p–ISSN: 2723 - 6609 e-ISSN: 2745-5254
Vol. 5, No. 1 January 2024 http://jist.publikasiindonesia.id/

Doi: 10.59141/jist.v5i01.863 281

CHEMICAL CASTRATION IN PERPETRATORS OF SEXUAL VIOLENCE

Hudi Winarso1*, Abraham Arwinta Sakti2, Irene Oktadiana Setijo3
Universitas Ciputra, Indonesia1, Universitas Surabaya, Indonesia2, Rumah Sakit Baptis

Kediri, Indonesia3

Email : [email protected]*, [email protected],
[email protected]

*Correspondence
ABSTRACT

Keywords: Chemical
castration; Sexual criminality;
Community Protection.

Regulations on chemical castration for perpetrators of sexual violence
have been stipulated in the legislation in Indonesia, Law 17 of 2016.
They followed up with Government Regulation (PP) NO 70 OF 2020,
which regulates the chemical castration procedure in more detail.
However, at the level of implementation, medical and bioethical
perspectives, there are still pros and cons. The paradigm of the group that
agrees to perform chemical castration on perpetrators is that the act of
chemical castration causes a decrease in sex hormone (testosterone)
levels, thus helping perpetrators manage their sex drive more
controllable. The paradigm of the group that does not agree on the act of
chemical castration, from the aspect of low levels of sex hormones, will
cause discomfort or health problems in the perpetrator. On the other
hand, the performing physician believes that the doctor's job is to help,
not cause discomfort. Medical studies and bioethical studies of chemical
castration in perpetrators of sexual violence can improve the
understanding of holistic management.

Introduction

UNICEF's global data on sexual violence against young women states that at least
5% of young women have experienced sexual violence. In Indonesia, data from the
Ministry of Women's Empowerment and Child Protection from January 2023 to August
30, 2023, found 17,039 cases of sexual violence, of which 10,296 cases were children
(Kurniasari et al., 2017). The majority of cases are found in children aged 13-17 years. In
cases of sexual violence, 89.6% of the perpetrators are men. Data on sexual violence is
an iceberg phenomenon because not all victims of sexual violence dare to report the
incident experienced, whether to parents or authorities (Daming, 2020).

The increasing number of cases of sexual violence against children must be a
concern for all parties, including the government (Probosiwi & Bahransyaf, 2015).
Sexual violence has a devastating impact on victims, including psychological impacts
where children can become traumatised; victims of sexual violence who are not
appropriately rehabilitated in the future can become perpetrators (Batubara, Leoni, Salim,
& Sinaga, 2023). The physical impact of sexual violence, including contracting sexually
transmitted infections, pregnancy, and even continuing abortion, will add to the
increasingly complex problem. The passing of the Law on punishment for perpetrators of
sexual violence against children is expected to reduce the incidence of sexual violence
and deter perpetrators of sexual violence in Indonesia (Sihotang, Warman, Yunara, &
Ikhsan, 2022). Based on Law No. 17 of 2016 Article 81, perpetrators of sexual violence

Hudi Winarso, Abraham Arwinta Sakti, Irene Oktadiana Setijo

Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 282

against children will be subject to criminal law, and one of the penalties written there is
chemical castration.

This castration or castration sentence raises a new problem. Namely, the
government expects the executor of this punishment to be a doctor because it is
considered that the medical profession is competent to carry out this castration act
(Santoso & Sispradana, 2021). However, this castration action contradicts the Code of
Medical Ethics, where the medical profession adheres to helping to ease the burden of
patients and not adding to suffering.
Chemical Castration Bioethical Concepts

In Indonesia, there are four bioethical principles that a doctor must always hold.
The first is Beneficence, a bioethical principle in which a physician acts for the benefit of
his patient to help prevent or eliminate harm. Beneficence can be interpreted as a doctor's
need to do good, respect human dignity, and make maximum efforts so that the patient
remains in good health (Sinurat & Dirgantara, 2021). The second principle is Non-
maleficence, where a doctor does not perform an act or action that can aggravate the
patient. The third principle is Autonomy; a doctor must respect human dignity and rights,
especially the right to determine his destiny (Widnyana, Dewi, & Karma, 2020). The
fourth principle is Justice, the principle by which a doctor is obliged to give fair treatment.
The act of chemical castration that can have an impact on worsening the quality of life,
and without regard to human rights as a whole, from a bioethical aspect, should be
pondered by the doctor implementing chemical castration.
Chemical castration medical concepts

