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. 2024 Jun;53(6):2141-2158.
doi: 10.1007/s10508-024-02847-z. Epub 2024 Apr 9.

"One a Day Keeps the Prison Away": Understanding the Experiences of Individuals Convicted of Sexual Offences Receiving Anti-Androgens for the Treatment of Problematic Sexual Arousal

Rebecca Lievesley  1 , Helen Swaby  2 , Belinda Winder  2 , Christine Norman  2 , Kerensa Hocken  3
Affiliations

"One a Day Keeps the Prison Away": Understanding the Experiences of Individuals Convicted of Sexual Offences Receiving Anti-Androgens for the Treatment of Problematic Sexual Arousal

Rebecca Lievesley et al. Arch Sex Behav. 2024 Jun.

Abstract

Problematic sexual arousal (PSA) is an umbrella term to describe a range of clinical presentations related to excessive sexual thinking (e.g., sexual preoccupation) and sexual behavior (e.g., hypersexuality). Although such concepts are known to affect sexual recidivism among individuals convicted of sexual offences, PSA is not routinely or directly targeted in offending behavior programs in England and Wales. However, in recent years, there have been moves to incorporate pharmacological interventions for addressing this among people with sexual offence histories. Although some work to understand the experiences of those taking SSRI medication for this purpose has emerged, little is known about the experiences of service users taking anti-androgen medication. In this study, we interviewed all individuals in prison taking anti-androgens for the treatment of problematic sexual arousal following convictions for sexual offences in England at the time of data collection (N = 10). Using a phenomenologically oriented thematic analysis, we established themes pertaining to "Differing needs: Motivations for treatment," "Medication as a risk management strategy," and how the medication helped the men in their pursuit of "Discovering a 'new me'." This work contributes important knowledge to inform the development of ethical and effective prescribing of anti-androgen medication with this population and offer recommendations for both future research and the development of clinical practice.

Keywords: Anti-androgens; Pharmacological therapy; Problematic sexual arousal; Sex offenders.

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Conflict of interest statement

RL, HS, BW, and CN received funding from HMPPS and NHS England to evaluate medication in the UK prison service for people with sexual convictions. KH is employed by HMPPS.

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