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A 30-year-old woman registered with a different GP for her contraceptive needs from the one she attended for general medical care. She explained the change by complaining that her regular doctor had told her that, at 30, it was time she came off the Pill and thought about a family. She also complained that he had not treated her vaginal discharge properly as she still had it. How easy it would be for the second doctor to side with the patient and believe that the first doctor had been tactless, insensitive and incompetent. The second doctor felt that the woman had some other hidden reason for her disproportionate distress and anger with the previous doctor and enquired further. Eventually the woman revealed that she had been unable to tell the previous doctor that her partner was already married with a family of his own. She had concealed how angry she had been with the doctor for making her confront the knowledge that she would never be able to have a child of her own if she continued with the same partner. Her complaints of vaginal discharge and loss of libido could only be understood within the context of her circumstances, hidden from her own doctor because of her shame, guilt and anger.

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The sources from which the case histories were obtained represent another variable meriting attention. There is no question that a much larger percentage of the patterned offenders were interviewed in California prisons and mental hospitals. This situation is chiefly the result of a selective process—the more repetitive offenders were likely to be found in the felony institutions or mental hospitals (i.e., our California sources) than in the Indiana prison which amounted to a county jail. Also, the interviewing process improved over the years and the California prison records were more detailed. Both these conditions would tend to result in our finding more patterned offenders in the California institutions.

The educational differences between the incidental and patterned offenders are consistent: in every instance the average (median) patterned offender had gone farther in school than the incidental offender. In all the incidental groups the median falls between the seventh and eighth grades, whereas among the patterned groups it lies between the ninth and tenth. The differences range from one year in the case of the incest offenders vs. children to three years in the case of the exhibitionists. The differences reflect the increasing emphasis on education (our California interviews were done years after those in Indiana), but what impact the differences have on our findings is unclear.

Yet another variable which might confuse our comparisons is that of marital status. In three groups the percentages of ever-married males are essentially the same for the incidental and patterned offenders; in two groups (the peepers and aggressors) the incidental offenders include considerably fewer ever-married males and in one group (offenders vs. children) the reverse is true.

While the variables we have discussed in the last few paragraphs may becloud the issue to some degree, there appears to be no consistent and serious bias which would render invalid our comparisons between incidental and patterned offenders.

*388\161\2*

To test this hypothesis we studied the sequence of the sex offenses committed by the men in the present study.

First of all, we were forced to rule out men with only one sex offense, many of whom were still serving their sentences. Moreover, as we stated earlier in the section on recidivism, our sample suffers from the serious defect of not having enough sex offenders who were out of prison at the time of interview. Our sampling procedure made it unlikely that we would include a man who had committed one sex offense, served his time, and thereafter kept out of trouble. Our data do, however, permit us to speak with considerable authority about the sequence of sex offenses among those convicted of more than one, and this is really the crux of the matter.

At one time we thought of categorizing the offenses according to some scale of seriousness, but this proved unprofitable. There is considerable disagreement both among the public and in professional groups about what offense is more serious than another. For example, one man may hold that an offense involving force is ipso facto more serious than one involving a voluntary relationship, yet the next man may feel that the seduction of a child is more serious than the rape of an adult, and a third man may claim that incest is the most pathological of all. One measure of seriousness might be the effect upon the male or female partner or victim, but in most instances we do not know the effect. Furthermore, the same offense would not produce a uniform effect. For instance, what to one person is an inconsequential dim childhood memory may to another be a life-molding unforgettable trauma. Consequently, we gave up the idea of scaling the offenses according to their gravity and decided simply to describe the sequence and type of offense.

Our method is simple. We first took the sex offenders who had been convicted of two or more offenses and divided them into groups according to their first offense. We then figured how many of their second offenses belonged in the same category or another one, and then did the same for their third and subsequent offenses. Thus, for example, we can say that the men whose first sex-offense conviction was for exhibition had 72 per cent of their second convictions also for exhibition, 6 per cent for peeping, etc.. We are aware of the oversimplification of this approach and the overemphasis this gives to the first offense. Had we more cases and time we could at least partly eliminate the fortuitous element involved and, more importantly, deal with all behavior rather than only with that which resulted in conviction.

