SAH StigmaandMHinMAPs

Running head: STIGMA IN MINOR ATTRACTED PEOPLE 1
Stigma-Related Stress, Complex Correlates of Disclosure, Mental Health, and Loneliness in
Minor Attracted People
Desiree L. Elchuk, Ian V. McPhail, and Mark E. Olver
University of Saskatchewan
Author Note
Desiree Elchuk, Department of Psychology, University of Saskatchewan; Ian V. McPhail,
Department of Psychology, University of Saskatchewan; Mark E. Olver, Department of
Psychology, University of Saskatchewan.
Correspondence concerning this article should be addressed to Ian V. McPhail, Department
of Psychology, University of Saskatchewan, Saskatchewan, Email: ian.mcphail@usask.ca; or
Mark E. Olver, Department of Psychology, University of Saskatchewan, Saskatchewan, Email:
mark.olver@usask.ca.
© 2021, American Psychological Association. This paper is not the copy of record and
may not exactly replicate the final, authoritative version of the article. Please do not
copy or cite without authors' permission. The final article will be available, upon
publication, via its DOI: 10.1037/sah0000317

STIGMA IN MINOR ATTRACTED PEOPLE 2
Abstract
Minor attracted persons (MAPs) represent a highly stigmatized population. While robust
literatures exist linking stigma-related stressors to negative psychological sequalae in other
stigmatized populations, the research examining stigma processes in MAPs has only recently
begun to develop. The present study expands this area of research by examining associations
between stigma-related stressors (e.g., internalized pedonegativity, perceived support from close
others, disclosing minor attraction), relational quality, loneliness, and psychological distress in
an online sample of MAPs (n = 202). Results demonstrated expected associations between
perceived lack of support from others, increased internalized pedonegativity, psychological
distress, and suicidality. Mediation modelling suggest loneliness mediates the relationship
between perceived support from family and mental health outcomes and partially mediates the
relationship between internalized pedonegativity and psychological distress. Our findings also
show that most MAPs had disclosed their minor attraction to someone in their life but disclosure
itself was not associated with improved mental health; whether a disclosure was followed by
support was associated with increased wellbeing. The results of this study improve our
understanding of MAPs’ mental health and can help inform how clinicians provide support to
this population.
Keywords: pedophilia; minor attracted person; stigma-related stress; mental health; mediation
Stigma-Related Stress, Complex Consequences of Disclosure, Mental Health and Loneliness in
Minor Attracted People
Minor attracted people (MAPs) experience sexual and romantic attractions towards
children (Cantor & McPhail, 2016; Martijn et al., 2020).1 While being attracted to children is a
risk factor for sexual contact with children, many MAPs live day-to-day with their sexual interest
toward children, do not engage in sexual contact with children, and express a strong desire to
never offend sexually (Cantor & McPhail, 2016). In addition, existent theory and research in
forensic psychology suggests that most individuals who sexually offend against children do so
for reasons other than a stable sexual interest in children (Schmidt et al., 2013; Seto, 2018).
Minor-attracted people are one of the most stigmatized groups in society. Whether they
have sexually offended or not, people hold more stigmatizing attitudes towards MAPs than those
with mental illness (Boysen, Chicosky, & Delmore, 2020), those with other paraphilic interests
(Lehmann, Schmidt, & Jahnke, 2020), and those who commit criminal acts (Jahnke, Imhoff, &
Hoyer, 2015). These stigmatizing attitudes may partially result from conflating sexual offending
with sexual attraction towards children (Jahnke, 2018); with individuals convicted of sexual
offences facing harsh stigma (Harper et al., 2017). For their part, MAPs are aware of the ways in
which others in society view them and they experience stigma-related stressors due to their
membership in a stigmatized group (Freimond, 2013). Given the associations found between
stigma-related stress and negative mental health outcomes in other populations (Hatzenbeuhler,
2009; Feinstein, 2020), the present study aims to examine whether stigma-related stressors and
1
Pedophilia, hebephilia, and pedohebephilia are clinical terms used to describe sexual attraction to children. For the
purpose of this study, we chose to use the phrase minor attracted person because it is a common term used by
members of the community and is potentially less stigmatizing than clinical language.
positive social relationships are associated with psychological distress, loneliness, and suicidality
in MAPs.
Interpersonal Relationships
The association between social supports and psychological wellbeing is well established
(Feeny & Collins, 2015; Cohen, 2004; Kawachi & Berkman, 2001). Social supports can help
maintain healthy psychological functioning (Cohen & Wills, 1985) and decrease psychological
distress and depression (Turner & Turner, 2013) in the face of stress. Sexual minorities are at
increased risk for mental health problems, loneliness, and suicidality and stigma processes are
posited as a reason for these disparities (Meyer, 2003; Plöderl & Fartacek, 2005; Hatzenbuehler,
2009; King et al., 2008). One risk factor for increased problems in these areas is low social
support (Mereish & Poteat, 2015; Spencer & Patrick, 2009).
MAPs report higher than average levels of social isolation (Jahnke et al., 2015) and may
feel unsupported in social relationships (e.g., discussing romantic feelings with adult friends)
owing to their attraction to children (Cantor & McPhail, 2016). One potential outcome for MAPs
who perceive others in their lives as unsupportive is an elevated sense of loneliness. Loneliness
has wide-ranging implications for mental and physical health in many populations (Leigh-Hunt
et al., 2017; Mushtaq et al., 2014) and is associated with mental health issues such as depression
(Cacioppo et al., 2006; Heinrich & Gullone, 2006). What is presently missing from our
understanding is whether MAPs perceive close others as supportive, the relationship between
perceived social support and mental health outcomes, and whether perceived social support is
directly associated with mental health outcomes (e.g., Graham & Barnow, 2013) or whether the
association is mediated by loneliness.
Disclosure of Sexual Interest and Degree of Outness

