Prostitution: Where’s the harm?

This is the text of our submission to the Women & Equalities Select Committee’s inquiry into prostitution. Unfortunately the inquiry is now closed because parliament has been dissolved for a general election. However, the evidence collected will remain available for future consideration.

What, if any, harms are associated with buying and selling sex? Who is affected? How?

Almost all prostitution buyers (punters) are male and the vast majority of those bought and sold are women and children. So prostitution is something that men do to predominantly women and children. Men are the subjects and the women and children are objects who must please the punters and allow them to do whatever they want, regardless whether it hurts, humiliates, or threatens their life.

On an individual level, prostitution works to feed men’s entitlement and women’s lack of self worth. On a societal level, it works to maintain male hegemony and female subordination. It is not possible to understand prostitution without framing it in gendered terms.

Our work is informed by women who have lived prostitution. There are many reasons women are unable to speak publicly about their involvement in prostitution, so we have a feature on our website where women can enter their experiences anonymously. We draw on their words below to illustrate the reality, some edited slightly for length.

Violence and social exclusion

meta-study found that violence is a prominent feature of prostitution, regardless of the setting, that social exclusion is the leading cause of entry, and prostitution usually deepens a woman’s social exclusion.

Sarah said:

“It reinforced everything I’d grown up with knowing – I don’t exist, I don’t matter, no one is safe, my body is just a piece of trash… I pray for a world where no one has to offer their body as an object and we all treat each other with dignity and respect.”

Harriet said:

“He used paddles, belts, shoes and batons to beat me. I was covered in bruises so I couldn’t sit down for days. He even drew blood. But I was scared to tell him to stop. I was in his house. What was stopping him from killing me and dumping my body, or taking the money back?”

A woman who wants to remain anonymous said:

“When I was 19 I started seeing johns through online ads for extra cash. I had bought into the ‘sex work is work’ line and expected it to not be that bad. It was horrific. Sometimes they’d do violent and disgusting things to me. Sometimes they’d not even pay. Even the ‘good’ johns traumatized me, as they got off on having more power than I did.”

Risks to physical health

Prostitution involves a series of male strangers penetrating the mouth, vagina and/or anus, often with violent and prolonged thrusting. This can lead to STIs and injuries to internal organs, causing chronic ill-health. Condoms provide little or no protection.

German medical study of 1,000 prostituted women found most show signs of premature ageing, suffer chronic lower abdominal pain from mechanical trauma, and had injuries deliberately inflicted by punters and from overuse of their orifices.

Emma said:

“I was first sold at 14 and the prostitution lasted until I was 28. It has truly ruined my life. I battled cocaine addiction after exiting prostitution. I was anally raped on a regular basis. I still have pain. Cocaine deadens the crying in my head.

I struggle to accept my body was violated five or six times a day in a brothel in Soho. I’m unable to function sexually now as I hate the very idea of being touched by a man.”

Erica said:

“When I finally managed to run away he found me and beat me in the head with a crowbar. […] I got sepsis from another beating and couldn’t work.”

Risks to mental health

Prostitution has a negative impact on mental health. In order to endure being groped and penetrated by multiple strangers, many women ‘split off’ from their conscious selves and/or take alcohol or drugs. This can lead to addictions and long term psychological difficulties.

Prostituted women experience high levels of PTSD. In a study of 854 people in prostitution in nine countries, 68% met the criteria for PTSD. This is in the range found in war veterans.

Rebecca said:

“Since leaving prostitution I have struggled with chronic depression, flashbacks, anorexia and self-harm. I have not been off psychiatric medication or out of therapy. I have never been able to enjoy sex or be in a loving relationship. The ‘sex-industry’ has robbed me of all these things.”

Taylor said:

“I stopped doing it at 19 and never did it again. The memories haunt me. The feeling of emptiness and hollowness of my body and mind will stick with me forever. I have no idea how women cope with prostitution for years and years. Explains why so many of them drink or take drugs.”

A woman who wants to remain anonymous said:

“I stopped, and thankfully I have better things going for me now. But the horror and PTSD will stick with me forever. I have trouble with sex and don’t feel sexual pleasure anymore.”


