Castrating chemicals

A sexually abusive doctor claims he's been cured by a testosterone - reducing drug called Lupron.

Topics:

Castrating chemicals

Tom battled for years to control his obsessive sexual attraction to teenage boys. It eventually landed him in court for stalking.

“It’s kind of like if you have a big sweet craving, when you think about it all the time,” he says. “I would hang around with teenagers and then things would happen.”

The 47-year-old, who asked not to be identified, isn’t the typical picture of a sex offender. Thoughtful and articulate, he lives with his wife and together they’ve made a commitment to work through his sexual deviance. And so far, he’s proud to report, they’re succeeding. Why? A drug called Lupron gets at least partial credit. The drug decreases testosterone, the hormone that fuels the sex drive. Tom’s desire for intercourse is almost nil now — but along with it has also largely gone the lust for adolescent boys.

“It’s a big help,” he says. “I would be OK without it because I’m committed to working on this deviant behavior, but it would be a lot harder. It would take a tremendous amount of will power.”

Lupron is one of the latest in a series of drugs, called antiandrogens, that trigger a reduction in the production of testosterone. Most commonly used to treat men with prostate cancer — like New York Mayor Rudolph Giuliani — and women with endometriosis, it also serves as a “chemical castration” to treat sex offenders.

In late August the new chemical castration drug surfaced in the news during the professional hearings of sex addict and former family practitioner Dr. Joseph Campanella. He had admitted to more than 200 improper sexual liaisons with members of his office staff, hospital employees, patients and homosexual strangers over the past 18 years. His license was finally suspended in January after he was caught masturbating in front of a church bus. When Campanella went before a Chicago medical disciplinary board, he claimed that he had already been “cured” and was ready to return to his medical practice.

His treatment? Six weeks of therapy and Lupron.



Campanella’s claims that Lupron can catalyze a quick-fix cure for sexual deviants has raised many questions about the use and efficacy of chemical castration drugs and the very essence of sexual deviance itself. The theory behind Lupron is that reduced sex drive results in a greater ability to control deviant sexual urges, but can flipping a testosterone-laden switch really turn off deviant sexual thoughts? Don’t sexual predators and pedophiles prey on vulnerable people and children in part out of a psychological desire to dominate or inflict pain? Can we really transform a person’s ethical system though tinkering with their chemistry? Is immorality in the end a treatable physical disability?

Most medical researchers would argue that sex offenders aren’t “cured” by such a quick-fix solution. They maintain that Lupron is just one part of a complete and complex treatment regimen. But still some clinicians wax enthusiastic about its ability to transform the dangerous but well-meaning perv into an upstanding citizen.

“It’s a wonderful drug,” says Dr. Gabrielle Paladino, a psychiatrist who works in a treatment program for convicted sex offenders at California’s Atascadero State Hospital. “It’s great to see that someone who can’t keep their hands off people is able to control those urges.”

Other doctors, however, remain skeptical of such ringing endorsements. “There are so many misconceptions about Lupron and other drugs like it,” says Dr. Fred Berlin, associate professor and founder of the Johns Hopkins Sexual Disorder Clinic. “Some people respond well to it, others don’t. Each sex offender is different.”

Lupron differs from Depo-Provera, another common antiandrogen, used primarily as a form of birth control for women. Instead of releasing a form of progesterone into the body as Depo-Provera does, Lupron works directly on the brain. By tripping up the hormone in the brain that signals to the pituitary gland to produce estrogen in women and testosterone in men, it has a generalized desexualizing effect.

“In a sense, you can say the sexual drive for both men and women begins in the brain with GnRH [gonadotropin-releasing hormone], which starts working at puberty,” says Dr. Richard Spark, associate professor at Harvard University and author of the book “Sexual Health for Men.”

Studies in Europe and the United States have shown that castration, whether chemical or the old-fashioned surgical kind, does tend to lower recidivism rates among sex offenders, Berlin says. In a report published two years ago in the New England Journal of Medicine, Israeli researchers found that all men studied responded with a decreased number of sexual fantasies and deviant sexual acts when treated with a combination of therapy and triptorelin, a Lupron-like clone medication. Though, interestingly, they noted a lag time of 10 to 11 months between the physical reduction of testosterone levels and reduction of sexual thoughts.

Still, even doctors who’ve had good results with Lupron don’t believe it can help those with violent tendencies. “Of course, some sex offenders don’t need much in the way of testosterone to offend,” says Paladino. “Many of these people have problems in their head, not their genitals.”

Paladino and Berlin deal with patients on different ends of the clinical spectrum. Paladino’s clients are convicted sex offenders identified before the end of their prison term as “sexually violent predators” who must receive treatment before being released, while Berlin generally deals with clients on an outpatient basis, who generally exhibit less extreme pathologies. Still, they’ve both noticed improvements in some of their patients who take Lupron.

