The impact of testosterone-lowering medication on recidivism in individuals convicted of sexual offenses

Abstract

Introduction

Treatment of individuals who have committed sexual offences with Testosterone-Lowering Medication (TLM) is a comparatively intrusive kind of intervention, which regularly takes place in coercive contexts. Thus, the question of efficacy, but also the question of who should be treated, when and for how long, are of great importance.

Methods

Recidivism rates of TLM-treated high-risk individuals (+TLM; n = 54) were compared with high-risk individuals treated with psychotherapy only in the same forensic outpatient clinic (−TLM; n = 79).

Results

Group differences suggested a higher initial risk of + TLM (e.g. higher ris-assessment, previous convictions). Despite the increased risk, after an average time at risk of six years, +TLM recidivated significantly less often and significantly later than − TLM (27.8% vs. 51.9%). Such an effect was also found for violent (1.9% vs. 15.2%), but not for sexual (5.6% vs. 10.1%) and serious recidivism (5.6% vs. 10.1%), which could be explained partly by the small number of cases. In the course of treatment, TLM proved to be a significant variable for a positive process, whereas a high risk-assessment score indicated a rather negative course. In total, n = 19 individuals had stopped their TLM treatment, of these 31.6% recidivated.

Conclusion

The results support the efficacy of TLM, particularly in the group of high-risk offenders.

Keywords:

• Antiandrogens
• GnRH-agonists
• recidivism risk
• paraphilic disorder
• paedophilic disorder

Author contribution

Julia Sauter: Conceptualisation, Methodology, Writing – original draft preparation. Laura M. Lingenti: Data Curation, Writing – original draft preparation. Martin Rettenberger: Conceptualisation, Methodology, Supervision, Writing – Reviewing. Daniel Turner: Conceptualisation, Methodology, Supervision, Writing – Reviewing. Peer Briken: Writing – Reviewing. Tatjana Voß: Supervision, Editing.

Ethical approval statement

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

The data reported in this manuscript were collected as part of a larger project to evaluate the effectiveness of forensic outpatient clinics. The results of the data collection have not been published elsewhere. The study was not preregistered. The recruitment began before March 1, 2019.

Data availability

The data that support the findings of this study are available from the corresponding author, JS, upon reasonable request. The data are not publicly available due to restrictions as their containing information that could compromise the privacy of research participants.

Disclosure statement

No potential conflict of interest was reported by the author(s).