Voluntary Surgical and Chemical Castration of Sex Offenders

Running Head: Voluntary Surgical And Chemical Castration Of Sex Offenders 1

Voluntary Surgical and Chemical Castration of Sex Offenders 7

Voluntary Surgical and Chemical Castration of Sex Offenders

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CHAPTER 3
3.0 Introduction
Over the years, some countries have adopted castration as a way of controlling and managing the behavior of sex offenders. Castration as a punishment has been embraced in response to both repeat sex offenses as well as offenses which are rated as brutal rape and murder. For example, the Indonesian president, Joko Widodo, endorsed a decree authorizing chemical castration among convicts of child molestation and defilement and requiring the offenders released on parole to wear electronic monitoring gadgets (Bradford, 1985). Other countries including Germany, Denmark, South Korea and Poland have legalized castration as a penalty for dangerous sex offenders. In the United States, laws governing chemical and surgical castration of sex offenders have been enacted over the years. Some of the States legalizing chemical castration as a punishment for sex-related offenses include California, Iowa, Georgia, Texas, Florida and Montana. However, there has been a debate on whether the methods for castration can prevent future sexual crimes (Bradford, 1985). Various researches have been conducted on the effectiveness of chemical and surgical castration. Non-governmental organization and human rights groups have also expressed their concern on the controversies surrounding castration as a punishment for sex offenders (Bradford, 1985).
This work aims at examining theoretically and morally the problem that is the treatment of surgical and chemical castration of sex offenders. The work, methodically, integrates different research studies to obtain more quality information about the surgical and chemical treatments effects on sex offenders. Simultaneously, the research approach focuses on findings from multiple studies, putting together the different results of the studies, summarizing the outcome and collecting general statements, evidence and results about the cause-and-effect relationship between the surgical and chemical treatment, and the sex offender sexual urge and recidivism.
The work also discusses, in details, the findings of the various studies, compares them and from that, answers the question of the survey, which is whether or not the “voluntary” surgical and/or chemical castration of sex offenders is effective and/or has an impact in reducing recidivism in future offenses. The summary results of previous studies help shape the effectiveness of the treatment of surgical and chemical castration of sex offenders (Bradford, 1985).

3.1 Analysis of the Effects of Chemical Castration
3.1.1 Chemical castration
Chemical castration involves the suppression of testosterone hormone, which is responsible for about 90% of sex drive, in sex offenders using drugs. Chemical castration leads to temporary impotence, reduced, libido, sex drive and sexual activity (Douglas et al., 2013). According to studies, chemical castration is a reversible process as normality can be attained when the dosage of the drugs is discontinued. However, some studies assert that sex offenders subjected to this process undergo permanent change in body chemistry which is sometimes manifested as bone density loss, especially for those administered with Cyproterone and Medroxyprogesterone (MPA). Despite these effects, chemical castration is offered on pedophiles and rapists in return for reduced sentences (Douglas et al., 2013). Despite being applied as a punishment, chemical castration is appreciated for its effectiveness as a therapy for prostate cancer. If administered well through the prescription of the right drugs, dosage, and intervals, chemical castration is a safe and efficient method of sexually incapacitating rapists and other sex offenders (Douglas et al., 2013).

3.1.2 Effects of chemical castration has on sex offenders (and others)
Chemical castration is known for its effectiveness in reducing sexual drive, sexual arousal, and compulsive sexual fantasies. In this method, life-threatening effects are rare, although some incidences of reduced bone density and increased body fat have been reported. Sex offenders who have undergone the process are prone to risks of long-term health conditions such as osteoporosis and cardiovascular diseases. Male Sex offenders subjected to this method of castration also have been reported to develop enlarged mammary glands. In women sex offenders, the effect of enlarged mammary glands has also been reported although little is reported about lowered sex drive. However, anti-androgenic hormone regimens lower testosterone in females which leading to decreased sexual response or sexual drive (Druhm, 1997).
The primary effect of chemical castration for female sex offenders is deflation of breast glands and expansion of size and nipples. Some researchers have reported diminished bone mass, lips discoloration, reduced muscle mass and body hair. Morally and behaviorally, chemical castration leads to lowered self-esteem, self-denial, and solitude. This arises as a result of stigmatization from the society (Furby et al., 1989). The society stereotypes an impotent man as physically challenged, outcast and totally incapacitated. The level of stigmatization is usually high in primitive societies as compared to the enlightened ones. The physically challenged man is highly ridiculed and looked down upon, a thing which greatly deflates one’s ego and self-esteem. Studies have highlighted that most sex offenders who undergo this process prefer it is done confidentially and that the act is not released to the public domain (Druhm, 1997).

