Technical ReportPDF Available

Study on the gender dimension of trafficking in human beings

March 2016

DOI:10.2837/698222

Report number: This report has been prepared under Contract No: HOME/2013/ISEC/PR/041-A2 between Lancaster University and the European Commission.
Affiliation: Lancaster University, European Commission.

Authors:

Sylvia Walby

City, University of London

Birgit Apitzsch

SOFI Göttingen

Jo Armstrong

Lancaster University

Susie Balderston

University of Strathclyde

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Directorate-General

for Develo pment and

Cooperation – EuropeAid

Migration and

Home Aﬀairs

Study on the gender

dimension of traﬃcking

in human beings

Final report

Study on gender

dimension of traﬃcking

in human beings

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S2

More information on the European Union is available on the internet (http://europa.eu).

For more information on the EU anti-traﬃcking policy visit: (http://ec.europa.eu/anti-traﬃcking/)

Luxembourg: Publications Oﬃce of the European Union, 2016

Language version: EN

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PDF ISBN 978-92-79-54062-2 doi:10.2837/698222 DR-04-15-944-EN-N

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Authors

Authorship: Sylvia Walby, Birgit Apitzsch, Jo Armstrong, Susie Balderston, Karolina Follis, Brian Francis, Liz Kelly,

Corinne May-Chahal, Awais Rashid, Karen Shire, Jude Towers, Markus Tunte.

This report has been prepared under Contract No: HOME/2013/ISEC/PR/041-A2 between Lancaster University and

the European Commission.

Disclaimer

‘The information and views set out in this publication are those of the author(s) and do not necessarily reﬂect the

oﬃcial opinion of the European Commission. The European Commission does not guarantee the accuracy of the data

included in this study. Neither the European Commission nor any person acting on the Commission’s behalf may be

held responsible for the use which may be made of the information contained therein’.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 3

CONTENTS

Executive summary � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 7

1� Introduction � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13

2� Methodology � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 19

3� Review of key issues in the literature � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 21

4� Victim assistance: United Kingdom example � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 33

5� Measuring traﬃcking EU-28 � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 57

6� Demand reduction: Germany and the Netherlands � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 93

7� Demand reduction: Sweden � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 123

8� Law enforcement: justice and home aﬀairs EU agencies � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 141

9� Emerging cyber technology � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 163

10� Conclusions from gender analysis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 181

11� Recommendations � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 195

12� Annex: Relevant law and policy instruments � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 201

13� References � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 205

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S4

Table 1.1 Gender of victims of traﬃcking in EU-28, 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Table 4.1 Boolean search strings and references . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Table 5.1 Gendered nature of registered victims of traﬃcking across the EU-28: 2010-2012 . . . . . . . . . . . . . . . . 61

Table 5.2 Forms of exploitation in traﬃcking in human beings across the EU-28: 2012 registered victims . . . . 61

Table 5.3 Gender and age dimensions of traﬃcking in human beings across the EU-28: 2012

registered victims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Table 5.4 Traﬃckers of human beings by form of traﬃcking and gender: EU-28 2012 . . . . . . . . . . . . . . . . . . . . . . . 68

Table 5.5 Recorded victims and suspects of traﬃcking in Germany 1994-2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

Table 5.6 Identiﬁed and presumed victims of traﬃcking in the Netherlands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Table 5.7 Police reported crimes in Sweden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Table 5.8 Identiﬁed and presumed victims of traﬃcking in the United Kingdom 2009-2013 . . . . . . . . . . . . . . . . . 73

Table 5.9 Number of on-street prostitutes in Sweden 1995-2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Table 5.10 Studies on cyber-enabled prostitution in Sweden 2000-2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Table 5.11 Estimated number of prostitutes in the Netherlands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Table 5.12 Rates of prostitution in Germany, the Netherlands and Sweden. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

Table 5.13 Systematic review search terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Table 5.14 Scholarly and grey literature repository databases and organisational websites for the

systematic reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Table 5.15 Number of documents retained from each repository database and organisational website . . . . . . . . 90

Table 5.16 Exclusion and selection criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Table 5.17 Scale of traﬃcking in human beings, by source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Table 6.1 Criminal codes relevant to eradicating traﬃcking for purposes of sexual exploitation:

Germany and the Netherlands (as of August 2015) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Table 6.2 Administrative provisions and procedures relevant to eradicating traﬃcking for purposes of

sexual exploitation: Germany and the Netherlands (as of July 2015) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

Table 6.3 Interviews for case studies of the city of Amsterdam and the city of Dortmund . . . . . . . . . . . . . . . . . . 105

Table 7.1 Actors interviewed for the Swedish case study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124

Table 7.2 Numbers of men suspected of and convicted for paying for sex 1999-2014 . . . . . . . . . . . . . . . . . . . . . 127

Table 7.3 Number of people involved in street prostitution 1998-2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

Table 7.4 Number of people involved in street prostitution in Stockholm 2008-2013 . . . . . . . . . . . . . . . . . . . . . . . 130

Table 7.5 Police reported cases of traﬃcking in adults and children for sexual purposes . . . . . . . . . . . . . . . . . . . . 133

Table 7.6 Police reported cases of procuring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

Table 9.1 Demographics of traﬃcking cases identiﬁed through signals to the Polaris project (NHTRC, 2014) . 166

Table 9.2 Search results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

Table 9.3 Technology and traﬃcking workshop attendees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

LIST OF TABLES

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 5

LIST OF FIGURES

Figure 6.1 The Service Work Triangle for prostitution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Figure 7.1 Screen grabs for Stockholm and Copenhagen from wikisexguide.com, 22 July 2015 . . . . . . . . . . . . . . 132

Figure 9.1 Map of hotline and publicly available data on traﬃcking in the United States . . . . . . . . . . . . . . . . . . . . . 166

Figure 9.2 Natural market, NGO scramble ‘anti-market’, synthetic market (Blair, 2014) . . . . . . . . . . . . . . . . . . . . . . 168

Figure 9.3 The New Abolitionists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 7

Executive summary (1)

INTRODUCTION

The purpose of this study is to contribute to the identiﬁcation and understanding of what it means to be ‘taking

into account the gender perspective, to strengthen the prevention of this crime and protection of the victims there-

of’, as required in Article 1 of European Union (EU) Directive 2011/36/EU on Preventing and Combating Traﬃcking

in Human Beings and Protecting its Victims in the context of the EU Strategy (COM(2012) 286 ﬁnal) Towards the

Eradication of Traﬃcking in Human Beings.

The study contributes to Priority E Action 2 of the Strategy, which states that ‘the Commission will develop knowl-

edge on the gender dimensions of human traﬃcking, including the gender consequences of the various forms

of traﬃcking and potential diﬀerences in the vulnerability of men and women to victimisation and its impact on

them.’ Its speciﬁc objectives and tasks are to address: the ‘gender dimension of vulnerability, recruitment, and

victimisation’; ‘gender issues related to traﬃckers and to those creating demand’; and ‘an examination of law and

policy responses on traﬃcking in human beings from a gender perspective’.

The study addresses the ﬁve priorities of the EU Strategy: identifying, protecting, and assisting victims of traf-

ﬁcking; stepping up the prevention of traﬃcking in human beings; better law enforcement; enhanced coordina-

tion and cooperation among key actors and policy coherence; and increased knowledge of an eﬀective response

to emerging concerns.

This study, according to its terms of reference, aims to look speciﬁcally at the gender dimension of traﬃcking

for the purpose of sexual exploitation. This follows evidence from statistical data from Eurostat, as well as da-

ta from The European Police Oﬃce (Europol) and the United Nations Oﬃce on Drugs and Crime (UNODC), accord-

ing to which the most reported form of exploitation of victims is that of sexual exploitation and its strong gen-

der dimension (96 % women and girls). It further addresses recommendations addressed in the Resolution of

the European Parliament of 26 February 2014 on sexual exploitation and prostitution and its impact on gender

equality (2013/2103(INI)) urging the European Commission to evaluate the impact that the European legal frame-

work designed to eliminate traﬃcking for sexual exploitation has had to date and to undertake further research

on patterns of prostitution, on human traﬃcking for the purpose of sexual exploitation and on the increased lev-

el of sex tourism in the EU, with particular reference to minors, and to promote the exchange of best practices

among the Member States.

The study identiﬁes and draws on EU law and policy competence in gender equality in its identiﬁcation of the gen-

der dimensions of traﬃcking. The gender dimensions are clustered into ﬁve issues: gender speciﬁcity and equal

treatment; gender expertise, gender balance in decision-making and gender mainstreaming; the relationship be-

tween prostitution and traﬃcking; gendered policy ﬁelds and strategic priorities; gendered systems and the the-

ory of prevention.

METHODOLOGY

There are three aspects to the methodology of the study. The ﬁrst is a review of the academic and policy litera-

ture. The second is in-depth case studies. The third is high-level gender analysis.

The review of the literature is presented in two ways: a summary of the key issues that pertain to the study as

a whole is in chapter 3; detailed reviews of the literature that pertain to the topics that were selected for in-depth

study, and the case studies themselves are presented in chapters 4 to 9. The gender analysis is presented in three

parts: the key issues to be addressed are introduced in chapter 3; the main analysis is presented in chapter 10;

and the recommendations derived from the analysis are presented in chapter 11.

(1) Sylvia Walby.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S8

PREVENTION

The study contributes to the goal of the Directive to prevent traﬃcking in human beings, as well as to protecting

its victims, ‘to strengthen the prevention of this crime’ (Article 1). Prevention requires a range of measures, iden-

tiﬁed in the Directive at Article 18 as including those to ‘discourage and reduce the demand that fosters all forms

of exploitation related to traﬃcking in human beings’. In this analysis of the gender dimension, we consider vari-

ous measures to achieve prevention, including innovations in the instruments to reduce demand.

VICTIM ASSISTANCE

Traﬃcking is gender speciﬁc. The victims of traﬃcking in human beings for diﬀerent purposes are gender specif-

ic. Women and girls are overwhelmingly (96 %) the victims of traﬃcking for purposes of sexual exploitation and

the majority (75 %) of victims of traﬃcking for all purposes, while being 26 % of those traﬃcked for labour ex-

ploitation and 52 % of those traﬃcked for other forms of exploitation (according to data for 2012 from Eurostat).

The harms from traﬃcking are gender speciﬁc. The harms from traﬃcking for purposes of sexual exploitation are

diﬀerent from the harms from traﬃcking for purposes of labour and other forms of exploitation. Their serious-

ness is related to the speciﬁc ways that the bodies of traﬃcked women are abused. There are severe, brutal and

long-term, gender-speciﬁc physical, gynaecological and mental health harms, risks to life and traumas from traf-

ﬁcking for purposes of sexual exploitation.

Identiﬁcation of victims of traﬃcking needs to take account of this gender speciﬁcity. Victims of traﬃcking for

purposes of sexual exploitation can be hidden within mixed populations of independent, exploited and coerced

prostitutes and in mixed migration ﬂows. They are fearful of both traﬃckers and authorities. Gender expertise is

needed to provide gender-sensitive processes of victim identiﬁcation in these circumstances.

Specialised service provision needs to be gender speciﬁc. It needs to take account of complex intersections with

other forms of disadvantage and vulnerability. It needs to recognise the gender-speciﬁc longer recovery time

from the harms of traﬃcking for purposes of sexual exploitation as compared with other forms. The provision of

specialised services to victims of traﬃcking needs to be appropriate to their needs. These are diﬀerent according

to the form of traﬃcking to which they have been subjected, and hence gender speciﬁc. These services are best

provided by organisations that include users, victim-survivors of traﬃcking and gender experts in their decision-

making and which have sustainable funding.

Access to mainstream services needs to be enabled by the mobilisation of the legal principle of equal treatment

in access to goods and services. This is to ensure that those traﬃcked for sexual exploitation (who are dispropor-

tionately female) gain access, on equal terms with others, to welfare, social protection, health, criminal justice

services, ﬁnancial services and support to reintegrate into the economy.

