As a mental health professional, early on in my education I was introduced to the term iatrogenic which basically refers to the illness or condition caused by a treatment. It frequently refers to the side effects of medication which then have to be treated with another medication which … One quickly grasps this progression.
Sometimes there are no good options. Taking blood pressure medication when exercise and other complimentary methods of treatment are not enough is a much better option than a stroke or other serious medical problem. One of the side effects of many blood pressure medications is erectile dysfunction. We now have a medication to treat ED. For some, this is an enormous blessing. My point is not that we can avoid all iatrogenic conditions, but that we need to be very cognizant of them and to avoid them when possible.
We could, I believe, accurately use the term to describe the situation or condition, which is frequently happening in the so-called criminal justice system in this culture. I could give many examples of this, but the one I want to address in this blog concerns the practice of labeling a wide variety of people in this country as sexual offenders – a designation that will have a negative impact on all aspects of their life for years and, in many states, for life.
In the United States over 747,000 people have been legally labeled as sexual offenders. This is a 23,2 % increase just since 2006. The cost for identifying, processing them through the legal system, incarcerating them and monitoring them (often for life) are staggering. In Florida, the state where I currently live, the number of registered sexual offenders is 64, 831 (Google search which I cannot independently verify) the number who is monitored and supervised in Florida alone is 150,00.
Many of these are or have been incarcerated at a cost of $20,553.00 per inmate per year. This figure does not tell us how much taxpayers paid in lost wages, the cost for helping single parents whose spouse in in prison, the cost of mental health services for all those affected by the original sexual behavior, the personal cost for those who have been labeled as sexual offenders, the cost of legal officials, and the cost of all the law enforcement individuals involved. This is just the monetary cost, which in itself is staggering.
The cost in ruined lives of both those labeled as victims and those labeled as offenders is even more staggering and difficult to calculate.
Who are the sexual offenders? When I ask most people they assume that most, if not all, sexual offenders are pedophiles – people whose primary object of desires or sexual conquest is a prepubescent child. Among those labeled, as sexual offenders there are a small percentage who are pedophiles; individuals who, for whatever reason, are compulsively sexually attracted to young, prepubescent children. These individuals have a dysfunction, which they did not ask for; which might require them to be put in a safe, protected environment – not to be punished, but to protect them and others. Some of these can be helped with treatment and medication. Some cannot yet be successfully treated.
Many of those labeled and prosecuted as sexual offenders are like the young man whose story I read this morning in the St. Petersburg Tribute (February 14, 2015, pages 1 and 6). This is the story of Antonio who was convicted of impregnating his 14-year-old girlfriend when he was 23. He was sentenced to community control and protection. When he went with his father to get car parts, which was a violation of his probation, he was sent to jail for 90 days. He was then released to live in an empty lot which was “one of the locations we put our homeless people at that time.” When Antonio decided he could no longer live in this lot and went to live with his family, this was a probation violation for which he was sentenced to 10 years in prison for his “willful and substantial violation”. “On Friday, the 13th of February 2015, the 2nd District of court of appeals reluctantly upheld Rivera’s punishment.” Using the most recent statistics I could find it will cost the state of Florida $20,553 a year to keep him in prison. Thus, if could cost the tax papers of Florida $205,530.00 plus the cost involved in prosecuting him, putting him in jail, monitoring him on probation when he is released, prosecuting him for a technical probation violation, and paying all those involved in the appeal process.
The justification for this enormous financial cost, to say nothing of the emotional cost, is predicated on the assumption that when he, at age 23 has sexual relationship with his 14-year-old girlfriend that behavior indicated that he was such a dangerous criminal that this cost was warranted; that justice for this “victim” require us to spend the time and money to ruin the life of this young man and to make the community pay a large amount of money. I know nothing of the so-called victim or the child (assuming she carried the baby to full term and the baby lived) or who is fulfilling the role of father.
