Earlier this year, the Royal College of Nursing (RCN) Congress voted overwhelmingly for a motion that requires the RCN Council to lobby Governments across the UK for the “decriminalisation of prostitution.” We believe this was a terrible mistake and that the debate was biased and those promoting the motion behaved improperly.

We therefore wrote a letter, jointly with Stand Against Sexual Exploitation (SASE), to the members of the RCN Council setting out why they might want to revisit the matter. We offered to meet with them to discuss the issues in more depth and we asked for a response by the end of August. We have not had a single reply and so we are publishing the letter here.

17 July 2019

Professor Rafferty, RCN President
Ms Coghill, Deputy RCN President
Members of the RCN Council

Dear Professor Rafferty, Ms Coghill, and members of the RCN Council,

We are writing to follow up the open letter we sent on 23 April spelling out concerns about the motion at the RCN Congress calling on “Council to lobby governments across the UK to decriminalise prostitution.”

The motion under debate concerned serious issues that have far reaching consequences. At a minimum it is extremely important that a) equal time and emphasis is given to both sides of the debate, b) the nature of the different possibilities relating to both decriminalisation and criminalisation are fully understood (the motion does not reflect this), and c) the issues are given adequate time as opposed to a short debate. The outcome of the debate impacts upon equality between men and women, human rights, and health and wellbeing. It is disappointing that the debate failed to seriously engage with these issues and to present accurate information.

Unfortunately, this may be because there are powerful vested interests (lead primarily by pimps who profit from the industry) who lobby hard to influence public opinion and present a sanitised view of the industry without having any real interest in the realities of exploitation. At NMN our sole and primary aim is to eradicate exploitation and harm. We are fully in support of women regardless of whether they are currently involved in prostitution or have left/are seeking to leave. We believe focussing only on the fact that a woman made a ‘choice’ and then leaving her unsupported and perpetually in survival mode is unfair and stigmatising. Instead, we focus on changing the context in which those choices are made so that more choices are available to women.

Mainstream opinion is divided between those who seek to fully decriminalise the sex trade and see it as a woman’s choice and right to work in it, and those who believe that prostitution can never be safe, that it is incompatible with women’s human rights to dignity and freedom from violence, and that it is an obstacle to equality between the sexes, and who therefore favour the Nordic Model approach. This decriminalises those who are prostituted, provides support services to help them exit, cracks down on pimps and brothel-keepers, and makes buying people for sex a criminal offence, in order to reduce the demand that drives sex trafficking.

However, resources are not split evenly. The sex industry generates vast profits, and like the tobacco industry, has powerful and wealthy backers and uses many ploys for obscuring the harms of prostitution and convincing people that its full decriminalisation is safer and the best approach for women. Sex industry lobbyists have even managed to influence many high-level organisations and funding bodies to ensure that support for their preferred approach is a condition for funding academics and community groups.

Those who favour the Nordic Model do not have access to such funding. For example, Nordic Model Now! (NMN) receives no funding other than donations (mostly small) from supporters, and all members are unpaid volunteers. And as our long-term aim is to bring the sex industry to an end, there are few, if any, vested interests in promoting this approach. We are motivated by a burning desire for social justice and a fairer, more equal society. Some of us have had personal experience of prostitution, and those who haven’t listen carefully to those who have.

We set out some of our concerns below, and follow with a request for a meeting to discuss how the RCN Council can respond ethically to the dilemma it now finds itself in.

The motion was confusing

The motion was confusing, if not misleading. It is questionable whether it would have passed had it set out clearly and in detail exactly what it was calling for.

The first paragraph of the notes under the motion on the agenda says: “sexual exploitation and/or trafficking of persons will remain illegal.” However, it doesn’t explain what it means by “sexual exploitation.” The UN glossary defines it like this:

Sexual exploitation

Any actual or attempted abuse of position of vulnerability, differential power or trust, for sexual purposes, including, but not limited to, profiting monetarily, socially or politically from the sexual exploitation of another.

Comment: “Sexual exploitation” is a broad term, which includes a number of acts described below, including “transactional sex”, “solicitation of transactional sex” and “exploitative relationship”

This definition clearly covers pimping (profiteering), brothel keeping, and sex buying. It seems likely therefore that many nurses might reasonably have understood the motion to mean the decriminalisation only of those engaged in prostitution, with the retention of laws against pimping and brothel keeping, and even the introduction of laws against sex buying along the lines of the Nordic Model.

