The nervous, wiry man in front of me has decided to embark on some last-minute
negotiations. “I won't talk about my crime,” he says. “There are people in
this hospital who don't know what I did.”
If anyone has ever bared his soul to you, then you will know that such people
usually do some emotional limbering up first - and this is what Thomas
Taylor is doing. He is wondering how far to go, sniffing out the boundaries.
But there is no way he isn't going to tell me about how he killed five
people because of his lust for a little girl.
So I let him bend and stretch until he loosens up, then off he goes, talking
about the parents who abandoned him, the abuse at the hands of an uncle, the
priests who forced themselves on him, his own abuse of young children and
the constant intrusion into his thoughts of paedophile fantasies urging him
to “rape, kill, rape, kill”. But now, he says with a smile, he is better.
We are alone in the office of Taylor's psychiatrist in a hospital housing some
of Canada's most dangerous psychopaths and sex criminals. And when we are
finished, Taylor, a fit 50-year-old, offers to fetch Brian Browne, a stout
man of the same age. Browne, like Taylor, is jarringly pleasant, a
paedophile talking about the procession of girls as young as 6 whom he has
sexually abused and raped. He has been in prisons and hospitals for 18
years, but now, he insists, he is safe. He won't touch kids again. Finally,
at the end of a dark and unpleasant day, I meet friendly and intelligent
Jesse White at a group therapy session for 25 paedophiles. White has done
time but is out of prison, and there's no way he'd molest those two little
girls again. Or spend hours trading child pornography on the internet,
living a dual life that his girlfriend knew nothing about. No. He's cured.
If you find this hard to believe, wait before rushing to judgment until you
consider what binds these men together: they have all been chemically
castrated. They have had their sex drives, and the deviant thoughts that go
with them, suppressed with the use of pharmaceuticals in a pioneering scheme
at the Royal Ottawa Mental Healthcare Centre, on the outskirts of the
Canadian capital. Up to 188 patients classed as “medium to high risk” are
housed in an environment that emphasises treatment rather than just
incarceration.
It is a centre of interest to psychiatrists in the UK because, under a new
Department for Health initiative, plans are being laid to make reversible
pharmaceutical castration more widely available to sex offenders who need,
and ask for, it. And many offenders do more than ask. They beg.
Chemical castration is not new. Antiandrogen (or antilibidinal) drugs that
reduce testosterone levels until a man is neither interested in nor, in most
cases, able to perform sex have been available for decades and used on a
voluntary basis on sex offenders in countries including the Netherlands,
Germany and the US. But in the UK their use has been limited. In the 1960s
they were used in prisons and mental hospitals on inmates with overactive
sex drives, but primarily they are licensed as prostate cancer treatments.
Prostate cancer needs testosterone to thrive; antiandrogens starve it of the
hormone. Already, several offenders in the UK have been chemically castrated
under the new initiative, and we shall meet one later. First, though, we
travel to Ottawa. Here, for the past seven years, Dr Paul Fedoroff, director
of the centre's sexual behaviour clinic, has been providing a service that
treats, side by side, serious sex criminals and individuals who have not
offended but are afraid they might. He uses psychotherapy, group counselling
and pharmaceuticals from antidepressants to the antilibidinals.
“I have seen many patients who have committed murders and rapes, who have been
involved in sexual torture of victims, who have changed dramatically on
these medications, to the point where they are nowhere near the risk they
were,” he says.
Fedoroff is in his late forties, non-judgmental and respected by his patients.
“When I give them the medication, many say it is like having a vacation from
the deviant thoughts that have plagued them all their lives,” he says. “Our
outpatient clinic, which looks after medium to high-risk offenders, has been
running for seven years. We treat about 200 patients a year, a quarter of
whom get antilibidinal medication, and we have never had anyone reoffend
with a hands-on sex crime.”
Thomas Taylor has probably committed the worst crime among Fedoroff's
patients, and was once considered too dangerous to be released. He is at a
medical centre associated with the Ottawa clinic but on a different campus.
It is thought that he could soon be back in the community.
“From the age of 11 I was having sexual fantasies,” Taylor says. He was born
in Montreal to a mother who was a prostitute and a father who was one of her
clients. “I was passed around relatives and care homes. When I started
having fantasies I was living with my aunt and I remember that the thoughts
turned to killing. I thought about raping and killing her, and those
thoughts scared me.”
