Prostitution: Exploitation, Not Work

Source: Josephine Ensign

A few weeks ago, I participated in a powerful healthcare system training titled “Beyond Sex Trafficking: Responding to Commercial Sexual Exploitation and the Role of Healthcare Systems.” Commercial sexual exploitation is the exchange of sex acts for money, or for anything of monetary value, including basic needs such as food, clothing, or shelter. Therefore, it includes survival sex, pornography, escort services, exotic dancing, stripping, and street or hotel or house-based prostitution. Often referred to as “sex work,” this is a mighty misnomer, because it is not a form of work; it is exploitation and violence. And it is gender-based violence since most, but not all, of the victims are girls and women, and the overwhelming majority of buyers are men.

The evidence is clear: no matter what city or county or country (including countries where prostitution is “legalized” and regulated and sanitized), upwards of 90 percent of “sex workers” have histories of childhood sexual abuse, untreated post-traumatic stress disorder, and are disproportionately persons of color from lives of poverty, including homelessness. They often come from backgrounds of violence and exploitation, and once they are in the “life” of sex work, they are once again victims of violence and exploitation. And those male buyers of sex? They are disproportionately white and well-off financially. Many buyers are married and occupy high-status positions in society, including doctors, lawyers, and politicians. Another interesting fact is that the majority of buyers of sex at some level feel remorse and would like to stop. (Note: The links to specific studies and references are included below.)

The conclusion is clear: There is no such thing as a happy, healthy hooker. Julia Roberts’ character of a prostitute in Pretty Woman is a sick, twisted version of the Cinderella fairytale—a romantic comedy that has nothing to do with true romance and that is decidedly not funny.

Healthcare providers, including nurses and physicians, are on the frontline of caring for victims of prostitution and all forms of sex trafficking and exploitation. We need to learn about these issues and do something about them. A terrific new online healthcare provider training module series on human trafficking (including sex trafficking) using a public health approach is SOAR, which stands for Stop, Observe, Ask, Respond. Offered free of charge through the Department of Health and Human Services, Administration for Children and Families, Office on Trafficking in Persons, it includes three training modules (for CE/CME): 1) SOAR to Health and Wellness, 2) Trauma-Informed Care, and 3) Culturally and Linguistically Appropriate Services.

For any nurse, physician, social worker, teacher (and other professions specified by law) in Washington State, it’s important to note that mandatory reporting of known or suspected child abuse includes commercial sexual exploitation of children (CSEC) and teens under 18 (1-800-ENDHARM). In Seattle/King County, there is the CSEC Hotline: 855-400-CSEC with community advocates 24/7 for sexually exploited youth ages 12-24 in King County; and the Human Trafficking Hotline (24 hrs) at 888-373-7888. Also in King County, we have the innovative and nationally-recognized resource, Stopping Sexual Exploitation: A Program for Men. For those who do not live and work in Washington, know the relevant laws and resources for your own state or country.