The wider context of gender equality, including but not only in employment, is relevant to the likelihood that vic-

tims of traﬃcking can access the independent forms of livelihood that are conducive to escape and to recuper-

ation. This includes the actions in the EU Strategy for Equality between Women and Men (COM(2010) 491 ﬁnal),

reducing the regulatory gap between workers in non-standard and standard work, and the inclusion of gender

equality in the EU 2020 Strategy for smart, inclusive and sustainable economic growth (COM(2010) 491 ﬁnal).

MEASUREMENT

There are four major ways of collecting data on traﬃcking in human beings: administrative statistics; large-scale

surveys; other studies; and the expert judgement of key actors. Ideally, all would be available for the investigation

of the causal processes linking changes in policy to changes in traﬃcking. There are current limitations to the data.

However, these could be mitigated by a sustained programme of improvement in methodology and data collection.

The Eurostat working papers on statistics on traﬃcking in human beings, including its gendered dimensions, has

made an important contribution to available knowledge and needs to be sustained and improved. Member States

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 9

should collect and provide data on victims and traﬃckers consistently using the deﬁnition of traﬃcking in the

Directive and always disaggregate them by gender.

There is a need to develop and fund a programme of research to develop methodologies to estimate the changing

scale and nature of traﬃcking which is sensitive to the gender dimensions. This should include concern for both

registered and non-registered victims, the development of theory and techniques necessary to produce estimates

of the total population of traﬃcked victims (registered and non-registered) from collected data and should com-

plement work by the UN Oﬃce on Drugs and Crime and the International Labour Organisation.

This programme of methodological development should be supported within the development and funding of

a wider research programme into what works to prevent traﬃcking in human beings with appropriate attention

to its gender dimension.

DEMAND REDUCTION

‘Demand reduction’ is a strategy to prevent traﬃcking by reducing the economic attraction of the institutions in-

to which people may be coerced by traﬃckers. In the case of traﬃcking for purposes of sexual exploitation, the

most important institution is prostitution. This study addresses the ways that the diﬀerent forms of regulation of

prostitution might reduce demand for the services of people traﬃcked into prostitution.

The regulation of prostitution is centred on one or more of three targets: those who sell sex/are sold; those who

engage in the exploitation of the prostitution of others; and the buyers of sex. Demand reduction through the

regulation of prostitution can logically be centred either on those that seek to exploit by taking proﬁt (e.g. rent

or fees) from prostitution or on the men (usually) who seek to buy sex. It is sometimes focused on reducing the

forms of prostitution that are likely to have a greater association with traﬃcking and other forms of criminality

and sometimes focused on prostitution in general.

While the ideal data to test approaches to prevent traﬃcking would have included robust statistics that are com-

parative over time and between countries (supplemented by qualitative data), these are limited. Thus adjudi-

cating between approaches depends upon a wider range of information including administrative data, research

studies and expert judgement of key actors, such as the police. We oﬀer in-depth case studies of Germany, the

Netherlands and Sweden, as well as some cross-country comparisons of Germany, the Netherlands and Sweden.

There are variations in the form of regulation of prostitution over time and between EU Member States. Recently, in

the EU, there has been a substantial move to de-criminalise the sellers of sex so that, in most EU Member States,

selling sex is not always illegal. This move is recommended in the European Parliament resolution of 26 February

2014 on sexual exploitation and prostitution and its impact on gender equality (2013/2103(INI)) (2014). There

are some exceptions, in Member States such as Croatia where selling sex is always illegal, and in other Member

States where it is illegal in particular locations, for example, on the street. This de-criminalisation of the selling

of sex, while widespread in the EU, is not found in many other jurisdictions, such as the United States. It is impor-

tant to note EU speciﬁcity when engaging in debates about traﬃcking and prostitution and to avoid any tenden-

cy to a false universalism concerning the criminalisation of the selling of sex. We ﬁnd that increased regulation

of one of the three parties does not necessarily mean increased regulation of the other two. Most EU Member

States have decriminalised the sale of sex (with some exceptions); maintain the criminalisation of the exploitation

of the prostitution of others; and criminalise the purchase of sex in speciﬁc circumstances, including from minors.

Germany and the Netherlands have permitted some proﬁt-taking from prostitution, combined with high levels of

surveillance and regulation. Sweden has criminalised the purchase of sex.

We found that Germany has the largest proportion of prostitution (for population size) of any of the three coun-

tries in our study. This is followed by the Netherlands, then Sweden, which has the lowest proportion of prostitu-

tion per head of population. Although there are limitations to the accuracy of these comparative statistics, the

larger scale of prostitution in Germany is rarely disputed. Both Germany and the Netherlands have introduced ad-

ditional policies to combat traﬃcking in some cities, including total bans on street prostitution, and are either dis-

cussing or implementing bans on the purchase of sex from those under 21, not only under 18 years. These have

been introduced to close down forms of prostitution (on the street and involving young people) that are consid-

ered by expert judgement of key actors to be the most associated with traﬃcking.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S10

We conclude that the changes in the legal regulation of speciﬁc forms of proﬁt-taking from prostitution have re-

sulted in less traﬃcking in this sector than in the non-regulated and illegal sectors. The best statistics available

suggest the overall scale of prostitution is larger in Germany and the Netherlands than in Sweden. This correla-

tion between the decriminalisation of proﬁt-taking in prostitution and its scale is consistent with the claim that

this aspect of decriminalisation, however well-regulated, is causally connected to a larger proportion of prostitu-

tion in the population. Reductions in traﬃcking have also occurred through the deployment of other legal instru-

ments in the non-regulated and illegal sector, especially bans on particular forms of prostitution that have been

enforced by the criminalisation of seller and buyer, thereby reducing the forms of prostitution most associated

with traﬃcking. The evidence does not support the claim that innovations in the regulation of the exploitation of

the prostitution of others in Germany and the Netherlands that allow speciﬁc and regulated proﬁt-taking have

reduced overall levels of traﬃcking for purposes of sexual exploitation in these countries. Our conclusion is that

the criminalisation of the exploitation of the prostitution of others, of proﬁt (rent and fee) taking from prostitu-

tion, remains an important legal instrument to reduce the demand that drives traﬃcking.

A key claim as to the eﬀectiveness of the law which criminalised the purchase of sex in reducing prostitution was

the halving of street prostitution in Sweden registered by the police in the period immediately aer the law came

into eﬀect, while that in neighbouring Nordic countries remained at similar levels. Since street prostitution is widely

held to be a key site of traﬃcking, this is likely to have entailed a decline in traﬃcking at the same time. This may

be considered to be the consequence of the normative eﬀect of the legislation on male behaviour or perhaps the

threat of sanctions. However, there are debates as to whether oﬀ-street prostitution has grown in compensation;

here the evidence base is weak and contested. In this context, an alternative approach to measuring changes has

been to focus on men’s willingness to buy sex. The proportion of men reporting that they have paid for sex de-

creased substantially aer the law came into eﬀect; some studies suggest that this fell by almost half, though

the evidence base as to the exact proportions is contested. Nevertheless, there are indications that Sweden has

a smaller market for sex than many other European countries. Thus the law may be considered to have had some

of the eﬀects that were sought in that it has reduced demand for the purchase of sex, with consequences for the

scale of the Swedish sex market.

LAW ENFORCEMENT, JUSTICE, AND HOME AFFAIRS (JHA) AGENCIES

The study engages with the practices of the EU Justice and Home Aﬀairs agencies, especially: Europol, Eurojust,

The European Union Agency for Fundamental Rights (FRA), The European Police College (CEPOL) and the European

Agency for the Management of Operational Cooperation at the External Borders (Frontex). This includes a review

of the materials through which they trained oﬃcers. The ﬁndings are that much progress has been made since

the inception of the Strategy to eradicate traﬃcking in human beings, particularly with regard to inter-agency

cooperation and the coordination of activities. However, the embrace of the gender perspective remains uneven.

Better acknowledgement of the gender-speciﬁc dimensions of traﬃcking and the development of gender exper-

tise in addressing these would improve the likelihood of eﬀective prosecution of traﬃckers. This could include: the

use of explicitly gender-speciﬁc, rather than gender neutral, language in policies; the consistent application of the

principle of equal treatment; the utilisation of more gender-speciﬁc materials during the training of law enforce-

ment oﬃcers; improvement of the gender balance in decision-making; and better resourcing of JHA agencies to

enable the appointment of gender-trained agency oﬃcers.

KNOWLEDGE: NEW TECHNOLOGY

Various potential implications of developing techniques of analysis are emerging. The nature of the online world

means that this more oen concerns traﬃcking for sexual exploitation than for labour exploitation, and hence con-

cerns women and girls in particular. Much of the technology development in the ﬁeld is focused on victim identi-

ﬁcation. This aims to free women and children from traﬃcked situations but also to assist in the prosecution of

perpetrators. The intersection of gender, sexual exploitation and digital technologies potentially form a distinc-

tive nexus. This is a way of thinking about how anti-traﬃcking movements can eﬀectively organise. Technical work

on tracing traﬃckers’ activities online using open source intelligence identiﬁes key themes that may assist in the

identiﬁcation and prevention of traﬃcking women and girls for the purposes of sexual exploitation. The gender

speciﬁcity of the digital world image of traﬃcking for the purposes of sexual exploitation is clear in that the gen-

der of those traﬃcked and displayed for sale is clearly visible. The majority concern the selling of women to men

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 11

for sex, though some men and boys are also advertised. Yet there appears to be little gender speciﬁcity in the law

enforcement response. There is concern that anti-traﬃcking movements can sometimes oﬀer exaggerated imag-

es of helpless femininity to assist their cause rather than images of resilience and resistance.

There is a need to develop gender expertise in relevant cyber technologies. This would enable the better identiﬁca-

tion of victims and the traces le by traﬃckers, including their movement of illicit funds. It could discover the best

ways to support those resisting traﬃcking. There is a need to improve the understanding of intersecting inequali-

ties, including that of age. It is important to improve the gender balance in decision-making in cybersecurity mat-

ters. It is also important to enhance the collaboration between those with gender expertise in traﬃcking in human

beings, law enforcement and cyber security experts. These developments would be assisted by the fuller imple-

mentation of the EU’s principles of gender equality within the EU Strategy on Cybersecurity (JOIN(2013) 1 ﬁnal).

ENHANCED COORDINATION AND COOPERATION AMONG KEY ACTORS AND POLICY

COHERENCE

There has been much development of EU policy to eradicate traﬃcking in human beings since the EU Anti-Traﬃcking

Directive in 2011 and the EU anti-traﬃcking Strategy in 2012. The policy could be made more eﬀective if it were

more deeply embedded in the wider strategies of the EU, especially the fuller implementation of its gender as-

pects. This includes the strategies on security, equality between women and men, economic growth, cybersecu-

rity, migration and external relations.

The Strategy on Security could include a more explicit gender dimension in the review of priorities of the European

Agenda on Security (COM(2015) 185 ﬁnal), including the 2018 mid-term review of the Internal Security Fund, and

the Commission’s planned reﬂection on maximisation of the contribution of relevant EU agencies to the Security

Strategy.

The Strategy for Equality between Women and Men (COM(2010) 491 ﬁnal) could make an important contribution

since it addresses the interconnected nature of the forms of gender inequality that contribute to traﬃcking in hu-

man beings, if its principles were more fully implemented.

The EU 2020 Strategy for Smart, Sustainable and Inclusive Growth (COM(2010) 2020 ﬁnal) could include gender

equality more explicitly as a goal. Reducing gender inequality in the economy assists the exit of women from traf-

ﬁcking; while prostitution should never be treated as an area for economic growth.

The Strategy on Cybersecurity (JOIN(2013) 1 ﬁnal) could include an explicit reference to the signiﬁcance of hu-

man dignity and the gender dimension of cybersecurity. This would facilitate recognition of the way that deep vi-

olations of human dignity are intrinsic to traﬃcking for purposes of sexual exploitation.

The European Agenda on Migration (COM(2015) 240 ﬁnal) could give greater priority to anti-traﬃcking so as to

facilitate the protection of victims.

