Obstacles and facilitators faced by people attracted to minors when seeking support for their paraphilic interest - a scoping review.

Abstract

Introduction: Although awareness of the mental health needs of minor-attracted persons (MAPs) is growing, barriers continue to limit their access to care, and evidence on what influences their help-seeking behavior remains limited. Addressing this gap calls for public health strategies that enhance the prevention of child sexual abuse through healthcare provision for MAPs. This review aims to map the barriers and facilitators to help-seeking in this population to inform policies that improve healthcare access.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, seven databases were searched without date restrictions, yielding 583 records. Of these, seven studies met the inclusion criteria and were included in the review. Data were charted and analyzed thematically.

Results: Although the included studies provided valuable data, they exhibited methodological limitations that are discussed in the review. Four main barriers were identified (1): structural, including limited resources and fear of mandatory reporting (2); financial constraints (3); social, such as stigma from harmful media portrayals; and (4) individual, such as feelings of shame. Facilitators spanned three dimensions (1): structural, such as anonymous online platforms and specialized clinical training (2); social, such as anti-stigma campaigns, and (3) individual, including recognizing one's attraction as problematic.

Discussion: These findings reveal a profound disconnect between MAPs' support needs and current healthcare capacity to provide accessible, non-stigmatizing care. Notable gaps remain regarding female and non-Western MAPs, longitudinal help-seeking trajectories, and interventions targeting psychological distress. Online communities and media emerged as paradoxical forces, capable of reinforcing isolation and stigma while also serving as low-threshold entry points into care. Addressing these barriers requires a multilevel approach combining structural reforms, clinical training, digital interventions, and anti-stigma campaigns, alongside policies that distinguish offending from non-offending MAPs to balance public safety with accessible, ethical care.