A bill in Alabama awaiting the governor's signature would require people convicted of certain sex offenses to undergo "chemical castration" as a condition of parole - a requirement meant to keep perpetrators from committing similar crimes.
The measure, passed by the Legislature, says a judge must order anyone convicted of a sex offense involving a child under the age of 13 to start receiving testosterone-inhibiting medication a month before release from prison. Most offenders would have to pay for the treatment, which would be administered by the Department of Public Health, until a judge decides the medication is no longer necessary.
Under the proposed law, a judge - and not a doctor - would tell the offender about the effects of the treatment. An offender could choose to stop getting the medication and return to prison to serve the remainder of the term. Anyone who stops receiving the treatment without approval would be considered guilty of a Class C felony, punishable under Alabama law by up to 10 years in prison and a fine of up to $15,000.
"Chemical castration" is a misnomer, since the process leaves the testes intact, can be reversed, and does not prevent a man from reproducing. It does not guarantee a man's sexual urge will be eliminated. There's no consensus on whether the treatment would be effective for women.
Experts warn that the treatment is not a panacea and should be used with caution; there are few studies that attempt to determine the success rate of the treatment. Several of these studies show success in offenders that have sexual desire involving children. Others found no significant effect.
Republican Rep. Steve Hurst, who sponsored the bill, did not respond to a request for comment. He told CBS 42 that some people have told him that mandated chemical castration is inhumane.
"I asked them, 'What's more inhumane than when you take a little infant child and you sexually molest that infant child when the child cannot defend themselves or get away, and they have to go through all the things they have to go through?' " Hurst told the news station.
Lori Jhons, a spokeswoman for Republican Gov. Kay Ivey, said on Wednesday that the governor's office was still deciding whether Ivey would sign the bill. The next signing ceremony is scheduled for Thursday, but the chemical castration bill was not on a list of legislation that Ivey planned to sign that day.
This is not the first time Hurst has proposed some version of a castration law. His bill in 2011 would have required surgical castration - removing parts of the testes - for people convicted of sex offenses involving children under 13 years old, according to The Anniston Star.
More than 57,000 children in the United States experienced sexual abuse in 2016, according to the Rape, Abuse & Incest National Network. In 93% of cases, the children knew their abusers.
Seven states and U.S. territories - California, Florida, Guam, Iowa, Louisiana, Montana and Wisconsin - permit some sex offenders to be forced to take testosterone-suppressing drugs as a condition of sentencing, release or supervision, according to the National Conference of State Legislatures. A Republican lawmaker in Oklahoma proposed a bill last year that would have authorized the treatment there, but the measure failed.
Frederick Berlin, director of the National Institute for the Study, Prevention and Treatment of Sexual Trauma, said testosterone-suppressing drugs produce "low rates of recidivism" in people whose abusive behaviors were driven by their sexual attraction to children. The dosage would depend on the specific hormone-suppressing drug, Berlin said, but all chemical castration drugs would work for only as long as the person kept taking it.
Side effects of the treatment can include depression, osteoporosis and anemia. Other possible side effects include anaphylaxis, kidney failure or heart failure, depending on the medication used.
Laws requiring chemical castration have come up against questions of constitutionality. John Stinneford, a law professor at the University of Florida, argued in a legal paper in 2006 that the treatment is "impermissibly cruel" under the Eighth Amendment's ban on "cruel and unusual punishments."
The Supreme Court, however, bases its definition of "cruel and unusual" on an "evolving standards of decency" test, Stinneford told The Washington Post. This process, he said, means if the public hates or strongly fears a group of people, the court is likely to support most punishments inflicted upon them.
Even if chemical castration is allowed, Stinneford said, it might fail to rehabilitate offenders because some of the side effects are so unpleasant. Paroled perpetrators might choose to flee from their supervision to avoid taking the drug, which would make them more of a public threat, Stinneford said.
"It seems more like a symbolic gesture that may actually undermine public safety," he said, "as opposed to a measure that would actually promote it."
Randall Marshall, the executive director of the ACLU of Alabama, said his organization considers chemical castration to be unconstitutional on other grounds, such as due process and the right to privacy. Altering someone's body through forced treatment constitutes impermissible medical experimentation, he said.
Similar laws passed in other states to require chemical castration are rarely used, Marshall said. Reducing someone's sex drive does not necessarily prevent reoffending, he said, because libido is not the only motivating factor behind sexual abuse.
"I think sexual assault has always been more than just about sex," Marshall said. "It's about power, it's about exercising control over someone else and a variety of other things."
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