3.1.3 Is it safe?
Chemical castration is a safe process only if administered by qualified health professionals. That is, it is necessary for the prescription of the right drugs, and the right dosage. Health professionals conduct chemical castration via the recommended procedures. The process is known to be simple and fast as compared to surgical removal of the testes which lead to permanent effect. Drugs are also administered at regular intervals to suppress the level of testosterone and hence infertility. Therefore, although it sounds scary, chemical castration is straightforward and safe process when performed by professionals. Chemical castration is not only applied as a punishment or a ritual but also widely practiced as a therapy for advanced prostate cancer. This allows control of cancer cell growth (Furby et al., 1989).

3.1.4 Does it work?
The effectiveness of castration in preventing future sexual offenses and recidivism has been highly doubted. For example, offenders who undergo chemical castration where their testosterone hormone is dramatically reduced can boost the hormone using drugs and therefore recover from the imposed sterility (Bradford and Pawlak, 1993). Despite this drawback, chemical castration has been embraced by some societies while other companies are on the verge of legitimizing it as a penalty for sex offenders. The work will highlight some of the weaknesses of castration and how it is ineffective (Bradford, 1983).
3.1.5 Arguments or ideas from others who have done this
According to Bradford and Pawlak (1993), proponents of chemical castration, chemical castration leads to a significant reduction in relapse rates in sex offenders’ behavior. He believes that the process is more ethical and morally acceptable that long-term sentence, which is usually attached to sex offenses. He also cited this method as more humane than surgical castration, which leads to permanent incapacitation. However, opponents of chemical castration including Miller (1998) have raised concern over the constitutionality of the practice. For example, it is argued that subjecting an individual to the procedure is a violation of one’s constitutional rights besides predisposing the individual to the associated side effects. Other researchers claim that both sides are valid provided that chemical castration is officially constituted and, made a voluntary procedure and carried out in the correct and recommended manner by qualified health professionals. It is recommended for counseling and awareness services be availed to the sex offenders before chemical castration is administered. This, for example, will help the offenders to make a voluntary choice of either serving a long-term sentence or undergoing the sterilization procedure (Furby et al., 1989).
3.2 Analysis of the effects of Surgical Castration
3.2.1 Surgical Castration
Surgical castration involves the removal of the testes through incisions. This is because 95% of testosterone is produced in the testes. Surgical castration has been in used for centuries as a social control means and treatment of prostate and testicular cancer. For example, castrated men were used as guards in women quarters used as chamberlains in ancient cultures. According to Norman (2006), young male choir members were castrated as they attained puberty to prevent the deepening of their voices. In the ancient societies such as Indiana, male prisoners charged with sex offenses were surgically castrated to reduce their sexual urge. This act was aimed towards reducing recidivism of the prisoners (Furby et al., 1989).
Surgical castration is highly criticized due to its reversible side effects. Human activities and other organizations regard surgical sterilization as barbaric and inhuman. This is because it leads to permanent sterilization, physical changes and psychological instability (Pawlak, 1993).
3.2.2 Advantages and disadvantages of the use of Chemical Castration on sex offenders
3.2.2.1 Advantages of chemical castration
Chemical castration is a safe procedure and an efficient method for suppressing libido and sexual activity. The drugs administered to the individual undergoing this kind of castration are known to reduce dramatically the level of testosterone which is produced in the testicles thus leading to reduced sexual urge without tempering with the individual’s ability to have sex. That is men who have undergone chemical castration can still have sexual intercourse although their sexual desire is significantly reduced (Norman, 2006).