The implementation of the Action Plan on Human Rights and Democracy (JOIN(2015) 16 ﬁnal) could include an

explicit gender dimension in its anti-traﬃcking activities. Improving the democratic participation and economic in-

dependence of women and girls in ‘source’ countries aids in the prevention of traﬃcking.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 13

1� Introduction (2)

PURPOSE OF STUDY

Traﬃcking in human beings has a gender dimension, especially in relation to traﬃcking for purposes of sexual ex-

ploitation (where women and girls are 96 % of the victims – Eurostat 2015). The purpose of the study is to con-

tribute to the identiﬁcation and understanding of what it means to be ‘taking into account the gender perspec-

tive, to strengthen the prevention of this crime and protection of the victims thereof’, as required in Article 1 of

EU Directive 2011/36/EU on preventing and combating traﬃcking in human beings and protecting its victims.

The Study contributes to the EU Strategy towards the Eradication of Traﬃcking in Human Beings 2012-2016,

Priority E Action 2, which stipulates that ‘the Commission will develop knowledge on the gender dimensions of

human traﬃcking, including the gender consequences of the various forms of traﬃcking and potential diﬀerences

in the vulnerability of men and women to victimisation and its impact on them.’ Its speciﬁc objectives and tasks

are to address: the ‘gender dimension of vulnerability, recruitment, and victimisation’; ‘gender issues related to

traﬃckers and to those creating demand’; and ‘an examination of law and policy responses on traﬃcking in hu-

man beings from a gender perspective’.

This study, according to its terms of reference, aims to look speciﬁcally at the gender dimension of traﬃcking for

the purpose of sexual exploitation. This follows evidence from statistical data of Eurostat, as well as data from

Europol and UNODC, according to which the most reported form of exploitation of victims is that of sexual ex-

ploitation and its strong gender dimension (96 % women and girls). It further addresses recommendations ad-

dressed in the Resolution of the European Parliament of 26 February 2014 on sexual exploitation and prostitu-

tion and its impact on gender equality (2013/2103(INI)) urging the European Commission to evaluate the impact

that the European legal framework designed to eliminate traﬃcking for sexual exploitation has had to date and

to undertake further research on patterns of prostitution, on human traﬃcking for the purpose of sexual exploi-

tation and on the increased level of sex tourism in the EU, with particular reference to minors, and to promote the

exchange of best practices among the Member States.

The study is situated within the law and policy environment in the EU on anti-traﬃcking in human beings and on

gender equality. This includes analysis of the gender dimension of each of the ﬁelds that are identiﬁed as priori-

ties in the EU Strategy (COM(2012) 286 ﬁnal) towards the eradication of traﬃcking in human beings (victim as-

sistance, law enforcement, prevention by demand reduction, coherence and coordination, and knowledge and

emerging concerns).

The study uses reviews of relevant literature, in-depth case studies and high-level analysis in order to reach con-

clusions with regard to the gender dimensions of traﬃcking in human beings and make recommendations con-

cerning law and policy implementation and improvement.

(2) Sylvia Walby.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S14

WHAT IS TRAFFICKING IN HUMAN BEINGS?

Understanding the meaning of traﬃcking in human beings for the purpose of this study involves at least three el-

ements: the legal deﬁnition; the implications for victims; and the identiﬁcation of the gender dimensions.

The EU Directive, in Article 2, deﬁnes oﬀences concerning traﬃcking in human beings as follows:

1. Member States shall take the necessary measures to ensure that the following intentional acts are pun-

ishable: The recruitment, transportation, transfer, harbouring or reception of persons, including the ex-

change or transfer of control over those persons, by means of the threat or use of force or other forms

of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability

or of the giving or receiving of payments or beneﬁts to achieve the consent of a person having control

over another person, for the purpose of exploitation.

2. A position of vulnerability means a situation in which the person concerned has no real or acceptable al-

ternative but to submit to the abuse involved.

3. Exploitation shall include, as a minimum, the exploitation of the prostitution of others or other forms of

sexual exploitation, forced labour or services, including begging, slavery or practices similar to slavery,

servitude, or the exploitation of criminal activities, or the removal of organs.

4. The consent of a victim of traﬃcking in human beings to the exploitation, whether intended or actual,

shall be irrelevant where any of the means set forth in paragraph 1 has been used.

5. When the conduct referred to in paragraph 1 involves a child, it shall be a punishable oﬀence of traﬃck-

ing in human beings even if none of the means set forth in paragraph 1 has been used.

6. For the purpose of this Directive, ‘child’ shall mean any person below 18 years of age.

The legal deﬁnition of traﬃcking in human beings in the EU is speciﬁed in the Directive 2011/36/EU. This is situ-

ated in a wider international context. The relevant legal instruments and policy documents are discussed below

and listed in Annex A.

Traﬃcking is a serious crime and violation of human rights with particularly horriﬁc long-term implications for

its victims. Victims of traﬃcking for purposes of sexual exploitation experience sexual brutality that causes seri-

ous damage to health and well-being. This sexual violence may cause vaginal injuries in women that lead to high

rates of sexually transmitted infections and risk of contracting HIV, and high rates of post-traumatic stress dis-

order, anxiety and depression. Victims live in fear of repercussions to themselves and/or their families if they at-

tempt to escape; moreover, rates of re-traﬃcking of those who do exit are high. See chapter 4 for further details.

Traﬃcking in human beings is gendered. Eurostat (2015) published data on victims of traﬃcking in human be-

ings in the EU-28 from 2012 ﬁnds that the majority (75 %) of victims registered with recognised authorities are

female. Registered victims of traﬃcking for the purpose of sexual exploitation are almost exclusively (96 %) fe-

male. Over 60 % of registered victims are traﬃcked for the purposes of sexual exploitation.

Table 1�1 Gender of victims of traﬃcking in EU-28, 2012

Form of traﬃcking in human beings Percentage (%) of victims that are female

Sexual exploitation 96

Labour exploitation 26

Other forms of exploitation 52

All 75

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 15

Percentages calculated from data in Eurostat (2015) tables A3, A4 and A5. Excludes data where the sex of the

victim is ‘unknown’: percentages are calculated on the sub-set of Member States that provide data disaggregat-

ed by both form of exploitation and gender of the victim.

EU LAW AND POLICY ON ANTI-TRAFFICKING AND ON GENDER EQUALITY

The EU has law and policy for addressing traﬃcking in human beings and for gender equality, both of which are

relevant for this study of the gender dimension of traﬃcking in human beings.

Anti-Traﬃcking

EU law and policy concerning traﬃcking in human beings is articulated in the Directive on Preventing and

Combating Traﬃcking in Human Beings and Protecting its Victims (Directive 2011/36/EU) and the EU Strategy

Towards the Eradication of Traﬃcking in Human Beings (COM(2012) 286 ﬁnal). The legal competence for the

Directive derives from the Treaty on the Functioning of the European Union (TFEU) Articles 82(2), concerning

judicial cooperation in criminal matters, and 83(1), which names ‘traﬃcking in human beings and sexual ex-

ploitation of women and girls’ as relevant crimes with a European dimension. The EU has established an EU

Anti-Traﬃcking Coordinator, as required by Article 20 of the Directive, ‘in order to contribute to a coordinated

and consolidated Union strategy against traﬃcking in human beings’.

The EU Strategy Towards the Eradication of Traﬃcking in Human Beings has ﬁve priorities:

(a) identifying, protecting and assisting victims of traﬃcking;

(b) stepping up the prevention of traﬃcking in human beings;

(d) enhanced coordination and cooperation among key actors and policy coherence;

(e) increased knowledge of and eﬀective response to emerging concerns related to all forms of traﬃcking

in human beings.

Traﬃcking in human beings is identiﬁed as an issue within further EU strategies, including, but not only, the Agenda

on Security (COM(2015) 185 ﬁnal) where it is located within the priority concerning serious and organised cross-

border crime.

The European Parliament, in its Resolution of 26 February 2014 on ‘sexual exploitation and prostitution and its

impact on gender equality’, stresses the ‘links between prostitution and traﬃcking’ and calls for further research

on ‘human traﬃcking for the purpose of sexual exploitation’.

The development of EU law and policy has taken place within an international context, including legal instru-

ments of both the United Nations (UN) and the Council of Europe, to which most EU Member States are parties.

The UN framework includes the United Nations (1949) Convention for the Suppression of the Traﬃc in Persons

and of the Exploitation of the Prostitution of Others, the United Nations (2000) Convention against Transnational

Organized Crime and its Protocol to Prevent, Suppress and Punish Traﬃcking in Persons, Especially Women and

Children and the United Nations (1979) Convention on the Elimination of Discrimination Against Women. The im-

plementation of UN legal instruments on traﬃcking is supported by the United Nations Oﬃce of Drugs and Crime

(UNODC). This international legal context is further strengthened by the Council of Europe’s (2005) Convention

on Action Against Traﬃcking in Human Beings and by its monitoring mechanism, led by the Group of Experts on

Action against Traﬃcking in Human Beings (GRETA). See Annex A for a list of the relevant international legal in-

struments and policy documents.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S16

Gender Equality

EU law and policy on gender equality is legally based on the competence found in the Treaty of Lisbon (2007). The

high-level aims of gender equality and equal treatment are speciﬁed in the Treaty on the European Union (TEU).

The division of responsibilities between the EU level and Member State level, taking into account the principles of

subsidiarity and proportionality, is speciﬁed in the Treaty on the Functioning of the European Union.

Article 2 of the Treaty on the European Union concerns the fundamental values of the EU and includes equality

between women and men:

The Union is founded on the values of respect for human dignity, freedom, democracy, equality, the rule

of law and respect for human rights, including the rights of persons belonging to minorities. These val-

ues are common to the Member States in a society in which pluralism, non-discrimination, tolerance, jus-

tice, solidarity and equality between women and men prevail.

Article 3 of the Treaty on the European Union further concerns both equality between women and men, combat-

ing social exclusion and discrimination, and the promotion of social justice and protection:

The Union’s aim is to promote peace, its values and the well-being of its peoples…

It shall combat social exclusion and discrimination, and shall promote social justice and protection, equal-

ity between women and men, solidarity between generations and protection of the rights of the child.

Article 8 of the Treaty on the Functioning of the European Union speciﬁes that both the EU level and the Member

State level should not only aim to eliminate inequalities, but also to promote equality. The reference to ‘all’ the

‘activities’ of the EU provides the legal basis for the strategy of ‘gender mainstreaming’ in which gender equality

is to be mainstreamed into all areas of EU activities, including policy formation and implementation:

In all its activities, the Union shall aim to eliminate inequalities, and to promote equality, between men

and women.

There are several EU Directives on gender equality, which are binding on all EU Member States, deriving their legal

competence from the Treaty. Early Directives concerned the equal treatment of women and men in pay and employ-

ment, extending later into the sale and distribution of goods and services, including provision of social security. More

recently, Directives have addressed aspects of gender-based violence, based on the legal competence to achieve the

judicial cooperation needed for the European area of justice, freedom and security (Walby 2013). The legal bases

for these Directives derive from four Articles of the Treaty on the Functioning of the European Union: Article 157(3)

for Directive 2002/73/EC on harassment (in employment); Article 19 for Directive 2004/113/EC on harassment (in

access to and distribution of goods and services); Article 82(1)(a) and (d) for Directive 2011/99/EU on protection or-

ders; Article 82(2) for Directive 2011/92/EU on child sex abuse; and Directive 2012/29/EU on victims’ rights. This is

in addition to the legal basis of the 2011 Anti-Traﬃcking Directive in Articles 82.2 and 83.1 (as discussed above).

The EU has a Strategy for Equality between Women and Men, 2010-15 (COM(2010) 491 ﬁnal), which contains the-

matic priorities on ‘equal economic independence for women and men; equal pay for work of equal value; equality

in decision-making; dignity, integrity and ending gender-based violence; and promoting gender equality beyond

the EU’. In addition to legislation on equal treatment and speciﬁc measures for the advancement of women, the

EU operates a practice of gender mainstreaming to promote gender equality, in which gender equality expertise

developed in specialist sites is used to support policy development throughout the wider policy process. Gender

equality policy is coordinated by a Commissioner based in Directorate-General (DG) for Justice and Consumers,

supported by a Gender Unit (D.2) within the Equality Directorate (D) in DG Justice and Consumers (2015). There

is an agency, the European Institute for Gender Equality (EIGE 2015), which provides technical support, especially

in the provision of data concerning gender equality. The European Parliament (2015) has a dedicated committee

centred on gender equality, the FEMM, or Women’s Rights and Gender Equality Committee.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 17

GENDER DIMENSIONS OF TRAFFICKING IN HUMAN BEINGS

The study identiﬁes the gender dimensions of traﬃcking in human beings. These are analysed in the report in two

ways, in relation to: the ﬁve priorities of the EU Anti-Traﬃcking Strategy (identiﬁed above); and the ﬁve clusters of

gender equality issues (introduced below). The ﬁve clusters of gender equality issues draw together the analysis

of 15 detailed dimensions, which are discussed in detail in the report.