Individuals who are members of a stigmatized group can attempt to conceal their
stigmatized identity or they can choose to disclose their identity to others. If disclosure is met
with a negative response, this can result in further concealment, isolation, feelings of rejection,
and negative views of oneself (Chaudoir & Fisher, 2010). Conversely, positive responses
following a disclosure are associated with positive psychological outcomes, such decreased
loneliness and lower lifetime suicidal ideation (D’Augelli et al., 2001; Pachankis, 2007;
Pachankis et al., 2015; Rothman et al., 2012).
For MAPs, disclosing their attraction of children is a significant source of stress and
fraught with danger (Freimond, 2013; Houtepen et al., 2016) and they may choose to conceal this
aspect of themselves to avoid being negatively stereotyped and socially devalued (Cash, 2016).
MAPs may also decide against seeking mental health services due to concerns over how a
clinician will react to a disclosure of minor attraction. This fear is perhaps not unfounded. In a
recent study, approximately a quarter of clinicians indicated they would make a report if a client
disclosed a minor attraction, despite the absence of other risk factors, the client’s commitment to
not offending, and no identifiable child being at-risk of harm (Stephens et al., 2021).
Being devalued and stereotyped by others has detrimental effects on psychological
wellbeing (Quinn & Earnshaw, 2013), particularly because self-disclosure is an essential part of
relationships (Chaudoir & Fisher, 2010). Despite the stresses and dangers involved in making a
disclosure, many MAPs disclose their attractions to others (Cash, 2016). The response that
MAPs experience following their disclosure determine whether being ‘out’ is associated with
mental health issues. In a recent study, most MAPs that disclosed their minor attraction to friends
and family typically reported at least one positive disclosure experience and these positive
experiences were associated with decreased loneliness (Cash, 2016). These results provide some
initial evidence that the quality of support received following disclosure may be associated with
level of stigma-related stress, loneliness, and psychological distress reported by MAPs.
Internalized Pedonegativity
Research examining mental health in sexual minorities has identified stigma-related
stressors as causes of the elevated rates of mental health concerns in this population (Meyer,
2003; Mays & Cochran, 2001). Internalized stigma is one such stressor that involves accepting
stigmatizing attitudes as true about oneself and attendant negative emotions (e.g., discomfort
with disclosure of sexual orientation to others; Meyer, 1995; Newcomb & Mustanski, 2010).
Sexual minorities who experience internalized homonegativity are susceptible to mental health
problems, lower self-regard, self-depreciating attitudes (Newcomb & Mustanski, 2010), self-
injurious behaviors (Williamson, 2000), suicidality (Plöderl et al., 2014), loneliness (Mereish &
Poteat, 2015), and rejection by others; all of which can result in individuals avoiding social
connection and close relationships for fear of discovery (Pachankis, 2007).
Analogously, MAPs may accept stigmatizing attitudes about themselves, or what can be
termed internalized pedonegativity. Internalized stigma is a multifaceted construct that can be
generally thought to involve the subjective experiences of stigma, which includes a subjective
perception of devaluation, shame, secrecy, and withdrawal due to accepting, agreeing with, or
endorsing negative stereotypes (Corrigan, 1998). In a general sense, the process of internalizing
stigma includes maladaptive behaviors, negative self-referential emotions, and negative
perceptions of the self-informed by endorsing negative stereotypes (e.g.,
concealment/withdrawal, shame, self as inferior; Link & Phelan, 2001; Livingston & Boyd,
2010; Ritsher et al., 2003). An example of internalized pedonegativity is negative self-concept
stemming from accepting societal portrayals of those who are attracted to minors as being
“monsters” (Cash, 2016). The stigma towards MAPs is found to be greater than stigma towards
other groups (e.g., sexual minorities, those with mental illness; Boysen et al., 2020; Lehmann et
al., 2020) and research examining a community-based sample of MAPs found high proportions
of suicidal ideation with intense stigma being the most significant risk factor (Cohen et al.,
2019). As such, we anticipate internalized pedonegativity to be a stigma-related stressor present
to varying degrees in MAPs. Given the robust association between internalized stigma and
mental health problems, it is likely that higher levels of internalized pedonegativity is associated
with mental health concerns in MAPs (Jahnke, 2018) including suicidal ideation (Cohen et al.,
2019; Walter & Pridmore, 2012) and loneliness (Jahnke et al., 2015). There are currently no
quantitative studies examining internalized pedonegativity in MAPs, but given what is known
about internalized stigma in other populations, it is anticipated that internalized pedonegativity
will be important for understanding loneliness, mental health, and suicidality in MAPs and may
even be mediated by loneliness.
Current Study
The aim of the current study is to examine the interrelations of mental health, suicidality,
and loneliness with the following: (1) interpersonal relationships (i.e., support of family and
friends), (2) degree of outness to close others and the broader community, and (3) internalized
pedonegativity. The focus will be on examining how these stigma-related stressors affect the
wellbeing of MAPs. Mediation and moderation models will also be examined. The following
hypotheses were proposed:
1. Perceived social support from parents and friends regarding one’s minor attraction would be
related to lower psychological distress (Freimond, 2013), loneliness (Jahnke et al., 2015), and
suicidality (Hershberger & D’Augelli, 1995; Chaudoir & Fisher, 2010). The associations
between perceived social support for minor attraction, psychological distress, and suicidality
would be mediated by loneliness.
2. Higher perceived relational quality would be associated with lower psychological distress,
loneliness, and suicidality (Chaudoir & Fisher, 2010; Cohen & Wills, 1985; Graham &
Barnow, 2013; Hershberger & D’Augelli, 1995; Mereish & Poteat, 2015; Spencer & Patrick,
2009). The associations between relational quality, psychological distress, and suicidality
would be mediated by loneliness.
3. Higher levels of internalized pedonegativity would be associated with greater psychological
distress (Jahnke, 2018), loneliness (Jahnke et al., 2015) and suicidality (Newcomb &
Mustanski, 2010; Cohen et al., 2019). The associations between internalized pedonegativity,
psychological distress, and suicidality would be mediated by loneliness.
4. It was anticipated that MAPs who have disclosed their attractions to family and friends
would report lower psychological distress (Cash, 2016), loneliness (Cash, 2016), and
suicidality (Cohen et al., 2019; Newcomb & Mustanski, 2010). Again, the associations
between outness, psychological distress, and suicidality would be mediated by loneliness.
Method
Participants and Procedure
Participants were required to be over 18 years of age and identify as being sexual attracted
to children to be included in the study. All participants completed an anonymous survey that was
posted online via social media websites and in online forums that provide support for individuals
with sexual interests in children (i.e., Virtuous Pedophiles, Visions of Alice). Past research has
been successful in using this methodology to recruit from this population (e.g., Bailey et al.,
2016). Participants completed demographic questions, social relationship measures, outness

