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Is Stopping of Testosterone-Lowering Medication in Men Convicted of Sexual Offenses Associated With an Increase in
Jochen Wolba1,2, Daniel Turner3, Peer Briken4
1Vitos Forensic-Psychiatric Outpatient Department (FPA) Hesse, Haina (Kloster)/Wiesbaden, Germany.
Abstract:
There is some evidence that testosterone-lowering medications (TLM) may be an effective treatment for men convicted of sexual offenses by attenuating paraphilic sexual fantasies and behaviors and reducing the recidivism risk. To date, however, only little is known about the effects of TLM stopping on risk-relevant aspects. Therefore, the current study aimed at examining the recidivism risk as measured by Stable-2007 as well as official records of reoffenses in 29 men having stopped TLM treatment as compared to 37 men with ongoing TLM treatment. The Stable-2007 was rated retrospectively at 4 time points: committal to forensic treatment (T1), starting (T2) and stopping of TLM treatment (T3), and at reporting date (T4). There was a significant decrease in Stable-2007 scores over time, but there were no significant group differences. Within the stopped-TLM group, there were no significant differences between T3 and T4, implying that the recidivism risk remained stable over an average observation period of 4.5 years after TLM stopping. In addition, there was no significant difference in actual reoffending rates between the groups. For sexual reoffending, the percentages were 17.2% for the stopped-TLM group and 10.8% for the ongoing-TLM group. However, although the current results suggest that there is at least no increase in risk assessment (i.e., Stable-2007) after having stopped TLM, the actual reoffending rates of both groups were higher than expected. This once again demonstrates that TLM stopping decisions remain very difficult to make. Further studies are urgently needed to draw clearer conclusions.
Insights
Stopping testosterone-lowering medications (TLM) did not increase recidivism risk scores in men convicted of sexual offenses. However, actual reoffending rates were higher than anticipated in both stopped and ongoing TLM groups, highlighting treatment challenges.
Area of Science:
- Forensic Psychiatry
- Clinical Psychology
- Endocrinology
Background:
- Testosterone-lowering medications (TLM) show promise in treating sexual offenses by reducing paraphilic behaviors.
- Limited data exists on the impact of discontinuing TLM on recidivism risk.
Purpose of the Study:
- To investigate recidivism risk after stopping TLM compared to ongoing treatment.
- To analyze changes in risk assessment scores and reoffense rates.
Main Methods:
- Retrospective study comparing 29 men who stopped TLM with 37 on ongoing TLM.
- Recidivism risk assessed using Stable-2007 scores and official reoffense records.
- Stable-2007 scores evaluated at four time points: committal, TLM start, TLM stop, and reporting date.
Main Results:
- Stable-2007 scores decreased significantly over time, with no group differences.
- No significant increase in Stable-2007 scores was observed after TLM cessation.
- Actual sexual reoffending rates were 17.2% for the stopped-TLM group and 10.8% for the ongoing-TLM group.
Conclusions:
- Stopping TLM does not appear to elevate assessed recidivism risk (Stable-2007).
- Actual reoffending rates in both groups exceeded expectations, indicating complex treatment dynamics.
- Decisions regarding TLM cessation are challenging, necessitating further research.
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