United States v. David Rothenberg , 923 F.3d 1309 ( 2019 )


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  •               Case: 17-12349     Date Filed: 05/08/2019    Page: 1 of 67
    [PUBLISH]
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE ELEVENTH CIRCUIT
    ________________________
    No. 17-12349
    ________________________
    D.C. Docket No. 0:16-cr-60054-WJZ-1
    UNITED STATES OF AMERICA,
    Plaintiff-Appellee,
    versus
    DAVID ROTHENBERG,
    Defendant-Appellant.
    ________________________
    Appeal from the United States District Court
    for the Southern District of Florida
    ________________________
    (May 8, 2019)
    Before ED CARNES, Chief Judge, and ROSENBAUM and HULL, Circuit Judges.
    HULL, Circuit Judge:
    After his guilty plea to possession of child pornography, David Rothenberg
    appeals from the district court’s restitution order requiring him to pay a total of
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    $142,600 in restitution to nine victims depicted in the images of child pornography
    that he possessed. Section 2259 mandates that district courts order defendants “to
    pay the victim . . . the full amount of the victim’s losses” as determined by the
    court. 
    18 U.S.C. § 2259
    . This case involves the question of how to calculate the
    amount of restitution a possessor of child pornography, like the defendant
    Rothenberg, must pay to a victim whose childhood sexual abuse appears in the
    pornographic images he possessed but did not create or distribute.
    On appeal, Rothenberg argues that: (1) the district court’s restitution order is
    flawed as to all of the victims because it failed to calculate and then disaggregate
    the victim’s losses caused by the initial abuser, distributors, and other possessors
    from those caused by Rothenberg himself; and (2) as to eight of the victims, the
    restitution award is not supported by competent evidence. After review, and with
    the benefit of oral argument, we conclude that the district court was not required to
    calculate and disaggregate the victim’s losses in the manner Rothenberg suggests
    and that reliable evidence supports the restitution awards as to eight victims, but
    not as to one victim. We thus affirm the restitution amounts as to eight victims and
    vacate and remand as to one victim.
    I. INDICTMENT AND GUILTY PLEA
    Defendant Rothenberg used to be a lawyer, a fact he told an undercover
    officer in an internet chatroom called “daddaughtersex.” Rothenberg also sent the
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    officer videos of child pornography and bragged that he was sexually exploiting a
    young girl at his house. In 2016, local and federal law enforcement went to
    Rothenberg’s house and rescued the young girl, who confirmed that Rothenberg
    had engaged in sexual activity with her. The officers also found and seized
    Rothenberg’s laptop, which contained approximately 1,000 unique video and
    picture files of child pornography. Some of those images depicted prepubescent
    children under the age of 12, and some portrayed sadistic and masochistic conduct,
    such as the binding and gagging of minor children.
    In 2016, a grand jury charged Rothenberg with: (1) four counts of
    distribution of child pornography, in violation of 
    18 U.S.C. § 2252
    (a)(2) & (b)(1)
    (Counts 1, 3, 4, and 5); (2) one count of receipt of child pornography, in violation
    of 
    18 U.S.C. § 2252
    (a)(2) & (b)(1) (Count 2); and (3) one count of possession of
    child pornography depicting a minor under the age of 12, in violation of 
    18 U.S.C. § 2252
    (a)(4)(B) & (b)(2) (Count 6). Pursuant to a written plea agreement,
    Rothenberg pled guilty to the possession offense in Count 6, and the government
    agreed to dismiss the receipt and distribution charges in Counts 1 through 5. The
    district court sentenced Rothenberg to 210 months’ imprisonment.
    On appeal, Rothenberg does not challenge his guilty plea or sentence.
    Rather, Rothenberg challenges only the district court’s restitution order granting a
    total of $142,600 to nine victims, which consists of: (1) $10,000 to Sierra;
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    (2) $3,000 to Jane; (3) $5,000 to Pia; (4) $5,000 to Mya; (5) $20,000 to Sarah;
    (6) $9,000 to Vicky; (7) $23,000 to Amy; (8) $42,600 to Jenny; and (9) $25,000 to
    Casseaopeia. We outline the thorough process the district court followed, the
    evidence submitted, and then the district court’s findings and conclusions.
    II. RESTITUTION PROCEEDINGS
    After sentencing, the district court considered restitution requests pursuant to
    
    18 U.S.C. § 2259
    (a), which provides for mandatory restitution to child
    pornography victims. Generally, the process worked as follows. First, the
    government identified the individual victims depicted in the images of child
    pornography found on Rothenberg’s computer and notified them or their attorneys
    of the upcoming restitution hearing. Then a victim’s attorney submitted a
    restitution request and supporting documentation to the government. Next, the
    government determined whether to support that request or ask the district court for
    a different amount. Rothenberg could agree to the request, try to negotiate down
    with the government or the victim’s attorney, or challenge the request before the
    district court.
    Eventually the government submitted restitution requests on behalf of ten
    victims, all of whom were identified in at least one of the images of child
    pornography from Rothenberg’s computer. One of the victims, “Angela,” later
    withdrew her request, leaving nine requests at issue for the hearing.
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    A.    Pre-Hearing Memoranda
    Prior to the restitution hearing, both parties submitted lengthy memoranda
    addressing (1) how the restitution determination should be made, and (2) what the
    award should be for each victim. The government and Rothenberg agreed that the
    Supreme Court’s decision in Paroline v. United States, 
    572 U.S. 434
    , 
    134 S. Ct. 1710
     (2014), governed how the restitution awards should be made, established a
    proximate cause requirement, and set forth a variety of factors for district courts to
    consider in determining the proper amount of restitution. Under Paroline’s
    proximate causation requirement, a defendant should pay restitution “in an amount
    that comports with the defendant’s relative role in the causal process that underlies
    the victim’s general losses.” Paroline, 572 U.S. at 458, 
    134 S. Ct. at 1727
    .
    But the parties disagreed about how exactly to apply the Paroline factors and
    how to calculate and determine that amount. The government recognized that,
    under Paroline, the district court must impose restitution in an amount that reflects
    the particular defendant’s relative role in the continuing traffic in the child
    pornography images of the victim. The government proposed that the district court
    make that calculation by using a variation of what is known as the “1/n method,”
    whereby the court would divide the total amount of each victim’s losses by the
    number of defendants, across multiple prosecutions, who had been ordered to pay
    restitution to the victim. The government submitted that this method would
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    provide the district court a starting point from which to exercise its discretion in
    determining the appropriate amount of restitution vis-à-vis Rothenberg, as only a
    possessor of images of child pornography.
    Rothenberg argued, by contrast, that the starting point should be
    “apportionment between the original abuser of the child, versus the distributor, and
    later, possessor of the pornography,” which Rothenberg referred to as
    “disaggregation.” Rothenberg asserted that this disaggregation requires two steps:
    first, the district court must separate the harm caused by the original abuser from
    that caused by later distributors and possessors; and second, the district court must
    separate the harm caused by the defendant from that caused by other distributors or
    possessors.
    Below, we detail for each victim (1) the victim’s restitution request and
    supporting evidence, (2) the government’s position, and then (3) Rothenberg’s
    position.
    B.    Sierra
    Sierra submitted a restitution request for $10,000. In support of her request,
    Sierra submitted a medical letter from Dr. Sharon W. Cooper, a forensic
    pediatrician, based on her December 2015 evaluation of Sierra. Dr. Cooper
    explained that victims of child pornography can experience physical, emotional,
    and spiritual issues as a result of their online exploitation, including immunological
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    problems, posttraumatic stress disorder (“PTSD”), anxiety, depression, suicidal
    ideation, and feelings of hopelessness. Dr. Cooper noted that “[w]hen images are
    known to be in distribution, the pre-existing dysfunction caused by the initial abuse
    is typically worsened, since children remain at risk for further victimization by the
    ongoing downloading, trading and possession of their images.”
    With respect to Sierra specifically, Dr. Cooper stated that Sierra’s medical
    evaluation showed she suffered from worsening insomnia, attention deficit
    hyperactivity disorder (“ADHD”), depression, suicidal ideation, PTSD, and mood
    lability. Dr. Cooper noted that, despite being on five different medications,
    Sierra’s condition remained unstable and she recently required emergency
    treatment for suicidality. Dr. Cooper opined that “[t]he ongoing presence of
    trafficking in images [of Sierra] on the Internet constitutes a significant aspect of
    psychological maltreatment that will add on to the initial adversities” caused by the
    original abuse. Based on Sierra’s past medical history, the documented adversities
    faced by victims of child sexual abuse and child pornography offenses, and
    Sierra’s present medical symptoms, Dr. Cooper estimated a total cost of
    $661,453.00 for Sierra’s future medical care.
    Sierra’s counsel also submitted a declaration of attorney’s fees, indicating
    Sierra had incurred nearly $5,000 in attorney’s fees in connection with this case.
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    The government supported Sierra’s $10,000 restitution request. The
    government observed that four other defendants had been ordered to pay restitution
    to victims in the same series of images as Sierra. Those awards were for $4,000,
    $1,000, $9,000, and $2,000.
    Rothenberg opposed Sierra’s restitution request. Rothenberg noted that he
    possessed only one image of Sierra1 and that the requested restitution amount was
    more than double the average of Sierra’s prior awards ($4,000). Rothenberg
    argued that Sierra’s restitution materials made no attempt at disaggregation and
    that the government provided no information to demonstrate the relative amount of
    Sierra’s harm caused by his conduct.
    C.     Jane
    Jane submitted a restitution request for $3,000. In support of her request,
    Jane submitted a victim impact statement, a psychological report, and an economic
    report. In her victim impact statement, Jane specifically described how the online
    trade in her child pornography images had affected and would continue to affect
    her. Jane explained: “Knowing people are watching what happened gives me a
    mix of anxiety, sadness, anger and it disgusts me. . . . If it wasn’t out there, I
    wouldn’t be as fearful as I am now.” Jane elaborated that the circulation of her
    1
    Throughout we refer to how many images of a victim Rothenberg had. Each of the
    images recounted in this case were child pornography, and for brevity sometimes we refer to
    them simply as “images.”
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    images made her feel afraid and unsafe because she worried that someone who had
    seen her images online might recognize her and try to harm her. Jane felt that her
    future would not be “very bright” and would be lonely because the existence of her
    images online made her socially isolated.
    Jane’s psychological evaluation was performed by Dr. Jennifer Clark in
    December 2014 “to determine the psychological effects of her continuous re-
    victimization in the form of Internet pornographic images and videos of her being
    exchanged and viewed.” Dr. Clark opined that the online trade in Jane’s images
    was currently impacting her, causing her great fear and anxiety and leaving her
    feeling unsafe and vulnerable. Dr. Clark observed that the trade in Jane’s images
    would continue to impact her in the future by exacerbating her “deep sense of
    mistrust in others” from the original abuse and hindering her healing and recovery
    process. Dr. Clark explained: “[Jane’s] awareness of the ongoing presence and
    distribution of [her] images will remain an ever present trigger to memories of
    what happened and a source of fear for her safety, and thus, ongoing psychological
    distress. Therefore, Jane will require therapy throughout her life. . . . Given that
    much of Jane’s distress manifests in somatic symptoms and physiological distress,
    she likely will also seek and need significant medical attention in the future.”
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    Jane’s economic evaluation estimated that she would have future medical
    and therapy costs of $101,027, and lost wages of between approximately $1.9 and
    $3.9 million.
