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Prostitution in Vancouver: Violence and the Colonization of First Nations Women

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  • Prostitution Research & Education, San Francisco CA USA

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We interviewed 100 women prostituting in Vancouver, Canada. We found an extremely high prevalence of lifetime violence and post-traumatic stress disorder (PTSD). Fifty-two percent of our interviewees were women from Canada's First Nations, a significant overrepresentation in prostitution compared with their representation in Vancouver generally (1.7-7%). Eighty-two percent reported a history of childhood sexual abuse, by an average of four perpetrators. Seventy-two percent reported childhood physical abuse, 90% had been physically assaulted in prostitution, 78% had been raped in prostitution. Seventy-two percent met DSM-IV criteria for PTSD. Ninety-five percent said that they wanted to leave prostitution. Eighty-six percent reported current or past homelessness with housing as one of their most urgent needs. Eighty-two percent expressed a need for treatment for drug or alcohol addictions. Findings are discussed in terms of the legacy of colonialism, the intrinsically traumatizing nature of prostitution and prostitution's violations of basic human rights.
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Transcultural Psychiatry
DOI: 10.1177/1363461505052667
2005; 42; 242 TRANSCULT PSYCHIATRY
Melissa Farley, Jacqueline Lynne and Ann J. Cotton
Women
Prostitution in Vancouver: Violence and the Colonization of First Nations
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Prostitution in Vancouver: Violence and the
Colonization of First Nations Women
MELISSA FARLEY
Prostitution Research and Education, San Francisco
JACQUELINE LYNNE
Vancouver, British Colombia
ANN J. COTTON
University of Washington, Seattle
Abstract We interviewed 100 women prostituting in Vancouver, Canada.
We found an extremely high prevalence of lifetime violence and post-
traumatic stress disorder (PTSD). Fifty-two percent of our interviewees
were women from Canadas First Nations, a significant overrepresentation
in prostitution compared with their representation in Vancouver generally
(1.7–7%). Eighty-two percent reported a history of childhood sexual abuse,
by an average of four perpetrators. Seventy-two percent reported childhood
physical abuse, 90% had been physically assaulted in prostitution, 78% had
been raped in prostitution. Seventy-two percent met DSM-IV criteria for
PTSD. Ninety-five percent said that they wanted to leave prostitution.
Eighty-six percent reported current or past homelessness with housing as
one of their most urgent needs. Eighty-two percent expressed a need for
treatment for drug or alcohol addictions. Findings are discussed in terms of
the legacy of colonialism, the intrinsically traumatizing nature of prosti-
tution and prostitutions violations of basic human rights.
Vol 42(2): 242–271 DOI: 10.1177/1363461505052667 www.sagepublications.com
Copyright © 2005 McGill University
transcultural
psychiatry
ARTICLE
June
2005
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Key words colonization • First Nations • post-traumatic stress disorder •
prostitution • sexual assault
Prostitution is a gendered survival strategy that involves the assumption of
unreasonable risks by the person in it. A number of authors have docu-
mented and analyzed the sexual and physical violence that is the norma-
tive experience for women in prostitution (Baldwin, 1993, 1999; Barry,
1979, 1995; Boyer, Chapman, & Marshall, 1993; Dworkin, 1981, 1997;
Farley, Baral, Kiremire, & Sezgin, 1998; Giobbe, 1991, 1993; Hoigard &
Finstad, 1986; Leidholdt, 1993; MacKinnon, 1993, 2001; McKeganey &
Barnard, 1996; Miller, 1995; Silbert & Pines, 1982; Silbert, Pines & Lynch,
1982; Vanwesenbeeck, 1994; Weisberg, 1985). For example, Silbert and
Pines (1981, 1982) reported that 70% of women suffered rape in prosti-
tution, with 65% having been physically assaulted by customers, and 66%
assaulted by pimps. The foregoing authors include data from Burma,
Germany, Mexico, Philippines, the Netherlands, Norway, Scotland, South
Africa, Thailand, Turkey, USA and Zambia.
Most of those in prostitution began prostituting as adolescents. Nadon,
Koverola, and Schludermann (1998) found that 89% had begun prosti-
tution before the age of 16. Of 60 women prostituting in escort, street, strip
club, phone sex,
1
and massage parlors in Seattle, all began prostituting
between the ages of 12 and 14 (Boyer et al., 1993). In Canada, as elsewhere,
most women and men enter prostitution as adolescents (Lowman, 1993).
2
Fifty-two percent of 183 Vancouver women were first prostituted when
they were younger than 16 years, and 70% first prostituted before age 18
(Cunningham & Christensen, 2001). Children typically enter prostitution
subsequent to abusive treatment by caregivers (Lowman, 1993) and
subsequent to running away from dangerous home environments
(Federal/Provincial Territorial Working Group on Prostitution, 1998).
Most people in prostitution were sexually abused as children, usually by
several perpetrators. Farley and colleagues (2003) found an average of four
perpetrators of childhood sexual abuse against those in prostitution in
nine countries. Those in prostitution are often still children (Youth Dele-
gates of Out of the Shadows, 1998). Across nine countries on five conti-
nents, 47% of the people in prostitution entered it when they were less
than 18 years of age (Farley et al., 2003). One girl prostituting in Seattle
said:
We’ve all been molested. Over and over, and raped. We were all molested
and sexually abused as children, don’t you know that? We ran to get away.
They didnt want us in the house anymore. We were thrown out, thrown
away. We’ve been on the street since we were 12, 13, 14. (Boyer et al., 1993,
p. 16)
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The most relevant paradigm currently available for understanding the
harm of prostitution is that of domestic violence. Physical coercion, rape
and violence by husband/partner/pimp and john are perpetrated against
women in prostitution (Currie, 1994; Lowman, 1993; Lowman & Fraser,
1995; Miller, 1995). Of 854 people in prostitution, 73% reported that they
had been physically assaulted in prostitution (Farley et al., 2003). In most
instances, women in prostitution are battered women. Giobbe (1993)
compared pimps and batterers and found similarities in their use of
enforced social isolation, minimization and denial, threats, intimidation,
verbal and sexual abuse, attitude of ownership, and extreme physical
violence to control women.