But later in the notes, it becomes clear that the motion is not advocating for the Nordic Model but for the New Zealand approach in which pimping, brothel keeping and sex buying are decriminalised, and hence legal, and as favoured by Amnesty International and the WHO. But what the New Zealand model entails exactly was not clearly spelled out.

What therefore did the assertion that sexual exploitation would remain illegal actually mean?

Ellen Grogan in her two-minute speech asked Lou Cahill why she hadn’t made it clear that the motion meant the decriminalisation of pimping, brothel keeping and sex buying, but Lou didn’t answer this question.

It was clear that speakers for the motion were confused. Mathew Sidebottom said that the motion “could be anything from the Nordic Model to decriminalisation.” Jessica Davidson said “where there’s exploitation, there will be enforcement from the law.” But no one clarified these obvious contradictions so that people would understand clearly what they were being asked to vote for.

Most of the ‘debate’ was focused, quite rightly, on the vulnerability of women caught up in prostitution and concern to improve their safety and well-being. There is widespread agreement that the women (and others) engaged in prostitution should be decriminalised. But that the motion went much further and implicitly called for the decriminalisation of pimps, brothel keepers and sex buyers was not made clear – nor how this would benefit the women when these are the very people who commit most of the violence against them.

While human trafficking and some exploitative practices may technically be illegal in New Zealand, they are difficult to prove in a court of law in an environment where prostitution is seen as just another job. Most therefore go unrecognised and their perpetrators unpunished, and their victims unsupported.

Manipulation

Twice in her speech, Lou Cahill exhorted the audience to not allow ‘moral’ bias and views to influence their decision on whether to support the motion. It is a common ploy to suggest that women’s concerns are simply down to old-fashioned Victorian morality. This is an age-old way of silencing women and it really doesn’t hold up to scrutiny. In a recent judicial review against Sheffield City Council for failing to comply with equality legislation when considering the licensing of local lap dancing clubs, the judge found that the council had wrongly written off objections as irrelevant “morality” and not as the serious equality issues that they clearly are.

The UK has binding obligations under international law to eliminate practices that perpetuate harmful gender stereotypes, because they inevitably lead to discrimination and violence against women and girls. There are few practices as based on harmful gender stereotypes as the system of prostitution. Yet there was no consideration of this during the debate, and it is likely that women felt intimidated from raising such issues for fear of being labelled a moralist or prude.

HIV and STIs

Great emphasis was placed on the recommendation of the World Health Organisation (WHO) and UNAIDS that the decriminalisation of the sex industry is the best way to reduce the spread of HIV and AIDS. But no mention was made that this recommendation was based on flawed modelling, and research in countries that have full criminalisation and not in any countries that have implemented the Nordic Model approach. Nor was any mention made of the scandal, uncovered by Kat Banyard, that the recommendation was driven by an organisation that purports to represent marginalised people in prostitution around the world, but in fact lobbies for pimping to be made legal, while under the leadership of a pimp. This is not unlike a tobacco industry mogul advising the WHO on smoking policy.

It is common sense that the transmission of HIV and other STIs is likely to be reduced when those engaged in prostitution are decriminalised and have access to healthcare. However, there is no compelling evidence that there are additional health benefits under full decriminalisation compared to a Nordic Model approach.

Sweden

The notes about the motion on the agenda and the proposer’s speech were factually incorrect on a number of points. For example, the notes say: “There is no reliable evidence to suggest that the decriminalisation of sex work would encourage human trafficking.” This is blatantly untrue, as is her assertion that the Nordic Model doesn’t work (which was also repeated several times by others during the debate).

She also made a number of sweeping statements about the Nordic Model approach in Sweden that are demonstrably false. Here are some verbatim quotes from her speech and closing remarks in bold, with an explanation as to why they are incorrect or misleading.

“In the 20 years Sweden has had this model, there has been no empirical evidence that sex work or the demand for it has reduced. It has failed to deliver.”

The evidence from Sweden shows that the number of individuals in street prostitution has halved since 1999 and there is no evidence it has been displaced elsewhere. There is no evidence that there has been an overall increase in prostitution in Sweden, even though there has been a significant increase in prostitution in the neighbouring countries since 2010.

The law has widespread public support and has changed men’s attitudes and led to a notable reduction in demand.

“Because the majority of sex workers enter the sex industry for socioeconomic reasons. These reasons remained unchanged by attempts to reduce demand.”

We have always argued that for the Nordic Model to be successful, it needs to be combined with robust measures to address women’s poverty and inequality. The evidence suggests that when prostitution is decriminalised or otherwise normalised, women get trapped in it and official motivation for addressing women’s poverty diminishes.

