National Report >> Czechia, Review Documentation, 42nd Session, January 2023

Surgical castrations are carried out pursuant to the Act on Specific Health Services, containing many guarantees protecting the rights of patients. A fundamental condition of the surgery is the patient’s voluntary request based on their own free decision. Other conditions are being at least 21 years old, a medically proven paraphilic disorder, the perpetration of a sexual offence, a medically proven high likelihood of repeating such offence and a failure or medical impossibility of treatment alternatives. The castration applications are always assessed by an expert committee that will obtain at least two independent expert opinions and invite the patient to its meeting, inform them of the surgery’s nature, its permanent effects and possible risks and verifies the patient’s full understanding and lack of any compulsion. The committee must approve the surgery unanimously. The Act excludes castration of persons serving a prison sentence or in custody. Castration cannot be made to patients with limited legal capacity. Patients in protective treatment or security detention can undergo castration only in especially justified cases, with the consent of the expert committee as well as the court. Such patients must be informed by the committee that castration does not entitle them for release. From 2012 till 2019, the committee discussed nine applications, approved 3 and rejected the rest. [Para 32]