1. Gender speciﬁcity and equal treatment. The identiﬁcation of the gender-speciﬁc aspects of traﬃcking is

necessary in order to identify victims and their needs and the most eﬀective points of intervention to

prevent traﬃcking. This is linked to the legal issue of equal treatment, which can be relevant to the pro-

vision of services.

2. Gender expertise and gender balance in decision-making: gender mainstreaming. The process of gender

mainstreaming is dependent upon the development of appropriate gender expertise that can be brought

to bear upon relevant mainstream policy processes and training of personnel. The implementation of

gender-informed policies is more eﬀective where there is gender balance in decision-making.

3. Gendered systems and the theory of prevention. In order to know how to eradicate traﬃcking in human

beings, it is necessary to have a theory of its causation and prevention. It is known that in this ﬁeld some

simple interventions can sometimes lead to displacement of the problem or to unintended and unwanted

consequences. This issue is addressed by analysing gendered relations as complex gendered systems.

4. The relationship between prostitution and traﬃcking. While the precise meaning of ‘the exploitation of the

prostitution of others’ is debated, its reduction is a goal established in law and policy by all EU Member

States, following UN protocols. This is a deeply gendered issue. It intersects with the issue of gendered

economics, which is a well-established ﬁeld of EU competence.

5. Gendered policy ﬁelds and strategic priorities. Traﬃcking in human beings is not only a policy ﬁeld in its

own right, but is located at the intersection of several other policy ﬁelds, each of which is gendered and

diﬀerently resourced. In pursuing the goal of policy coherence and coordination, the analysis of the re-

lationship between these ﬁelds is relevant.

METHODOLOGY

The approach to this study has been divided into three parts: a review of the literature, which identiﬁes the key is-

sues and state of the art knowledge on these; original in-depth case studies; and high-level gender analysis. The

in-depth case studies make original research contributions across the range of strategic priorities; additionally,

they jointly contribute to the analysis of prevention (deﬁned in the Directive at Article 18 (3)).

(3) 1. Member State s shall take a ppropriate measures, such as education and training, to discourage a nd reduce t he deman d that fosters all forms of exploitation

related to traffickin g in human beings.

2. Member States shall take appropriate actio n, including throug h the inter net, such as information and awareness- raising campaign s, researc h and educ ation

programmes, where appropriate in cooperation with releva nt civil society orga nisations and other stakeh olders, aimed at raising awarene ss and reducin g the risk of

people, especially c hildren, becoming victims of traffic king in human beings.

3. Mem ber States sha ll promote reg ular training for officials likely to come into co ntact wit h victims or potential victims of traffic king in human beings, including

front-line police officer s, aimed at ena bling them to identify and deal with victims and poten tial victims of trafficking in human beings.

4. In order to make the preventing and combatin g of trafficking in human b eings more effective by discouraging demand, Me mber States shall consider t aking

measures to establish as a crimina l offence the use of services which are the objects of ex ploitation as referr ed to in Article 2, with the kn owledge that th e person is

a victim of a n offence referred to in Article 2.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S18

STRUCTURE OF THE REPORT

Following this introduction, the report has chapters concerning: methodology; a review of the key issues in the

literature; each of the in-depth studies; conclusions from the gender analysis; recommendations; references; and

annexes. These are:

Chapter 2 Methodology

Chapter 3 Review of the key issues in the literature

Chapter 4 Victim assistance: United Kingdom example

Chapter 5 Measuring traﬃcking EU-28

Chapter 6 Demand reduction: Germany and the Netherlands

Chapter 7 Demand reduction: Sweden

Chapter 8 Law enforcement: EU Justice and Home Aﬀairs Agencies

Chapter 9 Emerging technology relevant to traﬃcking

Chapter 10 Conclusions from gender analysis

Chapter 11 Recommendations

Annex: Relevant law and policy instruments.

References

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 19

2� Methodology (4)

There are three parts to the methodology: a review of the literature and policy; in-depth case studies, including

of promising practices; and a high-level analysis of the gender dimension that integrates all aspects of the work

and leads to recommendations.

REVIEW OF THE LITERATURE

The study collects and critically reviews published literature and other material relevant to the analysis of the

gender dimension of policy developments on combating traﬃcking for purposes of sexual exploitation, including

academic and policy reports, surveys, statistics and other literature.

There are many intersecting aspects to this review, including policy and gender. The ﬁrst aspect is the evaluation

of legal and policy interventions, in the context of the EU Directive 2011/36/EU on traﬃcking and the associated

Strategy (COM(2012) 286 ﬁnal), that seek among others to eradicate traﬃcking for purposes of sexual exploita-

tion. This includes both detailed evaluations of speciﬁc policies and actors and also wider assessments with re-

gard to related matters such as the issues of social organisation pertinent to the generation of vulnerabilities and

of criminal exploitation. The detailed evaluations are divided so that they are situated adjacent to the case stud-

ies of promising practices. The wider assessment is oﬀered within an examination of the literature on ‘regimes’

concerning prostitution and gender, within which speciﬁc analyses are located. The second aspect addresses the

gender dimensions. This builds on the initial speciﬁcation of 15 gender dimensions. It addresses both the ways in

which gender inequalities are produced and entwined with traﬃcking in human beings; and the range of related

interventions (with a focus on the EU context). The literature on the intersection of EU policy on gender equality,

rooted in the EU Treaties and articulated in the Directives and other policy instruments, with traﬃcking in human

beings is part of this review.

The reviews included both ‘systematic’ and ‘narrative’ approaches as appropriate to the particular sub-project ﬁeld.

Systematic review approaches were used in those areas where the literature was most developed: assistance to

victims; and statistics. We have used a number of search engines to access a wide range of international sources

drawn from a number of academic disciplines. In other areas, the ‘narrative’ approach was used, drawing on ex-

pert access to specialised and fragmented literatures. None of the sub-ﬁelds were appropriate for meta-analysis

of existing studies since the study methods were too diverse to enable robust comparison.

The review of the literature is presented in two parts: the ﬁrst part identiﬁes the key issues that span the ﬁeld of

traﬃcking in human beings and is located early in the report; the second part engages in detail with the policy

developments, divided into the various priorities of the strategy, and is located in several parts adjacent to the

relevant in-depth study.

IN-DEPTH CASE STUDIES

We oﬀer in-depth case studies of diverse strategies to reduce traﬃcking for purposes of sexual exploitation. We

use multiple methodologies, combined as appropriate, including an analysis of relevant documentary and inter-

net material together with interviews with key actors, such as: law enforcement oﬃcials, civil society representa-

tives (including women’s organisations), service providers, labour inspectors, border oﬃcials and academics. The

case studies presented in chapters 4 to 9 of the report are outlined below:

Addressing vulnerable victims with intersecting disadvantages: This investigates the Poppy project in the United

Kingdom which assists vulnerable victims of traﬃcking who experience intersecting disadvantages.

(4) Sylvia Walby.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S20

Data: We assess the content and quality of the data that underpin analysis and evaluation of policies and make

proposals for their methodological improvement.

Demand reduction in Germany and the Netherlands: We analyse the developing German and Netherlands models

that aim to reduce traﬃcking by regulating sex work so that there is no space for traﬃcking.

Demand reduction in Sweden: We analyse the Nordic model that aims to reduce demand for traﬃcking by reduc-

ing demand for the prostitution into which women may be traﬃcked.

Law enforcement and borders: We investigate the EU Home Aﬀairs and Justice Agencies that are relevant to traf-

ﬁcking in relation to their introduction of gender expertise.

Emerging technologies: We review the prospects for improved utilisation of new technologies, including the inter-

net, for reducing rather than facilitating traﬃcking in human beings.

ANALYSIS OF THE GENDER DIMENSIONS

The ﬁnal component of the methodology is a high-level analysis of the gender dimensions of traﬃcking in human

beings for purposes of sexual exploitation which integrates the ﬁndings from the review of literature and policy

and from the case studies.

This analysis informs the recommendations that are made in the ﬁnal section of the report.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 21

3� Review of key issues in the literature (5)

INTRODUCTION

Our analysis concerns the gender dimension of traﬃcking in human beings, with a speciﬁc remit to focus on traf-

ﬁcking for purposes of sexual exploitation. The key issues for this analysis lie at the intersection of the ﬁve priori-

ties identiﬁed in the EU Anti-Traﬃcking Strategy and ﬁve clusters of gender issues identiﬁed in our study.

The anti-traﬃcking priorities are: identifying, protecting and assisting victims of traﬃcking; stepping up the pre-

vention of traﬃcking in human beings; increased law enforcement and prosecution of traﬃckers; enhanced coor-

dination and cooperation among key actors and policy coherence; and increased knowledge of and eﬀective re-

sponse to emerging concerns related to all forms of traﬃcking in human beings.

The ﬁve clusters of gender issues are: gender speciﬁcity and equal treatment; gender expertise, gender balance in

decision-making and gender mainstreaming; the relationship between the regulation of prostitution and traﬃck-

ing; the gendering of EU strategic priorities; and a gendered theory of the systems involved in prevention. These

gender questions rest on the legal instruments identiﬁed in the preceding chapter. A series of detailed issues were

addressed in the study to investigate the application of the principle of gender equality to the real world.

The material in this chapter is drawn from a review of the academic and policy literature. It draws on the detailed

reviews of literature that are provided in the six subsequent chapters. This chapter is focused on the identiﬁca-

tion of the key issues that are common to the study.

The analysis in this chapter leads from the ﬁve clusters of gender issues; it sets out the gender questions around

which the analysis of the ﬁelds of the Anti-Traﬃcking Strategy is conducted. The next six chapters each have a spe-

ciﬁc focus on issues associated with the Strategy and combine detailed literature reviews with original research.

Chapter 10 oﬀers conclusions to this analysis.

GENDER ISSUES

The ﬁve clusters of gender equality issues are as follows:

1. Gender speciﬁcity and equal treatment. The identiﬁcation of the gender-speciﬁc aspects of traﬃcking is

necessary in order to identify victims and their needs and the most eﬀective points of intervention to

prevent traﬃcking. This is linked to the legal issue of equal treatment, which can be relevant to the pro-

vision of services.

2. Gender expertise and gender balance in decision-making: gender mainstreaming. The process of gender

mainstreaming is dependent upon the development of appropriate gender expertise that can be brought

to bear upon relevant mainstream policy processes and the training of personnel. The implementation

of gender-informed policies is more eﬀective where there is gender balance in decision-making.

3. Gendered systems and the theory of prevention. In order to know how to eradicate traﬃcking in human

beings, it is necessary to have a theory of its causation and prevention. In this ﬁeld, it is known that some

simple interventions can sometimes lead to displacement of the problem or to unintended and unwanted

consequences. This issue is addressed by analysing gendered relations as complex gendered systems.

4. The relationship between prostitution and traﬃcking. While the precise meaning of ‘the exploitation of the

prostitution of others’ is debated, its reduction is a goal established in law and policy by all EU Member

(5) Sylvia Walby.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S22

States, following UN protocols. This is a deeply gendered issue. It intersects with gendered economic is-

sues, which is a well-established ﬁeld of EU competence.

5. Gendered policy ﬁelds and strategic priorities. Traﬃcking in human beings is not only a policy ﬁeld in its

own right, but is located at the intersection of several other policy ﬁelds, each of which is gendered and

diﬀerently resourced. In pursuing the goal of policy coherence and coordination, the analysis of the re-

lationship between these ﬁelds is relevant.