One other complication merits mention. In some instances the second (or even later) offense was committed before the man had been convicted of the first. For example, a man who had committed incest with his two daughters might be charged with two (or even more) offenses and convicted of each. In our statistical presentation it would appear that he had not “learned his lesson” from his first conviction, since it was followed by a second offense of the same sort. This sort of complication, while a minority phenomenon, should be kept in mind, since it falsely emphasizes recidivism.

The men whose first conviction was for a heterosexual offense against a child and who were convicted of a second sex offense repeated their first offense in about three fifths of the cases. This degree of specificity is neither large nor small compared to other groups. About a tenth of the second offenses were against minor girls, as one might expect. The third commonest form of recidivism is at first a bit surprising: 9 per cent of the second offenses were exhibition, but some of this appears to have been exhibition to female children and minors. The second offenses involving aggression are not numerous (7 per cent total) nor are the homosexual offenses. Other offenses are rarer yet.

The third and subsequent offenses reveal a certain inflexibility in these men: once more three fifths were against little girls, and almost the same percentage were exhibition. A hard core of pedophiles, defectives, and senile deteriorates resist learning through experience. The proportion of offenses involving force, however, declined; these men as a group are not physically dangerous. There was a marked increase in miscellaneous sex offenses (15 per cent, the second commonest type of offense for these men and a relatively very large figure compared to other groups). This seems to represent the almost random sort of nuisance behavior one can expect from men whose mental faculties, sometimes below-average to begin with, have been impaired by alcoholism and/or senility.

In summary, it appears that the offenders vs. children with multiple sex offenses generally repeat their original type of offense, relatively few begin using force, and a substantial minority commit what can be termed as nuisance offenses (including exhibition).

The sex-offender recidivists whose first offense was against acquiescent or cooperative minor girls seldom tended to repeat; only about one third of their second offenses and one sixth of their subsequent offenses were the same as the original one. Their second offenses were usually either “spillovers” into offenses against children or offenses against adults (both totaling 23 per cent of the second offenses), or aggressions against females (also totaling 23 per cent). This is the most use of force exhibited by any group except those whose first offense was one of aggression. Their third and later offenses again show the “spillover” phenomenon; the use of force is less but still substantial; and there is a marked increase in miscellaneous and nuisance offenses (totaling 25 per cent if one includes exhibition). In both second and later offenses these men display a pedophilic tendency: children strongly outnumber adults in heterosexual offenses without force and also in the homosexual offenses. Only when force or violence was involved do we find adult females outnumbering children and minors.

All in all, the men whose first offenses were against girls under sixteen inclined to a wide diversity of subsequent offenses. Their predilection toward young females coupled with a definite tendency toward the use of force makes them one of the more dangerous groups from a social viewpoint.

The men whose first offense was against a cooperative or at least passive adult female show the least specificity of any group in their later offenses. Their second offenses, for example, are scattered over virtually the whole gamut of sex offenses with no type of offense accounting for more than 17 per cent. This lack of specificity in part reflects social attitudes and law enforcement, since heterosexual activity with consenting adult females seldom results in arrest and conviction. While a moderate proportion of second offenses involved force none of the later offenses did, and these men cannot, as a group, be looked upon as physically dangerous. In the third and later offenses there is a strong trend toward miscellaneous and nuisance offenses. A full third are of this type, and if one adds in the 17 per cent of exhibition offenses, one finds that over half of these later offenses are not particularly serious.

