"Health Effects of Prostitution": Which Health? Which Prostitution?

In the interminable feminist battle about prostitution, too much reductionist prose is written. An article published in the last edition of this newsletter, "Health Effects of Prostitution", by Janice Raymond, cited studies from 1993 and 1994 of street prostitutes who had gone for help to social service projects in two cities in Minnesota and Oregon. Unsurprisingly, people who go to trauma centres are often found to be traumatised. No control groups were used in this research, an absence which means that we do not know whether the rate of trauma resulting from violence and abuse was similar for non-prostitute women of the same general background and class at that time in those two places. The author, however, extrapolates the research results not only to the rest of Minnesota and Oregon but to the rest of the United States and even to the rest of the world. Accepted standards for both qualitative and quantitative research do not allow such geographic and cultural extrapolation; nor do they permit generalisation to a general category called "prostitutes". As everyone now knows, street prostitutes receive the brunt of everyone's attention, but huge numbers of prostitutes are not on the street. Mixing and muddling all these categories and situations is bad social science, biased reporting and, in the end, absurd polemic.

There is no one study that proves or disproves the "health effects" of prostitution, because that would mean essentialising a single aspect of the lives of all the world's people who have any kind of transactions involving sex and money. That would mean a study that knew how to compare the health of Amsterdam window-workers with Sri Lankan beachboys, Nevada brothel prostitutes, Brazilian transgender street hookers, Bangkok bar girls, Kenyans in temporary marriages and Caribbean gigolos, the occasionals, the part-timers, and the full-time workers, the female, male, trans- or inter-genders and transvestites, to name a tiny fraction of the possibilities. Such a study would not suggest that rape can be understood in the same way in all cultures and situations. Such a study would ask questions that would make sense across immense cultural divides--questions concerning childhood relations with parents, concepts of violence and authority, norms within marriage, value of diverse sexual practices and ideas of self, agency, obligation and desires for the future. To even consider doing such a study would be arrogant.

In various contexts around the world, some "health effects"of prostitution have been studied. Since funds usually go to prevention of AIDS, HIV and STDs, those effects have been most researched, primarily the very specific activity called "condom use". In the rush to construct sex workers as "pools of contagion" and "vectors of disease"--19th century phrases that have changed little in the current phrase "high-risk groups" --societies essentialise these human beings to their sexual/reproductive organs. This essentialising can be called fetishising without stretching the definition at all.

Sex workers are organizing on their own behalf in many countries and even establishing political and service-oriented networks across international boundaries. Not all people who work in sex jobs agree on what prostitution is or whether there's a sex industry or which terms are best to use in which context. They don't all agree on what the precise solutions are to their problems. But from Thailand to Spain to South Africa they do almost universally recognise that existing laws and their enforcement (or non-enforcement when crimes are committed against prostitutes) are a major problem. The level of physical and mental violence some groups of prostitutes face from police and immigration authorities--and the resulting stress and depression--must be included when considering such a topic as "health effects" of their work.

Feminists could unite to demand that prostitutes--like clients and like everyone else--be viewed as whole persons. Since healthy living conditions, social relationships and basic self-esteem are prerequisites to fertility, family planning and prevention of STDs/AIDS, as well as to prevention of violence, the whole-person approach to health offers a way to change biases that target and stigmatise sex workers. "Healthy living conditions"--and healthy working conditions--being problematic for vast numbers of the world's people, attention should be refocussed on attaining these for everyone and not reiterating arguments that reduce an immense diversity of human experience to one word.

Laura María Agustín
Connexions for Migrants

RETURN
to "Sex Work and Migration" Table of Contents.

SWIMW HOME