Kyrgyz lawmakers are currently debating a draft law that would allow men convicted of raping or attempting to rape children to voluntarily choose chemical castration to rehabilitate themselves.
If Kyrgyzstan adopts the measure into law, the country would join a number of jurisdictions across the world that have introduced castration -- either chemical or surgical -- to deal with sex offenders.
Backers say such treatment is intended to protect society against sex crimes, but the practice raises serious concerns, including with regard to civil liberties.
Chemical castration, or "antilibidinal psychopharmacological intervention," consists of treating sex offenders with antiandrogen drugs. Such drugs reduce testosterone levels, leading to a reduction of sexual desire and performance. They can be prescribed alongside antidepressants that can help patients with obsessive sexual fantasies to control their sexual thoughts.
In some countries, including Moldova, Poland, Russia, South Korea, and a number of U.S. states, such treatment is mandatory for those convicted of sexual offenses against children. The voluntary use of this treatment is more widespread and has been introduced in a number of Western European countries as well. The medication reportedly costs about $4,500 a year for one person.
Iceland-based psychiatrist Petur Hauksson says the practice can be an efficient alternative to imprisonment, allowing the release of sex offenders while eliminating or reducing the chance that they reoffend. The practice has been employed in Denmark for many years.
"Sex offenders [who undergo] this treatment are followed very closely. And if they don't show up for an appointment the police know where they are, so they can catch them," Hauksson explains. "It is a cooperation between the doctors, prisoners, and police. The system seems to function very efficiently."
Questions Of Consent
Under the proposed Kyrgyz legislation, treatment would be voluntary but the patient would not be offered a more lenient sentence.
Parliament passed the draft in its first reading last month. It needs to pass two more readings and be ratified by the president before becoming law.
Parliament deputy Tursunbai Bakir-uulu tells RFE/RL's Kyrgyz Service that the treatment would help protect children at a time when reported sex crimes are on the rise.
"The proposed law says that the individual's opinion is taken into consideration before castration is used. Then a special medical commission checks that person's physical and psychological condition and gives a conclusion," the former ombudsman notes. "So the proposed draft law is much more humane than in some other countries where the practice is implemented."
Maggie Maloney, law and policy adviser at Amnesty International in Britain, says her organization is not completely opposed to the practice, but it has to be a voluntary medical treatment -- not a punishment -- on the basis of a serious medical assessment.
When individuals are offered a more lenient sentence or early release if they subject themselves to otherwise unwanted castration, Maloney says, their consent should not be considered "free." In such cases, medical intervention becomes part of the punishment and thus counter to the prohibition of cruel, inhumane, or degrading punishment under human rights law.
"It's very difficult to ensure that there's genuine consent," she adds. "The person shouldn't be put under pressure to accept the treatment."
Maloney also says individuals have to be fully informed about the effects of treatment. It is generally considered reversible when discontinued, although possible side effects among men include the development of breast tissue and bone density loss.
"We must consider protecting the victim primarily and consider the rights of the perpetrator or potential perpetrator as secondary," says Ludwig Lowenstein, the head of Southern England Psychological Services and president of the International Council of Psychologists, in response to objections to chemical castration on the grounds of civil liberties.
"Chemical castration is probably the lesser way of punishing an individual, but one needs to be certain that the individual concerned first of all reacts favorably to such castration and secondarily that he, in fact, accepts the fact that he needs this," Lowenstein adds.
Many psychologists insist that the treatment should be part of a range of interventions that ensure that the patient's treatment regime is being followed and is working.
An even more radical form of castration of sexual offenders is surgical castration or "testicular pulpectomy," which involves the removal of tissue inside the testicular capsule.
Germany and the Czech Republic are the only two European countries that allow the practice. Both have been criticized by the Council of Europe's antitorture committee for employing surgical castration, which it describes as degrading and mutilating.
Hauksson, a former committee member, says there is no guarantee the intended result will last permanently. "This is not very effective because it is so easy for these castrated men to obtain artificial testosterone and then they are back to normal -- so to say," he adds.
The Czech Republic is among the states that applaud the efficiency of their castration policies. In 2009, Martin Holly, director of the Bohnice Psychiatric Hospital in Prague, said none of the nearly 100 sex offenders who had been physically castrated over the previous decade had committed further offenses.
Hauksson casts doubt on such claims and notes that the practice cannot be considered voluntary because prisoners apply for castration with their release from detention in mind.
Written and reported by Antoine Blua, with additional reporting by RFE/RL's Kyrgyz Service