“Academic research conducted into [the Nordic Model] approach has shown that it increases violence against sex workers. It increases the spread of HIV and other STIs, and it leaves sex workers vulnerable to exploitation. This model is dangerous. This model also harms.”

All prostitution is violent. Nothing can change that. However, the assertion that the Nordic Model makes it more violent is questionable at best. A study in Norway claimed the Nordic Model had made prostitution more violent. However, this was based on improper manipulation of the data and the study was withdrawn. Unfortunately the English translation is still widely available and as few English speakers can read Norwegian, there is little knowledge outside Norway that the report has been discredited.

We do not believe that there is any credible evidence that the Nordic Model approach, when properly implemented, increases the spread of HIV and other STIs or leaves ‘sex workers’ more vulnerable to exploitation.

“[This  model] also denies women the right to self-determination, and I would say to you, my fellow nurses, be very wary of those who want to give the government control over women’s bodies. This is a fundamental human right issue.”

The evidence suggests that the majority of women and children enter prostitution as a result of childhood abuse, poverty and misfortune, grooming, coercion, and/or betrayal, rather than as a free choice between a number of viable options. Moreover, most women in prostitution want to leave but feel they have no other options for survival. In some surveys more than 90% of the women say this. It therefore makes little sense to suggest that for most women, prostitution is a matter of self-determination. The Nordic Model approach does not penalise those who sell sex and provides genuine alternatives for those who want them.

“In fact, we talk about Sweden as this great big bastion of success, but in Sweden their trafficking rate has increased year on year on year. So we cannot claim that the Nordic Model reduced trafficking.”

The following table shows the numbers of reported cases of human trafficking for the purpose of sexual exploitation in Sweden 2002-2017. This does not show a year on year increase. There was an increase after 2015, which can be explained by a large influx of asylum seekers from Syria, Iraq and Afghanistan, many of whom had been trafficked in other countries before they got to Sweden.

Listening to ‘sex workers’ – but only if they agree

Lou Cahill said that “we should listen to current sex workers” in her speech proposing the motion and in her closing remarks she said, “I’d encourage you to speak to the sex workers on social media.” Several other speakers said something similar.

The previous day, Lou had posted on Twitter saying:

“I could tell you #SexWorkers want decriminalisation of sex work.

I could tell you they don’t want the Nordic Model.

But their voices are more important, so I’ll let this thread build up with their views on why #Nurses should vote ‘FOR’ to back them.”

A member of NMN responded by sharing a link to an article that explained some of the many reasons why women cannot publicly disclose their involvement in prostitution, and that provided a summary of some of the themes we’d noticed in the stories women had shared anonymously about their experiences in the sex trade through our website. The article explained that we had only received one account that described prostitution positively, but there were reasons to question its authenticity. All of the other accounts were heartbreaking and disturbing.

Lou’s response? She ignored the women’s harrowing testimony, suggested we’d cherry-picked the quotes, and accused us of not sharing anything of “quality or academic merit” and claimed we are “anti-sex worker” and “harming women.”

When someone’s first response to awkward evidence is personal insults, it suggests their arguments are weak.

How can her callous dismissal of the women’s accounts of their experiences in prostitution in our article be justified? How can her claim to “listen to sex workers” be taken seriously when she only listens to those that confirm her bias?

As to her suggestion that people speak to “the sex workers on social media,” this reveals her naivety. People who claim to be ‘sex workers’ on social media cannot publicly proclaim their support for the Nordic Model, which would criminalise their clients, without risking enraging their clients and putting themselves in danger – especially considering social media is one of the ways they tout for business.

We are aware of large numbers of women who have experienced prostitution, including some who are still trapped in it, who are vehemently against the decriminalisation of pimps, brothel keepers and sex buyers, and who support the Nordic Model – but they are unlikely to call themselves ‘sex workers’ because they understand this term to be part of the sex industry lobby’s attempt to sanitise prostitution and to obscure the violence and abuse that’s inherent to it.

Dismissing opposing arguments as “lies”

On the day before the debate, Lou Cahill tweeted a video of herself describing the NMN flyers that volunteers were distributing in an attempt to bring some balance to the debate as “purple leaflets of lies.”

In response to the assertion that the motion supported the decriminalisation of pimps, punters and brothel keepers, she said: “the vast majority of brothel keepers are sex workers – when more than two sex workers work together then it’s a brothel. Do we think it’s right to decriminalise them? Yes, we do because we’re talking about keeping women safe.”

This seems to deny that people who profiteer from other people’s prostitution even exist – which is perhaps the understandable naivety and wishful thinking of a young woman who doesn’t want to face the awful reality – but to base public policy on such wishful thinking is unforgivable.

