the end of puberty. Stephens and Seto argue that hebephilia can be considered dysfunctional, stating that "conceptually, hebephilia is a paraphilia, reflecting an atypical (statistically rare) sexual age interest in pubescent children." They state that hebephilia is a malfunction of the biological mechanism which drives males to be attracted to sexually mature females, and that while typical men are attracted to youthfulness, they are also interested in cues of sexual maturity (adult size, fully developed breasts, and a waist-to-hip ratio of around 0.70). Hebephiles, by contrast, respond positively to cues of youthfulness but negatively to cues of sexual maturity. Penile plethysmography results show that heterosexual men are preferentially attracted to adult women, with lower responses to pubescent girls and then prepubescent girls, and then males of all ages causing the least response. Stephens and Seto also argue that hebephilia is dysfunctional because it causes significant distress or impairment in those who have it, perhaps via legal issues or disrupted adult relationships, because hebephilic behavior violates social norms or is even illegal in most contemporary cultures. Use in court Forensic psychologist Charles Patrick Ewing criticized the diagnosis, saying it is a transparent attempt to ensure that sex offenders who target pubescent teenagers may be subject to involuntary civil commitment. DSM-IV editors Michael First and Allen Frances expressed concern that hebephilia could be misused in civil commitment hearings, and questioned the need and evidence for the inclusion. Frances wrote that the diagnosis of hebephilia "has no place in forensic proceedings." Charles Moser argued against what he saw as the problematic use of paraphilic labels to pathologize unusual sexual interests and incarcerate individuals on the basis of their paraphilia rather than their behavior. He also questioned the usefulness of paraphilias in general when the real issue may be criminal behaviors or stigmatization of unusual but benign sexual acts. Of hebephilia in civil commitment, Prentky and Barbaree wrote, "Hence, for self-serving reasons, it is applauded by those who generally work for the prosecution and criticized by those who generally work for the defense. This is an admittedly cynical, if unfortunately accurate, commentary on the influence of adversarial litigation on clinical deliberation." Psychologist Douglas Tucker and lawyer Samuel Brakel stated that civil commitment as a sexually violent predator does not require a DSM diagnosis, so long as the clinicians who testify in courts do so in good faith and they identify a conceptually and empirically