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reader comments: penile plethysmograph

I found your site with a search for plethysmograph after learning the horrifying news that this "instrument," test actually existed from my 20-year-old son who is incarcerated and informed me that he was coerced into being subjected to this procedure. (By the way, my son actually committed an assault, not the sexual assault he was convicted of.) Now, along with all the "One Flew Over the Cuckoo's Nest" scenarios that have come to light since he has been in prison is the revelation that DOC [Department of Corrections?] thinks that locking up a young man when he is 18-20 years old, then forcing him to look at pornography can somehow lead to an assessment that he is a deviant through the use of this diabolical device. This Josef Mengele contraption thought up by some corporate sadists doesn't measure anything except that people, maybe especially 18-20-year-old men, have fantasies. But having tame or even "deviant" fantasies is no predictor of crime. What is really shocking is that I have found no one who knew this device existed or that such a test is being used in almost every state. I am terrified of what else DOC can do without the general public knowing what is going on--lobotomies? castration?

Name withheld

30 May 2000 
Hello, I'm the member of the committee of the organization of the Czech transgendered people Transforum. We've found your article about using PPG in diagnostic. I'd like to let you know that this machine is used in diagnostics of transsexuals (both Females to Males and Males to Females) here in the Czech republic.

Some of the doctors ask the clients to undergo the test with PPG as the obligatory test for making a diagnosis of transsexuality! They show erotic photos to transsexuals. Of course, we transsexuals consider this to be total nonsense. They think it is science .... They don't even consider the possibility of homosexual transsexuals .... oh, well. 

We consider this test to be very humiliating and at the same time absolutely useless in these cases. What's your opinion? Will you tell us, please.

reply: I think your doctors are very confused about sex and transgendering if they are measuring arousal to help them make a decision as to whether to proceed with the treatments.

10 Mar 2000 
I have a skeptical reference for the subject penile plethysmograph and related matters. It is "Sexual Instrumentation", IEEE Transactions on Biomedical Engineering Vol. BME-30, No.6, June 1983. pp 309-319.

This article is an applied review of sexual instrumentation, including the PPG. The paper is quite illuminating.
Steve Lutes

I am a psychologist in NY. Graduate of SUNY Buffalo. I've become more skeptical over the years.

I've received some heavy handed treatment of a certain powerful bureaucrats who insist that retarded individuals should be hooked up to penile plethysmographs to see if they're pedophiles. . . It's unbelievable! When you question their assumptions about this, they come back with veiled threats and ad hominem arguments.

The power of these people is scary.

Keep up the good work. . .

6 Nov 1996
Your argument holds true for the unauthorized use of the device in a prison or child custody situations, but in other cases it is a revolutionary and standardized method of determining the etiology of one's criminal persuasion.

reply: Revolutionary, perhaps, but in no way a standardized method of determining the etiology of anything, except perhaps the gullibility of soldiers, cops, prosecutors, parole boards, psychologists and social workers.

I think your "skeptical" cry to ban the device is little more than a witch hunt to eradicate its use.

reply: Thank you for noticing my "cry." Most people miss it. In any case, I haven't called for a "ban" on anything. You are partly right, though; I would like to eradicate the abuse of the PPG and see less wishful thinking and self-delusion in the world.

Perhaps addressing the inappropriate reasons for using the test should be focused on rather than the actual nuts-and-bolts of the setup.

Jim Roche, Seattle, WA

reply: I don't see why one can't do both.

Mr. Roche's follow up:
11 Nov 1996

You missed my whole point, charlie. Let me break it down to you. You popped up after an Infoseek search for the word "plethysmograph." I work in a residential care unit for witnessed sex offenders who for one reason or another stand incompetent to stand trial. They each received this test (albeit perhaps by an overzealous practitioner) to assess their compatibility with a community living environment. To make it simple, if they proved stimulated by a snapshot of a naked infant, their placement would be as far from infants as was possible. This expands to protect the public from any pursuits, because their conduct shows that they have low impulse control, and respond vigorously to stimuli that they see as appealing. ok? ok. I'm sure you're glad that there is a way, despite all of the financial, psychological, and bureaucratic hangups, to keep the predators away from your family and friends. Right? Thanks, jimr.

reply: "Residential care unit?" Is that the euphemism we now use for psychiatric facilities for sex-offenders? What kind of facility would consider placing "witnessed sex offenders who are incompetent to stand trial" anywhere in any community, except the community of other "witnessed sex offenders" and their caretakers? If your facility does, then I think the community needs to be protected from your facility as well.

31 Dec 1997
From 1982-1988, I was the Director of the Psychophysiological lab at the Sexual Behavior Clinic in New York City. I personally (not through a technician) assessed and treated over 700 adolescent and adult sex offenders. After reading your piece on the plethysmograph, I have a few comments:

1. Plethysmograph data is totally useless for determining guilt or innocence regarding deviant sexual acts. It would be like using a personality test to convict someone of burglary.

2. Plethysmographic data have no diagnostic value of any kind.

3. About one-third of offenders show no arousal in the lab.

4. The proper stimuli to use are not pictures, but taped fantasies. Ideally taped fantasies spoken by the offender themselves, describing the offenders' own fantasies as well as contrived ones.

5. The value in plethysmographic assessment is to aid the offender in learning how to control erection responses during deviant fantasy. that is it. It has no value in "seeing if the treatment worked." Treatment should not be court-ordered. The best outcomes I've seen were post-adjudication, when there was no coercion involving treatment. I had the occasion to do some treatment with post-adjudication offenders at a detention facility in Bucks County, PA.

6. The plethymograph most definitely has value in diagnosing organic versus psychogenic impotence. A study by Dr. Charles Fisher in 1965 determined that 1,000 out of 1,000 healthy men tested had penile erection responses during REM sleep. When there is lack of response, that indicates further evaluation by a urologist. So it is useful as a screening device.

In summary, I agree with many of your concerns regarding the plethysmograph. I may have more direct, hands-on experience with this device than anyone in this country, and I've spoken against its abuses for some time now. But don't throw it away completely. It still has some limited, though functional use.
Robert M. Stein, Ph.D.
Center for Neurobehavioral Health, Ltd.
Lancaster, PA

penile plethysmograph


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