measure, perceived social support measure, stigma-related stressor measure, followed by
loneliness, psychological distress, and suicidality scales. Participants also completed measures
regarding sexual functioning and sexual and social behavior; these measures are not included in
the present study. This research received ethical approval from the research ethics board at
[ANONYMIZED FOR REVIEW].
Network of Relationships Inventory-Relationship Quality Version (NRI-RQV). The
NRI-RQV assesses supportive and discordant qualities of relationships (Furman & Buhrmester,
2009). Items from the five scales measuring supportive qualities and closeness of relationships
were used in the present research (i.e., companionship, intimate disclosure, satisfaction,
emotional support, and approval). Respondents were asked to think of one or a few close adult
relationships while answering the items. Items are scored on a five-point Likert scale (1 Little or
None to 5 The Most). Scale scores are computed by averaging the three items comprising each
scale, and then summed to generate total scores (range 5 to 25); higher scores represent closer
and more supportive relationships. The NRI-RQV had high internal consistency in the present
sample ( = .95) consistent with past research ( = .79 to  = .89; Ruhl et al., 2015).
Perceived Social Support for Minor Attraction Scale (PSS–MAS). The PSS–MAS was
adapted from the Parental Support for Sexual Orientation Scale (Mohr & Fassinger, 2003) for the
purposes of this study. Twelve items were adapted for the current study from the original 18-item
scale in order to assess the level of support for participants’ minor attraction provided by family
and friends (see Supplemental Appendix for item list). The original maternal support questions
were converted to inquire about family support and the original paternal support questions were
converted to inquire about support from friends. Responses were rated on a seven-point Likert
scale (1 Disagree strongly to 7 Agree strongly). Total and subscale scores are generated from the
average items and range from 1 to 7; higher scores indicate more perceived support from family
and friends for participants’ minor attraction. Good internal consistency for the PSS–MAS in the
present sample (Total score  = .74; Family Support  = .80; Friend Support  = .74), somewhat
consistent with past research on the Parental Support for Sexual Orientation Scale (maternal and
paternal support:  = 0.92 and  = 0.91, respectively; Mohr & Fassinger, 2003).
A sizeable proportion of participants were expected to not have disclosed their minor
attraction to others and the response option Does not apply to me was available to accommodate
participants in this situation. This choice, however, creates the problem of deciding how to score
these responses. This response option was coded as missing because scoring these responses as 0
would assign a psychological meaning (i.e., lower perceived social support) to a response
equivalent to “not applicable”. In the present research, the PSS–MAS total score was derived as
an average for the items that participants answered with a response option other that Does not
apply to me, allowing up to a maximum of 6 items being coded as missing. This scoring choice
was based on the determination that having at least 6 items to assess the construct of interest was
adequate and allowed for inclusion of approximately 70% of the sample (n = 143 of 204).2 For
the PSS–MAS Family and Friend subscales, a similar approach was taken, with 4 of the 7 items
in the Family Support subscale and 3 of the 5 items in the Friend Support subscale being
required to have a response option other than Does not apply to me.
2
In making this decision, we computed the PSS–MAS total score using different numbers of required answers other
than Does not apply to me, ranging from requiring 3 to 10 of 12 items be answered in order to compute a total score.
Sample sizes ranged from 177 to 73 using these various criteria for computing the PSS–MAS total score. When we
ran correlational analyses using total scores derived from these various conditions, there was relatively little
difference between correlations derived from total scores using 3, 4, 5, 6, or 7 items (difference in r ranged from
|.01| to |.05|); however, there was a notable increase in correlation magnitude using a total score derived from 10
items (difference in r ranged from |.05| to |.25|).
Minor Attraction Outness Scale. The Minor Attraction Outness Scale was adapted
from the Outness Inventory, an 11-item scale with three subscales (i.e., outness to family, world,
and religion; see Supplemental Appendix for item list) designed to assess what extent lesbian,
gay, and bisexual individuals are open to others about their sexual orientation (Mohr &
Fassinger, 2000). The Outness Inventory was adapted for the current study to assess the extent to
which MAPs are open about their attraction towards children. Participants were asked to rate
their level of outness with different members of their family, world (e.g., friends, work peers),
and religious community using a seven-point Likert scale (0 Not applicable to your situation;
there is not such person in your life to 7 Person definitely knows about your minor attraction,
and it is openly talked about).3 Total scores were computed as the average across all the items
and can range from 0 to 7; higher scores indicate higher degree of outness. In the present study, a
family subscale (4 items; mother, father, siblings, extended family) and friend subscale (2 items;
current and past non-MAP friends) were computed using the average of item scores. In the
present sample, acceptable internal consistency (total score  = .82; family score  = .79; friend
score  = .59) 4 was obtained, although this is lower compared to previous research on an adult
gay male sample ( = .78,  = .80, and  = .97, for family, world, and religion, respectively;
Mohr & Fassinger, 2000).
Internalized Pedonegativity Scale. The Internalized Pedonegativity Scale was adapted
from the Internalized Homophobia Scale (Wagner, Serafini, Rabkin, Remien, & Williams, 1994;
3
As with the PSS–MAS, the Not applicable to your situation option was coded as missing. A total score was
computed if 6 of the 11 items were available; a family subscale score was computed of 3 of the 4 items were
available; and a friends subscale score was computed if 1 of the 2 items was available.
4
This low level of internal consistency may be attributable to the small number of items in this scale (i.e., 2 items),
as including few items can underestimate reliability (Graham, 2006). Interestingly, scales with fewer items can
actually have the same or higher levels of inter-item correlations when compared to scales with more items, but the
alpha coefficients are roughly equivalent for both scales (Schmitt 1996). In examining the average inter-item
correlations, for the two subscales were roughly equivalent (family average item r = .47, friend average item r =
.42).
Wagner, 2011), which was developed for use with gay men to measure the extent to which
negative attitudes and beliefs are internalized and integrated into how one feels about their sexual
identity. The changes required to make this scale applicable to MAPs consisted of replacing the
words homosexual with attraction to children; item content remained the same. The scale
consists of 22 items that assess concealment, degree of ego dystonia regarding one’s minor
attraction, experience of internalizing symptoms in relation to one’s minor attraction, which
negative attitudes and beliefs are internalized, and how one feels about being attracted to
children (see Supplemental Appendix for item list). Items are scored on a five-point Likert scale
(1 Strongly disagree to 5 Strongly agree); higher scores indicate higher levels of internalized
pedonegativity. High internal consistency ( = .94) was found in the present sample, which is
consistent with past research using the Internalized Homophobia scale ( = .92; Wagner et al.,
1994) with gay men.
UCLA-Revised Loneliness Scale. This 20-item scale measures subjective feelings of
loneliness and social isolation (Russell, Peplau, & Cutrona, 1980). Participants rate each item on
a four-point Likert scale (1 Never to 4 Often). Total scores range from 20 to 80, with higher
scores representing greater self-reported loneliness. High internal consistency ( = .94) was
obtained in the present sample, consistent with previous psychometric research ( = .89 to .94,
Russel, 1996).
Brief Symptom Inventory-18 (BSI-18). The Brief Symptom Inventory-18 is a self-report
measure of general psychological distress (Meijer, de Vries, & van Bruggen, 2011). Participants
are asked to rate on a five-point Likert scale (1 Not at all to 5 Extremely) how much a range of
problems associated with anxiety, depression, and somatization have caused distress during the
past seven days. In the present sample, high internal consistency was found for the BSI-18 ( =
.93), consistent with prior research ( = .93; Franke et al., 2017).
Suicide Behaviors Questionnaire-Revised (SBQ-R). The SBQ-R is a four-item scale
measuring past thoughts of suicide, frequency of these thoughts, disclosure of suicidal thoughts
to others, and likelihood of committing suicide in the future (Linehan & Neilsen, 1981). Total
scores range from 3 to 18 with higher scores indicating higher suicidality. Good internal
consistency ( = .79) was found in the present sample, consistent with past research on clinical
( = .87) and non-clinical samples ( = .76; Osman et al., 2001).
Age Orientation Scale – Prepubescent and Pubescent Versions. The Age Orientation
Scale – Prepubescent and Pubescent Versions are based on the Kinsey Scale for sexual
orientation (Kinsey, Pomeroy, & Martin, 1948). It assesses the level of exclusivity individuals
experience in their sexual attraction to prepubescent and pubescent children (Stephens &
McPhail, 2020). Participants respond to a single item on a seven-point Likert scale (0 Exclusively
interested in fully mature adults to 6 Exclusively interested in prepubescent children or
pubescent children) with the option to respond with X (No interest in prepubescent/pubescent
children or fully mature adults). This measure was used to identify participants who self-reported
a sexual interest in children for inclusion in the present study. Participants who self-reported
exclusive interest in adults (i.e., score of 0 on both scales) were screened out of the analyses (n =
2).
Planned Analyses
First, bivariate correlations between stigma-related stressors (i.e., internalized
pedonegativity, support for minor attraction, degree of outness), loneliness, relational quality,
psychological distress, and suicidality were conducted. The correlations were used to identify
significant relationships between measures. Second, we conducted mediation analyses to assess
whether loneliness mediates the relationship of both social and internalizing aspects of stigma-
related stress, psychological distress, and suicidality. Mediation analyses were conducted using
the IBM SPSS (version 20) software add-on program PROCESS (Hayes, 2013). Preliminary
diagnostics were conducted to verify the appropriateness of the data for mediation analysis (e.g.,
multivariate normality, outlier detection, scale internal consistency, normality of residuals).
Mediation analysis was undertaken when, in the correlation analyses: (a) the stigma-related
stressor was associated with loneliness, (b) the stigma-related stressor was associated with
psychological distress or suicidality, and (c) loneliness was associated with psychological
distress or suicidality. All linear associations were interpreted per Cohen’s (1992) guidelines for
correlation effect size magnitudes of .10 (small), .30 (medium), and .50 (large).
Results
The final sample included 202 self-identifying MAPs (12.9% female). The sample was 33
years of age (SD = 13.0) and the majority were currently single (67.3%; dating, common law,
married = 26.7%), had a postsecondary degree (55.0%; high school diploma = 35.1%), and were
employed (56.0%; unemployed = 36.6%). In terms of erotic age and sexual orientations,
approximately half of the sample reported an exclusive attraction to children (49.0%; non-
exclusive attraction = 51.0%) and a heterosexual orientation (47.5%; bisexual = 19.3%;
homosexual = 24.2%).
Bivariate Correlations
Table 1 provides bivariate correlations between the measures used in the present study.
Higher scores on the Total score and Family and Friends subscales of the Perceived Social
Support for Minor Attraction Scale (PSS-MAS) were positively correlated with the Degree of
Outness Scale total score and outness to friends (rs ranged from .26 to .38). Internalized
pedonegativity showed a moderate, significant negative correlation with the PSS-MAS (Total
score r = –.34, Family r = –.28, and Friend scores r = –.32). Internalized pedonegativity was
associated with lower outness to friends (r = –.23).
Internalized pedonegativity was associated with increased loneliness (r = .28),
psychological distress (r = .36), and suicidality (r = .34). Greater perceived support over and
from friends and family were each associated with lower levels of loneliness (rs from –.43 to –
.52), psychological distress (rs from –.36 to –.46), and suicidality (rs from –.35 to –.38).
Over half the sample (64.4%, n = 130) had disclosed their minor attraction to someone else
in their life (see Supplemental Table S1). For MAPs in the sample, their mothers and other close
family members and friends were the most likely to know of their minor attraction
(Supplemental Table S1). However, in the majority of cases, minor attraction was rarely
discussed. The large majority of MAPs indicated that people in their extended families, at work,
and in their religious communities did not know about their minor attraction. The Outness Total
and Friend scores were associated with loneliness (rs = –.20 and –.38) but were not associated
with psychological distress or suicidality. The Outness Family score was unrelated to the other
variables of interest.
Relational quality, as measured by the NRI-RQV, was associated with higher perceived
support from others, degree of outness to friends, and lower levels of loneliness. Relational
quality was not meaningfully associated with either psychological distress or suicidality and was
dropped from further consideration in the statistical mediation models.
Statistical Mediation Analysis