Now, let me say before I say anything else, that, as a father, I do not want a 23-year-old child starting a family with someone who is a 14-year-old nor do I want my 14-year-old making such important decisions as having sex (and unprotected sex at that) and having a baby. Absolutely not. Neither the 14-year-old nor 23- year-old individuals (even though the 14-year-old may be mature for her age and the 23-year-old may be immature) are ready for the adult responsibilities of raising a family. Obviously, many 23-years-olds do have a child and have to or need to assume these very adult responsibilities. Yet, few are financially and emotionally ready for this most important of jobs.
Having said that, do I think a 14-year-old is capable of falling in love; of having strong love feeling and strong sexual feelings. Yes. In many cultures, and not that many years ago in our own society, it was common for 14-year-old females to marry someone well into his adult years. In fact many of these marriage were and still are, in some places, arranged. Young men and women have been crowned king or queen to head a country at age 14 or younger. If any one of us dug into our family history closely we would find someone in the family who had married at 14 or married a 14- year-old and gone on to stay married for 50 years or longer. Did this make for a difficult life for many? Certainly it did. Did we tell the young woman that she was a victim and was permanently damaged? No! She was expected to perform her marital and maternal duties just as he was expected to perform his marital and paternal duties.
Is the case of Antonio an isolated one? Are most people on the sexual offender list pedophiles? In my experience a great many of the folks on the sexual offenders list are not a danger to others. Let me list just a couple of examples of people/often clients I have personally known. (Names have been changed to protect the individuals whose cases I am discussing).
First, let us consider the case of Sam who, at 19 had a same-sex relationship with a 15-year-old Robert. Sam himself was somewhat emotionally immature and probably emotionally close to the same age as Robert. Robert was a very willing participant and secretly videotaped their sexual encounters. When adult family members found the videos, he claimed to be a victim. Staffs of organizations who interview and work with those who are suspected of being a “victim” of sexual abuse often testify on behalf of the individual in court. In this case, the representative of this community organization, a social worker involved in the case and the parents all claimed in court that the “child” (now 16) had been “emotionally damaged for life by this heinous crime. “ Heinous crime”? I testified that the boys were emotionally the same age; that both enjoyed the sexual relationship and that the only damage was labeling this individual Robert a damaged victim and Sam a violent, dangerous, criminal. Sam spent several years in prison and remains on the sexual offenders list of the state in which he lives. This means he cannot work many places, cannot live close to schools, day care centers or anyplace children are likely to be living or playing. His family-of-origin have been financially responsible for him and continue to support him.
Do I think that a 19-year-old should choose a 15-year-old partner? No. Do I think a 15-year-old can be very sexually mature and very seductive? Yes. Do I think enjoying oral sex at 15 has to damage someone for life? Hardly. In some cultures young people are expected to be introduced to sexual relationships by an older member of the community. Do I think that the fact that this was a same sex relationship affected the decision to prosecute? Certainly. This took place in a very conservative community.
Another client of mine has served time in prison and was labeled a sexual offender for 10 years (state laws vary) for having a sexual encounter with an underage prostitute who lied about her age. We can argue the morals of professional sexual workers and those who use their services, but do we really think that this man is dangerous or so very unusual? Should we label everyone who has sex outside of marriage as a sexual offender?
Another family I saw had a 15-year-old daughter who was dating a college man. They did not approve but did not prosecute. Today the young woman is herself a college graduate and doing very well.
Yet, another man I saw brought someone home on more than one occasion with which he had sexual relationships. The visitor got on his computer and intentionally or unintentionally downloaded child porn among a lot of other porn. Through external tracking by law enforcement people it was determined that my client had child pornography on his computer. The client was then charged with possession of child pornography. My client admitted to downloading adult porn. In this case I presented evidence that it is possible for someone to download material on your computer that you do not want. We often view advertisements and other material on our computers that we did not solicit. Individuals can also do this with porn, including child porn. Do we want to prosecute everyone who downloads pornography images? Our jails would be even more crowded and our so-called justice system would be more broke.