One survivor described prostitution as a ‘harrowing metamorphosis’
that included frequent physical assaults and which ultimately resulted in a
neutralization of the body’ (Jaget, 1980, p. 188) or somatic dissociation.
The physical and emotional violence of prostitution leads to somatic
dissociation which itself has been regularly associated with chronic health
problems (Kirkingen, 2001). In 1858, Sanger asked 2000 prostitutes in New
York about their health and concluded that premature old age was the
invariable result of prostitution (cited in Benjamin & Masters, 1964).
Today we view the chronic ill health of those in prostitution as resulting
from physical abuse and neglect in childhood (Radomsky, 1995), sexual
assault (Golding, 1994), battering (Crowell & Burgess, 1996), untreated
health problems, and overwhelming stress and violence (Friedman &
Yehuda, 1995; Koss & Heslet, 1992; Southwick, Yehuda, & Morgan, 1995).
Sanger described conditions of despair, degradation, decline, and early
death among women in prostitution who survived, on average only 4 years
from entry into prostitution (Benjamin & Masters, 1964). Making the
same observation in the parlance of today’s global marketplace, an anony-
mous pimp commented on the ‘brief shelf life’ of a girl in prostitution.
Pheterson (1996) summarized the health problems of women in prosti-
tution: exhaustion, frequent viral illness, sexually transmitted diseases,
vaginal infections, backaches, sleeplessness, depression, headaches, stomach-
aches, and eating disorders. The longer women were in prostitution, the
more sexually transmitted diseases they reported (Parriott, 1994). Women
who were used by more customers in prostitution reported a range of
more severe physical symptoms (Vanwesenbeeck, 1994).
Prostitution can be lethal (Potterat et al., 2004). A Canadian
commission found that the death rate of women in prostitution was 40
times higher than that of the general population (Special Committee on
Pornography and Prostitution, 1985). A study of Vancouver prostitution
reported a 36% incidence of attempted murder (Cler-Cunningham &
Christenson, 2001).
Vancouver agencies serving women in prostitution have observed many
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First Nations women in prostitution. We use the words First Nations as a
term of respect for people whose ancestors were the first nations of people
in North America. We use the term Aboriginal interchangeably with First
Nations.
3
In a number of communities across Canada, Aboriginal youth
comprise ‘90% of the visible sex trade’ (Save the Children Canada, 2000,
p. 7), suggesting the importance of placing prostitution in historical
context. Acknowledging the adverse effects of colonialism, Cler-Cunning-
ham and Christenson (2001) observed the ‘immense overrepresentation
of Aboriginal women in Vancouver’s street-level sex trade.
The Royal Commission on Aboriginal Peoples (RCAP) documented
the perilous state of Aboriginal housing: 84% of Aboriginal households
on reserves did not have sufficient income to cover housing (RCAP,
1996). Housing instability results in reserve-to-urban migration, leaving
young women vulnerable to prostitution, in that homelessness has been
established as a primary risk factor for prostitution (Boyer et al., 1993;
Louie, Luu, & Tong, 1991; Silbert & Pines, 1983). When women in prosti-
tution are asked what they need, first on their list is housing (Farley et al,
1998).
Colonization and racism result in extensive and insidious trauma that
wears away its victims’ mental and physical health (Kelm, 1998; Root,
1996). Colonization of First Nations in Canada by the British and the
French resulted in well-documented health problems (Waldram, Herring
& Young, 2000). The combined effects of poverty, race discrimination and
cultural losses profoundly affect First Nations and are likely contributing
factors to high rates of interpersonal violence, depression, suicide and
substance abuse (Kirmayer, 1994).
4
Canadas Royal Commission on Abor-
iginal Peoples referred to premature death as one of the consequences of
colonization:
Aboriginal people are more likely [than non-Aboriginal people] to face
inadequate nutrition, substandard housing and sanitation, unemployment
and poverty, discrimination and racism, violence, inappropriate or absent
services, and subsequent high rates of physical, social and emotional illness,
injury, disability and premature death. (RCAP, 1996, p. 107)
The suicide rate among First Nations people across Canada was three times
that of other Canadians and six times higher for those aged 15–24 years
(Bobet, 1990).
The prevalence of violence against Aboriginal women is extremely high.
The death rate of First Nations women from homicide is more than four
times greater than that of all Canadian women (Health Canada, Medical
Services Branch, unpublished tables, 1995, cited in RCAP, 1996, p 153).
Nahanee (1993) wrote of ‘the almost total victimization of [Aboriginal]
women and children and concluded ‘violence against Aboriginal women
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has reached epidemic proportions according to most studies conducted
over the past few years. This violence includes the victimization of women
and their children, both of whom are seen as property of their men
(husbands, lovers, fathers), or of the community in which they live
(Nahanee, 1993, pp. 360–361). Similarly in the United States, 80% of
indigenous women seeking health care at one clinic reported having been
raped (Old Dog Cross, 1982).
First Nations gay men like First Nations women, are in double jeopardy.
Comparing Canadian Aboriginal and non-Aboriginal gay men,
researchers found that Aboriginal gay men were significantly more likely
to be poor, unstably housed, more depressed, to have been sexually abused
as children, to have been raped, and to have been prostituted (Heath et al.,
1999).
