is estimated to be lower than 5% among adult men. less is known about the prevalence of pedophilia in women, but there are case reports of women with strong sexual fantasies and urges towards children. male perpetrators account for the vast majority of sexual crimes committed against children. among convicted offenders, 0.4% to 4% are female, and one literature review estimates that the ratio of male-to-female child molesters is 10 to 1. the true number of female child molesters may be underrepresented by available estimates, for reasons including a "societal tendency to dismiss the negative impact of sexual relationships between young boys and adult women, as well as women's greater access to very young children who cannot report their abuse", among other explanations. the term pedophile is commonly used by the public to describe all child sexual abuse offenders. this usage is considered problematic by researchers, because many child molesters do not have a strong sexual interest in prepubescent children, and are consequently not pedophiles. there are motives for child sexual abuse that are unrelated to pedophilia, such as stress, marital problems, the unavailability of an adult partner, general anti-social tendencies, high sex drive or alcohol use. as child sexual abuse is not automatically an indicator that its perpetrator is a pedophile, offenders can be separated into two types: pedophilic and non-pedophilic (or preferential and situational). estimates for the rate of pedophilia in detected child molesters generally range between 25% and 50%. a 2006 study found that 35% of its sample of child molesters were pedophilic. pedophilia appears to be less common in incest offenders, especially fathers and step-fathers. according to a u.s. study on 2429 adult male sex offenders who were categorized as "pedophiles", only 7% identified themselves as exclusive; indicating that many or most child sexual abusers may fall into the non-exclusive category. some pedophiles do not molest children. little is known about this population because most studies of pedophilia use criminal or clinical samples, which may not be representative of pedophiles in general. researcher michael seto suggests that pedophiles who commit child sexual abuse do so because of other anti-social traits in addition to their sexual attraction. he states that pedophiles who are "reflective, sensitive to the feelings of others, averse to risk, abstain from alcohol or drug use, and endorse attitudes and beliefs supportive of norms and the laws" may be unlikely to abuse children. a 2015 study indicates that pedophiles who molested children are neurologically distinct from non-offending pedophiles. the pedophilic molesters had neurological deficits suggestive of disruptions in inhibitory regions of the brain, while non-offending pedophiles had no such deficits. according to abel, mittleman, and becker (1985) and ward et al. (1995), there are generally large distinctions between the characteristics of pedophilic and non-pedophilic molesters. they state that non-pedophilic offenders tend to offend at times of stress; have a later onset of offending; and have fewer, often familial, victims, while pedophilic offenders often start offending at an early age; often have a larger number of victims who are frequently extrafamilial; are more inwardly driven to offend; and have values or beliefs that strongly support an offense lifestyle. one study found that pedophilic molesters had a median of 1.3 victims for those with girl victims and 4.4 for those with boy victims. child molesters, pedophilic or not, employ a variety of methods to gain sexual access to children. some groom their victims into compliance with attention and gifts, while others use threats, alcohol or drugs, or physical force. history pedophilia is believed to have occurred in humans throughout history. the term "paedophilie" (in german) has been used since the late 1830's by researchers of pederasty in ancient greece. the term "paedophilia erotica" was coined in an 1896 article by the viennese psychiatrist richard von krafft-ebing but does not enter the author's psychopathia sexualis until the 10th german edition. a number of authors anticipated krafft-ebing's diagnostic gesture. in psychopathia sexualis, the term appears in a section titled "violation of individuals under the age of fourteen", which focuses on the forensic psychiatry aspect of child sexual offenders in general. krafft-ebing describes several typologies of offender, dividing them into psychopathological and non-psychopathological origins, and hypothesizes several apparent causal factors that may lead to the sexual abuse of children. krafft-ebing mentioned paedophilia erotica in a typology of "psycho-sexual perversion". he wrote that he had only encountered it four times in his career and gave brief descriptions of each case, listing three common traits: the individual is tainted (hereditär belastete) the subject's primary attraction is to children, rather than adults. the acts committed by the subject are typically not intercourse, but rather involve inappropriate touching or manipulating the child into performing an act on the subject. he mentions several cases of pedophilia among adult women (provided by another physician), and also considered the abuse of boys by homosexual men to be extremely rare. further clarifying this point, he indicated that cases of adult men who have some medical or neurological disorder and abuse a male child are not true pedophilia and that, in his observation, victims of such men tended to be older and pubescent. he also lists pseudopaedophilia as a related condition wherein "individuals who have lost libido for the adult through masturbation and subsequently turn to children for the gratification of their sexual appetite" and claimed this is much more common. austrian neurologist sigmund freud briefly wrote about the topic in his 1905 book three essays on the theory of sexuality in a section titled the sexually immature and animals as sexual objects. he wrote that exclusive pedophilia was rare and only occasionally were prepubescent children exclusive objects. he wrote that they usually were the subject of desire when a weak person "makes use of such substitutes" or when an uncontrollable instinct which will not allow delay seeks immediate gratification and cannot find a more appropriate object. in 1908, swiss neuroanatomist and psychiatrist auguste forel wrote of the phenomenon, proposing that it be referred to it as "pederosis", the "sexual appetite for children". similar to krafft-ebing's work, forel made the distinction between