts risks ostracizing the very people we seek to help while reinforcing
erroneous public beliefs that these people are beyond help.
In August 2018, ATSA’s journal Sexual Abuse published a guideline encouraging the use of person-first
language to describe individuals and groups in manuscript submissions (Willis &
Letourneau, 2018). In this
article, we encourage all of our ATSA friends and colleagues to consider
promoting person-first language more broadly – from the names of treatment
programs and agencies, to report writing and during informal conversations with
family and friends. First, we summarize some
of the problems with the offense and attraction-based labels commonly assigned
to our clients.
Problems with the “sex offender” and other commonly
promote misperceptions. The “sex offender” label suggests that is who someone is. Inherent in the label is the assumption
that “once an offender, always an offender.” Indeed, Harris and Socia (2016) found that survey respondents who read about “sex
offenders” rated them as less responsive to treatment and were more supportive
of contemporary sex crime policies than survey respondents who read about
“people who have committed crimes of a sexual nature”. Findings were even more robust for the
“juvenile sex offender” label. Yet it is
well established that sexual recidivism
base rates are low, and moreover, that rates decline with time spent offense-free
in the community (Hanson et al., 2014; Hanson et al., 2018). Offense-based labels further suggest that individuals with a history of
sexual offending represent a homogenous group whose members all present a
comparable likelihood of reoffending.
However, individuals who commit crimes of a sexual nature are diverse
across most characteristics (apart from gender), including with respect to
their risk profiles. Some “sex offenders” present an above average
risk of sexual recidivism, perhaps due to a combination of numerous priors,
atypical sexual interest, and low connection to social institutions, whereas
others assigned the same “sex offender” label present a risk of sexual
recidivism indistinguishable from people with only nonsexual offense
convictions (see Hanson et al., 2018).
Offense-based labels like “sex offender,” “child
molester” and “rapist” convey little about the etiology of offending, treatment
needs, or future risk of specific individuals.
As such, these labels lack validity.
By contrast, other labels commonly assigned to persons who have offended
or are at risk of offending are based on valid constructs (e.g., “psychopath”,
“pedophile”). Even so, these labels carry
negative connotations and risk stigmatizing the person behind the label (Imhoff, 2015).
stigmatizing individuals and groups. It is well documented that individuals labeled a “sex
offender” struggle integrating into society; for example, they struggle
securing stable housing and employment (for a review of
literature on attitudes towards persons who have sexually abused, see Harper,
Hogue, & Bartels, 2017). Many labels
commonly used by professionals might be perceived as stigmatizing and
pejorative, and not self-selected by the individuals and groups to whom they
are assigned. Respect for the dignity
of all persons is a core ethical principle in codes of ethics across the
helping professions (e.g., American
Psychological Association, 2010a; Code of Ethics Review Group, 2012; The
Australian Psychological Society, 2007; The British Psychological Society,
2009), and addressed explicitly in the American Psychological Association
(APA) Publication Manual (APA; 2010b). Specifically,
the APA manual states that “A label should not be used in any form that is
perceived as pejorative; if such a perception is possible you need to find more
neutral terms” (p. 72).
Of course, individuals vary in their perceptions of
labels to the extent that some self-select labels we might generally wish to
avoid using. Such a contradiction is
evident amongst the population of individuals with sexual interest in young
children. Some individuals choose to use
labels that acknowledge their sexual interest in children – for example, they
might refer to themselves as “minor-attracted persons” or “virtuous pedophiles”
(see also Malone, 2014). The APA Publication
Manual encourages authors to “respect people’s preferences; call people what
they prefer to be called” (p. 72). When
working with an individual or writing up a specific case, it is straightforward
to follow this recommendation to respect an individual’s labeling preferences. However, how might professionals respect
different labeling preferences when referring to groups of people presenting
with similar psychological phenomena (e.g., pedophilia)? Person-first language offers a neutral solution.
As its name
suggests, person-first language separates a person from a behavior, condition
or disorder (e.g., “persons with sexual offense histories,” “individual with
sexual interest in children”, “child/adolescent with sexual behavior problems”). Person-first language encourages us to
describe individuals and groups with greater precision, increases the
likelihood that others will perceive these individuals as amenable to
intervention, and reduces the likelihood of demeaning those we describe by assigning
a label that they might not self-select (see Willis, in press).
In the broader educational and psychology literature,
person-first language is commonplace.
For example, we no longer refer to individuals with intellectual
disabilities as “mental retards” or even “intellectually disabled,” and persons
with schizophrenia could not be labeled “schizophrenics” in modern journal articles. We believe that with time and effort, similar
change is achievable in our field. It
might be argued that individuals who have engaged in harmful or illegal sexual
behavior do not deserve the same considerations as individuals with intellectual
or mental health problems. Many would
say that people who cause harm, particularly sexual harm, deserve the labels
they have been assigned. We
disagree. Human rights, including the
right to dignity, apply to everyone, including people who have caused
harm. While it is important to
stigmatize harmful behavior, it is
counter-productive to stigmatize people.
How might ATSA members promote person-first
language? Sexual Abuse has set a precedent and we hope that the broader ATSA membership
will follow. We encourage ATSA members
to look closely at the names of the agencies they work for, the treatment
programs they run, and the academic courses and professional training programs they
offer. Are the names and titles of these
efforts consistent with a person-first approach? Or do they inadvertently reify the image of certain
groups as homogenous and high risk?
Likewise, we encourage ATSA members to examine how they describe their
clients or research subjects when talking with the media, during court
appearances, and within clinical and scholarly writings. Beyond work settings, we encourage ATSA
members to reflect on how they describe their work and client groups to
friends, family and others. As
professionals, we model for the public how to talk about and, therefore, how to
think about the people with whom we work.
We (Gwen and Elizabeth) have each used the very labels
that we now protest; we recognize that changing from offense-first to
person-first language is a process. We can attest that it gets much easier with
practice. We are also aware that many ATSA
members initiated person-first usage long before we did and we are grateful for
these efforts. ATSA members have
grappled several times with our organization’s title and will no doubt do so
again. Regardless of whether we change
the ATSA name, we can all change how we describe those with whom we work. Anything we do that makes it easier for
others to view the people with whom we work as people will make our work easier and more effective.
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 Labels will not
be used by the authors unless referring to current usage, which will be
indicated by quotation marks or italics.