    The government agreed that Jane’s $3,000 restitution request was
    appropriate. The government noted that seven other defendants had been ordered
    to pay restitution to Jane. Three of those seven defendants were ordered to pay
    $1,000, two were ordered to pay $2,500, one was ordered to pay $3,000, and one
    was ordered to pay $500.
    Rothenberg disputed Jane’s requested amount and argued that a restitution
    amount of $800 would be appropriate. Rothenberg noted that he possessed four
    images of Jane and that the average award to Jane from the prior cases was $1,642.
    Rothenberg acknowledged that Jane’s restitution materials were “the best of all
    provided to attempt disaggregation,” but argued his possession did not warrant a
    $3,000 award when compared with other defendants. Specifically, Rothenberg
    noted that one of the prior cases with a $1,000 restitution order involved
    distribution, and three of the other cases involved receipt of Jane’s images.
    D.    Pia
    Pia submitted a restitution request for $5,000. In support of her request, Pia
    submitted an interim impact statement from Dr. Marsha Hedrick, who conducted a
    forensic psychological evaluation of Pia, a declaration of attorney’s fees, and a
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    victim impact statement from Pia’s mother. Dr. Hedrick noted that Pia
    experienced anxiety, nightmares, suspiciousness, and sadness and was emotionally
    withdrawn. Dr. Hedrick explained that “[s]eparating the extent to which these
    difficulties are related to sexual abuse by her father versus her awareness that her
    sexual abuse is being viewed by others is not entirely possible,” but it was clear
    internet exploitation adds a layer of complexity to the psychological damages
    victims of child sexual abuse face. Indeed, Dr. Hedrick noted that Pia’s mother
    had explained to Pia there was no way to remove from the internet the images of
    her sexual abuse, resulting in “a level of suspiciousness and concern about
    exploitation that is atypical for Pia’s peers” and likely caused Pia to experience
    feelings of powerlessness. Dr. Hedrick estimated the cost of Pia’s therapy needs as
    $81,900, but explained that estimate reflected only the “current, most critical
    needs” for Pia and there was no way to know what the full extent of her losses
    would be over the course of her lifetime.
    The government concurred in Pia’s $5,000 restitution request. The
    government did not have information on any other defendants that were ordered to
    pay restitution to Pia, but Pia’s counsel advised one other defendant was ordered to
    pay restitution.
    Rothenberg disputed Pia’s requested amount and instead proposed a
    restitution award of $1,100. Rothenberg contended there was “no real attempt at
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    disaggregation” in Pia’s restitution documents, but agreed some amount of
    restitution was appropriate based on the number of images (14) he possessed of
    Pia. Rothenberg reasoned that $1,100 was appropriate because the government
    had requested $2,000 in restitution for Jenny (discussed below), and he possessed
    half as many images of Pia as he had of Jenny.
    E.    Mya
    Mya submitted a restitution request of $5,000. In support of her request,
    Mya’s counsel submitted a restitution cover letter and declarations from both of
    her attorneys. Mya’s counsel represented that they were still awaiting the results
    of Mya’s psychological evaluation, but that other similarly situated child
    pornography victims they had represented had psychological treatment costs
    exceeding $100,000. Mya’s counsel stated that Mya was aware of the existence of
    her images on the internet and “the knowledge that others have witnessed and even
    enjoyed [her] abuse is extremely upsetting to [her].” Counsel further represented
    that Mya was distrustful of other people and was at risk of being stalked or
    victimized by individuals who had seen her images online. Counsel also
    represented that they had expended $2,077.44 thus far in representing Mya and two
    other victims in the same series (one of whom was victim Pia, discussed above),
    and anticipated total legal costs of $30,000 for those three victims.
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    The government did not concur in Mya’s $5,000 restitution request. The
    government noted that there was no information on whether other defendants were
    ordered to pay restitution to Mya and determined that “[g]iven that [Rothenberg]
    possessed a single image of Mya and the future medical costs have not yet been
    established,” a restitution award of $500 was appropriate. The government stated
    that amount was neither trivial nor too severe.
    Rothenberg argued there was no sufficient basis for awarding any restitution
    to Mya given the lack of information regarding her future medical costs.
    Rothenberg also noted that he made an offer to Mya’s counsel to pay the $500
    amount the government sought, but that offer was rejected.
    F.    Sarah
    Sarah submitted a restitution request of $25,000. In support of her request,
    Sarah submitted, among other things, a cover letter, a victim impact statement, a
    2014 psychological evaluation by Dr. Randall Green, and an economic report. In
    the cover letter, Sarah’s counsel represented that her requested restitution amount
    of $25,000 would be “less than 1%” of her total losses and that 327 other
    defendants were ordered to pay restitution to Sarah.
    In her victim impact statement, Sarah explained that she worried that people
    who had seen her images online would “come after” her and try to victimize her in
    the same way her original abuser had. Sarah elaborated: “Every time someone else
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    sees pictures or videos of me it feels like they are the ones who hurt me to begin
    with. . . . It is like I am just here for other people’s pleasure and am not a person
    myself with my own wants and needs.” Sarah stated that her fear prevented her
    from leaving the house by herself and from engaging in other normal activities like
    going to school, having a job, or socializing with more than a few people.
    In his psychological evaluation, Dr. Green assessed “the impact and injuries
    caused by the discovery and daily awareness that multiple individuals are viewing
    images of sexual crimes being perpetrated against [Sarah] as a child.” As part of
    his assessment, Dr. Green interviewed Sarah and also performed various
    psychological tests. Based on these sources of information, Dr. Green opined that
    “the discovery of multiple downloaders and distributors of her images effectively
    exponentially multiplied in [Sarah’s] mind the number of sick and dangerous males
    ‘out there’ who might . . . do her harm.” Dr. Green explained that Sarah’s
    knowledge of the dissemination of her child pornography images online caused her
    daily psychological damage in the form of fear “that has reached a paranoid-like
    level of intensity.” Dr. Green determined that Sarah required “extensive and
    intensive therapy” for the trauma caused by both the original abuse and the
    continuing traffic in her images. Dr. Green estimated the costs of Sarah’s future
    psychiatric care were between $265,710 and $303,150.
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    Sarah’s counsel reported that Sarah had incurred $31,433.77 in attorney’s
    fees. The economic assessment for Sarah estimated a minimum of approximately
    $1.9 million in lost wages over her lifetime.
    The government did not concur in Sarah’s $25,000 restitution request and
    instead requested an award of $7,895 based on its 1/n calculation method. The
    government also provided a list of 155 prior restitution awards to Sarah, which
    ranged from $0 at the low end to $51,500 at the high end.
    Rothenberg opposed Sarah’s restitution request. Rothenberg cited three
    other cases involving Sarah in which the government presented the same restitution
    evidence and the courts found the government failed to establish proximate cause.
    Rothenberg argued that the government provided no evidence to disaggregate the
    harm proximately caused by his possession of six images of Sarah from that caused
    by the other defendants in the list it had provided.
    G.    Vicky
    Vicky submitted a restitution request of $10,000. In support of her request,
    Vicky submitted several victim impact statements, several psychological reports
    from Dr. Green, an economic report, and a statement of attorney’s fees. In her
    victim impact statements, Vicky described the effects of the ongoing distribution
    of the images of her sexual abuse as a child, including feelings of fear and
    paranoia, nightmares, and panic attacks. In a 2014 psychological status report,
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    Dr. Green opined that Vicky continued to require therapy as a result of the
    continuing traffic in her images, as well as her discovery of attempts by some
    viewers of her images to invade her privacy. Dr. Green explained that Vicky
    continued to experience anxiety, dissociative responses, social withdrawal, anger,
    feelings of powerlessness, and sleep disruption. Dr. Green estimated Vicky’s total
    therapy costs to be between $108,975 to $113,600.
    The economic report estimated Vicky’s net lost wages over the course of her
    lifetime to be $828,150. Vicky’s counsel represented that Vicky had incurred
    attorney’s fees and costs of $92,371.96.
    The government did not concur in Vicky’s $10,000 request and instead
    requested an award of $1,283 using its 1/n method. The government provided a
    list of 659 other restitution awards to Vicky, which ranged from approximately $24
    at the low end to $1 million at the high end.
    Rothenberg opposed Vicky’s restitution request for the same reasons he
    opposed Sarah’s request, noting that other courts had denied restitution requests
    based on the same evidence and that the government failed to disaggregate.
    Rothenberg also noted that he possessed only one image of Vicky and that the
    average post-Paroline restitution award to Vicky was $3,632.
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    H.    Amy
    Amy submitted a restitution request of $25,000. In support of her request,
    Amy provided a victim impact statement, several psychological evaluations from
    Dr. Joyanna Silberg, and an economic report. In her victim impact statement, Amy
    stated that she “live[s] in constant fear that someone will see [her] pictures and
    recognize [her].” Amy expressed feelings of powerlessness related to the traffic in
    the images of her sexual abuse as a child because “the crime has never really
    stopped and will never really stop.” Amy explained that she experienced fear,
    shame, and humiliation at the thought of her friends and other people she
    encounters discovering her images online.
    In a December 2014 report, Dr. Silberg opined that although Amy had made
    strides as a result of an intensive treatment plan initiated in 2012, ongoing issues
    related to PTSD remained. Dr. Silberg explained that Amy continued to
    experience flashbacks and nightmares, as well as “fear about the internet and
    shame associated with the ongoing viewing of her picture.” Dr. Silberg concluded
    that Amy “continues to suffer from the ongoing effects of her victimization from
    child abuse and from the continued use of her image by child pornography traders,
    viewers, and abusers,” and recommended continued psychological treatment and
    monitoring. Amy’s economic report estimated her net lost wages as $2,855,173,
    and her future counseling costs as $512,681.
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    The government did not concur in Amy’s $25,000 request and instead
    requested a restitution amount of $15,664 using its 1/n method. The government
    provided a list of 215 other restitution awards to Amy, ranging from $50 at the low
    end to $3.5 million at the high end.
    Rothenberg opposed Amy’s restitution request. Rothenberg noted that he
    possessed only one image of Amy and that the average post-Paroline restitution
    award to her was $3,891. Rothenberg asserted that the government’s list of prior
    restitution orders was inaccurate as to some of the awards and argued that the
    government made no attempt to disaggregate his conduct from that of other
    defendants.
    I.     Jenny
    Jenny submitted a restitution request of $42,600. In support of her request,
    Jenny submitted a victim impact statement and a cover letter from her counsel. In
    her victim impact statement, Jenny stated that she worried about the images of her
    sexual abuse that were “out there” and feared being recognized in public. Jenny
    expressed a strong desire to forget the abuse she had suffered but explained that
    “[w]ith the pictures still out there I can’t.”
    In their cover letter, Jenny’s counsel represented that this was Jenny’s
    seventh restitution request. Counsel stated that they were still in the process of
    obtaining expert reports for Jenny, but asserted that “such formal reports” were not
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    necessary for the district court to determine restitution. Counsel discussed a
    proposed bill which would set a $25,000 minimum restitution award for child
    pornography possession offenses, and represented that Jenny had costs of $5,100
    for legal and attorney’s fees and $12,500 for the preparation of expert reports.
    Because these three items totaled $42,600, Jenny’s counsel contended that $42,600
    amount was the appropriate restitution amount for Jenny.
