Is chemical castration a cure for perversion?

Chemical castration - designed to suppress the libido of sexual offenders - was first put into practice in the United States 30 years ago.

In recent years, several states in the U.S., including California, Texas, Georgia and Florida, have passed laws for courts to order forced chemical castration for sexual offenders. However, human rights organizations oppose the measure on the grounds that one can't force a person to take medication which may harm or suppress functions of his body, especially in light of the serious side effects connected with these medications.

Today, the castration is achieved mainly through the use of Decapeptyl, a hormone-based treatment that reduces the activity of testosterone and prevents erection and sexual fantasies. This medication is also used for other purposes, for example for blocking unwanted premature sexual maturity.

According to Dr. Yael Idisis, a Bar Ilan University criminologist who specializes in the treatment of sexual offenders, the use of this medication for treating sexual offenders went into practice in Israel about a decade ago.

The medication is given periodically in the form of injections, at the recommendation of a psychiatrist. In many cases, it causes "effeminate" side effects such as the growth of breasts, the shrinking of testicles and changes in body hair.

The medication can also trigger obesity and depression. Doctors have noted in the past that liver functioning can be affected.

Dr. Judith Abulafia, another criminologist and expert on sexual offenders from Bar Ilan University and the Ashkelon Academic College is not impressed by the enthusiasm for the drug.

"The medication does not help everyone," she says, "and it is not the be-all end-all of drugs. There are people who get the treatment but continue to pose a danger. It is supposed to create a feeling that the problem is being taken care of. But not everyone who assaults children is a sexual offender and there are some people for whom it is not at all suitable."

Abulafia is also opposed to the draft law submitted by Finance Minister Yuval Steinitz which would make it mandatory for pedophiles to undergo chemical castration if they want to leave jail.

"You can't put a pistol at a person's head and say: 'You can't leave prison unless you get treatment' and then call this treatment by consent. You have to remember that you are taking away the thing that most interests him - his sexual desire. The treatment has psychological consequences that have to be addressed."

In Israel, as in most Western countries, offenders must be given a referral before undergoing chemical castration. Idisis recommends quite a few of the offenders that she treats for the injections.

"Chemical castration, if not forced, can be an excellent, if merely partial, solution," she says. "It is true that the person being treated will sometimes have to give up sex for his entire life since his sexual activity is completely deviant. The choice is to remain a pervert or to give up his sex life. Sex is important but not if it is with a young boy or girl. I think it is right for the person to undergo it. I want him to be rehabilitated. I think that if he is a danger, [the treatment] is also to his benefit."

Nevertheless Idisis says that the treatment does not succeed in suppressing libido in offenders who carry out their crimes out of aggressive and anti-social urges rather than sexual lust.

Idisis is the clinical director of the Shlom Banecha non-profit, which aids ultra-Orthodox victims of sexual abuse. She says that ultra-Orthodox pedophiles she treats almost always agree to undergo chemical castration.

"In some cases the community was already aware of their problem or their partner put pressure on them [to undergo treatment]," she said. "In certain cases, we make adjustments to the treatment. There was a man who wanted to observe the commandment of having sex with his wife and it was necessary to adjust the treatment in such a way that he could have sexual relations at certain periods."

On the other hand, the readiness to undergo treatment is much lower among offenders who are serving prison sentences.

"In all my experience with clinical work in the prisons, it was very hard for those undergoing therapy to agree to such treatment," Idisis said. "Clearly it is very off-putting. Anyone would be afraid of taking medications that will force him to give up his sexual drive. Some of them say: 'it is true that I'm attracted to young girls, but also to older women, so it isn't fair.' It requires a great deal of preparation. You have to explain to the person what his problem is and how much it gets him in trouble. Some of them are frightened about the symptoms and the side effects but a lot are not prepared to undergo treatment because they don't want to give up their perversion. Someone who is deviant sometimes doesn't care of he is a pervert."