Throughout history, castration has been used as a means of punishment for sex offenders. The oldest form of castration is physical, meaning the physical removal of the testes via surgery. Another, more “modern” form of castration is chemical. This form involves the use of chemicals taken by the offender to enact the same effect of physical castration without surgical removal of the testes. Chemical castration typically takes place using the same or similar chemicals used for female contraceptives. The primary reason for the both forms of castration is to effect changes in the libido and to reduce deviant sexual behavior or desires in the offender. Physical castration has historically been employed for a variety of reasons, not just for curbing deviant behaviors and desires in sex offenders. Certain religions and cultures mandate physical castration to rid the male body of the biological chemicals that are associated with sexual desires to serve a higher purpose. The first documented case of physical castration dates back to the Bible in Matthew 19:12. Physical castration was first used as psychiatric therapy by Forell at a Swiss mental hospital (Meyer III & Cole, Physical and Chemical Castration of Sex Offenders, 2008). The purpose for the Forell physical castration was to curb hypersexuality. Chemical castration, on the other hand, is not documented as far back, historically, as physical castration. The first documented case of chemical castration is the early twentieth century during the eugenics movement (Meyer III & Cole, Physical and Chemical Castration of Sex Offenders, 2008). During the eugenics movement, chemical castration was used as a form of punishment for a plethora of different crimes.
The stakeholders interested in the policy of physical and chemical castration are quite varying on the spectrum of interests. At the beginning of the policy totem pole would be bill writers and sponsors. Bill writers can vary from lobbyists, special interest groups, or elected officials themselves. Typically, bills are written in response to an event. California was the first state to put a bill on the books in support of chemical castration. The catalyst for such law was a case known by the media as the “pillowcase rapist”. During the 1970’s Christopher Hubbart terrorized the Los Angeles area. He drove around L.A. finding homes where the man of the house had left for work and the mothers were home with their children. He would then enter into the home bind the woman’s hands, put a pillowcase over her head, and rape the woman without much struggle. He committed this modus operandi 26 times during a 3-year time span. In response to this case, Californians made known that a solution was needed. This solution was California law makers enacting chemical castration. Another stakeholder in castration policy is the prosecutors and judges who dish out and seek certain punishments. In the case of State of Texas V. Steven Allen Butler, the defendant was ordered to undergo physical castration in lieu of jail time. Butler was convicted of aggravated sexual assault on a 13-year old female. The judge and prosecutor both agreed to forego jail time in exchange for the defendant having his testicle surgically removed. This type of sentence in not typically something that prosecutors seek due to the controversial nature. Prosecutors and judges will however agree to it if it is brought up by the defendant themselves, which was the case here. This leads to the final stakeholder of castration policy; the criminal. As in the Texas v. Steven Allen Butler case, defendants can choose in some states whether they choose physical or chemical castration or jail time. Mr. Butler chose physical castration to avoid spending any time in jail for his crimes.
Both chemical castration and physical castration is done by what is called ADT, or androgen deprivation therapy. “ADT is a treatment to suppress the production of action of male hormones, primarily testosterone” (Rice & Harris, 2011). Androgen is a generic term used to describe any compound that controls the development of characteristics in males. In males the principal androgen is testosterone. Testosterone can be converted into estrogen, which is the most abundant female sex hormone (Rice & Harris, 2011). Testosterone is scientifically related to aggression in humans. The assumption made with ADT is that testosterone is linked to sexually deviant behavior. To curb those desires and behaviors, the levels of testosterone would need to be significantly decreased by either physical of chemical methods. For the purpose of chemical castration, ADT is achieved using pharmaceuticals. The drugs used with chemical castration is medroxyprogesterone (MPA), cyproterone acetate (CPA), and leutinizing hormone releasing hormone (LHRH) (Rice & Harris, 2011). Rice and Harris did a meta-analysis review of chemical castration. One such study that was reviewed in 2006 using MPA was done by Maletzky, Tolan, and McFarland (Rice & Harris, 2011). The man in this study were incarcerated in Oregon. Oregon is a state in which it is legal to order offenders to undergo chemical castration prior to release from custody. 274 inmates were evaluated by a medical professional for the purpose of appropriateness of study group. Of the 274 inmates, the study group included 134 inmate sex offenders, 70 of which received MPA. The remaining 63 were split into two control groups, of whom did not receive treatment. The follow-up period was 2.5 years. Those who received MPA had significantly fewer recidivism offenses than those who did not receive treatment. The group receiving treatment had a recidivism rate of 0%, meaning no future offenses. The control groups had a recidivism rate of 18% and 16%, meaning that 16 and 18% of the two control groups committed future sexual offenses after release of institutional custody.
The second study involves both physical and chemical castration of sex offenders. This meta-analysis went further to measure the mean level of testosterone in a group of chosen sex offenders. The Meyer et al. analysis showed a mean level of testosterone of 1025 +314ng/dl for rapists, 711+238 ng/dl for pedophiles, and 597+263 ng/dl for exhibitionists. This shows that violent males have a significantly higher mean level of testosterone than non-violent males. The physical castration level of the Meyer et al. analysis used a total of 3,589 males who were evaluated for surgical castration in European Countries. Each of the 3,589 inmates were evaluated by a psychiatrist to go over the side effects, risks, and a mental evaluation to make sure all was understood by the inmates. The actual number of inmates who were surgically castrated after evaluation was 79. The follow-up period for the meta-analysis varied from five years up to 35 years. The post-castration recidivism rate was 2.2%, while the recidivism rate for pre-castration was 73%. The gap between the two is quite large. Meyer et al. also analyzed a group of studies for the purpose of chemical castration effectiveness. The sample size for this analysis was 127 male sexual offenders. The actual sample of those receiving ADT was 8. Of the 8, the follow-up period ranged from 6 months to 4.5 years. The post-treatment recidivism rate for those 8 was 6%. The pre-treatment recidivism rate was 85%. This is also a significant gap between the two rates of recidivism.
The current, 2017, policy in the state of Florida is listed under Chapter 794, title XLVI. The current policy states that the court may order a defendant to undergo physical or chemical castration. Under Chapter 794, physical castration is listed as an alternative penalty to incarceration, meaning that the testes can be removed in exchanged for no jail time. The stipulation of physical castration is that the defendant be intelligent, knowing, and voluntarily consent (The Florida Legislature, 2017). The defendant must be of sound mind and understand fully the risks and side effects of being surgically castrated. Under Chapter 794, court can also mandate chemical castration. The ADT under the statute is MPA, as discussed above. The court must appoint a medical expert for the medical treatment. The defendant must also undergo a medical evaluation to make sure they are an appropriate candidate. The court can mandate the treatment of MPA for up to the lifetime of the offender. The treatment is to begin no later than one week prior to the defendant’s release from incarceration, ensuring that the MPA is well within the defendant’s system and any adverse effects can be monitored by a medical professional. The statute also states that if at any time the defendant refuses MPA treatment, they are guilty of a felony of a second degree, which would result in remand to custody. This is similar to violation of probation.