    The government did not concur in Jenny’s $42,600 restitution request and
    instead requested a restitution award of $2,000. The government emphasized that
    Rothenberg possessed 34 images and one video of Jenny but noted the lack of
    documentation to support Jenny’s restitution request. The government pointed out
    that one other defendant was ordered to pay restitution to Jenny in the amount of
    $7,500.
    Rothenberg likewise noted the lack of evidence supporting Jenny’s $42,600
    restitution request. Nevertheless, based on the number of images of Jenny he
    possessed, Rothenberg agreed that the government’s requested amount of $2,000
    was reasonable.
    J.    Casseaopeia
    Casseaopeia submitted a restitution request of $25,000. In support of her
    request, Casseaopeia provided a victim impact statement, a psychological report
    from Dr. Joyce Vesper, and an economic assessment. In her victim impact
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    statement, Casseaopeia described her ongoing victimization as a result of the
    online trade in her child pornography images. Casseaopeia stated that she worried
    the people viewing her images would seek her out and harm her. She explained
    that she suffers from anxiety, which makes it hard for her to work or go out in
    public, and experiences panic attacks when she thinks someone recognizes her
    from the internet. Casseaopeia further explained that the continuing traffic in her
    images made recovery from her PTSD and depression more difficult and
    “prevent[ed] the wound from healing.”
    In her September 2015 psychological report, Dr. Vesper described her
    clinical interview with Casseaopeia and the psychological tests she administered.
    From these assessments, Dr. Vesper concluded that Casseaopeia was “tortured by
    constant memories of childhood sexual abuse” and experienced “constant head
    chatter, graphic flashbacks, [and] panic attacks that are so overwhelming they feel
    like heart attacks.” Dr. Vesper described Casseaopeia as living “in constant fear
    that the people viewing the pornographic films and pictures of her” online would
    capture her and subject her to the same abuse all over again. Dr. Vesper opined
    that “[w]ithout the appropriate psychotherapy to address [her] dissociation,
    depersonalization, derealization, amnesia, anxiety and depression,” Casseaopeia
    would continue to experience flashbacks, nightmares, and depression. Dr. Vesper
    recommended intensive psychotherapy for Casseaopeia. In a supplemental report,
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    Dr. Vesper specifically addressed the effects on Casseaopeia of the ongoing traffic
    in her images. Dr. Vesper explained that Casseaopeia experienced persistent
    anxiety that people she knows will see on the internet images of her sexual abuse
    as a child and that this anxiety affects her recovery process.
    The economic assessment estimated Casseaopeia had economic damages
    totaling $1,078,159, including $748,438 in lost earning capacity and $329,721 in
    future medical expenses.
    The government requested a slightly lower restitution award of $21,563 for
    Casseaopeia, which was calculated using the 1/n method. The government noted
    that 49 other defendants were ordered to pay restitution to Casseaopeia and
    submitted a list of those prior awards. Those prior awards ranged from $0 at the
    low end to $50,000 at the high end.
    Rothenberg opposed Casseaopeia’s restitution request. Rothenberg noted
    that he possessed only two images of Casseaopeia and that the average restitution
    award to her was $3,974. Rothenberg argued that, like many of the other requests,
    the government did not differentiate between the harm he caused and that caused
    by other perpetrators. Rothenberg contended that Dr. Vesper’s report primarily
    dealt with effects of the original abuse rather than the traffic in Casseaopeia’s
    images.
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    K.     Restitution Hearing
    On November 18, 2016, the district court held a restitution hearing. At the
    restitution hearing, the government submitted the evidence on which its restitution
    requests were based, all of which was admitted into evidence.2 That evidence
    consisted of 891 pages of exhibits submitted by the victims and charts prepared by
    the government listing each victim’s prior restitution awards in other federal cases.
    The exhibits included the declarations, psychological evaluations, letters, and other
    evidence referenced in the government’s restitution requests. Rothenberg noted, at
    the outset of the hearing, that he agreed with the government’s requested award of
    $2,000 to Jenny and therefore did not offer any argument as to that award. The
    remaining requests were disputed, and the parties essentially reiterated the
    arguments raised in their prior memoranda as to those victims.
    III. COURT’S RESTITUTION ORDER
    Six months later, on May 9, 2017, the district court issued its restitution
    order. After outlining in detail Paroline’s framework (and expressing some
    frustration with its inexactitude), the district court analyzed each victim’s
    restitution request. As a preliminary matter, the district court stated that, with
    2
    Though the district court admitted the restitution exhibits into evidence at the restitution
    hearing, it did not scan and file those exhibits on the district court docket. On appeal,
    Rothenberg filed an unopposed motion to supplement the record to include those exhibits, which
    this Court granted.
    22
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    respect to each victim, it had assigned restitution in a manner that comported with
    Rothenberg’s relative role and only for damages he proximately caused. The
    district court explicitly explained that it had not “attempted to hold [Rothenberg]
    responsible for all losses sustained by any victim.” Furthermore, the district court
    expressly noted there was no evidence that Rothenberg was connected to the initial
    abuse of any of the victims or that he had reproduced or distributed their images.
    Instead, Rothenberg was a possessor only. And the district court specifically stated
    that it had “taken these factors into consideration in assigning [Rothenberg] a
    relative role as the proximate cause of these victims’ losses.”
    Turning to the specific awards, the district court determined that Sierra’s
    $10,000 request was reasonable. The district court found that: (1) Rothenberg
    possessed one image of Sierra; (2) a small number of criminal defendants had paid
    restitution to Sierra; (3) Sierra’s current mental health condition was severe; and
    (4) Sierra’s projected costs of care exceeded $600,000. The district court found “in
    consideration of her large amount of total costs, the small number of contributing
    offenders, and a request for a proportion of these costs proximately caused and to
    be paid by [Rothenberg], who neither created nor distributed her image, that
    $10,000 is a reasonable request under the Paroline analysis and factors.”
    Next, the district court determined that Jane’s $3,000 request was
    reasonable. The district court found that: (1) Rothenberg possessed four images of
    23
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    Jane; (2) a small number of criminal defendants had paid restitution to Jane;
    (3) Jane’s victim impact statement specifically addressed how the existence of her
    images on the internet affected her and isolated the harm caused by possessors and
    distributors from that caused by the original abuse; and (4) Jane’s estimated
    medical and therapy costs were $101,027. The district court found “in
    consideration of her medical costs, the small number of contributing offenders, and
    a request for a proportion of these costs to be paid by [Rothenberg], who neither
    created nor distributed her images, that $3,000 is a reasonable request under the
    Paroline analysis and factors.”
    The district court then determined that Pia’s $5,000 request was reasonable.
    The district court found that: (1) Rothenberg possessed 14 images of Pia; (2) there
    was no evidence regarding the number of other criminal defendants ordered to pay
    restitution to Pia, though Pia’s counsel indicated that one other defendant was so
    ordered; and (3) Pia’s estimated therapy costs over the next 20 years totaled
    $81,900. The district court found “in consideration of her total costs, the fact that
    she has only received restitution from one other defendant, the large number of
    images possessed by [Rothenberg] of [Pia], and a request for a proportion of these
    costs to be paid by [Rothenberg], who neither created nor distributed her images,
    that $5,000 is a reasonable request under the Paroline analysis and factors.”
    24
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    The district court also determined that Mya’s $5,000 request was reasonable,
    despite the government’s requested amount of only $500. The district court found
    that: (1) Rothenberg possessed one image of Mya; (2) there was no indication as to
    whether any other criminal defendants were ordered to pay restitution to Mya; and
    (3) Mya’s counsel indicated a reasonable treatment estimate for Mya would be
    more than $100,000. The district court found “in consideration of her total costs,
    the fact that she has not received any restitution at this time, and a request for a
    proportion of these costs to be paid by [Rothenberg], who neither created nor
    distributed her images, that $5,000 is a reasonable request under the Paroline
    analysis and factors.”
    As to Sarah, the district court determined that an award of $20,000—$5,000
    less than Sarah’s requested amount—was reasonable. The district court explained
    that: (1) Rothenberg possessed six images of Sarah; (2) over 150 criminal
    defendants were ordered to pay restitution to Sarah; (3) Sarah’s victim impact
    statement explicitly addressed how the existence of her images on the internet
    affected her, thereby isolating the harm caused by possession of her images from
    that caused by the original abuse; and (4) Sarah’s estimated cost of psychiatric care
    was nearly $300,000. The district court found, “in consideration of the amount of
    costs, the fact that many other offenders have been required to pay restitution to
    [Sarah]—which in the case of Sarah, the Court finds contributes to a finding that
    25
    Case: 17-12349     Date Filed: 05/08/2019   Page: 26 of 67
    the request is reasonable and acknowledged by many other courts—the large
    number of images possessed of [Sarah], and a request for a proportion of these
    costs proximately caused and to be paid by [Rothenberg], who neither created nor
    distributed her image[s], that $20,000 is an appropriate amount under the Paroline
    analysis and factors.”
    In a similar vein, the district court determined that for Vicky, $9,000—
    $1,000 less than Vicky’s requested $10,000 amount—was a reasonable award.
    The district court found that: (1) Rothenberg possessed one image of Vicky;
    (2) more than 600, and possibly more than 800, other criminal defendants were
    ordered to pay restitution to Vicky; (3) Vicky’s victim impact statement
    specifically addressed how the online traffic in her images affected her and
    explained the distinct harm caused by possessors and distributors of her images;
    and (4) Vicky’s predicted therapy costs exceeded $100,000. The district court
    found “in consideration of the amount of costs, the fact that many other offenders
    have been required to pay restitution to [Vicky]—which in the case of Vicky, the
    Court finds contributes to a finding that the request is reasonable and
    acknowledged by many other courts—and a request for a proportion of these costs
    proximately caused and to be paid by [Rothenberg], who neither created nor
    distributed her image, that $9,000 is an appropriate amount under the Paroline
    analysis and factors.”
    26
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    The district court likewise awarded a reduced amount to Amy. The district
    court noted that Amy requested $25,000 and that the government requested
    $15,664, but the district court ultimately determined that $23,000 was reasonable.
    The district court explained that: (1) Rothenberg possessed one image of Amy;
    (2) more than 200 criminal defendants had paid restitution to Amy; (3) Amy’s
    victim impact statement “provide[d] strong support for the different and separate
    harm that possessors proximately cause to victims such as [herself]”; and
    (4) Amy’s counseling and therapy costs could exceed $500,000. The district court
    found “in consideration of the large amount of costs, the fact that other offenders
    have been required to pay restitution to [Amy]—which, again, in the case of Amy,
    the Court finds contributes to a finding that the request is reasonable and
    acknowledged by other courts—and a request for a proportion of these costs
    proximately caused and to be paid by [Rothenberg], who neither created nor
    distributed her image, that $23,000 is an appropriate amount under the Paroline
    analysis and factors.”
    Regarding Jenny, the district court acknowledged that both the government
    and Rothenberg agreed that $2,000 was an appropriate amount, but that Jenny
    requested $42,600. The district court determined that Jenny’s requested amount
    was reasonable. The district court emphasized that (1) Rothenberg possessed 34
    images and one video of Jenny, and (2) only one other defendant had paid
    27
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    restitution to Jenny. The district court conceded there was “less documentation of
    Jenny’s psychological and medical expenses as compared with some other victims
    in this case,” but found that the $2,000 amount requested by the parties was
    insufficient. Considering “the extremely large number of images [Rothenberg]
    possessed of [Jenny], her costs, the fact that only one other defendant has so far
    contributed to these costs, and a request for a proportion of these costs to be paid
    by [Rothenberg], who neither created nor distributed her images, the Court finds
    that $42,600 is a reasonable request under the Paroline analysis and factors.”