To test whether loneliness mediated the relationships between stigma-related stressors
reported by MAPs and psychological distress and suicidality, statistical mediation models were
tested (see Figure 1 for model exemplar). For psychological distress, overall perceived social
support (B = –2.1), perceived social support from friends (B = –2.3), and internalized
pedonegativity (B = 0.2) each remained significant predictors after accounting for the mediating
role of loneliness (Table 2), indicating partial statistical mediation. The models accounted for
53% to 61% of the variance in psychological distress. After accounting for the mediating role of
loneliness, the direct effect of perceived support from family was no longer significant (B = –1.2,
95% CI = –2.7, 0.3). This finding suggests full statistical mediation.
For suicidality, perceived social support from friends (B = –0.4) and internalized
pedonegativity (B = 0.1) remained significant predictors after accounting for the mediating role
of loneliness (Table 2). The models accounted for 47% to 56% of the variance in suicidality.
Overall level of perceived support and perceived support from family did not predict
psychological distress after accounting for the mediating role of loneliness (B = –0.3 and B = –
0.3, respectively), indicating full statistical mediation by loneliness.
Post-Hoc Analyses
The absence of meaningful associations between degree of outness and distress, suicidality,
or loneliness was not expected. Beyond a true lack of relationship, this null result may be
indicative of complexity within the disclosure process for MAPs and other variables are involved
to explain a lack of relationship. We explored this complexity, in a post hoc manner, by
examining whether MAPs who had disclosed their minor attraction to close family and friends
perceived the others as being supportive of them or not.5 These analyses were informed by past
5
The PSS-MAS item, “My family has become a real support regarding my minor attraction”, was used to group
participants according to whether they perceived support from their family; the item “My friends have become a real
research that has found positive responses following disclosing a stigmatized identity may
mitigate negative psychological sequelae (e.g., Pachankis, 2007). For MAPs, having others in
their social support system be unsupportive or rejecting may exacerbate the psychological burden
of stigma-related stress. These analyses were conducted using one-way ANOVAs. Further, we
considered offense status as a covariate, as being “outed” from detection (i.e., arrested charged,
or convicted) for a sexual offense is a possible a third variable that might explain the association
between support following disclosure and negative outcomes. To account for this potential third
covariate, one-way ANCOVAs were conducted.
One-way ANOVA results suggest that those who had disclosed and did not perceive their
family as supportive reported the highest levels of loneliness, distress, and suicidality, and the
lowest ratings of relationship quality (Table 3). The results were significant for loneliness
(moderate to large effects) and suicidality (small to moderate effects). The results for disclosure
to and support from friends showed the same general pattern (Table 4). Notably, those who
disclosed and received support from friends had lower levels of loneliness, psychological
distress, and suicidality than those who disclosed to friends who were not supportive (moderate
to large effects). These patterns of results remained following inclusion of offence history in the
model (Tables 3 and 4; complete ANCOVA results found in Supplemental Tables S2 and S3).
Discussion
support regarding my minor attraction” was used to group participants according to whether they perceived support
from friends. The Outness Inventory items relating to mother, father, and siblings were used to group participants
according to whether a family member was aware of a participant’s minor attraction. The Outness Inventory item
relating to close friends was used as a marker of disclosure to non-MAP friends. Perceived support from family and
disclosure to family variables were combined to create three groups: No disclosure, disclosure with no perceived
support, and disclosure, with perceived support. The perceived support from friends and disclosure to friends
grouping were combined to create the same three groups. Separate one-way analyses of variance were conducted
using the three family support and disclosure variables and friend support and disclosure variables to examine group
differences on the internalized pedonegativity, loneliness, relationship quality, psychological distress, and
suicidality.
The present study examined the associations between stigma-related stress and wellbeing
among MAPs. Research with other stigmatized populations (e.g., those with serious mental
health concerns, sexual minority groups) was used as a guide to identify important stigma-related
processes that may be associated with psychological distress and suicidality in MAPs. Results
demonstrated associations between stigma-related stressors, such as internalized pedonegativity
and perceived lack of support from close others, with heightened psychological distress and
suicidality. A further aim of the study was to examine the association between relational quality
and MAP wellbeing, although supportive evidence here was lacking.
Perceived Social Support, Relationship Quality, and Loneliness
The data supported the hypothesis that participants with more perceived support from
friends and family as having greater relational quality and less loneliness, psychological distress,
and suicidality. These findings are consistent with the previous literature and emphasize the
importance of close supportive relationships for MAPs’ mental health and wellbeing (Cash,
2016; Cohen et al., 2019; Newcomb & Mustanski, 2010; Doty, Willoughby, Lindahl, & Malik,
2010). In addition, findings suggest MAPs with higher relational quality in general reported a
higher level of outness to friends and lower loneliness. These results suggest that higher quality
relationships (i.e., warm, supportive, approving, satisfying) are ones in which MAPs are more
comfortable making a disclosure and provide MAPs with more support following a disclosure.
However, relationship quality was not associated with distress or suicidality.
Loneliness is a profoundly distressing human experience associated with physical health
problems and mortality (Cacioppo et al., 2002; Holt-Lunstad et al., 2015) and is an important
social determinant of mental health (e.g., Cacioppo et al., 2006). Given its centrality to health,
we presumed examining loneliness in concert with stigma-related stress would further our
understanding of mental health in MAPs. We found that perceived support from friends
predicted lower loneliness and remained predictive of both mental health outcomes when
loneliness was included in the mediation model. In contrast, perceptions of support by family
members was fully mediated by loneliness. This result suggests that familial support may exert a
protective function mainly via reducing MAPs’ experience of loneliness. Support from friends
may provide experiences of warmth, affection, and feeling understood, which may contribute to
less loneliness. In addition, having friends who are supportive may mean not having to conceal
one’s sexuality or having to worry about friends’ judgments, which may more generally reduce
the stress burden for MAPs. These results are preliminary, yet encouraging, as it suggests
clinicians can support MAPs by helping them improve the support received from their social
network and through this, reduce experiences of loneliness and improve mental health.
The level of loneliness reported by this sample is markedly elevated and requires further
comment. Across several comparison samples available in past research, the level of loneliness
in the present sample of MAPs is elevated when compared with that of university students (d =
1.64, Russell, 1996; d = 0.95, Tan et al., 2020), community-dwelling adults (d = 1.74, Knight et
al., 1988) and adults over the age of 65 (d = 2.35, Ausín et al., 2019), gay, lesbian, and bisexual
adults (d = 0.63, Kakoullis, 2001; d = 0.84, Martin & Knox, 1997), and even individuals with
histories of sexual offending (d = 0.64, Beggs & Grace, 2011; d = 0.86, Elliott et al., 2009; d =
0.53, Marshall et al., 1998; d = 1.01, Olver et al., 2014; d = 0.91, Wielinga et al., 2019); the
lattermost being a population characterized as experiencing elevated rates of loneliness
(Marshall, 1989). These comparisons, while not representing a systematic review of the available
literature, suggest MAPs experience markedly higher rates of loneliness and may further
emphasize loneliness as an important risk factor for mental health concerns in this population.6
Internalized Pedonegativity
MAPs experiencing internalized pedonegativity were less likely to perceive family and
friends as supportive. These results are consistent with past findings that internalized stigma is
associated with lower perceptions of supported (Pachankis, 2007). MAPs experiencing
internalized pedonegativity were also less likely to disclose their minor attraction to friends but
not less likely to be out to family or in general. Qualitative research found the opposite in that
MAPs were more likely to disclose to friends first, and family and coworkers second (Cash,
2016). Given that disclosing an attraction to minors can be stressful event, it is promising that
MAPs experiencing internalized pedonegativity were still able to find people in their lives to
disclose their minor attraction. As anticipated by our hypothesis and previous research (Jahnke,
2018), MAPs experiencing internalized pedonegativity reported greater levels of loneliness,
psychological distress, and suicidality; loneliness only partially mediated the relationship
between internalized pedonegativity and mental health concerns. These results indicate that
internalized pedonegativity may be a driver of decreased wellbeing for MAPs and highlight the
need clinical services to focus on addressing internalized pedonegativity.
Outness and Disclosure of Minor Attraction
The pattern of results for degree of outness about minor attraction presents a complex
picture. Most MAPs in this sample had disclosed their minor attraction to someone in their lives.
At a general level, MAPs were more likely to disclose to those with whom they are close, and
6
A similar trend is found for both psychological distress and suicidality. For instance, on the SBQ-R, the average
score of this MAP sample is above the cutoff (i.e., a score of 8; Osmand et al., 2001) for identifying individuals at
elevated risk for suicide.
less likely to disclose to people outside their immediate social circle. The finding of not
disclosing at work or in religious communities suggests a high level of concealment in everyday
life and opens up a number of questions about the stress of concealing a stigmatized status for
MAPs. Furthermore, results suggest that disclosing one’s minor attraction may alleviate
loneliness, but the act of disclosing does reduce distress. These results suggest preliminarily that
disclosure by itself is not associated with better mental health, rather it is the quality of the
relationships following disclosure that may be the determining factor.
MAPs, when making decisions regarding disclosing their attractions to others, consider
whether a person will react positively or negatively (Cash, 2016). Given the potential
consequences for disclosing (e.g., ending the relationship, maintaining the relationship but
refusing to discuss or accept the disclosure, reporting the MAP to authorities), this seems a
functional strategy to perform prior to disclosure. Research with LGBTQ populations suggests
that the psychosocial benefits of disclosure are numerous, but may be offset by certain outcomes
that have negative associations with mental health and quality of life. Concealment as a strategy
used to cope with or avoid stigma, can also have its own negative sequalae, especially in the long
term (Miller & Major, 2000; Mohr & Fassinger, 2006).
To provide a preliminary examination of the complexity inherent in making disclosures,
we grouped MAPs according to whether they had disclosed or not and whether they felt
supported by the people they disclosed to. The results of the present study suggest that
disclosures that result in perceptions of support are associated with less loneliness and
suicidality. Findings that stand out include disclosures that are not successful are associated with
levels of loneliness and suicidality that were greater than the levels reported by MAPs who had
not disclosed their attractions. This latter set of findings suggests concealment may be a more
functional strategy than a disclosure that has negative consequences. To our knowledge, this is
the first quantitative study to examine disclosure status in concert with perceptions of support.
These results are tentative and await replication before more confidence can be placed in this
interpretation. There are a number of future steps in this line of research into disclosure and
concealment by MAPs, such as identifying intra- and interpersonal factors associated with
disclosure by MAPs, the characteristics of the disclosed-to-other that predict disclosure success,
differences between disclosing to non-MAP others versus other MAPs, other positive and
negative outcomes following disclosure that predict mental health outcomes for MAPs, and the
effects of concealment on MAPs.
The results regarding disclosure in relation to perceived support are interesting. However,
the measures we used should be thought of as a proxy for perceived support following disclosure
because the items used did not directly ask about the specific person MAPs made the disclosure
to. This approach weakens the confidence we can have in these results to a certain degree.
Further, disclosure is a complex phenomenon when an individual’s entire social network is
considered, and our results should be viewed as assessing disclosure to a limited range of a
MAP’s social network. A potential remedy would be to use a methodology like that used in the
Disclosure Grid which allows for a structured method of assessing multiple aspects of the
disclosure process across one’s social network (Beals & Peplau, 2006).
There is an interesting set of findings hiding in plain view within the outness and
perceived support results; a notable proportion of MAPs disclosed their attractions and felt
supported by the people they disclosed to. This suggests that MAPs are indeed able to find other
people to come out to and that these others are not rejecting them. This speaks to the social
acuity of MAPs to identify people in their lives that would not be rejecting, courage on their part
to take the risk of making a disclosure, and the compassion of these people in their lives to be
supportive of the MAPs that have made a disclosure. These results are encouraging for those
working with MAPs clinically and for MAPs themselves, as they suggest most people who
experience an attraction to children can find others to provide them with care and support.
Limitations
There are notable limitations to the current study, in addition to the issues raised above,
that constrain the generalizability of the results and confidence we can have in certain
interpretations. The study design resulted in cross-sectional data, which eliminates our ability to
interpret the directionality of effects. For instance, we do not know whether internalized
pedonegativity leads to more depressive symptomatology or increased risk for suicidality. It
might be that individuals experiencing depression currently are more likely to make negative
evaluations of self or elevated suicide risk is due to depression. Bailey (2019) offers a
compelling critic of the sexual minority stress model and future research can use this scholarship
to begin to account for third-variable explanations.
The online forums where data were collected limit generalizability. One forum, Virtuous
Pedophiles, is intended as a place where MAPs can receive support from each other for issues
including distress, suicidality, and offence risk. The other forum, Visions of Alice, is for
individuals who are sexually attracted to girls to discuss topics relevant to their attractions. While
we do not have data to outline the differences between forums for support versus general MAP
forums or individuals attracted to girls compared to those attracted to boys, it may be premature
to widely generalize the present results. For instance, this sample may represent an especially
distressed sample, since these individuals were participating on a forum for those seeking
support.
It is also notable that we focused our attention on disclosures to non-MAP friends. There
may be important processes at play when disclosures are made to other MAPs or to mental health
professionals and how these individuals respond to disclosures. Last, our operationalization of
disclosure was broad and potentially included instances where an individual was outed by being
arrested for an offence. While we applied statistical modelling to account for the potential impact
of offending on the associations between outness and outcomes, which suggests that support
following outness continues to be an important determinant of outcome, a stronger design would
ask after outness due to offending in addition to volitional disclosures. These two limitations
point to the complexities involved in the disclosure process for MAPs and future research should
build on the present results by including these additional considerations.
The measure of internalized pedonegativity used in the current study included several
items relevant to ego dystonic minor attraction, among other items that assess concealment
behaviors and internalizing symptoms related to minor attraction. These items assess a sense of
despair, dissatisfaction, and desire to make changes to one’s attraction. There is some complexity
in the concept of internalized pedonegativity that deserves further comment. A specific example
in the present research is an item assessing the desire for a "miracle pill" to change one's
attractions. It may appear adaptive for a MAP to wish for such a cure. However, we view this
desire as reflective of self-stigma processes wherein there exists a societal stereotype that minor
attraction is negative in some way (e.g., wrong, hopeless, dangerous, deviant, a mark of personal
deficiency or undesirability), prejudice and discrimination are directed towards MAPs, and
MAPs experience a desire to remove this stigmatizing mark. A person with a minor attraction
does not necessarily have to endorse these views of “self-as-deviant” for the desire to remove a
stigmatizing mark to be a facet of self-stigma.

