Surgical Castration and Sexual Recidivism Risk

Abstract

The efficacy of using castration to lower criminal sexual recidivism among sex offenders, especially those considered to be high risk, and in an uncontrolled release environment remains a controversial issue. The existing literature regarding castrated sex offenders reveals a very low incidence of sexual recidivism. However, the low sexual recidivism rates may not be generalizable to modem sexual violent predator assessments given the various methodological limitations inherent in these studies. Animal studies demonstrate that castration results in a loss of sex drive and an abolishment of mating behavior and that such a drive could be restored by testosterone replacement While hormonal therapy is more widely accepted as a method of reducing testosterone among sex offenders, surgical castration (i.e., bilateral orchiectomy) is also presently used, albeit to a very limited extent Ethical issues raised by surgical castration as the treatment of choice for a sex offender: assessing whether the choice to submit to orchiectomy is done freely or is due to coercive elements inherent to the individual's situation (i.e., the individual opts for a drastic procedure in order to facilitate obtaining freedom from custody). The evaluator considering risk in surgically castrated offenders should be familiar with the impact of bilateral orchiectomy upon sexual function, the translation of such data to risk assessment when considering offenders who may be released under non-supervised conditions, and the potential for adverse outcomes if offenders access testosterone replacement Orchiectomy may have a role in risk assessments; however, other variables should be considered, particularly as the effects can be reversed by replacement testosterone (Weinberger, Sreenivasan, & Garrick, 2005). The purpose of this chapter is to (1) review existing studies involving surgical castration of sex offenders, (2) review ethical issues raised by bilateral orchiectomy of involuntarily committed sex offenders, and (3) provide a framework for the impact of bilateral orchiectomy in assessing risk reduction. (PsycInfo Database Record (c) 2023 APA, all rights reserved)