Open letter to the BMA

More than 30 organisations and nearly 300 individuals have added their name to an open letter calling on the British Medical Association (BMA) to reject a new policy passed by junior doctors backing the full decriminalisation of the sex trade (including of pimps and brothel owners) as implemented in New Zealand.


On Saturday 13 May 2017, the BMA Junior Doctors’ conference  voted in favour of a policy backing full decriminalisation of the sex trade (including of pimps and brothel owners) as implemented in New Zealand. It was passed after less than 20 minutes of “debate.”

There was no explanation of how decriminalising pimps would help those in prostitution, and many statements were made that were naïve or incorrect. For example, it was argued that the Nordic Model (or Sex Buyer Law) is dangerous because under it punters don’t give their real names when making bookings. As if married men  give their real names under any regime.

A more worrying example was the incorrect assertion that the United Nations (UN) recommends full decriminalisation of the sex trade, including pimps. Although UNAIDS recommends that approach, the UN itself does not. On the contrary, since 1949 the UN has defined prostitution as incompatible with the human rights enshrined in the Universal Declaration of Human Rights; and later UN instruments (such as CEDAW and the Palermo Protocol) put binding obligations on ratifying states (the UK is one) to outlaw profiteering from prostitution and to take measures to reduce the demand for prostitution that drives sex trafficking. The JDC policy therefore stands in direct conflict with these UN human rights treaties.

It is worth noting that the UNAIDS policy was developed by an advisory group that was co-chaired by the Network of Sex Work Projects (NSWP) under the leadership of Alejandra Gil, who has since been jailed for 15 years for sex trafficking – which is not unlike a tobacco industry mogul advising on smoking policy.

Open letter to the BMA

Click to download PDF version of the letter

Mark Porter, Chair of the BMA, members of the BMA council,
Jeeves Wijesura, Chair of the JDC, and members of the JDC
BMA House,
Tavistock Square,

23 May 2017

Dear Mark Porter, Jeeves Wijesura, and BMA council and JDC members

We write to express our dismay at the adoption of the J1126 64 motion from North Thames RJDC (the full text of which is set out in an appendix below) at the recent Junior Doctors Conference 2017 and to request that the BMA does not implement it. It is based on a false premise and, as explained below, it is dangerous.

The motion is based on a false premise

The motion starts: “This conference: (i) Recognises the evidence that the policy approach of full decriminalisation of sex work, as adopted by New Zealand, has resulted in public health benefits for both sex workers and wider society – in particular by improving sexual health, personal safety and tackling human trafficking;”

This is factually incorrect. New Zealand changed its prostitution law in 2003, when the Prostitution Reform Act (known as the PRA) was passed. Before that, soliciting was illegal, along with pimping and brothel keeping; and allegations of police violence and corruption were common. But within those constraints prostituted women were able to negotiate their own deals with punters, and maintain clear boundaries, including insisting on condoms and banning kissing.

This all changed after the PRA, which decriminalised all of the actors including pimps. Brothels now set the price through “all inclusives” and prices fell. Men expect more, including anal, kissing, and no condoms. Where before the men paid for the act – direct to the woman – now they pay the brothel, by the hour or half hour, and they expect whatever they want as many times as possible within that time.

Punter violence remains common and in 2008 the New Zealand Prostitution Law Review Committee found that a majority of prostituted persons felt that the PRA “could do little about violence that occurred.” The Committee further reported that abusive brothels did not improve conditions for prostituted individuals; the brothels that “had unfair management practices continued with them.”

It is incorrect therefore to say that decriminalisation has improved the sexual health and personal safety of prostituted persons.

People campaigning for the PRA wanted to improve things for the women – to give them more power. In fact the PRA had the opposite effect. More power has gone to the pimps and punters. Although police violence is now less common, women seldom report pimp and punter violence to the police.

Local authorities have some control over where the larger brothels are sited but not the smaller ones, classified as “Small Owner Operated Brothels” (or SOOBs), over which authorities and local residents have no say. There’s been rapid expansion in the number of SOOBs, and many are run by pimps. SOOBs are excluded from the official brothel data, which therefore gives a distorted view of the reality.

Sex trafficking is now recognised to be prevalent in New Zealand, and Māori and Pacific Islander women and children are disproportionately represented. Because brothels and SOOBs are legal, there is little or no oversight from the police.