    Lastly, as to Casseaopeia, the district court determined that her requested
    award of $25,000 was reasonable, even though the government requested only
    $21,563. The district court found that: (1) Rothenberg possessed two images of
    Casseaopeia; (2) more than 50 criminal defendants were ordered to pay her
    restitution; and (3) her projected costs of care exceeded $300,000. Considering
    “her costs, the number of contributing offenders, and a request for a proportion of
    these costs proximately caused and to be paid by [Rothenberg], who neither
    created nor distributed her image,” the district court found that “$25,000 is a
    reasonable request under the Paroline analysis and factors.”
    In total, the district court ordered Rothenberg to pay $142,600 in restitution,
    to be apportioned to the nine victims in the amounts set out above. On appeal,
    Rothenberg argues that the district court erred as to all nine restitution awards. We
    28
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    begin with the restitution statute and then review the Supreme Court’s Paroline
    decision, which both parties agree governs this appeal.
    IV. 
    18 U.S.C. § 2259
    Congress has mandated that district courts award restitution to victims of
    certain federal crimes, including child pornography possession. See 
    18 U.S.C. § 2259
    (a) (2012).3 The possessor of child pornography must pay restitution to the
    victim whose childhood abuse appears in the pornographic materials he possessed.
    See 
    id.
     § 2259(b)(1), (c)(4). The statute requires that “[t]he order of restitution . . .
    shall direct the defendant to pay the victim . . . the full amount of the victim’s
    losses as determined by the court.” Id. § 2259(b)(1). The statute defines the term
    “full amount of the victim’s losses” to include any costs incurred by the victim for:
    (A) medical services relating to physical, psychiatric, or psychological
    care;
    (B) physical and occupational therapy or rehabilitation;
    (C) necessary transportation, temporary housing, and child care
    expenses;
    (D) lost income;
    (E) attorneys’ fees, as well as other costs incurred; and
    (F) any other losses suffered by the victim as a proximate result of the
    offense.
    3
    Since Rothenberg’s guilty plea and restitution hearing, Congress amended 
    18 U.S.C. § 2259
    , effective December 7, 2018. See Amy, Vicky, and Andy Child Pornography Victim
    Assistance Act of 2018, Pub. L. No. 115-299, 
    132 Stat. 4383
     (2018). All citations in this opinion
    are to the previous version of 
    18 U.S.C. § 2259
    , which was in effect both when Paroline was
    decided and at the time of the district court’s restitution order in this case.
    29
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    Id.
     § 2259(b)(3) (emphasis added). The statute defines a victim as “the individual
    harmed as a result of the commission of a crime under this chapter.” Id.
    § 2255(c)(4) (emphasis added). A court may not decline to issue restitution
    because of the economic circumstances of the defendant or because the victim has
    received compensation from another source. See id. § 2259(b)(4)(B).
    “The burden of demonstrating the amount of the loss sustained by a victim
    as a result of the offense shall be on the attorney for the Government.” Id.
    §§ 3664(e), 2259(b)(2) (emphasis added). In Paroline, the Supreme Court
    addressed the meaning of “as a result of” and “proximate result” in § 2259 and
    precisely what type of causal connection or proximate cause must exist between
    the victim’s losses and the defendant’s offense. We review Paroline next.
    V. SUPREME COURT’S PAROLINE DECISION
    Like this case, Paroline involved a possessor of child pornography images in
    wide circulation on the internet. In Paroline, the defendant was a possessor and not
    a distributor or the initial abuser. See 572 U.S. at 439, 
    134 S. Ct. at 1716
    . The
    Supreme Court grappled with the question of what causal relationship must be
    established between a defendant possessor’s conduct and a victim’s losses for
    purposes of determining the right to, and the amount of, restitution under § 2259.
    Id. As a preliminary matter, the Supreme Court interpreted § 2259’s statutory
    language to impose a general proximate-cause limitation. Id. at 448, 
    134 S. Ct. at
    30
    Case: 17-12349      Date Filed: 05/08/2019   Page: 31 of 67
    1721. The Supreme Court determined that “[r]estitution is therefore proper under
    § 2259 only to the extent the defendant’s offense proximately caused a victim’s
    losses.” Id. at 448, 
    134 S. Ct. at 1722
    .
    The difficulty, the Supreme Court explained, comes in applying that
    causation requirement in a particular child pornography case. Id. at 449, 
    134 S. Ct. at 1722
    . This is so because of the “somewhat atypical causal process underlying
    the losses [a child pornography] victim claims.” 
    Id.
     The Supreme Court reasoned
    that it may be “simple enough” for a victim to prove the aggregate losses that stem
    from the ongoing traffic in her images as a whole. 
    Id.
     Importantly, the Supreme
    Court observed that it is more difficult to determine “the ‘full amount’ of those
    general losses, if any, that are the proximate result of the offense conduct of a
    particular defendant who is one of thousands who have possessed and will in the
    future possess the victim’s images but who has no other connection to the victim.”
    
    Id.
    Therefore, in child pornography possession offenses, the Paroline Court
    recognized that it would be virtually impossible to show that the defendant
    possessor was a but-for cause of any particular portion of the victim’s losses
    “where the defendant is an anonymous possessor of images in wide circulation on
    the Internet.” Id. at 450-51, 
    134 S. Ct. at 1722-23
    . Nevertheless, the Supreme
    Court observed that “[w]hile it is not possible to identify a discrete, readily
    31
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    definable incremental loss [a defendant possessor] caused, it is indisputable that
    [the defendant possessor] was a part of the overall phenomenon that caused [the
    victim’s] general losses.” Id. at 456-57, 
    134 S. Ct. at 1726
    . And it would
    undermine the purposes of § 2259 to deny restitution in cases involving possessors
    of child pornography. Id. at 456-58, 
    134 S. Ct. at 1726-27
    .
    The Supreme Court also recognized that the original abuse crime is
    compounded by the distribution and possession of images of the victim’s original
    abuser’s “horrific acts, which meant the wrongs inflicted on her were in effect
    repeated; for she knew her humiliation and hurt were and would be renewed into
    the future as an ever-increasing number of wrongdoers witnessed the crimes
    committed against her.” Id. at 441, 
    134 S. Ct. at 1717
    . It does not matter that the
    victim does not know the name of the possessor because the losses do not flow
    from any specific knowledge of him; rather, the cause of the victim’s losses “is the
    trade in her images.” Id. at 456, 134 S. Ct at 1726. The Supreme Court also
    observed that “the victim suffers continuing and grievous harm as a result of her
    knowledge that a large, indeterminate number of individuals have viewed and will
    in the future view images of the sexual abuse she endured.” Id. at 457, 
    134 S. Ct. at 1726
    . “In a sense, every viewing of child pornography is a repetition of the
    victim’s abuse.” Id. at 457, 
    134 S. Ct. at 1727
    . “The cause of the victim’s general
    losses is the trade in her images.” Id. at 456, 
    134 S. Ct. at 1726
    .
    32
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    After rejecting a but-for test for proximate cause, the Paroline Court adopted
    a causation-in-fact standard for cases where: (1) “a defendant possessed a victim’s
    images”; (2) “a victim has outstanding losses caused by the continuing traffic in
    those images”; and yet (3) “it is impossible to trace a particular amount of those
    losses to the individual defendant by recourse to a more traditional causal inquiry.”
    Id. at 458, 
    134 S. Ct. at 1727
    . In that situation, the Supreme Court concluded that a
    defendant possessor of child pornography should be ordered to pay restitution “in
    an amount that comports with the defendant’s relative role in the causal process
    that underlies the victim’s general losses.” 
    Id.
     The Supreme Court explained that
    the award “would not be severe” in a case where the possessor is only one of many
    thousands of offenders, but also would not be “a token or nominal amount.” Id. at
    458-59, 
    134 S. Ct. at 1727
    . Rather, the required restitution would be “reasonable
    and circumscribed” and “suited to the relative size of [the defendant’s] causal
    role.” Id. at 459, 
    134 S. Ct. at 1727
    .
    Further, the Supreme Court instructed, there is no “practical way to isolate
    some subset of the victim’s general losses that [the possessor] Paroline’s conduct
    alone would have been sufficient to cause.” Id. at 451, 
    134 S. Ct. at 1723
    . In
    Paroline, the defendant possessor was one of thousands who possessed the victim’s
    images. Id. at 450, 
    134 S. Ct. at 1723
    . The Supreme Court stressed that even though
    the victim does not know the possessor, the victim’s “knowledge that her images
    33
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    were circulated far and wide renewed the victim’s trauma and made it difficult for
    her to recover from her abuse.” Id. at 440, 
    134 S. Ct. at 1717
    . “While it is not
    possible to identify a discrete, readily definable incremental loss he [the possessor]
    caused, it is indisputable that he was a part of the overall phenomenon that caused
    her general losses.” Id. at 456-57, 
    134 S. Ct. at 1726
    . In other words, the defendant
    possessor of the images caused in fact part of the general losses, even if “it is
    impossible to trace a particular amount of those losses to the individual defendant.”
    Id. at 458, 
    134 S. Ct. at 1727
    .
    The Paroline Court then turned to the question of how district courts are to
    determine the proper amount of restitution in these “possessor” cases. 
    Id.
     As a
    general matter, the Supreme Court stated that a district court “must assess as best it
    can from available evidence the significance of the individual defendant’s conduct
    in light of the broader causal process that produced the victim’s losses.” Id. at 459,
    
    134 S. Ct. at 1727-28
    . The Supreme Court emphasized that this “cannot be a precise
    mathematical inquiry,” but rather involves the exercise of “wide discretion” and
    “sound judgment” of the sort district courts typically exercise in the context of
    criminal sentencing and restitution more broadly. Id. at 459-62, 
    134 S. Ct. at
    1728-
    29. The Supreme Court then expressly identified “a variety of factors district courts
    might consider” in determining a proper restitution amount for possession. Id. at
    459-60, 
    134 S. Ct. at 1728
     (emphasis added).
    34
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    As a starting point, the Supreme Court suggested that district courts
    “determine the amount of the victim’s losses caused by the continuing traffic in the
    victim’s images.” Id. at 460, 
    134 S. Ct. at 1728
     (emphasis added). Then, to
    determine the defendant possessor’s relative role in causing those general losses, the
    district court could consider factors such as: (1) “the number of past criminal
    defendants found to have contributed to the victim’s general losses”; (2) “reasonable
    predictions of the number of future offenders likely to be caught and convicted for
    crimes contributing to the victim’s general losses”; (3) “any available and
    reasonably reliable estimate of the broader number of offenders involved (most of
    whom will, of course, never be caught or convicted)”; (4) “whether the defendant
    reproduced or distributed images of the victim”; (5) “whether the defendant had any
    connection to the initial production of the images”; (6) “how many images of the
    victim the defendant possessed”; and (7) “other facts relevant to the defendant’s
    relative causal role.” 
    Id.
    The Supreme Court reiterated that these factors should not be used as a “rigid
    formula,” but should instead serve as “rough guideposts” in determining a restitution
    amount for the possessor criminal defendant. 
    Id.
