Jesse Harris Dr.

Jojo Munoz ENC 1101 October 12, 2006 Word Count:

Pros and Cons of Chemical Castration

What if our nation where to take a true no tolerance approach to sex offenders? What if the old adage the devil made me do it was no longer an excuse, thrown out along with I could not help it and I am sick, its not my fault? In our nation now only a handful of states offer a medical alternative for sexual predators, the option of chemical castration. In this paper I will explore the pros and cons of making this nationwide, non- voluntary, and required in order for a freed felon to submit to in order to remain free. I will explore the constitutional, moral and financial issues along with the effectiveness of using chemical castration. The main issues regarding this subject are; is it constitutional? Do we have the right to exact such a price from an individual who has already served their sentence? Is chemical castration successful enough to warrant its use? The first question that needs to be addressed is; what is chemical castration? First off, lets identify what chemical castration is. Chemical castration is when the offender is injected intramuscularly with a hormone, known as DEPO-PROVERA, commonly used as a method of birth control for women, once every 1-3 months. The hormone is known to lower sex drive and when used in the more concentrated form, as would be used for these felons, it will reduce the urges that drive these men to commit their crimes. It is totally reversible [just discontinue injections] does not deprive the recipient of the ability or enjoyment of sexual encounters nor does it deprive them of the right to procreate. SO WHATS THE PROBLEM?? Chemical castration is a form of temporary castration caused by certain hormonal drugs. It was developed as a temporary preventive measure or punishment, typically for male child sex offenders and rapists. Depo Provera, a progestin and tamoxifen, a drug previously used in breast cancer, are the drugs most commonly used today for sex offenders. Depo Provera acts on the brain to inhibit hormones that stimulate the testicles to produce testosterone. Tamoxifen works by blocking the aromatase enzyme. This enzyme converts testosterone to Estrogen. Estrogen is responsible for sexual drive in men not testosterone. Depo Provera works by removing all testosterone so none can be converted to estrogen by the aromatase enzyme. The Herb chrysin also works on blocking the aromatase enzyme.

Depo-Provera is a common birth control pill that containing a synthetic version of the female hormone progesterone. Advocates of chemical castration hope that injections of Depo-Provera will prevent men from molesting children. Scientists have observed the link between testosterone and aggression and concluded that high levels of testosterone correspond with increased violent and aggressive behavior in men. "It is the reason that stallions are high strung and impossible to train, the reason male dogs become vicious and start to bite people. It's why boys take chances and chase girls, why they drive too fast and deliberately start fights. In violent criminals, these tendencies are exaggerated and carried to extremes". In an effort to stop male pedophiles, male child molesters have the option of being chemically castrated in some states. Pros According to the article Sex Offender Treatment, their question was how successful is successful enough? In my opinion saving a fraction of the number they quote is more than enough to justify a requirement of treatment for repeat offenders. For 94.7% of treated heterosexuals to have no repeat offenses in 17 years is substantial. An article in the Crime Times a study in Germany compared 99 surgically castrated individuals and 35 non castrated individuals for 10 years after release. the recidivism rate for the castrated men was 3% compared to 46% non castrated men. These are VERY substantial numbers and even though surgical castration is more severe the end results for chemical vs. surgical are very similar, and a very good argument can be made for the humanity of chemical castration. In a news article, Pro and Con: Is castration a Just Punishment for Sex Offenders a recipient of the injections who had been a repeat offender stated he was finally happy now that the uncontrollable urges that drove him crazy were finally gone. Yes, there are situations were this method will not work. It has been shown that the drug is not as effective for rapists or those who wish to hurt children in ways additional to their sexual urges. I also agree that to ignore the underlying problems and eliminate therapy would be an injustice [and in fact therapists find that the reduced urges aid in therapy] but the statistics prove that there is significant results with the drugs and therapy can take years or even decades where as the drugs are effective within the first month of treatment. In some states prisoners have begged the states to chemically castrate them with the states actually refusing. In Texas, Larry Don McQuay begged the state to give him the drug stating that he had molested some 200 children and would do it again if he was released. Johns Hopkins University found a recidivism rate of 65% for non treated felons, this number fell below 15% with treatment. The numbers go on and on of amazing drops in the recidivism rates, none were inconclusive or minor changes. To the parents of the victims to be this is meaningful, life changing. Studies also show that there is a strong correlation between adult molesters and their own personal sexual abuse as children so this could also help to break a viscious cycle. Onto the next argument, excessive or multiple punishment for one crime but as I stated earlier, we demand parole checks as a condition of release, they are not totally free once released so how different is this? This is not life altering for the recipients, for goodness sake, women use this drug for years as a form of birth control, not as a punishment!

