Prostitution A Psychological Perspective Sociology Essay

Published Date: 23 Mar 2015

"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.

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.

Devadasi System:

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.

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 interfere with the normal functioning of women engaged in prostitution.Most individuals suffering from psychological disorders are subject to treatment and therapy, Given the nature of their work environment and the moral stigma attached to their work, it is unlikely that prostitutes have access or are willing to seek psychological/psychiatric treatment. However, the apoplectic nature of the research indicates that in most cases women who engage in prostitution are at risk for developing an array of psychological problems which will adversely affect the quality of their lives.

Does legalization or decriminalization decrease the dangers of prostitution?

It is believed that legalization or regulation of the sex trade industry will create a system that will help to control the atrocities inflicted upon the women engaged in this occupation. There are several arguments in support of such a system .Some of these are the belief that decriminalizing prostitution will safeguard the human rights of sex workers, protect sex workers from exploitation, promote the welfare and occupational safety and health of sex workers, and create an environment that is conducive to public health. It is also alleged that laws decriminalizing prostitution would protect children from the exploitation of prostitution (New Zealand Justice and Electoral Committee, 2001)

Underpinning laws that legalize or decriminalize prostitution is the belief that prostitution is inevitable and hence should be addressed by the state government in a manner that will offer protective rights to prostitutes.

Often, those promoting prostitution are sex industry businessmen and government officials. Sex businesses such as escort prostitution, massage brothels, strip clubs, phone sex businesses, and Internet prostitution have been described by Lim (1998) as the sex sector of a state's economy. In some countries, profits from the sex sector are included in estimates of its economic activity. For example, in the Netherlands, the sex industry constitutes 5% of the GDP (Daley, 2001). According to Schippers, (2002) Women in Dutch prostitution feel that legalization of prostitution was promoted as a way to improve their lives; they view it primarily as a way for the State to tax their earnings. Often they do not think that their health has benefited or that they are offered more protection under legalized or decriminalized prostitution.

Some social scientists define the predatory behaviors of men buying women in prostitution as normal, maintaining that prostitution is simply part of human nature (Ahmad, 2001; Fisher, 1992; Masters & Johnson, 1973; Pheterson, 1996; Scambler & Scambler, 1995). This definition of normalcy is then reflected in public policy that defines prostitution as a form of labor (sex work), where prostitution is considered an unpleasant job but not different from other kinds of unpleasant jobs, such as factory work. From this perspective, prostituted women are viewed as simply another category of workers with special problems and needs (Bullough & Bullough, 1996; Kinnell, 2001; Nairne, 2000).

One of the argument's supporting prostitution as a phenomenon suggests that male sexual need is a "natural" instinct that requires fulfillment and considers the prostitute as servicing this need. Its theoretical defense is given in what is termed the "contractarian" argument, according to which the need for sexual gratification is a need similar to the need for food and fresh air (and hence should be as readily available) and, further, that under conditions of "sound" prostitution, sexual services may be freely sold in the market place (Ericsson 1980).

According to advocates of legalization of prostitution, the primary harm of prostitution is social stigma against prostitution. Those on all sides of the debate agree that women in prostitution are stigmatized. The 1949 Convention against Trafficking in Persons states that 'prostitution and the accompanying evil of the traffick in persons' are 'incompatible with the dignity and worth of the human person' (United Nations 1949).

Advocates of decriminalization argue that the health of those in prostitution will be improved by decriminalization because otherwise women will not have access to health care. It is assumed that women will seek health care as soon as the stigma of arrest is removed from prostitution. If the stigma is removed, advocates argue, women will then file a complaint whenever they are abused, raped, or assaulted in prostitution. They assume that the complaint will be followed with a police response that treats women in prostitution with dignity and as ordinary citizens. Unfortunately, health care workers and police too often share the same contempt toward those in prostitution that others do.

An editorial in Lancet (1996) suggested that decriminalization of prostitution would decrease police harassment and assist prostituted women in finding safer state licensed brothels in which to work, although the writer questioned whether "herding" prostitutes into brothels would actually benefit their health or safety.

It seems that in most of the arguments the question revolves around reducing stigma, social prejudice and a creation of sudden respect for women in prostitution as a result of legalizing it. The fact that is largely ignored is that prostitution is a 'profession' that does serious harm to the mental, emotional and behavioural well-being of an individual. The act of selling one's body in exchange for money and engaging in behaviour that is often degrading and humiliating on a regular basis ultimately leads to psychological symptoms which are neglected due to the very nature of the work environment and social status of a prostitute. There is a complete lack of consideration of the psychological health of a prostitute with an over emphasis on the spread of diseases or rather the control of them by regulating prostitution. This constant objective standpoint on the issue disregards the individual problems and concerns of women in prostitution. It fails to recognize them as people who are exposed to mentally unhygienic conditions on a subjective level.