     The Supreme Court noted that
    “[t]his approach is not without its difficulties,” as it “involves discretion and
    estimation,” but “courts can only do their best to apply the statute as written in a
    workable manner.” Id. at 462, 
    134 S. Ct. at 1729
    . The Supreme Court emphasized
    35
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    that district courts regularly exercise wide discretion, and there was “no reason to
    believe they cannot apply th[is] causal standard . . . in a reasonable manner.” Id.4
    VI. STANDARD OF REVIEW
    We review de novo the legality of a restitution order, but review for clear
    error the factual findings underlying that order. United States v. McDaniel, 
    631 F.3d 1204
    , 1207 (11th Cir. 2011); see also United States v. Osman, 
    853 F.3d 1184
    ,
    1188 (11th Cir. 2017). We review the amount of the district court’s restitution
    award only for an abuse of discretion. See United States v. Robertson, 
    493 F.3d 1322
    , 1330 (11th Cir. 2007); see also Paroline, 572 U.S. at 459, 134 S. Ct at 1727-
    28 (emphasizing that “determining the proper amount of restitution” involves “the
    use of discretion and sound judgment” on the part of the district court).
    A district court abuses its discretion if it applies an incorrect legal standard,
    follows improper procedures, or makes clearly erroneous findings of fact. United
    States v. Jordan, 
    582 F.3d 1239
    , 1249 (11th Cir. 2009). The abuse of discretion
    standard recognizes that the district court has a range of choices, and this Court
    4
    Three of the four dissenting justices were not so sure and complained that “[w]hen it
    comes to [the defendant’s] crime—possession of two of [the victim’s] images—it is not possible
    to do anything more than pick an arbitrary number” as “the amount of the loss sustained by a
    victim as a result of” the defendant’s crime. Paroline, 572 U.S. at 463, 
    134 S. Ct. at 1730
    (Roberts, C.J., dissenting). The fourth dissenter, Justice Sotomayor, would have embraced the
    victim’s joint and several liability theory, holding each possessor liable for restitution in the full
    amount of the victim’s losses. Id. at 473, 
    134 S. Ct. at 1735
     (Sotomayor, J., dissenting).
    36
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    will not reverse the district court’s choice as long as its decision does not amount
    to a clear error of judgment. 
    Id.
    Osman, our only published post-Paroline restitution decision to date, did not
    address how the abuse of discretion standard applies in assessing whether the
    district court adequately considered the Paroline factors and imposed a reasonable
    restitution award. See generally Osman, 853 F.3d at 1189-92. But Paroline itself
    provides some important clues. In Paroline, the Supreme Court emphasized that
    determining the proper restitution amount “involves the use of discretion and
    sound judgment” in a manner akin to that exercised “in the wider context of
    criminal sentencing,” and that the ultimate award must be “reasonable and
    circumscribed.” Paroline, 572 U.S. at 459, 
    134 S. Ct. at 1727-28
    ; see also id. at
    462, 
    134 S. Ct. at 1729
     (explaining that “[d]istrict courts routinely exercise wide
    discretion . . . in sentencing as a general matter” and should likewise apply
    Paroline’s causal standard “in a reasonable manner”). And to guide the district
    court’s exercise of its discretion, the Paroline Court identified a number of factors
    district courts may consider in fashioning an appropriate restitution award. Id. at
    459-60, 
    134 S. Ct. at 1728
    .
    Paroline thus established a framework not unlike the one we apply in
    assessing the reasonableness of a defendant’s sentence, in which we look to see
    whether the district court appropriately exercised its sentencing discretion in light
    37
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    of the 
    18 U.S.C. § 3553
    (a) factors. See, e.g., Gall v. United States, 
    552 U.S. 38
    ,
    51, 
    128 S. Ct. 586
    , 597 (2007); United States v. Irey, 
    612 F.3d 1160
    , 1188-91 (11th
    Cir. 2010) (en banc). In that § 3553(a) context, we evaluate whether the district
    court failed to consider relevant factors, improperly weighed the relevant factors,
    or considered improper factors, and ultimately assess whether, under the totality of
    the circumstances, the sentence is reasonable. See Irey, 
    612 F.3d at 1189
    . And we
    will vacate a sentence imposed by the district court only if we are “left with the
    definite and firm conviction that the district court committed a clear error of
    judgment in weighing the § 3553(a) factors by arriving at a sentence that lies
    outside the range of reasonable sentences dictated by the facts of the case.” Id. at
    1190 (internal quotation marks omitted).
    Additionally, in sentencing cases, we do not require district courts to make
    detailed findings or give a thorough explanation for the sentence it chose. See id.
    at 1194-95. Specifically, “[t]he district court need not state on the record that it has
    explicitly considered each factor and need not discuss each factor,” United States
    v. Dorman, 
    488 F.3d 936
    , 938 (11th Cir. 2007), “so long as the record reflects the
    court’s consideration of many of those factors,” United States v. Carpenter, 
    803 F.3d 1224
    , 1232 (11th Cir. 2015). “Rather, an acknowledgment by the district
    court that it has considered the defendant’s arguments and the § 3553(a) factors
    will suffice.” Dorman, 
    488 F.3d at 938
    .
    38
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    A similar approach makes sense here. As in the sentencing context, in
    evaluating child pornography restitution awards under Paroline, appellate courts
    must determine whether the district court appropriately exercised its broad
    discretion in light of the facts of the particular case and awarded restitution in an
    amount that comports with the particular defendant’s conduct. See Paroline, 572
    U.S. at 458-59, 462, 
    134 S. Ct. at 1727-29
    ; Irey, 
    612 F.3d at 1190
    . And as in the
    sentencing context, a number of relevant factors guide the district court’s exercise
    of its discretion. See Paroline, 572 U.S. at 459-60, 
    134 S. Ct. at 1728
    ; Gall, 
    552 U.S. at 51
    , 
    128 S. Ct. at 597
    . Furthermore, the Supreme Court in Paroline
    indicated that the exercise of discretion at issue in child pornography restitution
    cases is similar to that exercised in criminal sentencing more generally. See
    Paroline, 572 U.S. at 459, 
    134 S. Ct. at 1727-28
    .
    Accordingly, in reviewing child pornography restitution awards under
    Paroline, this Court should consider whether, in light of the Paroline factors, the
    district court arrived at a restitution amount that lies within the general range of
    reasonable restitution awards dictated by the facts of the case. See Irey, 
    612 F.3d at 1190
    . In doing so, this Court should give due deference to the district court’s
    determination that the Paroline factors, on the whole, justify the restitution amount
    awarded and should not vacate an award unless left with the definite and firm
    conviction that the district court committed a clear error of judgment in setting the
    39
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    award amount. See id.; Gall, 
    552 U.S. at 51
    , 
    128 S. Ct. at 597
    . Moreover, so long
    as the district court acknowledges that it has considered the Paroline factors and
    the defendant’s arguments regarding restitution, we will not vacate a restitution
    award solely on the basis that the district court did not address each factor
    explicitly. See Carpenter, 803 F.3d at 1232; Dorman, 
    488 F.3d at 938
    .
    With these principles in mind, we turn now to Rothenberg’s disaggregation
    argument, which is a legal challenge to the district court’s restitution order that we
    review de novo. Osman, 853 F.3d at 1188.
    VII. DISAGGREGATION
    On appeal, Rothenberg first argues that, as to all nine victims, the district
    court failed to “disaggregate” their losses. Rothenberg contends that Paroline
    requires district courts to engage in disaggregation at two levels: first, by
    disaggregating the portion of the victim’s losses caused by the original abuse; and
    second, by disaggregating the losses caused by the defendant from those caused by
    other possessors or distributors.
    Rothenberg asserts that the district court here failed at the first level by
    relying on total loss estimates for each victim that did not separate out and deduct
    the losses caused by the original abuser. Because the expert reports did not
    disaggregate the losses caused by the original abuser from those caused by the
    distributors or possessors, Rothenberg contends that the district court was required
    40
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    to conduct that separating out itself. Rothenberg maintains that the district court
    also failed to disaggregate at the second level by failing to use the amounts of the
    prior restitution orders against other defendant possessors or distributors for the
    same victims as a guidepost for determining his relative level of culpability.
    The government responds that nothing in Paroline requires district courts to
    engage in the sort of formal disaggregation Rothenberg envisions. Rather, the
    government contends that Paroline simply requires that the district court consider
    the Paroline factors and exercise its discretion in determining the amount of a
    victim’s losses caused by the instant defendant. The government submits that the
    district court here complied with those requirements, explicitly stating it was not
    holding Rothenberg accountable for the original abuse or distribution of the
    victims’ images and setting restitution amounts that “best approximat[ed]
    Rothenberg’s relative role.”
    This Court has not yet addressed whether, in awarding restitution post-
    Paroline, district courts first must formally disaggregate a victim’s losses between
    the original abuser, distributors, and subsequent possessors. Several of our sister
    circuits, however, have grappled with that question, and the results are mixed.
    A.    Eighth and Fifth Circuits’ Decisions
    We start with the Eighth Circuit’s decision in United States v. Bordman, 
    895 F.3d 1048
    , 1058-59 (8th Cir. 2018), cert. denied, 
    2019 WL 1886056
     (U.S. Apr. 29,
    41
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    2019), a restitution case involving a defendant convicted of only possessing child
    pornography. In Bordman, the Eighth Circuit expressly held that a district court is
    not required to formally disaggregate categories of loss before ordering restitution,
    such as the loss caused by the initial abuser. 
    Id. at 1058-59
    .
    In doing so, the Eighth Circuit affirmed the district court’s $3,000 award of
    restitution to a victim where the district court considered multiple factors,
    including: (1) the 1/n method, which took into account the number of defendants
    (32) who had already paid the victim restitution plus 1 (the defendant Bordman),
    for a total of 33; (2) the child pornography being videos with two copies of the
    same video in different folders; and (3) the “very aggravating factor” of the nature
    of the video. 
    Id. at 1052-53, 1059
    . The victim’s losses included $91,900 in
    therapy, related expenses, and for a vocational assessment and counseling, legal
    costs of $10,187.13, and attorney’s fees. 
    Id. at 1052
    . At the sentencing hearing,
    the government took the sum of $95,295.71 ($91,900 plus one third of the
    attorney’s fees) and divided it by 33 defendants, resulting in the sum of $2,887.75.
    
    Id. at 1052-53
    . One-third of the attorney’s fees was used because this same
    attorney had represented three victims. 
    Id. at 1052
    . The district court imposed a
    $3,000 restitution amount for the victim. 
    Id. at 1054
    .
    On appeal, the defendant-possessor Bordman specifically claimed that “the
    district court abused its discretion by failing to disaggregate the harm caused by the
    42
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    initial abuse from the harm that his later possession caused.” 
    Id. at 1058
    . In
    rejecting that claim, the Eighth Circuit reasoned that “one of the Paroline factors
    already accounts for disaggregation”—namely, “whether the defendant had any
    connection to the initial production of the images.” 
    Id. at 1059
     (quoting Paroline,
    572 U.S. at 460, 
    134 S. Ct. at 1728
    ). The Eighth Circuit “decline[d] to transform”
    this disaggregation factor “from a ‘rough guidepost’ into a ‘rigid formula.’” 
    Id.
    (quoting Paroline, 572 U.S. at 460, 
    134 S. Ct. at 1728
    ).
    The Fifth Circuit also has rejected, under plain error review, a defendant’s
    challenge to restitution awards that relied on psychological reports that “did not
    separate the losses caused by [the defendant possessor] from the losses caused by
    other abusers.” United States v. Halverson, 
    897 F.3d 645
    , 654-55 n.4 (5th Cir.
