What is sexual deviance? When is deviance simply abnormal and when does it become dangerous?

Rapists, serial killers, and active pedophiles are subject to two institutions -- the medical world and the courts. But it seems these two worlds are not strictly separate.

If deviant sexual behavior has biological origins, as many physicians believe, and hormone therapy proves effective, can you impose such treatment? Does that not violate a person’s fundamental right to self-determination?

Filmmaker Elizabeth Salgado took on all these questions in her search for critics, advocates, and victims of castration in her new homeland of the Czech Republic. When she heard that sex offenders in this European country undergo castration -- be it surgical or chemical -- she could hardly believe it. Even more shocking for her was the discovery that her husband supported the practice.

As it turns out, chemical castration also takes place in Denmark, Sweden, Germany, California, and Texas.

According to the government’s latest figures, more than 300 men were chemically castrated in the Czech Republic between 2000 and 2012. Add to that some 80 surgical castrations annually. But the castration of sexual offenders is not limited to the Czech Republic. As it turns out, chemical castration also takes place in Denmark, Sweden, Germany, California, and Texas. In 2012 the European Committee for the Prevention of Torture denounced castration practices in German prisons. Convicted rapists, serial killers, pedophiles, and other sexual offenders may undergo the surgical procedure there voluntarily.

The German government responded with a statement that the surgical procedure should not be seen as punishment, but as a medical treatment which eases the suffering of the individual involved. It also referred to the low recidivism rate among castrated offenders: Of the 104 men castrated between 1970 and 1980, only three subsequently committed a crime. Of the non-castrated men, more than 40% reoffended.

On the other hand, scientists point out that while the medicines used to treat sexual offenders may lead to a drop in their sex drive and a decrease in sexual behavior, the treatments are unlikely to actually cure offenders.

So which is it? Is castration a medical procedure or a punishment?

The film addresses these questions in a frank and at times shocking way. Some material may be disturbing to some viewers. Viewer discretion advised.