The PRA has also failed to stop the prostitution of children, which remains a major problem. Mama Tere Strickland, a community worker, says: “At least the old law kept a lid on the numbers, but with no law on the streets, the pimps and gangs have moved in.” The children typically have a background in family violence and sexual abuse.

Since the change in the law there’s been a significant rise in reported rape, sexual assault and other male violence against women and girls in the general population. This is not surprising given that there’s been an increase in the amount of prostitution, and evidence that prostitution-buying makes men more prone to sexual violence.

Violence is intrinsic to prostitution

Study after study has shown that prostitution is damaging both to those in it and to society more generally. For example:

  • A meta study conducted by UCL found that “violence is a prominent feature in the lives of sex workers in almost all sex work settings”; “a single year of engagement in sex work is likely to have the same impact on mental health as an entire life of experiences prior to involvement in sex work;” and “Social exclusion is the leading cause of entrance into sex work and exclusion is often deepened as a result of engaging in sex work.”
  • A UN multi-country study found that men perpetrating rape of non-partners and violence against intimate partners are associated with prostitution-buying. Studies of punters have found they are more likely to commit rape and other aggressive sexual acts. In addition, the contempt they have for women is borne out by survivor testimony and research on punter forums.

Health risks are not limited to STIs

Prostitution typically involves a series of male strangers penetrating a woman’s mouth, vagina and/or anus, often with violent and prolonged thrusting. This can lead to infection with HIV and other STIs and injuries to the reproductive and other internal organs, which can cause sterility, problems in pregnancy, and long-term ill-health.

A German study based on medical examinations of 1,000 prostituted women found that:

  • Most suffer from chronic lower abdominal pain caused by inflammation and mechanical trauma.
  • Most show signs of premature ageing, a symptom of persistent stress.
  • Most had injuries caused by the overuse of their delicate sexual organs and orifices.
  • Most had injuries deliberately inflicted by punters.

This makes women more vulnerable to infections. Condoms provide little or no protection. Financial or other pressures meant that most of the women in the study had to continue in prostitution even when they were in severe physical pain.

Risks to mental health

Prostitution often has a profound negative impact on mental health. In order to endure the undesired groping and sexual penetration by multiple strangers on a daily basis, many women describe needing to “split off” from their conscious selves and/or to take alcohol or drugs in order to endure it. This can lead to addictions and long term psychological difficulties.

Not surprisingly given the prevalence of violence, prostituted women experience high levels of post traumatic stress disorder (PTSD). For example, in a study of 854 people in prostitution in 9 countries (including Germany where it is fully decriminalised), 68% of the respondents met the criteria for PTSD. This is in the range found in war veterans. Other studies have had similar results.


Prostitution can also be lethal. A Canadian commission estimated that the death rate of women in prostitution was 40 times higher than that of the general population. Women in indoor prostitution in particular have a very high rate of suicide. In one study, 75% of women in escort prostitution had attempted it.

Many prostituted women are murdered by punters and pimps and sadly this remains true in New Zealand since the PRA. The more prostitution that takes place, the more murders of prostituted women there are.


Prostitution is not the commodification of a person’s labour as in other forms of work, but of her body and her self. This reduces her status (and by extension the status of all women) to that of an object that can be bought and sold. This is the root of the stigma associated with prostitution: it is intrinsic to its very nature. We believe that it is therefore not possible to eradicate stigma without eradicating prostitution itself.

Sex trafficking increases under decriminalisation/legalisation

A large body of evidence shows that when the sex trade is decriminalised and/or legalised, sex trafficking increases. For example:

  • A study with data from 150 countries found that countries with “legalized prostitution experience a larger reported incidence of trafficking inflows.”
  • An economic analysis concluded the same thing.
  • And so did an extensive study by the European Parliament.


The idea that full decriminalisation of the sex trade, including of brothel owners, pimps and profiteers as implemented in New Zealand, can bring prostitution to an acceptable level of safety is not only far-fetched, but dangerous.

New Zealand has a small population and is uniquely geographically isolated. Since the law changed, it has become a sex tourist destination. However, its isolation and the expense of getting there, mean numbers are relatively low. Were New Zealand situated in Europe, no doubt numbers would be closer to Germany’s and so would the reality.