    2018). The Fifth Circuit reasoned that nothing in Paroline clearly required victims
    to present a new psychological report in each case that “disaggregates a
    defendant’s conduct from all other possible sources of the victim’s losses.” 
    Id.
    The Fifth Circuit approved the district court’s use of a restitution method which
    awarded each victim (1) a base $5,000 amount of restitution, plus (2) an additional
    sum of $1,409 for each image of the victim that the defendant possessed because
    the district court discussed factors that bore on the relative significance of the
    defendant’s conduct and the district court was not required to make findings as to
    all of the Paroline factors. 
    Id. at 653-54
    .
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    B.    Fourth and Seventh Circuits’ Decisions
    While not directly ruling on the initial-abuser-disaggregation issue, two
    other decisions of our sister circuits bear mentioning. That is because both
    decisions, post-Paroline, (1) emphasized the district court’s wide discretion
    inherent in determining the amount of restitution, (2) affirmed restitution awards
    under various methodologies against possessors of child pornography, and
    (3) refused to impose more structure beyond the Supreme Court’s multi-factored
    test. See United States v. Dillard, 
    891 F.3d 151
    , 160-62 (4th Cir. 2018) (noting
    that Paroline did not set any “evidentiary minimums” for establishing restitution,
    that “[p]ost-Paroline, our sister courts of appeals have approved of various
    methods of determining a restitution award,” and that “[d]istrict courts have great
    discretion in selecting an appropriate methodology”); United States v. Sainz, 
    827 F.3d 602
    , 605-07 (7th Cir. 2016) (discussing the district court’s ability to employ
    varying methodologies, including the 1/n method, to calculate a restitution amount
    under Paroline and stating that “the bottom line here is that the amount of the
    award is substantively reasonable”). We discuss Dillard and Sainz in detail, as
    they demonstrate not only how to apply the Paroline factors, but also a common-
    sense, practical approach to restitution for victims whose losses are caused by the
    continuing traffic in their child pornography images.
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    In the Fourth Circuit’s Dillard decision, while the defendant was the initial
    abuser of one child victim, he also possessed images of other child victims with
    whom he had no contact. Dillard, 891 F.3d at 154. The district court denied all
    restitution to the non-contact victims because the record contained no evidence that
    the victims were aware Dillard had their images and no evidence connecting the
    non-contact victims’ harm to Dillard. Id. at 156. In reversing, the Fourth Circuit
    explained Paroline disavowed any such requirements. Id. at 159-60. The Fourth
    Circuit held the “[g]overnment satisfied its burden of causation by the uncontested
    evidence that Dillard’s offense conduct included the seven non-contact victims’
    images” and “that these victims have outstanding losses caused by the continuing
    traffic in those images.” Id. at 160 (internal quotation marks omitted).
    As to how to calculate those non-contact victims’ losses caused by Dillard,
    the Fourth Circuit said the district court “‘might, as a starting point, determine the
    amount of the victim’s losses caused by the continuing traffic in the victim’s
    images’” and “‘then set an award of restitution in consideration of factors that bear
    on the relative causal significance of the defendant’s conduct in producing those
    losses.’” Id. at 160 (quoting Paroline, 572 U.S. at 460, 
    134 S. Ct. at 1728
    ). The
    Fourth Circuit remanded for the district court to consider the Paroline factors and
    award at least some “non-nominal amount of restitution” for the losses of the non-
    contact victims whose images Dillard possessed. Id. at 161-62. Where it was
    45
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    “uncontested that the individuals seeking restitution were Dillard’s victims and had
    outstanding losses associated with the continued trade in their images, they were
    entitled by statute to some non-nominal amount of restitution.” Id. at 161 (citing
    Paroline, 572 U.S. at 458-60, 
    134 S. Ct. at 1727-28
    ).
    Similarly, the Seventh Circuit’s decision in Sainz stresses the district court’s
    “considerable discretion in deciding the extent of a defendant’s restitution” who
    possessed child pornography. Sainz, 827 F.3d at 605. The defendant Sainz
    possessed six images of the victim that had circulated widely on the internet, but
    had no role in creating or distributing them. Id. at 604. The victim had “incurred
    financial losses such as future lost earnings, attorney fees, and medical and
    psychiatric expenses” that totaled $1.1 million. Id. at 604, 605 n.1. On appeal, the
    defendant Sainz did not challenge that he must pay some amount of restitution but
    argued that the $8,387.43 amount he was ordered to pay was “disproportionate to
    his relative role in causing” the victim’s losses. Id. at 604-05. Sainz also claimed
    “he was not a legal cause of [the victim’s] harm because hundreds or thousands of
    others also possessed the images, so she would have been harmed by others even if
    he had never possessed the images of her.” Id. at 604.
    Using the 1/n method advocated for by the government, the district court
    divided the total loss of $1.1 million by 136 because defendant Sainz was the 136th
    offender who was prosecuted and ordered to pay restitution. See id. at 605. By
    46
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    possessing and viewing the victim’s images, Sainz had re-victimized her and made
    her feel that the abuse was continuing. Id. at 604.
    In finding no legal error or abuse of discretion in the $8,387.43 restitution
    award, the Seventh Circuit affirmed and reasoned: (1) that the Supreme Court in
    Paroline “avoided rigid or mechanical rules” and left the district courts with
    “considerable discretion”; (2) the amount of restitution for a possessor like Sainz
    “should be neither ‘severe’ nor a ‘token or nominal amount’”; (3) Paroline does not
    require “district courts to consider in every case every factor mentioned” and the
    district court does “not err by not addressing every Paroline factor” 5; and (4) the
    Paroline factors are permissive, not mandatory and provide “rough guideposts” that
    “district courts might consider in determining a proper amount of restitution.” Id.
    at 605-07 (internal quotation marks omitted). The Seventh Circuit recognized that
    the 1/n method is not appropriate for all cases because, when n is “very small or
    very large, a more nuanced method may be required.” Id. at 607. The Seventh
    Circuit concluded, however, that the application of the 1/n method to Sainz’s case
    “resulted in a reasonable restitution order of $8,400 for an offender who possessed
    six images of the victim and indisputably contributed to her harm.” Id.
    5
    The Seventh Circuit explained some of the Paroline factors refer to information that may
    not be “reliably known,” such as “the number of offenders likely to be convicted in the future or
    the broader numbers of offenders who were involved but are unlikely to be caught.” Sainz, 827
    F.3d at 607. The Seventh Circuit stated that “the Supreme Court made clear in Paroline that the
    difficulty of coming up with reasonable estimates for an indeterminate number of other offenders
    should not be a barrier to all compensation for victims of child pornography.” Id.
    47
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    We acknowledge that the defendant Sainz did not ask the court to
    disaggregate the losses from the initial abuser. Nonetheless, the Seventh Circuit’s
    decision is instructive because it emphasizes that (1) the district court has
    “considerable discretion,” (2) the court’s method of restitution calculation can vary
    from case to case depending on the facts, and (3) “the bottom line” is that the
    district court’s award of $8,387.43 was “substantively reasonable” for the
    defendant possessor Sainz, even though there were hundreds of other possessors of
    the same victim’s images. See id. at 604-607.
    C.    Ninth and Tenth Circuits’ Decisions
    In contrast to these decisions, the Ninth and Tenth Circuits have determined
    that district courts must engage in some level of disaggregation as to the harms
    caused by the original abuse versus the harms caused by later distributors and
    possessors before awarding restitution against a particular possessor of child
    pornography. See United States v. Galan, 
    804 F.3d 1287
     (9th Cir. 2015); United
    States v. Dunn, 
    777 F.3d 1171
     (10th Cir. 2015). But even those post-Paroline
    decisions are nuanced and do not adopt a rigid, mathematical rule in that regard.
    Furthermore, the facts of the Tenth Circuit’s Dunn case are important to
    understand what the Tenth Circuit did or did not conclude in that case.
    In Dunn, one victim sought restitution of $583,955, which represented her
    total losses minus the amount of restitution already received from other defendants.
    48
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    See Dunn, 777 F.3d at 1174, 1179. Because Dunn was a distributor of the images,
    the district court determined that “he should be held jointly and severally liable for
    the entirety of [the victim’s] injuries.” Id. at 1179. The victim’s total losses were
    $1,330,015, and the district court held Dunn responsible for $583,955 of those total
    losses as the amount not yet paid. See id. at 1181.
    In reversing, the Tenth Circuit emphasized that the district court held the
    defendant Dunn liable for all of the victim’s unpaid losses, including those caused
    by the initial abuser, and erred by not assessing Dunn’s individual relative role in
    the causal process underlying the victim’s losses. See id. at 1181. The Tenth
    Circuit concluded: “[T]o the extent that the district court relied on an expert report
    that did not disaggregate [the harms caused by the original abuser], the district
    court’s adoption of $1.3 million as the total measure of damages cannot stand.” Id.
    at 1182.6 The disaggregation conclusion in Dunn must be read in the factual
    context of a reversal of a district court’s ruling that a defendant was jointly and
    6
    Though it has not addressed whether district courts must disaggregate, the First Circuit
    has held that a district court order comported with Paroline’s framework where it “excluded past
    costs and based its award on an estimate of [the victim’s] future therapy costs, occasioned by
    defendant’s conduct.” United States v. Rogers, 
    758 F.3d 37
    , 39 (1st Cir. 2014). The district
    court also “limited the losses to general losses from ‘continuing’ traffic” in the victim’s images
    and “distinguished the future therapy losses attributable to defendant from the harm resulting
    from other viewers and from [the victim’s] therapy needs relating to [the original abuser].” 
    Id.
    The First Circuit commented that the district court’s $3,150 restitution award “represent[ed] the
    cost of 18 therapy visits,” but the district court “noted that 50 visits would also have been a
    reasonable conclusion.” 
    Id.
     The mere fact that this type of formal disaggregation is permissible
    under Paroline, however, does not mean that it is required.
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    severally liable with all other defendants, including the abuser, for the entirety of
    the victim’s $1,330,015 total losses, minus only what other defendants had already
    paid. We read Dunn as requiring disaggregation in that case because the defendant
    was held jointly and severally liable with the abuser for the entirety of the losses;
    we do not read Dunn as requiring disaggregation in each and every restitution case.
    Unlike Dunn’s recounting of the restitution facts, the Ninth Circuit’s
    decision in Galan does not indicate the amounts of the victim’s losses or even the
    restitution award at issue. Galan, 804 F.3d at 1288. Rather, Galan recounts only
    these two facts: (1) the defendant Galan was not the victim’s original abuser, who
    “made images of his disgusting crimes against [the victim] over an extended
    period” of time; and (2) that abuse ended about 11 years before Galan possessed
    the images. See id.
    In reversing, the Ninth Circuit went much further than the Tenth. The Ninth
    Circuit held “that in calculating the amount of restitution to be imposed upon a
    defendant who was convicted of distribution or possession of child pornography,
    the losses, including ongoing losses, caused by the original abuse of the victim
    should be disaggregated from the losses caused by the ongoing distribution and
    possession of images of that original abuse, to the extent possible.” Id. at 1291.
    The Ninth Circuit concluded “that Galan should not be required to pay for losses
    caused by the original abuser’s actions.” Id. at 1290. The Ninth Circuit
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    determined, in effect, that some type of calculation should be made between
    original abusers on the one hand and the distributors and possessors on the other.
    See id. at 1288, 1290.
