24 Mar 2016

Prostituted and Sexually Trafficked Persons are Rape Victims, Too

What everyone — SANE and SART professionals especially — should know

Authored By: Lisa Thompson, Vice President and Director of Education and Outreach, National Center on Sexual Exploitation (NCOSE)

Lisa Thompson ImageAs former Manhattan sex crimes prosecutor Linda Fairstein observed in her book Sexual Violence: Our War against Rape, it is unlikely that any “lifestyle exposes a woman to the threat of assault and gratuitous violence as constantly and completely as prostitution.”[1]

Despite the more than twenty intervening years since she penned those words, and the tremendous amount of effort that has been exerted by activists to expose the harms endemic to prostitution, there is no reason to believe that this situation has changed.

Studies characterize the violence that animates prostitution as brutal,[2] extreme,[3] common,[4] frequent,[5] startling,[6] normative,[7] and ever-present.[8] Indeed, physical and sexual violence across prostitution types is pervasive—whether one is prostituting in Miami or Chicago, indoors or outdoors, for drugs or to pay the rent, on a street corner, in a car, back alley, brothel, massage parlor, or strip club—both the threat of, as well as actual violence, permeate everyday existence in “the zone.”[9]

In their seminal study of prostitution across nine countries, Farley et al. found that 75% of prostituting persons in the U.S. reported being raped, and of those, 59% were raped more than five times.[10] Survivors have described their experiences of prostitution as “paid rape,” “pay-as-you-go rape,” and “being raped for a living.”[11] Indeed, rape is the defining experience of prostitution: the fear of it, the daily hypervigilance required to prevent it, the crushing physical and psychological trauma experienced by victims when it inevitably occurs.

Overwhelmingly, the persons purchased for sex are women (but also include male and female children, transgender males, and prostituting men), and those doing the purchasing are men.[12] The vast majority of physical and sexual violence inflicted on those in the sex trade is perpetrated either by sex buyers or intimate partners who also frequently double as pimps (i.e. sex traffickers).[13]

Regarding pimps, their “specific activities include recruitment, harboring, transporting, provisioning and obtaining persons [specific elements of sex trafficking] for purposes of exploiting them by pandering them for commercial sex acts. Thus, the terms pimp and sex trafficker are synonymous.”[14] Consequently, any pimp-controlled (i.e. prostituted) individual is a sexually trafficked person.

Regardless of its legal status (legal, illegal, zoned, or decriminalized), prostitution is extremely dangerous for women. For instance, some prostituted women are unrecognized victims of intimate partner violence by pimps who masquerade as boyfriends. Both pimps and sex buyers use methods of coercion and control like those of other batters.[15]

The Intersection of Sex Trafficking, Pornography, Prostitution, and Rape

Sex trafficking involves the exploitation of individuals in the commercial sex industry where the victim is expected to provide commercial sex acts on demand. Commercial sex acts are any sex acts on account of which anything of value (e.g. money, clothes, shelter, food, drugs, etc.) is given to or received by any person.

Pornography is prostitution for mass consumption and contributes to sex trafficking by conditioning users (who are predominantly males) to view females as mere objects for their sexual use, and by leading some men to seek sex through prostitution.

Once trafficked into the commercial sex industry, victims endure unspeakable acts of physical brutality and violence; suffer serial rape by so-called customers and pimps; undergo forced abortions; acquire drug and alcohol dependencies; live in fear of their lives and for the lives of their family and friends; suffer acute psychological reactions as a result of their ongoing, extreme physical and emotional trauma; and contract sexually transmitted diseases, which all too often bring life-long illness and hasten death. If they survive the physical abuse, the psychological and spiritual impacts of these experiences on victims are devastating and enduring.

Because a person has no meaningful right to refuse sex in such a context, the principle nature of exploitation is that of rape and the abrogation of individual autonomy. The victims’ experience of rape is greatly intensified by the serial sexual assaults perpetrated against them by untold numbers of people who pay money to their traffickers/pimps in order to sexually exploit them.

Whether or not the commercial sex buyer is aware that the individual they have purchased is trafficked does not mitigate the victim’s experience of their sexual encounter as one of rape.[16] As individuals compelled to sell themselves, the individuals providing sex are not “consenting,” thus the sex acts in which they are involved are inherently sexual assault and rape.

