Prostitution: Exploitation, Not Work

IMG_2219A 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.

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 front-line 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 (includes 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  https://www.dshs.wa.gov/report-abuse-and-neglect). 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. 

Sources and Further Resources:

Ending Exploitation Collaborative/ References and The Harm of Sexual Exploitation 

Organization for Prostitution Survivors 

National Human Trafficking Hotline

Polaris Project

The Life Story, including the powerful video for healthcare providers Medical Emergency 

 

Stories Matter

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“Stories matter. Many stories matter,” states author Chimamanda Ngozi Adichie in her powerful TED talk “The Danger of the Single Story.”  Adichie points out that listening and clinging to a single story—about a person, a place, a situation—creates stereotypes, and, in her words, “the problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story.” She goes on to say, “The consequence of the single story is this: it robs people of dignity; it makes our recognition of our common humanity difficult; it emphasizes how we are different rather than how we are similar.”

I thought about Adichie’s wise words earlier this week as I moderated a hospital-based panel discussion on service provision and community advocacy to end commercial sexual exploitation and sex trafficking. The panel and the day-long training for health care providers included personal stories of survivors of sexual exploitation. None of the survivors remotely resembled Julia Roberts in the “modern Cinderella story” movie Pretty Woman, which reinforces the common stereotype of the high-class and empowered hooker. Instead, the survivors told stories of trauma and violence which both preceded and accompanied sexual exploitation.

In my introductory talk about why this topic matters, I linked to an important storytelling video geared towards healthcare providers on The Life Story website, “Medical Emergency.”  I appreciate how this particular video weaves together the stories of women in their own voices. Advocacy is not about speaking for those less fortunate, less powerful, but of using our own power and privilege to amplify their voices, their stories. Our job as healthcare providers, as compassionate citizens, is to step back and listen respectfully.

Another powerful story came to me today via a colleague who sent me the link to this NYT Op-Docs Season 6 video “We Became Fragments” directed by Luisa Conlon, Hanna Miller, and Lacy Jane Roberts. Through their video, they step back, listen, and then amplify the voice and words of Ibraheem Sarhan, a young Syrian refugee now living in Canada. I love how this short video highlights the importance of competent and compassionate, trauma-informed teachers and healthcare providers. When one of Ibraheem’s teachers gives an in-class assignment to write about their family, the teacher gently points out to Ibraheem that he doesn’t have to write about his family if it is too painful a topic. The teacher must know that a bomb in Syria killed Ibraheem’s mother and siblings and left him with a shattered leg. Ibraheem tells us that when people ask him about his visible leg injury, “they don’t know how much my heart burns when I tell my story.”

Stories matter to the teller and to the listener. What we need more of in this world is for all of us to increase our capacity to listen to a multiplicity of stories and within those stories to recognize our common humanity.

 

 

Love and Sex in the Time of Misogyny

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“Woman in Love” stainless steel, 1983, Bob Haozous at the Heard Museum, Phoenix, Arizona. Photo credit: Josephine Ensign/2016

Prostitution is commercial sexual exploitation and no, I’m not throwing women under the bus by stating this, and yes, I am a feminist. Prostitution is not a victimless crime. Prostitution is a public health issue. Prostitution is a significant part of continued and even accelerated violence against women and children. Amnesty International‘s prostitution policy, which was enacted on May 26, 2016, frames prostitution as sex work, pimps as legitimate sex business operators, and johns as deserving customers. Did Amnesty International sell its human rights soul to the highly lucrative and heavily male-dominated sex industry?

Consider this: “The commercial sex industry is sustained through violence and exploitation. Prostituted people live with the daily threat of violence. Traffickers and pimps are not the only abusers—buyers cause tremendous harm through the repeated sexual use of women and children and other physical and psychological violence. Sex buying exploits vulnerable people and hurts our communities.” (source citations at Ending Exploitation.)  The vast majority of women and children who are prostituted come from poor and marginalized communities and have histories of childhood sexual abuse. The typical age of entry into prostitution is 12-15 years of age and upwards of 90% of all prostituted women and children want to leave “the life.” And in countries that legalize/decriminalize/regulate prostitution, the demand increases as does the number of women and children (typically, again, from impoverished and marginalized communities) trafficked into prostitution.

And consider this innovative Seattle-based program on men’s accountability (and misogyny and perpetuation of the patriarchy): The Buyer Beware partnership to end commercial sexual exploitation, coordinated by the King County Prosecuting Attorney’s Office and the Organization for Prostitution Survivors (OPS).  The Buyer Beware model emphasizes prosecuting (and educating) sex buyers and connecting prostituted women and children to services. The goal of the program is to reduce demand for commercial sex, thereby decreasing harm to prostituted persons, reducing self-destructive (toxic masculinity) behaviors of buyers, and curbing sex trafficking in our region. This is a highly enlightened approach and one that our health system—including public health—should support. For instance, standard screening questions on sexual health for health care providers to use with patients can include ones pertinent to sexual exploitation and the buying of sex, along with appropriate referrals for assistance.

In the Seattle area we have YouthCare’s Bridge Program for prostituted teens, the OPS programs for adult women seeking to exit commercial sex exploitation, and the OPS men’s accountability program “Stopping Sexual Exploitation: A Program for Men.” There is a recent and fascinating GQ article “Can we ‘cure’ the men who pay for sex?” about this program by Brooke Jarvis (February 2, 2017). In the article, Jarvis avoids straying into the current political climate as it relates to the fueling of toxic masculinity and violence against women, but she does write this tagline: “Inside a two-month program that aims to end prostitution—and help dismantle the patriarchy—by rehabilitating the men who perpetuate it.” It should be abundantly clear that this is a lofty—and essential—goal for all of us to be working towards.