Title: Policing "perversion"
Author(s): Daniel C. Tsang
Affiliation: University of California, Irvine
Citation: Tsang, D.C., "Policing ‘perversion’," Journal of Homosexuality, vol. 28, nos. 3-4, 1995, pp. 397-426.
In the early twentieth century, medical intervention began involuntarily subjecting homosexuals and other sex offenders to desperate cures such as castration, or destruction or removal of certain parts of the brain. Today, the favored treatment for sex offenders is to drug the brain rather than to remove part of it. One commonly used drug is Depo-Provera, or medroxyprogesterone acetate (MPA), manufactured by Upjohn. It blocks testosterone which is believed to govern male sex drive. Little is known about the complex interactions and effects of hormones and MPA on brain functioning.
Originally developed as a contraceptive for women, it was banned in the U.S. because of its link to uterine and breast cancer. However, the FDA approved its use in 1992, over the objections of several women’s health organizations. Upjohn does not market it for use with sex offenders because, a company spokesman said, "we could be construed as encouraging the inappropriate prescribing of a non-approved drug." Although the FDA has not approved its use with sex offenders, it is used for this purpose under a law which allows drugs approved for one use to be prescribed by physicians for other uses as part of individualized patient care.
The typical dosage when used with sex offenders is up to 40 times as strong as when used as a contraceptive. It is used with adults and sometimes children considered to be "sexually precocious." No controlled scientific studies of its safety or effectiveness have been conducted. However, reported possible side-effects include appetite and weight gain, fatigue, depression, hyperglycemia, impotence, abnormal sperm (which may lead to birth defects), insomnia, nightmares, difficulty breathing, hot and cold flashes, loss of body hair, nausea, leg cramps, irregular gall bladder function, diverticulitis, aggravation of migraine, hypogonadism, hypertension, phlebitis, diabetic symptoms, thrombosis (which may lead to heart attack), and shrinkage of prostate and seminal vesicles. Another antiandrogen, cyproterone acetate (CPA), has also been prescribed for sexually taboo behavior. It has been linked to testicular atrophy, and German researchers have found antiandrogens have serious effects on the bones and liver.
The use of these drugs is based on the assumption that sexuality is essentially hormonal, ignoring personal experience and social factors. This approach essentially reduces humans to sexual robots, and justifies reprogramming them to operate within social norms. John Money, head of the psychohormonal unit at Johns Hopkins medical school, proposes that all sex offenders be given a choice between incarceration and placement in a halfway house with Depo-Provera treatment. He sounds compassionate in his advocacy of the use of Depo-Provera, but men in the criminal justice system are not free to give informed consent. Proponents of MPA do not describe all of its risks and side-effects, and they do not inform the individual of the likelihood that they will resume their forbidden behavior as soon as treatment is ended.
The Michigan Supreme Court, the U.S. Congress, and Ralph Nader’s Health Research Group have described the use of MPA on prisoners variously as human experimentation, cruel and unusual punishment, "shocking to the conscience of reasonably civilized people," and "a mockery of the whole concept of informed consent." Researchers have concluded that the use of Depo-Provera and similar drugs raises serious ethical issues because of the lack of knowledge regarding their safety and their potentially irreversible side-effects.
The author writes,
It is a travesty of justice that any human being under the law is subjected to coercive treatment that severely reduces brain function and could eventually result in death from cancer (at least for women). It is a barbarian practice that cries for reform when we recall that some of the men subjected to such cruel treatment are punished for having sex with teenagers...