While we believe this process is an aspect of internalized stigma, others may reasonably
subscribe to another position and wish to consider this in future research. There are also other
aspects of internalized stigma that we did not assess in this study. Other constructs that an
internalized pedonegativity scale might measure include alienation, discrimination experiences,
and even stigma resistance (Ritser et al., 2003). The present study is one of the first to examine
internalized pedonegativity with a psychometric scale and future developments in the field will
continue to expand and revise scales to assess important stigma processes in this population.
Recommendations and Conclusions
The present research has some initial clinical implications. The results provide evidence
that considering the role of internalized stigma in the mental health concerns of MAP clients may
be important when providing clinical services to this population. Assessing for the presence of
internalized pedonegativity may inform the kinds of interventions provided to these clients (e.g.,
compassion-focused interventions; cognitive reframing). Clinicians may also be well-served by
improving their understanding of minor attraction and issues surrounding providing treatment to
these clients. Recent scholarship in this area provides in-depth examination of the issues around
mandatory reporting in general (Kenny et al., 2017) and with minor attracted clients (McPhail et
al., 2018). Of note, clinician stigma is a strong predictor of whether a clinician makes a
mandatory report, over-and-above client characteristics (Stephens et al., 2021). We predict that
pursuing educational resources will reduce clinician stigma towards MAPs, as there is some
evidence to suggest education has this effect for clinicians (Jahnke et al., 2015). In addition, two
findings, that disclosure followed by a lack of support seeming to be associated with negative
outcomes while non-disclosure was not as negative, indicates that care and attention should be
paid when working with clients around making a disclosure. There is an absence of research on
the characteristics of people who are supportive following a disclosure by an MAP, which
further complicates this clinical task. Beyond assessing and addressing stigma-related stressors,
the present results and past research indicate that assessment and intervention with MAPs should
address loneliness and suicidality. These recommendations are to be balanced with the limits that
come with cross-sectional designs.
The present study provides some of the first data examining the mental health correlates of
stigma-related stressors experienced by minor attracted people. By relying on previous research
into stigma-related stress in stigmatized populations, we identified important stigma processes
(i.e., internalizing stigma, perceptions of support from others, disclosure) that may help
understand experiences of loneliness, psychological distress, and suicidality in this population.
The data provided by MAPs allows us to make initial conclusions that both internalized
pedonegativity and perceptions of support are related to these three mental health outcomes.
Loneliness also stands out as an important aspect of MAPs’ psychosocial functioning likely
owing to its mediating role between stigma-related stress and mental health outcomes and the
markedly elevated rate reported by MAPs. Being open with others about minor attractions is a
complex process, and whether disclosure has a positive effect on mental health appears to
partially depend on the reactions of others. The present results provide an initial understanding of
how these stigma processes may impact MAPs psychological and social functioning and provide
interesting directions for future research.

