Physiological means of treating sex offenders include the following:

  1. Chemical castration – This treatment typically involves the administration of antiandrogen hormones, such as Depo-Provera or Lupron, thus lowering testosterone levels. 
  2. Surgical castration – The procedure involves removal of parts of the testes, significantly reducing testosterone levels. 
  • The Czech Republic and Slovakia are the only Western countries in which sexual offenders can be surgically castrated within the judicial system (Pfaefflin, 2010).
  • Though castration is reserved for repeat, violent offenders diagnosed with a sexual paraphilia who volunteer for it, The Committee for the Prevention of Torture (CPT), which forms part of the Council of Europe’s human rights directorate, has called it “invasive, irreversible, and mutilating” (2009) and demanded that the Czech Republic stop offering it. Among the committee’s concerns was whether the procedure is truly voluntary, given that it may result in reduced time in confinement (in prison or a rehabilitation clinic).

With either treatment, lower testosterone levels may diminish sex drive, lowering the risk of recidivism. Side effects can include an increased risk of osteoporosis, an increase in breast tissue, and decreased body hair. Permanent infertility occurs with surgical castration.