Football and the Sexual Side Effects of Head Trauma

Andy Clark/Reuters

To be perfectly honest, I follow football the way I follow television. I read about it. (Breaking Bad sounds like something I should watch someday.) And the only reason I've been reading about football is my morbid fascination with the two major scandals in which the game has lately been sandwiched: the long-term harm caused by repetitive head injuries and the Sandusky pedophilia story. I can't stop wondering: Could they be related?

We now know that professional football players' helmets are not magically saving their brains from all the pounding they take. The New York Times reports that, to date, twenty NFL veterans have been shown to have suffered from chronic traumatic encephalopathy (CTE) - a progressive decaying of the brain. Many more players have been living with the symptoms: early-onset dementia, erratic behavior, and major depression.

CTE can only conclusively be diagnosed in autopsy, and Boston University's Center for the Study of Traumatic Encephalopathy, the leading research institution in this field, has been doing most of the postmortems. At my own medical school, I arranged on this story a different kind of postmortem - an ethical one. Purposefully exposing young people to increased risks of major brain problems - even death - for sport is surely even more ethically complicated than sending young people into this same neurological danger zone as soldiers. So I invited the Times editor from this story to come talk with Northwestern University's doctors and coaches about this ethical problem.

At the session, I was dismayed to learn that life-changing head injuries from sports are not limited to NFL and NCAA players, but also can affect high schoolers and even younger children. Moreover, while the symptoms of CTE are perhaps the most striking, repeated head trauma could cause many more subtle neurological problems.

This got me thinking of my main line of work, sex research. As it turns out, another group of work acquaintances of mine, based at the Centre for Addiction and Mental Health in Toronto, has been working to ascertain the bases for pedophilia. Although no one can point to a simple cause-effect chain for any sexual orientation, the Toronto group, led by psychologists Ray Blanchard and James Cantor, has found evidence that pedophiles, as a group, seem to have a greater history of childhood head trauma than non-pedophiles.

For example, a 2003 study of 685 men, published in the Archives of Sexual Behavior, found that "pedophilic patients reported more head injuries before age 13 than did the nonpedophilic patients." While it is true that the head injuries we are now most concerned with in football occur after age 13, it is also true that most NFL and NCAA players and coaches (like Sandusky) are likely to have started getting their heads game-bashed as children.

Moreover, the medical literature contains reports of the onset of "hypersexuality" and altered sexual preference - including the development of pedophilic behaviors - following brain injuries in adulthood. When I asked psychologist Ray Blanchard about this, he expressed skepticism that this really represents a change of sexual orientation, given what researchers know about the nature of human sexual orientation.

Blanchard said he instead thinks it is "more likely that brain injuries in adulthood disinhibit sexual behaviors (including dormant paraphilias) rather than establishing them." In other words, after a brain injury, a man may no longer effectively suppress sexual desires he has already long had, and he may lose the ability to stop himself from harming others he sexually desires.

A study published last year in the Journal of Sexual Medicine reported on eight men who in mid-life showed evidence of "acquired pedophilic behavior from brain disease." Because some of these men also showed other forms of sexually abusive behavior, the authors of this report noted that certain brain injuries can result in "broader disinhibition deficit or hypersexuality . . . not just focused on children." Indeed, a general association between brain injury and poor sexual impulse control has now been well established.

Let's be clear: suffering brain injuries doesn't mean you'll become a pedophile, and a link between pedophilia and brain injuries doesn't mean we should "excuse" or condone pedophilic behaviors. But all this does leave me wondering whether we need to consider the possibility that sports head injuries can cause a much wider range of life-altering effects than is now being openly discussed. (And whether seminaries are rougher places than I've given them credit for.)

Whether or not additional research bears out the theory that head injuries can contribute to pedophilic behavior, the two ongoing scandals in football - repetitive head injuries and the possible cover-up of Sandusky's pedophilic activities at Penn State - do have one clear link: in both cases, those in charge have taken big risks in playing with the idea of putting the game first and the well-being of youngsters second.