Tuesday 1 January 2013

Chemical castration for rapists: The issues involved make it difficult to implement

By Syed Akbar
Hyderabad: The Central government may have scored a political
point by proposing chemical castration for rape convicts, but medical
experts feel that it easily said than implemented. It is also wrought
with human rights and legal and health issues that will only
complicate matters for the government. In a free country, the consent
of the convict is must, irrespective of what the legislation says.

Simply put, chemical castration is injecting female hormone into male
body. The female hormone called progesterone, when injected in high
doses, fights against the male hormone, androgen, and nullifies the
attraction of a man towards a woman. Since chemical castration
inhibits the masculinity, the man loses interest in the opposite sex.

India will be the first country to go in for chemical castration
legislation in 2013, if the Centre has its way. During 2012, two
countries (Moldova and Estonia) legalized chemical castration and
before that, Russia and South Korea made similar legislation but
involving paedophiles.

The drugs used for chemical castration work for just 90 days, and the
person has to take the fresh dose every three months. Unlike the
surgical castration, which involves removal of the testes, chemical
castration is a reversible process. Stop the dose and the person
becomes normal with male hormones regaining their vigour. And here
lies the major problem: tracing the person every three months and
injecting him anti-androgen drug once he is out of jail. Incidentally,
this drug does not work if the convict secretly takes male hormonal
injections. Moreover, forceful administration of the drug is a
violation of human rights and the convict’s consent has to be obtained
before going in for chemical castration.

“In a hugely populous country like India where corruption is common,
follow up of rape convicts out of jail every three months though out
life is next to impossible. Thus, drug compliant is difficult.
Generally, drugs like medroxyprogesterone acetate and cyproterone
acetate are injected into the buttocks. These drugs also serve as
female contraceptives for those women, who do not want to go in for
other methods like oral pills or copper T. They cause severe health
issues including cardiac problems in men. They are also not safe for
post-menopausal women,” said Dr Kammela Sreedhar, senior urologist and
micro-surgical andrologists.

Dr Hari Kishan Boorugu, consultant physician, Apollo Hospitals,
Hyderguda, argues that the effect of chemical castration is reversible
and “may not be 100 per cent effective”.

“It is not a one-time solution. The drug has many complications,
though life-threatening side effects are rare,” points out
cardiologist Dr Sai Sudhakar. It will create feminine characteristics
in men and damage bones. The drug will also affect the heart. However,
some studies, he added have showed no adverse side effects.
Medroxyprogesterone acetate is a successful method for those involved
in repeated sexual offences.

According to Dr K Subramanyam, consultant urologist, the drugs are
used for advanced prostrate cancer treatment. They reduce testosterone
or male hormone to negligible levels, which results in libido or urge
for sex receding. “Long term usage can lead to symptoms typically
exhibited by women attaining menopause like calcium levels coming down
in bones, muscle wasting and hot flushes leading to temporary sweating.

Internal medicine expert Dr SP Singh said only 0.01 per cent of men
are hyperactive. Chemical castration is the physiological suppression
of libido using anti-androgen drugs, but it has to be used very
cautiously.

“These drugs generally suppress the hormones but physical
characteristics may be altered. There could be several complications
including psychological disorders like alcohol abuse or so on,” he
warns.

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