May 04, 2020
https://newatlas.com/science/pedophile-study-chemical-castration-reduce-risk-child-sexual-abuse/
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2764552

Four years after it was first announced, the results of a controversial clinical trial have finally been published in the journal JAMA Psychiatry. The study found a testosterone-reducing drug, originally developed as a prostate cancer treatment, lowered sexual interest in children for men with pedophilic disorder.

The unique clinical trial initially made headlines in 2016 when its research team, from the Karolinska Institutet and Gothenburg University in Sweden, turned to crowdfunding after it fell short of its funding goals. The trial set out to offer the first ever randomized, double-blind, placebo-controlled investigation into the efficacy of chemical castration for men with sexual attraction to children.

Chemical castration, an umbrella-term referring to drug treatments designed to lower sex drive and desire, has long been a controversial method for treating convicted pedophiles. In several parts of the world the treatment is forced upon convicted sex offenders, while other places offer the therapy on a voluntary basis for convicted men in prison.

Alongside any ethical considerations, the efficacy of chemical castration as a method to control pedophilic impulses is still yet to be clearly demonstrated. All uses of the method so far have been limited to correctional facilities, and lower rates of recidivism when subjects have been subsequently released are often pointed to as examples of a self-fulfilling prophecy – the men most compelled to undergo the treatment may be the least likely to reoffend.

The only way to eliminate these questions over efficacy would be through a rigorous clinical trial. Of course, there is absolutely no ethical body in the world that would approve giving placebos to men convicted of child sexual abuse and then releasing them into a community as a control group to compare their results against an active drug group. So a team of researchers in Sweden came up with a fascinating way around this ethical dilemma.

In Sweden there is a national telephone help line for individuals with unwanted sexual thoughts called PrevenTell. The goal of the helpline is to prevent sexual abuse or violence before it occurs by offering specialist help to those with problem behaviors. Through the helpline, the researchers recruited 52 men with self-confessed pedophilic disorder. On their initial visit to the hospital for baseline evaluation, the men were administered either a placebo or a drug called degarelix.

Degarelix is a gonadotropin-releasing hormone antagonist first approved for human use as a prostate cancer treatment a little over a decade ago. Because the drug is known to swiftly decrease testosterone levels to almost zero in a matter of days, it was hypothesized as being potentially useful in this context as a way to rapidly reduce acute pedophilic urges.

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