Chemical Castration Condition for Parole in Alabama

[J.Adderton]

Alabama’s Governor, Kay Ivey, signed a controversial bill requiring “chemical castration” as a condition of parole for people convicted of certain sex crimes. Alabama joins eight other states with similar laws enacted to reduce the risk of convicted sex offenders committing similar crimes after release from prison.

What will Alabama Require?

People convicted of certain sex crimes, including rape, sodomy or incest, involving victims younger than 13 years of age will be required to undergo chemical castration. Sex offenders eligible for parole will be required to:

• Take a testosterone inhibiting or other hormones to lower sex drive
• Start receiving treatment 1 month prior to their release from prison
• Most offenders will be required to pay for treatment
• Continue taking the medication until a judge rules it is no longer needed
• Treatment will be administered by the state’s Department of Public Health
• Intentionally stopping treatment will result in a felony

At this time, it is not known how many Alabama sex offenders tthe law will affect.

About Chemical Castration

Chemical castration involves administration of pharmacological agents to reduce testosterone to a prepubescent level. The goal is to suppress the offenders sexual urges and assist in suppressing sexually deviant thoughts and behaviors. Medroxyprogesterone acetate (MPA), the active ingredient in Depo Provera, and cyproterone acetate are commonly used drugs. They have the following affects:

• Lower testosterone levels in men
• Lowers sex drive
• Reduce ability to become sexually stimulated
• May lesson aggression in men

What Other States Have Castration Laws?

In 1996, California became the first state to set requirements for chemical castration for sex offenders. Since then, eight other states, including Alabama, have enacted similar laws. These states include Florida, Georgia, Louisiana, Montana, Oregon, Texas and Wisconsin.

What Are the Pros?

The most relevant advantage of chemical castration is the contribution to public safety. Research has shown chemical castration substantially lowers recidivism rates (the tendency of a convicted criminal to reoffend) to 2% from 75% of sex offenders left untreated. In addition, it costs less to treat sex offenders through chemical castration than to house in a prison facility. Lastly, offenders can reenter society and be a productive member with an increased level of supervision that would not be received without chemical castration.

What are the Cons?

Critics opposing chemical castration have both medical and societal concerns. Since the effects of the medication is temporary, repeat administration is needed and treatment is costly. Other concerns include:

Medical considerations

The drugs used for chemical castration can have serious side effects.

• Lower estradiol levels leading to osteoporosis
• Cardiovascular disease
• Impaired glucose metabolism
• Impaired lipid metabolism
• Depression
• Hot flashes
• Infertility
• Anemia
• Weight gain
• Decreased muscle mass

The side effects may increase in relation to the duration of treatment. Also, the cost of treatment may not make follow-up and on-going treatments financially feasible for some.

Ethical considerations

There are several key arguments against chemical castration of sex offenders.

• Not all sexual offenses against children are of pedophilic interest and the treatment would not be effective (i.e. crimes of opportunity or the offender has an antisocial personality)
• The treatment is not effective on women, who account for about 7% of registered sex offenders
• The law constitutes cruel and unusual punishment by forcing people to change body chemistry as a condition of parole
• Alabama’s law requires a judge, not a physician, to explain the treatment and side effects to the convicted sex offender, therefore, raising questions of informed consent.
• Concerns that a sex offender could potentially be “coerced” into agreeing with chemical castration

Alabama’s law will go into effect on September 1, 2019. It is unknown how many inmates will be affected by the new law.

What are thoughts on Alabama’s new law? Do you have a for or against argument to share?

Resources:

What to Know About the Chemical Castration Law

Coercion, Incarceration, and Chemical Castration: An Argument From Autonomy

Chemical Castration for Sex Offenders: Physicians View

[myoglobin, ASN, BSN, MSN]

I'm not sure about the legalities of this particular case. But, I actually sought Androcur from several MD's as a teenager when I was losing my hair to male pattern baldness. My reasoning was that there was evidence that it would arrest (and potentially reverse hair loss), lower my chances of dying of prostate cancer like my father, and reduce my interest in girls thus facilitating more time and money to be spent on study. Not to mention needing to shave less. Weight gain doesn't have to be a problem if you practice IF, a ketogenic diet and work out daily. According to what I read you could still have kids if you stopped the drug for a time (or banked your sperm ahead of time). I found it frustrating that people who wanted to be a different sex could in some cases have their procedures paid for by insurance (even Medicaid in some cases) and get hormone therapy. However, I just wanted the drug to better "focus" and no one seemed to think that "wanting to reduce sex drive" was a viable goal. Still frustrates me that I see commercials on TV for plenty of drugs to increase sex drive, but none to diminish it. Indeed, when I see clients in clinic complaining that their Zoloft "makes them feel great", but wreaks their sex drive I have to restrain myself from saying "but have you considered the positive benefits of a lower sex drive". At one time a lower sex drive was considered a "worthy goal" for everyone (indeed it is part of why cornflakes were invented). I'm not saying it is for everyone, but it should certainly be an option especially for those who have proven that their sex drive contributes to public safety issues.

