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Androgen Deprivation Therapy

Two very influential behavioral science experts, Marnie Rice & Grant Harris, have a paper that was just published in the journal, Psychology, Public Policy, and Law about the effectiveness of androgen deprivation therapy with sex offenders.  Unfortunately, the paper is embargoed for most university libraries until next week, but even a glimpse of the abstract is quite revealing:

We review the effects of androgen deprivation on the sexual behavior of human males. Although eunuchs have existed in many cultures over the last 4,000 years, there is scant detailed and specific information in the historical record about castration status and sexual behavior. From the literature on modern-day eunuchs who are not sex offenders, we conclude that androgen deprivation reduces sexual desire and behavior, including sexual intercourse. Most men, especially those who did not volunteer for the treatment, experience the side effects as extremely bothersome. Androgen deprivation therapy (ADT) receives endorsements from some clinicians who treat sex offenders, and it probably reduces sexual recidivism among men who freely request the procedure, but good evidence is sorely lacking. Men who freely request and persist with ADT are probably an especially low-risk group. Little is known about the effects of sexual or violent recidivism among sex offenders who do not freely request it. Little is known about the long term effects of ADT on sexual behavior in general, and sexual recidivism in particular, or about long-term health effects. Clearly, much more research is needed before ADT has a sufficient scientific basis to be relied upon as a principal component of sex offender treatment.

Lay people often think that physical or chemical androgen therapy is the way to go with sex offenders.  But as Rice and Harris hint, we have little data to be so confident.  More importantly, low testosterone in men is strongly associated with depression and anxiety and these psychological symptoms have been linked with general criminal recidivism as well as sexual offending.  Likewise, low androgens in men is associated with numerous physical aliments, including osteoporosis, diabetes, obesity, and cardiovascular disease. This treatment modality really isn't where we should be placing our proverbial hopes on.   

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