“As psychologists, we hope to see a change in the health professions’ relative silence regarding prostitution’s harm to women, as well as a change in the perspective on prostitution held by the criminal justice system.”
-Melissa Farley & Avnessa Kelly
There is a lot of debate about whether prostitution should be legalized and regulated or whether the continuing laws(in India and elsewhere) which criminalize the act of brothel keeping, living off the earnings of a prostitute, soliciting or seducing for the purposes of prostitution should remain a punishable offence. The arguments for either side ultimately boil down to the question of why one stance over the other? The decision is largely influenced by a person’s perception of what benefits society as well as the exploitative nature of this profession .If prostitution were to be legalized these individuals would become part of a system that sanctions their work and also condones the act of selling one’s body as well as paying for sexual services. Such a system would be accountable for the repercussions this occupation has upon its members. For every occupation that is sanctioned by law and society there exists a representative in the form of an organization or a union that supports the best interest of its employees and ensures their well being. However the question that arises in the case of prostitution is whether the occupation is such that it poses a serious immediate threat to a woman’s psychological and physical health on a regular continuous basis? if so, then the act of sanctioning such an occupation and creating a system that supports it leads to a paradox not only in a moral sense but also in keeping with the actual negative effects of the occupation versus the benefits of legalizing prostitution.
The present paper is an attempt to gain greater clarity about the potential risks of this occupation. To assess whether commercial sex workers will ultimately suffer traumatic experiences to such an extent that their psychological and emotional health will prevent them from leading functional productive social and healthy lives.
Some might argue that traumatic experiences or harmful effects are faced by individuals in various other professions such as the military, war journalism, psychiatry, medical science or people working in factories where they are exposed to harmful substances on a daily basis. Thus these occupations are also a great cause for concern. However prostitution has been described as an act which is intrinsically traumatizing to the person being prostituted.(Farley et al, 1988)
Researchers have found that 92% of people interviewd stated that they wanted to leave prostitution .Also it has been reported that Sexual and other physical violence is the normative experience for women in prostitution (Baldwin, 1992; Farley and Barkan, 1998; Hunter, 1994; Silbert and Pines, 1982)
In light of such evidence one can hardly suggest that prostitution is an occupation that an individual would willingly participate in if she truly had another option or was entirely aware of the health risk involved.Infact Silbert and her colleagues(1982) have described a “psychological paralysis” of prostituted women, characterized by immobility, acceptance of victimization, hopelessness, and an inability to take the opportunity to change, which results from the inescapable violence they encountered throughout their lives (Silbert & Pines, 1982).
According to Farley (2006) Prostitution is sexual violence that results in massive economic profit for some of its perpetrators. The sex industry, like other global enterprises, has domestic and international sectors, marketing sectors, a range of physical locations out of which it operates in each community, is controlled by many different owners and managers, and is constantly
expanding as technology, law, and public opinion permit. She further stresses that prostitution as a profession is rife with every imaginable type of physical and sexual violence.
If prostitution is to be legalized, would it then become a recognized profession such as teaching, management, law etc? Would it be part of a career guidance course, would the individuals engaged in this occupation be treated with the same respect, dignity and rights that are allotted to others? Although it remains a personal choice to judge another human being, collective morality exists in every society and forms the basis for norms and beliefs in that society. Legalization of prostitution would condone an act that is considered inhumane by many yet legalization might afford better right to prostitutes and improve their standard of living. This debate eventually turns into a circular argument that requires a subjective approach rather than an objective methodology applied to all other aspects of human science. It becomes a matter of safety and humanity rather than a debate of legality and morality. Hence from the author’s perspective a Psychological study aimed at evaluating the mental health of prostitutes and determining to what extent this correlates to their occupation will indeed contribute to the argument and perhaps indicate how one can decide the matter of whether prostitution should be legalized and thus condoned by government and subsequently (but unlikely) be accepted morally; or whether we must at some point accept that the ‘oldest profession’ in the world has seriously contributed to the psychopathology of women engaged in this profession.
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There are several different perspectives on prostitution that have been discussed and documented. The perspective that prostitution is violence against women has been described and critiqued by Jeffreys (2000).She argues that that child and adult prostitution are inextricably interlinked, both in personnel (the women and children work together), in terms of the abusers (who make no distinctions), in the harm they cause and in that both constitute harmful traditional practices which must be ended.
