Sexual Deviance over the Lifespan: Reductions in Deviant Sexual Behavior in the Aging Sex Offender

Howard E. Barbaree & Tay Blanchard, “Sexual Deviance over the Lifespan: Reductions in Deviant Sexual Behavior in the Aging Sex Offender,”

 Barbara & Blanchard, 37….[A]lthough some individual traits and predispositions underlying sexual deviance, such as sexual preferences or antisocial traits, may persist to the end of life, the expression or performance of sexually deviant behavior decreases with age.”

 Barabee & Blanchard, 39: “The Role of the Male Sex Hormone Testosterone

“Mammalian gonads and adrenals secrete several male sex hormones called ‘androgens’.  All are steroid hormones produced primarily in the Leydig cells in the male testes, although some small amounts of these hormones are produced in the adrenals in both males and females. Testosterone is the most potent and abundant androgen (Seidman, 2005). Close to 98% of testosterone molecules are protein-bound, with approximately one-third of these weakly bound to albumin and the remainder strongly bound to sex-hormone binding globulin (SHBG). Because the testosterone molecules that are bound with SHBG cannot bind with receptor cells, this component of testosterone has no behavioral effect. Only the non-SHBG-bound testosterone is biologically active(‘bioavailable’), including free testosterone and testosterone that is loosely bound to albumin(Seidman, 2005).  Free testosterone diffuses into target cells where it is converted to dihydrotestosterone and estradiol.  Testosterone and dihydrotestosterone bind to androgen receptor cells mediating the effects of sexual behavior(Sneidman, 2005).”  Close to 98% of testosterone molecules are protein-bound, with approximately one-third of these weakly bound to albumin and the remainder strongly bound to sex-hormone-binding globulin(SHBG).  Because the testosterone molecules that are bound with SHBG cannot bind with receptor cells, this component of testosterone has no behavioral effect.  Only the non-SHBG-bound testosterone is biologically active(‘bioavailable’), including free testosterone and testosterone that is loosely bound to albumin (Seidman, 2005).  Free testosterone diffuses into target cells where it is converted to dihydrotestosterone and estradiol. Testosterone and dihydrotestosterone bind to androgen receptor cells mediating the effects of sexual behavior (Seidman, 2005).”

 Barabee & Blanchard 39-40: “When men exhibit low levels of total testosterone in their blood (below 300 ng/dl) due to malfunctioning of their hypothalamic-pituitary-gonadal axis, they are referred to as ‘hypogonadal.’  Hypogonadism is characterized by a loss of libido and a loss of both sleep-associated and spontaneous erections (Anderson, Bancroft, & Wu, 1992). Davidson, Kwan & Greenleaf (1982) utilized a within-subject design to study the effects of injected doses of exogenous testosterone on sexual behavior in six hypogonadal men.  These patients received (12) 100 mg. Of testosterone, (2) 400 mg. Of testosterone, or (3) placebo.  Each patient received each treatment with a gap of 6 weeks between treatments, and the order of treatment was varied among patients to control for treatment order effects.  Results indicated that injections of testosterone increased plasma testosterone levels.  The effect was temporary (with peak effects 7 days after injection) and dose-dependent  (with larger doses producing larger increases in blood levels). The hypogonadal men kept daily diaries of the sexual behavior and penile erections.  The largest behavioral effects of testosterone injections were reported 1 week after injection, corresponding to the time of peak effect on plasma testosterone level.  Dose-dependent effects of testosterone injections were observed for total erections, nocturnal erections, cital attempts, masturnation, and orgasm, with larger doses producing larger increases in sexual behavior (Davidson et al., 1982).

Testosterone is necessary or at least important to maintaining libido. Increasing plasma androgens at puberty is correlated with the onset of nocturnal emissions, masturbation, dating, and infatuation (Kemper, 1990). The level of bioavailable testosterone is correlated with sexual thoughts (Meston & Frohlich, 2000).  Males with an early onset of androgen secretion develop an early interest in sexuality and erotic fantasies (Feder, 1984).  A significant relationship between serum testosterone levels and libido has been found in the following populations: normal men (Anderson et al., 1992); Bagatell, Heiman, Rivier, & Bremner, 1994), noral adolescent boys (Udry, Billy, Morris, Groff, & Raj, 1985), men complaining of loss of sexual interest (O’Carroll & Bancroft, 1984), men with erectile dysfunction (Schiavi, White, Mandeli, & Levine, 1997), and hypogondalmen (Davidson, Camargo, & Smith, 1979; Kwan, Greenleaf, Mann, Crapo, & Davidson, 1983; Luid & Franchi, 1980; O’Carroll, Shapiro & Bancroft, 1985).”