GENDER SPECIFICITY AND EQUAL TREATMENT

The questions

The starting point is to identify whether, and if so how, the practices, institutions, policies and strategies under

consideration are gender speciﬁc. Sometimes these practices have been treated as if they were gender neutral,

but our analysis ﬁnds that many are gender speciﬁc. Recognition of this gender speciﬁcity is necessary to prevent

traﬃcking. It is relevant for the precise tailoring of services and interventions to needs of victims of traﬃcking,

the prosecution of oﬀenders and also for the eﬀective implementation of EU law and policy on the equal treat-

ment of women and men.

The distinction between gender neutral and gender-speciﬁc has implications for the design of best practice in

the provision of services and other forms of intervention to assist victims and prevent traﬃcking in order to en-

sure that these are carefully designed according to need and relevance. The distinction is also relevant to the im-

plementation of the legal principle of equal treatment because identiﬁcation of gender speciﬁcity is necessary

to establish if there is a basis upon which this principle might be applied; it can only be applied if it is possible to

compare the treatment of women and men (whether directly or indirectly). The principle of equal treatment is es-

tablished within EU law only in certain areas, especially employment and the sale and distribution of goods and

services, so careful identiﬁcation of gender-speciﬁc practices is required. The signiﬁcance of gender speciﬁcity in-

cludes rather than neglects ‘trans’ forms of gender identity and same sex sexual orientation.

Gender speciﬁcity is relevant to the provision of services for victims, law enforcement, demand reduction and oth-

er forms of prevention, the development of new technologies, measurement frameworks and their implementa-

tion as well as the development of wider strategic priorities.

The ensuing analysis addresses a range of questions to ascertain gender speciﬁcity, both aspects which are al-

ready addressed and those which are implicit and require attention. Is gender made visible? Are the gendered

forms of vulnerability and recruitment into traﬃcking identiﬁed? Do statistics and other data provide gender dis-

aggregated information? Do public services, including victim assistance and law enforcement, adequately recog-

nise the gendered needs of victims of traﬃcking? Is the gender speciﬁcity of the harms from diﬀerent forms of

traﬃcking, for purposes of labour or sexual exploitation, made visible and addressed? Are services appropriately

targeted to meet the gender-speciﬁc needs of victims? Is there gender speciﬁcity of recruitment, impact, and en-

gagement of agencies addressing diﬀerent forms of traﬃcking?

How is the principle of gender equality implemented? Is the principle of ‘equal treatment’ pertinent under EU law

to the area under analysis? If so, is it applied in practice? Is the provision of services, including victim assistance

and law enforcement, conducted according to the principle of equal treatment of men and women? Are prostitutes

less likely to gain access to services than non-prostitutes; if so, does this constitute indirect gender discrimina-

tion? Are there gaps that might be addressed by legal or policy development? What is the vision of gender equal-

ity that underlies diﬀerent anti-traﬃcking policies? In what way are these wider societal visions of gendered fu-

tures articulated in speciﬁc policy debates and with what implications?

Gender equality, human rights and fundamental rights are overlapping concepts and strategies; but they are not

the same. Are policies anchored in human rights? What diﬀerence does it make if gender equality is subsumed

to a human rights/fundamental rights strategy rather than being addressed explicitly? Is the concept of human

rights or fundamental rights deployed and, if so, how does it articulate with gender equality in service provision,

policy practice, and development of strategic priorities?

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 23

Are inequalities that intersect with gender addressed? If so, which and how? In what way do inequalities that in-

tersect with gender aﬀect policy and practice? Are practices child-sensitive? How is the adult/minor boundary ad-

dressed in practice and how should it be?

Potential applications

Victim assistance

Insofar as there is gender speciﬁcity in the harms associated with diﬀerent forms of traﬃcking in human beings

then gender-speciﬁc needs are experienced by the victims. Gender-speciﬁc harms are consequent on traﬃcking

for sexual exploitation, which concerns largely women, as compared with traﬃcking for labour exploitation, which

concerns men more oen than women. Chapter 4 considers the nature of the harms from traﬃcking for sexual

exploitation. It follows this with an analysis of the extent to which the provision of services to assist victims like-

wise needs to be gender speciﬁc. These gender-speciﬁc services are to: reduce harm; provide safe shelter, ad-

vice and advocacy; provide access to justice and compensation; prevent re-traﬃcking and assist re-integration;

and provide public education and expert advice to policy-makers to assist wider practices promoting prevention.

Mainstream services and information are also necessary.

Measurement

While it is known that traﬃcking is gendered, discovering the exact extent of traﬃcking and of its gendering is chal-

lenging. The development of gender disaggregated statistics of traﬃcking and of prostitution are necessary steps

in the achievement of the knowledge base to eﬀectively address traﬃcking in human beings for sexual exploitation.

Demand reduction

Demand reduction concerns changing the wider environment into which people may be traﬃcked so as to reduce

incentives for traﬃcking. In the case of traﬃcking for purposes of sexual exploitation, this wider environment is

critically shaped by the institution of prostitution. This is a gendered institution in that its majority form concerns

men buying the sexual services of women, though there are in addition variants in which men buy other men, or,

very occasionally, in which women buy men. The diﬀerent forms of regulating the gendered institution of prosti-

tution, in particular, the exploitation of the prostitution of others, has implications for traﬃcking for purposes of

sexual exploitation. Chapter 5 considers the challenges in providing quantitative evidence to assist the evaluation

of policy and theory. The innovative forms of regulation in Germany, the Netherlands and Sweden are investigat-

ed in detail using a range of quantitative and qualitative evidence in Chapters 6 and 7.

Law enforcement

The gender speciﬁcity of traﬃcking means that gender-speciﬁc practices in law enforcement procedures are re-

quired. Since women are the majority of the victims of traﬃcking, in particular in traﬃcking for sexual exploita-

tion, and men are the majority of those in the EU Justice and Home Aﬀairs agencies tasked with addressing traf-

ﬁcking, there is a need to pay particular attention to training to ensure that the practices meet gendered needs.

Insofar as the justice component in anti-traﬃcking law enforcement is understood through a lens of human rights

that is interpreted in a gender-neutral manner, then gender issues remain to be fully addressed. Chapter 5 con-

siders the gender dimensions of training materials used by the EU agencies in investigating these issues, identi-

fying which are more gender-speciﬁc and gender sensitive than others.

New technology

Traﬃcking in human beings for purposes of sexual exploitation is increasingly cyber-enabled, in the sense that

the communication potential of cyberspace is used to facilitate these transactions. Despite the gender speciﬁcity

of traﬃcking, most of the current discussion of justice as it pertains to cyber security privileges other concerns,

including gender neutral notions of freedom of expression, surveillance and censorship. The question is how at-

tention to the gender speciﬁcity in the development of cyber-tools might enhance the ability of victims to achieve

resilience and the capacity of law enforcement to secure convictions.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S24

GENDER MAINSTREAMING, GENDER EXPERTISE AND GENDER BALANCE IN

DECISION-MAKING

The questions

The most eﬀective development and implementation of policy will normally require addressing its gender dimen-

sion. The principle and practice of gender mainstreaming has been developed, in the EU and elsewhere, to achieve

this goal. It requires speciﬁc actions and the development of gender expertise together with the attention of all

relevant policy actors and widespread application. Gender balance in decision-making is required, not only be-

cause it is just, but also to ensure gender balance in the voices, experience and expertise of those contributing to

decisions. These principles are embedded in EU policy and law but their implementation is varied. The study in-

vestigates the application of these principles in practice.

The implementation of gender equality requires expertise. Is there eﬀort to develop gender expertise and, if so, is

this mainstreamed into normal policy practice? Is there a special post or unit where this expertise is located, de-

veloped, and from which it is systematically deployed across the organisation? Where is gender equality expertise

located, for example, in the ﬁeld or in the headquarters? What gender expertise is relevant? In what way is gen-

der expertise developed and deployed? Is there a location in which gender expertise is developed and nurtured?

If so, is this fulﬁlled by a person, a unit, a practice and is it internal or external to the organisation? Is there the

movement of this gender expertise, via mainstreaming, into the work of the normal actors in policy and practice?

Are the bodies making decisions relevant to traﬃcking subject to eﬀective policies on gender balance in deci-

sion-making? Gender balance in decision-making is a well-established principle and priority in the EU Strategy for

Equality between Women and Men. It has been applied to political positions (parliament, public appointments)

and is under discussion for economic ones (e.g. discussions on quotas for boards of directors). The presence of

women has been considered relevant in other issues of gender-based violence and has been subject to policy in-

tervention. In the security ﬁeld, the UN Security Council has applied this principle to peace-keeping/negotiating.

Is there gender balance in decision-making on policy to prevent traﬃcking in human beings? What evidence and

discussion of the implications of gendered decision-making is there in relation to combating traﬃcking in human

beings? Is this principle applied in law enforcement, service provision to victims, or other areas of relevant policy-

making? What are the implications of the involvement of diﬀerently gendered political entities in decision-mak-

ing around traﬃcking?

Potential applications

Victim assistance

Expertise is required in providing the specialised assistance needed by victims of traﬃcking to: mitigate harms;

access appropriate shelter, advice and advocacy; access justice and compensation; prevent re-traﬃcking and aid

re-integration. This knowledge needs to be mainstreamed such that it is communicated to those responsible for

devising policies. Insofar as these forms of assistance are gender speciﬁc, then this expertise is also gender spe-

ciﬁc. In order to facilitate the development of this gender expertise in the entities providing services to victims of

traﬃcking, it is relevant to consider the development of gender balance in decision-making. This may be linked to

the inclusion of those who were formerly traﬃcked in the governance of these institutions. The relevance of gen-

der expertise and gender balance in decision-making for both specialist services and mainstream policy develop-

ments is investigated in chapter 4.

Measurement

The quantitative data needed to evaluate policy to eradicate traﬃcking is currently insuﬃcient. The devel-

opment of expertise in the gender dimensions of the measurement of traﬃcking is discussed in chapter 5.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 25

Law enforcement

The development of specialised expertise in the gender dimension of traﬃcking is necessary to ensure the

eﬀective identiﬁcation of victims by law enforcement bodies. A comparison of how this gendered expertise

is developed among the EU Justice and Home Aﬀairs agencies is presented in chapter 8. This chapter also

investigates the various ways in which gender expertise could be developed in these agencies, for example,

through the use of special oﬃcers and outside experts.

New technology

The signiﬁcance of the development of gender expertise in cyber matters, especially cyber security, is investigated

in chapter 9. The conventional assumption that technology expertise is gender neutral is challenged by recognis-

ing the need for the co-production of technical knowledge by cyber experts and those who have intimate knowl-

edge of traﬃcking. The current gender imbalance in decision-making regarding priorities for resources in the ﬁeld

of cyber security is potentially part of the problem.

GENDERED SYSTEMS AND THE THEORY OF PREVENTION

The study contributes to the goal of the Directive to prevent traﬃcking in human beings, as well as to protecting

its victims, ‘to strengthen the prevention of this crime’ (Article 1). Prevention requires a range of measures, iden-

tiﬁed in the Directive in Article 18 (6) as including those to ‘discourage and reduce the demand that fosters all

forms of exploitation related to traﬃcking in human beings’. In this analysis of the gender dimension, we consider

various measures to achieve prevention, including innovations in the instruments to reduce demand.

The goal is the eradication of traﬃcking in human beings. The achievement of this goal requires a theory of pre-

vention within which to situate the various potential actions to address speciﬁc aspects of traﬃcking. One conven-

tional approach to prevention has been to identify ‘risk factors’ as if these were separate and additive and could

be individually addressed. However, prevention is better addressed by conceptualising the underlying causes as

‘systems’ that ‘mutually adapt’ in order to address the interactions between them.

It is known that policies to address traﬃcking can sometimes have ‘perverse eﬀects’ producing the opposite of

what was intended. This is an example of the functioning of a complex system, rather than one in which the ele-

ments can be treated in a simple additive manner. Sometimes policies to reduce traﬃcking in one location appear

to be successful only for it to emerge or increase elsewhere, which is a phenomenon known as displacement. For

these reasons, it is important to understand the wider system, or rather, the complex ecology of mutually adapt-

ing systems, within which anti-traﬃcking policy is operating. The nature of the interaction, or coupling, of systems

is necessary to fully understand the implications of policy.

