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König's (2025) critique of the German Prevention Project Dunkelfeld mis-applies standards developed for adjudicated ("Hellfeld") offenders to a voluntary, non-forensic prevention setting. We clarify why context-appropriate science is essential for evaluating interventions that reach individuals whose child sexual abuse (CSA) behaviour remains hidden from the justice system. First, the large gap between official recidivism and high self-reported offending is not methodological failure but strong evidence of the well-documented "dark figure" of undetected sexual crime. Second, Germany's unique legal framework (§ 65d SGB V; § 203 StGB) enables confidential, face-to-face treatment and pharmacological options that are infeasible in jurisdictions with mandatory reporting, making Dunkelfeld programmes a public-health imperative. Third, forensic risk tools and the CODC (2007) guidelines lack demonstrated validity for voluntary help-seekers; carefully collected self-report and dynamic risk-factor change therefore constitute the only context-relevant outcome metrics. Fourth, concerns about iatrogenic effects must be interpreted through the Risk-Need-Responsivity lens: specialised, multi-modal interventions such as the Berlin Dissexuality Therapy (BEDIT) show beneficial changes in cognitive and behavioural risk markers, mirroring findings from recent RCTs of internet-delivered CBT and pharmacological therapy. Finally, all German model sites are currently undergoing an independent, multi-year evaluation commissioned by the national health-insurance association. We conclude that preventing CSA and CSAM requires embracing rigorous yet context-sensitive methodologies rather than importing standards that overlook the dark figure. The ethical imperative to prevent harm and offer help to those at risk persists even acknowledging that no intervention guarantees universal success, demanding our most contextually sensitive scientific efforts.
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http://dx.doi.org/10.1007/s10935-025-00859-6 | DOI Listing |
J Sex Marital Ther
September 2025
Department of Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye.
The etiology of gender dysphoria (GD) involves both biological and psychosocial factors and may have a neurodevelopmental aspect. We aimed to compare individuals with GD with each other and with cisgender individuals based on minor physical anomalies (MPAs). The case group comprised 108 individuals with GD (60 GD assigned female at birth [AFAB]; 48 GD assigned male at birth [AMAB]), most with same-biological-sex attraction.
View Article and Find Full Text PDFCien Saude Colet
August 2025
Programa de Pós-Graduação em Ciências da Saúde, Universidade do Sul de Santa Catarina. Av. José Acácio Moreira 787, Humaitá. 88704-900 Tubarão SC Brasil.
The aim is to review the temporal trend and spatial distribution of reported cases of sexual violence in Brazil from 2013 to 2022. This is a mixed ecological study, descriptive of multiple groups, with a temporal trend analysis. Notifications of sexual violence from the Information System for Notifiable Diseases were reviewed.
View Article and Find Full Text PDFCien Saude Colet
August 2025
Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
The impact of the COVID-19 pandemic on women was severe. In sexual and reproductive health, it led to an increase in maternal deaths among black women. This study sought to analyze access and quality of care for pregnant and postpartum women during the pandemic.
View Article and Find Full Text PDFPLoS One
September 2025
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Background: Sexually transmitted infections (STIs) remain a major public health threats in sub-Saharan Africa (SSA). Delay in seeking care is a significant barrier for the prevention and control of STIs. This study aimed to assess the proportion of women seeking STI-related care and its determinants in SSA.
View Article and Find Full Text PDFGames Health J
September 2025
Radiant Digital, Vienna, Virginia, USA.
Intergenerational games offer a potential channel to impact parent-youth sexual health communication. The "Secret of Seven Stones" (SSS) is an 18-level online adventure game and parent website designed to engage parents and youth (11-14 years) in conversations about healthy dating relationships and sexual behavior and to provide sexual health skills training to youth. Study hypotheses were that SSS exposure would increase sexual health parent-child communication, increase youth intentions to delay sexual debut, and reduce youth exposure to situations that promote sexual activity.
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