Kevin Giordano

Once referred to as a form of mutilation by the American Civil Liberties Union, a reference to the Eighth Amendment to the Bill of Rights (which says, “Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted”), chemical castration is slowly gaining ground throughout the country as a means of sentencing and treating sex offenders.

Tennessee is currently debating whether to adopt a bill that would make it the ninth state with a law governing the use of the drug medroxyprogesterone acetate (MPA), which acts as a sexual suppressant. “There’s been a heightened recognition of sex offenses,” says Berlin, referring to the “two strikes, you’re out” Child Protection Act of 1999, which says repeat sex offenders get life in prison, and “Megan’s Law,” which requires that sex offenders be registered with local authorities and the FBI upon release from incarceration.

Says Berlin, founder of the sexual disorders clinic at Johns Hopkins University in Maryland: Such laws are “likely to progress to other states, after they establish committees to advise legislators.”

- – - – - – - – - – - – - – - – - – - – - – - – - – - – - –

State Sen. Tim Burchett, at 35 the youngest member of the Tennessee Senate, is sponsoring the bill that would make the use of drugs such as Depo-Provera and Depo-Lupron an optional part of a convicted person’s sentence. “Part of the problem is just the name ‘castration,’” Burchett says. “I hear the jokes and talk, it doesn’t bother me. If you’ve ever talked to a mother whose daughter or son has been raped, you’d never question my reasons.”

Burchett’s steadfast efforts to bring up the bill began in earnest four years ago when he was in the state House. The committee considering the bill was undecided and deferred it, but assisted Burchett in drafting new versions. “Castration was something we needed to look at,” Burchett says. “Everyone assumed it was some kind of mutilation, but it doesn’t have anything to do with mutilation. It’s just a form of treatment.”

In 1996, California became the first state to pass a measure known as a chemical castration law, which requires chemical castration of any person found guilty a second time of specified sex offenses. Florida, Georgia, Louisiana, Montana, Oregon, Texas and Wisconsin followed shortly thereafter with similar laws. Dr. Mark Graff of the California Psychiatric Association is wary of this trend and says the California measure was intended to be harsh. The law “gives an illusion of protection because its punitive ‘castrate ‘em and hang-’em-up model’ attracts legislators,” Graff says. “This was no attempt to rehabilitate people.”

Burchett, in a cogent response to other states’ laws, made an alternative suggestion. Under present Tennessee law, any person who commits or attempts to commit a sexual offense is to be sentenced to community supervision for life. Burchett’s bill would add that as part of supervision, a qualifying offender would be required to submit to Depo-Provera treatment, a drug that contains MPA. (To qualify for testosterone-reducing drugs, an offender would first have to be determined to have uncontrollable sexual urges, that is, be labeled a child molester or a pedophile. If it was found that he was sexually abusive because of problems with authority or a desire to break rules, or because he was seeking power, he might be termed a sadist, and therefore might not qualify for testosterone-reducing drugs.)

Says psychiatrist Berlin of Burchett’s proposed requirement: “I think there’s a subgroup [of offenders] who want it and need it. I’d mandate its availability, but I have significant reservations [about] mandating its use.”

According to Franklin Zimring, professor of law at the University of California at Berkeley, there isn’t a lot of academic research on the subject. “There aren’t any good impact studies on the outcomes that I’m aware of,” he says. “None of the clinical experiences points to involuntary studies in a coercive environment. How many people have been subjected who were not volunteers and what were the outcomes?”

Despite the laws already in place in eight states, and cases documenting drug treatment’s effectiveness, there remains a split in the legal and medical communities. Most feel the treatment can be helpful if a patient is amenable to it. “I don’t know if it’s a deterrent,” says Burchett, “but if someone wants to get help, this is something that can help them.”

The word “castration” evokes haunting images of men strapped to a table, heavily anesthetized and fearing for their life. Just the mention of the word makes men wince and women giggle. To be sure, physical castration and chemical castration both have the same goal: to stop the production of testosterone, which is considered by mental health experts to be one of the sources of sexually offensive or aggressive behavior. Surgical castration involves removal of the testes, after which it is possible but unlikely for a man to have an erection, and his sex drive is considerably lowered. Chemical castration — also called sexual suppression — entails taking a drug that inhibits or reduces the production of testosterone. Again, the patient can still “perform,” but his drive is considerably lowered. (In the handful of women convicted as sex offenders, similar drugs would merely act as oral contraceptives.)