She went on to claim that “the Nordic Model increases sex trafficking and exploitation” and to say that the flyer – which she flicks dismissively – is “just propaganda” and “about as serious as a leaflet claiming the MMR vaccine causes harm.”

At no point did she attempt to engage seriously with the points raised briefly in the leaflet and in more detail in the linked articles on our website.

This does raise the question of who was actually engaging in distortion and propaganda.

Services

Several speakers in the debate talked of the need for services for those involved in prostitution, and this was a focus of much of the press coverage after the motion was passed. For example, Ms Donovan from the RCN was quoted in The Stylist as saying:

“The political appetite to fund sexual health services targeting sex workers isn’t there. As nurses, we have a duty to ensure we serve the needs of society’s most vulnerable. […] The future of these services depends on a proper, meaningful investment and we must also consider if the government must change the law to improve the health of these people.”

This is misleading, because the motion did not call for investment in services for those involved in prostitution and Ellen Grogan’s amendment that did call for such services was rejected.

The evidence from New Zealand is that there are few specialist services for those involved in prostitution, because when prostitution is decriminalised, it is by definition seen as unproblematic.

Victim blaming

Justifications for the motion included that prostitution is a job like any other and the best solution is to decriminalise it and bring it under employment legislation, and that women have a right to choose ‘sex work’ and that must be respected. But there are real problems with these views.

Let’s leave aside that we do not believe there is any evidence anywhere in the world of women in brothels having regular employment contracts and of trade unions collectively bargaining for better employment deals on their behalf. Invariably they are freelancers, who have to pay the brothel a fee for every session they work, and there are many extras they must pay for (such as charges for laundry and condoms) and they can be ‘fined’ for non-compliance with the ‘house rules.’ Instead let’s look at the implications of the underlying attitudes.

We have heard over and over from women that when they mention an involvement in prostitution to a healthcare professional, empathy and offers of support dry up, and the notion that it’s a job like any other and it’s the woman’s god-given right to choose it palpably fills the air.

One woman who was struggling to recover from the anxiety and PTSD she’d developed during 10 long years in prostitution told us that a healthcare worker refused to refer her to trauma therapy on the basis of her experience in prostitution. It was only when she mentioned that she’d also been raped as a teenager that he relented. Unfortunately the trauma therapist she eventually saw would also not accept that prostitution could be traumatic and so the therapy was of limited benefit.

These attitudes make it hard for women to mention the harms of prostitution except in terms of atypical clients. One woman said this made her feel like she was being ‘gaslit.’

We believe that the ‘prostitution is a normal job and a woman’s choice’ narrative is in fact a sophisticated form of victim blaming. It absolves everyone apart from the victims of responsibility and removes the need for society to look its dark side firmly in the face. We believe that it would be a catastrophe for the nursing profession to adopt these attitudes wholesale.

Improper conduct

In addition to the confusion and misinformation that we have documented above, we believe that the RCN was negligent in not ensuring that similar time was allocated to putting forward alternative arguments and refuting the misinformation that the proposer and others voiced so strongly. Only four minutes were given to opposers of the motion in a debate that lasted for nearly 30 minutes. That the debate was not chaired dispassionately is evidenced by the chair congratulating Rowan Kitchen for her contribution, which included valorising a brothel-keeper.

After the debate, the English Collective of Prostitutes (ECP) were thanked from the stage for their help. We are concerned that the RCN relied too heavily on partisan advice from this organisation, which is not transparent about the background of their speakers, whose membership is not restricted to prostituted people, and whose stated goal is the full decriminalisation of the entire sex trade, including pimps and brothel keepers.

After the motion had been passed, Lou Cahill tweeted that NMN had “lobbied hard with propaganda & hate.”

What evidence is there that we are filled with hate? How can it be ethical for someone putting through a motion about such a key issue for women and girls to write off legitimate differences of opinion as “hate”?

Moving forward

We hope that the information we have provided above gives you pause for thought. We do not believe that the passing of the motion under these circumstances gives RCN a mandate to push forward with lobbying UK governments to fully decriminalise the sex trade. And indeed, to do so would raise serious ethical issues and risk damaging the RCN’s reputation.

We request a meeting with key members of the RCN Council to discuss our concerns in more detail. It is imperative that the RCN Council understands the implications of full decriminalisation and strives to find an ethical way forward.

We look forward to your response to these concerns and hope to hear from you before the end of August.

Yours sincerely

Nordic Model Now! (NMN) and Stand Against Sexual Exploitation (SASE)