Another perspective suggests that in recent decades prostitution has been industrialized and globalized. Industrialization means the ways in which traditional forms of organization of prostitution are being changed by economic and social forces to become large scale and concentrated, normalized and part of the mainstream corporate sphere. Prostitution has been transformed from an illegal, small scale, largely local and socially despised form of abuse of women into a hugely profitable and either legal or tolerated international industry. In states that have legalized their prostitution industries large-scale, industrialized brothels employ hundreds of women overseen and regulated by government agencies (M. Sullivan, 2007).
In some parts of Asia the industrialization of prostitution has taken place in the form of the creation of massive prostitution areas within cities. In Daulatdia, formed 20 years ago, in a port
city in Bangladesh, 1,600 women are sexually used by 3,000 men daily (Hammond, 2008).
This paper is presented in three parts. The first part highlights the Framework that governs the sex trade industry in India, the second part focuses on the Psychological implications of prostitution and the third part discusses the implications of legalizing and regulating sex trade.
Prostitution in India
India is a country that prides itself for upholding age old traditions and cultural practices rooted in religious beliefs which encourage a way of life that is ‘morally correct’ and ‘ethically sound’. It is a country which has great respect for the elderly, believes in the integrity of honesty and fidelity and places much emphasis on ‘purity’. Right from the religious scriptures to the common man’s notion about what is the ideal way of living one can witness a belief in simplicity, generosity and secularity. This comes from the fact that India is a country of a hundred cultures all inter-mingling to create a nation that is unified in language, sport and entertainment and often diversified in religion, custom and caste.
However one thing that remains collective and common to all the culturally opposed regions is the practice of sex trade. Prostitution in India has a long history.
In ancient India prostitutes have been referred to as Devadasis. Originally, Devadasis were celibate dancing girls used in temple ceremonies and they entertained members of the ruling class. But sometime around the 6th Century, the practice of “dedicating” girls to Hindu gods became prevalent in a practice that developed into ritualized prostitution. Devadasi literally means God’s (Dev) female servant (Dasi), where according to the ancient Indian practice, young pre-pubertal girls are ‘married off’, ‘given away’ in matrimony to God or Local religious deity of the temple. The marriage usually occurs before the girl reaches puberty and requires the girl to become a prostitute for upper-caste community members. Such girls are known as jogini. They are forbidden to enter into a real marriage.
In Karnataka, the most common form of traditional sex work is associated with the Devadasi system.
Today, the districts bordering Maharashtra and Karnataka, known as the “Devadasi belt,” have trafficking structures operating at various levels. The women here are in prostitution either because their husbands deserted them, or they are trafficked through coercion and deception Many are devadasi dedicated into prostitution for the goddess Yellamma. In one Karnataka brothel, all 15 girls are devadasi. (Meena Menon, “The Unknown Faces”).
Researchers have found that differences between Devadasi and non-Devadasi Female sex worker’s (FSWs) with regard to the pattern and environment of sex work were substantial. Devadasi FSWs were much more likely to entertain clients at home, reported a higher average number of sex partners in the past week, and charged less on average to each client. Devadasi FSWs were less likely to migrate to work at another location within the state of Karnataka but were somewhat more likely to have migrated to another state for work. Devadasi FSWs were more likely to accept every client and reported client initiated violence much less often than did non-Devadasi FSWs. Devadasi FSWs also were significantly less likely to report having ever been harassed by the police (Laanchard, F, J et al 2005).
Sex trade Industry in India:
There are approximately 10 million prostitutes in India. (Human Rights Watch, Robert I. Freidman, “India’s Shame: Sexual Slavery and Political Corruption Are Leading to An AIDS Catastrophe,” The Nation, 8 April 1996).The largest red light district in India, perhaps in the world, is the Falkland Road Kamatipura area of Bombay. There are more than 100,000 women in prostitution in Bombay, Asia’s largest sex industry center (Freidman, R.I 1996).