The diagnosis of post-traumatic stress disorder (PTSD) describes
psychological symptoms resulting from overwhelmingly traumatic events
such as rape, war, and prostitution. PTSD can result when people have
experienced ‘extreme traumatic stressors involving direct personal experi-
ence of an event that involves actual or threatened death or serious injury;
or other threat to ones personal integrity; or witnessing an event that
involves death, injury, or a threat to the physical integrity of another
person; or learning about unexpected or violent death, serious harm, or
threat of death or injury experienced by a family member or other close
associate (American Psychiatric Association, 1994). PTSD is characterized
by anxiety, depression, insomnia, irritability, flashbacks, emotional
numbing, and hyperalertness. Symptoms are more severe and long lasting
when the stressor is of human design. PTSD is common among prostituted
women. Farley and colleagues (1998) found a PTSD prevalence rate of
67% among those in prostitution in five countries.
Cultural and social factors are known to have a causal role in PTSD
symptoms (U.S. Department of Health and Human Services, 2001).
Trauma history and PTSD vary by race/ethnicity and national origin with,
for example, refugees from South Asian countries experiencing high rates
of war-related traumatic events (Mollica et al., 1990) and indigenous
peoples in the United States suffering multiple and cumulative trauma
when compared with other groups (Robin, Chester, & Goldman, 1996). In
a study that included a majority of Alaska Native women, 70% of a sample
of pregnant women in substance abuse treatment had experienced child-
hood physical and sexual abuse (Brems & Namyniuk, 2002).
There are many anecdotal accounts and case studies of prostitution
(Farley & Kelly, 2000). We noted the need for quantitative data. This work
was an attempt to expand a quantitative database on prostitution, history
of violence and PTSD that now includes nine countries (Farley et al.,
2003). An analysis of the intersections of race, class and gender is crucial
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to an understanding of prostitution. In reviewing the literature regarding
colonialism, cultural alienation, and violence against First Nations, we
predicted that First Nations women, compared with non-First Nations
women in prostitution, would report increased rates of violence both
during prostitution and in their lives prior to prostitution. Given the
previous findings of extremely high rates of PTSD among those prosti-
tuted, we did not anticipate finding differences in PTSD between First
Nations women and white European-Canadian women in prostitution.
Method
Brief structured interviews of 100 prostituting women and children were
conducted in Vancouver, Canada. We contacted agencies working with
prostitutes and set up collaborative efforts where possible. The second
author was a board member of a Vancouver agency that provided services
to prostitutes and was familiar with locations where prostitution
commonly occurred in Vancouver. She was known to some of our inter-
viewees in her capacity as a social worker. Interviewers were screened for
the ability to establish an easygoing rapport on the street and in occasion-
ally dangerous locations.
The women we interviewed were from the Downtown Eastside,
Franklin, and Broadway/Fraser prostitution strolls in Vancouver, BC. We
attempted to contact any woman known to be prostituting, whether
indoor or outdoors. Using a snowball recruitment technique, we asked
women to let their friends who were prostituting elsewhere (e.g. in other
areas or indoors) know that we would return to a specific location at a
specific time the next day. Usually we had access only to people prostitut-
ing on the street. Only four women refused to participate; several appeared
to be in the process of approaching customers.
Informed consent included a summary of research goals and partici-
pants’ rights. Respondents’ copies of the consent form included names and
phone numbers of local agencies that could be contacted for support and
assistance and included the authors phone numbers and email addresses.
In all cases we offered to read the items to respondents. Most were able to
complete the questionnaire without assistance; however, a few were illiter-
ate.
If respondents indicated that they were prostituting we asked them to
fill out three questionnaires. We paid a small stipend ($10 Canadian) to
those who responded to the three questionnaires. The Prostitution Ques-
tionnaire (PQ), used in similar research in South Africa, Thailand, Turkey,
the USA and Zambia, consists of 32 items asking about physical and sexual
assault in prostitution, lifetime history of physical and sexual violence, and
the use of or making of pornography during prostitution (Farley et al.,
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1998). The questionnaire asked whether respondents wished to leave
prostitution and what they needed in order to leave. We asked if they had
been homeless, if they had physical health problems, and if they used drugs
or alcohol or both. Because of item heterogeneity, psychometrics on the
PQ are not available. Sample items include:
2. Since you’ve been in prostitution, have you been physically assaulted?
14a. When you were a child, were you ever hit or beaten by a parent or
caregiver until you had bruises on your body or were injured in some
other way by them?
16. Did you ever have pictures taken of you while you were working in
prostitution?
19. Have you ever been homeless?
Respondents also completed the PTSD Checklist (PCL), a 17-item scale
that assesses DSM-IV symptoms of PTSD (Weathers, Litz, Herman,
Huska, & Keane, 1993). Respondents were asked to rate the 17 symptoms
of PTSD (see Table 1) on a 5-point scale with 1 = not at all;2=a little bit;
3=moderately;4=quite a bit; and 5 = extremely. Weathers and colleagues
(1993) report PCL test–retest reliability of .96. Internal consistency as
measured by Cronbachs alpha was .97 for all 17 items. Validity of the scale
is reflected in its strong correlations with the Mississippi PTSD Scale (.93),
the PK scale of the MMPI-2 (.77) and the Impact of Event Scale (.90). The
PCL has functioned comparably across ethnic subcultures in the USA
(Keane, Kaloupek, & Weathers, 1996).
Based on previous responses to open-ended questions about health
problems among prostituted women, we constructed a Chronic Health
Problems Questionnaire (CHPQ; Farley et al., 1998). The CHPQ is a
symptom checklist with dichotomous items. Interviewees were asked
whether or not they had symptoms or experienced events commonly
reported by women in prostitution. Sample items included joint pain, jaw
pain, loss of feeling on skin, pain in breasts and head injury. Scale mean
was 17.6, with SD = 8.6. Internal consistency as measured by Cronbachs
alpha was .92 for 36 items.