Citing cases like Coleman’s and the nationally publicized case of Robert Komarenski (who, in 1992, begged the courts after he completed his sentence for sexual molestation to put him on testosterone-reducing drugs and has since been virtually cured), Berlin argues that counseling is key to determining who appropriately qualifies for drug treatment. Says Liz Schroeder, associate director of the ACLU in Southern California, “Not all sex offenders are pedophiles. The drug may work on a pedophile, but it’s unlikely to work against sadists. Counseling is imperative. It’s one of these legislative fixes that hasn’t been thought through.”

Even if it hasn’t been sufficiently thought through, the use of chemical castration on pedophiles in the United States dates as far back as the mid-’60s. Drugs such as Depo-Provera and Depo-Lupron have been and are being used in efforts to stop crimes before they happen. Explains Berlin, “In layman’s terms, with chemical castration you are providing people with a sexual appetite suppressant.”

Europeans have employed surgical and chemical castration since before the time Hitler. Berlin points to a well-known study conducted in Scandinavia over a 30-year period that demonstrated significant results. Among the more than 900 sex offenders in that country who underwent surgical castration, the recurrence of sexual offenses was less than 3 percent. This is a staggering figure when compared with some American studies showing that as many as 50 percent of sex offenders who are released commit similar crimes again. Yet statistics on the subject are few and far between.

“In general, there’s a 16 percent recidivism rate across the country,” says Zimring, who notes that when the California law was first put forth, Gov. Pete Wilson said the rate was much higher. “Wherever [the subject] has been studied in the Western world, sex offenders and child molesters have the lowest recidivism rate, next to burglars and thieves.”

Dr. Richard Krueger, medical director of the sexual behavior clinic at New York State Psychiatric Institute, has been treating sex offenders since the mid-’80s. He is currently preparing a symposium on treatment of sexual offenders to present before the American Academy of Psychiatry Law meeting in October in Vancouver, Canada. In the past, he has prescribed testosterone-reducing drugs to patients, but only after the patient’s request.

“Usually these laws are framed in a mandatory way,” Krueger says. “The medical association has taken the position that it’s unethical to administer medications without written consent.” When asked about the Tennessee bill, Krueger offered no opinion.

Who should qualify for chemical castration in the United States is a hotly argued issue. In the first place, legal and medical professionals differ in their definitions of what a sexual offense is. According to the Family Research Council, sex crimes against children include rape, sodomy, intimate touching, exposing oneself, voyeurism, forcing a child to engage in prostitution, pornography and live sex performances. Crimes against women include many of the same behaviors.

Yet many sex crimes committed against children are labeled molestation instead of sexual offenses. There’s also confusion over the difference between a child molester and a pedophile, not to mention a sadist. According to the American Psychiatric Association, a pedophile can be successfully treated with drugs like Depo-Provera, but a sadist (a person who acts out against written laws just to break them) is not a good candidate for chemical castration.

In May 1999 and in January of this year, the Tennessee bill was deferred by the judiciary committee. It is now under consideration once again. Burchett reports that funding is the main problem, not a lack of support. The fear of many in the Tennessee Senate and House is that administration of the drugs will be too costly to the state. “They think every offender who gets the drug each month will eventually hop on welfare, and then we pay for it,” says Burchett. But there’s an amendment in the bill, he says, that would make offenders pay for treatment themselves (at a cost of as much as $500 per monthly injection).

Regardless of the bill’s outcome, the Tennessee Senate will need to consider closely how it will handle convicted sexual offenders in the future. “What I’d like to do is pass the law and then implement the program,” Burchett says. “I hear horrible stories about 12-year-old kids. We’ve got to do something because we’re not doing anything. We’re locking them up and letting them out.”

In a 1992 interview with the Los Angeles Times, convicted offender Komarenski said the results of taking the testosterone-reducing drug Depo-Lupron were startling. “My sex drive is practically zero,” he said. “It works. It really works.”

She married and had a baby boy. Her husband, seven years her senior, worked construction and was often out of town. Jenks worked part-time as a
waitress but money was tight. That was when things
got bad. “Right after I had the baby I had a hard time,” she says. “All my
friends went off to college, I had no support, I was 19 and I had weight problems.” Around this time, Valerie decided to enter therapy.