Germany fully decriminalised prostitution in 2002. Prostitution is now big business, and generates large tax revenues for the government. There are about 3,500 registered brothels and large numbers of smaller unregistered ones.

Practices are more dangerous than before with less protection for the women. There are “menus” where men can choose from a long list that includes things like anal fist fucking, group sex, man shits on woman, two men to one woman, and flat-rate “all you can eat” deals. There’s even a demand for pregnant women, who have to serve up to 40 men a day, right up until they give birth.

Mega-brothels cater for up to 1,000 men at a time. Germany is now a sex tourist destination. Buses transport men from the airport directly to the mega-brothels.

Police estimate there are half a million women in prostitution in Germany, of whom only about 44 are registered. Most of the women come from poor communities in Eastern Europe, many trafficked. Women are shipped from town to town, because men want “fresh meat.” They live in the brothels, eat and sleep in the same room they serve the punters. They live under constant fear: of violent punters, of not earning enough to pay the daily fixed costs, of getting sick, of getting pregnant, of the police, of the pimps, of the competition…

A clinical psychologist specialising in trauma says: “The German model is producing hell on earth. The lives and rights of the women are sacrificed, but for what? Are they defending our democracy? Is it to protect our land from invasion or terrorism? No, these women are sacrificed so that some men can have sex whenever they want.”

A police inspector says the law has made Germany an Eldorado for traffickers, pimps and brothel owners.

The Nordic Model

Rather than full decriminalisation of the sex trade, the Nordic Model is the human rights-based and equality model. Also known as the Sex Buyer Law, it decriminalises all those who are prostituted, provides services to help them exit, and makes buying prostitution a criminal offence, while imposing tough penalties on pimps and traffickers. The aim is to change behaviour and reduce the demand that drives sex trafficking; thus setting new social norms.

Because prostituted persons are fully decriminalised under the Nordic Model, there is no reason for their access to sexual health care and condoms to be restricted.

Those who insist that the Nordic Model puts prostituted persons at heightened risk from HIV and STIs usually base their research in countries that follow a full prohibition model where all parties are criminalised. For example, in written evidence to the Home Affairs Select Committee, the Sex Work Research Hub when arguing against the Nordic Model (which they refer to as “criminalising sex work”) stated that “data from multiple countries linked criminalisation of sex work with up to a five-fold increase in risk of HIV infection or other sexually transmitted infections.” However, the research referenced was not conducted in a country that has implemented the Nordic Model approach, but rather where all parties are criminalised.


We have shown above that the motion is based on a false premise and is misguided. We therefore call on the BMA to reject it.

We question the wisdom of a BMA conference deciding policy about a complex social and political issue by a vote after a short discussion – particularly when that policy has profound implications for sex equality and the human rights, health and well-being of women and children and the most disadvantaged groups in society, and over which powerful vested interests lobby hard.

We believe that when the full evidence is examined honestly and dispassionately, it will be clear that the Nordic Model is a better approach.

While we welcome the spirit of wanting to consult and collaborate with “peer-led sex worker organisations,” caution needs to be applied. Many people who style themselves as “sex workers” and campaign for full decriminalisation have not experienced being prostituted per se and some are pimps and brothel keepers. Recently 12 high-profile people who publicly identify as “sex workers,” promote decriminalized pimping, and are associated with “sex worker” unions, collectives or advocacy groups, were exposed as having sold others in prostitution directly or indirectly. Clearly such people have a conflict of interests.

SCOT-Pep and the SWARM Collective are organisations of self-styled “sex workers” that campaign for the full decriminalisation of the sex trade, including pimps. The English Collective of Prostitutes (ECP) claims to be a prostitute collective, but it refuses to declare the backgrounds or occupations of its members. We do not believe that these organisations are representative of the vast majority of prostituted persons.

Many prostituted women reject the term “sex worker” because they do not see prostitution as work, and few, if any, of the most marginalised women in prostitution are in a position to speak frankly. Many have faced beatings for attempting to speak in the past or have heard of others who have suffered this.

Of course, those who are and have been prostituted should be consulted. However, for the reasons described above, there are many difficulties to be addressed. Perhaps therefore the most important voices are those in the growing movement of women who have survived prostitution and have managed to leave it and build a life outside, where they are no longer dependent on pleasing punters or the sex trade and its vested interests.

