Home

Help for parents

Legislative Update

News

Understanding the issue

Personal stories

Media coverage

Criticism from experts

Juvenile sex law

Get involved

Discussion board

Reading list

Organizations and links

Research on youth sexuality

References:

1. Abel, G. & Harlow, N., The Stop Child Molestation Book, Xlibris, 2001.

2. Burton, D. & Smith-Darden, J., North American Survey of Sexual Abuser Treatment and Models 2000, Brandon, VT: Safer Society Foundation, 2001.

3. Lotringer, S., Overexposed: Treating sexual perversions in America, New York: Pantheon Books, 1988.

4. Righthand, S. & Welch, C., "Juveniles Who Have Sexually Offended," U.S. Office of Juvenile Justice and Delinquency Prevention, March 2001.

About the author

DANGEROUS DRUGS

Some youth classified as sex offenders are required to use drugs to reduce their testosterone levels and therefore their sex drive. Such use requires very high dosages, and is frequently called “chemical castration.” The most commonly used drugs are antiandrogens (Provera, Depo-Provera, and cyproterone acetate) and selective serotonin reuptake inhibitors (SSRIs).

Antiandrogens

Experts note several dangerous side effects of these drugs:

• There has been considerable interest in the use of antiandrogen drugs to decrease sexually aggressive behavior. The evidence for the role of testosterone in sexually aggressive behavior, however, is equivocal and conflicting...The literature is confusing...Antiandrogen drugs such as cyproterone acetate (CPA) and MPA [Depo-provera] may delay the onset of puberty. CPA has been associated with a number of undesirable side effects such as gynecomastia, hypersomnia, fatigue, depression, and alterations in adrenal functioning, while MPA has been related to increased weight gain, gastrointestinal upset, headaches, sleep disturbances, malaise, and hyperglycemia. There are considerable ethical and legal implications in the use of antiandrogen medications as they are not approved by the Food and Drug Administration for the treatment of sexual abusers.⁵
  --American Academy of Child and Adolescent Psychiatry

• ...this so-called castrating drug has two drawbacks. It may have to be prescribed at high doses...General physicians usually have no experience with Provera used to treat child molesters (its primary use is for breakthrough uterine bleeding) and are reluctant to prescribe a high dosage of a drug that could cause such serious side effects as diabetes, or blood clots. Since it interferes with bone growth, it would stunt a child's height, therefore, this drug is rarely prescribed for anyone under 18.¹
  --Sexual deviance expert Gene Abel

In spite of this statement, there are reports of the use of antiandrogens on juveniles. The 17 year old convicted for a sexual relationship with a 15 year old and interviewed by Lotringer described his experience this way:

This drug would stop you from getting an erection to anything…They said, 'you can stop whenever you want.'...He’ll talk you into the drug, into increasing the dosage more and more, like he did to me. The way he put it, you couldn’t say no...I was taking 100 milligrams a day for about two weeks. I had less sex drive, but I was getting sick...The side effects were cold spells, sweating. They gave me two more drugs to stop those. I felt worse than before, so I threw them all out...I went over to the clinic and told the doctor what I did, and he had a heart attack...He said that if I did it one more time, he’d take me off the course…And you know what taking me off would mean once the judge found out...You feel so bad, you start thinking of suicide…I tried to kill myself in jail. The pants I used to hang myself ripped.³

Serotonin reuptake inhibitors (SSRIs)

Sexual deviance experts recommend SSRIs as a safer alternative to antiandrogens. One describes them as miraculous “drugs that change sex thoughts”:

You probably know SSRIs as the group of drugs psychiatrists prescribe most often to combat depression...What you may not know is that psychiatrists also commonly prescribe these drugs in larger doses for patients who have problems such as obsessive-compulsive disorders...In dosages at the high end of what psychiatrists prescribe for patients with an obsessive-compulsive disorder, these drugs have a major effect on the paraphilic [deviant] sex drive.¹
--Sexual deviance expert Gene Abel

However, experts admit there are drawbacks to SSRIs:

• Less than 10% have nausea, insomnia, dry mouth, headache, tremors, weight loss. Liver injury. Depression of white blood cells.¹
  --Gene Abel

• The role of serotonin in regulating sexual behavior is not fully understood. Many questions concerning psychopharmacological approaches remain. These questions include which juveniles are likely to benefit from such an approach and at what dosages.⁴
  --U.S. Office of Juvenile Justice

Nevertheless, Abel recommends the use of SSRIs even on boys who have not molested, but who have deviant feelings according to plethysmographs or his sexual interest test:

Now that the SSRIs are proven effective, we have a drug that is safe to use with older children and teenagers...This class of drugs can be used for prevention. Not only can we identify teenagers with sexual interest in young children, we also now have drugs that, when used in combination with cognitive-behavioral treatment, can stop a teenage boy before he has a victim.¹

Surveys do not indicate how many programs for juveniles use these particular drugs. A 2000 survey found that 45% of juvenile offender programs and 38% programs for children used some type of medication, but this figure included luprolide acetate, tranquilizers, lithium carbonate, Anafranil, and Buspar, in addition to antiandrogens and SSRIs.²

• Continue to Striking Comparisons