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Table 1
Descriptive Statistics and Correlations for Study Variables
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
1. Perceived support – Total --
2. Perceived support – Family .92*** -- .
(125)
3. Perceived support – Friends .89*** .58*** --
(102) (84)
4. Internalized pedonegativity –.34*** –.28** –.32** --
(143) (129) (107)
5. Degree of outness – Total .26** .29** .12 –.09 --
(128) (117) (98) (180)
6. Degree of outness – Family .04 .15 –.10 .03 .86*** --
(125) (115) (94) (177) (171)
7. Degree of outness – Friends .38*** .29** .35*** –.23** .83*** .48*** --
(134) (120) (102) (190) (175) (170)
8. Loneliness –.52*** –.47*** –.43*** .28*** –.20** –.00 –.38*** --
(143) (129) (107) (201) (179) (176) (189)
9. Relational quality .33*** .29** .24* –.04 .01 –.11 .15* –.44*** --
(130) (116) (97) (185) (167) (164) (177) (184)
10. Psychological distress –.43*** –.36*** –.46*** .36*** –.01 .04 –.09 .48*** –.05 --
(143) (129) (107) (202) (180) (177) (190) (201) (185)
11. Suicidality –.35*** –.35*** –.38*** .34*** .01 .08 –.05 .41*** .08 .62*** --
(143) (129) (107) (202) (180) (177) (190) (201) (185) (202)
M 4.2 4.0 4.7 64.0 2.2 2.4 2.8 53.7 2.4 40.2 9.6
SD 1.5 1.7 1.8 20.3 1.2 1.5 1.9 13.0 1.0 14.8 4.1
n 143 129 107 202 180 177 194 201 185 202 202
Note. Sample sizes for the correlations are provided in brackets below the coefficient. Degree of outness descriptives statistics, as
category frequency counts, are provided in Supplemental Table S1.
*
p < .05. **p < .01. ***p < .001.
Table 2
Mediation pathways between support for minor attraction, internalized pedonegativity, and degree of outness with loneliness and
mental health outcomes
Psychological distress Suicidalitya
Predictor a (SE) b (SE) c’ (SE) R2 b (SE) c’ (SE) R2
[95% CI] [95% CI] [95% CI] [95% CI] [95% CI]
(n) (n)
Perceived support – –4.30*** (.60) 0.48***(.09) –2.05** (.78) .56 0.15*** (.03) –0.32 (.23) .52
Total [–5.49, –3.11] [0.29, 0.66] [–3.60, –0.50] [0.09, 0.20] [–0.77, 0.12]
(143) (143)
Perceived support – –3.63*** (.61) 0.55*** (.10) –1.23 (.75) .56 0.16*** (.03) –0.34 (.22) .55
Family [–4.85, –2.41] [0.36, 0.75] [–2.72, 0.26] [0.10, 0.21] [–0.77, 0.09]
(129) (129)
Perceived support – –3.13*** (.64) 0.49*** (.10) –2.30** (.72) .61 0.15*** (.03) –0.44* (.21) .56
Friends [–4.40, –1.85] [0.30, 0.70] [–3.73, –0.87] [0.09, 0.21] [–.0.86, –0.01]
(107) (107)
Internalized 0.18*** (.04) 0.46*** (.07) 0.18*** (.05) .53 0.101*** (.02) 0.05*** (.01) .47
pedonegativity [0.09, 0.26] [0.32, 0.60] [0.09, 0.27] [0.07, 0.15] [0.02, 0.07]
(201) (201)
Note. a path = direct effect between the predictor and loneliness; b path = association between loneliness and the dependent variable
(i.e., psychological distress or suicidality) controlling for the predictor in the model; c’ path = indirect effect of the predictor’s
association with the dependent variable, controlling for loneliness.
a
The a path is not provided for suicidality because this path is the same for both models (i.e., predictor to loneliness). All coefficients
reported are unstandardized regression coefficients.
*
p < .05. **p < .01. ***p < .001.
Figure 1
Model for the mediating effect of loneliness on the relationship between perceived support and
psychological distress
Note. This figure provides an example of how the mediation analyses were conducted across the
different predictors. All mediation models tested in this study used the sample model.
***p < .001.