Canadian commission estimated the death rate of women in prostitution is 40 times higher than 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.

Erica said:

“I tried to commit suicide. I was sent to a mental hospital.”

Alice said:

“Nobody really prepares you for this, when you enter into prostitution. They tell you about burn out, vaguely, dismissively. But not the details. If it happens you just need time off, they’d say. And so you would, at first, take just a few days. Then a few weeks. Then months. Then you’d realise that you were not just suffering from a transient inertia, but headed towards all out atrophy. I saw it many times over the years in prostitution; women becoming depressed, anxious, hallucinatory, suicidal.”

Many prostituted women are murdered by punters and pimps. The more prostitution that takes place, the more murders of prostituted women there are.

Official figures are likely to underestimate the mortality of women in prostitution. Many are isolated from family and friends and have no one to report them missing, so pimps and punters get away with dumping their bodies. Many women who have been in prostitution talk about women they knew in brothels or on the streets disappearing.

When Anna was asked what happened to the women she’d known, she said:

“There’s a few that have just gone missing and nobody seems to know where they are.”

Damage to children

While we vehemently oppose women losing custody of their children simply because they are involved in prostitution, the stresses involved can create difficulties for their children.

Anna said:

“The three eldest children that grew up in that life, their lives are really difficult. And obviously I’m a big part to blame for that. Their dad, the pimp, is now a learning mentor in a school, and is doing really well. He’s got a new relationship and still has our old house – while I’ve had to constantly move because of the trouble my kids have got into.”

Some women who are involved in prostitution do become so fractured they cannot provide appropriate care for their children. Taking children into care is hugely expensive. It therefore makes financial sense for authorities to prioritise the prevention of prostitution and the provision of real alternatives and genuine routes out for the women involved.

How does buying and selling sex affect attitudes towards women more widely?

Research shows that punters are more likely than other men to rape and engage in all forms of male violence against women and girls (VAWG). This is hardly surprising because buying sex feeds men’s sense of entitlement and superiority – the very attitudes that underpin VAWG.

Instead of being an encounter based on mutuality, prostitution is one-sided. He pays because she doesn’t want to have sex with him but is being coerced or needs the money – and so she has little room for refusing punters and has to pretend she’s enjoying it, even when every cell in her body is screaming otherwise.

Sarah put it like this:

“I used to think that men bought sex because they couldn’t get it consensually. After my experience in prostitution I realised that most of them could get it for free – they just don’t want to. They don’t want the give and take, or to consider their partner or their needs. They just want to be the centre of it and have every wish and whim indulged. They are like emotional babies.”

The one-sided nature of prostitution mirrors the one-sided nature of child sexual abuse (CSA). Many punters get off on very young women and/or make them pretend to be a child.

Megan said:

“The reality of prostitution is that you are used to ignite, legitimise and encourage paedophilic behaviour.”

Prostitution therefore inevitably increases the prevalence of CSA.

These dynamics mean many men come to think it’s unreasonable when any woman doesn’t let them have their own way. This wrecks men’s intimate relationships and general connections with women, reducing everything to a transaction, and leading to shallow and emotionally impoverished lives. As a result many men mistakenly feel they’re being robbed by women.

One woman explained the impact of prostitution on men’s attitudes like this:

“They count every favour they do (stuff they do freely for their male friends) and expect a result. There’s no emotional content to the relationship and your whole purpose is sexual. And it’s not that they’re driven by sexual desire either. It’s something else. It’s about control, status and bragging rights. Women always owe them. Women are there to serve. It’s like the way white people used to call black men ‘boy’ and assume they were there to carry their luggage.”

While not all men are punters, many are, and lap dancing clubs are common, and most younger men use porn – which is filmed prostitution. As a result, the values of prostitution now infuse our culture. This is particularly pernicious for children and young people – setting girls up as fodder for the sex industry and boys as punters or even pimps.

Whether we like it or not, the cultural messages affect us all subliminally and lead us to internalise the idea that men are subjects, full humans, and women are objects, second class, not quite fully human. And once you see women as not quite human, it’s easy to see other marginalised groups like that too.