Once it was apparent that we were interested in hearing about womens
experiences during prostitution, many volunteered information regarding
what prostitution was like for them. Some of their observations are
included here. Whenever an interviewee wanted to talk with us, we
welcomed that and took notes. During this process, referrals were made to
substance abuse treatment centers, First Nations community centers and
medical clinics.
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Participants
We describe all of the 100 interviewees in this study as women, although
one respondent identified as transgendered. This person was included as a
woman with the rest of our respondents. Ages ranged from 13 to 49 years,
with a mean age of 28 years (SD = 7.8 years).
The youngest age at recruitment into prostitution was 10 years. Respon-
dents spent an average of 10 years in escort, massage, and street prostitution
(SD = 7 years). A few respondents had been in prostitution less than a year,
with 4 months being the least amount of time any of our interviewees spent
in prostitution. One woman had been prostituted for 31 years.
With respect to race/ethnicity, 52% were First Nations, 38% were white
European-Canadian, 5% were African-Canadian, and 5% left the question
unanswered. Ethnicity was self-reported. The majority of the 52 First
Nations women described themselves as Native (n = 24), First Nations
(n = 2) or Native Indian (n = 2). Next most often, they described them-
selves as Metis (n = 10), a French word that translates to English as ‘mixed
blood’ and is used to describe people who are of both First Nations and
European ancestries. Historically, the two major colonizers of First Nations
of Canada were the British and the French; therefore most of those called
Metis were First Nations/French or First Nations/British. In current use in
the Downtown Eastside of Vancouver, the word Metis refers to anyone who
is biracial or multiracial. We use the term Metis in its broadest sense and
not as a term that refers to legal status. The First Nations women also
categorized themselves as Cree or Cree Native (n = 3), Cree/French (n = 2),
Ojibwa (n = 2), Aboriginal (n = 2), Native/El Salvador (n = 2),
Blackfoot/Cree (n = 1), Cree/Metis/Mexican (n = 1), and Interior Salish
(n = 1). In order to make statistical comparisons, we collapsed all the fore-
going groups into the category ‘First Nations. Fewer than 10 women
identified themselves by nation, so we were unable to compare nations in
our analyses.
Results
Childhood Violence
Eighty-two percent of our respondents reported a history of childhood
sexual abuse, by an average of four perpetrators. This statistic (those
assaulted by an average of four perpetrators) did not include those who
responded to the question ‘If there was unwanted sexual touching or sexual
contact between you and an adult, how many people in all?’ with ‘tons or
‘I can’t count that high or ‘I was too young to remember. Seventy-two
percent reported that as children, they had been hit or beaten by a care-
giver until they had bruises or were injured.
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Eighty-six percent of these women in Vancouver prostitution reported
current or past homelessness.
Physical and Sexual Violence in Prostitution
Ninety percent of these women had been physically assaulted in prosti-
tution. Of those who reported physical assault, 82% of the perpetrators
were their customers. Eighty-nine percent had been physically threatened
while in prostitution and 67% had been physically threatened with a
weapon. Seventy-eight percent had been raped in prostitution, with 67%
of those raped having been raped more than five times. Seventy-six percent
of those who had been raped had been raped by customers.
Sixty-seven percent of our interviewees reported that pornography was
made of them in prostitution; and 64% had been upset by an attempt to
force them to perform an act that customers had seen in pornography.
Verbal and Emotional Abuse in Prostitution
Eighty-eight percent of the women responding to our questionnaires
reported that they had been verbally abused. One woman commented,‘lots
of [customers] are super-nice at first. Then when the sex act starts, they
get real verbally abusive. Another told us that while legal prostitution
might make her feel safer from physical assaults, it would not change the
verbal abuse and harassment that she knew was intrinsic to prostitution.
Physical Health Problems
Sixty-three percent of these women in prostitution reported health
problems. Common symptoms were memory problems (66%), trouble
concentrating (66%), headaches (56%), dizziness (44%), vision problems
(45%), hearing problems (40%), balance problems (41%), aching muscles
(78%), joint pain (60%), jaw pain (38%), and swelling of limbs (33%).
Cardiovascular symptoms included chest pain (43%), pain/numbness in
hands/feet (49%), irregular heartbeat (33%) and shortness of breath
(60%). Sixty-one percent of these respondents had cold/flu symptoms. In
addition, 35% reported allergies and 32% reported asthma. Twenty four
percent reported both painful menstruation and vaginal pain. Twenty
three percent had breast pain. In response to a general query about health,
30% of the women we interviewed reported hepatitis C. Some of the
cardiovascular, neurological and joint complaints may have been
symptoms of drug withdrawal.
Seventy-five percent of the women reported physical injuries from
violence in prostitution. Many reported stabbings and beatings,
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concussions and broken bones (broken jaws, ribs, collar bones, fingers,
spinal injuries, and a fractured skull), as well as cuts, black eyes, and ‘fat
lips.
5
Fifty percent of these women had head injuries resulting from
violent assaults with, for example, baseball bats and crowbars. Many had
their heads slammed against walls and against car dashboards. Customers
and pimps regularly subjected then to extreme violence when they refused
to perform a specific sex act.
Post-Traumatic Stress Disorder
PTSD consists of three types of symptoms: (1) persistent, intrusive re-
experiencing of trauma; (2) numbing of responsiveness and persistent
avoidance of stimuli associated with trauma; and (3) persistent autonomic
hyperarousal. A diagnosis of PTSD requires at least one intrusive
symptom, three numbing/avoidance symptoms, and two hyperarousal
symptoms, as well as having experienced a traumatic stressor (criterion A).
Criterion A requires having experienced or witnessed an event or events
involving actual or threatened death or serious injury, or a threat to the
physical integrity of self or others, and reacting with intense fear, helpless-
ness, or horror to these events (American Psychiatric Association, 1994).