He was sent to more children's homes and was, he says, continually sexually
abused. He did time in prison and in a mental institution before raping a
prostitute and handing himself in to police and he served almost two years.
After his release he met a woman and married, but among her family he says
that he was the only person who worked and he felt put-upon. He believes
that one of the reasons he stuck around was to be close to his wife's
sister, Katie, 13, whom he had been trying to get to sleep with him. One
day, after a violent argument with his in-laws, he snapped. “That day I was
ready to explode. I'd spent half my life fighting thoughts that urged me to
rape and kill, rape and kill.” After the in-laws had gone, five family
members (two children and three adults) were in the house. “I remember
walking round the living room with my rifle. Then I remembered their
daughter, Katie. The previous week I had asked her to make love to me. She
had said no, she was a virgin, and I respected that. But now this thought
pushed me over the edge. I went from room to room and shot them one by one,
undressed Katie's body, laid her down and looked at her. I didn't touch her.
Now I realise that was the motivation for the killings. It was not simply
the anger; it was sexual. The difference between killing them all and not
killing them was that girl. And I learnt that before I could ever be
considered safe, it was this paedophilia that I would have to deal with.”
I don't believe Taylor when he says that he did nothing sexual to the girl,
but patient confidentiality dictates that Fedoroff cannot tell me one way or
the other. It might be easier to admit to murder than to sexually assaulting
a (dead?) 13-year-old girl. One thing the doctor can tell me is that Taylor
is not the risk he was. Taylor believes this, too. After three decades in
the Canadian psychiatric and penal systems, he was put in Fedoroff's hands
about six months ago. The psychiatrist assessed him and suggested Lupron, an
antilibidinal, gonadotropin-releasing hormone agonist, or GnRH. The brand
name in the UK is Prostap.
“Before, I was never able to meet a woman without thinking about sex,” Taylor
says. “Since being on the Lupron, I have no sex drive. For the first time I
have established friendships with women [patients] that have nothing to do
with sex. I can get on with life like a normal person.”
That is all very well, but how can the public be sure that such men would be
safe on release? How can we even know that they would take their medication?
While some medication - for those under daily supervision - is in pill form,
most is administered by injections either monthly or every three or four
months, at a cost of about £500 for three months. There can be side-effects
(hot flushes, weight gain and osteoporosis) but most offenders/patients feel
that the benefits outweigh the drawbacks. They turn up weekly for individual
or group therapy sessions, and are constantly assessed. Any failure to turn
up for an injection means a visit from a social worker. And it can take up
to six months for hormones to return to normal levels.
Not one of the men I interviewed said that he would consider coming off the
medication unless his psychiatrist thought it appropriate. They do not want
to go back to offending. They want normal lives.
Brian Browne is a case in point. “I am a repeat paedophile offender,” he says.
“I come from a dysfunctional family, I've been in trouble with the law since
I was 8. Sex has been part of my life as far back as I can remember. My
first offence, I didn't get charged. It was a six-year-old girl in a group
home that I was in; I was 13 at the time.”
More serious offences and spells in jail followed until the last offence 18
years ago, which he says horrifies him. “I had been working and drinking
with the boys and doing drugs, too. Instead of going to meet my wife and son
I saw three girls going into the mall,” he says. “I followed them and
managed to coerce one outside. I got her into an enclosed area, held her
hand and offered her money for sex. It scared the daylights out of her. She
was about 10.
“I've been on medication in the past and found that it didn't help. Now I'm on
Lupron and there is no sex drive. There are no sexual desires. If I'd heard
of this years ago it would probably have saved me a lot of time in jail -
and saved a lot of victims.”
I ask if he would be likely to reoffend if he was released. “I don't think I'd
be a danger because I've gone through the programme, I've learnt how to see
triggers - things I wouldn't have thought about in the past that led to my
offences,” he says.
I see Jesse White again the next day. He was first arrested after sharing
child pornography with the wrong e-mail address. When the police arrived, he
confessed to molesting two young girls. He is now out of prison, holds down
a responsible job and attends weekly group therapy sessions.