Prostitution presents severe problems for women's reproductive and sexual health because it entails the use of women's reproductive tract, anus, mouth and other body parts by penises, hands and objects. It is the only form of 'work' which requires use of the inside of women's bodies, apart from reproductive surrogacy (Jeffreys, 1997).

Whilst other businesses, like building sites or offices, may have health and safety officers to inspect the safety of the workplace, and employers know they may be held accountable, none of this applies to the dangers of prostitution, where brothel owners have no accountability.

Any advantage that legalization can offer in reducing the threat of this violence would only be available to a small minority of women in the industry, however, since most women in Australia, in Nevada, in the Netherlands and Germany are prostituted in illegal sectors from brothel to escort, strip club and street prostitution (Wallman, 2001). These harms may be alleviated to some extent in brothel systems, whether or not these are legalized, simply because the male buyers cannot be so anonymous and may be more circumspect about the violence they inflict. They are not eliminated. There is no evidence that legalized brothels provide alleviation of the harms that are involved in the ordinary everyday acts of penetration that the male buyers pay for, however, or the psychological humiliation and distress that prostituted women experience. The psychological harms that result from the continual disassociation of mind and body needed to survive prostitution, and the routine dehumanization integral to the practice commonly bear all the characteristics of post-traumatic stress disorder (Farley, 2004).

Thus the argument that Legalizing prostitution is beneficial to the well being of the prostitute does not hold true. The evidence clearly suggests that by nature prostitution is a 'profession' that inflicts harm on a woman even within a system that is regulated. A prostituted woman is most often at the mercy of the man paying for the sexual services. Considering the power dynamic between 'customer' and prostitute she has little control over her own well being, and hence is unlikely to be benefitted by a regulated system. Such a system would require the regulation of clients to ensure that they are not likely to be a threat to the prostitute or inflict any harm upon her, physically or psychologically. However such a task would be close to impossible since the very act of repeatedly having sexual intercourse with strangers in exchange for money results in a state of dissociation or detachment from the act, which in the long run has harmful psychological implications.

It has been found that legalization of the prostitution industry makes trafficking in women more profitable. The European nations that have legalized, the Netherlands and Germany, have the highest numbers of trafficked women. Thus estimates of the percentages of prostituted women in those two countries that are trafficked are never less than 50 per cent and in some cases are as high as 90 per cent in the case of Germany (Monzini, 2005).

Governments that legalize do not usually consider what percentage of their male citizens they want to have becoming prostitutors, but this is a question with considerable implications for the women whose partners and sons are involved. In legalized environments men feel justified in their prostitution behaviour and it is believed the percentage of men who prostitute women is likely to increase. Thus in Australia, 1 in 6, or 15.6 per cent, of men report paying for sex (Rissel et al., 2003). The corresponding number of men in the UK is 1 in 29, though that number has doubled in a decade as a result of the growth of the illegal industry in the UK, stimulated by the normalization of strip clubs and pornography, which fosters prostitution behaviour, and sex tourism (Coy et al., 2007).

In 1999, Sweden became the first country to make it illegal to pay for sex, but not to be a prostitute (the client commits a crime, but not the prostitute). A similar law was passed in Norway (in 2009) and in Iceland (in 2009).

In some countries, (or administrative subdivisions within a country), prostitution is legal and regulated. In these jurisdictions, there is a specific law, which explicitly allows the practice of prostitution if certain conditions are met (as opposed to the places where prostitution is legal only because there is no law to prohibit it) (Anderson & O'Conell 2003)

In countries where prostitution is regulated, the prostitutes may be registered, they may be hired by a brothel, they may organize trade unions, they may be covered by workers protection laws, their proceeds may be taxable, they may be required to undergo regular health checks, etc. The degree of regulation, however, varies very much by jurisdiction.

The belief is that prostitution is impossible to eliminate, and thus some societies have chosen to regulate it in an attempt to reduce the more undesirable consequences. Goals of such regulations include controlling sexually transmitted disease, reducing sexual slavery, controlling where brothels may operate and reducing the involvement of prostitutes in Criminal enterprises.