Attempted rape is commonly accepted as meeting criterion A for diagnosis
of PTSD (Avina & O’Donohue, 2002). Ninety percent of our respondents
had themselves been physically assaulted in prostitution. Based on
previous findings we concluded that all of our respondents met criterion
A by having experienced or witnessed serious injury.
We summed respondents’ ratings across the 17 items of the PCL, gener-
ating an overall measure of PTSD symptom severity that was previously
used by the scales authors. Mean PCL score for our respondents was 55.7
(SD = 15.6).
Using Weathers et al.s (1993) formulation we considered a score of 3
(moderately), 4 (quite a bit) or 5 (extremely) on a PCL item to be a
symptom of PTSD. Eighty-nine percent of our respondents endorsed at
least one intrusive symptom of PTSD, 81% endorsed at least three
numbing and avoidance symptoms of PTSD, and 85% endorsed at least
two of the physiologic hyperarousal symptoms of PTSD. The mean scores
for these 100 women in prostitution were within the clinically symptom-
atic range (3 or greater) on two of the five intrusive symptoms, for all seven
of the numbing/avoidance symptoms, and all five of the hyperarousal
symptoms of PTSD. See Table 1 for mean scores of each of the 17 PCL
items. Seventy-two percent of our respondents met criteria for a PTSD
diagnosis.
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History of Violence and PTSD
We investigated four types of lifetime violence experienced by these inter-
viewees: childhood sexual assault, childhood physical assault, rape in adult
prostitution, and physical assault in adult prostitution. Eighty-nine
percent reported childhood sexual assault, 72% reported childhood
physical assault, 92% reported rape in adult prostitution, and 90%
reported physical assault in adult prostitution. Four percent of the sample
had experienced only one type of lifetime violence, 11% reported two
types, 23% reported three types, and 62% reported experiencing all four
types of lifetime violence.
PTSD diagnosis and severity were not related to number of types of
lifetime violence as would normally be expected. These respondents
extremely high incidence of lifetime violence created a ceiling effect.
Because 85% of the sample experienced three or four types of lifetime
violence, there were not enough people in the group who experienced only
Transcultural Psychiatry 42(2)
252
TABLE 1
PTSD symptoms of 100 Vancouver women in prostitution
Percent
responding at
PTSD symptom
PTSD symptom Mean SD level (%)
Intrusive re-experiencing (B symptoms)
Memories of trauma from the past 3.1 1.3 64
Dreams of trauma from the past 2.8 1.4 54
Act/feel as if traumatic event were happening again 2.8 1.3 53
Very upset when reminded of trauma from past 3.5 1.2 76
Physical reactions to memories of past trauma 2.6 1.4 52
Numbing and avoidance (C symptoms)
Avoid thinking or feeling about past trauma 3.5 1.4 76
Avoid activities which remind you of past trauma 3.4 1.4 68
Trouble remembering parts of trauma from past 3.1 1.5 65
Loss of interest in activities you used to enjoy 3.8 1.3 78
Feeling distant or cut off from people 3.7 1.4 72
Emotionally numb; unable to have loving feelings 3.4 1.5 70
Feel as if future will be cut short 3.4 1.5 68
Hyperarousal (D symptoms)
Trouble falling or staying asleep 3.1 1.4 67
Feeling irritable or having angry outbursts 3.3 1.5 64
Difficulty concentrating 3.3 1.3 72
‘Superalert’ or watchful or on guard 3.6 1.3 81
Feeling jumpy or easily startled 3.3 1.5 66
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one or two forms of lifetime violence (15%) to determine whether there
was a relationship between PTSD severity and number of different types
of lifetime violence.
Current Needs of Interviewees
Ninety-five percent of these respondents stated that they wanted to leave
prostitution. Eighty-two percent expressed a need for drug or alcohol
addiction treatment. They voiced a need for job training (67%), a home
or safe place (66%), individual counseling (58%), self-defense training
(49%), health care (41%) and peer support (41%). Thirty-three percent
needed legal assistance, 32% wanted legalized prostitution, 12% needed
childcare, and 4% wanted physical protection from pimps.
Differences with Respect to Race/Ethnicity
We compared First Nations women with European-Canadian women in a
number of analyses. Table 2 summarizes these comparisons. Childhood
sexual abuse was reported significantly more often by interviewees identi-
fying as First Nations than by those describing themselves as European
Canadian (χ
2
(1) = 5.2, p = .02). Of those First Nations women reporting
sexual abuse, relatives were specified as perpetrators 41% of the time, adult
friends or community members were specified as perpetrators 34% of the
time, and an older child was specified as perpetrator 25% of the time.
Significantly more First Nations women than European-Canadian women
reported childhood physical abuse (χ
2
(1) = 5.6, p = .02).
Farley et al.: Prostitution in Vancouver
253
TABLE 2
Comparison of First Nations and European-Canadian women: Childhood
physical and sexual abuse, homelessness, and violence in prostitution
First Nations European-Canadian
% (n = 52) % (n = 38) χ
2
p
Childhood physical abuse* 81 (42) 58 (22) 5.6 .02
Childhood sexual abuse* 96 (50) 82 (31) 5.2 .02
Verbal abuse in prostitution 88 (45) 92 (35) 1.0 .30
Physical abuse in prostitution 88 (46) 89 (34) .02 .88
Raped in prostitution 92 (48) 92 (35) .00 .97
Threatened with a weapon 63 (33) 66 (25) .16 .69
Homelessness 83 (43) 87 (33) .43 .51
Upset by being forced to 69 (36) 58 (22) 1.2 .28
imitate pornography
Had pornography made of them 65 (34) 60 (23) .49 .48
*p < .05.
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There were ethnic differences in response to a needs assessment. See
Table 3. First Nations women indicated a significantly greater need for self-
defense training (χ
2
(1) = 7.4, p = .006), a greater need for peer support
(χ
2
(1) = 6.3, p = .01), a greater need for job training (χ
2
(1) = 4.6, p = .03),
and for individual counseling (χ
2
(1) = 3.9, p = .05).
