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Alabama’s law forcing sex offenders to get chemically castrated, explained

The law is supposed to keep children safe. Critics say it won’t work.

The Alabama State House in Montgomery, Alabama, pictured on May 15, 2019
The Alabama State House in Montgomery, Alabama, pictured on May 15, 2019.
Julie Bennett/Getty Images
Anna North is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of three novels, including the New York Times bestseller Outlawed.

A new Alabama law will require some sex offenders to undergo chemical castration, a forced medical treatment that critics say is both inhumane and ineffective.

The law, signed by Republican Gov. Kay Ivey on Monday, requires people convicted of a sex crime against a child under 13 to begin chemical castration treatment before their release, according to CNN. They must continue the treatment, which consists of drugs designed to dampen a person’s sex drive, until a court rules they can stop.

Ivey described the law as “a step toward protecting children in Alabama.”

But critics of the law say it violates Alabamians’ rights by forcing them to alter their body chemistry against their will. “This chemical castration bill is a violation of the Eighth Amendment,” which prohibits cruel and unusual punishment, Dillon Nettles, a policy analyst for the American Civil Liberties Union of Alabama, told Vox. The ACLU is considering a legal challenge to the law.

State legislators around the country have passed chemical castration bills in an effort to keep sex offenders from reoffending. But laws like the one in Alabama are misguided, said Dr. Renee Sorrentino, a forensic psychiatrist in Massachusetts who prescribes chemical castration, because the process is only effective in some sex offenders and needs to be coupled with therapy and medical evaluation.

Meanwhile, Alabama was already receiving nationwide attention after Gov. Ivey signed a law last month banning abortion at all stages of pregnancy, with no exceptions for rape or incest. Opponents of the chemical castration law say it’s hypocritical that the state wants to castrate sex offenders but not allow people who get pregnant from rape to get abortions. According to Nettles, both laws are part of a “pattern of stripping people of their constitutional rights” in Alabama.

Alabama becomes one of several states with chemical castration laws on the books

Alabama’s law, HB 379, passed the state legislature in May. The law requires anyone convicted of a sex offense against someone under 13 to start chemical castration treatment at least a month prior to release on parole, according to CNN, and to continue “until the court determines the treatment is no longer necessary.”

The law requires offenders to pay for their own treatment, though it says that they cannot be denied parole solely for their inability to pay. Chemical castration treatment can cost $1,000 a month for the medication alone, Sorrentino said.

The law’s sponsor, Republican state Rep. Steve Hurst, has been hoping to pass such legislation for almost 15 years, according to local news network WBRC.

“I’d prefer it be surgical, because the way I look at it, if they’re going to mark these children for life, they need to be marked for life,” he told the network. “My preference would be, if someone does a small infant child like that, they need to die.”

Hurst has not responded to Vox’s request for comment on the law. Alabama will become one of eight states and territories to authorize chemical castration for sex offenders, according to USA Today — including California, Iowa, and Texas — though not all of those states make the treatment mandatory.

Doctors and human rights groups say the Alabama law is misguided

Chemical castration was developed as a more humane and reversible alternative to surgical castration for sex offenders, Sorrentino said.

The treatment is usually delivered by injection every month or every 90 days, and consists of one of several medications that reduce male patients’ testosterone to prepubescent levels.

Castration can help keep some sex offenders from reoffending, Sorrentino said. Research on surgical castration has shown it to be effective in reducing recidivism.

When it comes to chemical castration, some people even request the treatment — people who have committed sex offenses and those who are worried they might act on their sexual attraction to children frequently call Sorrentino seeking treatment, she said.

But the treatment has many potential side effects, including hair loss, breast growth, weight gain, diabetes, and bone loss. Patients need a thorough explanation of these side effects in addition to a medical evaluation to determine if the treatment is safe for them, Sorrentino said, and not all states that require chemical castration provide for that.

Moreover, chemical castration isn’t appropriate for all sex offenders.

“There are multiple reasons for engaging in sexual offenses” against children, Sorrentino said, “only one of which is pedophilic interest.” For people who abuse children simply because of opportunity, as is the case in some crimes of incest, or because they have antisocial personality disorder, “lowering their testosterone is not going to solve the problem.”

The treatment also does not work on women, who are about 7 percent of registered sex offenders.

Overall, mandated chemical castration laws are misguided from a medical perspective, Sorrentino said. In Alabama, “the way that the law is set up is that it’s not going to deliver protection.”

Survivors’ rights advocates have also criticized the Alabama law. Legislation like HB 379 can undermine more effective policies for sex offender treatment, “because it is looking at all people who sexually offend as though they are the same,” said Laura Palumbo, communications director of the National Sexual Violence Resource Center.

Meanwhile, Nettles, the ACLU policy analyst, argues that the law constitutes cruel and unusual punishment by forcing people to “alter their body chemistry” as a condition of parole. He compared the law to medieval punishments like eye-gouging.

“This is still the same principle,” he said. “You’re altering a person’s body physically.”

The chemical castration law comes just weeks after Ivey signed Alabama’s near-total abortion ban, the strictest of a series of abortion restrictions passing around the country in recent months. Rep. Hurst, the sponsor of the chemical castration law, voted for the abortion ban.

“It’s almost ludicrous to say that these individuals are driven to protect victims,” when they don’t believe that rape survivors should be able to get abortions, Nettles said.

The ACLU, which has already challenged the abortion ban in court, is likely to do the same with the chemical castration law, but will wait until a judge actually orders the treatment for someone, Nettles said.