Chemical castration is celebrated for its ability to reduce recidivism. According to major studies contacted on regarding chemical castration in male sex offenders, there is a dramatic decline in relapse rate. Pawlak (1993) argued that recidivism rate among offenders undergone chemical castration is 2%, a remarkably low value compared to the 40% without chemical castration (Norman, 2006).
Chemical castration leads to a reduced incarceration term. That is, in many states, offenders subjected to chemical castration are often released earlier from prisons, and thus their incarceration terms are remarkably reduced.
3.2.2.2 Disadvantages of chemical castration
Some studies have indicated that chemical castration can pose devastating health effects. Although the consequences of the process usually fade away after treatment is halted, its side effects may thrive over time. Some of the health effects include increased body fat and reduced bone density linked to osteoporosis and muscle mass loss. Increased body fat is associated with heart diseases. Studies have also cited other side effects such as impotence, mood swings, hot flashes, anemia and increased breast size.
Chemical castration is known to violate human rights of the sex offenders. This is so, especially when administered without the consent of the criminal. Opponents of chemical castration argue that forcing offenders to undergo the process violates the offenders’ constitutional rights. This is because the process may render them incapable of having the sex drive and unproductive. However, some offenders voluntarily prefer chemical castration to an indefinite sentence.
Chemical castration can be relatively costly. This is because the effects of the drugs need to be administered frequently and repeatedly. Moreover, the offenders need to visit the health professional regularly and follow up a dosage schedule. This might be inconveniencing and sometimes not feasible (Norman, 2006).
3.2.3 Advantages and disadvantages of the use of surgical castration of sex offenders
3.2.3.1 Advantages surgical castration
Surgical castration remarkably reduces recidivism. This is because the removal of the testes leads to a permanent loss of sexual function. According to some studies contacted on regarding surgical castration in male prisoners, there is a dramatic decline in relapse rate. Pawlak (1993) argued that recidivism rate among offenders undergone surgical castration almost zero, compared to the 40% without any form of sterilization.
Just as chemical castration, surgical castration leads to a reduced incarceration term. That is, upon undergoing the process, sex offenders enjoy early release earlier from incarceration.
Surgical castration is also fast and quick method. It doesn’t involve the hectic adherence to doctor’s appointments for drugs as in chemical castration. The procedure is carried once and for all. Also, rather than being applied as a punishment too for sex offenders, surgical sterilization has been used with success in metastatic cancer patients. The removal of the testes helps treat the spread of testicular cancer (Norman, 2006).
3.2.3.2 Disadvantages of surgical castration
Surgical sterilization is associated with devastating side effects. The procedure leads to changes in physical appearance such as loss of body hair. In some instances, a male body softens akin to that of a female. Increased body weight among individual undergone through this process increases risks of conditions such as hypertension, cardiovascular arrest, and other heart diseases. Psychological effect has been reported as rampant among individuals. This effect manifests itself as withdrawal, isolation, depression and, in some cases, suicide.
Unlike chemical castration, surgical sterilization is a permanent procedure which is not reversible. Upon undergoing this process, an individual can not only have the sexual drive but also it becomes impossible for the individual to bring forth children. Studies have shown that, due to this fact, the process is considered unethical and against human rights in some countries (Schwartz, 1994).
Although is a one-off practice, surgical castration is costly. This is because in involves a major surgery which calls for an expert for the successful outcome. The fact that surgical castration is irreversible makes it less practiced as compared to chemical castration. For example, while chemical castration can be used as a rehabilitation process in which it is discontinued upon cognitive, and behavioral changes are installed to the offender, surgical sterilization is a total sexual incapacitation and therefore less preferred (Norman, 2006).

