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While its classification as a mental disorder is debated, we adopt this assumption provisionally to apply a cost-of-illness (COI) framework. COI studies, though methodologically limited, offer a pragmatic tool to translate individual impairment into societal costs\u2014thus enabling health policy discussions, identifying service gaps, and supporting early intervention. This article outlines the potential COI associated with pedophilic disorder, distinguishing between cases with offense-related behaviors (child sexual abuse and exploitation material use) and non-offending individuals. We argue that neglecting this condition economically and institutionally has led to avoidable human suffering and may increase long-term societal costs. Applying a COI perspective allows for a more empathetic and preventive public health approach\u2014one that fosters help-seeking, reduces stigma, and ultimately helps prevent sexual victimization of children. By quantifying the hidden burden of pedophilic disorder, COI studies may support more rational, humane, and effective responses to a complex condition. They offer a dual benefit: improving care for affected individuals and reducing harm to others. In doing so, they contribute to a public health framework that neither ignores nor criminalizes, but seeks to prevent.<\/jats:p>","DOI":"10.1007\/s10508-025-03406-w","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T20:09:49Z","timestamp":1773518989000},"page":"1013-1022","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opening the Discussion on the Costs of Pedophilic Disorder as a Mental Health Concern"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7930-4204","authenticated-orcid":false,"given":"Till","family":"Amelung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1710-348X","authenticated-orcid":false,"given":"Robert J. 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