Without a conscious decision to mainstream sex equality, policy makers invariably prioritise men’s needs rather than women’s – and so do juries on rape and VAWG trials, and journalists write with more empathy for the male murderer than his murdered wife. And there’s a tendency to treat male colleagues with more respect and pay male staff more, etc.

We gave written evidence to the committee’s inquiry into sexual harassment showing how prostitution and related activities normalise the sexual harassment of women and girls in public places and how this is worse anywhere the sex trade is tolerated.

A young woman got in touch to say:

“I was a student at UCL and my campus was right next to Spearmint Rhino. Every time I passed I had to endure vile comments from the male clients and the personnel telling me about all the money I could make. It was horrible.”

She went on to talk about how men sexually harass her in the red light districts in Germany, where her grandmother lives.

Another woman talked about the psychological damage and devastating impact on her self esteem after she discovered her husband was a punter.

While the impact for all women and girls is chilling, the impact on men themselves is also dire. The longest study on men’s wellbeing found the quality and warmth of personal, family and community relationships throughout men’s lives is the most important factor in their life satisfaction, and even physical health and financial stability. As we have shown, prostitution wrecks men’s ability to form and maintain warm relationships, particularly with women.

Giving men impunity as we currently do is not the solution. Men are able to make different choices, and legislation and policy should focus on encouraging and enabling that.

Cumulatively the individual effects add up to a massive impact on society at large. It is a vast feed back loop that is corroding the very fabric of society. When public authorities condone and legitimise prostitution and related activities, they are condoning not only the abuse of women and girls, but also attitudes that underpin VAWG.

If we want a more humane, fairer and more equitable society we must take measures to bring the prostitution system to an end, and reverse the pornified messages, images and stereotyped gender roles that infuse the culture, and to redress the worsening economic inequality that drives so many women into prostitution.

What local initiatives are you aware of that address these harms? Are they effective? Why?

Ipswich implemented a strategy that aimed to end street prostitution in the town and rehabilitate the women involved by:

  1. Ending targeting the women with criminal sanctions and instead providing them with substantial, individually tailored support to exit prostitution and rebuild their lives.
  2. A zero-tolerance approach to kerb crawling, using number plate recognition technology.
  3. Working with children at risk of being groomed into the sex trade to prevent another generation of women on the streets.

This strategy more or less corresponds to a Nordic Model approach to street prostitution. Studies by the University of East Anglia found it succeeded in its aims and saved public money through lower social service and criminal justice costs.

Unfortunately legislation doesn’t provide a simple strategy for deterring punters who use indoor prostitution. Section 53A of the Sexual Offences Act 2003 was introduced with the aim of reducing demand but it is ineffective in practice. This is a strong argument for introducing legislation to ban buying sex per se.

What, if any, are the challenges for those facing harm in accessing services (for example, healthcare; support services; advice; exit services)? What needs to change?

Most public spending on services for women in prostitution is focused on ‘harm reduction’ rather than providing genuine routes out. Many of the organisations that receive public funding to provide services are committed to the full decriminalisation of the sex trade (including of pimps and brothel keepers) and see prostitution as regular work. [*] Services underpinned by these attitudes usually serve to prolong women’s involvement in prostitution and to maintain a thriving sex trade.

Because of the lack of material help for women to exit, and the increase in women’s poverty, the increasing inadequacy of the welfare system and the scarcity of decent employment opportunities for women, large numbers of women are trapped in prostitution.

The ‘sex work as choice’ narrative has also infected the healthcare and social work professions. We have heard too many times that when a woman discloses an involvement in prostitution to a professional, empathy and offers of support dry up.

We hear that when social services work with a family where the mother is involved in prostitution, they typically view her as a risk rather than at risk herself – as if her involvement really is a choice and not a result of coercion and lack of options.

When professionals hold the idea that ‘sex work’ is regular work and a choice that must not be examined, the system becomes a toxic environment for women who are struggling to survive the sex trade or to recover from it. The choice narrative is victim blaming – absolving everyone apart from the victim of responsibility and removing the need for society to look its dark side in the face.