At least 2,000 women were in prostitution along the Baina beachfront in Goa. (Moronh,F 1997).There are 300,000-500,000 children in prostitution in India. ( Bedi,R 1997)
India, along with Thailand and the Philippines, has 1.3 million children in its sex-trade centers. (Soma Wadhwa, “For sale childhood,” Outlook, 1998)
India and Paksitan are the main destinations for children under 16 who are trafficked in south Asia. (Masako Iijima, S. Asia urged to unite against child prostitution,” Reuters, 19 June 1998)
In India, Karnataka, Andha Pradesh, Maharashtra, and Tamil Nadu are considered “high supply zones” for women in prostitution. Bijapur, Belgaum and Kolhapur are common districts from which women migrate to the big cities, as part of an organised trafficking network. (Central Welfare Board, Meena Menon, “The Unknown Faces”)
A few hundred thousand men have sexual relations with prostitutes every day in India. Insights derived by health practitioners and social workers from the experience of working in red-light areas suggest that the following categories of men are frequent visitors to prostitutes: low-level workers in the manufacturing and transport industries; other workers living away from their families for a length of time; traders and customers in transitory markets; visitors to fairs, festivals and pilgrim centres; defence personnel living away from families; students; pimps and others who have some control over prostitutes; traders and service providers in red-light areas.
According to one author of “The Unkown Faces” There are three routes into prostitution for most women in India. 1) Deception 2) Devadasi dedication and 3) Bad marriages or families.
A study conducted by researcher s in Karnataka, a Southern state of India found that Participants gave diverse reasons for entering sex work . Overall 26% stated that induction into the Devadasi tradition was at least 1 reason that they entered sex work, and 66% of these Female sex worker’s (FSWs) listed it as the only reason that they entered sex work. Other stated reasons for entering sex work included financial need- 36%, marital or family discord or dissolution -30%, and being coerced or lured- 20%.
Chattopadhyay M, Bandyopadhyay S, Duttagupta C, (1994) conducted interviews with 33 female prostitutes in Domjur, Howrah District, West Bengal, to understand the processes by which women become prostitutes. Twenty-one of them were married. More than 50%, who had been married before the age of 18, became prostitutes before 25 and were older than 30. 66% did not engage in illicit sex before becoming prostitutes. About 20% had been prostitutes for more than 15 years. Most prostitutes earned about Rs. 1000 per month. 66% had a maximum number of five clients/day. Three prostitutes had as many as seven to eight clients/day. Life events and their reactions that led them to become prostitutes belonged to two categories: (1) women who were either widowed (17 women) or abused by husband and in-laws (4 women), leaving them with no social or economic support and (2) women who chose prostitution as an easy means to support themselves (9 women) or because they had sexual urges or were curious (3 women).
Empirical studies along in red-light areas of a few large cities corroborate the common knowledge that prostitutes, in general, lead a poor standard of life in dilapidated and unhygienic environments (Gilada n.d.; Ghosh and Das 1994). A major portion of what their clients pay is shared by pimps, landlords, madams, financiers and policemen. They do not get nutritionally adequate food and they are exploited by local traders who sell them essential goods. Because of strong prejudice against them they cannot take advantage of the government health facilities and have to depend mostly on local quacks who charge them exorbitantly for treatment and medicines. A large proportion of them suffer intermittently from various kinds of STDs. Most of them are forced to enter this occupation because of adverse circumstances.
In a country that has strict values and restrictions towards marriage,dating and pre-marital sex there seems to be a rampant disregard for the value of a woman’s right to dignity and integrity.In India, It is generally considered unacceptable for a woman or man to engage in sex before marriage or with more than one partner. Speaking about sex related issues is taboo in most households and sex education in schools is strongly opposed and rendered inappropriate. It is believed that one should respect traditions and avoid places,people,movies,books or music that are provocative or in any way of a sexual nature. Conservatism and orthodox customs are welcomed and whole heardtedly preached and in some cases practiced in India. Thus, it comes as a shock to realize that the hub of the Sex trade throughout Asia and possibly the world is housed in the biggest city in India-Mumbai. It is a sad and cruel paradox that a country that preaches about purity and chastity has the largest brothels in the world and is a central point in the human trafficking system.
Legal position in India:
Laws related to prostitution in India:
Suppression of Immoral Traffic in Women and Girl Act -1956
Prevention of Immoral Traffic Act-1956
Immoral Traffic (Prevention) Act-1956
In legal terms, the Indian Immoral Traffic (Prevention) Act 1956, criminalized the volitional act of “a female offering her body for promiscuous sexual intercourse for hire whether in money or in kind”. But, under the revised 1986 Act, “prostitution” means ” the sexual exploitation or abuse of persons for commercial purpose, and the expression ‘prostitute’ shall be constructed accordingly” – so there is not only no criminality if there is “offering by way of free contract”, there is not even prostitution.