3.2.4 Effects of surgical castration on sex offenders
There are some side effects of surgical castration. For example, the procedure is associated with the change in physical appearance. That is, the individual usually loses body hair, and their skin becomes tender akin to that of a female. In some instances, persons who have undergone surgical castration report increased body weight.
Surgical castration leads to changes in organs. Studies have reported that there are usually changes in calcium content in the bones. This subsequently results in reduced hemoglobin levels and loss of body protein (Schwartz, 1994).
The psychological effect is a common phenomenon among sex offenders who are surgically castrated. Some studies assert that the most disastrous effects take place on the psychology of the individual. The individual appears withdrawn, suffers reduced self-esteem, depression, and prefers seclusion. Adverse psychological effects may lead to suicide. Since the surgical procedure is a permanent and full of side effects, it uses in habitual sex offenders has raised ethical issues (Schwartz, 1994).

3.2.5 Is it safe?
Just like chemical castration, surgical sterilization is a safe procedure if undertaken by qualified health professionals. It is a healing process which involves removal of the testes which is responsible for the production of testosterone in male offenders.

3.2.6 Does it works?
Surgical castration is known to be an efficient and permanent method of sexual sterilization. Offenders who undergo surgical castration where their testes are surgically removed are rendered completely incapacitated (Bradford and Pawlak, 1993). Although the surgical practice is embraced in some States, there has been a significant opposition from civil societies, researchers and psychologists are as they argue that the act is inhuman and barbaric (Bradford, 1983).
3.2.7 Arguments or ideas from others who have done this
For those who oppose surgical castration, the argue that it is a crude way of managing the behavior of sex offenders. For example, the American Civil Liberties Union have been lobbying against the practice referring to it as a cruel and unusual punishment. They also assert that surgical castration is the most controversial and severe as compared to other forms of managing behavior among criminal. Pawlak (1993) argues that surgical castration is not a quick method of reducing recidivism, and that doesn’t work for everyone. According to Fred Berlin, surgical sterilization is mostly like to be useful for offenders who are motivated to commit the crime by their sex drive. These offenders include pedophiles and those aroused by coercive sex. However, he warns that the practice may not be sufficient for offenders who commit sex offenses for other reasons. For example, those who lack conscience or abuse alcohol and drugs would not benefit from this practice (Schwartz, 1994).
3.3 Problems, Weaknesses, and Solutions
Studies related to the topic have found that castration the act of castration as punishment for sex offenders is wrong and ineffective. For example, it limits reproduction which is critical for the continuation of generation. A physically challenged man also leads an abnormal life full stigmatization and cultural contempt. Testicular and prostate cancer studies reveal that although sexual urge is reduced by orchiectomy, the ability to have an erection in response to sexually stimulative material is not alleviated. Studies have shown that surgical removal of male testes from a sex offender does not render the individual totally incapacitated since some testosterone may be produced in the walls of the urethra of the penis. Surgical castration is also not considered as a standard way for reduction of recidivism.
However, some prisoners convicted by law of sexual offenses prefer castration as an option to be released to the community (Furby et al., 1989). Sex offenders are also driven by aggression more than sex drive and therefore castration becomes ineffective. Research has also shown that an individual can commit rape without necessarily having an erection. For example, women commit a crime against both women and men and therefore no need to lower levels of testosterone. Rape can also be committed using fingers. Finally, a chemically castrated offender can reverse the condition by using drugs. Rather than castration, the sex offender should be subjected to cognitive and behavioral treatment programs aimed at prevention of recidivism (Furby et al., 1989). For example, the offender may be put in rehabilitation program where both cognitive and behavioral change is administered. This method has worked with promising results in some countries. That is, rather than rendering the offender incapacitated, the programs promote activities and programs which transform the offender into a useful member of the society (Schwartz, 1994).
