The hormonal treatment of paraphiliacs with depo-provera

Psychological therapies as described by Marshall are but one means of reducing the rapist's and child molester's sexual aggressive urges and behaviors. Various organic therapies have been recommended, including psychosurgery and surgical castration. Spodak, Falck, and Rappeport review a newer and more reversible form of castration, chemical castration by the use of the female hormone medroxyprogesterone acetate and the new antiandrogen, cyproterone acetate. These drugs are used to decrease the functioning level of the male hormone, testosterone. Reduction of testosterone appears to decrease overall sexual drive and rather rapidly allows the rapist or child molester to gain greater control (in some cases complete control) of his aggressive sexual urges. Spodak, Falck, and Rappeport describe the use of these hormonal agents, their effects and side effects, and give therapists some guidelines to follow when using these chemical interventions. Although not seen as a panacea, these agents do appear rapidly to assist the deviant in gaining control of his urges, and when coupled with psychotherapy they serve a valuable adjunct to the therapist armamentarium.