Laura describes it like this:

“So I did sex work to avoid ending up on the streets. It hurts to read on Twitter how empowering it is and about choice. Those people have never been in this situation. It’s insulting to so many women worldwide who are in this not through choice and who don’t have much of a voice.

I went to a project to try to exit and they kept saying it was a lifestyle choice. They dismissed all of the medical problems I have and the pain I was in. So I disengaged and went it alone. People like me are hidden, you don’t see us.”

Megan who was in prostitution herself and now works with women involved in prostitution explains the complicated dynamics:

“One of the biggest barriers of supporting women exploited by the sex trade, in my view, is the denial. All the former ‘sex workers’ I know say that at the time, they believed they were strong and free and liberated because they were choosing this.

But upon leaving they realised the opposite was true.

They weren’t free, they were not liberated and they absolutely did not have a choice or were incapable of making an informed choice at the time due to mental health struggles or the control of a pimp.

They describe a mental battle of trying to ascertain freedom. Is freedom the ability to ‘sleep with who they want and earn money at the same time’ or is that in fact total bondage?

Luckily the girls I know who have escaped, eventually came to the second conclusion. If there is a pimp involved or a partner, it can be a little like Stockholm syndrome. When time passes and healing happens, they realise that escaping is the true freedom.”

So what needs to change?

  • Prostitution must be understood as VAWG and a human rights abuse.
  • The welfare system must be fixed so it provides a proper safety net and women are not left with no recourse but prostitution.
  • Services for women in prostitution must include trauma-informed psycho-social care, woman-centred addiction services, and individually tailored material help to exit prostitution and rebuild their lives.
  • Health and social workers must be trained about the realities of prostitution so they understand the choice narrative as a form of victim blaming.
  • Men’s impunity for buying sex and pimping women must end.

What relevance does the Public Sector Equality Duty (PSED) have for the way that public authorities address prostitution in their area?

The PSED places obligations on public authorities to consciously consider how policies can contribute to removing and minimising disadvantages suffered by women relative to men, breaking the cycles of disadvantage that females suffer and aiding their advancement and participation in public life, and fostering good relations between the sexes.

We have shown how prostitution and related activities do the exact opposite of this – they entrench women’s disadvantages, are an obstacle to women’s advancement and participation in public life, increase rates of VAWG, and wreck relations between the sexes. So the PSED is of direct relevance to how prostitution is addressed.

Furthermore the CEDAW Committee considers prostitution a form of VAWG and CEDAW Article 6 requires measures to suppress third parties exploiting (i.e. profiting from) women’s prostitution. The UK has binding obligations under the Palermo Protocol to take measures to prevent sex trafficking, discourage the demand for prostitution that drives it, and address the poverty and inequality that make women and children vulnerable to being trafficked.

Therefore any policies that condone kerb crawling, sex buying, brothel-keeping, pimping, or third-party profiteering from prostitution, or that penalise women for their involvement in prostitution, can never be compliant with the PSED and are likely to violate international law.

Most public authorities do not understand this and have been influenced by the damaging ‘sex work is work and a choice’ narratives. We submitted written evidence to the committee’s inquiry into the enforcement of the Equality Act showing that women’s inequality is practically invisible to most authorities and the PSED is commonly flouted, particularly in regards to women’s rights.

At the very least, strong guidance must be issued to all public authorities explaining this and mandating the mainstreaming of sex equality. This is in the country’s interests because measures that promote equality between the sexes are likely to quickly pay for themselves.

How does the law currently treat paying for sex? How could law and policy be improved to address harm?

Prostitution legislation in England and Wales is incoherent and sends out a confused message.

The Modern Slavery Act (MSA) lacks a gendered analysis, implicitly normalises and trivialises prostitution, and frames it as a form of regular work – and this understanding now dominates public policy. The Home Office’s Typology of Modern Slavery defines sexual exploitation as ‘forced sex work,’ even when the victim is a child and even though the Palermo Protocol specifies no force is necessary to meet the trafficking definition when the victim is a child. Police Guidance accepts prostitution as inevitable and not inherently harmful, and implies it would be wasting time to enforce laws that penalise men who buy sex, and even pimps and brothel keepers.

