Dagerlind: Dangerous Overreliance on Chemical Castration

EDITORIAL • The debate over chemical castration of pedophiles has once again flared up. Several parliamentary parties also want to link the treatment to conditional release. But the political statements reflect a risky oversimplification—the belief that medication can replace incarceration, control, and a clear focus on the victims.

The discussion about chemical castration is not new, but has gained renewed relevance following media attention on sexual abuse of children. The Moderates, Christian Democrats, and Sweden Democrats have long raised the issue, and now the Social Democrats are also joining the position that the treatment can be linked to conditional release.

At the same time, the Sweden Democrats are going further than other parties. They want to fundamentally limit or completely abolish the possibility of release for this group and instead introduce security detention of indefinite duration. This is a stance that emphasizes the central fact often downplayed in the debate: the high risk of recidivism and the serious harm caused by these crimes.

Other parties are more vague or silent. The Left Party and Green Party have largely avoided taking a clear stance on the issue or have emphasized rehabilitation and legal safeguards for offenders in a way that tends to overlook the victims’ perspective.

In the political discussion, chemical castration is highlighted as a solution—a quick fix—when it should only be discussed as a complement, an extra safety measure on top, not as a replacement for anything else and not associated with any rewards for the criminal.

What Chemical Castration Is—and Is Not

Chemical castration means lowering testosterone levels to so-called castration levels through medication. The purpose is to suppress sexual drive.

But unlike surgical castration, this is not a permanent intervention. The treatment requires ongoing medication—pills or regular injections, often both. The effect ceases if treatment is discontinued.

This is where a clear risk arises: How do we ensure that the treatment is actually followed over time? If monitoring fails, the protection is illusory. The danger increases and vigilance decreases if we are lulled into a false sense of security, believing we’ve turned the wolf into a lamb.

Moreover—and this is important—the treatment does not work for everyone. Experiences from, for example, prostate cancer treatment show that sexual desire does not always disappear. For a significant number of those treated, libido remains entirely or partially.

This means a person may appear “treated” without the underlying drive disappearing. For the pedophile, there is incentive to conceal this.

It should also be clear that the medications discussed here are expensive, some very expensive—tens of thousands of kronor for a month’s treatment. The money comes from taxpayers when the treatment is covered by the high-cost protection scheme.

Sexual Crimes Are About More Than Sex

A crucial objection, often overlooked, is that sexual abuse is not solely about sexual drive. They also involve elements of power, control, dominance, excitement, and boundary crossing. These needs and impulses are not affected in the same way by lowered testosterone.

Reducing the problem to a biological drive risks missing the core of the behavior. A person driven by the need for power and control or aggressive impulses can in practice remain dangerous—even with reduced libido.

Dangerous Combination with Shortened Sentences

In the political discussion, chemical castration is increasingly linked to conditional release. In practice, this means treatment becomes a ticket out of prison.

This creates strong incentives to “play along.” The convicted person has everything to gain by appearing treatable and cooperative—regardless of the actual effect.

There are already examples where convicted offenders describe the treatment as positive, only to reoffend shortly afterward. These kinds of statements should be met with significant skepticism.

When reduced sentences are linked to treatment, the focus shifts from crime and responsibility to therapy and adjustment. This risks undermining the sense of justice and overlooking victims’ experience of justice being served.

Overreliance on Rehabilitation

A fundamental idea in Swedish criminal policy is that criminals can be rehabilitated. This also influences attitudes toward sexual crimes.

The prison and probation services and parts of the psychological profession point to treatment programs and relatively low rates of recidivism. At the same time, there are strong reasons to question the accuracy and honesty of these figures.

The dark numbers are large. Many crimes are never reported. Recidivism can therefore be grossly underestimated. Furthermore, both therapists and clients have incentives to show good results—to lie, plainly put. Those who developed the treatment programs have academic prestige to protect. There is also a financial incentive as the services are sold to the correctional system.

Viewing pedophilia as a treatable disease also risks shifting focus from offender to “patient.” It creates a narrative in which the perpetrator becomes someone to pity—rather than someone who bears full responsibility for their actions. Such a perspective is both scientifically dubious and morally problematic.

An Orientation—Not a Treatable Disease

Pedophilia is often portrayed as a treatable mental disorder. But there is much to suggest that it is instead a sexual orientation established early in life and thereafter is difficult or impossible to change.

Possible explanations for how it arises might include that the individual has been abused themselves and has come to see this as normal, or that negative experiences during puberty create an inability or fear of equal adult relationships. In both cases, a deviant sexual orientation can develop—but that doesn’t mean it can later be “treated away.”

History gives reason for reflection. Homosexuality was long considered a disease to be cured—something we now know was wrong and more rooted in values than science. The modern view is instead that sexual orientations are deeply rooted and practically irreversible.

To simultaneously claim that pedophilia—which also concerns sexual orientation—is curable therefore appears inconsistent. This inconsistency seems largely ideological, rather than scientific. If the orientation is fundamentally as stable as other sexual preferences, the notion of effective rehabilitation falls away—and thereby much of the argument for replacing control and incarceration with treatment. At least not with anything resembling Christian faith-healing rituals. Therapy aimed at building barriers between thought and action might be effective, but is not something that can be greatly relied upon.

A Crime Unlike Any Other

Sexual abuse of children ranks among the most serious crimes there are. They cause deep and often lifelong trauma for the victims.

The general sense of justice does not readily accept that perpetrators have “served their time” merely by serving a sentence—and even less so by undergoing medical treatment, especially when combined with reduced sentences.

This is what sets these crimes apart from many others. The offender has destroyed something irretrievably. This requires greater protection for society—not less. The threshold for forgiveness is also higher or even insurmountable, not just among victims and their families, but among us all.

Served time or not. Rehabilitated or not. Chemically castrated or not. Someone who has abused children is not a person we want to encounter. Ever. Not someone we want to see or deal with in our everyday life, at work—anywhere.

What Risks Being Set Aside

The greatest danger of overreliance on chemical castration may be what risks being set aside. If the treatment is seen as a solution, the pressure decreases on other measures—prolonged or lifelong incarceration, electronic surveillance, bans on being present in environments with children, public registers of convicted offenders, and special housing outside open society.

These are measures that directly reduce the risk of new crimes—regardless of the individual’s willingness or treatment outcome. Believing these can be replaced by medication is naively—and directly—dangerous.

The Victim Perspective Is the Only Relevant One

At its core, the issue is one of perspective. Should the starting point be the perpetrator’s opportunity for rehabilitation—or the children’s right to protection and justice?

When the debate is dominated by treatment optimism, expert opinions, and stories from offenders themselves, victims risk being pushed aside in favor of the coddling of offenders that has long characterized the Swedish correctional system. This is a development that must be reversed—not only in general, but especially for the category of offenders we are discussing here.

A Complement—Not a Solution

Chemical castration can in some cases serve as a complement. But it is neither sufficient nor reliable as a main measure. Building criminal policy on such an assumption is to play a risky game with children’s safety.

To the extent it is used, the focus should also be on the victims—not on freeing the perpetrator from an anxiety-inducing sexual urge. Nor to allow him to get out of prison sooner than otherwise.

What is needed instead is a more realistic and restrictive stance—clear sentences, prolonged control, and a consistent prioritization of society’s interest in protection and restitution for the victims.

Anything else is a dangerous overreliance.