Brothel prostitution is legal in Germany. In an indictment of legal prostitution, 59% of German respondents told researchers that they did not think that legal prostitution made them any safer from rape and physical assault (Farley et al., 2003). A comparable 50% of 100 prostitutes in a Washington, D.C., survey expressed the same opinion (Valera et al., 2001). Hunter, (1993) believes it is not possible to protect the health of someone whose "job" means that they will get raped on average once a week . In a study conducted by Leone, (2001) one woman explained that prostitution is "like domestic violence taken to the extreme" .Another woman said, "What is rape for others, is normal for us".

Thus we can no longer deny that regulating prostitution does not necessarily mean a violence free, healthier environment for the prostitute. Although regulating the phenomenon of prostitution might make sense out of an otherwise chaotic system it does not derail the negative impact or psychological health hazards of this occupation.

Globally, there have been various attempts to regulate the sex trade industry and to include it into a more main stream and acceptable service. For example, the Irish, Japanese and Canadian governments have, until recently, had special visa categories for entertainers' which enable the trafficking in women for strip clubs and prostitution (Macklin, 2003).

States in South East Asia, such as the Philippines, have special training programmes for 'entertainers' that facilitate trafficking for prostitution. None of these states have officially legalized prostitution, however. Jeffreys (2009) in her book "The Industrial Vagina" criticizes these legal systems and suggests that as the industry expands, legalization exacerbates the harms associated with prostitution, rather than reducing them. Further she emphasizes that the legalizing states are responsible for the management of 'free' methods of recruitment, trying to ensure that prostituted women are not obviously recruited by force, deception or trafficking.

In legalized systems brothels are licensed and regulated by the state. In decriminalized systems there is no state oversight of brothels. They do not need licences and, like any other businesses, they need only apply for planning permission. The common understanding is that prostitution is inevitable and that women will always be prostituted, so the state has the responsibility to step forward on behalf of these unfortunate women and seek to better their situation through what is commonly referred to as 'harm minimization'.(Jeffreys, 2009)

Harm minimization masks the issue of who stands to gain most from the policy of legalization, such as the pimps and procurers and male buyers, rather than the small number of prostituted women who will end up in the legalized segment of the industry. But also it is based on the idea that the male urge to use prostituted women is something bestowed by nature and uncontrollable, that the state can only seek to regulate to a certain extenet but not fully contain. Occupational health and safety (OHS) advice is offered by legalizing states, usually in collaboration with state funded 'sex work' organizations, to prostituted women as a way to fulfil their responsibility to make prostitution safer, but the advice shows little acknowledgement of the physical or psychological harms involved, and is unable to offer realistic solutions (M. Sullivan, 2007).

The effects of legalization on the numbers of women involved in prostitution is clear from a comparison of Germany, which has legalized brothels and has 3.8 prostituted people per 1,000 population, and Sweden, which penalizes the male buyers and has 0.3 prostituted people per 1,000 population (Ward and Day, 2004).

The increased numbers of prostitutors in tolerated or legalized environments is of concern because of the attitudes they have towards prostituted women. More than three-quarters of prostitution buyers in a study carried out in London, where massage parlour prostitution is tolerated, saw prostituted women as dirty (89 per cent) and inferior (77 per cent) (Coy et al., 2007). According to Jeffrey's (2009) this is problematic for the safety and mental health of prostituted women and their motives for prostitute use indicate how such male behaviour undermines men's respect for women's equality in general.

Sex is viewed as a product to shop for, or something to be bought as a group after an evening out (Jeffreys, 2009).According to the evidence assembled in her book Jeffrey's believes that it is very unrealistic to imagine that there is, somewhere, a safe, free, respectable industry of prostitution, entered only by fully empowered adults, which is worthy of sidestepping and looking the other way.

Conclusion

There are a large number of people who believe that prostitution should be legalized. That it will create a system that will support the women engaged in this profession and provide them with equal rights. Many believe that it will help to control the spread of HIV and other harmful diseases. There are those who go so far as to say that prostitution keeps other women safe as it keeps men with uncontrollable lust off the streets. For these activists prostitutes have become a class of people who are already in a situation from which they cannot escape so we might as well aide them and stop opposing their 'profession'. They completely ignore the plight of these women most of whom suffer severe traumatic experiences on a daily basis. From a psychological perspective women engaged in prostitution no longer view themselves as whole. Dissociation being the most common consequence of continuous experience of trauma; these women have created a mental wall around their role as prostitutes. They no longer experience pain, violence and abuse as harmful but rather it has become a norm that they repress and dissociate from on a daily basis. Most women report that they cannot prostitute unless they dissociate. When they do not dissociate, they are at risk for being overwhelmed with pain, shame, and rage (Farley 2006).