The hormone testosterone, which is 98% produced by Leydig cells in the testes,
during puberty is produced in significant levels, influential, among other things, in sexual
attraction. Testosterone levels after puberty will increase, which peaks at about 30 years,
for then levels will be constant until around the age of 45. Age 45 is the average age at
which the hormone testosterone decreases. Lower testosterone levels in the blood will
cause discomfort. The impact of decreasing testosterone levels includes mood disorders
(bad mood), easy abdominal obesity (visceral obesity), decreased haemoglobin levels,
decreased muscle mass, decreased bone mass, decreased sex drive, and sex potential
(Octascriptiriani & Putri, 2022).

Chemical castration is done by giving substances that cause a decrease in
testosterone levels in extreme conditions of decline, which will cause discomfort/
physical and psychological problems.

Research Methods

The method used in this study is a literature study. The author collects various data
sources from legislation, articles and papers as data in this study. The author uses primary
data and secondary data. Primary data is obtained from the Law of the Republic of
Indonesia, Fatwa MKEK and KODEKI. Secondary data are taken from various journals
and articles with related topics. Then, the author will explain in narrative-descriptive
form.

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Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 283

Results and Discussion
Acts or acts that degrade, insult, attack and other acts against the body related to

sexual appetite, sexual desire, and reproductive function, which are carried out forcibly,
are classified as sexual violence. In children, sexual violence is a relationship between a
child and an older person or adult, where the child is used as an object to satisfy the sexual
needs of the perpetrator. This violence can take the form of sexual immorality, threats,
coercion, physical violence and rape (Lewoleba & Fahrozi, 2020). The impact that occurs
on victims of sexual violence can be physical, psychological, or social (Ekaningtyas,
2020). The problem is that not all victims of sexual violence want to come forward, so
the trauma that occurs cannot be rehabilitated completely. The psychological trauma that
is not resolved will make the problem counterproductive continuously, and there can be
severe or fatal problems, including suicide attempts. This psychological trauma can also
be a supporting factor that allows a korab to become a perpetrator of sexual violence in
the future (Winarso & Subagyo, 2016).

The incidence of sex violence cases in Indonesia, which has no signs of decreasing,
as well as the impact of the problem on victims of sex violence, which is very detrimental,
is a consideration for the government to play a role in tackling the problem of sex
violence. Efforts made by the government to minimise cases of sexual violence need
support. At the regulatory level, the promulgation of Law No. 17 of 2016 concerning
Child Protection and (PP) No. 70 of 2020, which regulates the chemical castration
procedure in more detail, shows the government's sincerity.
Bioethical Perspective of Chemical Castration for Perpetrators of Sexual Violence

The concept of medical bioethics has four principles, namely Beneficence (all
actions for the good of patients), non-maleficence (not worsening or harming patients),
justice (doing justice), and autonomy (respecting the right to autonomy of patients). In
this principle, a doctor is expected to do his job by thinking about what is good and
positive for the patient and does not harm the patient.

Chemical castration is carried out on sex abusers by injecting substances/drugs that
function to cause testosterone levels to be deficient. In the body, the hormone testosterone
not only functions related to sex drive but also other body functions, including anabolic.
The condition of the hormone testosterone is deficient and will have a health impact that
interferes with health conditions. Disorders that occur due to chemical castration actions
that cause health problems are not appropriate from the aspect of medical bioethics.

In addition, according to KODEKI article 6, a doctor must be careful in applying
any discovery or treatment. The effectiveness of chemical castration is still a question
because no solid double-blind studies have proven it. Hence, the principle of Beneficence
and non-maleficence of chemical castration is still debated. This is also why IDI refuses
to be involved in criminal Chemical Castration (Efendi, 2023). so that in MKEK fatwa
number 1 of 2016, the Indonesian Medical Association (IDI) rejected the involvement of
doctors as executors of chemical castration.

In Law No. 29 of 2004 concerning the practice of medicine, article 52 explains that
patients have the right to get a complete explanation of the medical action to be given.