In India the primary law dealing with the status of sex workers is the 1956 law referred to as the The Immoral Traffic (Suppression) Act (SITA). According to this law, sex work in India is neither legal nor illegal; it is tolerated since prostitutes can practice their trade privately but cannot legally solicit customers in public. Unlike as is the case with other professions, however, sex workers are not protected under normal workers laws, and are not entitled to minimum wage benefits, compensation for injury or other benefits that are common in other types of work.
Although prostitution (the act of selling one’s body in a non public setting) is legal in India, brothel keeping, living off the earnings of a prostitute, soliciting or seducing for the purposes of prostitution are all punishable offenses. (Robert I. Freidman, “India’s Shame: Sexual Slavery and Political Corruption Are Leading to An AIDS Catastrophe,” The Nation, 8 April 1996)
Psychological distress among sex workers
Considerable research has been conducted in the area of sex trade and prostitution. Most of this research in the social sciences focuses on the health risks involved, particularly HIV, AIDS.
There is a large-scale ignorance of the psychological harm that is faced by women who are prostituted. Prostitution has been defined in many ways either by political or legal organizations.
The World Health Organization (WHO) defined prostitution as a dynamic and
adaptive process that involves a transaction between seller and buyer of a sexual service (World Health Organization, 1988). WHO has since recommended decriminalization of prostitution (Ahmad, 2001). Much of the health sciences literature has viewed prostitution as a job choice (Deren et al., 1996; Farr, Castro, DiSantostefano, Claassen, & Olguin, 1996; Green et al., 1993; Romans, Potter,Martin,&Herbison, 2001; UN/AIDS, 2002). However the notion that prostitution is work tends to make its harm invisible.
Important questions remain unanswered regarding the epidemiology and etiology of psychological distress among sex traders. Many sex traders and drug users from poor neighborhoods have experienced homelessness, rape, and other violent events associated with psychological distress.
High proportions of prostitutes are drug-dependent and have experienced physical and sexual abuse in childhood and adulthood (Church, Henderson, Barnard, & Hart, 2001; El-Bassel, Schilling, Irwin, Faruque, Gilbert, Von Bargen, Serrano, & Edlin, 1997; El- Bassel, Simoni, Cooper, Gilbert, & Schilling, 2001).
The Psychological literature on Prostitution has focused on different theories to explain the role of a prostitute either as a victim or a risk-taker. There has been tremendous debate over the underlying factors that lead a woman into this ‘profession’. It is assumed that prostituted women have personality characteristics which lead to their victimization. Rosiello (1993) described the inherent masochism of prostituted women as a “necessary ingredient” of their self-concept. MacVicar and Dillon (1980) suggested that masochism plays a central role in the acceptance of abuse by pimps. Psychoanalytic theories that prostituting originates in maternal deprivation or from the anal desires of the child -have been described by Weisberg (1985) and Bullough & Bullough (1996).Vanwesenbeeck, et al (1993) identified three groups of prostituted women as 1) those who had a positive, businesslike attitude and consistent condom use, 2) those who had a negative attitude and occasional failure to use condoms),and 3) “risk takers” who did not use condoms and who reported feeling powerless. The “risk takers” reported fears of violence and despair in situations where they were powerless. One woman stated that health planning was not a priority when “your whole life’s a misery and pain” (Vanwesenbeeck et al., 1993).
Women in prostitution are often assumed to have an underlying personality disorder. De Schampheleire (1990) concluded that 61 prostituted women had emotional difficulties that resulted first in addictions, and later in prostitution, which was itself described as a “diversion” from other psychological problems.
This is clearly indicative that there is a belief that emotionally disturbed or vulnerable women are more likely to enter into prostitution, further become victimized and continue in this ‘profession’ as a means of coping with their initial sense of turmoil or unworthiness. This literature fails to recognize the various other reasons that women enter into prostitution (such as financial need or coercion), and ultimately suffer psychological difficulties as a result of this ‘profession’. It is assumed with a stance of such stoicism that women willingly enter into a profession in which they become victims of battering, rape, fatal physiological conditions, constant trauma and degradation.
