I preface this by saying: I know the Biblical quote that it’s easier to see the speck in another person’s eye than to see the plank in your own. In the U.S. we have a lot of work to do in terms of overcoming misogyny in all its ugly forms (including commercial sex trade/exploitation or perhaps even all the books by Philip Roth?) We have a very large plank, especially in places like Nevada.
But I have to say that one of the most surprising things I’ve learned while in New Zealand these past months is the country’s level of violence against women. Before coming here I mainly knew that New Zealand was rightly proud of the fact that it was the first country in the world to give women the right to vote (in 1893). I also knew that there was a healthy cadre of New Zealand feminists at work influencing national policy through research, direct service, and the arts. What I had not realized was how deeply ingrained the sexism is here, perhaps as yet another direct descendant of British colonialism? That is what one of my Maori female informants and experts on this topic asked somewhat rhetorically in answer to my question to her about this topic. I had not realized that prostitution is legal in New Zealand (the photo here is of the Calendar Girls strip club/’gentleman’s club/brothel left standing in the Red Zone of Christchurch.) I had not realized that New Zealand is one of the worst industrialized countries in terms of violence against women. (See: Facts on Violence Against Women, by Janet Fanslow, New Zealand Herald, 11-25-11.) Of course, those issues are all interrelated.
A society’s level of sexism and misogyny, plus tolerance of violence, plus racism, plus poverty, plus sexualization of girls, plus a high level of commoditization and commercialism, are all documented risk factors for commercial sexual exploitation (CSE) of girls and women. Additional environmental risk factors for CSE include: open presence of the adult sex industry, transient male populations, and proximity to borders/ports.
I have spent many decades as a nurse working with homeless and prostituted teens and young adults on both coasts of the U.S., as well as in Thailand. There was a time during the early part of the HIV/AIDS epidemic when I bought the idea of sex trade as potentially being empowering work for women, along the idea that legalizing and regulating (including health screens) prostitution/sex work were all good things. But that belief was short-lived when I realized how dangerous the work is, no matter how ‘upscale’ or regulated or sanitized. And when I realized (from both credible research reports and stories from young women I worked with) that the women and children in prostitution anywhere in the world come from the most marginalized and oppressed groups in society. And how many (upwards of 90% in many studies) have untreated PTSD and histories of sexual abuse as children. And there is mounting evidence that legalizing prostitution only increases human/sex trafficking.
Efforts like those in my home state of Washington to decriminalize prostitution for the women/men/girls/trans in sex work (and refer them to appropriate services), while simultaneously stepping up the severity of prosecution of the buyers (‘Johns’) and the traders (‘Pimps’), make the most sense to me. Meanwhile, Nevada has counties near places like Las Vegas where prostitution is not only legal. They lock women inside barbed-wire secured brothels called ‘ranches,’ and then busloads of ‘customers’ arrive to be serviced. Like I said, we have planks in our own eyes.
Nurses and other front-line primary care providers need education and training in how to identify and effectively work with children and adults involved in CSE. Similar to gaining skills in working with victims of intimate partner violence, any screening or intervention is based on building rapport, maintaining appropriate professional boundaries (including not ‘rushing in to the rescue’), understanding PTSD and trauma bonding, using the principles of harm reduction to help the client build a safety plan, and knowing good community resources for appropriate referrals. One important health component I’ve found to be essential is having culturally-clued in positive body work (like yoga) to refer people to. It helps them get cued in to what the body can do, instead of what is done to the body (body as object). And for anyone who doesn’t know how to ask a patient about this topic, here’s the standard screening question: “Have you ever traded sex for money or other things needed to survive?”
And remember the words of Gloria Steinem: “Prostitution isn’t the world’s oldest profession. It’s the oldest oppression.”
Polaris Project: For a World Without Slavery
The Washington Anti-Trafficking Response Network: 206-245-0782
National Center for Missing and Exploited Children: 1-800-THE-LOST
National Human Trafficking Resource Center Hotline: 1-888-373-7888
An excellent 5-minute training/education video about the process of ‘grooming’ that can draw young women into prostitution: GEMS The Making of Girl.