This paper takes a look at pedophilia from a medical point of view. The main point is that anti-androgens can reduce unwanted sexual urges, and allow the individual to regain control.
The paper begins with a helpful overview of the paraphilias, based on the DSM-III. This section makes the important distinction between sex offenders and persons with paraphilias. The former group acts, for whatever reason, while the latter group has the ideation (stuff going on in the head). Of course, there is some overlap, but the groups are not identical.
In a study of 34 paraphilic patients, most were found to have biologic abnormalities. These included Klinefelter's syndrome (XXY chromosome), elevated testosterone, abnormal luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and, in some cases, other neurological problems such as seizures. The middle part of the paper is a fairly detailed account of laboratory procedures for testing for such biological abnormalities.
The paper also touches on the use of PET scans. Apparently, differences in PET scans do show up during sexual arousal. There are some signs that paraphilias would have distinctive signatures on a PET scan. I think this is a fascinating research direction. Unfortunately, as far as I know, it hasn't been followed up.
The final section of the paper goes into more detail about the use of antiandrogens such as Depo-Provera. These medications work by reducing testosterone level, and perhaps also directly on the brain, to reduce sexual urges. In their clinical experience, the authors find that this treatment works, with low recidivism rates as long as treatment continues.
They also compare antiandrogens with castration. In a number of studies in Europe, castration has been found to dramatically reduce the recidivism rate. Antiandrogens seem to perform even better. There are two biological factors that might explain this. First, only 90% of androgens are supplied by the testes. The other 10% are supplied by the adrenal cortex. On the other hand, antiandrogens work to suppress the action of androgens no matter what the source. Second, castration usually results in a compensating elevation in FSH and LH by the pituitary gland, which antiandrogens do not. A third reason may be that antiandrogens work directly on the brain.
The best treatment is a combination of group therapy and antiandrogens, with less than a 10% recidivism rate (any type of offense), and with no physically violent crimes among their sample.
The main story of this paper is that there is a large biological component to the paraphilias, including pedophilia. For those who are not in control of their urges, relief is available, in the form of antiandrogens. In the closing paragraph, they state that it is possible to provide this treatment to any interested individual, and that it is particularly effective combined with group therapy. "Furthermore," they state, "in many instances, this appears to be a just and humane course to follow."
Peace,
Somebody Somewhere