Exactly how chemical castration works and who would be forced to do it

Justice Secretary Shabana Mahmood is exploring plans to make chemical castration mandatory for and under plans to curb sex offenders' vile urges.

A , published today, called for more evidence to be gathered on chemical castration. But Ms is said to want to take it further and explore whether rather than just voluntary.

Jailed offenders could be forced to undergo hormonal treatment to curb their sexual urges in a move to prevent reoffending. A voluntary scheme will see sex offenders chemically castrated in two regions in England, covering 20 prisons, as a first step to rolling out nationwide.

Here's everything you need to know about the approach.

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What is chemical castration?

Chemical castration uses two drugs — selective serotonin reuptake inhibitors to limit invasive sexual thoughts, and anti-androgens to reduce testosterone and limit libido.

The purpose of the treatment is to lower the levels of male hormones, also known as androgens. Anti-androgens stop the effects of male hormones such as testosterone. They are also used in some forms of cancer treatment, including attempts to stop prostate cancer cells from growing. Hormone treatments can usually be administered through injections, tablets or implants.

For sex offenders, the drugs are taken alongside psychiatric work that targets other causes of sexual offending, such as a desire for power and control.

Research has "closely linked" the androgen system to sexual development and behaviour. A study published in 2019 in the American National Library of Medicine supported "theories of testosterone-linked abnormalities in early brain development in delinquent behaviour" among child sexual offenders.

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Does the treatment work?

Research on the impact of chemical castration - while limited - has shown considerable reductions in reoffending rates.

One study, which followed 10 offenders, showed none of those involved reoffended after the treatment. Another study paired one group of sex offenders who had been chemically castrated, with another who had not. Reoffending rates were 60% lower among the group who had been chemically castrated.

In 2013, a study in the Journal of Korean Medical Science found chemical castration reduces reoffending "effectively when offered to sexual offenders within the context of simultaneous comprehensive psychotherapeutic treatment". Korea became the first country to introduce chemical castration

Where does it happen already?

Chemical castration actually already exists in the UK. The approach has been used at HMP Whatton, in Nottingham, for more than a decade. A pilot has been ongoing in the South West of England for the last few years, where around 30 to 34 prisoners a month are subject to the treatment.

Elsewhere, the approach is used to manage sex offenders across the , including in European countries such as Germany, France, Sweden and Denmark, as well as further afield in Indonesia and Korea. In most countries, it is voluntary, though it is mandatory in a few countries and some US states.

What is the government's position?

Former Justice Secretary David Gauke's , which is independent from the government, today called for ministers to gather more evidence on chemical castration - a drug treatment that reduces hormone levels to curb libido. It wants the small pilot in the South West of England, to be continued.

Speaking this morning, Mr Gauke told Sky News the approach is "not appropriate for every sexual offender, and the evidence base for this does need to be built up". He said: "I'm not going to claim it's the answer for everything. This is about reducing the risk of reoffending in future. There are some sex offenders who want to reduce their desires. And if we can explore this, I think that is something that's worthwhile," he said.

Asked if this would be used instead of keeping sex offenders in prison, he said: "The point being is at some point almost every prisoner will be released. We have to look across the system at doing everything we can do to minimise the risk of reoffending. You cannot remove that risk altogether. "

Justice Secretary wants the voluntary scheme to be expanded to two regions in England, covering 20 prisons, as a first step to rolling out nationwide. But she is is also exploring whether the approach could be made mandatory, rather than just voluntary.

A Government source told The : “For too long, we have turned a blind eye to the threat sex offenders pose, considering the solutions too difficult or unpalatable. Shabana isn't squeamish about doing what it takes to protect the public. As always, she will grab this problem by the proverbials.”

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