One of the systems within which anti-traﬃcking policy operates is a gender system, or gender regime. The way

the gender regime operates in relation to traﬃcking has important implications. To what extent are the variously

gendered facets of traﬃcking for purposes of sexual exploitation interconnected? Is the eﬀectiveness of particular

policies to reduce traﬃcking for purposes of sexual exploitation dependent on the nature of the gender regime in

which they are located? For example, are diﬀerent strategies of demand reduction appropriate for diﬀerent forms

of gender regime? Is there likely to be ‘displacement’ or ‘accumulation’ as a result of interventions? What under-

lying model of gender relations is most useful in addressing the issue of traﬃcking for purposes of sexual exploi-

tation? How are diﬀerent aspects of gender relations connected?

(6) 1. Member State s shall take a ppropriate measures, such as edu cation and t raining, to discourage a nd reduce t he deman d that fosters all forms of exploitation

related to traffickin g in human beings.

2. Member States shall take appropriate actio n, including throug h the inter net, such as information and awareness- raising campaign s, researc h and educ ation

programmes, where appropriate in cooperation with releva nt civil society orga nisations and other stakeh olders, aimed at raising awarene ss and reducin g the risk of

people, especially c hildren, becoming victims of traffic king in human beings.

3. Mem ber States sha ll promote reg ular training for officials likely to come into co ntact wit h victims or potential victims of traffic king in human beings, including

front-line police officer s, aimed at ena bling them to identify and deal with victims and poten tial victims of trafficking in human beings.

4. In order to make the preventing and combatin g of trafficking in human b eings more effective by discouraging demand, Me mber States shall consider t aking

measures to establish as a crimina l offence the use of services which are the objects of ex ploitation as referr ed to in Article 2, with the kn owledge that th e person is

a victim of a n offence referred to in Article 2.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S26

The concept of gender regime is based on the conceptualisation of gender relations in diﬀerent aspects of soci-

ety being interconnected. Each institution is treated as a system (complex system) that adapts to other systems

(complex systems). This complex formulation of gender regime means that there is no assumption of simple lin-

ear ‘impacts’ of ‘factors’ as in some models of prevention (e.g. WHO). There is still a question regarding the im-

pact of changes in gender relations in one area (e.g. the regulation of prostitution) on the gender regime as other

gendered institutions adapt to this change: does it lead to changes in the gender regime and gendered institu-

tions which are in the same direction (cumulative change), in the reverse direction (reaction), or does it lead to

changes elsewhere (displacement)? This question is partly theoretical and partly empirical. We investigate these

issues throughout the project.

THE RELATIONSHIP BETWEEN PROSTITUTION AND TRAFFICKING

Introduction

The forms of exploitation in traﬃcking in human beings are gendered, especially but not only, because women

are much more likely than men to be traﬃcked for purposes of sexual exploitation. Policies to address the gen-

der dimension of traﬃcking in human beings must therefore address, in particular, traﬃcking for purposes of sex-

ual exploitation. Since a major part of sexual exploitation is prostitution, though not the only one, it is important

to consider the relationship between prostitution and traﬃcking. This requires consideration of the implications

of diﬀerent forms of regulation of prostitution for the scale of traﬃcking for purposes of sexual exploitation. The

simple version of this question is whether a particular form of regulation of prostitution decreases or increases

traﬃcking. This in turn requires diﬀerentiation of the forms of regulation of prostitution into the most relevant

categories. It also, ideally, requires information regarding the extent of prostitution and of traﬃcking under dif-

ferent forms of regulation. These are challenging requirements.

We start with the deﬁnition of prostitution. We note the diﬀerent terms and concepts used to signify prostitution,

though this is not our primary concern. In all EU Member States prostitution is regulated in one way or another.

We identify the range of activities concerning prostitution that are regulated before considering whether these

might be clustered into diﬀerent forms of regulation. There are, logically, three main actors that can be regulat-

ed: those who sell sex/are sold; those who derive proﬁt (rent or fees) from prostitution; and the clients. The laws

deployed in this regulation include both criminal and non-criminal types. We thus use an empirically oriented ap-

proach to the identiﬁcation of diﬀerent forms of regulation of prostitution rather than the more conventional ap-

proach of abstractly conceptualised distinctions between prostitution regimes. We do this so that we can bring

empirical evidence to bear on intensely contested debates.

Deﬁnition and terminology

An act of prostitution is deﬁned as the provision of sexual services for payment. For example, in England and Wales,

the deﬁnition in law (Sexual Oﬀences Act 2003, Section 51 (2)) is that: ‘’prostitute’ means a person (A) who, on

at least one occasion and whether or not compelled to do so, oﬀers or provides sexual services to another per-

son in return for payment or a promise of payment to A or a third person’. Payment is deﬁned (Sexual Oﬀences

Act 2003 Section 51 (3)) as ‘any ﬁnancial advantage, including the discharge of an obligation to pay or the provi-

sion of goods or services’. This statement of law, while drawn from the United Kingdom, is typical of EU Member

States. Prostitution, however, is an institution rather than just a collection of individual acts. Prostitution is an in-

stitution in the sense that it entails repeated, organised social relations, which go beyond those of the individu-

als concerned in a particular encounter. The concept of sexual service is open to further development. For exam-

ple, O’Connell Davidson (1998: 3) states: ‘Prostitution is an institution that allows clients temporarily to secure

certain powers of command over prostitutes’. These are powers of command that are normally only allowed on

a basis of mutual exchange. In prostitution these powers of command are exchanged for money or similar pay-

ment. This ﬁnancial exchange identiﬁes the relations of inequality in prostitution. These social relations are usu-

ally gendered, with the purchaser a heterosexual man and the seller a woman; but not always, in particular men

may purchase sex from a man, while even more rarely a woman may purchase sex, usually from a man. The pur-

chase of sex from a child (under 18 years of age) is illegal across EU Member States.

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 27

Threaded through the debates as to the best way to eradicate traﬃcking in human beings are substantial debates

about terminology and deﬁnitions. This study prefers to use terminology that is neutral and open in order to at-

tempt to prevent premature foreclosure of discussion by conceptual closure. When it is necessary to choose, our

criteria include staying close to: the legal terminology and deﬁnitions used at the EU level as articulated in the EU

Anti-Traﬃcking Directive; the legal terminology and deﬁnitions used in the Member State when discussing their

law and policy; and the terminology and deﬁnitions used by speciﬁc actors when discussing their actions. These

issues are especially pertinent to the discussion of the relationship between prostitution and traﬃcking.

Prostitution. The consequence of these criteria mean that the report most frequently uses the term ‘prostitution’

since this is the term used in the EU Anti-Traﬃcking Directive that is the framework for this study. ‘Prostitution’

is also the term used by the legislative instruments of our case study countries of Germany and the Netherlands

(‘Prostitution Law’ 2002), as well as in oﬃcial reports discussing the situation in those countries (e.g. German

Federal Ministry 2007). The associated term ‘prostitute’ is used when someone is selling sex either independent-

ly or exploited by a third-party. The term ‘prostituted’ is used when there is coercion, as is the case in traﬃcking,

so that the sex is sold by the traﬃcker, not by the person over whose body the right of command is being sold.

Sex worker. In response to the concern that ‘prostitute’ is a stigmatising term, it has been sometimes argued that

the term ‘sex worker’ is preferable (Global Alliance against Traﬃc in Women 2007, 2010). This signals the free

agency and rights of the person concerned. It is important to stress that the extent of this freedom varies mark-

edly. Further, there is an ambiguity as to whether the term ‘worker’ entails the concept ‘employee’ with an ‘employ-

er’ which is rare since the status of ‘self-employed’ (i.e. without an employer from whom rights may be claimed)

is more common. This term is used when it is deployed in the literature under review and by the respondents who

were interviewed for the study.

Selling sex. The term ‘selling sex’ has the advantage of avoiding the diﬃculties identiﬁed with the positions identi-

ﬁed above. Its disadvantage is its use in situations of traﬃcking when the seller is the traﬃcker and not the person

whose body is being prostituted. Here, it might imply more autonomous agency by the traﬃcking victim than is ac-

tually present. The term is used by Kelly, Coy and Davenport (2009). It is also used in the Swedish government re-

ports (SOU 2010). In these reports, ‘selling sex’ is used in the discussion of Swedish law and policy. It is used more

widely when there is no reason to stay close to speciﬁc national, EU, Council of Europe or UN legal terminology.

Actors subject to regulation

The regulation of prostitution is focused on three actors: prostitutes; proﬁt (rent or fee) takers; and the buyers of

sex. Attempts to reduce traﬃcking have led to changes in the forms and focus of regulation of prostitution. These

intersect with changes in the regulation of prostitution for other reasons.

Prostitutes have traditionally been a major focus of regulation. Many Member States have criminalised the sell-

ers of sex in the past. Some Member States, for example the United Kingdom, have traditionally not criminalised

prostitutes when the transaction was carried out in private, only when selling sex was publicly visible, for example,

soliciting on the street. This was part of a wider tradition of tolerance of minority practices, disliked by the ma-

jority, if they were carried out in private. Recently, in the EU, there has been a substantial move to de-criminalise

the sellers of sex so that in most EU Member States selling sex is not always illegal. This move is recommended

in the European Parliament Resolution (2014) (7) and the Council of Europe Parliamentary Assembly Resolution

(2014) (8). There are some exceptions, in Member States such as Croatia where selling sex is always illegal, and

in other Member States where it is illegal in particular locations, for example, on the street. This de-criminalisa-

tion of the selling of sex, while widespread in the EU, is not found in many other jurisdictions, such as the United

States. It is important to note EU speciﬁcity when engaging in debates about traﬃcking and prostitution and to

avoid any tendency to a false universalism concerning the criminalisation of the selling of sex.

Proﬁt-taking, in any form, including rent and fees, has been and remains a major focus of regulation. In most

Member States it has been and remains a criminal act. This includes running a brothel, escort services, pimping

and living oﬀ the earnings of a prostitute (see, for example, in England and Wales the Sexual Oﬀences Act 1956

(7) Resolution of the European Parliament of 26 Febr uary 2014 on sexual exploitation and prostitution a nd its impact on g ender equality (2013/2103(INI))

(8) Resolut ion 1983 (2014) Prostitution, trafficking and modern slaver y in Europe

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S28

Sections 33, 34, 35 and 36). In some Member States, including Germany and the Netherlands, limited and high-

ly regulated forms of proﬁt-taking have been allowed since around 2000/2002. There is public debate about the

nature of these regulations and there has been a tendency to increase the regulations concerning the way proﬁt

extraction is permitted in order to attempt to reduce the associated increase in exploitation, associated criminal

activity and public nuisance. We investigate these issues in the case studies.

Buyers of sex have traditionally not been a major focus of regulation in the EU. Recently there have been moves

to make buyers of sex as prosecutable as sellers of sex in those instances when prostitution is banned in par-

ticular locations, such as streets. For example, England and Wales criminalised the ‘kerb crawling’ of men in cars

seeking to buy sex on the street (creating the oﬀence in the 1985 Sexual Oﬀences Act and becoming an arresta-

ble oﬀence in the 2001 Criminal Justice and Police Act). Further, in some places, including Sweden and Northern

Ireland, the purchase of sex in general has been criminalised. It has also been criminalised in some countries in

the European Economic Area (Norway and Iceland), and similar proposals have been or are under discussion in

Finland, France, Ireland, Latvia, Lithuania (9) and Scotland. Such laws have been recommended by the European

Parliament (2014) and the Council of Europe Parliamentary Assembly (2014). We investigate this practice in the

case study on Sweden.

The distinction between the three main types of actors subject to criminal and other types of law is important

and no assumption should be made that the criminalisation or illegality of the action of one of these groups has

any necessary link to that of other groups. This means that discussions couched in general terms of ‘decriminali-

sation’ are usually too imprecise to be particularly meaningful in an EU context. Further, discussions focused on

‘regulation’ are oen too imprecise unless the speciﬁc actors and actions to be regulated are identiﬁed.