Survivors of prostitution make up some of the most active and committed members of the international movement campaigning for the adoption of the Nordic Model. We urge you to listen to them.

However, prostitution affects all women because it affects how all men see and treat women. Therefore there must be a consultation with a wide variety of women’s organisations, including organisations like Nia, Women @ the Well, and Routes Out that provide services to help women exit prostitution; women’s organisations like the European Women’s Lobby, Equality Now, and NAWO; and organisations that research policy affecting women and children, like the End Violence Against Women Coalition, the Child and Woman Abuse Studies Unit, Women Analysing Policy on Women, and the Women’s Budget Group.

A note about Amnesty International

Amnesty International made many very serious procedural errors in developing its prostitution policy. Amnesty International admitted in testimony that Douglas Fox, who was a member in one of their north-east branches, and running the largest prostitution ring in the north-east of England, was a member of the group that brought forward the motion calling for the organization to adopt a policy of full decriminalization. There were a few concessions over the successive drafts – the original premise that buying sex is a human right was taken out, after it was realised that it couldn’t actually be justified.

They inserted a section on “intersectional discrimination and structural inequalities,” which conspicuously lacks any discussion of the racism inherent in prostitution, or prostitution’s role in colonialism and maintaining the structural inequalities between the sexes, or the rights of women and girls to live free from commercial sexual exploitation.

The original reliance on advice from the Global Network of Sex Work Projects was downplayed after feminist writer and activist Kat Banyard exposed that its vice-president Alejandra Gil was a pimp who has now been jailed for 15 years for sex trafficking.

But the essence of the final policy remained as Fox first suggested: that all aspects of “consensual adult sex work,” including pimps and brothel-keepers (now called “organisers”), must be fully decriminalised in order to secure “sex workers’ human rights” even though, way back in 1949, the United Nations defined prostitution as incompatible with the human rights set out in the Universal Declaration of Human Rights.

Most shockingly, at no time did Amnesty International carry out any research in any country, like New Zealand or Germany, that has in fact implemented the policy for which they now lobby. Moreover, its research in Norway was of very poor quality.


We urge you to rethink this policy, informed by women’s groups, survivors’ organisations and a full consideration of the comprehensive problems of the New Zealand approach. We also request a meeting with senior BMA and JDC officers to discuss the issues in more depth.


Groups and organisations

  1. Nordic Model Now! (
  2. Equality Now (
  3. European Network of Migrant Women (
  4. Filia (
  5. The Judith Trust
  6. Women’s Equality Party Scotland
  7. Michael Conroy for A CALL TO MEN UK
  8. Not Buying It (
  9. End Online Misogyny
  10. JURIES (
  11. East Ayrshire Women’s Aid
  12. Truth About Rape (
  13. Campaign to End Rape
  14. Zero Option Sheffield (
  15. Yes Matters
  16. Campaign to End the Leeds Sex Trade (CELST)
  17. Not for Sale in Scotland
  18. Siren Press (
  19. Vera Media
  20. Scary Little Girls (
  21. London Feminist Network (
  22. Manchester Feminist Network (
  23. Critical Sisters
  24. Chelt Fems
  25. Gloucestershire Sisters
  26. Older Feminist Network (
  27. Essex Feminist Collective
  28. Suffolk Feminist Society (
  29. One Billion Rising Sheffield
  30. Nova Scotians for the Prevention of Prostitution and Human Trafficking
  31. Freedom Foundation, Israel
  32. Resistenza Femminista, Italy (
  33. Abolition 2014, Germany (
  34. Initiative Stop Sexkauf, Germany (


