A total of 38 participants (35 males and 3 females) that had been prescribed anti-libidinal (hormonal or anti-psychotic) medication were compared with participants that showed problematic sexual behavior but had not been prescribed anti-libidinal medication. There was also a sub-group that had committed non-sexual offenses against other people. Assessment was conducted over a maximum of three sessions, depending on the requirements for individual participants. The aim of the first session was to establish the participant’s ability to consent, obtain a personal history, and assess intelligence quotient (IQ) and adaptive behavior functioning. The second and third sessions involved exploration of participants’ sexual attitudes and knowledge, level of victim empathy, moral judgment, and self-esteem. A major finding of the research was that individuals with cognitive disabilities that were receiving anti-libidinal medication were similar on most variables to those that were not receiving anti-libidinal medication or any medication at all, and also to those that had committed non-sexual offenses against other people. Significant differences were found between the anti-libidinal medication group and other participants for presence of delusions/hallucinations, and personality disorder. Apart from these psychiatric symptoms, there were no findings that suggested that those that were prescribed anti-libidinal medication were more violent, aggressive, or dangerous than the comparison groups. Appropriate interventions must address the person’s environment (including their own safety from abuse) and incorporate a broad-based assessment of psychiatric symptoms and socio-sexual behavior by a multi-disciplinary team; assessment of the impact of other medications; and implementation of other interventions to address empathy, communication skills and adaptive behaviors. 18 tables, 4 appendices, 88 references