I believe it's like sexuality in general. No one can say whether or not something is nurture or nature. What we don't generally understand is that those paths are not mutually exclusive. Something such as sexual preferences and even mannerisms can be passed down genetically, and we never really see that. My dad was out of my life from age 2 until he was dying, so I was about 14. My mother has told me that I have his penmanship, I have his voice, and I always speak with my hands, just like him.
Can it be suppressed? Yes, but it takes a lot of counseling, and it has to be shown to the patient why it's wrong. It needs to be understood that you're causing destruction in an innocent child's life. But to tell the truth, that person will probably always have those wants and desires in the back of their minds.
Is it a choice? Absolutely not, and that's unfortunate.