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However there is literature that supports the idea that prostitution does indeed inflict psychological distress on the individual. Graaf et al. (1995) and Plant et al (1989) found that women’s alcohol use in prostitution was related to the psychological trauma of prostitution. It permitted a chemical dissociation, as well as a means of anesthetizing their physical aversion for the act of sex for payment. Green et al (1993) noted that some Glasgow women were only able to prostitute under the influence of drugs or alcohol.
Alegria et al (1994) found that 70% of 127 Puerto Rican women in prostitution had symptoms of depression which were associated with increased risk behaviors for HIV.
Violence against women in Prostitution:
In the past decade, a number of authors have documented or analyzed the sexual and physical violence that is the normative experience for women in prostitution, including Baldwin (1993,
1999); Barry (1979, 1995); Boyer, Dworkin (1981, 1997, 2000); Farley, Baral, Kiremire, and Sezgin (1998); Giobbe (1991, 1993) .Sexual violence and physical assault are the norm for women in all types of prostitution. Nemoto, Operario, Takenaka, Iwamoto, and Le (2003) reported that 62% of Asian women in San Francisco massage parlors had been physically assaulted by customers. Raymond, D’Cunha, et al. (2002) found that 80% of women who had been trafficked or prostituted suffered violence-related injuries in prostitution.
Among the women interviewed by Parriott (1994), 85% had been raped in prostitution. In another study, 94% of those in street prostitution had experienced sexual assault and 75% had been raped by one or more customers (Miller, 1995). In the Netherlands, where prostitution is legal, 60% of prostituted women suffered physical assaults; 70% experienced verbal threats of physical assault; 40% experienced sexual violence; and 40% had been forced into prostitution or sexual abuse by acquaintances (Vanwesenbeeck, 1994). Most young women in prostitution were abused or beaten by customers as well as pimps. Silbert and Pines (1981, 1982) reported that 70% of women suffered rape in prostitution, with 65% having been physically assaulted by customers and 66% assaulted by pimps.
Of 854 people in prostitution in nine countries (Canada, Colombia, Germany, Mexico, South Africa, Thailand, Turkey, United States, and Zambia), 71% experienced physical assaults in prostitution, and 62% reported rapes in prostitution (Farley, Cotton, et al., 2003). Eighty-nine percent told the researchers that they wanted to leave prostitution but did not have other options for economic survival.
To normalize prostitution as a reasonable job choice for poor women makes invisible their strong desire to escape prostitution. Vanwesenbeeck (1994) found that two factors were associated with greater violence in prostitution. The greater the poverty, the greater the violence; and the longer one is in prostitution, the more likely one is to experience violence.
Research and clinical reports have documented the prevalence of childhood sexual abuse and chronic traumatization among prostituted women (Belton, 1992; Burgess,et al., 1987; Giobbe et al., 1990; James & Meyerding, 1977; Paperny & Deisher, 1983; Silbert & Pines, 1981, Simons & Whitbeck, 1991; Widom & Kuhns, 1996).
Weisberg (1985) reported that 70% of women suffered rape in prostitution, with 65% of prostitutes having been physically assaulted by customers; and 66% assaulted by pimps.
The Council for Prostitution Alternatives in Portland, Oregon, reported that prostituted women were raped an average of once a week (Hunter, 1994).
Women in prostitution are battered women. Prostitution, like battering, is a form of domestic violence. Giobbe (1993) compared pimps and batterers and found similarities in their use of enforced social isolation, minimization and denial, threats, intimidation, verbal and sexual abuse,
attitude of ownership, and extreme physical violence to control women. The techniques of physical violence used by pimps are often the same as those used by torturers. Gray (1973, cited in Weisberg, 1985) reported that one teenager was beaten with a 6-foot bullwhip and another was tied to a car and forced to run behind it. It has been reasonably estimated that prostitution
is 80% to 90% pimp-controlled (Giobbe & Gamache, 1990; Hunter, 1994).
The primary concern of prostituted women in Glasgow was violence from customers (Green et al., 1993). Rape was common. The women in Glasgow were physically abused as part of the job of prostitution. They were whipped and 1 7 beaten up, with payment at times received “per individual blow” (Green et al., 1993, page 328). Prostituted women described a minority of customers as extremely dangerous. These men were likely to assault or murder women in prostitution for pleasure. They used fists, feet, baseball bats, knives, or guns in their assaults on the women. One man inserted a shotgun into at least one woman’s vagina and mouth.
