Getting people into the room is the hardest part across the entire industry. Most people who go to therapy have little need for it, and those who do don't recognize they have a problem to begin with. They've either built such a cushy headspace its doesn't even register its wrong, or they have justified it entirely.

Also the confidentiality clause is required to be broken if you are an immediate threat to yourself or others. Look at the immediate reaction most people have to just hearing the word pedo. They will absolutely consider you an immediate threat to children and report you. So there is good reason for not trusting that confidentiality either.

So the stigma problem is "getting help before you are a shaking mess one bad day from snapping" and the much more general "actually getting help instead of justifying it to yourself."