Commentary: The impact of surgical castration on sexual recidivism risk among civilly committed sexual offenders.

Most civilly committed sexual offenders are sexually disordered. Sexually disordered offenders— that is, those with a paraphilic disorder— cannot be cured. However, research evidence suggests that many can be successfully treated. In general, the treatment of any chronic behavioral disorder, be it drug addiction, alcoholism, or a paraphilia, depends on the availability of adequate community-based resources, in some instances following a period of residential care. As noted earlier, rather than predicting how the castrated sexual offender is likely to fare following release into the community, it may be more crucial to manage effectively any risk that may be present at the time of his re-entry. Perhaps that could be accomplished best by insuring that all such releases are conditional (as is the case in several states), as opposed to unconditional, so that ongoing support, treatment, and monitoring can be regulated. In that way, one could guard against the surgically castrated sex offender’s reversing his status by means of the ingestion of exogenous testosterone. A simple mandated blood test could quickly detect any attempt to do so. A variety of other safeguards would then also be possible, including electronic surveillance, and prophylactic recommitment, if indicated. If, in the meantime, predictions must nevertheless still be made, then the available scientific research seems to suggest that, in general, low rates of sexual recidivism can ordinarily be expected following surgical castration.