 Barabee & Blanchard 40: “The Effects of Aging on testosterone and Sexual Behavior

“…Testosterone levels decline through both central (pituitary) and peripheral (testicular) mechanisms, and there is an age-related loss of circadian rhythm (Seidman, 2005; Swerdlaff & Wang, 1993). Numerous studies have established that levels of both total and bioavailable testosterone peak in early adulthood and thereafter decrease with age through the remainder of the lifespan (e.g., Baker et al., 1976; Denti et al., 2000; Harman, Metter, Tobin, Pearson & Blackman, 2001); Jankoswka, Rogucka, Medras & Welon, 2000; Doi et al., 1998; Vermeulen, Goemaere & Kaufman, 1999).

“….[W]hen study methodology has employed appropriate controls for extraneous factors, the relationship between aging and testosterone blood levels indicate a significant effect of age.”

  Barabee & Blanchard 41 …[L]evels of both total and bioavailable testosterone were seen to decrease in a linear function from age 30 to age 90.

“In the same study, significant numbers of older men could be diagnosed as hypogonadal, in the sense that their blood levels of testosterone had declined below the diagnostic criteria ( Harman et al., 2001). FIgure 3.2 presents the proportion of different-age samples who met diagnostic criteria for hypogonadism, based on both total and bioavailable testosterone (free T index).  As can be seen, the proportion increased significantly with age.  Testosterone deficiency in elderly men could be considered a normal aging phenomenon… This condition in older men has been referred to as ‘andropause’, and it is considered to be the male equivalent of menopause on women.”

 Barabee & Blanchard, 42 …A few authors have suggested that testosterone receptor sites may become less sensitive with age, so that the threshold concentration of testosterone necessary to maintain libido may increase with age (e.g., Baker & Hudson, 1983); Schiavi, 1999, pp.52-53; Tsitouras et al., 1982).”

 Barbara & Blanchard, 43 …Feldman, Goldstein, Hatzchristou, Krane & McKinlay (1994) studied erectile function over different age cohorts and reported that while the prevalence of minimal erectile difficulties remained constant (<20%) from age 40 to age 80, the prevalence of moderate and complete erectile dysfunction increases so that by age 60, the majority of research participants reported at least minimal erectile dysfunction.

“… In men, lack of interest in sex, erectile difficulties, and inability to achieve orgasm were more prevalent in older men; the older the respondents, the more prevalent these problems became.”

P.44: [My note: Note the relatively small decrease in erection amplitude with age.  Also note that age brackets of ages 51-65 and 66-80 are virtually the same.  This is true even though recidivism rates plummet sharply past age 50 and are statistically insignificant past age 60.  Hence, erection girth or volume as measured by the PPG is not really predictive of recidivism.]

 Barabee & Blanchard, 45 The Effects of Aging on Sexual Arousal in the Sex Offender The current literature supports the notion that sexual arousal decreases with age in sex offenders…[A]rousability was inversely related to age.  This reduction in sex offender arousability seems to begin at an early age.”

 Barabee & Blanchard, 49 Figure 3.9 Replotted recidivism as a function of age at release from custody corrected to 5 years’ time at risk (data from Barbaree et al. 2003) [N-468; correlation: .99]

“Based on the data reviewed above, it would be reasonable to conclude that when sex offenders are released from custody at different ages, they show age-related decreases in recidivism.  The best description of the age function is a gradual linear decrease in recidivism rates from age 25 to age 70, at which point the estimated recidivism rate is near zero.  This age function is similar to that described earlier in this chapter for blood levels of testosterone, for sexual arousal in normal men, and for sexual arousal in sex offenders.  Additionally, these reductions in sexual recidivism are very similar to reductions in nonsexual recidivism (both violent and nonviolent) among nonsexual criminals (Hirschi & Gottfredson, 1983; Sampson & Laud, 2003, 2005).

“…In the current discussion of risk factors, static risk factors are those characteristics of offenders related to recidivism that do not change over time.  Dynamic risk factors are those that may change over time.  In contrast to both of these factors, maturation is a risk factor that exhibits changes over time; however, unlike dynamic risk, the change is predictable and inexorable, and once maturational changes occur, they are not reversed under normal circumstances.”

 Barabee & Blanchard, 56 Professional standards guiding the use of psychological tests warn against the use of tests if such use may be discriminatory on the basis of age, race, culture, or other factors. …The current chapter makes the point that direct application of current actuarial instruments to elderly sex offenders is potentially discriminatory.”

 Barabee & Blanchard, 56-57 The implications of the aging effects reviewed in this chapter are profound.  Current policy and legislation in most Western jurisdictions target sex offenders for civil commitment or long-term incapacitation when the offenders are in their middle years. Current practice is to continue the detention of many of these offenders on into old age.  Incarceration of these offenders is grossly expensive and seems unjustified if risk is generally lower in the aged sex offender.  One solution is the revamping of the current risk assessment methodologies to accommodate reductions in the performance of sexually deviant behavior in the older sex offender.”

Originally appeared in “The Legal Pad” Volume 2, Issue 10 (October 20th, 2018) by Cyrus P. Gladden Ⅱ

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