Castration as a punishment for sexual offences is a practice that dates back thousands of years, first appearing on the historical record in Ancient China. It’s understandable that people would look to it as a means of exacting revenge in situations of that sort; understandable, too, that modern society has moved away from punishment and revenge, to focus on responses that can address the problem, be applied consistently, and minimise collateral damage. Now, however, the government is looking at reintroducing castration, albeit in a modern form, targeted at serious sexual offenders. It’s even considering whether it could make it mandatory.
Why is it doing this now? Politics aside, it has been inspired by the results of a small pilot project carried out in two regions of southwest England, which found a significant decrease in reoffending rates among prisoners who opted to undergo chemical castration (alongside specialist counselling) and were then released. At first glance, this looks impressive, but look more closely and it’s clear that it needs to be approached with caution.
What does ‘chemical castration’ actually involve?
‘Chemical castration’ – which is not a clinical term used by medical professionals – is the use of anti-libidinal medication to reduce or stop the production of sex hormones. It is a safer method than its surgical equivalent because it is reversible – so if somebody turns out to have been wrongly convicted, less harm is done. It first occurred in 1944, when diethylstilbestrol was used with the purpose of lowering men’s testosterone. Today, it involves the administration of two types of drug:
- Selective serotonin reuptake inhibitors (SSRIs), which as many people who have taken them to treat depression know, reduce sexual thoughts.
- Anti-androgens, which reduce testosterone levels, thereby reducing libido and, in many cases, making it difficult to achieve an erection.
Anti-androgens are used in some cancer treatments and by trans women as part of the transition process. In the latter case, oestrogen is usually taken alongside them, and this does many of the same additional jobs in the body that testosterone does. In the absence of either of these hormones, health consequences can be severe.
We spoke to a man who has to receive testosterone through a monthly injection because medical issues mean he can no longer produce it naturally. When the level in his body is at its lowest, he revealed, he feels exhausted all the time, shivery and cold, and lacking in executive function – experiencing what is commonly known as ‘brain fog’. He relies on caffeine and sugar just to do basic household tasks – very bad for the health in the long run – and any injuries take longer to heal.
If released into the community in this condition, offenders would struggle to reintegrate – and reintegration itself has been shown to play a key role in reducing the risk of reoffending. They might lack energy for social interaction and would be unable to work, potentially plunging their families into poverty.
The impact of chemical castration on offending behaviour
These difficulties might seem acceptable if they prevent sexual violence. Some of those who volunteer for such treatment say it’s worth it for them, because they don’t want to hurt others and they would rather endure any amount of suffering than go back into prison.
This raises an immediate question, however: if people are motivated to undergo the treatment by their desire to stop offending, might the apparent reduction in offending have more to do with that than with the treatment itself? The fact is that we don’t have very good data to base decisions on. In a review published in 2010 by the Dalhousie Law Journal, the evidence of success was very limited:
“Assessing the whole of the sex offender literature, the Cochrane Collaboration was able to identify only a single study using anti-androgen medication that met their inclusion criteria. After reviewing the study, the authors provided the following advice for physicians: ‘anti-libidinal drugs should be used with caution [because] there is no trial-derived data to support or refute their use.’
“They then suggested that use of such medication should be considered experimental and that its use could only be justified in the context of well-conducted randomized experimental trials. The Cochrane Collaboration reveals the negligible evidentiary base for the use of chemical castration to prevent recidivism in sex offenders.”
We don’t know if castration is, in itself, having any effect at all. More worryingly, some criminologists have suggested that if castration appeals to individuals who are strongly motivated to get out of prison, those people are likely to make more effort to conceal any crimes they do commit, creating an additional risk of bias in the research and an additional risk to the public.
Will the use of anti-libidinal medication reduce sexual offending?
Looking at the data from the recent experiment, an independent sentencing review panel came to the conclusion that it was worth exploring the potential of this treatment further, but only with specific types of sexual offender. This takes into account the additional complication that rape and sexual assault are not always motivated by sexual desire, and rarely by that alone.
Decades’ worth of studies have shown that they are more often about the desire for power or control, or a simple wish to hurt and humiliate someone. Castration does not stop offenders with this type of motive from continuing to do harm of this sort, even if they have to go about it in a different way.
Although initial government sources were unclear on this, justice secretary Shabana Mahmood has now clarified that she is aware that there are multiple types of offender, and she has further emphasised the need for specialist counselling “alongside” castration. It remains unclear how this would be resourced, in light of the present shortage of professional counsellors across all areas.
If the government is serious about reducing sexual violence, there are several things that we know do work:
- Comprehensive sex education, with an emphasis on consent.
- Eradicating misogyny across society, from upbringing to adult behaviour (including the way grown men behave in parliament).
- Ensuring that the justice system is perceived as taking sexual violence seriously.
At present, only 2.7% of rapes reported in England and Wales result in charges being brought. But it doesn’t have to be this way. In Scotland it is 15% – still depressingly low, but indicative of the fact that this is about policy and resourcing, not just the type of society we live in.
To make a real difference, we need to be prepared to invest money, not just make tough-sounding statements on TV.
The vital principle of consent
The desire to sound tough seems to be a strong motivator for Mahmood, who responded to the recent debate by declaring that she was “exploring whether mandating the approach is possible” for the most serious offenders. In other words, she is looking into disposing of the longstanding legal principle that nobody should be forced to undergo medical treatment without their full and informed consent.
This is particularly worrying to many, because it comes from a party that has already passed laws interfering in the relationship between young trans people and their doctors, as well as suggesting that unemployed people living with obesity should be given weight loss drugs to get them back to work. It’s easier to undermine the principle of bodily autonomy if one starts with groups of people whom the public has already been encouraged to think of as undeserving.
Few people may feel inclined to stand up for sex offenders, but if this principle is abandoned, who could come next?
Doctors, as it turns out, just might. Leading experts in carrying out chemical castration have said that they would refuse to use it on non-consenting individuals. The government’s plan to expand the original pilot study across multiple additional regions could constitute a violation of the Nuremberg Code, which was developed during the trial of Nazi war criminals and forbids medical experimentation on non-consenting human subjects. Some have asked if prisoners are really able to consent at all given the constrained circumstances in which they find themselves.
Perhaps the strangest thing about all this is that the government says its primary motive is reducing overcrowding in English and Welsh prisons. At the same time, it is investing in a significant expansion of facilities to detain migrants. Why lock up the latter group of people at all, when most of them have no criminal convictions and could be released into the community at no particular risk? Releasing those already in detention would create substantially more space for housing actual criminals, relieving pressure on the system and decreasing the need for urgent measures which could easily end up doing more harm than good.
