Introduction: Pedohebephilic disorder is characterized by intense sexual urges or fantasies involving children, which can lead to distress or sexual behavior with children. While theoretical and qualitative accounts suggest that accepting one's pedohebephilic sexual interests may help mitigate both distress and problematic behaviors, the only published quantitative study to date has linked acceptance with behavior but did not analyze its effect on distress.
Methods: We examined the relationship between acceptance of sexual interests and child sexual abuse (CSA), the use of child sexual exploitation material (CSEM), and psychological distress in 238 pedohebephilic and teleiophilic men outside the judicial system (i.