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Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 284

This relates to Article 45, where a doctor or dentist must get the patient's approval for
medical actions. However, currently, there is no precise regulation on whether sex
offenders who will get chemical castration can be aligned as patients. In some countries,
this chemical castration sentence is carried out without the consent of the individual
concerned, resulting in controversy in medical ethics (Efiyanti & Widjaja, 2021).
Consideration of regulatory and bioethical aspects of medicine, making chemical
castration for sex violence perpetrators not easy to do.
Regulation of Chemical Castration for Perpetrators of Sexual Violence

Castration has been carried out in various countries as a form of punishment for
perpetrators of sexual violence since medieval times. Castration is the medical term for
castration. Denmark is the first country to make castration a punishment for perpetrators
of sexual violence, followed by 20 other countries and states to date (Alam, 2020).

Table 1
Chemical agents in chemical castration

no Agent Name How it Works Dose Special
Attention

1 Dietilstilbesrol (DES) It is a non-steroidal
synthetic estrogen.
Kills the HPG axis,
thereby decreasing
testosterone
production

Blood
clotting

disorders

2 Cyproterone acetate
(CPA)

1. is a potent
androgen receptor
antagonist, competes
with testosterone, and
DHT occupies the
receptor
2. decrease LHRH
secretion from the
hypothalamus

1.oral 100-
600 mg
(daily)

2. Depot
400-700
mg lm
(weekly)

1.
Interference
Freezing
blood
2. Gangguan

liver
heavy
3.
Interference
active
pituitary

3 Medroxyprogesterone
acetate (MPA)

1. Induces
testosterone-a-
reductase production
and increases the
binding of
testosterone with
hormone-binding
globulin
2. decreases LHRH
secretion from the
hypothalamus

1.Oral 100-
500 mg
(daily)
2. Depot
100-600
mg ml
(weekly)

1. Blood
clotting
disorders
2. Severe
liver
disorders
3. Active
pituitary
disorders

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Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 285

4 Leuprolide (agonies
luteinising hormone-
releasing hormone
(LHRH)

Overstimulation of
LHRH receptors
leads to a significant
decrease in LH and
testosterone

Depot
3.75-7.5
mg lm
(daily)

1.
Osteoporosis
2. Active
pituitary
disorder

5. Selective serotonin
reuptake inhibitors

(SSRIs)

Increases the
secretion of prolactin.
Thus lowering libido
and disrupting the
sexual response cycle.

Same with
therapeutic

doses in
cases of

depression
or

obsessive-
compulsive

disorder

Are using
drugs that
increase
serotonin
(increases
the risk of

severe
serotonin

syndrome)

The use of chemical castration drugs also has some side effects, such as blood
clotting disorders, osteoporosis, alopecia, emotional disorders, and liver and hormonal
disorders. So, in its use, close assistance and supervision are needed.

Low testosterone can decrease an individual's sex drive, but it does not guarantee
that when therapy is stopped, the crime will not be repeated. There are still many
psychological factors at play. There is a possibility that the perpetrator can become more
aggressive after therapy is stopped due to psychological and social factors where the
perpetrator feels hurt, anger and resentment.
Therefore, this chemical castration will be more effective when monitoring physical and
psychological conditions. Education on physical, psychological and spiritual aspects
needs to be done, with the hope that perpetrators of sexual violence do not experience
health problems and minimise the potential to repeat these evil deeds.

Conclusion

Chemical castration is performed using drugs to target lowering testosterone levels
in the body. Lowering testosterone levels at a significant level is expected to decrease the
sex drive and aggressiveness of the perpetrator.
The pros and cons of opinion against the implementation of chemical castration in
perpetrators of sexual violence, on their grounds, can be understood. Implementing
chemical castration by taking into account bioethical and medical aspects, accompanied
by regular monitoring of physical and psychological conditions, as well as improvement
of disorders experienced due to chemical castration procedures, is a solution that must be
the concern of all parties.