  1. Jill Leigh
  2. Alice Bondi, Retired psychotherapist
  3. Dr Helen Mott
  4. Magi Gibson
  5. Bo Novak
  6. Helen Rowlands, Cardiff
  7. Professor Roger Matthews
  8. Annie Fatet
  9. Dr Kathleen Richardson, De Montfort University,Leicester, Founder of the Campaign Against Sex Robots (
  10. Wendy Davis,  Director Rooms of our Own (
  11. Rukshana Afia
  12. Lucy Coghill
  13. Claire Harries
  14. Kate Morrissey (MBCAP)
  15. Rahila Gupta, journalist
  16. Elizabeth Carola
  17. Stephanie Davies-Arai
  18. Annette Lawson OBE; Chair, the Judith Trust; Ambassador, NAWO
  19. Sarah Sharkey
  20. Jay Ginn (Dr)
  21. Heather Downs
  22. Jacqueline Gruhn
  23. Siobhan Jess
  24. Jalna Hanmer
  25. Lynda Bennett
  26. Lorraine Roberts
  27. Caroline Ayerst
  28. Barbara Lapthorn
  29. Sue Banting
  30. Valerie Dunn
  31. Dr Jacci Stoyle, Secretary to the Cross Party Group (CPG) on Commercial Sexual Exploitation at the Scottish Parliament, Representative of the Episcopal Church in Scotland on the anti-trafficking group of ACTS (Action of Churches Together in Scotland) and a member of the Trafficking CPG.
  32. Kirstein Rummery, WEP candidate for Stirling
  33. Julie Smith
  34. David Battersby
  35. Mirabelle Galvin
  36. Dr Judith Dodds, Clinical Medical Officer in Community Paediatrics and Staff Grade doctor, Integrated Sexual Health Service
  37. L. Bondarchuk, Edmonton Small Press Association (ESPA)
  38. Eleanor Rose Price
  39. Natalie Painter
  40. Morgan King (Ms)
  41. Penny White (USA)
  42. Marcia Lieberman, Providence, RI (Rhode Island), USA
  43. Julian Vigo, PhD, FRSA
  44. Maggi Knowles
  45. Professor Richard Byng
  46. Judith Green, RM
  47. Maria Kuznetsova
  48. Sarah Johnson
  49. Christopher Hall, MA DipArch ARB, Member of the Cross Party Group on Commercial Sexual Exploitation at the Scottish Parliament
  50. Survivor of 10 years in prostitution
  51. Jessica Newbold
  52. Josephine Bartosch
  53. Sophie Hopkins
  54. Lynn Alderson
  55. Jayne Egerton
  56. Rebecca Turner
  57. Eliza Karat
  58. Caroline Boreham
  59. Elisabet Tasa-Vinyals, Junior doctor (Barcelona, Spain)
  60. Mick Parkin
  61. Carola Svensson
  62. Clare Fisher
  63. Susan Moffat, Retired Senior Health Promotion Specialist
  64. Racheal Rodman
  65. Lauren Smallcalder
  66. Lynda Murphy (Ireland)
  67. Ernesto Aguilar
  68. Vivien Parker
  69. Patricia Kenyon
  70. Jane Galloway
  71. Arianna Martignon
  72. Marie Johansson
  73. Ms Jacky Holyoake
  74. Izabela Palinska
  75. Josephine Liptrott
  76. Fiona Roberts
  77. Sarah Cummings
  78. Kate Jacob
  79. Alabama Whitman
  80. Lesley Painter
  81. Caroline Barnard
  82. Ghada Jabbour
  83. Hazel Lindsay
  84. Jan E Goodyear
  85. Marina Strinkovsky, Swindon
  86. Sally Jackson
  87. Silvia Beike
  88. Lesley Semmens
  89. Jan Goodyear
  90. Elizabeth Matz
  91. Emma Kettle
  92. Anna Shea
  93. Rebecca Mott (survivor of prostitution)
  94. Helen Saxby
  95. Daniella Binning
  96. Mary Mulligan
  97. Ingrid Maria Mørch
  98. Roberta Stevenson
  99. Emma Flynn
  100. Jan Moran
  101. Sareyeh Hadian
  102. Anne Martin
  103. Scott Bamford
  104. Sue Henderson
  105. David Menzies
  106. Ilaria Cerchiaro
  107. Liliana Forero
  108. Emily Weir, daughter of a retired doctor and granddaughter of a concentration camp survivor who narrowly escaped being sold as a “comfort woman.”
  109. Ceri Gazey
  110. Adrianna Rocca-Weatherby
  111. Mandy Oram
  112. Sarah Ferguson
  113. Jill Tinsley
  114. Charlie Dacke
  115. Anonymous
  116. Joolz Saville-Hippely
  117. Rachel King
  118. Estrellita Angeles
  119. Kari Müller
  120. Reay (retired hospital doctor and radical feminist, horrified at what my young colleagues are proposing)
  121. Pauline Kranendonk
  122. Kate Coleman-Brueckheimer
  123. Laura Tagliabue (Italy)
  124. Susan Kennedy
  125. Audrey Yvernault
  126. Sabela Eiriz
  127. Joshua Hippely
  128. Kelly Ann Muldoon
  129. Jan Martin
  130. Elizabeth Gordon
  131. Claire Jones, retired OT
  132. T. Alexandra Reid
  133. Erin Mansell
  134. Rebecca Pennington
  135. Ana Sofia Fernandes