We found no race/ethnic differences in the frequency of health problems
endorsed on the Chronic Health Problems Questionnaire (F(1,82) = .06,
p = .81).
First Nations women in the sample were not more likely than European
Canadians to qualify for a diagnosis of PTSD (χ
2
(1) = .01, p = .92) nor
was there a significant statistical relationship between PTSD severity, as
measured by the mean PCL sum score and First Nations heritage (Pearson
r = –.02, p = .86).
Discussion
The clinical expression ‘hypervigilance does not adequately describe the
physical terror and despair we witnessed in many of these women. Violence
seemed to be in the very air they breathed. Our findings document this
extreme level of sexual violence. One woman told us that she was continu-
ally raped in prostitution, explaining ‘what rape is to others, is normal to us.
Another woman, aged 36, described a rape as the ‘defining experience’ of her
life. At age 16 she was raped at knifepoint after which the rapist gave her a
gold chain in effect paying her for the rape and defining her as a prostitute.
Transcultural Psychiatry 42(2)
254
TABLE 3
Responses to ‘What do you need?’ asked of women in prostitution
First Nations European-Canadian
Need % (n = 49) % (n = 36) χ
2
p
Drug or alcohol treatment 88 (43) 75 (27) 2.3 .13
Job training* 78 (38) 56 (20) 4.6 .03
Individual counseling* 67 (33) 44 (16) 3.9 .05
Self-defense training** 63 (31) 33 (12) 7.4 .006
Home or safe place 61 (30) 75 (27) 1.3 .25
Peer support* 53 (26) 25 (9) 6.3 .01
Medical or health care 41 (20) 36 (13) .2 .66
Legal assistance 33 (16) 28 (10) .2 .63
Legalized prostitution 24 (12) 36 (13) 1.3 .24
Childcare 16 (8) 8 (3) 1.2 .28
Physical protection from pimp 4 (2) 3 (1) .1 .75
Note. Five participants did not respond to these questions.
*p < .05; **p < .01.
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Most of our respondents had been physically assaulted (90%) or raped
(78%) in prostitution. A fear of men was pervasive. One woman told us
that being hit and bruised were ‘just your common aggressiveness from
men. In a separate study of Vancouver prostitution, 68% of women had
been recently raped, 72% had been kidnapped, and 89% had had
customers refuse condoms in the previous year (Cunningham & Christen-
son, 2001).
For many of our interviewees, accommodation to violence began in
childhood. Most women in this study (82%) reported sexual abuse as
children, usually with multiple perpetrators. Currie (1994) found a
comparable prevalence of childhood sexual abuse (73%) among 600
women prostituting in Vancouver. Benoit and Millar (2001) noted a 55%
incidence of childhood sexual abuse among 201 women prostituting in
Victoria, BC. A Toronto study noted that many women who were prosti-
tuting cited persistent abuse as precipitating their drug use (Butters &
Erickson, 2003).
Cler-Cunningham and Christenson (2001) reported that 85% of 183
women in Vancouver prostitution had been verbally or physically harassed
more than once in the past year. The verbal abuse in prostitution is socially
invisible just as other sexual harassment in prostitution is normalized and
invisible. Yet it is pervasive: 88% of our respondents described verbal abuse
as intrinsic to prostitution. Customers’ verbal assaults in all types of prosti-
tution are likely to cause acute and long-term psychological symptoms. A
woman in another study explained this: ‘It is internally damaging. You
become in your own mind what these people do and say with you. You
wonder how could you let yourself do this and why do these people want
to do this to you?’ (Farley, 2003b). The verbal abuse against prostituted
women is reflected in the names that all women are called by violent men
during sexual assaults. The epithets seem intended ‘to humiliate, to eroti-
cize, and to satisfy an urge for self-justification.’ (Baldwin, 1992, p. 60).
The 72% incidence of current PTSD in these women in prostitution is
among the highest reported in populations where PTSD has been studied,
including battered women, combat veterans, childhood trauma survivors,
rape survivors, and torture survivors (Bownes, O’Gorman, & Sayers, 1991;
Farley et al., 1998; Feeney, Zoellner, & Foa, 2000; Houskamp & Foy, 1991;
Kemp, Rawlings, & Green, 1991; Ramsay, Gorst-Unsworth, & Turner, 1993;
Weathers et al., 1993). Rates of PTSD among these prostituted women
from Canada did not differ significantly from prostituted women in other
countries including South Africa, Thailand, Turkey, the USA and Zambia
(F(5,575) = .95, p = .45). The mean PCL score (56) of these prostituted
women was in the same range (51–56) as that of people in prostitution in
South Africa, Thailand, Turkey, the USA and Zambia (Farley et al., 1998)
and similar to the mean PTSD score (51) of treatment-seeking Vietnam
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veterans (Weathers et al., 1993) and much higher than means in studies of
Persian Gulf War veterans (35, Weathers et al., 1993), and women HMO
members with and without childhood physical and sexual abuse (24–37,
Farley & Patsalides, 2001).
When we compared European-Canadian women with First Nations
women we did not find differences in PTSD. The pervasiveness and
severity of trauma exposure experienced by these women in prostitution
may have obscured differences in PTSD that would otherwise be expected
on the basis of race/ethnicity. Our findings are consistent with two studies
that failed to find race differences in PTSD symptoms among combat
veterans (Beals et al., 2002; Monnier, Elhai, Frueh, Sauvageot, & Magruder,
2002). In these studies, combat (like prostitution) was the overwhelmingly
traumatic event that mitigated differences in PTSD based on race.