    Importantly, however, the Ninth Circuit cautioned that it “express[ed] no
    opinion about what portion of the victim’s ongoing loss should be attributable to an
    original abuser.” Id. at 1291. It also did not instruct how the disaggregation
    calculation should be done, and it even added that “[i]f the ultimate apportionment
    is not scientifically precise, we can only say that precision is neither expected nor
    required.” Id.
    D.    Our Analysis
    After careful review of Paroline, we conclude that a district court is not
    required to determine, calculate, or disaggregate the specific amount of loss caused
    by the original abuser-creator or distributor of child pornography before it can
    decide the amount of the victim’s losses caused by the later defendant who
    possesses and views the images. Paroline requires no such disaggregation.
    Certainly, Paroline directed district courts to hold a defendant accountable only for
    his own individual conduct and set a restitution “amount that comports with the
    defendant’s relative role” in causing the victim’s general losses. See Paroline, 572
    U.S. at 454-55, 458-59, 
    134 S. Ct. at 1725, 1727
    . How a district court arrives at
    that figure is largely up to the district court, so long as the number is a “reasonable
    51
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    and circumscribed award” that is “suited to the relative size” of the defendant’s
    causal role in the entire chain of events that caused the victim’s loss. Id. at 459,
    
    134 S. Ct. at 1727
    .
    In arriving at that figure, Paroline does require some consideration by the
    district court of whether the defendant possessor was also an abuser-creator or a
    distributor. See 
    id.
     Indeed, that is why Paroline includes among its list of relevant
    factors “whether the defendant had any connection to the initial production of the
    images,” and “whether the defendant reproduced or distributed images of the
    victim.” Id. at 460, 
    134 S. Ct. at 1728
    . But those factors do not require that the
    district court make fact findings about the amount of losses caused by different
    groups of offenders.
    To be clear, the district court should ensure that its restitution order relates
    only to the amount of harm and loss caused by the defendant possessor. But
    Paroline also repeatedly stresses the flexibility and broad discretion district courts
    have in arriving at such a reasonable restitution amount. See, e.g., id. at 459, 
    134 S. Ct. at 1727-28
     (“[A] court must assess as best it can from available evidence the
    significance of the individual defendant’s conduct in light of the broader causal
    process that produced the victim’s losses. This cannot be a precise mathematical
    inquiry and involves the use of discretion and sound judgment.”); id. at 459-60,
    
    134 S. Ct. at 1728
     (“[I]t is neither necessary nor appropriate to prescribe a precise
    52
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    algorithm for determining the proper restitution amount at this point in the law’s
    development. Doing so would unduly constrain the decisionmakers closest to the
    facts of any given case.”); id. at 460, 
    134 S. Ct. at 1728
     (“These factors need not be
    converted into a rigid formula . . . . They should rather serve as rough guideposts
    for determining an amount that fits the offense.”); id. at 462, 
    134 S. Ct. at 1729
    (stating, “the approach articulated above involves discretion and estimation,” and
    “courts can only do their best to apply the statute as written in a workable
    manner”).
    Like the Eighth Circuit, we think it would be inconsistent with Paroline’s
    flexible, discretionary framework to require district courts to perform an initial,
    formal step of calculating and then separately assigning a total loss amount to the
    initial abuser, then one to the distributors and possessors generally, and only then
    one to the particular defendant possessor. Rather, even if a victim’s total loss
    estimate includes losses caused both by the original abuser-creator, the distributors,
    and other possessors, the district court need only indicate in some manner that it
    has considered that the instant defendant is a possessor, and not the initial abuser or
    a distributor, and has assigned restitution based solely on the defendant possessor’s
    particular conduct and relative role in causing those losses. See id. at 458-62, 
    134 S. Ct. at 1727-29
    .
    53
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    Here, the district court did exactly that. In its restitution order, the district
    court explicitly found up front that “there is no evidence with respect to any victim
    that [Rothenberg] reproduced or distributed images of the victim or that he had [a]
    connection to the initial production of the images.” The district court expressly
    stated that it had “taken these factors into consideration in assigning [Rothenberg]
    a relative role as the proximate cause of these victims’ losses.” And in setting each
    individual award, the district court reiterated that Rothenberg “neither created nor
    distributed” the victim’s image. Under Paroline, that is enough. We therefore
    reject Rothenberg’s disaggregation argument.
    Before concluding, we recognize that the Supreme Court in Paroline did
    note in dicta that “[c]omplications may arise in disaggregating losses sustained as a
    result of the initial physical abuse, but those questions may be set aside for present
    purposes.” Id. at 449, 
    134 S. Ct. at 1722
    . We do not read this dicta, which is
    contained in a parenthetical, as requiring in any way that the district courts in
    possessor cases take on the job of determining the harm and loss caused by the
    initial abuser or the distributors. 7 Rather, the district court’s job is to determine the
    7
    We acknowledge that the Ninth Circuit concluded that the set-aside statement in this
    parenthetical meant the Supreme Court “plainly perceived a need for separation” of losses from
    the initial abuser and the later possessor defendants. Galan, 804 F.3d at 1290. However, we read
    the dicta in this parenthetical sentence not in isolation, but in the context surrounding it, which to
    us signals that in possessor cases a court is not required to delve into the special losses caused by
    the original abuser. Rather, in possessor cases, the court is examining only the general losses
    caused by the continuing traffic in the pornographic images and awarding restitution that
    54
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    defendant possessor’s causal role in the general losses caused by his participation
    in the ongoing traffic in the victim’s images.
    We likewise reject Rothenberg’s argument that the district court erred in
    creating restitution disparities between himself and other possessors by
    “impos[ing] restitution in amounts substantially above the average [for other
    possessors] without providing any explanation at all.” We recognize that the
    Supreme Court in Paroline listed as a factor “the number of past criminal
    defendants found to have contributed to the victim’s general losses” and noted that
    the government “could also inform district courts of restitution sought and ordered
    in other cases.” See id. at 460, 462, 
    134 S. Ct. at 1728-29
    . However, the Supreme
    Court did not require district courts to dive into the facts of every past order and
    position their restitution findings in relation to those of other courts. See 
    id.
     The
    district court is not required to say why it did not follow or disagreed with
    restitution orders as to the same victim imposed by other courts. Paroline requires
    no such fact findings or analysis. Rather, the number of past criminal defendants
    and their restitution amounts, even as to the same victim, are just one of many
    comports with the defendant possessor’s relative role as a possessor. In our view, nothing in
    Paroline requires disaggregation, and everything in Paroline suggests otherwise.
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    factors the district court considers generally without having to make mathematical
    calculations. 8 See 
    id.
    VIII. SUFFICIENCY OF THE EVIDENCE
    A.     McGarity
    Rothenberg’s next argument concerns victims Sierra, Jane, Sarah, Vicky,
    Amy, and Casseaopeia. 9 As to these six victims, Rothenberg argues that the
    district court erred in relying on loss estimates that were based on psychological
    evaluations conducted before his arrest and thus before these victims learned of his
    criminal possession offense, citing this Court’s prior precedent in United States v.
    McGarity, 
    669 F.3d 1218
     (11th Cir. 2012). The government responds that the
    portion of McGarity on which Rothenberg relies was overruled by Paroline.
    In McGarity, which was decided prior to Paroline, this Court concluded that
    a psychological evaluation performed before the defendant’s arrest and prosecution
    could not show the harm to the victim. 
    669 F.3d at 1269
    . More specifically, for
    proximate cause to exist in a child pornography case, “there must be a causal
    connection between the actions of the end-user and the harm suffered by the
    8
    In this case, the government’s submission and calculations used the 1/n method, but only
    as a starting point for the district court’s exercise of discretion and then application of the
    Paroline factors. While we affirm the thorough and multifactored process used in this case, we
    caution that the application of a strict 1/n approach, in which the only thing the district court does
    is divide the total loss amount by the total number of defendants who have been ordered to pay
    restitution, ordinarily will not meet the individualized assessment requirement of Paroline.
    9
    On appeal, Rothenberg does not challenge the evidentiary basis for victim Pia’s $5,000
    restitution award.
    56
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    victim.” 
    Id.
     The McGarity Court determined that, in that case, the government
    failed to provide any basis for determining “whether [the defendant’s] possession
    of child pornography proximately caused any of [the victim’s] harm,” given the
    victim’s psychological evaluation occurred before the defendant’s arrest and
    prosecution. 
    Id.
    As such, the McGarity Court determined that the psychological evaluation
    could not show the harm caused to the victim by the particular defendant’s conduct
    in that case. 
    Id.
     at 1269-70 (citing with approval the Second Circuit’s decision in
    United States v. Aumais, 
    656 F.3d 147
    , 154 (2d Cir. 2011), that remarked that the
    victim’s psychological evaluation preceded the defendant’s arrest, and thus it could
    not demonstrate the impact on the victim caused by that defendant). In other
    words, the McGarity Court concluded that to establish proximate cause, the
    government must show that the victim actually learned of the particular
    defendant’s possession of her images. See id. at 1269-70.
    We agree with the government that this aspect of McGarity was abrogated
    by Paroline. See United States v. Archer, 
    531 F.3d 1347
    , 1352 (11th Cir. 2008)
    (“[A] prior panel’s holding is binding on all subsequent panels unless and until it is
    overruled or undermined to the point of abrogation by the Supreme Court or by
    this court sitting en banc.”). In requiring to show harm that the victim was aware
    of a particular defendant’s conduct, the McGarity Court essentially required that
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    the government establish a direct, but-for causal link between some portion of the
    victim’s losses and the specific defendant’s offense. See McGarity, 
    669 F.3d at 1269-70
    . As discussed above, however, Paroline rejected exactly that sort of direct
    or but-for causation requirement in setting out its new standard. See Paroline, 572
    U.S. at 450-59, 
    134 S. Ct. at 1722-28
    . In Paroline, the Supreme Court recognized
    that “it is not possible to prove that [a victim’s] losses would be less (and by how
    much) but for one possessor’s individual role in the large, loosely connected
    network through which her images circulate,” nor is there “a practical way to
    isolate some subset of the victim’s general losses that [the defendant’s] conduct
    alone would have been sufficient to cause.” Id. at 450-51, 
    134 S. Ct. at 1723
    .
    Nevertheless, the Supreme Court explained that “it is indisputable that [the
    defendant] was a part of the overall phenomenon that caused [the victim’s] general
    losses.” Id. at 457, 
    134 S. Ct. at 1726
    .
    In Paroline, the Supreme Court thus held that, “[i]n this special context”
    where it is clear both that the defendant possessed images of the victim and that the
    victim has outstanding losses as a result of the traffic in her images, “but where it
    is impossible to trace a particular amount of those losses to the individual
    defendant,” courts should order restitution “in an amount that comports with the
    defendant’s relative role in the causal process that underlies the victim’s general
    losses.” Id. at 458, 
    134 S. Ct. at 1727
    . The Supreme Court held that the
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    government need not establish that some specific portion of the victim’s losses
    were directly caused by the defendant possessor’s conduct, as McGarity had
    required. See id.; McGarity, 
    669 F.3d at 1269
    . Rather, the government need
    establish only that the victim suffered losses from the traffic in her images and that
    the defendant contributed to those losses by possessing her images, regardless of
    whether the victim was specifically aware of the defendant’s conduct. Paroline,
    572 U.S. at 458, 
    134 S. Ct. at 1727
    ; see also id. at 442, 450, 134 S. Ct at 1718,
    1723 (noting that the parties “stipulated that the victim did not know who Paroline
    was and that none of her claimed losses flowed from any specific knowledge about
    him or his offense conduct,” and the victim therefore could not show her losses
    “would have been any different but for Paroline’s offense”).