  136. Katie Toms
  137. Courtney Mitchell
  138. Asa Fritzon
  139. Pamela Rubin
  140. Gemma Aitchison
  141. Pippa Banham
  142. Lauren Sennett
  143. Jane Roper
  144. Gina Jenkinson
  145. Lizzie Roper
  146. Rebecca Harrison
  147. Spider Redgold, Adjunct Professor – Sydney Australia
  148. Jacqueline Gwynne, Former receptionist in a legal brothel in Victoria, Australia
  149. Carol Ackroyd
  150. Richard Hambleton
  151. Natalie Hislop-Holland
  152. Michelle Russell
  153. Sara Bernabeo
  154. Frances O’Connell
  155. Rhea Arini
  156. Sue Wardell
  157. Elizabeth Miller
  158. Cristina Vieira
  159. Maureen Bennison
  160. Chiara Rossi
  161. Katherine Dickinson
  162. Daniel Read
  163. Ana Margarida Neves
  164. Margarida Medina Martins (Portugal)
  165. Sarah Brown
  166. Al Garthwaite BA MA LLD (Hon) PGCE
  167. Georgia Constantinou
  168. Silvia Santarelli (Italy)
  169. Lynne Harne
  170. Susan Federspiel
  171. Laura Di Mascolo
  172. Jane Allen
  173. Christine Gaffney
  174. Jessica Smith
  175. Martin Dufesne (Montreal, Canada)
  176. Janet Elizabeth Hacker
  177. Simone Watson, survivor of prostitution and director Nordic Model Australia Coalition (NorMAC)
  178. Huschke Mau, survivor of prostitution (Germany)
  179. Louise Wild
  180. Caroline Page
  181. Jasmine Anglen
  182. Alice Wickenden
  183. Chantelle Rial
  184. Clara Hilger
  185. Diane Stoianov
  186. Emily Rose Szalay Prausnitz
  187. Freya Judd
  188. Lily Rae
  189. May Mundt-Leach
  190. Natasha Kendall
  191. Samara Jundi
  192. Louise Abel
  193. Clarissa Payne
  194. Heather Wood
  195. Mary Wood
  196. Tuscany Roux
  197. Clare Solomon
  198. Jen Isakson
  199. Jackie Mearns
  200. Ali Batts
  201. Kelly Frost (survivor of male violence)
  202. Kat Pinder (survivor of prostitution)
  203. Lori Hirt
  204. Joy Wood BSc (Hons)
  205. Suzzan Blac (Trainer of social workers in CSA and CSE.  Also a survivor of CSA and sex trafficking victim at sixteen – Raped and paid for by violent men who didn’t know, ask or care as to whether I was trafficked or not.)
  206. Lily Marks
  207. Arianna di Vitto
  208. Francesca Cirelli
  209. Katarina Vidović
  210. Helen Lipscomb
  211. Alexandra Sofia de Moura Teixeira da Silva
  212. Ken Doggrell
  213. Giti Doggrell
  214. Steph Pike
  215. Julie O’Dwyer
  216. Elena Urru
  217. Sarah Crossland Morris
  218. Nikki Bond
  219. Delilah Williams
  220. Andrew Minney
  221. Dr Melanie McCarry
  222. RoseAnn Cameron
  223. Helen Taylor
  224. Selma Nieuwoudt
  225. Sally Beckford Hendry
  226. Alison Togher
  227. Emma Howard
  228. Maria Riveiro
  229. Lucy Wainwright
  230. Philippa Vipham
  231. Kelly Ryan, Oxford
  232. Leopoldo Vargas
  233. Caroline Murphy
  234. Morag Murchison
  235. Sue Kay
  236. Isha Hussain
  237. Anonymous
  238. Roisin Brennan
  239. Dr Marina Chitoni
  240. Audrey Gleeson
  241. Ashleigh O’Donnell
  242. Tania Caliendo
  243. Cristina Costa
  244. Henrike van den Hoff
  245. Shannon Toppi
  246. Maria Irene De Maeyer
  247. Victoria Alice Jones
  248. Judy Ferguson
  249. Louise Sykes
  250. Audrey Taylor
  251. Joanne Lowe
  252. Penny Forsyth
  253. Jane Ellis
  254. Gunhild Mewes
  255. Jenny Kruse
  256. Steve Rawbone
  257. Adelina (survivor of sex trafficking)
  258. Susan Cole
  259. Barbara Hughes
  260. Liz Walker
  261. Jessica Goldie
  262. Antonia Burrows
  263. Gabriele Mahler
  264. Christopher Goldie
  265. Anne Kazimirski
  266. Melanie Camu
  267. Louise Roberts
  268. Inge Kleine
  269. Anita Heiliger, Kofra (Munich)
  270. Therese Melbotte
  271. Dee Sekhon
  272. Dr Lesley Orr
  273. Kara Newsome
  274. Anonymous, trafficking survivor
  275. Karrie Payne
  276. Betty Holt
  277. Marina O’Brien
  278. Kate Graham
  279. Ruth Maguire MSP (SNP)
  280. Nimco Ali, WEP candidate for Hornsey and Wood Green
  281. Rowena Knight
  282. Ruth Mulenga
  283. Richard Newbold
  284. Simon Aalders, Director, The Recovery Hub Ipswich
  285. Mrs A E Hall BSc Hons, PGDE
  286. Francine Sporenda
  287. Katie Keene
  288. Rebecca Mordan
  289. Amy Corcoran
  290. Clare Brivati

