People do not decide voluntarily what partners or behaviors they find to be erotically appealing. When their erotic desires could cause harm to themselves or others, psychiatric help may be needed. Pedophilia means sexual attraction to children and has been identified almost exclusively in men. Both life experience and constitution appear to be the source of sexual orientation and interests. Many pedophiles were sexually involved with adults when they were children or experienced excessive prohibition of early sexual expression. Some have biological abnormalities. Assessments must focus on the state of mind that contributed to an individual's behavior. They must distinguish between diminished mental capacities, personality traits, and sexual orientation. They must also understand the compulsive nature of the acts, indicating that many men with pedophilic sexual orientations need help to control their behavior appropriately. The four major treatment approaches that have been proposed are psychotherapy, behavior therapy, surgery, and medication. Medication may also be combined with counseling. Treating these men does not reflect a lack of concern for young children. Instead, it serves the interests of both society and the pedophile, who should be able to seek help without fear of stigmatization, retaliation, or disdain. 30 references.