“I’ve treated many men who took it and it helps them,” says Berlin. “But I would never recommend using it strictly on its own. It’s not like throwing a switch, it’s more subtle … when I’m hungry, for example, I’m thinking obsessively about food. But absence of hunger is not a presence, and therefore it’s hard to measure. But certainly, with an absence of hunger, I’m less likely to eat.”

Paladino says Lupron works for different reasons on different types of offenders. “It’s a very effective treatment for a psychopath, for example, as an external control or monitor … But for other patients who are tormented by sexual thoughts, Lupron is a godsend. I have a guy who drops his pants in front of female police officers in the hospital. He just can’t help himself on his own.”

Regardless of the effectiveness and understanding of the proper use of Lupron and other testosterone-lowering drugs, the political reaction to castration ranges wildly from horror to blind faith. In 1996, convicted sex offender Larry Don McQuay actually begged for the state of Texas to castrate him before he was released. (State officials refused to perform either a surgical or chemical castration). The same year, California passed a law mandating that certain types of convicted sex offenders on parole be required to take a Depo-Provera injection.

“I’d call myself a moderate,” says Berlin. “I think no one should be forced to take any of these drugs, but certainly, the drugs should be made available to those who want it.”

Tom, one of Berlin’s patients, says he couldn’t maintain his ordinary married life without Lupron. And despite the fact that he’s suffered the drug’s worst side effects — flushing, bone mass density problems and lowered sex drive — he’s become one of Lupron’s biggest fans.

He concedes that his use of Lupron has caused certain problems in his marriage. “I can just barely have sex with my wife,” he says. But, he quickly adds, being free from deviant sexual thoughts is worth whatever sacrifices they have to make. “In a strange way,” he muses, “you could actually say it’s brought us closer.”

Leah Kohlenberg is a freelance writer and teacher in Seattle.

More Related Stories

Featured Slide Shows

  • Share on Twitter
  • Share on Facebook
  • 1 of 11
  • Close
  • Fullscreen
  • Thumbnails

    Ten spectacular graphic novels from 2014

    Beautiful Darkness by Fabien Vehlmann & Kerascoët
    Kerascoët's lovely, delicate pen-and-watercolor art -- all intricate botanicals, big eyes and flowing hair -- gives this fairy story a deceptively pretty finish. You find out quickly, however, that these are the heartless and heedless fairies of folk legend, not the sentimental sprites beloved by the Victorians and Disney fans. A host of tiny hominid creatures must learn to survive in the forest after fleeing their former home -- a little girl who lies dead in the woods. The main character, Aurora, tries to organize the group into a community, but most of her cohort is too capricious, lazy and selfish to participate for long. There's no real moral to this story, which is refreshing in itself, beyond the perpetual lessons that life is hard and you have to be careful whom you trust. Never has ugly truth been given a prettier face.

    Ten spectacular graphic novels from 2014

    Climate Changed: A Personal Journey Through the Science by Philippe Squarzoni
    Squarzoni is a French cartoonist who makes nonfiction graphic novels about contemporary issues and politics. While finishing up a book about France under Jacques Chirac, he realized that when it came to environmental policy, he didn't know what he was talking about. "Climate Changed" is the result of his efforts to understand what has been happening to the planet, a striking combination of memoir and data that ruminates on a notoriously elusive, difficult and even imponderable subject. Panels of talking heads dispensing information (or Squarzoni discussing the issues with his partner) are juxtaposed with detailed and meticulous yet lyrical scenes from the author's childhood, the countryside where he takes a holiday and a visit to New York. He uses his own unreachable past as a way to grasp the imminent transformation of the Earth. The result is both enlightening and unexpectedly moving.

    Ten spectacular graphic novels from 2014

    Here by Richard McGuire
    A six-page version of this innovative work by a regular contributor to the New Yorker first appeared in RAW magazine 25 years ago. Each two-page spread depicts a single place, sometimes occupied by a corner of a room, over the course of 4 billion years. The oldest image is a blur of pink and purple gases; others depict hazmat-suited explorers from 300 years in the future. Inset images show the changing decor and inhabitants of the house throughout its existence: family photos, quarrels, kids in Halloween costumes, a woman reading a book, a cat walking across the floor. The cumulative effect is serene and ravishing, an intimation of the immensity of time and the wonder embodied in the humblest things.

    Ten spectacular graphic novels from 2014

    Kill My Mother by Jules Feiffer
    The legendary Pulitzer Prize-winning cartoonist delivers his debut graphic novel at 85, a deliriously over-the-top blend of classic movie noir and melodrama that roams from chiaroscuro Bay City to Hollywood to a USO gig in the Pacific theater of World War II. There's a burnt-out drunk of a private eye, but the story is soon commandeered by a multigenerational collection of ferocious women, including a mysterious chanteuse who never speaks, a radio comedy writer who makes a childhood friend the butt of a hit series and a ruthless dame intent on making her whiny coward of a husband into a star. There are disguises, musical numbers and plenty of gunfights, but the drawing is the main attraction. Nobody convey's bodies in motion more thrillingly than Feiffer, whether they're dancing, running or duking it out. The kid has promise.

