Is Stopping of Testosterone-Lowering Medication in Men Convicted of Sexual Offenses Associated With an Increase in Recidivism Risk?

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.