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Purpose Within the German legal framework, if an unlawful act is committed by a substance-addicted offender, courts shall make a forensic addiction treatment order (referred to as FAT). In 2010-2015, German courts applied this rule to 14,576 individuals. The article aims to explore the development of FAT sex ratios, its relation to other criminological measures and its regional distribution - and to describe gender-related differences within the FAT population. Methods Yearly and state-specific sex ratios in FAT orders were calculated