    Ten spectacular graphic novels from 2014

    The Motherless Oven by Rob Davis
    This is a weird one, but in the nervy surreal way that word-playful novels like "A Clockwork Orange" or "Ulysses" are weird. The main character, a teenage schoolboy named Scarper Lee, lives in a world where it rains knives and people make their own parents, contraptions that can be anything from a tiny figurine stashable in a pocket to biomorphic boiler-like entities that seem to have escaped from Dr. Seuss' nightmares. Their homes are crammed with gadgets they call gods and instead of TV they watch a hulu-hoop-size wheel of repeating images that changes with the day of the week. They also know their own "death day," and Scarper's is coming up fast. Maybe that's why he runs off with the new girl at school, a real troublemaker, and the obscurely dysfunctional Castro, whose mother is a cageful of talking parakeets. A solid towline of teenage angst holds this manically inventive vision together, and proves that some graphic novels can rival the text-only kind at their own game.

    Ten spectacular graphic novels from 2014

    NOBROW 9: It's Oh So Quiet
    For each issue, the anthology magazine put out by this adventurous U.K.-based publisher of independent graphic design, illustration and comics gives 45 artists a four-color palette and a theme. In the ninth issue, the theme is silence, and the results are magnificent and full of surprises. The comics, each told in images only, range from atmospheric to trippy to jokey to melancholy to epic to creepy. But the two-page illustrations are even more powerful, even if it's not always easy to see how they pertain to the overall concept of silence. Well, except perhaps for the fact that so many of them left me utterly dumbstruck with visual delight.

    Ten spectacular graphic novels from 2014

    Over Easy by Mimi Pond
    When Pond was a broke art student in the 1970s, she took a job at a neighborhood breakfast spot in Oakland, a place with good food, splendid coffee and an endlessly entertaining crew of short-order cooks, waitresses, dishwashers and regular customers. This graphic memoir, influenced by the work of Pond's friend, Alison Bechdel, captures the funky ethos of the time, when hippies, punks and disco aficionados mingled in a Bay Area at the height of its eccentricity. The staff of the Imperial Cafe were forever swapping wisecracks and hopping in and out of each other's beds, which makes them more or less like every restaurant team in history. There's an intoxicating esprit de corps to a well-run everyday joint like the Imperial Cafe, and never has the delight in being part of it been more winningly portrayed.

    Ten spectacular graphic novels from 2014

    The Shadow Hero by Gene Luen Yang and Sonny Liew
    You don't have to be a superhero fan to be utterly charmed by Yang and Liew's revival of a little-known character created in the 1940s by the cartoonist Chu Hing. This version of the Green Turtle, however, is rich in characterization, comedy and luscious period detail from the Chinatown of "San Incendio" (a ringer for San Francisco). Hank, son of a mild-mannered grocer, would like to follow in his father's footsteps, but his restless mother (the book's best character and drawn with masterful nuance by Liew) has other ideas after her thrilling encounter with a superhero. Yang's story effortlessly folds pathos into humor without stooping to either slapstick or cheap "darkness." This is that rare tribute that far surpasses the thing it celebrates.

    Ten spectacular graphic novels from 2014

    Shoplifter by Michael Cho
    Corinna Park, former English major, works, unhappily, in a Toronto advertising agency. When the dissatisfaction of the past five years begins to oppress her, she lets off steam by pilfering magazines from a local convenience store. Cho's moody character study is as much about city life as it is about Corinna. He depicts her falling asleep in front of the TV in her condo, brooding on the subway, roaming the crowded streets after a budding romance goes awry. Like a great short story, this is a simple tale of a young woman figuring out how to get her life back, but if feels as if it contains so much of contemporary existence -- its comforts, its loneliness, its self-deceptions -- suspended in wintery amber.

    Ten spectacular graphic novels from 2014

    Through the Woods by Emily Carroll
    This collection of archetypal horror, fairy and ghost stories, all about young girls, comes lushly decked in Carroll's inky black, snowy white and blood-scarlet art. A young bride hears her predecessor's bones singing from under the floorboards, two friends make the mistake of pretending to summon the spirits of the dead, a family of orphaned siblings disappears one by one into the winter nights. Carroll's color-saturated images can be jagged, ornate and gruesome, but she also knows how to chill with absence, shadows and a single staring eye. Literary readers who cherish the work of Kelly Link or the late Angela Carter's collection, "The Bloody Chamber," will adore the violent beauty on these pages.

  • Recent Slide Shows

Comments

0 Comments

Comment Preview

Your name will appear as username ( settings | log out )

You may use these HTML tags and attributes: <a href=""> <b> <em> <strong> <i> <blockquote>