Not every pedophile is a rapist.

[Losty]

Another point I've raised before is how different things would be in a society where sex with children was acceptable. Are the negative psychological effects all to do with the shame of how society views them, and the constant requirement not to act on urges which have no acceptable outlet? Or does the condition itself inherently cause negative effects?

For some kids, it breaks their will to be an individual/independent of the the one defiling them. Others simply develop later if at all emotionally/mentally. Those who seek to retain their independence while being molested turn their anger on society/rebel or they turn on themselves and self mutilate or attempt suicide.

I've worked with kids who had it real bad... I didn't last a year, see the effect on them was too much..

So yes, the child has to endure alot of bad things for a very long time. the 'bad stuff' has nothing to do with societal shame, but a loss of control/innocence to know you and your buddies are not the same puts one in a self inflicted exile. Because to "play" or interact as your friends do is just a reminder of all that you lost.

The question Rob was asking is if it negatively impacts the adult with the desire not the child.