And a further eight individuals who do not want to be publicly identified.


J1126 64 Motion by NORTH THAMES RJDC

This conference:

(i) Recognises the evidence that the policy approach of full decriminalisation of sex work, as adopted by New Zealand, has resulted in public health benefits for both sex workers and wider society – in particular by improving sexual health, personal safety and tackling human trafficking; therefore Calls upon the BMA to:

(ii) Publicly announce support for this policy approach and to lobby the government towards this end

(iii) Develop educational resources to enable doctors and medical students to better understand and respond to the specific healthcare needs of sex workers, such as CPD events and BMJ Learning resources

(iv) Create a working group to work on the above and consider collaboration with peer-led sex worker organisations such as SCOT-Pep, the English Collective of Prostitutes and the SWARM Collective, and other organisations working on this issue such as Amnesty International, in order to achieve the above aims


Download a PDF version of this letter.

Addendum (added 13 June 2017)

Reply from the BMA

On 26 May 2017, we received the following reply:

Dear Anna Fisher,

I just wanted to thank you for the briefing and letter that you sent to Dr. Porter and Dr. Wijesuriya and to acknowledge that they have seen it.

I also wanted to clarify that a motion passed at a BMA branch of practice conference like the junior doctors conference or the medical students conference does not automatically become BMA policy.

Best wishes,

Sally Brett
Head of Equality, Inclusion and Culture
Professionalism and Guidance
Policy Directorate

Our response

We responded on Monday 12 June as follows:

Dear Ms Brett and Dr Porter,

Thank you for getting back to us. We do understand that policy passed at the Junior Doctors and Medical Students Conferences does not automatically become BMA policy.

However, we remain deeply concerned for several reasons. Firstly, the JDC policy calls on the BMA to take action. Secondly the policy was passed on the basis of biased, misleading and false statements and without a proper debate. And thirdly because those who brought the motions will undoubtedly be looking to bring a similar motion to the BMA in the near future.

Much was made during the Junior Doctors Conference debate that the motion was “neutral” and did not make a “judgement.” This is disingenuous. We showed in our open letter that prostitution is intrinsically harmful – not just to those caught up in it who often suffer lifelong negative consequences – but also to the buyers who tend to become more narcissistic and less empathetic and hence to society as a whole.

How is it possible to be “neutral” about an intrinsically harmful practice? Consider another harmful practice – the use of asbestos. In the long battle to get the harms recognised, who claimed neutrality? Was it the campaigners whose friends and neighbours were suffering mesothelioma? Or was it the academics funded by the asbestos barons? If those who claimed neutrality had won the day, to the suffering of those whose health had been ruined would be added the suggestion that they had brought it on themselves, that it was their fault, that they only had themselves to blame, that it was a “neutral” thing.

