Castration, or removal of the testes, has been documented throughout history, occurring for a variety of social, punishment, and medical reasons. Currently, both “physical” and “chemical” castration are being hotly debated with respect to sex offenders, as the public and legislators are calling for actions to reduce sexual violence. Chemical castration has been proposed as a reversible alternative; its effectiveness, side-effects, risks, and recidivism rates have been studied extensively over the last 25 years. Physical castration, on the other hand, has been used primarily in Europe, has not been rigorously investigated, and remains a highly controversial and irreversible procedure. However, reported recidivism rates are strikingly better than those for chemical castration. Testosterone lowering therapy does offer a way to decrease and control the deviant sexual fantasies and urges of hard-core perpetrators. Ethical and scientific guidelines should be developed to investigate whether physical or chemical castration could be considered beneficial to the offender and to society.
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