The article indicates pedophilic sex offenders pose a grave risk to the health and safety of children, primarily because effects of sexual abuse inflict lifelong physical and psychological damage and may even predispose child victims to sexually abuse children themselves in adolescence and adulthood. In addition, research clearly demonstrates pedophilic behavior may be effectively suppressed through several treatment regimes that reduce male testosterone levels or curtail the motivation to engage in deviant sexual conduct involving child victims. Some jurisdictions, including California, Montana, Florida, and Texas, have enacted laws that provide for or at least sanction surgical castration as a meaningful response to sexual disorders that result in offenses involving child victims. The authors examine the nature and treatment of pedophilia disorder, with emphasis on surgical castration. Examples of recent legislative responses to the problem of sex offending involving children are analyzed. Consideration is also paid to significant legal issues raised by surgical castration and to how legislation pertaining to surgical castration may be legally and ethically construed in the context of medical treatment. The authors suggest that permitting incarcerated pedophiles convicted of sex offenses against children to undergo voluntary surgical castration within the context of treatment for their pedophilia disorder is both constitutionally defensible and morally permissible. 406 footnotes