Another client has been in prison in New Jersey for many years for having child pornography on his computer. There was good reason to believe that another person living in the same house downloaded that material. As it happens my client has a history of being sexually abused and used by his mother starting at a very young age and, as an adult, did abuse young girls himself. He had served time in prison, but not for the abuse of which he was guilty. This man has not had a sexual relationship with anyone of any sex or age for many years, is very physically, ill, differently abled and not a danger to anyone. Yet, we are spending a lot of money to keep him in jail and treating his diabetes, his heart condition, his vision issues and other health issues. Why is he in jail? There has been no evidence that he is a danger to anyone for many, many years.
Yet, another client is in prison in Florida for downloading pornography and fleeing the authorities when he was caught. I think that this man may have deliberately downloaded child pornography. I have no evidence that he even attempted to have sex with any children. Yet, he sits in prison. Can this man be “cured” of his desire to watch child pornography? I doubt it. Is he a bad person? No. Did he ask for this obsession? Could anyone of us have such an obsession? Could his obsession be treated? I am not sure, but I am confident he has not acted on his obsession. His only illicit sexual behavior of which I am aware, other than downloading child porn, was, as a younger man, exposing himself. This was, I believe, an act of anger related to unresolved issues. This is a very good man who does need some ongoing counseling. There is even the possibility that he might need to be in protective custody, although I have no evidence of that.
Should anyone be exploiting children and using them in pornography videos, films, books or photos? Absolutely not. Should children be kidnapped and forced to service adults.? Absolutely not. Children have the right to grow up without being used as an object for any purpose. All adults have the same rights.
If, in fact, we would focus our attention on treating and, in some few cases, retaining those few people who may present a danger to prepubescent children in a safe, humane place where they are treated with love and respect, we would spend much less money and we would quit creating criminals who become outcasts. Why, a friend who was reading this before I published it asked, would we treat such people with love and respect. There are at least two important reasons. Reason one is that they did not ask for the particular sexual desires or obsessions. Reason two is that treating people as if they are not worth anything or as if they do not deserve respect does not result in positive behavior. Just as mistreating a hunting dog will not produce a flexible, dependable hunting dog, mistreating any of we humans will not produce positive results.
When we mistreat people whose behavior we do not like or whose behavior with which we are not comfortable, we create or increase emotional illness/dysfunction. Any of us who have been mistreated as children or adults knows how sad, frustrated, angry or withdrawn we can become if bullied or otherwise mistreated. As I have discussed in other blogs, we know how to create people who are either very passive or very angry. The study of the psychology of oppression by such learned colleagues as Dr. James Cone documents this process. When we mistreat others, they become emotionally ill and/or dysfunctional. We often then blame them for being angry or emotionally unstable, even though the behavior is a reaction to the mistreatment.
It is long past time when we began to take a look at a judicial system that has created the careers of many politicians and law enforcement people at the cost of billions of dollars and at the cost of ruining the lives of perfectly good people whose behavior may not be consistent with our particular beliefs.
We, as a society, can change. Just today I attended a same sex wedding ceremony, which was officiated by the major of the community in which I am now living. In some parts of the world today and not long ago in this society, such an event could not have happened and, if it had, people would have been jailed, stoned to death or otherwise “punished” – punished for loving another person. Just recently people in another country were killed because of their loving and/or sexual behavior with someone of the same sex.
I have lived long enough to witness our ability as humans to change. In fact, I have changed my thoughts and actions over the years and continue to change. I know it is possible. I also know that fear often prevents many of we humans from being the loving people we essentially are. The fear of not being enough, of being different, of not being considered moral according to the limited definition of some, or of not being respected can result in shutting down and doing nothing or striking out at others.
Change usually begins with often-painful honesty. We are, with our current practice of labeling and punishing so many people as sexual offenders, creating criminals and blaming them. The “disease” is an iatrogenic one. The cure is not to beat ourselves up for actively or passively condoning this unjust and ineffective practice, but to recognize that is not working and to devote our time and energy to making meaningful changes; changes, which will help, create a more just and loving community. We can then also use our limited resources to create a safer community for all of us.