Once a repeat offender is tried and convicted how many rights should they have and what of the rights of the innocent, their victims who will never be the same again, will be emotionally scarred for life and many even grow to repeat this offense to another innocent and so on and so on....

Recidivism is extremely high among child molesters; 75% are convicted more than once for sexually abusing young people. Pedophiles commit sexual assault for a variety of reasons. Some rape children because of similar instances of abuse in their own childhoods. Some view the act of molestation as a way to gain power over another individual. Some pedophiles act purely on sexual desires. Regardless, Depo-Provera has been proven to inhibit the abilities of pedophilias to assault children. The progesterone in Depo-Provera counteracts the biological tendencies that lead men to rape children. By lowering testosterone, Depo-Provera reduces sex drive. Males can have sexual intercourse but do not want to. Depo-Provera also decreases aggressive tendencies by reducing testosterone. "[T]he castrated criminal would be more docile and have a better opportunity to be rehabilitated, educated, and to become a worthwhile citizen". Castration removes the biological and chemical tendencies that are intrinsically linked to the desire to rape in males. Depo-Provera also reduces recidivism rates. When used as a mandatory condition of parole, chemical castration decreases the occurrence of repeat offenses from 75% to 2%. Prison is less desirable because it serves no rehabilitative purpose for sexual offenders. Pedophiles who spend time festering in a prison cell are given extensive downtime to concoct new sordid sexual fantasies involving children. These horrific visions are translated into terrifying realities once the criminal comes back into contact with children following his inevitable release from prison. Prison simply produces sneakier criminals. Pedophiles do not want to be incarcerated again so they think of new ways to rape children that will avoid detection and future detention. Prison increases aggressive tendencies in male pedophiles while chemical castration addresses the root causes of sexual assault and decreases further sexual deviance. For years, a notorious Texas inmate, Larry Don McQuay, begged the state to castrate him, saying he had molested over 200 children and would resume when released from prison. There were also experts like Dr. Fred Berlin, founder of the Sexual Disorders Clinic at Johns Hopkins University, who noted that molesters may have a recidivism rate as high as 65%. Dr. Berlin cited domestic and European studies in which the recidivism rate fell below 15% when participants were chemically castrated. Such statistics attracted the attention of Rep. Mark Ogles (RBradenton) who, having watched the California General Assembly enact a chemical castration statute in 1996 (a law which is currently under legal challenged by the ACLU of Northern California), introduced HB 83 early in the 1997 session. Rep. Ogles talked of prevention, not punishment.