Posttraumatic stress disorder (PTSD) commonly occurs among prostituted women, and is indicative of their extreme emotional distress. In nine countries, researchers found that 68% of those in prostitution met criteria for a diagnosis of PTSD,a prevalence that was comparable to battered women seeking shelter, rape survivors seeking treatment,( Bownes et al, 1996) and survivors of state-sponsored torture.(Houskamp & W. Foy, 1990)

What most people fail to acknowledge is that a sexual encounter is one of the most intimate, vulnerable moments of any individual's life. When such an act is repeatedly shared with a stranger in exchange for money and often associated with violence, coercion or abuse it scars the mind in an irrevocable manner. It begins to erode a person's sense of self worth, their self esteem, self concept and ultimately results in an emotional state that is numbed and unable to experience a normal range of emotions. Most people who have been in prostitution for any length of time have difficulty with sexual intimacy.Sex becomes a job, rather than an act of love or passion. Men who prostitute experience similar damage to their sexuality and to their sense of self, as well as symptoms of traumatic stress that are identical to women's (Farley, 2006).

This paper has already highlighted the instances of depression, post traumatic Stress disorder and drug abuse experienced by women who are prostitutes. It is unimaginable that we would consider spending energy and resources in creating a system that legitimizes this 'profession'. Instead the same resources should be invested to rehabilitate women engaged in this 'profession' and prosecuting men who continuously view soliciting sex as an acceptable form of entertainment. It is unlikely that a man has ever died due to lack of sex, thus the argument that a man's sexual needs are biological and normal and must meet gratification does not stand true.

Regardless of prostitution's legal status (legal, illegal, zoned, or decriminalized) or its physical location (strip club, massage parlor, street, escort/home/hotel), prostitution is extremely dangerous for women. (Farley, 2006). Prostituted women are unrecognized victims of intimate partner violence by customers as well as pimps (Farley, 2003).

As Psychologists we are trained to seek out psychological symptoms such as depression, anxiety, drug use, trauma etc and to help an individual overcome their inflictions. It is in our nature to believe that everybody can be healed and deserves a fair chance at it. Thus as a psychologist it becomes impossible to accept that there exists a 'profession' that so profoundly harms people and yet we believe that it can be overlooked or 'regulated' and thereby reduce the harm it causes. In reality regulating prostitution is a means of cleaning one's conscience, knowing that we are attempting to integrate prostitutes into society and give them equal rights.

It has been suggested by some sex work groups that prostitution is a positive experience, an exercise of personal choice and should be seen as legitimate work .Such activists believe that empowerment of prostituted women lies in regulation and recognition of prostitution as a legitimate profession. Their intent might be to ensure that prostitutes receive equal rights and appropriate health care but as has already been discussed legalizing prostitution does not guarantee a safer environment for prostitutes. Although many people think that decriminalization simply means protecting prostituted women from arrest, it also refers, dangerously, to the decriminalization of prostitutors and pimps. In this way prostitution is normalized, pimps and traffickers become legitimated entrepreneurs.

Survivors of prostitution have described it as "volunteer slavery" (Vanwesenbeek, 1994) and as "the choice made by those who have no choice." (Wisterich, 2000) Defined as whores when they were young, women who appear to choose prostitution have been sexually abused as children at much higher rates than other women. One way that women end up 'choosing' prostitution is that they are paid for the abuse that they have already grown up with. They assume that's all they are good for (Farley, 2006).

From a Psychological perspective women in prostitution are part of an occupation that causes serious psychological harm. The mental health needs of these women are unlikely to be acknowledged, considering the lack of resources available to cater to their physical well being.

It becomes the responsibility of individuals engaged in the mental health profession to recognize and fight for the rights of a class of women whose mental health has been grossly neglected.

Over the decades of debate about legalization and criminalization little attention is given to the emotional and mental well being of women in prostitution. Perhaps it is time we stop trying to decide whether it is a legitimate 'profession' or not, whether these women are stigmatized, how prostitution affects global economy and policy making; perhaps it is time that we address an issue that surely deserves attention. Prostitution may or may not be a crime, it may or may not be inhumane, but it is surely not human of us as educated mental health professionals to continue to ignore the severe psychological impact of being a prostitute and to deny that this 'profession' is likely to continue to deteriorate the emotional and mental well being of the women engaged in it.