incidental sexual abuse by persons with dementia and other organic brain conditions, and the truly preferential and sometimes exclusive sexual desire for children. however, he disagreed with krafft-ebing in that he felt the condition of the latter was largely ingrained and unchangeable. the term pedophilia became the generally accepted term for the condition and saw widespread adoption in the early 20th century, appearing in many popular medical dictionaries such as the 5th edition of stedman's in 1918. in 1952, it was included in the first edition of the diagnostic and statistical manual of mental disorders. this edition and the subsequent dsm-ii listed the disorder as one subtype of the classification "sexual deviation", but no diagnostic criteria were provided. the dsm-iii, published in 1980, contained a full description of the disorder and provided a set of guidelines for diagnosis. the revision in 1987, the dsm-iii-r, kept the description largely the same, but updated and expanded the diagnostic criteria. law and forensic psychology definitions pedophilia is not a legal term, and having a sexual attraction to children is not illegal. in law enforcement circles, the term pedophile is sometimes used informally to refer to any person who commits one or more sexually-based crimes that relate to legally underage victims. these crimes may include child sexual abuse, statutory rape, offenses involving child pornography, child grooming, stalking, and indecent exposure. one unit of the united kingdom's child abuse investigation command is known as the "paedophile unit" and specializes in online investigations and enforcement work. some forensic science texts, such as holmes (2008), use the term to refer to offenders who target child victims, even when such children are not the primary sexual interest of the offender. fbi agent kenneth lanning, however, makes a point of distinguishing between pedophiles and child molesters. civil and legal commitment in the united states, following kansas v. hendricks, sex offenders who have certain mental disorders, including pedophilia, can be subject to indefinite civil commitment under various state laws (generically called svp laws) and the federal adam walsh child protection and safety act of 2006. similar legislation exists in canada. in kansas v. hendricks, the us supreme court upheld as constitutional a kansas law, the sexually violent predator act, under which hendricks, a pedophile, was found to have a "mental abnormality" defined as a "congenital or acquired condition affecting the emotional or volitional capacity which predisposes the person to commit sexually violent offenses to the degree that such person is a menace to the health and safety of others", which allowed the state to confine hendricks indefinitely irrespective of whether the state provided any treatment to him. in united states v. comstock, this type of indefinite confinement was upheld for someone previously convicted on child pornography charges; this time a federal law was involved—the adam walsh child protection and safety act. the walsh act does not require a conviction on a sex offense charge, but only that the person be a federal prisoner, and one who "has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others", and who "would have serious difficulty in refraining from sexually violent conduct or child molestation if released". in the us, offenders with pedophilia are more likely to be recommended for civil commitment than non-pedophilic offenders. about half of committed offenders have a diagnosis of pedophilia. psychiatrist michael first writes that, since not all people with a paraphilia have difficulty controlling their behavior, the evaluating clinician must present additional evidence of volitional impairment instead of recommending commitment based on pedophilia alone. society and culture general pedophilia is one of the most stigmatized mental disorders. among the public, common feelings include anger, fear and social rejection of pedophiles who have not committed a crime. such attitudes could negatively impact child sexual abuse prevention by reducing pedophiles' mental stability and discouraging them from seeking help. according to sociologists melanie-angela neuilly and kristen zgoba, social concern over pedophilia intensified greatly in the 1990s, coinciding with several sensational sex crimes (but a general decline in child sexual abuse rates). they found that pedophile appeared only rarely in the new york times and le monde before 1996, with zero mentions in 1991. social attitudes towards child sexual abuse are extremely negative, with some surveys ranking it as morally worse than murder. early research showed that there was a great deal of misunderstanding and unrealistic perceptions in the general public about child sexual abuse and pedophiles. a 2004 study concluded that the public was well-informed on some aspects of these subjects. misuse of medical terminology the words pedophile and pedophilia are commonly used informally to describe an adult's sexual interest in pubescent or post-pubescent persons under the age of consent. the terms hebephilia or ephebophilia may be more accurate in these cases. another common usage of pedophilia is to refer to the act of sexual abuse itself, rather than the medical meaning, which is a preference for prepubescents on the part of the older individual (see above for an explanation of the distinction). there are also situations where the terms are misused to refer to relationships where the younger person is an adult of legal age, but is either considered too young in comparison to their older partner, or the older partner occupies a position of authority over them. researchers state that the above uses of the term pedophilia are imprecise or suggest that they are best avoided. the mayo clinic states that pedophilia "is not a criminal or legal term". pedophile advocacy groups from the late 1950s to early 1990s, several pedophile membership organizations advocated age of consent reform to lower or abolish age of consent laws, as well as for the acceptance of pedophilia as a sexual orientation rather than a psychological disorder, and for the legalization of child pornography. the efforts of pedophile advocacy groups did not gain mainstream acceptance, and today those few groups that have not dissolved have only minimal membership and have ceased their activities other than through a few websites. there are also pedophile advocacy groups and online groups that do not support or condone sexual activities between adults and minors, but stand against the stigma surrounding people