Finally, a major question would be cost vs. benefit. There are two ways to view this question, one would be cost to society vs. benefit to society and the other would be actual dollars and cents cost analysis. First issue would be constitutional rights, how far the government has a right to govern citizens vs. protecting innocent victims. Given the recidivism rate of this type of crime it seems to me in cases of repeat offenders it is our absolute duty to protect any new possible victims, how can the rights of these felons have more priority than societies right to be protected from them. Given the non-permanence of the solution and the fact that it would not be disfiguring along with the facts that it may in fact be helpful in enabling these men to live some semblance of a normal life I cannot see why so many states hesitate to make this part of legislation. As for monetary cost analysis, it costs anywhere from ten thousand to seventy seven thousand dollars, depending on the state, to house a prisoner, an average breaking down to forty four dollars per day per prisoner. The cost of this type of therapy would be an average of twenty one dollars per day, a savings of over 50%. In some states the offender has to pay for his own injections. I am sure that there are those that can argue all of my points and can even come up with different statistics to support their own points. I had the unexpected opportunity to speak with an individual who has spent years working with sex offenders, he does not wish to be named here but maintains that the angle of castration is big business, the research and studies all spell big bucks for the researchers and that is why there is such a push for the question to continue BUT also maintains that since sex is such a small inconsequential result of sex offenses, that they are so borne of control and violence issues that a drug which works to suppress the libido will not make a significant difference in the true numbers. He also maintains that since sex offenders are so highly functional in general the studies would be difficult to prove, are they just better skilled at not getting caught? While this therapist says he has never worked within these studies or with anyone who has been castrated he is still very skeptical based on his years of experience working with these men. He certainly feels that if not coupled with psychotherapy the drugs can never be a cure all. Last but not least, examining this issue based on theories I have learned, I can apply the Kantian and Mill approach that a person has rights until they effect the persons near them. Since these men have so overstepped their spheres of freedom [Baxter] and broken social contract [Hobbes] to such a heinous extreme, I personally feel, they have forfeited their rights to freely, and without conditions, walk freely among society. I can also apply utilitarian theory, the ends DO justify the means. If even the smallest percentage of children are saved does that not justify putting these requirements upon their known predators? Plus we have the bonus for utilitarians, this treatment puts hope for the future of these tortured souls, it is more than simply exacting the pound of flesh but is an attempt to rehabilitate. This even follows consequentialism, there are consequences to all actions, these men have to pay the consequences and take responsibility for their crimes. I can find no true bad consequences for society, even in the worst case scenario, the drug is not as effective as hoped, no one has been permanently mutilated or suffered any irreversible harm and considering the crimes committed there is valid cause to continue studies and implementation. On the other

hand, as a society, we cannot use this as a Band-Aid and turn our heads. If the drug therapy does not work these men must be closely monitored to prevent them from having a free for all under the misnomer of being cured.

cons The use of Depo-Provera can cause several side effects including weight gain, fatigue, thromboembolism, malaise, hypertension, mild depression, hypoglycemia and rare changes in liver enzymes. Depo-Provera also has caused side effects in some men "including depression, fatigue, diabetes, [and] blood clots" The use of tamoxifen in men may result in headaches, nausea and/or vomiting, skin rash, impotence, or a decrease in sexual interest. Weight loss has also been reported in men due to reversal of the bloating effect of excess estrogen caused by fluid retention. In addition to ethical concerns, chemical castration may increase blood pressure in males, sometimes to dangerous levels. Other side effects, such as the formation of abnormal fat deposits in the liver, are being investigated. Though generally considered more humane than surgical castration, chemical castration has attracted a number of critics. The American Civil Liberties Union opposes the coerced administration of any drug, including antiandrogen drugs for sex offenders. They argued in 1997 that forced chemical castration was a "cruel and unusual punishment," and thereby constitutionally prohibited by the Eighth Amendment. They also stated that it interfered with sex offenders' "right to procreate," and could expose users to various health problems. Large doses are required to be effective in men. Most men will receive 400mg to 500mg per week, equal to 2.5 ml in each buttock. In some cases, men given oral doses as high as 700 mg/day have still reported regular sexual arousal and fantasies. However, some experts argue that Depo-Provera is ineffective and will not prevent molestation. Forced castration may have the adverse affect of angering a criminal, increasing his violent tendencies and lead to additional sexual abuse. Additionally, DepoProvera is reversible. Therefore, unless injections are mandatory and monitored, pedophiles will not be "cured" by the drug therapy. The child molester will have renewed sexual fantasies and high levels of testosterone if the injections are discontinued. Joseph Frank Smith, a convicted child molester, became an advocate for chemical castration after undergoing the therapy in the 1980s. Smith stopped using the injections in 1989. In 1999, he was convicted for molesting a five-year old girl and immediately returned to prison. For decades after the fall of Nazi Germany and the discovery of the infamous medical experiments of Dr. Josef Mengele, it constituted a periodic embarrassment. An enraged judge would condemn a defendant convicted of a sex crime to castration. The sentence would be disallowed on appeal, and a relieved public would laud itself for living in more enlightened times. Well, the definition of enlightenment has changed. During the 1997 Regular Session, the Florida Legislature overwhelmingly passed a bill imposing weekly

