Do Sex Workers Have Better Mental Health In Cultures Where Prostitution Is Legal?

Today in my study abroad course on sex and culture in the Netherlands, we're focusing on sex work, especially the link between prostitution and mental health. Many studies have been conducted on the mental health of people (mostly women) who sell sex for a living. Most of this research has found that female sex workers suffer from rates of depression, anxiety, and PTSD that are much higher than the rest of the female population. However, virtually of all of this research is based on studies of female sex workers who live in countries where prostitution is illegal.

So what about places, like the Netherlands, where sex work is permitted under the law? Do sex workers tend to have better mental health in these cultures? Research suggests that they do, but that working conditions still matter a lot [1,2].

Women who work the streets, even in cultures where sex work is legal, suffer from high rates of mental health problems. This is due to the fact that those who work the streets tend to be more financially desperate to begin with (meaning they often enter prostitution as an option of last resort). Streetwalkers are also more likely to have drug additions and are at much higher risk of sexual violence due to the nature of this working environment.

By contrast, those who work in private studios tend to be much better off. In fact, in places where sex work is legal, their rates of mental health disorders are no different from women in the general population [1]. Studios offer more protection from sexual violence and help to ensure sex workers are not taken advantage of because panic buttons are often installed in these rooms and others are often nearby to provide security and oversight. Perhaps not surprisingly, unlike streetwalkers, those who work in studios are far more likely to voluntarily enter the profession and to say they enjoy their work. 

In short, it's not necessarily the case that all sex workers are better off in cultures where prostitution is legal because working conditions and motivations for entering the job still matter a lot. However, these results tell us that sex work is not inherently traumatizing to women. Many sex workers do enjoy their jobs and their mental health does necessarily not suffer because of it--however, this scenario is far more likely to be observed in cultures where sex work is legal than it is in countries where it's illegal. 

To get an inside perspective about what it's like to be a sex worker in the Netherlands, my students and I are sitting down today with a Dutch sex worker at the Prostitution Information Center (PIC) for a seminar and Q&A (side note: the PIC is an organization dedicated to educating the public about the realities of prostitution--in other words, they're ambassadors for sex work). If you're ever in Amsterdam, I highly recommend stopping by the PIC and taking one of their tours because you'll get information that you just won't get anywhere else. 

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[1] Rössler, W., Koch, U., Lauber, C., Hass, A. K., Altwegg, M., Ajdacic‐Gross, V., & Landolt, K. (2010). The mental health of female sex workers. Acta Psychiatrica Scandinavica122(2), 143-152.

[2] Krumrei-Mancuso, E. J. (2017). Sex work and mental health: a study of women in the Netherlands. Archives of Sexual Behavior46(6), 1843-1856.

Image Source: 123RF.com/Josep Curto

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