There are profound implications to doctors accepting that prostitution is “neutral.” We frequently hear reports from women attempting to exit and recover from prostitution that they get little or no help from their GPs because they see prostitution as just another job. One woman told us that her GP would not refer her to trauma counselling on the basis of her many years in the sex trade but would on the basis that she was raped as a teenager. We trust that you are as disturbed by this as we are.

We are living through a period when many of the gains towards sex equality achieved in the last century are rapidly being eroded. Over recent years there has been an escalation of male violence towards women and children and this is connected with the proliferation of porn and prostitution. At the same time, women’s social and economic position has been under assault from seven years of austerity measures that have disproportionately impacted women and organisations fighting for their safety and rights. This means that many of the voices that have in the past campaigned for the recognition of prostitution as violence against women and girls have been silenced as their funding has been cut and their workload increased by rising numbers of women in crisis seeking help.

It is no accident therefore that the most vocal and well-funded voices in the prostitution debate are those that campaign for the full decriminalisation of the sex trade, including of pimps and procurers. Just like in the asbestos debate, they are not “neutral” and do not represent the opinions of the majority of those who have survived the sex trade.

We ask again for a meeting with senior BMA and JDC officers to discuss the issues at greater depth and so they can hear for themselves the voices of survivors of the sex trade and those who work with marginalised and trafficked women and girls.

We also ask that you forward our open letter to all members of the JDC and BMA councils. We have attached it to this email for your convenience. We would be grateful if you could confirm this.

Yours sincerely

Anna Fisher
Chair, Nordic Model Now!

6 thoughts on “Open letter to the BMA

  1. Excellent letter and I fully support this detailed analysis of the issues and the conclusions reached. My views on this matter have been strengthened by several years’ experience working with victims and survivors of sexual violence.

  2. Mortality
    It’s always a good idea to trace back the source of such assertions and see if there is any validity in what they say-and if the quoted “source” actually says what is claimed
    You say in your letter “Prostitution can also be lethal. A Canadian commission found that the death rate of women in prostitution was 40 times higher than that of the general population. “

    1) The linked to article in the NMN letter to the BMA is this one (Mathieson,A 2015 Prostitution policy:legalization, decriminalization and the Nordic Model Seattle Journal for Social Justice 14, 366-428).
    2) This in turn says (p377) “Additionally, in 1985, “the Special Committee on Pornography and Prostitution in Canada quoted estimates that mortality for prostituted persons may be 40 times higher than the national average 57 “(note that “found” in the NMN letter is actually “quoted”, “was” in the NMN letter is actually “estimates…may be”) The cited reference (57) refers to
    3) reference (56) which is WALTMAN, supra note 23, at 453
    4) which in turn is Waltman ,M 2011 Sweden’s prohibition of purchase of sex: The Law’s reasons, impact, and potential Woman’s studies international forum 34, 449-474,
    5) In that paper p453 we find “Similarly, the Special Committee on Pornography and Prostitution in Canada (1985) quoted estimates that mortality for prostituted persons may be 40 times higher than the national average (p. 350).”
    6) Going to that reference we find (p350 para 3) quoted part of a submission to the Committee on pornography and prostitution from the City of Regina , a town in Saskatchewan (the submitters were the Mayor Larry Schneider and Raymond Tessier)

    “They have been and will continue to be subject of attacks by the customers and their pimps. National figures show that instances of drug use and addiction are inordinately high among street prostitutes, so much so that between violent death and drug overdose their mortality rate may be forty times the national average”

    Note that no source is given for the asserted levels of mortality aside from “National figures” and it is unclear if the “National figures” applies only to drug use and addiction or to the level of mortality as well. I know the Canadian prostitution literature pretty well and have not come across any survey that reports such high levels of mortality.

    So I wrote to Prof John Lowman who is an acknowledged expert on violence and murder of prostitutes in Canada and he said “The citation trail you have uncovered suggests that the 40X figure is unsubstantiated”

    So get your facts right-that would be a change.

    1. Professor John Lowman is vehemently against the Nordic Model and frequently speaks against the work of researchers who see prostitution as part of the continuum of violence against women.

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