What is prostitution?
NHS Greater Glasgow & Clyde considers prostitution to be a form of commercial sexual exploitation and part of the spectrum of gender-based violence.
What causes prostitution?
The primary reason for prostitution is that there is a high demand by men (predominantly) for the sale and purchase of sex. Commercial sexual exploitation is a major, global industry which has proliferated in recent years as a result of the internet combined with major changes in national political and economic systems that have impoverished millions across the globe.
Currently, the global prostitution industry is estimated to make US$52 billion dollars a year. To keep the sex industry in business, women and children are trafficked to, from and through every region in the world.
The value of this global trade in women and children as commodities for sex industries is estimated to be between seven and twelve billion dollars annually.
A Scottish study of 110 men that had paid for sex found that:
Who is exploited through prostitution?
It is mostly women who are exploited through prostitution although some men are also exploited in this way.
The women and men involved in prostitution who have engaged with NHSGGC services present with common themes of early trauma, including:
Childhood neglect and familial domestic abuse
Direct emotional, physical and sexual abuse, including child sexual abuse
Experience of statutory residential care
Early entry into homelessness services
Experience of addiction to substances by self and/or carer/partner
Experience of domestic abuse by partner
Poverty and financial pressures are also contributory factors.
These factors, which serve to lead or force women into prostitution, help us to understand prostitution as survival behaviour rather than sexual behaviour or a lifestyle choice. Once the factors behind women’s involvement in prostitution are understood it makes no sense to label prostitution as ‘sex’ work or legitimate employment – to do so would legitimise exploitation. As such, prostitution should not be confused and conflated with the right of an individual to participate in a mutually consenting and fulfilling private life.
Health Impact of Prostitution
The physical, emotional and psychological consequences of prostitution can be profound and include rape and sexual assault, depression, addiction, post traumatic stress disorder, self harm and suicide.
Poor health consequences also impact on vulnerable young people of both sexes, the families of the women involved, especially their children, on the men who purchase sex, their partners and on the social health of the wider community.
Many women involved in prostitution have reported experiences of emotional abuse, physical violence, sexual abuse and rape and sexual assault perpetrated by men purchasing sex. Women also experience the psychological trauma of having to repeatedly submit to unwanted sex. Given this, the health consequences of involvement in prostitution are significant and enduring. They include physical injuries, gynaecological problems, emotional trauma, addiction issues and mental health problems such as depression, eating disorders, suicidal ideation and self-harm.
Women and men involved in prostitution are denied positive experiences of sexual health as defined by the World Health Organisation, namely:
“The possibility of having pleasurable and safe sex experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”
Prostitution and other marginalised groups and protected characteristics
Many women are criminalized as a result of their involvement in prostitution and this makes it more difficult for them to exit prostitution and to access the labour market. There is also a correlation with other marginalised groups such as prisoners and ex- offenders.
Age: While society rightly condemns and criminalises men who engage in child prostitution, and protects children who are sexually exploited, society often condones or ignores adult prostitution.
What NHSGGC is doing to respond to prostitution
Many people affected by prostitution are reluctant to come forward to agencies, often through fear or shame, but do present across the whole range of primary and acute health settings. Consequently, health workers are in a unique position to provide help and support.
Our organisation’s Gender-based Violence Action Plan includes action to address prostitution and other forms of commercial exploitation. These actions include sensitively enquiring of service users about any current or previous involvement in prostitution as part of core practice within key services, and ensuring care pathways adapt care and treatment to take any disclosures into account.
NHS Greater Glasgow & Clyde provides services to women involved in prostitution through joint work betweenits Sexual Health Services (Sandyford), Glasgow Addiction Services, and Glasgow Community & Safety Services.
It provides services to men involved in prostitution through its NHS Open Road Service and Sandyford Sexual Health Services in partnership with Glasgow Addiction Services
To eradicate the harm caused by prostitution, then the circumstances which allow prostitution to exist must be challenged and NHSGGC works with partner agencies to challenge male demand for prostitution through involvement in the White Ribbon Campaignand local multi-agency partnerships on violence against women.
"A practice by which a person achieves sexual gratification, financial gain or advancement through the abuse or exploitation of a person's sexuality by abrogating that person's human right to dignity, equality, autonomy, and physical and mental well-being; i.e. trafficking, prostitution, prostitution tourism, mail-order-bride trade, pornography, stripping,battering, incest, rape and sexual harassment. Sexual exploitation preys onwomen and children made vulnerable by poverty and economic development policies and practices; refugee and displaced persons; and on women in the migrating process. Sexual exploitation eroticizes women's inequality and is a vehicle for racism and "first world" domination, disproportionately victimizing minority and "third world" women. Sexualexploitation violates the human rights of anyone subjected to it, whether female or male, adult or child, Northern or Southern.”
(Professor Donna Hughes,2000)
Scottish Social Attitudes Survey 2014 - Attitudes to violence against women in Scotland. This survey shows that the majority of Scottish people support an approach to target those who purchase sexual activity.
Money & Power: Commercial Sexual Exploitation DVD - available FREE of charge
Click here for a range of resources from the Women's Support Project