Introduction
Many prostitutes extinguish their emotions while they are with customers. At least that is the case for Roberta Victor, a prostitute who was interviewed in Working by Studs Terkel. At the outset of her interview, Victor claims, "The role one plays when hustling has nothing to do with who you are” (57). However, by the end of the interview, she states, "You become your job. I became what I did. I became a hustler. I became cold, I became hard, I became turned off, I became numb. Even when I wasn’t hustling, I was a hustler. I also don’t think it’s terribly different from somebody who works on the assembly line forty hours a week and comes home cut off, numb, dehumanized. People aren’t built to switch on and off like water faucets” (65). Victor seems unaware of the fact that she contradicts herself by stating that she becomes her job [a prostitute] when before she said that she is a different person when she works. Her mindset and analytical process have changed enormously. This striking contrast in Victor's statements raises several critical questions: What factors led to such a dramatic shift in her perspective? How do the psychological and physical demands of sex work transform a person's identity? This research explores these questions by examining the complex effects of prostitution on both the mental and physical well-being of sex workers.
How Prostitutes Cope through Emotional Detachment
Like Roberta Victor trying to separate herself from her work, most prostitutes try to protect themselves by shutting off their feelings. Based on what I found, this emotional shutting down is actually a really common way prostitutes deal with their jobs. They try to create a different person for work and keep their real personality hidden. This emotional detachment starts as protection but becomes a real problem for their mental health. Most prostitutes disconnect from their feelings, which changes how they see themselves completely. I found that they might start acting cold or distant even when they're not working, just like how Victor described becoming "cold" and "numb." This emotional shutdown becomes like a habit they can't break. Even though emotional detachment helps them get through their work at first, it ends up changing how they deal with all their relationships, not just the ones with customers.
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Research shows emotional detachment causes serious issues later in life. Most prostitutes can't connect with other people anymore because they get used to shutting down their emotions. They simply don't know how to feel normal emotions anymore, even when they want to. The psychology of prostitution shows that when someone has to pretend they don't have feelings day after day, it changes how their brain deals with emotions permanently. This helps explain why so many prostitutes end up feeling empty or disconnected from themselves, even when they're trying to have normal relationships.
Psychological Effects of Prostitution
The psychological effects of prostitution are mainly Post Traumatic Stress Disorder (PTSD), somatization and stigmatization, and anxiety and depression. The physical effects of prostitution include the high risk of STDs, sexual or physical violence, and introduction to drugs and alcohol. This mindset and alteration of the analytical process is the result of exposure to violence through prostitution. So far, it has been said that counseling, cognitive behavioral therapy, and medication can help ease the symptoms of PTSD; however, there is no permanent solution because the condition requires ongoing treatment to control the symptoms and improve the sufferer’s life. Even though there are also solutions being found to decrease the physical effects of prostitution in order, there is no perfect solution. There is not any type of medication or therapy that eliminates the psychological or physical effects of prostitution completely.
The Complexity of PTSD in Prostitution
One of the strongest psychological effects of prostitution on prostitutes is Post Traumatic Stress Disorder (PTSD). PTSD is described as bouts of anxiety, depression, insomnia, irritability, flashbacks, emotional numbing, and hyper-alertness. Symptoms of PTSD are more severe and long-lasting when the stressor is a person ( Farley, “Is”). According to Melissa Farley, “PTSD is normative among prostituted women” (“Is”). In San Francisco, Farley conducted an experiment with one hundred and thirty prostitutes, where fifty-five percent of them stated that they were sexually assaulted as children, and forty-nine percent of them were physically assaulted as children. As adults in prostitution: eighty-two percent had been physically assaulted, eighty-three percent had been threatened with a weapon, sixty-eight percent had been raped while working as prostitutes, and eighty-four percent reported current or former homelessness. In accordance with the one hundred thirty people interviewed, sixty-eight percent of them met the DSM III-R, which is a criterion for a diagnosis of PTSD (Farley et al., “Prostitution, Violence”). My interpretation is that most PTSD symptoms are caused by the different types of lifetime sexual and physical violence that can begin from childhood and continue to adulthood. According to Farley, seventy-three percent of the total four hundred and seventy-three people interviewed in five different countries (South Africa, Thailand, Turkey, USA, and Zambia) reported that they had been assaulted in prostitution, and sixty-two percent had been raped in prostitution (Farley et al., “Prostitution in Five”). Any prostitutes who experience any trauma type of PTSD can result in PTSD. Researchers discovered that out of the five hundred prostitutes interviewed worldwide, sixty-seven percent of them suffer from PTSD.