injections of a sex drive reducing hormone called Depo Provera on paroled sex offenders. Judges were also authorized to order this form of "chemical castration" for first time offenders. The ACLU of Florida, which stood virtually alone in opposing the bill and which is expected to file its own legal challenge to the new law in the future, argued that the involuntary use of chemical castration is unconstitutional. 1. Mandatory chemical castration interferes with an offender's fundamental right to procreate and the right to refuse medical treatment. 2. Although judges will be required under the new law to have the inmate submit to a medical examination to determine whether he is "an appropriate candidate for the treatment," it will be the trial judge, not the examining physician, who will make the ultimate decision whether the inmate must receive weekly injections of this non-FDA approved, experimental drug as a condition of probation or parole. 3. Judges, not doctors or even the convicted sex offender himself, will determine when, or if, the use of the experimental drug can be discontinued. 4. "Cruel and unusual punishment" analysis strongly suggests that mandatory chemical castration is not a medical treatment, but rather an additional form of punishment for sex offenders. 5. The state may not, without their consent, expose individuals to potentially dangerous medical side effects. The physiological effects of Depo Provera include temporary diminution of erections and ejaculations and a reduction in sperm count. The drug may also cause diabetes, gallstones, hypertension, fatigue, weight gain, cold sweats, nightmares and muscle weakness. The long term effects are unknown. 6. Determined sex offenders can, in all probability, reverse Depo Provera's effects with other drugs. 7. Castration fails to treat the psychological roots of sexually deviant behavior. 8. Unlike other conditions of parole or probation, submission to the treatment is not subject to the statutory maximum periods of incarceration. It can be ordered for life. These concerns should have weighed heavily with the Florida Legislature. In fact even Dr. Berlin, who favors the availability of voluntary chemical castration, opposes the Florida law. "There are many sex offenders for whom this is not going to be appropriate or useful," he said. "In effect, the legislators are practicing medicine without a license." Public Law 97184 calls for the chemical castration of defendants convicted of sexual battery. The act permits the court to sentence any defendant convicted of sexual battery to

the treatment, but it requires the court to sentence a repeat offender to undergo chemical castration. The Florida Department of Corrections will provide the services and financial means to facilitate the administration of the treatment. If the defendant fails to submit to or refuse to appear for treatment, the defendant is guilty of an additional second degree felony. The new law is scheduled to take effect on October 1, 1997. Forget the legal argument. What is wrong with the chemical form of castration: using a pill or an injection to reduce the sex drive of dangerous people? The members of the Florida Legislature think that they can prevent repeat sexual offenders by utilizing this method. It sounds well intentioned, but the Legislature needs to realize just how inappropriate this solution is. Chemical castration assumes that sexual offenders, after losing their sexual drive, will stop molesting children or attacking women. Unfortunately, that simply is not true. Anyone with an elementary knowledge of psychology can tell you that there are many other reasons why offenders commit sex crimes. These are not individuals looking to score on a Saturday night. They are sick, not desperate. Reducing their sexual drive does not necessarily solve the problem. Sexual assault is not about sex that is a myth. This law reinforces the stereotype that men are sex crazed individuals and that child molesters and sexual predators need to be drugged to control sexual impulses. In reality, sexual assaults are about violence, power and the humiliation of a survivor or victim. Eliminating sexual desire or a body part, for that matter seems like a quick fix. No more trying to squeeze extra convicts into already overcrowded jails. No more spending money to feed and clothe another felon sentenced to life. Just get rid of the testes. But this law avoids the real issues. The United States penal system effective or not is designed to protect society from harmful members and to rehabilitate those who can eventually rejoin society. Chemical castration does not make sex offenders ready to face society. Getting to the root of the problem, via psychological treatment, is crucial if offenders are ever going to be contributing members of society. Counseling should be as much a part of the penal system as jail time is it is a more civilized way to deal with criminals than physical mutilation is. Of course, counseling is a long term proposition, one which should be instituted at the time the inmate is first incarcerated or placed on probation, and it is expensive. That may explain why funds for inmate counseling is such a low priority on our legislators' to do list, and why any form of mandated counseling is conspicuously absent in the new law.