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Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 286

Bibliography

Alam, Kodrat. (2020). Menakar Keterlibatan Dokter dalam Pelaksanaan Tindakan Kebiri
Kimia bagi Pelaku Kekerasan seksual terhadap Anak. Jurnal Hukum, 36(2), 93–
116. https://doi.org/10.26532/jh.v36i2.7561

Batubara, Sonya Airini, Leoni, Cindy C., Salim, Ferry, Sinaga, Frans Deo Fanny. (2023).
Analisis Hukum terhadap Hukuman Kebiri Bagi pelaku Kekerasan Seksual
Terhadap Anak Berdasarkan Peraturan Pemerintah No. 70 tahun 2020. Jurnal
Ilmiah Universitas Batanghari Jambi, 23(1), 882–886.
https://doi.org/10.33087/jiubj.v23i1.2804

Daming, Saharuddin. (2020). Mengkaji Pidana Kebiri Kimia Dalam Perspektif Medis,
Hukum Dan Ham. Supremasi Hukum: Jurnal Kajian Ilmu Hukum, 9(1), 22–29.

Efendi, Achmad Taufan. (2023). TANGGUNG JAWAB YURIDIS DOKTER
TERHADAP TERPIDANA KEBIRI KIMIA SEBAGAI EKSEKUTOR:
Universitas 17 Agustus 1945 Surabaya. YUSTISI, 10(2), 37–44.

Efiyanti, Mellisa, & Widjaja, Gunawan. (2021). Penolakan Ikatan Dokter Indonesia untuk
Melaksanakan Sanksi Kebiri Kimia dalam Undang-undang Nomor 17 Tahun 2016.
Jurnal Yuridis, 8(2), 327–346.

Ekaningtyas, Ni Luh Drajati. (2020). Psikologi komunikasi dan kekerasan seksual pada
anak usia dini. Pratama Widya: Jurnal Pendidikan Anak Usia Dini, 5(2), 147–158.
https://doi.org/10.25078/pw.v5i2.1339

Kurniasari, Alit, Widodo, Nurdin, Yusuf, Husmiati, Susantyo, Badrun, Wismayanti,
Yanuar Farida, & Irmayani, Nyi R. (2017). Prevalensi kekerasan terhadap anak
laki-laki dan anak perempuan di Indonesia. Sosio Konsepsia: Jurnal Penelitian Dan
Pengembangan Kesejahteraan Sosial, 6(3), 287–300.

Lewoleba, Kayus Kayowuan, & Fahrozi, Muhammad Helmi. (2020). Studi Faktor-Faktor
Terjadinya Tindak Kekerasan Seksual Pada Anak-Anak. Jurnal Esensi Hukum,
2(1), 27–48.

Octascriptiriani, Nuur, & Putri, Kusuma. (2022). Hubungan Perubahan Fungsi
Seksualitas Dengan Frekuensi Hubungan Seksual Pada Lansia Wanita Usia 45-59
Tahun di Kelurahan Tipar Wilayah Kerja Puskesmas Tipar Kota Sukabumi. Jurnal
Health Society, 11(1).

Probosiwi, Ratih, & Bahransyaf, Daud. (2015). Pedofilia dan kekerasan seksual: Masalah
dan perlindungan terhadap anak. Sosio Informa, 52836.

Santoso, Aprih, & Sispradana, Audi Redha. (2021). Analysis of purchase decision
determinant factors. Asian Management and Business Review, pp. 155–164.

Sihotang, Gita Cristin Debora, Warman, Edi, Yunara, Edi, & Ikhsan, Edy. (2022).
Penjatuhan Pidana Tambahan Kebiri Kimia Terhadap Predator Anak Pada Putusan
No. 69/Pid. Sus/2019/PN. Mjk. Locus Journal of Academic Literature Review, 170–

Chemical Castration in Perpetrators of Sexual Violence

Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 287

180.

Sinurat, Winson, & Dirgantara, I. Made Bayu. (2021). The effects of brand equity, price,
and brand proliferation on new product performance through product trial: evidence
from FMCG industry in Indonesia. Diponegoro International Journal of Business,
4(1), 58–68.

Widnyana, I. Komang, Dewi, Anak Agung Sagung Laksmi, & Karma, Ni Made
Sukaryati. (2020). Sanksi Pidana Kebiri Kimia Terhadap Pelaku Tindak Pidana
Kekerasan Seksual Anak. Jurnal Konstruksi Hukum, 1(1), 197–202.

Winarso, Hudi, & Subagyo, Roni. (2016). Dependent Personality in a Case of Sexual
Offence on a Child (A Case Study). ANIMA Indonesian Psychological Journal,
31(4), 192–195.