Another psychological effect of prostitution, which is slightly more complex, is somatization. Somatization is the making of recurrent and multiple medical symptoms with no main cause. Somatization disorder results in women who were assaulted in childhood and were sexually abused. Somatization is the result of negative affectivity and feelings of incompetence (Christiansen). The relationship between trauma and somatization appears to be a result of PTSD. Somatic symptoms are common among prostitutes who are trauma survivors. According to Dorte M. Christiansen, depression, dissociation, and anxiety are not associated with the degree of somatization. Not much research has been conducted on somatization and its disorders among prostitutes.
Stigma and Society's Role
Another psychological effect of prostitution is stigmatization.
Stigma is “a mark of disgrace associated with a particular circumstance, quality, or person.” Stigma emerges in relationships in the sense that people learn to judge, condemn, stereotype, and fault others for having certain characteristics (skin color, weight, physical disability) or engaging in behaviors (illicit drug use, smoking, sex work) that are considered socially or culturally disrespectful (Agustin). Stigma usually involves blaming, shaming, and status loss of the sufferer and is often related to social anxieties, fears, and a related need to maintain social order or control. It’s also been said that powerful social norms and values effects lead to negative stereotypes, such as that sex workers or prostitutes are considered immoral, unclean, or dangerous. Prostitutes who are often negatively stereotyped and tend to be identified by a certain characteristic mainly think that this characteristic is their sole defining characteristic, just as how Roberta Victor began to think that she was a prostitute, not a woman who worked as one. Some prostitutes worry about “perceived stigma,” so they do not socially interact out of the fear that people will treat them unequally because they work in prostitution as their line of work(Agustin).
Another way individuals are affected by stigma is “enacted stigma” or discrimination when prostitutes are treated negatively because of the societal beliefs held about them (Agustin). However, unlike some prostitutes who internalize stigma, others perceive themselves as playing a role that is very important in society, such as emotional or sexual health counselors (Agustin). Even though some prostitutes may stigmatize themselves, they are likely to not do anything about the discrimination that occurs. Even though some prostitutes resist stigma, they are likely to hide their jobs from family and loved ones because even if they think they are completely resistant to stigma, many would secretly loathe themselves (Corrigan). Stigma is one of the stronger psychological effects of prostitution because there is a possibility that stigma can lead to stress disorders and mental illness (Corrigan). There are not many cures for stigma. However, there is an ongoing argument that legalizing prostitution would help decrease the psychological effect of prostitution. I believe that researchers who argue that legalizing prostitution would help seem to think that prostitutes would not feel as stigmatized because it might seem to them that they are doing a job that is now legal, and this would help increase their level of self-esteem. However, it is not completely likely that everyone would approve of the legalization of prostitution because people and societies may think that it is immoral and undignified.
The more common psychological effects are anxiety and depression. Anxiety can be the cause of PTSD. Anxiety and depression rates are high among prostitutes; however, according to Margarita Alegria, only nine point seven percent of them are actually receiving treatment, and about seventy percent of the prostitutes suffer from depression ( “Is”). According to Lloyd A. Goldsamt et al., anxiety and depression are closely related to the illicit use of drugs and sexual behavior. Even though prostitution is illegal in Switzerland, Zhana Vrangalova 2005 conducted research with one hundred ninety-three legally registered prostitutes in Zurich. The result of this research showed that thirty percent of the prostitutes were suffering from anxiety (Vrangalova). Anxiety and depression are very common among prostitutes and can lead to serious disorders and mental illnesses. They both are very harmful psychological effects of prostitution. Solutions and ways include meditation, socializing, therapeutic help, and exercise, but no permanent solutions have been found.