According to Fred Berlin, castration is effective for offenders such as pedophiles and those aroused by coercive sex as they are motivated to commit a crime by their sex drive. However, the practice is an ineffective method for offenders who commit sex offenses for other reasons such as lack of conscience and abuse of drugs (Schwartz, 1994).
3.4 Alternative Plans and Positive Aspects of Chemical and Surgical Castration
According to research, there is a significant correlation between castrations and recidivism among sex offenders. However, sex offenders who undergo both voluntary and involuntary sterilization still uphold the tendency of repeating the offense once more. Researchers have therefore supported the notion of using other methods to instill behavioral change rather than the cruel and inhuman act of castration (Schwartz, 1994).
Rehabilitation has been cited as the most efficient alternative method. This is because the offenders are put under programs which involve counseling and physical activities geared towards both cognitive and behavioral change. For example, it has been found that most sex offenders are motivated by aggression and not sexual drive. Studies have shown cases where sex offender use hands to perpetrate rape. Also, from the cancer patients who undergo tests removal, they still experience significant sexual urge. The majority of the patients experience healthy erection and therefore, are sexually active regardless of their medical condition. Therefore there is the need to transform them into useful members of the society without necessarily incapacitating them. Rehabilitation has the advantage of instilling positive values, integrating them into the society and making them lead a normal life after that. Unlike castration, recovery does not pose any side effects to the offenders (Schwartz, 1994).
Reducing the severity of sentences attached to rape and sexual assault in some States can drastically lessen the preference of castration among sex offenders. For example, in California alone, 15 sex offenders have requested for castration as a way of avoiding long-term incarceration. Regarding this, studies have revealed that the rampant cases of sterilization are found in countries with strict and severe legislation’s underlying sex offenses. If such laws are amended and penalties moderated, sex criminal will no longer opt for castration. This will enable them undergo the relatively short-term sentence and ultimately, attain freedom and get integrated into the society as a changed and good members of the community (Schwartz, 1994).
Campaigns and public education on the peaceful coexistence of humanity can drastically reduce sex offenses, which culminate into castration. This is because most of the sex offenders opt for castration as a way of avoiding indefinite incarceration. Most of them are ignorant of the side effects of castration. Therefore, if the public is enlightened on the side effects of castration and the need to respect sex and thus avoid indulging in activities which promote rape and sex offenses, there would be reduced cases of sterilization. This method also has the significance of being safe and without any form of side effects.
Finally, a currently a fashionable alternative solution is the introduction of the “sexual predator law” in other states. The law has been existing in the Washington state. According to this law, upon completion of sentence, the offender is critically examined to determine if he is dangerous to the society. If found dangerous, the offender is retained until he is harmless to integrate into the society. This means that the completion of the sentence does not a determinant of release from prison but cognitive and behavioral change among sex detainees. This method could dramatically reduce recidivism. It is safe and does not pose side effects (Schwartz, 1994).