We explained in our submission to the Parliamentary Inquiry into Trafficking for Sexual Exploitation why we consider it a catastrophe that the MSA doesn’t use the definition of human trafficking set out in the Palermo Protocol and instead centres the definition on travel, and how consequently most sex trafficking is officially invisible – meaning perpetrators have impunity and victims are unrecognised and fail to get the support and rehabilitation to which they are entitled.

Our investigation into the Holbeck ‘managed approach’ (which theoretically decriminalises soliciting), shows that women are regularly served with ASBO-type orders, cautions, fines and sometimes prison sentences even though most fall under the Palermo Protocol definition of sex trafficking victims, while their pimps and punters have virtual impunity. The approach attracts punters from a wide geographical area and they harass local women and girls relentlessly, making the environment hostile and intimidating, which acts as a barrier to their participation in public life on the same terms as men.

While there are pockets of good practice around the country, the situation in many red light areas (e.g. Coventry and Southend) though less extreme than Holbeck is not dissimilar. Just as the police turn a blind eye to kerb crawlers, they also turn a blind eye to most pimping (unless they decide it is ‘organised crime’) and brothel keeping.

As a result pimping, brothel keeping and prostitution-buying are more or less de facto decriminalised in this country.

Our recommendations for addressing the harms of prostitution are as follows:

  1. Define prostitution as a human rights abuse and form of VAWG in policy.
  2. Redraft the MSA so Section 2 matches the Palermo Protocol definition and Section 3 explicitly includes profiting or otherwise benefiting from the prostitution or other forms of sexual exploitation of the victim – in line with the recommendations of the CEDAW Committee.
  3. Remove Section 3 subsection (6) because this should now be covered by Section 2.
  4. Ensure all offences involving the trafficking and sexual exploitation of a child under 18 (including paying for ‘sexual services’) are strict liability offences.
  5. Remove offences of controlling the prostitution of an adult or sexual exploitation of a child from the Sexual Offences Act 2003, because these would now come under Section 2 of the MSA.
  6. Introduce new offences of profiting (or otherwise benefiting) from another person’s prostitution.
  7. Introduce offences of advertising another person’s prostitution in any medium.
  8. Introduce an offence of purchasing or attempting to purchase sexual services (using the Swedish legislation as a model).
  9. Repeal offences of loitering and soliciting to sell sex.
  10. Redraft brothel-keeping legislation so it focuses on profiteers rather than vulnerable women who might perform cleaning or reception duties or simply live together.
  11. Introduce legislation to make provision for ring-fenced funding for a nationwide network of high-quality specialist services for those involved in prostitution, including genuine routes out.
  12. Take effective measures to address women’s poverty and inequality.
  13. Full funding for the implementation and enforcement of the above.

How effective are different international approaches at addressing any harms associated with buying and selling sex?

We believe the Nordic Model approach is best at addressing the harms of prostitution and that Sweden has implemented it most effectively.

Zoë Goodall did research in Canada on how its Nordic Model law was working in practice. She found little had changed since the law was passed. In some regions official police policy is to not implement the law at all, and elsewhere things are not much better. The $20 million the government promised for exiting services has not materialised. The only positive thing is that women are no longer arrested as they had been before.

This shows that getting Nordic Model legislation on the books is only the first step. Implementing it requires the cooperation of many different public bodies and services. The entire approach is predicated on a paradigm shift that challenges men’s historic entitlement to sexual access to women and girls. Many people, particularly men, resist this. As men retain disproportionate power within most public institutions, there are many opportunities for the spirit and implementation of the approach to be sabotaged – on a national, regional and local level – as Zoë’s work in Canada shows.

Any assessment of the Nordic Model needs to understand these dynamics and look at how effectively it is being implemented, as well as how the legislation is drafted.


We leave you with the words of Emma:

“I simply know that prostitution is the most evil thing ever. It uses girls’ bodies for men’s pleasure. Over 5,000 men raped me coz I never once wanted sex, so I didn’t consent. That’s the reality of being a prostitute. I feel so ashamed.”

September 2019


You can download a PDF version of this paper from the Women & Equalities Committee’s site.

[*] Examples are National Ugly Mugs, Basis Yorkshire.

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