In sum, virtually everything which was assumed about sex offenders and about castration, chemical or surgical, by the Florida Legislature when it enacted Public Law 97184 is a myth, a leap of faith, or just plain wrong. This leap of faith is too big for our society. We cannot base a horrific new punishment on a faulty premise, and we cannot allow our disgust to cloud our judgment. These sexual offenders are sick and their actions are reprehensible, but we cannot start down a dangerous path of reactionary punishment that serves no purpose.

Convicted paedophiles are to be forced to undergo chemical castration as a condition of their parole, under new measures approved in California. The California Assembly approved the move by 51 to 8. It was passed by the state senate in August, by a similar margin, and now awaits only the signature of governor Pete Wilson, who supports the move. California will be the first state to force convicted paedophiles to undergo chemical castration, but Florida, Texas, Massachusetts, and Washington are considering similar measures. Under the terms of the law, which takes effect on 1 January 1997, castration would be optional for first time offenders and mandatory for repeat offenders. Men will be offered the choice of permanent castration through surgery or temporary castration through weekly injections of Depo-Provera, which is already used as a female contraceptive. In men Depo-Provera reduces testosterone concentrations and thus sex drive. Testosterone concentrations return to normal when administration of the drug ends. Dr Fred Berlin, founder of the Johns Hopkins sexual disorders clinic in Baltimore and author of some of the studies on which the legislation was based, criticised the approach because it did not first require medical or psychiatric assessment to see if the individual had a condition that would respond to this treatment. Dr Berlin cited his own experience in following up 600 people in treatment, 400 of them paedophiles. They received group therapy plus family or individual therapy; only 15% were also undergoing treatment with antiandrogens. Only 8% of the subjects relapsed over a five year period. Thus, "the overwhelming majority did well without medication." Dr Berlin suggested that state officials start with a voluntary program, which can be expanded should it prove successful. He added: "This may be helpful if it gets us to recognise paedophilia as a public health problem. But you cannot punish this behaviour away--something in these people is broken and needs repair. We must make them take responsibility for their behaviour, but we also have to give them the tools to be able to do that." "I think this will lower the reoffence rate somewhat, but not nearly as much as they think it will," said Dr Robert Dickey, head of the sexual behaviours clinic at the Clarke Institute of Psychiatry, University of Toronto. He noted that the treatment has a number of drawbacks. Depo-Provera has potentially serious side effects, including thromboembolism, and may cause weight gain, fatigue, malaise, mild depression, hypertension, hyperglycaemia, and rare changes in liver enzymes. Also, a high volume of injection is required. Most men will probably receive 400 mg to 500 mg Depo-Provera per week, which amounts to an injection of 2.5 ml into each buttock each time and

probably contributes to the high dropout rate seen with this treatment. Dr Dicky added that there is no guarantee that the treatment will work. Individuals vary in their response, and men given oral doses as high as 700 mg/day have still reported regular sexual arousal and fantasies. "You are relying on their self reports, which raises issues with respect to monitoring," he said. In the SVP Act Faces Constitutional Challenge article I found the most harsh opposition, and even there I was not in the least swayed. The first potential hurdle would be the Ex Post Facto laws. Any new laws regarding chemical castration could only apply to offenders subsequent to the passing of the statute in each state. Our prisons are already full of offenders who would not, could not be eligible, unless they were to do so voluntarily. The same article also finds problems in our Double Jeopardy laws, No one can receive multiple punishments for the same offense. Once a man has served his term he cannot be dealt a second punishment of required medical treatment, although how this differs from court ordered parole is beyond me, this is also a condition for prison release. Finally this particular article points out our constitutional rights regarding proof of present dangerousness. How does one prove that this person still poses a threat to society and children once treated? This is one point I can concede holds some merit. For a first time offender, to require a lifetime of hormone injections based of a presumption of recidivism can be unconstitutional, however, once you have a repeat offender I believe certain assumptions can now be made. For moral arguments I found it even more difficult to find opposition. One of the few articles, Sex Offender Treatment, that labeled itself as con posed the question, how successful is successful enough to warrant imposing this penalty on felons then gave statistics showing a success rate of 94.7% for heterosexuals, 86.4% for homosexuals and the lowest number of 73.5% for rapists. This study was done over a 17 year period involving 5000 offenders. The argument here is whether this is successful enough?? I will cover these statistics further when I argue pro castration. Of course no constitutional and moral argument would be complete without the input of the American Civil Liberties Union, who, by no real surprise, do find that chemical castration is cruel and unusual punishment. A.C.L.U. compares chemical castration to the eugenics period in America when the mentally retarded and mentally ill were surgically sterilized to prevent procreation of a less than desirable trait and to prevent unwanted pregnancies for those who could not be responsible for birth control or those taken advantage of in facilities. The A.C.L.U. also claims that this method of control can not possibly work since the origin of the problem is not organic and also that unwilling subjugation does not make for success. In agreement with the A.C.L.U. is an article titled Close Up, California Mandates Chemical Castration. This article cites potential pitfalls for this method of treatment due to the fact that chemical castration does not address the underlying psychological defects and the need for therapy. This article views the problem as not a sexual drive but an anger and power issue, it goes on to state that to take an already embittered, volatile person and make him unwillingly submit to this treatment can only exacerbate a bad situation to a much more dangerous one. Finally stated as a cause to not use this method of treatment [or punishment] are the