Table 3
Means, Standard Deviations, Cohen’s d, and One-Way Analyses of Variance in Outness Status and Perceived Support from Family
Scale (1) No (2) Disclosure, (3) Disclosure, 1 vs. 2 1 vs. 3 2 vs. 3 FANOVA p FANCOVAa p
disclosure no support support d d d
M (SD) M (SD) M (SD) [95% CI] [95% CI] [95% CI]
n = 103 n = 36 n = 49
Internalized 65.1 61.6 65.0 0.22 0.01 –0.13 0.4 .659 0.3 .731
pedonegativity (19.2) (19.9) (23.0) [–0.17, 0.63] [–0.35, 0.39] [–0.58, 0.31]
Loneliness 54.7 59.4 47.2 –0.42 0.63 1.07 11.1 <.001 9.0 <.001
(12.7) (12.2) (11.4) [–0.83, –0.04] [0.30, 1.00] [0.62, 1.66]
Relationship 42.2 38.6 43.3 –0.27 0.10 0.34 1.0 .365 1.0 .369
qualityb (14.7) (13.4) (13.9) [–0.71, 0.14] [–0.27, 0.48] [–0.13, 0.86]
Psychological 39.9 40.8 39.9 –0.03 0.01 0.06 0.1 .948 0.1 .923
distress (14.1) (16.0) (15.2) [–0.44, 0.38] [–0.35, 0.37] [–0.40, 0.51]
Suicidality 9.4 11.0 8.6 –0.38 0.12 0.50 2.6 .075
(4.1) (4.1) (4.2) [–0.80, –0.01] [–0.24, 0.48] [0.06, 0.98]
Note. The Cohen’s ds represent the standardized mean difference between two of the groups presented in the table. For instance, the
“1 vs. 2” column provides the Cohen’s d for the difference between those who have not disclosed their minor attraction to family and
those who have disclosed, but do not perceive their family as supportive. Cohen’s d coefficients that are bolded are significant at the p
< .05 (or smaller) level. A positive Cohen’s d indicates that the disclosure group had low scores on a problematic variable (e.g.,
loneliness) or higher scores on a positive variable (e.g., relationship quality). For comparisons between the two disclosure groups, a
positive Cohen’s d indicates the disclosure + perceived support group reported lower scores on a problematic variable and higher
scores on a positive variable. CI = Confidence interval.
a
The sample sizes available for the ANCOVA were somewhat diminished due to a proportion of the sample abstaining from
responding to questions regarding offense history. See Supplemental Tables S2 and S3 for full details on sample sizes in these
analyses.
b
ns = 97, 30, 44.
Table 4
Means, Standard Deviations, Cohen’s d, and One-Way Analyses of Variance in Outness Status and Perceived Support from Friends
Scale (1) No (2) Disclosure, (3) Disclosure, 1 vs. 2 1 vs. 3 2 vs. 3 FANOVA p FANCOVAa p
n = 102 n=9 n = 49
Internalized 66.8 64.6 59.8 0.18 0.34 0.14 2.0 .133 1.9 .160
pedonegativity (19.7) (24.3) (19.4) [–0.59, 1.03] [0.00, 0.71] [–0.65, 0.98]
Loneliness 56.4 57.4 45.4 –0.19 0.96 0.96 14.1 <.001 6.8 .002
(12.4) (15.1) (11.0) [–1.00, 0.56] [0.62, 1.36] [0.10, 2.77]
Relationship 38.7 44.5 47.9 0.52 0.69 0.21 7.3 .001 5.5 .001
qualityb (13.8) (11.6) (13.9) [0–.31, 1.61] [0.35, 1.09] [–0.51, 0.99]
Psychological 40.5 47.9 37.1 –0.47 0.22 0.77 2.4 .095 1.3 .289
distress (14.7) (16.7) (13.5) [–1.32, 0.23] [–0.12, 0.57] [0.02, 1.88]
Suicidality 9.5 12.9 8.8 –0.77 0.10 1.04 3.8 .024 2.8 .064
(4.2) (4.5) (3.6) [–1.75, –0.08] [–0.24, 0.45] [0.22, 2.70]
those who have disclosed, but do not perceive their friends as supportive. Cohen’s d coefficients that are bolded are significant at the p
a
The sample sizes available for the ANCOVA were somewhat diminished due to a proportion of the sample abstaining from
responding to questions regarding offence history. See Supplemental Tables S2 and S3 for full details on sample sizes in these
analyses.
b
ns = 97, 30, 44.
Supplemental Appendix: Stigma-Related Stress and Outness Scale Items
Perceived Social Support for Minor Attraction Scale
Coming out to my family has been a very painful process for me.
My family has become a real support regarding my minor attraction.
My family does not recognize my minor attraction as legitimate.
I feel like I will never live up to my family’s expectations of be because of my minor attraction.
I feel I have failed my family by being a minor attracted person.
I fear that my family will never accept my minor attraction.
Being a minor attracted person has destroyed my relationship with my family.
Coming out to my friends has been a very painful process for me.
My friends have become a real support regarding my minor attraction.
My friends do not recognize my minor attraction as legitimate.
I fear that my friends will never accept my minor attraction.
Being a minor attracted person has destroyed my relationship with my friends.
Minor Attraction Outness Scale Items
Mother
Father
Siblings (sisters, brothers)
Extended family/relatives
My current non-MAP friends
My work peers
My work supervisor(s)
Member of my religious community (e.g., church, temple)
Leaders of my religious community (e.g., church temple)
Strangers/new acquaintances
My past non-MAP friends
Internalized Pedonegativity Scale Items
Attraction to children is a natural expression of sexuality in humans.

I wish I were only attracted to adults.
When I’m sexually attracted to a child, I do not mind if someone else knows how I feel.
Most problems that MAPs have come from their status as an oppressed minority, not from their
sexual or romantic attraction to children per se.
Life as an MAP is not as fulfilling as life as a non-MAP.
I am glad to be an MAP.
Whenever I think a lot about being an MAP, I feel critical about myself.
I am confident that my pedophilia does not make me inferior.
Whenever I think a lot about being an MAP, I feel depressed.
If it were possible, I would accept the opportunity to be attracted to adults.
I wish I could become more sexually attracted and romantically attracted to adults.
If there were a pill that could change my minor attraction, I would take it.
I would not give up being an MAP even if I could.
Attraction to children is deviant.
It would not bother me if I had children who were MAPs.
Being an MAP is a satisfactory and acceptable way of life for me.
If I were attracted to adults, I would probably be happier.
Most MAPs end up lonely and isolated.
For the most part, I do not care who knows I am an MAP.
I have no regrets about being an MAP.
I have tried to stop being attracted to children in general.
I would like to get professional help in order to change my attraction to children to attraction to
adults
Supplemental Table S1.