Before she did, she sought advice from other
women. They recommended Dr. Mark Stephenson, then affiliated with the Eastern Idaho Medical Treatment Center. Jenks, 20 at the time, went to her first session with her first husband. Her original reasons for going were a weight problem and alcohol abuse. “He asked if I knew anything about hypnosis and gave a brief description of what it would entail,” Jenks says. “I never went under hypnosis before, but my husband was there and, after all, this was a doctor who was supposed to be helping me.”

By the end of the first hypnotherapy session, Jenks came to believe that she’d been sexually abused not only by her family but also by friends and strangers. Jenks says she answered “yes” to many of Stephenson’s questions by tapping the index finger of her left hand.

“I had no belief I was molested by anyone. But it wasn’t a dream,” she says about being under hypnosis, during which time the doctor took notes or recorded what she was saying. “I was conscious and awake and knew what I was saying. When I’d ask how can I believe it, he would say, ‘Our memories are true.’

“I already suffered abuse, so I made myself vulnerable,” she says now. “I
was searching for answers and he offered the right ones. He made everything fit. I wanted to believe there were reasons for my weight problems, alcohol problems and depression.”

Over the course of six months, Jenks was led through a series of
so-called repressed childhood memories that included specific details of
being sexually molested. Meanwhile, her marriage began to crumble.
Already an introverted person, she cut off family and friends and
frequently considered suicide. She had nightmares of the sexual
abuse; she recounted them to her therapist. The doctor then drew out further memories, including one of her being a member of her grandparents’ satanic cult. She was led to believe she had helped torture and kill babies
and children. After six sessions, Jenks’ entire perception of her memory had been altered. Jenks claims that by asking repeated questions and coaxing “yes” or “no” answers from her, Stephenson was able to create pictures in her mind of events that haunt her to this day.

“His leading and guiding questions brought me to the conclusion that I had
been molested and raped by several family members,” she says.

Later that summer, Stephenson concluded that Jenks was having an affair with her father and diagnosed her with multiple personality disorder (MPD). Jenks claims this was an incorrect diagnosis spawned from the memories he was planting in her mind. But that wasn’t enough to get Jenks out of Stephenson’s office. The sessions reached a finale
when Stephenson asked Jenks to participate in a three-hour hypnosis session to unearth the object implanted in her mind that originally made her a satanic cult member.

Sound wacky enough for you? It was for Jenks. She stopped seeing Stephenson in August 1993. In the fall, she visited the doctor’s employer, the Eastern Idaho Medical Treatment Center, and made her complaint.

There, Jenks found out that several other patients of
Stephenson had the same stories. Shortly after, Stephenson was fired, although he was then rehired by the hospital due to a contract dispute. It wasn’t
until Jenks and two other former Stephenson clients filed a complaint with Idaho’s state licensing board that Stephenson’s activities came to light.

In November 1998 Jenks reached a modest out-of-court settlement with Stephenson, who, she says, changed her perception of her
childhood forever. She was ruled the victim of false memory syndrome (FMS), a sister epidemic to the widely publicized MPD. In FMS, using mostly hypnotherapy, mental-health practitioners recover so-called repressed memories from patients they believe are suffering from traumatic events they’ve blocked from their memories.

According to a new book by Joan Acocella, “Creating Hysteria: Women and the Myth of Multiple Personality Disorder,” 40,000 cases of MPD were reported between 1985 and 1995. According to the False Memory Syndrome Foundation, 92 percent of the people who have it are female; 74 percent are between the ages of 31 and 50; 31 percent have education beyond college; and 60 percent report memory of abuse prior to age 4.

In the past five years the number of reported cases has declined, but malpractice suits continue to fill courtrooms and women like Valerie Jenks are now telling their stories and seeking compensation. Sums of $11 million and more are being paid to victims and, most recently,
mental-health practitioners are being prosecuted. In September of this
year, a Wisconsin jury awarded $862,000 to a victim of a psychiatrist’s
incorrect recovered-memory and MPD diagnosis.

Acocella argues that the rise in recovered-memory treatment was aided by feminism and child-protection groups as well as by the belief that, as she says, “Childhood sexual abuse is very common, affecting about one-third of girls.”

