Pedophilia

==== Sex drive reduction ====
Pharmacological interventions are used to lower the sex drive in general, which can ease the management of pedophilic feelings, but does not change sexual preference.<ref name="camilleri199">{{cite book | first1 = Joseph A. | last1 = Camilleri | first2 = Vernon L. | last2 = Quinsey | date= 2008 | title = Sexual Deviance: Theory, Assessment, and Treatment, 2nd edition | url = https://archive.org/details/sexualdevianceth00laws | publisher = The Guilford Press | pages = [https://archive.org/details/sexualdevianceth00laws/page/199 199]–200 | chapter = Pedophilia: Assessment and Treatment |isbn= 9781593856052 | editor1-last = Laws | editor1-first = D. Richard}}</ref> [[Antiandrogens]] work by interfering with the activity of testosterone. [[Cyproterone acetate]] (Androcur) and [[medroxyprogesterone acetate]] (Depo-Provera) are the most commonly used. The efficacy of antiandrogens has some support, but few high-quality studies exist. Cyproterone acetate has the strongest evidence for reducing sexual arousal, while findings on medroxyprogesterone acetate have been mixed.{{r|seto|pp=177-181}}

[[Gonadotropin-releasing hormone analog]]s such as [[leuprorelin]] (Lupron), which last longer and have fewer side-effects, are also used to reduce libido,<ref name="pmid15985890">{{cite journal | vauthors = Cohen LJ, Galynker II | title = Clinical features of pedophilia and implications for treatment | journal = Journal of Psychiatric Practice | volume = 8 | issue = 5 | pages = 276–89 | year = 2002 | pmid = 15985890 | doi = 10.1097/00131746-200209000-00004 | s2cid = 22782583 }}</ref> as are [[selective serotonin reuptake inhibitor]]s.{{r|seto|pp=177-181}} The evidence for these alternatives is more limited and mostly based on open trials and case studies.<ref name=SetoReview/> All of these treatments, commonly referred to as "[[chemical castration]]", are often used in conjunction with cognitive behavioral therapy.<ref>{{cite journal | author = Guay, DR | year = 2009 | title = Drug treatment of paraphilic and nonparaphilic sexual disorders | journal = Clinical Therapeutics | volume = 31 | issue = 1 | pages = 1–31 | doi=10.1016/j.clinthera.2009.01.009 | pmid=19243704}}</ref> According to the [[Association for the Treatment of Sexual Abusers]], when treating child molesters, "anti-androgen treatment should be coupled with appropriate monitoring and counseling within a comprehensive treatment plan."<ref name="atsacast">{{cite web | title = Anti-androgen therapy and surgical castration | work = Association for the Treatment of Sexual Abusers | url = http://www.atsa.com/ppantiandro.html | year = 1997 | url-status = dead | archive-url = https://web.archive.org/web/20110829070929/http://www.atsa.com/ppantiandro.html | archive-date = August 29, 2011 }}</ref> These drugs may have side-effects, such as weight gain, breast development, liver damage and osteoporosis.<ref name=SetoReview/>

Historically, surgical [[castration]] was used to lower sex drive by reducing testosterone. The emergence of pharmacological methods of adjusting testosterone has made it largely obsolete, because they are similarly effective and less invasive.<ref name="camilleri199"/> It is still occasionally performed in Germany, the Czech Republic, Switzerland, and a few U.S. states. Non-randomized studies have reported that surgical castration reduces recidivism in contact sex offenders.{{r|seto|pp=181–182, 192}} The Association for the Treatment of Sexual Abusers opposes surgical castration<ref name="atsacast"/> and the [[Council of Europe]] works to bring the practice to an end in Eastern European countries where it is still applied through the courts.<ref>{{cite news | title = Prague Urged to End Castration of Sex Offenders | newspaper = DW.DE | date = 2009-02-05 | url = http://www.dw-world.de/dw/article/0,,4004260,00.html | access-date = 2015-01-19 | archive-date = 2012-01-07 | archive-url = https://web.archive.org/web/20120107041148/http://www.dw-world.de/dw/article/0,,4004260,00.html | url-status = live }}</ref>