CHAPTER 4
4.1 Risk reduction
Recidivism has been a difficult concept to instill among sex offenders. This is because few cases are reported to authorities and the private nature of sex crimes. Sufficient research should, therefore, be conducted to determine the actual rates of recidivism and how the society can be safe from sex offenders, child molesters, and burglars. For example, it has been confirmed that the observed recidivism rates are not the real reoffense rates. This means that the magnitude of the gap between the actual and observed rate of recurrence is still very high (Zonana et al., 1999).
This, therefore, shows that the practitioners and policymakers should provide an imperial basis for the understanding of known risks posed by varied types of convicted sex offenders. Both policy makers and practitioners should also highlight some of the risks posed by different methods of castration and provide a basis and bright conditions under which castration is necessitated (Zonana et al., 1999).

4.2 Criticism of Castration Statutes
4.2.1 Common criticism of castration
Some critics maintain that malicious reasons for the government to enforce sterilization policies vary in both purpose and intent. For example, sterilization policies are implemented to manage population growth, as genocide act against minorities, to alleviate reproduction among the mentally challenged people, as a penalty for sexual offenders, among other reasons (Zonana et al., 1999). Criticism surrounds castration as inhume practice and against human rights. While there are states where transgender individuals are required first to get castrated before obtaining legal recognition of their gender, the act is greatly shunned by the opponents of castration. It is feared that if castration becomes a common practice among sex offenders, it might, in future be imposed involuntarily in the sterilization of marginalized and vulnerable populations. For example, sterilization of on physically challenged people on the perception that they people are sexually inactive.
Some other critics argue that castration promotes uncivilized and inhumane practices. For example, female genital mutilation (FGM) is rampant in African countries where it is practiced on ethnic minority women and girls (Lehne, 2000). FGM is believed to significantly lower sex drive in females.
4.2.2 Ways in which the statutes of castration of sex offenders had been challenged
In the Criminal Justice system of the United States, sexual offenses include, child defilement, statutory rape, female genital mutilation, bestially, sexual assault and sexual imposition. Other sex crime laws in the United States classify less severe sexual offenses like those involving sex offender registrations (Lehne, 2000). In some states of America, unlawful incarceration of a minor, public urination and having sex on a beach constitute sexual crimes requiring registration. Critics expect that, in States where castration of sex offenders is legalized, there should be a clear legal network stipulating on instances where castration can be imposed. In some other States, governments have been challenged to allow the sex offender to make a choice on whether to serve jail term or to undergo castration upon conviction. This gives the individual the freedom to determine the imposition of castration (Schwartz, 1994).

4.2.3 Trends of sterilization statutes in the last ten years
In 1996, California emerged the first State to legalize the use of surgical and chemical castration for sex offenders released from prisons into the community. Despite the fact that it was considered controversial, other eight states passed laws for sterilization for individuals convicted of sex abuse and considered for parole and probation. Out of the eight states permitting sterilization, four legalized the use of chemical castration only. They include; Georgia, Montana, Wisconsin and Oregon states (Schwartz, 1994).
4.2.4 Researchers’ view about flaws and dangerousness of castration.
Over the last few years, sterilization has proved to most judges and state officials that it is an effective method to curb recidivism. For example, in 1999, in the State of Florida, a sex offender’s sentence was canceled after he was castrated. Across the United States, law enforcement officials are robustly experimenting other ways to deal with criminals’ libidos and help in behavioral change. This has been triggered by a warning by psychologists on the psychological and physical effects victims of castration undergo (Lehne, 2000). For example, psychologist prefers long-term sentences rather than castration in which, afterward, the individual is prone depression and perhaps suicide. Also, despite the severity of the sterilization process, researchers and even medical officers are not entirely convinced of its effectiveness. For example, it has been found that a substantial number of surgically castrated sex offenders have some levels of sexual functioning. According to Association for Treatment of Sexual Abusers (ATSA), less invasive medication therapies have the potential to achieve better or equal results rather than castration (Lehne, 2000).
4.2.5 Reasons as to why activists and legislators critique the practice of castration, and how they challenge the laws legalizing it.
Through castration, the level of recidivism has been reported to be lower than it is commonly believed. For example, a 2002 study conducted on 9,691 male sex offenders released from prisons in the United States show that within a duration of 3 years after release from prisons, cases of re-arrests and conviction for new sex offenses were 5.3 and 3.5 respectively. This translates into 1 out of 19 of released prisoners who were apprehended within three years after release (Furby et al.,1989).
CONCLUSIONS
This work has highlighted substantial reasons to conclude that surgical and chemical castration is wrong and highly ineffective. According to the data and information obtained and analyzed, most sex offenders are motivated by aggression and not sexual drive. Consequently, sex offenders who undergo both voluntary and involuntary castration still uphold the tendency of repeating the offense once more. For example, from the cancer patients who undergo tests removal, there is significant sexual urge after the operation. The majority of the patients experience healthy erection and therefore, is sexually active regardless of their medical condition. The work of Furby et al.,(1989) found that the practice of surgical and chemical castration of sex offenders is not active and thus alternative methods such as a change in legislation, public education, and enactment of sex predator laws can be embraced (Lehne, 2000).
The expected results of the study will be useful for a paradigm shift in the practice of surgical and chemical castration of sex offenders. Activists and legislators may use the data and information collected to challenge laws legalizing involuntary/voluntary sterilization. Educationists and consultants will find the data and information relevant in advising agencies and organizations on better and efficient correctional methods of sex offenders. For example, they will advocate for cognitive and behavioral corrective methods and treatment programs.
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