There's been an unexpected spike in castration-related news this week. I suppose that any news would constitute a spike, but still, there's an unprecedented two breaking news stories involving chemical castration. In South Korea, following the sensational rape and murder of a seven-year-old child, government officials are contemplating introducing harsher punishments – including compulsory chemical castration – for sex offenders. Also in the news is the case of a Sydney doctor who was banned from practicing medicine after prescribing chemical castration drugs as a "cure" for an eighteen-year-old patient's homosexuality.
So, how, exactly, do you chemically castrate someone? As we bravely rush forward into a future where sexuality can be augmented and shaped – beyond a present which features testosterone treatments and erectile dysfunction drugs for men and hormone-based drugs for women to increase libido – how do governments choose to ethically utilize drugs that alter sexuality?
If you, like me, have ever had the misfortune to fall into the seemingly endless rabbit hole of Law and Order: Special Victims Unit episodes available on Netflix (if you haven’t, it’s the offshoot where all detectives do is investigate horrific sex crimes, child murders, and pedophiles), you start to find a common thread in the actions of the police. Someone will propose an ethically-questionable or flat-out illegal technique for catching a pedophile/murderer/guest-star Robin Williams and the lady District Attorney will wail, "But what about their civil liberties?!" And then hotheaded Detective Elliott Stabler will be like, "What do you care about? Some liberal bullshit civil liberties or saving this child?"
Apologies for the diversion, but it's actually an appropriate use of my otherwise useless knowledge of the SVU canon. Today, when someone says, "sex offender," the rest of us react like Stabler. We want to take the perp down; we'll think about their civil liberties later. But there’s a huge difference between quasi-legal entrapment on a TV show and radically altering someone’s body and psyche via drug therapy at the state’s discretion.
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Doctor John Money first employed chemical castration in the United States in 1966. He prescribed medroxyprogesterone acetate (MPA) for a man struggling with pedophilic fantasies. MPA is the base drug in the commonly used hormonal contraceptive Depo Provera, and MPA-based chemical castration has been used in the United States since '66. In 1996, California was the first state to introduce legislation including compulsory chemical castration. The law stipulates that sex offenders convicted of an offense against a child under the age of 13 may be treated with Depo Provera when on parole. If it is their second offense, they may not have the option to reject the treatment. Florida followed suit with a similar statue in 1997 and at least seven other states – Georgia, Iowa, Louisiana, Montana, Oregon, Texas, and Wisconsin – have experimented with chemical castration.
Depo Provera contains synthetic progesterone, a female sex hormone used to prevent pregnancy in women. The drug works in chemical castration by diminishing testosterone levels, leading to a decrease in sex drive and aggressive behaviors. The drug seems to have had some impressive results where it's been used. Recidivism rates are notoriously high for sex offenders, and one study found that rates dropped from 80% recidivism for the untreated study participants to 2.4% for surgically (not chemically) castrated participants.
Chemically castrated individuals also show lower recidivism rates, but chemical castration is compliance-based, even when legally mandated, as individuals have to take their medications as prescribed or show up to receive injections of the castrating drugs. Joseph Frank Smith famously underwent voluntary chemical castration in the 1980s after a conviction for child molestation and became a vocal supporter of the treatment. At some point he stopped taking the castration drugs and was convicted of molesting a five-year-old girl in 1998.
Treatment with serotonin reuptake inhibitors has shown some efficacy in reducing compulsive sexual behaviors, notably in diminishing unwanted or undesirable fantasies, though this is more of a pharmacological chemical augmentation than an actual castration.
In Europe, the antiandrogen drug cyproterone acetate is used in chemical castration. In 1952 computer scientist Alan Turing underwent chemical castration to avoid imprisonment. Turing wasn't a sex offender; he was gay, and at the time homosexuality was illegal in Great Britain, thought of as a mental disease that could be "cured." Turing died two years later of cyanide poisoning, which was apparently suicide. The gay New Zealand man at the center of the Australian controversy was prescribed CPA after coming out to his church's minister, who suggested he go on the medication to free him of the temptations of his sexuality.
So, is chemical castration ethical in certain cases? If so, how do governments implement the use of these powerful drugs? The ACLU opposes compulsory chemical castrations, deeming it "cruel and unusual" punishment. Today, like lawmakers, we're tasked with weighing the high recidivism rates and their possible consequences against the idea that a person's sexuality is theirs to enjoy and control. It's also difficult to predict the outcome of enforced chemical castration. In the future, will prospective pedophiles, those who have experienced pedophilic urges but have not acted upon them, also be deemed too dangerous to remain hormonally intact? It’s possible, as compulsory medication has the potential to extend to other areas of society. There are already provisions for mandatory medication compliance for schizophrenics in 42 states in the US; it seems likely that medication compliance laws could extend to other mental illnesses as well.
The compulsory medication of certain sectors of society seems to be a quick fix to difficult problems, and it no doubt helps many sleep better at night. We're a culture that seeks out pharmacological wonder solutions to very deep-seeded problems. It can also be hard to argue against state-mandated chemical castration without someone saying you’re sympathetic to sex offenders, which I most assuredly am not. But I will always be skeptical about any policy that oversteps the bounds of our rights to our own bodies.
Follow Kelly Bourdet on Twitter: @kellybourdet.