As psychologist Wendy Freed has observed, “When an individual has been beaten into submission, and has become passive and accepting of what is done to her because she is a captive, then any sexual encounter she has is rape. Even if she has worked hard to attract the customer, because she has no right to refuse consent, she is being raped.”[17]

Leidholdt (2003) explains that sex trafficking and prostitution overlap in key ways, including:

  1. Those in the sex industry (sexually trafficked or not) share key demographic characteristics such as poverty, histories of abuse, and minority status;
  2. Sex buyers use sexually trafficked and other women in prostitution interchangeably; in other words, there is no specific demand for sexually trafficked women per se, but demand for women (as well as children and men) in prostitution;
  3. Sexually trafficked and prostituted women suffer the same harms: physical injury from sexual assaults and beatings, acquisition of sexually transmitted infections, post-traumatic stress disorder, etc.[18]

Thus, “in spite of efforts to differentiate and separate prostitution and trafficking, the inescapable conclusion is that the difference between the two, at best, is one of degree of, not of kind.”[19]

Research has found that factors such as emergency room visits due to brutal physical violence, sexually transmitted infections incurred through commercial sex acts, and reproductive issues (e.g. obtaining contraception, tubal ligations, miscarriages, abortions, forced abortions, and hysterectomies), bring prostituted (i.e. sexually trafficked) women into the orbit of healthcare professionals.[20] Unfortunately, surveys of survivors have found that, “These opportunities have largely been missed as even those healthcare professionals who recognized that victims might have been ‘on the street’ rarely understood that they had a pimp/trafficker. . . . At least two prior studies have demonstrated that medical care providers are woefully unprepared to identify trafficking victims.”[21]

Health Professionals’ Response

In light of the extreme sexual and physical violence experienced by prostituted and sexually trafficked persons, Lederer and Wetzel urge that:

“Medical professionals must be made aware of critical signals for identifying trafficking victims. An important part of this training should be to help the health care professional understand the coercive dynamic of trafficking, especially the extreme degree of control exercised by traffickers, and the prevalence of this criminal exploitation of women and girls. Setting up internal protocols, procedures and regulations can further these goals and assist medical care providers in their vital role as identifiers of trafficking victims.”[22]

Equally so, sexual assault response team members such as victim advocates, law enforcement officers, prosecutors, or other legal professionals, should be aware of the dynamics and indicators of commercial sexual exploitation and sexual trafficking, in order to help identify and respond appropriately to such victims.

Recognizing this need, Dr. Hani Stoklosa has co-founded HEAL (Health, Education, Advocacy, Linkage) Trafficking, an international network of more than 600 professionals dedicated to improving the health of trafficking survivors. HEAL Trafficking brings together social workers, physicians, nurse, psychologists, counselors, attorneys, public health workers, and others across North America to develop resources and responses designed to identify trafficking victims and to meet their health needs.

This is a very encouraging development for the anti-trafficking movement. But as NPR’s Marketplace reported in a recent series on health care and human trafficking, only 60 of the U.S.’s 5,686 hospitals have a protocol in place to respond to cases of human trafficking, thus the effort to equip frontline responders has only just begun.


Sources:

[1] Linda Fairstein, Sexual Violence: Our War against Rape (New York, NY: Berkley Books, 1995), p. 171.

[2] Celia Williamson and Gail Folaron, “Violence, Risk, and Survival Strategies of Street Prostitution,” Western Journal of Nursing Research 23, no. 5 (2001): 463-475; Jody Miller and Martin Schwartz, “Rape Myths and Violence against Street Prostitutes,” Deviant Behavior: An Interdisciplinary Journal, 16 (1995): 1–23.

[3] Melissa Farley, Jacqueline Lynne, and Ann Cotton, “Prostitution in Vancouver: Violence and the Colonization of First Nations Women,” Transcultural Psychiatry 42, no. 2, (2005): 242–271; Jody Raphael and Deborah L. Shapiro, “Sisters Speak Out: The Lives and Needs of Prostituted Women in Chicago, A Research Study,” (Center for Impact Research, Chicago, Illinois, 2002).

[4] Melissa Farley, “Prostitution, Trafficking, and Cultural Amnesia: What We Must Not Know in Order To Keep the Business of Sexual Exploitation Running Smoothly,” Yale Journal of Law and Feminism 18, (2006): 101–136; Celia Williamson and Gail Folaron, “Violence, Risk, and Survival Strategies of Street Prostitution,” Western Journal of Nursing Research 23, no. 5 (2001): 463–475.

