Some crimes don’t begin in the shadows — they start in silence. In this groundbreaking conversation, we sit down with Dr. Christoffer Rahm, psychiatrist and lead researcher at the Karolinska Institute in Stockholm, and Allison McMahan, psychologist and doctoral candidate specializing in early intervention for individuals with pedophilic disorder. Together, they’re part of a pioneering movement asking one of society’s hardest questions: What if we could stop child sexual abuse before it ever happens?

From clinical trials to darknet outreach, their team at Karolinska is reshaping what prevention looks like — through neuroscience, psychotherapy, and empathy. Their program Prevent It offers anonymous, evidence-based therapy to individuals seeking help before they offend, reaching participants across continents and languages. In our discussion, Rahm and McMahan unpack the complexity of pedophilia — what science tells us about its origins, why most sufferers discover their attraction in adolescence, and how empathy, anonymity, and access can literally save lives.

They challenge common myths — including the belief that people with these urges are untreatable or destined to offend — and reveal why traditional criminal justice approaches can’t solve a public health crisis this large. This is a conversation about prevention, compassion, and the courage to confront what society avoids. Because silence doesn’t just protect victims — it protects perpetrators.

Dr. Christoffer Rahm is a psychiatrist and senior researcher at the Karolinska Institute, one of the world’s leading medical universities. His work focuses on understanding and preventing sexual offending, with an emphasis on early intervention for individuals experiencing pedophilic disorder.

Rahm’s clinical and research leadership at the Centre for Psychiatry Research, Region Stockholm, has produced groundbreaking trials — including PRIOtab and Prevent It, programs using psychotherapy and pharmacological treatment (such as testosterone-suppressing agents like degarelix) to reduce risk and improve quality of life. His interdisciplinary approach bridges neuroscience, psychiatry, and public health — reframing child sexual abuse not just as a legal issue, but a preventable medical one.

His work has been recognized internationally for offering hope and evidence where once there was only stigma — helping clinicians worldwide understand that empathy and science, together, can stop harm before it starts.

Allison McMahan is a licensed clinical psychologist and PhD candidate at the Karolinska Institute, where she co-leads international projects aimed at preventing child sexual abuse. As project coordinator for the Prevent It program — an anonymous, internet-based cognitive behavioral therapy for individuals with pedophilic thoughts — McMahan has worked on expanding access across languages and cultures.

Her research focuses on early intervention, treatment optimization, and global accessibility, ensuring those struggling with these thoughts can receive help long before harm occurs. With a background in behavioral therapy and trauma psychology, McMahan brings a compassionate, evidence-based lens to one of the world’s most stigmatized clinical areas.

Her mission: to make prevention practical, ethical, and accessible — and to ensure that those seeking help can find it, safely and without shame.

Contact Dr. Rahm: https://ki.se/en/people/christoffer-rahm

Contact Allison: https://ki.se/en/people/allison-mcmahan