Our respondents appeared to be in a state of almost constant revictim-
ization. The assaults against these women in prostitution were part of a
lifetime surround of exploitation and abuse. Because of this pervasive
violence we cannot separate the effects of childhood and adult violence on
current PTSD symptoms. It is likely that experiences of violence over the
course of one’s lifetime have a cumulative effect on PTSD symptoms
(Follette, Polusny, Bechtle, & Naugle, 1996). Other research found that a
history of sexual assaults is a common precursor to prostitution. West,
Williams, and Siegel (2000) found that women were most likely to prosti-
tute if they had experienced both sexual abuse as children and were later
revictimized by rape as adults. One young woman told Silbert and Pines
(1982, p. 488), ‘I started turning tricks to show my father what he made
me. Dworkin (1997, p. 143) described incest as ‘boot camp for prosti-
tution.
Fifty-two percent of our respondents were First Nations women, a lower
percentage than the 70% of First Nations women in street prostitution in
another Vancouver study (Currie, 1994, reported in Federal/Provincial
Territorial Working Group, 1998). In population census estimates, 7% of
Vancouver’s people are First Nations (Vancouver/Richmond Health Board,
1999). The overrepresentation of First Nations women in prostitution, and
prostitutions prevalence in an area of Vancouver with a high proportion
of First Nations residents reflects not only their poverty, but also their
marginalized and devalued status as Canadians. Others report similar
findings. For example 15% of women in escort prostitution in Victoria, BC
were First Nations although the First Nations population of Victoria has
been estimated at 2% (Benoit & Millar, 2001 p. 18).
In New Zealand, Plumridge and Abel (2001) observed that 7% of the
Christchurch population were Maori women but 19% of those in
Christchurch prostitution were Maori women. Maori in prostitution were
significantly more likely than European-ancestry New Zealanders to have
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experienced homelessness and to have entered prostitution as children
(Farley, 2003a). As we did in Vancouver, New Zealand researchers sampled
from the poorest community in Auckland and reported that twice as many
Maori there were in prostitution (40%) compared with their represen-
tation in northern New Zealand generally (21%) (Saphira & Herbert,
2003). In the early 1990s, Atayal and other Aboriginal girls comprised 70%
of those in Taiwanese debt-bondage prostitution although they were only
1.8% of the total population (Hwang & Bedford, 2003). The researchers
noted that pathways into prostitution for Aboriginal Taiwanese adoles-
cents were similar to those pathways elsewhere: globalization of the
economy, social and cultural disruption, race/ethnic discrimination, and
extremely high levels of family violence.
For women, prostitution is intimately associated with poverty. Its First
Nations residents refer to Vancouver’s Downtown Eastside, one of the
poorest areas in North America, as the ‘urban reserve. Colonization left
many First Nations people in extreme poverty that has endured for gener-
ations (LaFramboise, Choney, James, & Running Wolf, 1995). Eighty-six
percent of our respondents were currently or previously homeless. First
Nations youth who leave their home communities for urban areas are
particularly vulnerable to sexual exploitation in that they are both
homeless and in an unfamiliar cultural environment (Federal/Provincial
Working Group, 1998). Although we do not yet have data to confirm this,
we suspect that First Nations women are more likely to be overrepresented
in the poorest types of prostitution – street and massage – than in strip
club, phone sex, and Internet prostitution. The first author observed that
in Mexico City, Mayan women were often sold in prostitution for the
lowest price and were made available for more violent sex acts, such as anal
rapes, that other women refused to perform.
Analyzing the effects of racism is central to an understanding of prosti-
tution. Racism has a profound effect on health (Williams, Lavizzo-Mourey,
& Warren, 1994; Turner & Kramer, 1995). For example a U.S. report
located more than 175 studies documenting race/ethnic disparities in
diagnosis and treatment of medical conditions (Institute of Medicine,
2002). Reflecting poverty, malnutrition, chronic stress and inadequate
health care, premature aging is commonplace in the Downtown Eastside
where one neighborhood center categorizes anyone over age 40 as a senior.
The vulnerabilities of race, class and gender have been recognized as multi-
plicative risk factors for HIV (Osmond et al., 1993), and we think that they
are also multiplicative risk factors for prostitution. In Canada, the triple
force of race, class and sex discrimination disparately impacts First Nations
women. Prostitution of Aboriginal women occurs globally in epidemic
numbers with indigenous women at the bottom of a racialized sexual hier-
archy in prostitution itself. This phenomenon has been observed by others
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(Grant, Grabosky, & David, 1999; Ministry of Foreign Affairs and Trade,
2001; UNICEF, 2004).
For many, the experience of prostitution stems from the historical
trauma of colonization. Imposing a sexist and racist regime on First
Nations women, colonization simultaneously elevated male power within
the colonized community (Fiske, 1995). Today, many First Nations women
are dominated by a newly evolved state of traditional governance that
replaced more egalitarian systems (Brunen, 2000). The cultural destruc-
tion of positive roles for First Nations men and their subsequent identifi-
cation with supremacist attitudes have had disastrous consequences for
First Nations women, with astronomical rates of incest, rape and husband
violence.
Freire (1994) described the colonial destruction of positive roles for
men as resulting in adhesion to the oppressor’ (p. 27). Dworkin also
discussed the harm inflicted on women by colonized men:
The stigma of the prostitute allows the violent, the angry, the socially and
politically impoverished male to nurse a grudge against all women, includ-
ing prostituted women; this is aggressive bias, made rawer and more danger-
ous by the need to counter ones own presumed inferiority. (Dworkin, 2000,
p. 325)
Sexual violence and other family violence are major social problems in
First Nations communities. A Dene woman described communities in
which the entire female population had been sexually assaulted by men.
She had been threatened with further violence if she spoke out against this
(Lynne, 1998, p. 43). Consistent with others’ reports, First Nations women
in our study were significantly more likely than non-First Nations to report
childhood physical and sexual abuse.