Repressed memory syndrome (RMS) therapy is based on the idea that childhood traumatic events often
dictate emotional behavior in adulthood. As Elizabeth Loftus, Ph. D.,
professor of psychology and adjunct professor of law at University of
Washington, puts it, “Mental-health practitioners use techniques to dig out
allegedly buried trauma memories under the belief that they must be ferreted out to heal the patient.”

Jenks’ therapist used hypnotherapy to get at those memories. In his statement before the board of psychologists of the state of Idaho in 1996, Stephenson cited his paper, “Overcoming the Structure of Control,” in which he explains that patients can discover this structure through motor responses to questions (hence the finger movements).

“He was trying to get a response via body movement,” says Chuck Lloyd of
the Minneapolis firm Lindquist & Vennum. Lloyd was one of three lawyers who represented Jenks. “When he [Stephenson] didn’t get the answer he
liked he’d tap on the ‘yes’ finger.”

Stephenson’s technique used the concept of ideomotor response, or a
physical response to an idea, in which fingers are used to designate
“yes,” “no” and “I’m not sure” answers. At Jenks’ first session, the questions went from the innocuous (name, birthday) to the more significant (“Have you ever been sexually molested?”).

“The notion of hypnotherapy makes sense if you believe that we
store everything we hear or see,” says Pamela Freyd, Ph.D., of the False Memory Syndrome Foundation in Philadelphia. “But it makes no sense because that’s not how the memory works. These recovered memories are highly contaminated; they can be false because of the suggestions by the
therapist.”

New York therapist David Halperin, Ph.D., steers clear of
hypnotherapy. “The problem is the issue of suggestibility,” he says. “When a person is in a state of hypnosis, the question is, To what extent are they impressionable? Is it a reflection of the patient, or a reflection of what the hypnotist is bringing to the situation?” And yet Halperin, as do thousands of others, concedes: “Freud used hypnosis. A colleague of mine used it. It can be used as a relaxation technique, but suggestibility is much more part of the process, and the risks are greater.”

According to Freyd, most people treated for RMS are white and female, between 25 and 45. “All of them were distressed with something in their life to go into
therapy for the first place,” he says. “Some went after birth of a baby, some were
anxious about relationships, a lot of people got into this because they
were too fat, so people entered into therapy for a variety of reasons. But
if you turn to somebody for help, and they tell you you were abused, then
that stage is set.”

Attorneys are getting a big boost from the epidemic through
malpractice cases. Christopher Barden, a Minnesota psychologist and another of Jenks’ attorneys, has made a career of successfully suing therapists in MPD cases. Barden participated in one of the largest settlements in history in a psychotherapy negligence case when one of his clients, Patricia Burgus, received a $10.6 million settlement in November 1997.

Lloyd points out that big settlements generally occur in states such as Texas, where juries historically award big sums, as opposed to states such as Idaho, where juries tend to behave more conservatively.

Although media hype has waned, court cases and victims continue to crop up. America’s therapy community may be partly to blame. Also, in an atmosphere filled with inaccurate information and dramatic Hollywood reenactments, few laws govern how psychotherapists and mental-health practitioners operate. “In Washington, you can call yourself a therapist if you have $80 and take a test,” Loftus says. “The public is not at all educated on therapy. They can’t make distinctions.

“Because it wasn’t regulated, the crisis
erupted and these false accusations became widespread,” Loftus says.
“The regulation [of therapists] has, sadly, been accomplished through
litigation. Only after huge settlements that were leveled against
psychotherapists have insurers stopped paying.”

Acocella claims that many women who missed the boat on feminism found solace in their presumed mental dilemmas. “Many of these had the same grim lives as their mothers: early pregnancy, unkind husbands or boyfriends, boring jobs, little money, no education. The process helps to explain the great outbreak of female disorders in the last few decades. Many women, then, had reason to take shelter in multiple personality disorder. It restored their dignity; it gave them a career.”

Jenks is now working on a real career. She lives in Boise, Idaho, with her second husband and newborn. Her plans are to attend college and pursue journalism. Looking back, she says, “Before I met [Stephenson] I had a weight problem and guilty feelings. Now I’ve lost childhood memories and I have severe depression. I’ve lost a lot of time with my family. I’m never going to therapy again. Heavens, no.”