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Possible Treatments for Sex Offenders

Possible Treatments for Sex Offenders - Possible Treatments...

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Possible Treatments for Sex Offenders Surgical treatments “Surgical treatments for sex offenders are of two general types: neurosurgery and castration. The neurosurgical procedure, stereotaxic hypothalamotomy, involves removal of parts of the hypothalamus to disrupt production of male hormones and decrease sexual arousal and impulsive behaviors. However, the neuroendocrine mechanisms involved are not well understood, and the procedure has shown a significant failure rate and adverse sequelae. For primarily ethical reasons, surgical castration has not been widely advocated as a treatment for sex offenders, and in some countries such treatment is illegal. Castration has been shown to be highly effective in European literature. For example, Cornu) reported that among a group of sex offenders followed for periods of five to 30 years, those who had accepted the option of castration had recidivism rates of 5.8 percent compared with 52 percent for those who refused castration. Recidivism rates have been reported to decrease over time following the procedure, which may be related to the rate of decline of testosterone levels following the procedure. Such a finding, if substantiated, might contribute an empirical basis for determining clinically indicated lengths of hospitalization or institutional confinement following surgery. Favorable reports on castration have been countered by reviews in which it has been disparaged on ethical grounds and scientifically discredited as not 100 percent effective. With the advent of sexual predator laws, castration as a treatment option is now subject to discussion that includes media attention to individual cases as well as focused state legislation specifying the conditions under which orchiectomy may be performed. Recent legislation permitting voluntary orchiectomy in Texas was coupled with a requirement for follow-up research on recidivism” (Psychiatric Services , 1998)
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Medical treatments “Before the more widespread use of antiandrogens in the treatment of sex offenders, clinicians attempted treatment with oral and implantable estrogens and with an estrogen analogue, diethylstilbesterol. In general, research findings agree that the potential for adverse effects limits the utility of estrogen treatment for sex offenders. A number of early studies reported on the treatment of sex offenders with neuroleptics. However, these agents were found to be of limited benefit, which did not outweigh the risk of tardive dyskinesia. Antipsychotic agents may benefit sex offenders with comorbid psychotic disorders, especially patients who are receiving hormonal therapy, which may exacerbate psychosis. The advent of newer, atypical antipsychotic medications may warrant a reassessment of therapeutic effects and side-effect risks associated with these medications” (Psychiatric Services, 1998) Antiandrogen medications “Among the most important biological advancements is the use of antiandrogen medications. The two most widely used forms
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