[5] Celia Williamson and Gail Folaron, “Violence, Risk, and Survival Strategies of Street Prostitution,” Western Journal of Nursing Research 23, no. 5 (2001): 463–475.

[6] Kendra Nixon, Leslie Tutty, Pamela Downe, Kelly Gorkoff, and Jane Ursel, “The Everyday Occurrence: Violence in the Lives of Girls Exploited through Prostitution,” Violence against Women 8, no. 9 (September 2002): 1016–1043.

[7] Melissa Farley, “Prostitution, Trafficking, and Cultural Amnesia: What We Must Not Know in Order to Keep the Business of Sexual Exploitation Running Smoothly,” Yale Journal of Law and Feminism, 18 (2006): 109–144.

[8] Geetha Suresh, L. Allen Furr, and Aylur Kailasom Srikrishnan, “An Assessment of the Mental Health of Street-based Sex Workers in Chennai, India, Journal of Contemporary Criminal Justice 25, no. 2 (2009): 186-201; Jody Miller and Martin Schwartz, “Rape Myths and Violence against Street Prostitutes,” Deviant Behavior: An Interdisciplinary Journal, 16 (1995): 1–23.

[9] National Center on Sexual Exploitation, “Prostitution: ‘The Zone’ of Raw Male Physical and Sexual Violence,” (2015), https://endsexualexploitation.org/wp-content/uploads/NCOSE_ViolenceInProstitutionBooklet_rv3.pdf (accessed January 19, 2016).

[10] Melissa Farley et al., “Prostitution and Trafficking in Nine Countries: An Update on Violence and Posttraumatic Stress Disorder,” in Prostitution, Trafficking and Traumatic Stress, ed. Melissa Farley (Binghamton, NY: The Haworth Maltreatment & Trauma Press, 2003), 33–74.

[11] Rachel Moran, Paid for: My Journey through Prostitution (New York: W.W. Norton & Company, 2013).

[12] Vern Bullough and Bonnie Bullough, Women and Prostitution: A Social History (Buffalo, NY: Prometheus Books, 1987).

[13] National Center on Sexual Exploitation, ibid.

[14] Lisa L. Thompson, ibid.

[15] Farley, M. (2006). Prostitution, Trafficking, and Cultural Amnesia: What We Must Not Know in Order To Keep the Business of Sexual Exploitation Running Smoothly. Yale Journal of Law and Feminism, 18, 101–136; Lisa L. Thompson, “On a Street Corner by You: Pimps as Practitioners of Torture,” in Global Perspectives on Prostitution and Sex Trafficking: Europe, Latin American, North America, and Global, ed. Rochelle L. Dalla, Lynda M. Baker, John DeFrain, and Celia Williamson (Lanham, Maryland: Lexington Books, 2012), 291–314.

[16] It is important to note that the experiences of women in prostitution mirror those of women who are sexually trafficked. Rachel Moran explains this well in her book Paid For: My Journey Through Prostitution: “Prostitution and rape are commonly distinguished by the logical fact that to buy something and to steal something are two different things; but when we consider that the sex bought in prostitution is the same type of sex stolen in rape, sex that is as Kathleen Barry put it: ‘. . . disembodied, enacted on the bodies of women who, for the men, do not exist as human beings, and the men are always in control’—it is then that we understand how deeply traumatizing it is for the women whose body is so used,” 112–113.

[17] Wendy Freed, “From Duty to Despair: Brothel Prostitution in Cambodia,” Prostitution, Trafficking and Traumatic Stress, ed. Melissa Farley (Binghamton, NY: The Haworth Maltreatment and Trauma Press, 2003), 133–146.

[18] Dorchen Leidholdt, “Prostitution and Trafficking in Women: An Intimate Relationship,” Prostitution, Trafficking and Traumatic Stress, ed. Melissa Farley (Binghamton, NY: The Haworth Maltreatment & Trauma Press, 2003), 167–183.

[19] Ibid.

[20] Laura J. Lederer and Christopher A. Wetzel, “The Health Consequences of Sex Trafficking and Their Implications for Identifying Victims in Healthcare Facilities,” Annuals of Health Law 23 (2014): 61–91; Celia Williamson and Gail Folaron, “Violence, Risk, and Survival Strategies of Street Prostitution,” Western Journal of Nursing Research 23, no. 5 (2001): 463–475.

[21] Laura J. Lederer and Christopher A Wetzel, ibid.

[22] Ibid.

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