87% of prostituted women interviewed by Miller (1995) were physically assaulted in prostitution, with 31% having been stabbed, and 25% being hit with an object. 37% of her sample had been held captive. Prostituted women were often assaulted and robbed (Green et al, 1993; Hardesty & Greif, 1994; Miller, 1995).
Miller & Schwartz (1995) found that 94% of those in street prostitution had experienced some form of sexual assault; 75% had been raped by one or more customers. In spite of this, there was a widespread belief that the concept of rape did not apply to prostitutes. If rape of a prostituting
woman occurs, some have considered the rape to be “theft” or “breach of contract” rather than rape. Many people assumed that when a prostituted woman was raped, it was part of her job and that she deserved or even asked for the rape. In an example of this bias, a California judge overturned a jury’s decision to charge a customer with rape, saying that “a woman who goes out on the street and makes a whore out of herself opens herself up to anybody.”
One juror interpreted the judge’s decision as a refusal to give rights to prostitutes (Arax, 1986).
Psychological Trauma as a result of prostitution:
Dissociation is the psychological process of banishing traumatic events from consciousness (Herman, 1992). It is an emotional shutting-down which occurs during extreme stress among prisoners of war who are being tortured, among children who are being sexually assaulted, and among women being battered or raped or prostituted. Vanwesenbeeck (1994) considered dissociation in those prostituted to be a consequence of both childhood violence and adult violence in prostitution. She noted that a proficiency in dissociation, perhaps learned in order to
survive sexual abuse as a child, was required in prostitution.
Ross et al (1990) noted dissociative symptoms in women in strip club prostitution. Belton (1998) reported that depression as well as dissociative disorders were common among prostituted women.
It is clear that women in prostitution suffer from psychological trauma which affects their functioning.Other than dissociation,drug use an emotional vulnerability women in prostitution suffer from posttraumatic stress disorder (PTSD). Symptoms are anxiety, depression, insomnia, irritability, flashbacks, emotional numbing, and hyperalertness. Farley et al., (1998) interviewed 475 prostituted people in 5 countries (South Africa, Thailand, Turkey, USA, and Zambia) and found that 67% met diagnostic criteria for PTSD, suggesting that the traumatic sequelae of prostitution were similar across different cultures.
The violence of prostitution, the constant humiliation, the social indignity and misogyny result in personality changes which have been described by Herman (1992) as complex posttraumatic stress disorder (CPTSD). Symptoms of CPTSD include changes in consciousness and self-concept, changes in the ability to regulate emotions, changes in systems of meaning, such as
loss of faith, and an unremitting sense of despair. Once out of prostitution, 76% of a group of women interviewed by Parriott (1994) reported that they had great difficulty with intimate relationships. Not only were sexual feelings destroyed in prostitution, but the emotional part of the self was eroded. (Hoigard & Finstad,1986; Giobbe, 1991, 1992) One of the longer-lasting effects of CPTSD involves changes in relations with other people, including changes in perception of the perpetrator of abuse.
Previous research on women who engaged in prostitution has found a high rate of drug abuse among this population (Kuhns, Heide, & Silverman, 1992; El-Bassel et al., 1997; Nadon, Koverola, & Schludermann, 1998; Potterat,)The need for drugs, both physical and emotional, often overpowers prostitutes’ aversion toward the degrading aspects of their occupation (Weeks et al., 1998).
In another study, El-Bassel and colleagues (1997) found that drug-using prostitutes scored higher than drug-using non-prostitutes from the same community on several measures of psychological distress, such as depression, anxiety, and paranoid ideation, and suggested that psychological distress among prostitutes was brought about by the dangerous and degrading circumstances surrounding their work.
Researchers found that the women who were prostituting were more likely to report using drugs to increase their feelings of confidence, sense of control, and feelings of closeness to others and to decrease their feelings of guilt and sexual distress. (Young,A,M et al 2000). Furthermore the researchers found that the subservient, humiliating nature of prostitution suggests that these women would tend to feel less confident and in control while working, and would wish to regain these feelings, and the ability to feel close to others, after being sexually involved with a stranger or strangers. Other studies have found that women engaged in prostitution use drugs and alcohol to feel more confident on the job, more calm and able to suppress negative feelings, and more relaxed and sociable (Gossop et al., 1994; Silbert et al 1982; Feucht, 1993).
The evidence is clear and alarming, Psychological distress is an inevitable result of prostitution and is more than likely to inte
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