[NurseBlaq]

2 hours ago, adventure_rn said:

To be fair, this practice was started in California according to the article. I'm actually kind of surprised to see that such a controversial practice has been adopted in some of the most progressive states (CA, OR) as well as the most conservative states (TX, LA, GA) in the country. I wouldn't think that CA and OR would be on board with this type of legislation.

I feel link bringing attention back to Alabama over and over again is just to try to make the article relevant with the current news cycle, even though this practice has been going on for two decades.

I live in Alabama and they've been passing dumb laws recently and Kay Ivey has been super excited to sign them. That's why I said AL strikes again.

[VivaLasViejas, ASN, RN]

I don't think pedophilia or rape are things that can be eradicated with drugs. Most rape, including child rape and molestation, has more to do with power than sex, and you're not going to fix that by giving an offender chemicals to reduce their sex drive. I'd much rather see them rot in prison for the rest of their miserable lives than take the chance that drug treatment doesn't work, or that they don't stay on the meds, or that the treatment fails to minimize their lust for power and control over their victims.

[myoglobin, ASN, BSN, MSN]

2 hours ago, VivaLasViejas said:

I don't think pedophilia or rape are things that can be eradicated with drugs. Most rape, including child rape and molestation, has more to do with power than sex, and you're not going to fix that by giving an offender chemicals to reduce their sex drive. I'd much rather see them rot in prison for the rest of their miserable lives than take the chance that drug treatment doesn't work, or that they don't stay on the meds, or that the treatment fails to minimize their lust for power and control over their victims.

I think there is good evidence that there is also a sexual drive aspect to molestation. Just consider the enormous amount of pedophilia related Mediaography that is seized each year and the many charges brought based upon this. Also, consider the shows like "To catch a Predator" which detailed hundreds of men who sought to arrange sexual contact with (what they believed) were underage children. In these cases the motivation is clearly sexual. Therefore, it is not unreasonable to believe reducing sexual desire may reduce recidivism and there are studies to support this view http://jaapl.org/content/33/1/16#sec-18 (although these studies acknowledge that the data set is small, it is not a complete elimination of recidivism, and should be part of larger psychological interventions). Also, while I believe that sentences should be longer for these crimes, we are talking about people taking parole (if I understand the law correctly). A convict can simply choose to serve out their sentence and not take the parole and avoid the chemical castration (although, I don't think parole is usually a good idea in this population as a general rule).

[Missa310]

I watched a documentary on Amazon Prime about this. They are trying it in the UK. It was an interesting watch.

https://www.imdb.com/title/tt1068767/

[neuron]

On 6/12/2019 at 8:27 AM, J.Adderton said:

• The treatment is not effective on women, who account for about 7% of registered sex offenders

Men are far more associated with pedophilia and violence than women. The drug reduces the amount of testosterone, I say go for it. So there are 100 sex offenders, and 7 of them are women. This is why certain conditions have to be met to administer this drug. I'd like to see how many of the women meet those conditions.

[myoglobin, ASN, BSN, MSN]

8 minutes ago, fibroblast said:

Men are far more associated with pedophilia than women. The drug reduces the amount of testosterone, I say go for it. So there are 100 sex offenders, and 7 of them are women. This is why certain conditions have to be met to administer this drug. I'd like to see how many of the women meet those conditions.

Also according to some studies women are far less likely to reoffend (less than 1%) and over 50% of the time their crimes were committed with the assistance of a make co- felon.

[hppygr8ful, ASN, RN, EMT-I]

I was going to write a lengthy reply but since my feelings about rape and child molestation, recidivism among rapists and molesters, as well as disgust for certain political factions with regard to both are pretty well known I guess I will just remain silent.

Hppy

[Here.I.Stand, BSN, RN]

I disagree with it, but not because of ethics. 1) rape is an act of violence and exertion of power on a victim. It’s not about uncontrollable libido. 2) It won’t prevent acts of molestation not involving the member. 3) if they are such a threat that we are having this discussion about protecting the public.... maybe we shouldn’t be allowing them access TO the public. 4) releasing NONVIOLENT offenders is the appropriate solution to prison overcrowding. I’m perfectly content for someone running a Ponzi scheme to be on probation and required to make restitution. Pedophiles should stay locked up.

[myoglobin, ASN, BSN, MSN]

I agree they should stay locked up. However there is also evidence that chemical castration reduces (but doesn’t eliminate) recidivism. Therefore, it should at least be an option for those who will be paroled (but shouldn’t) as well as those convicted of charges like possession of child Mediaography which carries less than a life sentence. It should also be an option for those of us who are non criminals and simply want to reduce our normal sex drive for one reason or another (such as being able to focus on school or staying together in a largely sexless marriage). If you can “ get a pill” to increase sex drive or to change your sexual phenotype, you shouldn’t be prevented from doing the same to decrease it.

[CrunchRN, ADN, RN]

Worth a try

[Jedrnurse, BSN, RN]

If you're worried about the ethics of hormone manipulation, I bet the negative health effects of the medication are less harmful than the cumulative effects of staying in prison.