*350\161\2*

By and large, the proportions of total outlet constituted by marital coitus remain remarkably stable throughout life. For example, between ages sixteen and fifty-five there is a variation of only five percentage points in the control group (the range being 88 to 93 per cent) and eight in the prison group. Large variation is seen only among a few groups, and in these cases is usually explicable. Among the homosexual offenders vs. adults, heterosexuality was weak enough to be periodically seriously diminished by homosexuality and masturbation with homosexual fantasy. Among the exhibitionists, spells of exhibition with masturbation plus solitary masturbation caused the large variation.

Trends are not easily observed and one must beware of those caused by our methods. For instance, the trend of the prison group to derive progressively more of their outlet from marital activity seems to be factually accurate—it reflects a “settling down” phenomenon which we have previously noted among males of the lower socioeconomic level. One might say that departure from a “settling down” pattern or from a stable pattern is indicative of marital discord and/or sex-offense behavior.

*312\161\2*

Since the psychoanalytic tradition is so enmeshed in Western culture, and even more narrowly in middle-class culture, the relevance of the “primal scene” to other cultures and even other classes is moot.6 Anthropologists report frequent observation by children of adult sexual behavior in many non-Western groups. Such observation may serve as a method of learning about techniques of sexual activity.

If observation by a child of parental coitus frequently has the pro found effect claimed for it by many psychoanalysts, it seems reasonable to expect that this should be evident in our data. If the outcome of such observation is the interpretation of coitus as aggression, then it is possible that the type of sex offense committed years later by such persons would be characterized by force or sadism. If the outcome is reinforcement of castration fears, then the individual might become interested in persons of the same sex or interested in children as non-castrating objects.7 This interpretation would suggest that force offenders, pedophiles, and homosexual offenders would be more likely to have observed parental coitus than other groups.

In the control group nearly one in 20 (4 per cent) reported having observed the “primal scene”. This increases to one in ten (10 per cent) for the prison group. Ten of the sex-offender groups are within or close to this range. In one group, the incest offenders vs. adults, no subject reported seeing parental coitus. The homosexual offenders present a mixed picture with two groups similar to the prison group and one like the controls. The incest-offender groups are similarly low, near the controls, as are the peepers, the heterosexual minor and adult offenders, and the heterosexual adult aggressors. The exhibitionists on the other hand are higher and similar to the prison group in this respect.

The only groups in which a larger proportion had observed parental coitus were the aggressors vs. minors (22 per cent), the aggressors vs. children (21 per cent), and the heterosexual offenders vs. children (16 per cent). The proportion for this last group is the only indication of a tendency within any tripartite offense group for the offenders against children to have observed parental coitus in a slightly greater proportion than the groups whose offenses were against older persons. The two force groups tend somewhat to bear out the notion that the “primal scene” may induce sadistic attitudes in sexual behavior, but there is no evidence for the castration complex theory in the sense that the male may later be induced to seek out nonthreatening children or males as sexual partners.

In any case, it appears that the observation of parental coitus may occur with no untoward consequences for some people at least, and that its frequency is not much greater for any sex-offense groups, except the three mentioned, than might be expected from current social class practices. The “primal scene,” as recalled at the conscious level at least, represents, as many psychoanalytic concepts do, a partial truth.

*274\161\2*

The accumulative incidences of petting to orgasm are naturally lower. Relatively few exhibitionists had this experience, and they generally rank second to fourth lowest by any age. By age thirty about one fifth had had an orgasm from premarital petting.

There is nothing noteworthy about the frequency with which the exhibitionists reached orgasm through petting, and the age-specific incidence is similarly moderate in all age-periods. Since the behavior that resulted in their conviction was genital display, one might expect that something significant would be seen in a study of petting techniques involving the genitalia. This expectation is not fulfilled. About all that can be said is that the exhibitionists are somewhat given to mouth-genital contact, ranking third in premarital cunnilingus with companions (22 per cent) and fellation by prostitutes (55 per cent), and being in the upper half of the rank-orders for other categories of mouth-genital activity.

*235\161\2*