arguments regarding possible side effects which include breast growth, headaches, weight gain and a lowered sex drive Conclusion Most medical experts agree that, under proper conditions, the drug can be an effective rehabilitative tool for a narrow category of sex offenders. Consequently, there is no reason to propose an absolute ban on the use of antiandrogen drugs as an alternative to incarceration for some convicted sex offenders. However, we can do far better than Floridas new chemical castration statute. The Florida legislature, in its haste to address a serious societal problem, has enacted a statute that not only ignores sound medical judgement, but is probably unconstitutional as well. In any other context, the action of the Florida Legislature would be deemed practicing medicine without a license. Although chemical castration is not the perfect solution to inhibit child molestation, it discourages sexual assault better than incarceration. Injections of Depo-Provera decrease the aggressive tendencies that lead to rape in males. Castration also discourages sexual fantasies and eradicates sexual obsessions. chemical castration should be encouraged as an alternative to prison for male child molesters in order to stop recidivism and decrease instances of sexual assault. coupled with therapy and monitoring a very viable solution to the dilemma the world faces of how to deal with these crimes in a fashion beneficial to both society and the offenders.

References
1)Castration Works an article by Susan Feinstein for 212.net regarding the implications of chemical castration on pedophiles. 2)Chemical Castration Law May Backfire, Experts Warn an article off the ACLU Newswire from September 18, 1996. 3)Convict Who Had Chemical Castration Gets 40 Years For New Sexual Attack the Roswell Daily Record Online, February 4, 1999. 4)Is Chemical Castration an Acceptable Punishment For Male Sex Offenders by LaLaurine Hayes for the online database "Sex Crimes, Punishment and Therapy" constructed by students in a Psychology course at California State University Northridge. 5)High Testosterone Levels Linked to Crimes of Sex, Violence Volume 1 No. 3, 1995, pg. 2.

6)Repeat Sexual Offenders Must Face Chemical Castration an article prepared by Crystal Hutchinson, a student at Monroe Community College in New York State. 7)Chemical Castration: A Strange Cure for Rape from the Kudzu Monthly, an e-zine popular among the Southern States. 8)Dr. Robert Girard in a scientific study on factors that contribute to criminal conduct, in an article by Susan Feinstein chronicling the effects of chemical castration as posted on 212.net. 9)http://en.wikipedia.org/wiki/Chemical_castration Wikipedia, the free encyclopedia Chemical castration From

10)http://bmj.bmjjournals.com/cgi/content/full/313/7059/707/a Chemical castration for paedophiles approved 11)http://inst.santafe.cc.fl.us/~bkramer/chemical.htm Norra Macready, freelance journalist, Irvine, California 12)http://www.aclufl.org/about/newsletters/1997/chem.cfm Chemical Castration: A Return to the Dark Ages By Larry Helm Spalding Legislative Staff Counsel, August 1997 13)Chemical Castration: The Benefits and Disadvantages Intrinsic to Injecting Male Pedophiliacs with Depo-Provera Katherine Amlin http://serendip.brynmawr.edu/biology/b103/f02/web1/kamlin.html