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Says psychiatrist Berlin of Burchett's proposed requirement: "I think there's a subgroup [of offenders] who want it and need it. I'd mandate its availability, but I have significant reservations [about] mandating its use."

According to Franklin Zimring, professor of law at the University of California at Berkeley, there isn't a lot of academic research on the subject. "There aren't any good impact studies on the outcomes that I'm aware of," he says. "None of the clinical experiences points to involuntary studies in a coercive environment. How many people have been subjected who were not volunteers and what were the outcomes?"

Despite the laws already in place in eight states, and cases documenting drug treatment's effectiveness, there remains a split in the legal and medical communities. Most feel the treatment can be helpful if a patient is amenable to it. "I don't know if it's a deterrent," says Burchett, "but if someone wants to get help, this is something that can help them."

The word "castration" evokes haunting images of men strapped to a table, heavily anesthetized and fearing for their life. Just the mention of the word makes men wince and women giggle. To be sure, physical castration and chemical castration both have the same goal: to stop the production of testosterone, which is considered by mental health experts to be one of the sources of sexually offensive or aggressive behavior. Surgical castration involves removal of the testes, after which it is possible but unlikely for a man to have an erection, and his sex drive is considerably lowered. Chemical castration -- also called sexual suppression -- entails taking a drug that inhibits or reduces the production of testosterone. Again, the patient can still "perform," but his drive is considerably lowered. (In the handful of women convicted as sex offenders, similar drugs would merely act as oral contraceptives.)

Citing cases like Coleman's and the nationally publicized case of Robert Komarenski (who, in 1992, begged the courts after he completed his sentence for sexual molestation to put him on testosterone-reducing drugs and has since been virtually cured), Berlin argues that counseling is key to determining who appropriately qualifies for drug treatment. Says Liz Schroeder, associate director of the ACLU in Southern California, "Not all sex offenders are pedophiles. The drug may work on a pedophile, but it's unlikely to work against sadists. Counseling is imperative. It's one of these legislative fixes that hasn't been thought through."

Even if it hasn't been sufficiently thought through, the use of chemical castration on pedophiles in the United States dates as far back as the mid-'60s. Drugs such as Depo-Provera and Depo-Lupron have been and are being used in efforts to stop crimes before they happen. Explains Berlin, "In layman's terms, with chemical castration you are providing people with a sexual appetite suppressant."

Europeans have employed surgical and chemical castration since before the time Hitler. Berlin points to a well-known study conducted in Scandinavia over a 30-year period that demonstrated significant results. Among the more than 900 sex offenders in that country who underwent surgical castration, the recurrence of sexual offenses was less than 3 percent. This is a staggering figure when compared with some American studies showing that as many as 50 percent of sex offenders who are released commit similar crimes again. Yet statistics on the subject are few and far between.

"In general, there's a 16 percent recidivism rate across the country," says Zimring, who notes that when the California law was first put forth, Gov. Pete Wilson said the rate was much higher. "Wherever [the subject] has been studied in the Western world, sex offenders and child molesters have the lowest recidivism rate, next to burglars and thieves."

Dr. Richard Krueger, medical director of the sexual behavior clinic at New York State Psychiatric Institute, has been treating sex offenders since the mid-'80s. He is currently preparing a symposium on treatment of sexual offenders to present before the American Academy of Psychiatry Law meeting in October in Vancouver, Canada. In the past, he has prescribed testosterone-reducing drugs to patients, but only after the patient's request.

"Usually these laws are framed in a mandatory way," Krueger says. "The medical association has taken the position that it's unethical to administer medications without written consent." When asked about the Tennessee bill, Krueger offered no opinion.

Who should qualify for chemical castration in the United States is a hotly argued issue. In the first place, legal and medical professionals differ in their definitions of what a sexual offense is. According to the Family Research Council, sex crimes against children include rape, sodomy, intimate touching, exposing oneself, voyeurism, forcing a child to engage in prostitution, pornography and live sex performances. Crimes against women include many of the same behaviors.

Yet many sex crimes committed against children are labeled molestation instead of sexual offenses. There's also confusion over the difference between a child molester and a pedophile, not to mention a sadist. According to the American Psychiatric Association, a pedophile can be successfully treated with drugs like Depo-Provera, but a sadist (a person who acts out against written laws just to break them) is not a good candidate for chemical castration.

In May 1999 and in January of this year, the Tennessee bill was deferred by the judiciary committee. It is now under consideration once again. Burchett reports that funding is the main problem, not a lack of support. The fear of many in the Tennessee Senate and House is that administration of the drugs will be too costly to the state. "They think every offender who gets the drug each month will eventually hop on welfare, and then we pay for it," says Burchett. But there's an amendment in the bill, he says, that would make offenders pay for treatment themselves (at a cost of as much as $500 per monthly injection).

Regardless of the bill's outcome, the Tennessee Senate will need to consider closely how it will handle convicted sexual offenders in the future. "What I'd like to do is pass the law and then implement the program," Burchett says. "I hear horrible stories about 12-year-old kids. We've got to do something because we're not doing anything. We're locking them up and letting them out."

In a 1992 interview with the Los Angeles Times, convicted offender Komarenski said the results of taking the testosterone-reducing drug Depo-Lupron were startling. "My sex drive is practically zero," he said. "It works. It really works."
salon.com | March 1, 2000

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