Exploitation of the prostitution of others

The concept ‘exploitation of the prostitution of others’ is encoded in international legal instruments including the

UN (1949) Convention for the Suppression of the Traﬃc in Persons and of the Exploitation of the Prostitution of

Others and Article 6 of the UN Convention for the Elimination of the Discrimination against Women (CEDAW) (10).

The ‘exploitation of the prostitution of others’ is recognised as one of the major purposes of traﬃcking in human

beings, including in the EU Directive (2011/36/EU) on preventing traﬃcking. Legally, the crime of traﬃcking addi-

tionally involves actions and means as well as purpose. Nevertheless, logically, the prevention of the exploitation

of the prostitution of others has a major place in the prevention of traﬃcking. Reducing demand for traﬃcking is

legally part of this remit, under Article 18 of the EU Directive.

The criminalisation of the ‘exploitation of the prostitution of others’ is actualised in the criminalisation of the var-

ious forms of proﬁt (rent and fee) extraction. This is included in the criminal law of all EU Member States, in one

way or another.

The deﬁnition of ‘the exploitation of the prostitution of others’, however, contains ambiguities; in particular, con-

cerning the concept of ‘exploitation’, the meaning of which is contested, especially when considered in adjacen-

cy to the concept of ‘vulnerability’. Although the concepts of ‘exploitation’ and ‘vulnerability’ are included in the

Directive, their deﬁnition is open to interpretation. The variations and ambiguities in legally interpreting the con-

cepts hinge upon their social context (see UNODC 2013, 2015). In one sense, ‘exploitation’ is always an illegal ex-

cess. This is the interpretation in relation to prostitution in the majority of EU Member States. In another sense,

some exploitation is considered reasonable when it refers to the proportionate taking of proﬁts and only exces-

sive where it crosses the boundary of acceptability into illegality. This is the interpretation in relation to prosti-

tution in Germany and the Netherlands. In the wider legal environment, the concept of ‘exploitation’ sits next to

the concept of ‘vulnerability’ and derives important aspects of its meaning from this adjacency since prevention

of the exploitation of vulnerability is the goal. If prostitutes are considered as always ‘vulnerable’ to exploitation,

then proﬁt-taking from them cannot be justiﬁed. If they are considered ‘normal’ economic actors, then the situ-

ation is diﬀerent. However, in yet another sense, the taking of proﬁts from the selling of sex may be considered

(9) The Lith uanian Seimas (2014) passed a Resolutio n on 16 Decemb er 2014 (No XII-1464) that propose d that the Government of t he Republic of Lithuania should

‘submit amendments to the Criminal Code of t he Republic of Lithuania criminalisin g the purchase of services of prostitution, pornograp hy or other forms of sexual

exploitation’.

(10) CEDAW Ar ticle 6 states t hat parties sh all take all appr opriate measure s, including le gislation, to sup press all forms of t raffic in women an d exploitation of p rostitution

of women .

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 29

unreasonable exploitation per se, in the context of the pursuit of the goal of gender inequality whereby mutual-

ity rather than commercial exchange in intimacy is regarded as an essential part of a system of gender equality.

This category, ‘the exploitation of the prostitution of others’, is central to all major international legal instru-

ments concerning traﬃcking for purposes of sexual exploitation� It is identiﬁed as one of the purposes of

traﬃcking� Yet it is neglected or le out of focus in many recent texts concerning traﬃcking in human be-

ings that instead address ‘prostitution/sex work/selling sex’� By bringing the category ‘the exploitation of

the prostitution of others’ into focus and into the foreground of debate we can make a signiﬁcant contribu-

tion to the articulation of the gender perspective in the process of policy development� While the regulation

of ‘prostitution’ is traditionally considered a matter of national competence, in discussions on the UN Protocol, the

regulation of the exploitation of the prostitution of others probably sits on the boundary of EU level and

Member State competence since it is named as a purpose of traﬃcking in the EU Directive�

Variations in the form of prostitution

Although sometimes prostitution is analysed as a single phenomenon, debates regarding its intersection with

traﬃcking usually deploy nuanced diﬀerentiations between forms of prostitution. Some forms are more closely

associated with traﬃcking than others. We address the variations in three ways. First, by using a typology to

capture the most important distinctions relevant to the debates about the causal connections between traf-

ﬁcking and prostitution. Second, by listing the categories within which empirical data has oen been collect-

ed. Third, by consideration of categories pertinent to new forms of regulation. The extent of overlap between

these issues is a question to be investigated.

First, we devised a fourfold typology to capture the most relevant diﬀerences: independent; legally exploited; il-

legally exploited; and coerced. Both independent and exploited prostitutes are usually ‘self-employed’; rarely are

some directly employed (‘employees’) even in those countries that permit this as a legal form. Exploited has two

categories for those Member States that permit legal proﬁt (rent or fee) extraction from prostitution in certain

but not all circumstances: legal exploitation and illegal exploitation. Exploited is only ‘illegal exploitation’ in those

Member States that criminalise all proﬁt (rent or fee) extraction from prostitution since there is no ‘legal exploita-

tion’. Coercion into prostitution is illegal everywhere in the EU. This category includes but is not conﬁned to those

subjected to the control of a pimp. Traﬃcked prostitutes are a sub-set of ‘coerced’ prostitutes. The boundary be-

tween each of these types of prostitution is subject to both theoretical and empirical debate. There is a chal-

lenge in identifying those who have been traﬃcked within mixed populations of independent, exploited and co-

erced prostitutes.

Second, we note the existing categories within which empirical data on prostitution has been collected. The most

important distinction is between ‘street’ and ‘oﬀ-street’. This has been pertinent to the legal regulation of prosti-

tution, with much more attention historically paid to street than to oﬀ-street, so data is sometimes collected us-

ing this categorisation. There are diﬀerences within ‘oﬀ-street’, according to whether it is organised through broth-

els, ﬂats or escort agencies. There is emerging use of virtual communication to connect buyers and sellers which

may lead to further diﬀerentiation.

Third, there are additional relevant categories. One concerns age, with distinctions: under 18, 18 to 21, and over 21

years of age. The age at which buying and selling sex is legal has risen to 18 following international legal develop-

ment, but there is illegal under-age purchase. There are moves to raise the age to 21, for example in legal develop-

ments in Germany and the Netherlands and in the Resolution of the European Parliament (2014), on the grounds

that those under 21 are too vulnerable to be engaging in prostitution. Another concerns gender, with distinctions

as to whether a man is buying the services of a woman or a man; and rarely, whether the purchaser is female.

Empirical investigation of the links between traﬃcking and prostitution

Those traﬃcked for sexual exploitation constitute a subset of the larger population involved in commercial

sex. While the conceptual distinction may be clear (the ﬁrst typology is relevant) the empirical identiﬁcation

is less so. In pursuit of the empirical evidence to test the thesis that changes in the regulation of prostitution

can reduce traﬃcking attention has oen focused on the empirical categories (the second typology). A compli-

cation arises from the issue of ‘displacement’, in which changes in regulation reduce prostitution in one form/

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S30

location only to increase it in another, resulting in no overall decrease in prostitution. There are a series of

testable assumptions as to the change in the amount of traﬃcking for purposes of sexual exploitation and

the change in the amount of sub-sets of prostitution.

The general question is whether changes in the form of regulation of prostitution lead to a decrease in those forms

of prostitution associated with traﬃcking for purposes of sexual exploitation. There are several focused claims

and associated questions. One mobilises the distinction between street and non-street locations and the implica-

tions of reducing street prostitution. Another concerns the distinction between prostitution organised through le-

gal or illegal proﬁt-taking; in particular, whether allowing the former reduces traﬃcking. A further claim concerns

the implications of the criminalisation of the purchase of sex. The more far-reaching question concerns the im-

plication of other forms of intervention and contexts against prostitution and traﬃcking.

We address these issues in the case studies and in the assessment of the quantitative evidence.

Improving measurement

The data requirements to answer these questions are challenging. It involves the identiﬁcation of variations in

the extent of traﬃcking and in the diﬀerent forms of regulation and practice of prostitution. These challenges

can potentially be addressed through the use of comparisons between countries and over time if suﬃcient da-

ta of appropriate quality were collected on a comparable basis over time. These challenges are addressed in the

measurement chapter.

GENDERED POLICY FIELDS AND STRATEGIC PRIORITIES

Anti-traﬃcking policy is a component of several overlapping policy ﬁelds and strategic priorities. These policy ﬁelds

and strategic priorities have diﬀerent resources attached to them. They also vary as to the extent to which gen-

der equality is embedded as a core goal that is systematically implemented. Variation in the positioning of an-

ti-traﬃcking policy within competing and cooperating policy ﬁelds and strategies is likely to make a diﬀerence to

the resources available for anti-traﬃcking policy in the context of scarce resources. Further, and of consequence

to the analysis here, there is variation in the implementation of EU policies concerning gender equality, which in-

tersect with those concerning anti-traﬃcking.

Anti-traﬃcking policy is relevant to many of the EU strategic policy priorities, including: equality between women

and men; security; cyber security; migration; and economic growth. In more conventional policy terms, and with

greater applicability to policy at the Member State level, it is relevant to crime, economy, welfare, health, equal-

ity and violence against women, and external relations.

There is a question as to the location of anti-traﬃcking policy within this diverse policy ecology. Within which ﬁeld

is the development and implementation of policy on gender and traﬃcking located? Is it considered primarily as

a crime (and located in home aﬀairs) or a gender equality issue? Or is it primarily located in agencies addressing

border security or migration? What are the diﬀerences in the approach of these policy ﬁelds to gender equality?

Are some ﬁelds and priorities better resourced than others? What are the implications of the location of anti-traf-

ﬁcking policy in one ﬁeld or strategy for the gender dimension of the policy to reduce traﬃcking?

Is there tension over the prioritisation of gender equality and human rights principles on the one hand, and immi-

gration policies on the other. If there are such tensions between the principle of gender equality and other policy

goals and laws, which takes precedence and why? Does the balance between gender equality and other principles

vary, and if so why? What are the eﬀects of locating anti-traﬃcking policy in one ﬁeld rather than a relevant ad-

jacent policy ﬁeld with regard to its resourcing and gender content?

Is traﬃcking treated as a form of violence against women? Do strategies to reduce violence against women in-

clude a component on traﬃcking? What are the implications of diﬀerent practices to reduce violence against wom-

en and victim-survivor service provision for the reduction of traﬃcking in human beings? What is the relationship

between the ﬁelds of ‘gender equality’, ‘violence against women’ and ‘anti-traﬃcking in human beings for pur-

poses of sexual exploitation’? What impact does this relationship have upon the construction of anti-traﬃcking

policy, knowledge and statistics?

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 31

How is traﬃcking for purposes of sexual exploitation articulated in criminal law? What processes and which peo-

ple or groups of people are subject to criminal sanctions? Is there evidence of ‘displacement’ when criminal sanc-

tions are deployed? What is the nature of the intersection of the agendas and practices in law enforcement to

prosecute and prevent traﬃcking for sexual exploitation and security and migration issues? Does the deployment

of a strategy that is gender speciﬁc, anchored in human rights, child-sensitive and victim-centred ensure that the

anti-traﬃcking agenda is not submerged by the priorities of security and migration agendas? How does anti-traf-

ﬁcking policy articulate with security policy? In what way is the European Agenda on Security gendered? Does an-

ti-traﬃcking policy and practice follow these principles? In relation to cybersecurity, there are questions as to the

ways traﬃckers use the internet and social media as tools in their recruitment of victims; can the ﬂows in infor-

mation be captured in a gendered form and used to develop eﬀective interventions? How is the technology used

for and against traﬃcking gendered?

What is the gendered economic dimension to anti-traﬃcking policy? In what way is traﬃcking for purposes of

sexual exploitation linked to a wider economy; what are the contours and interconnections of this economy; how

is this gendered? Is more eﬀective regulation of employment an eﬀective mechanism to reduce traﬃcking for

purposes of sexual exploitation? What is the articulation of prostitution with the EU’s economic strategy? Does it

add, detract from or is it neutral in relation to the EU 2020 Strategy for Smart, Sustainable and Inclusive Growth?

