Surgical castration of sex offenders has been used in several countries to prevent sexual recidivism and is still practiced in several states in the United States. In Europe, it has remained in limited use in Germany and in the Czech Republic (Douglas et al. 2013). Since the 1960s, most jurisdictions have replaced irreversible surgical castration of sex offenders with reversible chemical castration with anti-androgen drugs. In Denmark, use of surgical castration was stopped in 1970, and since the late 1980s, serious sex offenders have on a trial basis been treated with anti-androgen drugs (Hansen and Lykke-Olesen 1997). In 1997, an official treatment program for sex offenders was introduced on a trial basis, and in 2011 this scheme was made permanent (Nielsen 2001).

The first part of the scheme covers persons with a suspended sentence with conditions of sexological treatment. This program serves as an alternative to suspended sentences of up to one and a half years of prison for criminals convicted of a sex crime that does not include violence and/or illegal coercion (Nielsen 2001). Participation in the treatment scheme presupposes that the criminal declares himself guilty and voluntarily accepts to join the program. The final decision regarding whether the accused is suitable and motivated to participate in the treatment program is made by the Prison and Probation Service based on the results of mental and physical examinations. The first part of the treatment program is assumed to last at least two years and consists of different phases: (a) a stay of three to six months in an institution where the sex offender’s free movements can be restricted; (b) outpatient treatment in a specialized psychiatric hospital department for at least one year; and, thereafter, (c) a six-month supervision period of the sex offender.

The second part of the treatment program is called the “visitation scheme” (Nielsen 2001). The visitation scheme covers sex offenders who are sentenced to fixed-term imprisonment of up to five years for rape, incest, paedophilia, and other coarse sex crimes. The program is managed by the Prison and Probation Service as a part of the normal resocialisation process of imprisoned people. In this situation, the convicted must voluntarily accept treatment with anti-androgen drugs; otherwise this treatment cannot be implemented (Nielsen 2001). In cases where the Prison and Probation Service is planning to initiate treatment with anti-androgen drugs, the Danish Legal Medical Council must approve the decision. Treatment of sexual offenders with anti-androgen drugs has also been applied in cases of parole and probation and in some cases of release of dangerous sex offenders from an indefinite sentence (Nielsen 2001). However, release of criminals from an indefinite sentence is not made by the Prison and Probation Service but the national courts and thereby also the decision of treatment with anti-androgen drugs.