Rust's physical symptoms included infertility, shrunken genitalia, and sexual difficulties. After his murder convictions, his diagnosis of Klinefelter's was linked to his sexual offending. During an episode of Inside the Mind of a Serial Killer, Dr Linda Papadopoulos stated that his sexual offending likely evolved out of the enjoyment he obtained from shocking others with his unusual physique, particularly his "shrivelled genitalia", and a 2004 psychiatric report stated that he found it "more thrilling to masturbate in front of a pretty woman, mainly due to the reaction it would provoke for his victim".