    We therefore conclude that the portion of McGarity’s holding requiring the
    government to show that a child pornography victim was aware of, and specifically
    harmed by, a particular defendant possessor’s conduct was abrogated by Paroline.
    See Archer, 
    531 F.3d at 1352
    . Consequently, Rothenberg’s challenge to the
    restitution awards for six victims—Sierra, Jane, Sarah, Vicky, Amy, and
    Casseaopeia—based on that portion of McGarity fails. 10
    10
    The government asserts that Rothenberg did not specifically raise this before-my-arrest
    argument in the district court, and it should be reviewed only for plain error. We need not decide
    that issue; regardless of the standard of review, this claim fails because Paroline overruled this
    part of McGarity and Paroline was decided before Rothenberg’s offense.
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    B.     Mya and Jenny
    Next, as to victims Mya and Jenny, Rothenberg argues the government
    failed to submit reliable or sufficient evidence of their losses because neither of
    those victims had psychological or economic reports detailing their losses. In
    opposition, the government asserts that it need not submit expert reports to
    establish a victim’s losses and that the evidence presented in support of Mya’s and
    Jenny’s restitution requests provided a sufficient basis for the district court’s
    awards. 11
    The government bears the burden of proving the restitution amount by a
    preponderance of the evidence. Osman, 853 F.3d at 1189. The government must
    do so “with evidence bearing sufficient indicia of reliability to support its probable
    accuracy.” Id. (internal quotation marks omitted). Nevertheless, because “the
    determination of the restitution amount is by nature an inexact science,” a district
    court “may accept a reasonable estimate of the loss based on the evidence
    presented.” Id. (internal quotation marks omitted).
    11
    We disagree with the government’s contention that Rothenberg did not preserve his
    challenge to Mya’s and Jenny’s restitution awards on the ground that they were not supported by
    competent evidence. Accordingly, we review the factual findings underlying the district court’s
    restitution orders as to Mya and Jenny for clear error, Osman, 853 F.3d at 1188, and the amount
    of their restitution awards for an abuse of discretion, see Robertson, 
    493 F.3d at 1330
    ; see also
    Paroline, 572 U.S. at 462, 134 S. Ct at 1729 (recognizing that “[d]istrict courts routinely exercise
    wide discretion . . . in fashioning restitution orders”).
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    1.     Mya
    Regarding Mya, the district court did not clearly err in determining that
    sufficient evidence supported Mya’s restitution request. One of Mya’s counsel,
    Carol Hepburn, submitted a signed declaration stating Mya needed therapy and/or
    medical care. Rothenberg faults the district court for accepting the “self-serving”
    estimate provided by Mya’s counsel that Mya’s future medical costs would likely
    exceed $100,000. In her declaration, Hepburn explained that the $100,000
    estimate was not just pulled out of thin air. Rather, it was based on Hepburn’s
    experience representing eight other, similarly situated child pornography victims.
    Indeed, the restitution exhibits presented to the district court show that Hepburn
    represented or co-represented several of the other victims in this case—Sierra, Pia,
    Sarah, and Vicky. Considering Hepburn’s demonstrated experience in this area, it
    was not unreasonable for the district court to consider her estimate as reliable
    evidence of Mya’s likely future costs. See id.
    Furthermore, counsel Hepburn explained that Mya was part of the same
    child pornography series as Pia. Though a psychological evaluation was
    unavailable for Mya at the time of the restitution hearing, 12 her co-victim Pia was
    12
    In challenging Mya’s and Jenny’s awards, Rothenberg also argues that a victim must
    always supply an expert medical or psychological report to support her restitution request.
    Rothenberg cites no caselaw for this proposition, and nothing in either Paroline or our own
    precedent establishes such a rigid requirement. See Osman, 853 F.3d at 1189 (requiring only
    that the government present evidence “bearing sufficient indicia of reliability”). Though such
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    able to submit a preliminary evaluation. That evaluation indicated that, at a bare
    minimum, Pia had estimated therapy costs of $81,900 and emphasized that this
    estimate reflected “only the current, most critical needs” for Pia, who like Mya was
    still a minor, and did not account for the full extent of her losses or the services she
    would require over the course of her lifetime. And notably, Rothenberg does not
    challenge the evidentiary basis for Pia’s restitution award in this case. That Mya’s
    co-victim Pia had preliminary estimated costs of at least $81,900 is a further
    indicator that counsel Hepburn’s $100,000 total cost estimate for Mya was
    reasonable and appropriately relied upon by the district court. See id. On this
    record, we are not left with a definite and firm conviction that the district court was
    mistaken in concluding that sufficient evidence supported Mya’s restitution
    request. See Robertson, 
    493 F.3d at 1330
    .
    Nor did the district court abuse its broad discretion in awarding Mya her
    requested restitution amount of $5,000. See 
    id.
     Here, the district court properly
    identified Paroline as the correct legal standard for awarding restitution in child
    pornography cases. In setting the amount of Mya’s restitution award, the district
    court addressed several relevant Paroline factors, noting that: (1) Rothenberg
    possessed one image of Mya; (2) no other defendant was yet ordered to pay
    expert reports are undoubtedly helpful to district court’s in fashioning a restitution award, they
    are by no means the only way to establish a reasonable estimate of a victim’s losses.
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    restitution to Mya; (3) Mya had estimated losses exceeding $100,000; and
    (4) Rothenberg neither created nor distributed Mya’s images. Paroline, 572 U.S. at
    460, 
    134 S. Ct. at 1728
    . In light of these factors, the district court determined that
    Mya’s $5,000 restitution request was reasonable. Given the wide discretion
    afforded by Paroline to district courts in this context, we cannot say this
    determination was unreasonable. See id. at 462, 
    134 S. Ct. at 1729
    ; Jordan, 
    582 F.3d at 1249
    .
    2.     Jenny
    Based on the more limited record as to Jenny, we agree with Rothenberg that
    the district court clearly erred in determining there was sufficient evidence to
    support Jenny’s $42,600 request. In support of her restitution request, Jenny’s
    counsel submitted a restitution cover letter and a victim impact statement from
    Jenny. In the letter, Jenny’s counsel requested restitution in the following
    amounts: (1) $12,500 to pay for psychological and economic reports; (2) $5,000 in
    attorney’s fees related to her request in this case; (3) $100 in legal fees related to
    her request in this case; and (4) $25,000 for “the defendant’s appropriate share of
    the general losses caused to Jenny.”
    Like Mya, at the time of the restitution hearing, Jenny was still in the
    process of obtaining expert reports documenting her total losses. Unlike Mya,
    however, Jenny’s separate counsel did not provide any reasonable estimate of what
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    those total losses might be. Indeed, counsel did not provide any estimate of what
    Jenny’s total losses might be. Rather, in asserting that $25,000 was Rothenberg’s
    “appropriate share” of Jenny’s losses, counsel relied on (1) a proposed statute that
    would set a minimum restitution award of $25,000 for possession of child
    pornography, and (2) Masha’s law, 
    18 U.S.C. § 2255
    (a), which creates a civil
    cause of action for victims who suffered personal injury as a result of a child
    pornography offense and sets a liquidated damages amount of $150,000.
    This evidence is sufficient to show that Jenny has incurred costs of
    $17,600—to pay for expert reports and legal fees—in connection with her
    restitution request in this case, 13 yet it is not sufficient to establish what proportion
    of Jenny’s as-yet-undetermined total losses Rothenberg proximately caused.
    Jenny’s counsel suggested that the $150,000 liquidated damages amount in
    Masha’s Law represents a reasonable estimate by Congress of the minimum
    amount of total damages suffered by a child pornography victim. But the damages
    available to a plaintiff in a civil lawsuit may be quite different from the concrete
    “costs incurred” for which § 2259 provides recompense. See 
    18 U.S.C. § 2259
    (c)(2). For example, a plaintiff in a civil damages suit under § 2255(a) may
    be able to recover for noneconomic losses, such as pain and suffering or mental
    13
    We note that the $12,500 portion of those costs for psychological and economic reports
    would not necessarily be fully attributable to Rothenberg, as Jenny will, unfortunately but
    undoubtedly, need to use those reports in support of future requests against other defendants.
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    and emotional distress, that are not available in a restitution proceeding under
    § 2259. See Doe v. Hesketh, 
    828 F.3d 159
    , 170 (3d Cir. 2016). As such, we do
    not see that Masha’s Law provides much guidance in the present context.
    Similarly, Jenny’s counsel’s reliance on proposed legislation setting a
    minimum $25,000 restitution award for child pornography possession offenses also
    provides little to no guidance here. While Congress certainly would be well within
    its rights to establish such a mandatory minimum restitution amount in these cases,
    it had not done so at the time of Rothenberg’s restitution hearing. 14 Thus, the
    district court was required to instead follow Paroline’s framework, which requires
    an individualized assessment of each particular defendant’s restitutionary liability
    based on his conduct and relative role in the causal process. Paroline, 572 U.S. at
    445, 458-59, 462, 
    134 S. Ct. at 1720, 1727-29
    . Imposing a pre-set minimum
    amount of restitution based solely on the type of offense Rothenberg committed
    does not comply with Paroline’s framework, and the government did not submit
    evidence from which the district court reasonably could have determined that
    $25,000 was Rothenberg’s relative share of Jenny’s losses.
    14
    Congress recently passed, and the president signed, a different version of the bill
    Jenny’s counsel referred to, but that version sets the minimum restitution amount much lower, at
    $3,000. See Amy, Vicky, and Andy Child Pornography Victim Assistance Act of 2018, Pub. L.
    No. 115-299, 
    132 Stat. 4383
     (2018).
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    It is indisputable that Jenny has suffered some, likely large amount of losses
    from the online traffic in her images. See 
    id. at 457
    , 
    134 S. Ct. at 1726
    . It is also
    indisputable that Rothenberg, who possessed 34 images and 1 video of Jenny, is
    responsible for some, possibly significant amount of those losses. 
    Id.
     But the
    government bears the burden of proving at least a reasonable estimate of that
    amount based on reliable evidence, and it has not satisfied that burden here.
    Osman, 853 F.3d at 1189. In the absence of competent evidence to support the
    award, the district court clearly erred in ordering Rothenberg to pay $42,600 in
    restitution to Jenny. See id.
    We therefore vacate the district court’s restitution award as to Jenny and
    remand for further proceedings consistent with this opinion. On remand, the
    district court should allow Jenny to supplement her restitution request with
    evidence of her losses. See 
    18 U.S.C. § 3664
    (d)(5) (allowing a victim to seek an
    amended restitution order if the victim discovers additional losses after
    sentencing). The district court should then determine, in light of all the available
    evidence and the Paroline factors, the portion of Jenny’s losses for which
    Rothenberg is responsible. Paroline, 572 U.S. at 458-60, 
    134 S. Ct. at 1727-28
    .
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    IX. CONCLUSION
    For the foregoing reasons, we affirm the district court’s restitution order as
    to victims Sierra, Jane, Pia, Mya, Sarah, Vicky, Amy, and Casseaopeia, and vacate
    and remand the district court’s restitution order as to victim Jenny.
    AFFIRMED in part; VACATED and REMANDED in part.
    67