Are there links to EU policy for social inclusion and employment which would implicate the use of the European

Structural Fund and European Social Fund?

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 33

4� Victim assistance: United Kingdom

example (11)

INTRODUCTION

Victims who have been traﬃcked for the purposes of sexual exploitation need specialist services through which

they can exit exploitation, achieve positive outcomes and rebuild their lives. This academic review systematically

examines 15 years of civil society intervention research literature regarding the EU Anti-Traﬃcking Directive stand-

ards (2011/36/EU). It appraises how support for adult victims of traﬃcking for sexual exploitation can best meet

the ‘ﬁve broad needs of victims’ set out in Priority A of the EU Strategy (COM(2012) 286 ﬁnal: 6), namely, ‘respect

and recognition, assistance, protection, access to justice and compensation’. The rights under the Directive are

summarised for victims, practitioners and Member States in Commission guidance (European Commission 2013).

An analysis of specialist, gender-speciﬁc interventions illuminates promising practices with survivors who experi-

ence intersecting inequalities to support exit from traﬃcking for sexual exploitation, reintegration into society as

well as prevention initiatives. It illuminates the societal (macro), institution or community (meso) and individual

(micro) inequalities and barriers to support and assesses the extent to which the services and interventions de-

liver the victim-centred, anchored in human rights and gender-speciﬁc values of the EU Directive and Strategy.

The empirical case study maps how one gender-speciﬁc non-governmental organisation (NGO) operationalises

culturally competent support for victims of traﬃcking for sexual exploitation in line with the standards set out in

the EU Directive and Strategy. It explores gaps and barriers to victim rights, for victims, practitioners and Member

States (for example, in the provision of assistance, information and support), as set out by the European Union (EU

Rights of Traﬃcking Victims European Commission 2013). The review concludes with evidence-based transfera-

ble and gender-speciﬁc recommendations to eradicate the signiﬁcant harms of traﬃcking in EU Member States.

The ‘victim pathway’ (Hammond and McGlone 2014), of women and girls traﬃcked for the purposes of sexual

exploitation, is developed logically in this review of promising practices and inequalities in services and interven-

tions: harms and risks for victims; harm reduction; gender-speciﬁc safe shelter, advice and advocacy; justice and

compensation; prevention and re-integration; public education; mainstream services and information; governance

and sustainability of services.

METHODOLOGY

A systematic literature search for the review was conducted following the method suggested by Hart (1998) and

used Boolean logic strings to ensure consistency. English language texts from 2000-2015 were identiﬁed, includ-

ing expert reports, academic and ‘grey’ literature (e.g. material from NGO evaluations). The method is contained

in an appendix to this chapter.

The Poppy Project (run by Eaves for Women) was chosen as a promising practice case study; it delivered a range

of services across the whole ‘victim pathway’, has been rigorously evaluated over several years and is used as

an indicative case study to demonstrate important, specialist factors in a gender-speciﬁc, expert service working

with women who are victim-survivors of traﬃcking for the purposes of sexual exploitation. The Poppy Project also

participates in the EU Civil Society Platform against Traﬃcking in Human Beings (THB), launched by the European

Commission (12). The case study draws upon semi-structured interviews adapting a method described by Kvale

and Brinkmann (2009) and was grounded in a standpoint feminist position (cf. Harding 2007). Workers from the

(11) Susie Balderston .

This chapter is wr itten ‘in memory of Denise’ (Denise Marshall, fou nder of Poppy Project, Chief Exec utive of Eaves for Women).

(12) The EU Civil S ociety Platfor m against THB wa s launched by t he European Co mmission on 31 May 2013, as a d eliverable of the EU Strategy towards the Erad ication

of Traffickin g in Human Beings. The Civil Society Platform currently meets every 2 years , bringing toget her over 100 civil society organisations working in the field of

THB in t he Member States a nd in four neighbouring priority countries (Albania, Morocco, Turkey an d Ukraine).

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S34

Poppy Project were interviewed and transcripts from the recording were supplemented with a review of exist-

ing evidence. On 30 September 2015, Eaves for Women closed, due to a lack of sustainable funding. The Poppy

Project is being established independently to continue the work supporting victim-survivors of traﬃcking for the

purposes of sexual exploitation.

Finally, based on the gender dimensions identiﬁed from the literature and case study, the chapter proposes sev-

eral grounded gender dimensions and recommendations for future policy and practice.

FINDINGS

The harms of traﬃcking for the purposes of sexual exploitation

Traﬃcking for sexual exploitation is a particularly gendered, severe and sustained form of violence against wom-

en (Akidwa 2010) with physical (Payne 2007; Williamson et al. 2010; Imhoﬀ et al. 2012; Ehrenpreis 2012), repro-

ductive (Silverman et al. 2011; Samandari et al. 2011; McGuinness and Newby 2012; Ehrenpreis 2012), mental

health impacts (McCabe 2008; Roe-Sepowitz et al. 2012) and secondary victimisation harms (Andrijasevic 2010;

Akwida 2010, Mishra 2013), oen diﬀerent and more severe than those aer domestic violence (Roe-Sepowitz et

al. 2014a). In addition to these harms, most women ﬂeeing from traﬃcking usually have no economic means of

survival (Reid 2012). Thus, eﬀective intervention requires a wide range of gender-speciﬁc specialist services for

victim-survivors. The European Union (2011/36/EU) recognises that victims of traﬃcking for the purposes of sex-

ual exploitation have no real or acceptable alternative but to submit to the abuse involved (European Commission

2013, The EU Rights of Victims of Traﬃcking in Human Beings) and therefore cannot consent to the activities into

which they are coerced and through which they are exploited. McDonald (2014: 136), in discussing the value of

anti-traﬃcking programmes in the EU and United States, helpfully directs the focus to be: ‘thought of in terms of

the numbers of victims freed from oppressive, degrading circumstances’.

Women traﬃcked into street prostitution are much more likely to be murdered than other women or traﬃcked

people. Estimates range from women in street prostitution being 12 to 18 times more likely to be murdered than

women of the same age in the United Kingdom (Salfati 2009; Järvinen et al. 2008). Internationally, research-

ers provide a homicide mortality rate for presumed-active prostitutes of 229 deaths per 100 000 including data

from the United Kingdom, United States, Nigeria and Kenya. In the United States, this means that 3.7 % of mur-

der victims (aged 16-44) were women in prostitution. Workplace homicides (204 per 100 000) estimated in the

study are many times higher than the second highest risk group (29 per 100 000 deaths) of the homicide rate

for male taxicab drivers in the United States since the 1980s (Potterat et al. 2004). However, the authors assess

their ﬁgures of murders and deaths (from HIV and drug use) are still under-estimates, because they were unable

to include those who died in a foreign country (which is likely to include women traﬃcked for sexual exploitation)

or women who were murdered but their bodies not found.

Women traﬃcked for the purposes of sexual exploitation also faced greater violence, including sexual violence

(Akidwa 2010), than either non-traﬃcked sex workers (Sarkar et al. 2008) or women aer domestic violence (Roe-

Sepowitz et al. 2014a). They are also at greater risk of sustained, multiple and forcible rape by men outside their

primary sexual relationship (Roe-Sepowitz et al. 2014a) than women experiencing domestic violence.

Women and girl victims of traﬃcking for sexual exploitation experience sexual brutality (Akidwa 2010) and in-

creased HIV exposure from the ﬁrst experience of being prostituted and regularly within the ﬁrst month of being

sex traﬃcked (Silverman et al. 2011). The sexual violence may be hyper-violent, causing vaginal injuries and sig-

niﬁcant blood loss, which in turn leads to high rates of sexually transmitted infections (Silverman et al. 2011) and

greater risk of contracting HIV. Higher HIV and other sexually transmitted infection rates are increased by victim

inability to use condoms in forced sex and frequent alcohol use — used by perpetrators (men who buy sex, pimps

and gang rape by traﬃckers) to ‘initiate’ women into prostitution or to reduce autonomy and resistance to rape

(Andrijasevic 2010; Silverman et al. 2011). In the medium term, sex traﬃcked women continue to experience great-

er risk exposure to sexual violence and HIV-infection and have high rates of HIV positive status (Zimmerman et

al. 2003; Williamson et al. 2010; Silverman et al. 2011; Ostrovschi et al. 2011) than is usually seen aer domestic

violence. The longer term harms are then multiplied by lower access to, or compliance with, anti-retro-viral treat-

ment therapies (Silverman et al. 2011). Whilst it may not be possible to generalise from Silverman et al.’s (2011)

STU DY ON TH E GEND ER DIM ENS ION OF T RAF FICK ING IN H UMAN B EING S 35

research from South Asia, similar patterns of sexually transmitted infection and HIV status are reported consist-

ently amongst sex traﬃcked women in other source and destination countries (Zimmerman et al. 2008; McCauley

et al. 2010; Mishra 2013; Walby et al. 2013).

Speciﬁcally, gendered harms also include spontaneous or multiple pregnancies and unsafe (illegal) abortions

which lead to long-term chronic vaginal and pelvic pain (McGuinness and Newby 2012) and infertility (Silverman

et al. 2011). Other health harms experienced by sex traﬃcked women include neck and mouth injury from forced

oral sex, hepatitis C infection, severe diarrhoea (Ehrenpreis 2012), extreme dehydration, fatigue and malnutrition

(McGuinness and Newby 2012). Further gendered health harms reported aer rape, relevant to women traﬃcked

for sexual exploitation, include women conceiving and being more likely to be at-risk of violent death during preg-

nancy (Samandari et al. 2011) and severe pelvic ﬂoor injury (Imhoﬀ et al. 2012). Victims also have more lifetime

surgeries for gastrointestinal or vaginal disease including ﬁstulas and damaged colons from anal rape or ﬁsting

(Delacroix 2011; Ehrenpreis 2012).

The eﬀects of rape are also psychological; research has reported over four times the rate of Post-Traumatic Stress

Disorder (PTSD) (Resnick et al. 1993), twice the lifetime level of depression and ten times the level of eating dis-

orders (Chen et al. 2010), higher rates of attempted suicide (Ilgen et al. 2010) and completed suicide (Heke et al.

2009) amongst women who have been raped compared to other crime victims. The mental health harms caused

by the grooming, coercion, threats, isolation, normalised daily violence, substance use and the trauma of being

traﬃcked for the purposes of sexual exploitation are severe and enduring. Such harms are also found in cases of

family exploitation, where disabled women are groomed and traﬃcked for forced marriage (Shah et al. 2015) or

where women and girls are traﬃcked to other family members for domestic slavery, in which they are also raped

or sexually exploited in ritual abuse. Women traﬃcked for labour are similarly unable to withdraw their consent,

for example, au pairs being coerced to sleep with their employers (McCabe 2008) or when images of victim-sur-

vivors are sold or distributed as pornography (Kotrla 2010).

Traﬃckers and pimps perpetrate sex crimes against their victims through abuses of power such as abduction,

transportation, debt-bondage deception, withholding travel documents or money, fraud, coercion, threats, depri-

vation of liberty, violence and harassment (United Nations 2000; Council of Europe 2005; Kelly and Regan 2000).

Victims are oen given false identities and threatened such that revealing their real identities to anyone becomes

highly unlikely (Hammond and McGlone 2014). The eﬀects of sustained coercion, trauma and violence include

PTSD (Hossain et al. 2010; Hammond and McGlone 2012), anxiety, panic attacks and depression (McGuiness and

Newby 2012), obsessive-compulsive disorder (Hossain et al. 2010), attachment disorder, self-harm, suicide and

dis-associative Identity Disorder (DID) (Dahlenberg et al. 2012).

Like other forms of violence against women, the harms of traﬃcking for sexual exploitation are exacerbated when

women attempt to exit. Women who do not command a high price for sexual exploitation, due to their age, disa-

bility, drug use or injuries, may be coerced into ‘hustling’ (stealing money from men who buy sex), sham or forced

marriages (Hughes 2004), begging and other illegal activity (Williamson and Baker 2009) which may lead to phys-

ical violence, imprisonment by perpetrators or arrest (McCabe 2008). Pimps and traﬃckers use drugs and alcohol

to contro