Physical Effects of Prostitution
The psychology of prostitution is heavily impacted by its physical effects. When prostitutes deal with STDs, it's not just a physical problem - it totally changes how they think and feel about themselves. STDs create this constant worry and stress that messes with their head. I think this shows how the physical and mental effects are connected. When prostitutes get STDs, which happens a lot because of unprotected sex, it leads to even more anxiety and depression on top of what they're already dealing with. STDs are, nowadays, more common among teens; however, the numbers are still higher among prostitutes. Prostitutes can easily come in contact with STDs because of unprotected sexual intercourse. Prostitutes are generally known as the “high-risk group” (Gasper et al.). There is no one hundred percent chance to prevent STDs.Some STDs are curable, while others are not. STDs include Chlamydia, Chancroid, Crabs (Pubic lice), Genital herpes, Genital warts, Hepatitis B, HIV/AIDS, Human Papillomavirus (HPV), Trichomoniasis (parasitic infection), Molluscum Contagiosum, Pelvic Inflammatory Disease (PID), Scabies, Syphilis, Gonorrhea, and Trichomoniasis (Trich) (STD Awareness). STDs have been increasing since 2006; the CDC estimates a prevalence of one hundred and ten million new STDs annually in the US, which costs approximately sixteen billion dollars in healthcare expenses alone (“STD Awareness”). In my opinion, these are astronomically high rates. The rates of STDs are five to sixty times higher among sex workers than the general population (“STD Awareness”). Studies have shown that only forty-seven percent of prostitutes (women) know what their HIV status is (“STD Awareness”). Steps can be taken to prevent STDs; however, there is no guarantee.
STDs can be prevented by using latex condoms, avoiding sharing towels or underclothing, washing hands before and after sexual intercourse, getting a vaccination for Hepatitis B, getting tested for HIV, and abstaining from sexual intercourse. These are some of the ways that you can prevent catching an STD.
Another physical effect of prostitution is sexual/physical violence. Roberta Victor reports that when she was a streetwalker, she had been raped and knives over her head. According to Sophie Day, who conducted a survey in London in 1989-91, one hundred and thirteen out of the one hundred and ninety-three women who reported assault were prostitutes. Sexual violence is very common among prostitutes. Beatings, kidnappings, rape, and even murder are generally considered “occupational hazards” of prostitution. A prostitute’s work and personal life are both full of dangers because of the constant danger of their customers. No real solutions would completely eliminate sexual and physical violence; however, measures can be taken to decrease the violence.
Drug use is one of the biggest physical effects of prostitution. Not only do drugs affect the prostitute, but there is a great possibility that they affect the clients also. Roberta Victor states that she did drugs (heroin, cocaine, and grass) as a recreational activity; however, she soon became addicted, and she worked in order to maintain her drug habit. According to Wikipedia, there are forty to eighty percent of streetwalkers that abuse drugs.
Most prostitutes start using drugs to handle the stress of their work. They need something to help them get through their job. Victor's story shows this clearly - she started drugs for fun but then needed them to cope with prostitution. This is very common among prostitutes. The drugs help them forget about their problems for a while. Some prostitutes say they can't work without being high because the emotional pain is too strong. Drug use becomes their main way to deal with trauma from being a prostitute.
Researchers have found that the choice of drug can be important to the prostitute in serving real or perceived functions, such as putting on an act during work (the perceived function) and helping them remain themselves during their private lives (the real function). It has been said that prostitution and drug addiction/abuse are closely linked because some people go into prostitution in order to maintain their drug habit, while prostitutes get to "use" drugs through prostitution. This is why drug addiction can be considered a physical factor of prostitution.
Support Systems and Professional Help
Professional counseling helps prostitutes deal with mental health problems. Most prostitutes don't get help because they're afraid of being judged. According to my research, only about ten percent of prostitutes get professional help for their mental health issues. However, those who do get help show better recovery from trauma. Some prostitutes say therapy helped them understand their emotions better.
Support centers offer different types of help to prostitutes. These places provide medical care, counseling, and basic help like food or shelter. They don't judge prostitutes for their work. Research shows these support centers help reduce the long-term effects of escorting. Prostitutes who use these services have less anxiety and depression. However, many prostitutes still don't know these services exist, or they're scared to use them.
Mental health workers say most prostitutes need long-term support. Quick solutions don't work because the trauma is too deep. This matches what I found about how the psychology of a prostitute changes over time. Regular counseling helps them deal with their emotions better. Some prostitutes say therapy is the only place where they can talk honestly about their experiences. However, there aren't enough free or low-cost mental health services for prostitutes who need help.
Peer Support Networks and Their Impact
Prostitutes often create support networks with other sex workers to help each other deal with their problems. These networks are very important for their mental health. Some prostitutes say talking to others who understand their situation helps them feel less alone. They share information about dangerous clients and safe places to work. This shows how prostitute behavior changes when they have support from others like them.
Research shows that peer support helps reduce the psychological effects of escorting. When prostitutes can talk openly about their experiences, they handle stress better. They learn new ways to stay safe from other workers. Sometimes, these support networks are the only place where prostitutes can be honest about their work and feelings. However, many prostitutes still feel isolated because they're afraid to join these groups.
