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Sir: I read with interest the letter to the editor authoredby Briken and colleagues.1 Although I certainly appreciate thepoints raised in their case report, it is important to consider thefollowing issues when evaluating and treating patients afflictedwith paraphilic disorders. (1) As documented in the orchiectomyand pharmacotherapy literature, paraphilic patients remain atrisk for sexual offense recidivism irrespective of the biologicaltreatment they are receiving.' ‹