You have accessJournal of UrologyHistory of Urology Forum II1 Apr 2015FRII-03 CASTRATION OF SEXUAL OFFENDERS IN THE UNITED STATES. Ariel Schulman, Ruben Pinkhasov, Ciril Godec, and David Silver Ariel SchulmanAriel Schulman More articles by this author , Ruben PinkhasovRuben Pinkhasov More articles by this author , Ciril GodecCiril Godec More articles by this author , and David SilverDavid Silver More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.494AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urologists manipulate the male androgen axis with stimulation for hypogonadism and blockade for prostate cancer. Less common but more controversial is the castration of sex offenders, a practice that is currently legal in many states. We review the history and associated controversies of punitive castration in the United States. METHODS Journals and news publications were examined for relevant historical information. RESULTS Castration can be traced throughout human history and is documented as early as the 1700's as punishment for sexual deviance in the United States. Surgical castration was used until the 1960's when reversible forms of chemical castration were developed. Medroxyprogesterone (MPA,) a synthetic form of progesterone, is the drug of choice for long-acting, chemical castration. Formal legislation exists in nine states, including Louisiana, for castration of those convicted of a range of sexual crimes. There is variation among states regarding type of offense, method of castration and consequences of non-compliance. The goal is to reduce deviant sexual impulses to allow convicted sex offenders to return to the community. But the practice presents important ethical questions including the validity of informed consent given by a prisoner as a condition for release from incarceration and the justifiability of the detrimental consequences of iatrogenic hypogonadism. Further difficulties arise finding appropriately trained medical professionals to administer injections, perform surgery and monitor hormone levels. CONCLUSIONS The practice of punitive castration in the United States is designed to reintegrate sexual offenders into the community while protecting the public from victimization. While seemingly well intentioned, critical issues including incentivized consent, the sequelae of iatrogenic hypogonadism and appropriate medical supervision remain unresolved. As Urologists, we may face the decision to participate in this procedure and should know its history. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e589 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ariel Schulman More articles by this author Ruben Pinkhasov More articles by this author Ciril Godec More articles by this author David Silver More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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