“My psychiatrist was hesitant about putting me on the medication,” he says. “I
had to say, look, this is killing me - I was inundated with sexually deviant
thoughts - and I convinced the doctor to let me have it. Those thoughts went
away. After a while I stopped thinking deviant thoughts about children.
Without it I would have committed suicide by now.”
All three men say they would not consider going off the medication unless they
found themselves in a stable relationship with an understanding adult female
- and then only in agreement with a psychiatrist.
In the UK, the Department for Health has commissioned Professor Don Grubin, of
the Institute of Neuroscience at Newcastle University, a consultant forensic
psychiatrist in the Northumberland, Tyne & Wear NHS Trust, to
co-ordinate better provision of voluntary antilibidinals (medical
professionals don't like the term “chemical castration”). He has set up the
National Psychiatric Offender Advisory Service to offer information and
guidance to professionals whose patients or inmates might benefit from the
treatment. “We're aiming to set up protocols for people to follow and to
provide supervision and consultation,” says Grubin. He is establishing a
system of evaluating patients to see if they would benefit from treatment.
According to Grubin - and all the professionals to whom I spoke - medication
would be administered only on a voluntary basis. Castration as a punishment
or condition of parole would probably be in breach of an individual's human
rights.
One of the first organisations to use Grubin's network was a primary
healthcare trust in southwest England, where one psychiatrist says: “I heard
about Grubin's work and met him to find out about the treatment. Now I am
treating my first patient with cyproterone acetate (Androcur) and the
results have been amazing.”
Mark Colley is a self-professed loner in his twenties who was abused and
bullied within his family as a child. He became obsessed with forming
relationships with children. His worst offence, for which he was jailed,
involved abducting a nine-year-old girl at knifepoint and sexually
assaulting her. “I had even convinced myself at the time that I was doing
nothing wrong,” he says. “I have always had urges and sexual fantasies about
children. When I was offered the chance to go on this medication, I was
worried at first but I wanted to solve my problems. Now the urges and
thoughts have gone away and I have counselling to help me to understand my
problem and deal with it. For the first time I can imagine having a positive
future.”
Neither Fedoroff nor Grubin is aware of any serious academic research that can
indicate how effective antiandrogens are at preventing reoffending.
Anecdotally, they say that recidivism among offenders is very low - maybe 3
per cent, according to Fedoroff.
“There may be those who don't like the idea of offenders receiving help,” says
Grubin. “But these are not individuals who are going to be released because
of this treatment. They are offenders who have served their time. This isn't
part of the punishment, but aims to reduce the likelihood that they will
need to be punished again. The question is: do you want them out there with
treatment, or without it?”
There is another side to this story. The psychiatrist treating Colley said
that he'd like to see a system in which individuals could seek help before
they offend. Grubin says that the present provision is a lottery (some NHS
trusts won't prescribe an antiprostate cancer drug as an antilibidinal).
But in Canada I meet Toby Walker, a nervous 21-year-old student. He went to
see his doctor about being depressed and admitted having thoughts about sex
with children. His doctor referred him to Fedoroff. He is now on
antiandrogens. His mother is with him and she is close to tears. “I hope my
medication will stop me having these fantasies so I won't act them out,”
says Walker. He is almost in tears, too. “I want my life back. To be a
normal person.”
I ask what would have happened to him if this service, this medication, had
not been available. “I would probably have committed suicide,” he says, “I
promised that before I harmed anyone, I'd kill myself.”
All names of patients and some details of their crimes have been altered to
respect patient confidentiality
©Steve Boggan
Castration: the facts
Chemical castration works by administering chemicals, either through pills,
injections or implants, which diminish the sex drive by suppressing
testosterone production.
A 1997 survey in Denmark showed that out of 700 sex criminals chemically
castrated, repeat offences fell from between 17 and 50 per cent to 2 per
cent.
In smaller studies in Scandinavia and Italy, chemical castration was found to
be equally effective in some groups of volunteer prisoners.
However, other studies have shown that treatment isn't always effective. Some
paedophiles who have received significant oral dosages of medication still
reported regular sexual arousal and fantasies.
Some side-effects of the antiandrogens can be osteoporosis, gynecomastia (male
breast growth), heart problems and hot flushes.
