Castration to Prevent Sexual Crime, Effective?

Medical Video: Tom Douglas defends the chemical castration of sex offenders

Following the emergency decree passed by Joko Widodo in May 2016, now the Indonesian court system can force the perpetrators of chemical crimes to be neutered chemically in response to the crisis of sexual violence on children which is rampant in this country.

In addition to the castration, the decision also allowed judges to order sex offenders to use electronic tracking devices after they were released from prison, and to exacerbate maximum penalties for cases of sexual violence and child abuse until the death penalty.

However, the act of castration has received various criticisms as a reckless attempt to deal with complex social problems of sexual violence. Why so?

When is usually castration done?

Apart from the use of castration practices as punishment, there are some situations where sometimes acts of castration are common.

1. Castration as an act of sterilization

Basically, castration is one method of contraception to prevent pregnancy. Castration is a medical action used to eliminate testicular function in men. Castration in the world of health is called gonadectomy. In women, the act of castration is done to remove the uterus, known as oophorectomy.

There are two types of castration procedures for men, namely castration with a surgical procedure to physically lift both testicles, aka bilateral orchiectomy, and chemical castration using drugs to deactivate testicular function.

Transgender women often undergo orchiectomy because this procedure can be done as part of a general sex change procedure, either before or accompanied by other procedures. Surgical castration can also be performed on transgender people who do not want, or cannot, operate further.

2. Castration as a religious and cultural ritual

Castration has been used in religious and social ceremonies in various different cultures from all corners of the world. War fighters will castrate hostages or corpses from their enemies to signify victory and dominance, allowing the winning camp to declare ownership of women from the defeated party.

Not infrequently, the act of castration is carried out as a method of torture in various ancient histories. In ancient times, castration generally involved total removal of male genitals. This causes a fatal risk due to severe bleeding or infection, to death. Conversely, removal of only the two testicles has a much smaller risk.

3. Castration as an action for prostate cancer treatment

In addition to physically removing both testes, castration also affects the production of certain hormones in the body, such as testosterone in men and estrogen in women. Therefore, surgical castration is also seen as a treatment option for men who have metastatic prostate cancer.

The long-term impact of shrinking the amount of sex hormones in the body will appear very real throughout the body. All medical efforts made to reduce testosterone levels in the body, including castration, will reduce the urge or need, obsession, as well as sexual behavior, or its combination.

What medical risks might occur after castration?

According to research by Wilson and Roehrborn in the journal JCEM in 2011, along with a decrease in sexual appetite and hormone levels in the body, the risk of long-term effects of castration actions could include enlargement of the pituitary gland, skull shape changes - thinning of skull thickness and developing kyphosis (curvature of the spine which causes a hunchback posture) as a classic symptom of osteoporosis in male - gynecomastia, until the loss of the prostate. The impact of prostate loss can actually be attributed to the function of time after castration, seeing the duration of castration in the object of their research recorded taking longer than other reports.

In addition, groups of people who have received a castration procedure through hormone treatment can also experience some side effects, such as weight gain, hair loss, and breast formation.

Is it effective for castration as a preventive measure for sexual crime?

Judging from its effectiveness in reducing sexual desire, acts of castration have been carried out for many years in many countries, including the United States and Czechoslovakia, as 'therapeutic' options for sex offenders or those who have sexual deviations to enable them to return to active roles as part of functional community members after serving a sentence.

Estrogen hormone drugs, such as medroxyprogesterone acetate and prostate cancer drugs, have been used extensively in the United States, Canada, and Europe for chemical castration in prisoners involved in cases of pedophilia and other sexual violence. In general, hormone therapy seems successful for some sexual offenders and groups of people who suffer from deviant sexual desires. These drugs allow patients to manage their sexual desires by manipulating the workings of the brain to suppress testosterone production, enabling them to focus on behavioral therapy to "straighten out" their deviations.

Castration through surgical procedures has been proven to suppress sexual urges, including many sexual offenders. Reporting from ABC News, a German study showed the average rate of repetition (of acts of sexual violence) for prisoners who had received castration only as much as three percent compared to those who were not castrated, ie a 46% higher risk of repeating their crimes.

Quoted from Medical Daily, less than 10 percent of 626 patients who received chemical castration reported returning to five-year sex crimes since receiving the procedure. In addition, two separate studies from South Korea stated that 38 patients receiving chemical castration reported a decrease in the frequency and intensity of sexual drive, frequency of masturbation and sexual fantasy.

In some people, sexual desire and ability do not change even after castration

However, castration may not work for the whole person. One study from Korea found that some patients experienced a sudden surge in testosterone levels, as well as immense sexual desire and desire after the first two months of receiving an act of castration due to drug work that did not completely nullify a person's sexual desires. When these drugs are used in prostate cancer patients to suppress tumor growth, about 10 percent of them can still have sexual intercourse as usual. Likewise with prisoners who accept castration through the surgical process. Most (if not all) prisoners of sexual crimes castrated through surgical procedures are found to retain some of their sexual functions.

Surgery is more likely to be effective if it is done on people whose sexual drive motivates criminal acts, such as pedophiles and rape on the basis of sheer lust. However, despite the decline in sexual drive due to low testosterone levels, men who have received castration can still experience sexual arousal, erection, and even ejaculation like normal men in general - although the frequency, strength, and duration will be lower, and there is no residue sperm in the semen. Even if a man who has been castrated cannot maintain his erection, he can temporarily reverse his condition with the help of testosterone supplements, either in the form of patches or gels.

What needs to be understood is that not all sexual crimes are based on burning sexual desires; Low sexual desire will not prevent attacks driven by the need for domination. The castration principle will not be effective for sex offenders who commit crimes on other grounds, such as rape under the influence of alcohol or drugs, revenge, or pure crime.