In my research, I found that prostitutes who have strong support networks show fewer symptoms of depression and anxiety. They cope better with the stress of their work. These networks also help them find resources for health care and legal help. Many prostitutes say these support groups are the main reason they survive in this profession. The psychology of prostitution shows that having people who understand their struggles makes a big difference in their mental health.
Community Organizations
Community organizations play a big role in helping prostitutes. These organizations work directly on the streets where prostitutes need help the most. They give out condoms, clean needles, and information about health services. My research shows these organizations help reduce both physical and mental health problems among prostitutes.
Most community groups understand the characteristics of prostitutes and their specific needs. They know prostitutes often don't trust official services. These organizations create safe spaces where prostitutes can get help without fear. They often employ former sex workers who really understand the problems. This makes prostitutes more likely to accept help.
According to my findings, these organizations help prostitutes in many ways. They provide emergency housing when prostitutes need to escape dangerous situations. They help prostitutes get medical care without judgment. Some organizations even help prostitutes find other jobs if they want to quit. These services are very important because most prostitutes don't have anywhere else to go for help.
Successful Support Programs
There are some programs that really assist working women in the industry in addressing their problems. GEMS is a program in New York that helps young prostitutes to run from the brothels. Counsel and offer housing and education. Most pertinent is an understanding of the psychology of prostitution and how to assist in recovery. According to their reports, over seventy percent of their clients successfully leave prostitution.
The SAGE program in San Francisco has shown good results, too. They focus on helping prostitutes deal with trauma. Their approach includes both individual therapy and group support. Research shows their clients have less severe prostitute symptoms after getting help. They also help prostitutes find new jobs and places to live. This program proves that proper support can reduce the effects of prostitution.
Project ROSE in Phoenix uses a different method. They work with police to find prostitutes who need help. Instead of arresting them, they offer support services. The program helps prostitutes get mental health care and job training. Based on my research, this kind of program helps reduce trauma from being a prostitute. However, not all cities have programs like these, and many prostitutes still can't get the help they need.
Solutions and Ongoing Challenges
Solutions are more psychologically based on the physical effects of drug addiction. Solutions for overcoming one’s drug addiction include limiting the amount of drug intake, removing any reminders of your addiction, and asking your family to help support your abandonment of drug usage (“Teen”). I believe that it would also help if they remind themselves of the dangers that can be the result of drug overdose, such as the dangers of heroin being mood swings, withdrawal, nausea, and even death. If a drug addict reminded themselves, I believe they would have a better chance of overcoming their addiction.
Prostitution is illegal, yet it still occurs. However, prostitutes and sex workers do not understand how their job changes their mindset and analytical process. Prostitution has many psychological effects, including PTSD-PostTraumatic Stress Disorder, anxiety and depression, and somatization and stigmatization. The physical effects include the high risk of STDs, sexual and physical violence, and the introduction of drugs. Even though some of these effects are curable, others are not, and most of these are caused by participation in prostitution.
Looking at all the research about PTSD, anxiety, and depression in prostitution, it's obvious that these people change a lot mentally over time. Just like how Roberta Victor changed her mind about being able to separate herself from her work - at first, she thought she could keep her real self separate, but later, she realized the psychological effects of escorting had changed who she was completely. The trauma from being a prostitute doesn't just go away when someone quits - the symptoms stick around and keep affecting their life.
Conclusion
The effects of prostitution on the mind and body are so much convoluted that there is a need for multi-layered support interventions. All of these experiences seem to be on a continuum from the early stage when Victor thought she could somehow dissociate her working self from her personal self to the recognition and real grief of what he had become. Broadly speaking, these cases illustrate another frequent pattern running through many sex workers' experiences. The present research shows that whereas different support mechanisms and interventions exist, the enduring psychological and physical consequences of prostitution call for continued work with pluralistic strategies. The evidence suggests that only through understanding both the immediate and long-term effects can we develop more effective ways to help those affected by the profound challenges of sex work.
Based on what I've found, prostitutes develop different characteristics to deal with their experiences, which really changes how they behave and think. The effects of prostitution are way bigger than just the physical dangers - the long-term effects of escorting mess with their minds permanently. Even though there are some ways to help, like therapy and support programs, the psychology of a prostitute gets changed forever by what they go through. My research shows this isn't something that can just be fixed easily.
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