Frequencies for Minor Attraction Outness Scale
Mother Father Siblings Extended Current Past Work Work Religion – Religion – Strangersa
n n n family friends friends peers supervisor Members Leaders n
(%) (%) (%) n n n n n n n (%)
(%) (%) (%) (%) (%) (%) (%)
Person definitely does NOT know about 72 84 78 138 81 108 128 130 81 79 145
minor attraction (39.3) (49.7) (44.6) (73.8) (45.5) (53.5) (63.4) (64.4) (40.1) (39.1) (71.8)
Person might know about minor attraction, 30 33 38 23 21 21 8 6 4 3 15
but it is NEVER talked about (16.4) (19.5) (21.7) (12.3) (11.8) (10.4) (4.0) (3.0) (2.0) (1.5) (7.4)
Person probably knows about minor 12 9 10 3 5 9 1 0 1 3 0
attraction, but it is NEVER talked about (6.6) (5.3) (5.7) (1.6) (2.8) (4.5) (0.5) (0) (0.5) (1.5) (0)
Person probably knows about minor 2 1 4 1 4 12 0 0 0 0 7
attraction, but it is RARELY talked about (1.1) (0.5) (2.3) (0.5) (2.2) (5.9) (0) (0) (0) (0) (3.5)
Person definitely knows about minor 40 31 28 15 16 15 2 0 4 1 0
attraction, but it is RARELY talked about (21.8) (18.3) (16.0) (8.0) (8.9) (7.4) (1.0) (0) (2.0) (0.5) (0)
attraction, and it is SOMETIMES talked (6.0) (2.4) (5.7) (1.1) (19.1) (6.9) (0.5) (0.5) (2.0) (2.5) (2.0)
about
attraction, and it is OPENLY talked about (8.7) (4.1) (4.0) (2.1) (9.6) (6.4) (1.0) (0) (0.5) (0.5) (2.5)
Not applicable, no such person or group in -- -- -- -- -- 10 60 65 107 110 26
your life (5.0) (29.7) (32.2) (53.0) (54.5) (12.9)
a
This category included new acquaintances.
Supplemental Table S2
Means, Standard Deviations, Cohen’s d, and One-Way Analyses of Covariance in Outness Status and Perceived Support from Family
Scale No Disclosure, Disclosure, 1 vs. 2 1 vs. 3 2 vs. 3 F p
n = 81 n = 27 n = 39
Internalized pedonegativity 64.4 62.2 66.5 0.11 –0.10 –0.20 0.3 .731
(19.7) (20.4) (22.7) [–0.33, 0.55] [–0.48, 0.28] [–0.69, 0.29]
Loneliness 53.6 60.8 47.9 –0.58 0.46 1.14 9.0 <.001
(12.8) (11.0) (11.6) [–1.02, –0.14] [0.07, 0.85] [0.61, 1.66]
Relationship qualitya 42.3 37.0 42.0 –0.37 –0.02 0.37 1.0 .369
(14.6) (12.4) (14.3) [–0.85, 0.10] [–0.42, 0.38] [–0.17, 0.91]
Psychological distress 39.0 40.3 40.3 –0.09 –0.09 0.00 0.1 .923
(14.4) (14.2) (15.8) [–0.53, 0.35] [–0.47, 0.29] [–0.49, 0.49]
Suicidality 9.3 11.0 8.8 –0.41 0.13 0.53 2.3 .099
(4.0) (4.4) (4.0) [–0.85, 0.02] [–0.26, 0.51] [0.03, 1.03]
a
ns = 76, 22, 35.
Supplemental Table S3
Means, Standard Deviations, Cohen’s d, and One-Way Analyses of Covariance in Outness Status and Perceived Support from Friends
Scale No Disclosure, Disclosure, 1 vs. 2 1 vs. 3 2 vs. 3 F p
n = 83 n=8 n = 35
Internalized pedonegativity 66.8 63.6 59.8 0.12 0.32 0.20 1.9 .160
(19.9) (25.8) (17.8) [–0.61, 0.84] [–0.08, 0.72] [–0.57, 0.97]
Loneliness 55.0 57.6 46.1 –0.20 0.73 0.97 6.8 .002
(12.8) (16.1) (10.8) [–0.92, 0.53] [0.32, 1.13] [0.17, 1.76]
Relationship qualitya 38.7 44.4 47.5 0.42 0.63 0.21 5.5 .005
(13.6) (12.9) (14.7) [–0.49, 1.33] [0.22, 1.04] [–0.72, 1.15]
Psychological distress 39.2 46.9 37.8 –0.52 0.10 0.63 1.3 .289
(14.7) (17.5) (13.7) [–0.21, 1.24] [–0.30, 0.49] [–0.15, 1.41]
Suicidality 9.3 12.4 8.6 –0.75 0.17 0.96 2.8 .064
(4.1) (4.6) (3.8) [–1.48, –0.01] [–0.22, 0.57] [0.17, 1.76]
a
ns = 78, 5, 35.

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Running head: STIGMA IN MINOR ATTRACTED PEOPLE 1

Stigma-Related Stress, Complex Correlates of Disclosure, Mental Health, and Loneliness in

Minor Attracted People

Desiree L. Elchuk, Ian V. McPhail, and Mark E. Olver

Desiree Elchuk, Department of Psychology, University of Saskatchewan; Ian V. McPhail,

Department of Psychology, University of Saskatchewan; Mark E. Olver, Department of

Psychology, University of Saskatchewan.

Correspondence concerning this article should be addressed to Ian V. McPhail, Department

of Psychology, University of Saskatchewan, Saskatchewan, Email: ian.mcphail@usask.ca; or

Mark E. Olver, Department of Psychology, University of Saskatchewan, Saskatchewan, Email:

publication, via its DOI: 10.1037/sah0000317

literatures exist linking stigma-related stressors to negative psychological sequalae in other

an online sample of MAPs (n = 202). Results demonstrated expected associations between

perceived lack of support from others, increased internalized pedonegativity, psychological

Stigma-Related Stress, Complex Consequences of Disclosure, Mental Health and Loneliness in

Minor Attracted People

support (Mereish & Poteat, 2015; Spencer & Patrick, 2009).

association is mediated by loneliness.

Disclosure of Sexual Interest and Degree of Outness

Pachankis et al., 2015; Rothman et al., 2012).

Being devalued and stereotyped by others has detrimental effects on psychological

level of stigma-related stress, loneliness, and psychological distress reported by MAPs.

Research examining mental health in sexual minorities has identified stigma-related

connection and close relationships for fear of discovery (Pachankis, 2007).

termed internalized pedonegativity. Internalized stigma is a multifaceted construct that can be

stigma includes maladaptive behaviors, negative self-referential emotions, and negative

perceptions of the self-informed by endorsing negative stereotypes (e.g.,

2010; Ritsher et al., 2003). An example of internalized pedonegativity is negative self-concept

2019). As such, we anticipate internalized pedonegativity to be a stigma-related stressor present

about internalized stigma in other populations, it is anticipated that internalized pedonegativity

even be mediated by loneliness.

hypotheses were proposed:

would be mediated by loneliness.

would be mediated by loneliness.

3. Higher levels of internalized pedonegativity would be associated with greater psychological

psychological distress, and suicidality would be mediated by loneliness.

between outness, psychological distress, and suicidality would be mediated by loneliness.

Participants and Procedure

2016). Participants completed demographic questions, social relationship measures, outness

measure, perceived social support measure, stigma-related stressor measure, followed by

[ANONYMIZED FOR REVIEW].

Network of Relationships Inventory-Relationship Quality Version (NRI-RQV). The

Mohr & Fassinger, 2000).

Internalized Pedonegativity Scale. The Internalized Pedonegativity Scale was adapted

attraction, experience of internalizing symptoms in relation to one’s minor attraction, which

1994) with gay men.

UCLA-Revised Loneliness Scale. This 20-item scale measures subjective feelings of

Brief Symptom Inventory-18 (BSI-18). The Brief Symptom Inventory-18 is a self-report

.93), consistent with prior research ( = .93; Franke et al., 2017).

Suicide Behaviors Questionnaire-Revised (SBQ-R). The SBQ-R is a four-item scale

( = .87) and non-clinical samples ( = .76; Osman et al., 2001).

interested in fully mature adults to 6 Exclusively interested in prepubescent children or

First, bivariate correlations between stigma-related stressors (i.e., internalized

significant relationships between measures. Second, we conducted mediation analyses to assess

multivariate normality, outlier detection, scale internal consistency, normality of residuals).

exclusive attraction = 51.0%) and a heterosexual orientation (47.5%; bisexual = 19.3%;

associated with lower outness to friends (r = –.23).

Internalized pedonegativity was associated with increased loneliness (r = .28),

dropped from further consideration in the statistical mediation models.

Statistical Mediation Analysis

To test whether loneliness mediated the relationships between stigma-related stressors

95% CI = –2.7, 0.3). This finding suggests full statistical mediation.

0.3, respectively), indicating full statistical mediation by loneliness.