There is an urgent need for further exploration of these connections
between gender, race/ethnicity, and class in prostitution not only in
Canada but elsewhere (Bourgeault, 1989). Prostitution is one specific
legacy of colonization although it is infrequently analyzed as such (Lynne,
1998; Scully, 2001). A perspective that understands prostitution to be
colonization of First Nations women by both First Nations and non-First
Nations men may be helpful in addressing the problem.
The RCAP report suggested that a general health strategy for First
Nations should involve equitable access to health services, holistic
approaches to treatment, Aboriginal control of services, and diverse
approaches that respond to cultural priorities and community needs
(RCAP, 1996). These four strategies are applicable to the healing of women
escaping prostitution. Models for healing of First Nations women in
prostitution would include a decolonizing perspective that analyzes
historical trauma, violent crimes, family violence, child abuse and neglect,
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discrimination, unresolved grief and mourning. Cultural moderators of
these traumatic experiences that would promote healing include
family/community support, traditional spiritual practices and medicine,
and a positive indigenous identity (Walters, Simoni, & Evans-Campbell,
2002). A study of the needs of Vancouver prostituted women underscores
these recommendations (Benoit, Carroll, & Chaudhry, 2002). A Toronto
study of 30 prostituting women emphasized their need for mental health
services, including drop-in crisis centers open at night as well as hotlines
staffed by peers (Butters & Erickson, 2003). Access to alternative employ-
ment that would generate sustainable income is necessary in order to
remove the economic motivation for prostitution.
In our opinion, western medical treatment of PTSD is best combined
with traditional healing for First Nations women who want to escape
prostitution. The Peguis First Nation community in Manitoba found that
a combination of traditional and western healing approaches was
especially effective for those who suffer from emotional problems, includ-
ing those related to alcohol and drug abuse, violence and suicide (Cohen,
cited in RCAP, 1996).
Women in prostitution self-medicate for depression and PTSD with
drugs and alcohol.
6
An urgent need for treatment of drug and alcohol
addiction was voiced by 82% of those we interviewed. An approach that
simultaneously treats substance abuse and PTSD has proven more effec-
tive than treatment that only treats substance abuse and fails to address
PTSD (Epstein, Saunders, Kilpatrick, & Resnick, 1998; Najavits, Weiss,
Shaw, & Muenz, 1998; Ouimette, Kimerling, Shaw, & Moos, 2000). Women
in prostitution who are dealing with addictions are not likely to benefit
from treatment in mixed-gender groups. It is unsafe for them to discuss
prostitution in the traditional 12-step setting, because men regularly
proposition them as soon as the women are known to have prostituted.
Furthermore, confidentiality is a concern in communities where everyone
is either related or knows one another (Rees, 2001).
Any intervention for those in prostitution must first acknowledge prosti-
tution as a form of violence. As with battered women, physical safety is a
critical concern. In order to address the harm of prostitution it is necessary
to use education, prevention and intervention strategies similar to those
dedicated to other forms of gender-based abuse such as rape and intimate
partner violence. This understanding of prostitution as violence against
women must then become a part of public policy and it must be struc-
turally implemented in public health care, mental health services, homeless
shelters, rape crisis centers and battered womens shelters (Stark &
Hodgson, 2003). The healthcare provider must become not only culturally
competent regarding differences between nations in culture and language
but also acquainted with community services and anti-violence resources
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(Polacca, 2003). In the United States there is the additional complexity of
jurisdictional confusion. Tribal courts may lack the means and the will for
strong prosecution of perpetrators of violence. Tribal jurisdiction some-
times conflicts with federal law enforcement, and perpetrators may be
aware that there are minimal consequences for violence against women
(National Sexual Violence Resource Center, 2000; Polacca, 2003).
Caution is warranted in interpreting these results because we ran
multiple post-hoc analyses on this data, which has not been statistically
corrected for the increased probability of finding significant results when
multiple analyses are performed. Nonetheless, we are confident that the
trends we have described are accurate and that they warrant further
investigation.
Because of the ongoing trauma of prostitution and homelessness it is
likely that some of these women minimized childhood violence. To review
a history of trauma while in the midst of ongoing abuse was likely to have
been too painful for some. Some of these women did not categorize
juvenile prostitution as childhood sexual abuse.
7
Others minimized
violence they had experienced by comparing it with that suffered by
friends. One woman told us that since she had no broken bones and had
not been assaulted with a weapon, therefore her rape and strangulation by
a john did not count as much. Thus we assume that the reporting of
trauma history among our respondents is conservative and that the actual
prevalence of traumatic events, health symptoms, and PTSD symptoms is
likely to be higher than reported here. Some women we interviewed were
obviously intoxicated. This does not decrease our confidence in the
accuracy of these results. Along with others we have noted that addicts
report life events with as much accuracy as non-addicts do (Bonito, Nurco,
& Shaffer, 1976).
No study of prostitution can claim a representative or random sample,
given the illegality of prostitution in most locations. There is quite simply
no such thing as a representative sample of women selling sex’ (McKeganey
& Barnard, 1996). We interviewed those people to whom we had access. In
most cases we and other researchers have access only to people prostitut-
ing on the street. That said, we made every attempt to contact any woman
known to be prostituting, indoors or outdoors. We did this by asking
women to tell friends who were prostituting elsewhere (e.g. in other areas
or from their homes or clubs) that we would return to a certain location
at a specific time the next day. Interviewees often reported involvement in
prostitution across multiple locations, for example, strip club, escort and
massage parlors as well as street prostitution.
8
As shown in these findings, prostitution is a sexually exploitive often-
violent economic option most often entered into by those with a lengthy
history of sexual, racial and economic victimization. Prostitution is only
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now beginning to be understood as violence against women and children.
It has rarely been included in discussions of sexual violence against First
Nations.
9
It is crucial to understand the sexual exploitation of First Nations
women in prostitution today in a historical context of colonial violence
against nations (Frideres, 1993; Ryser, 1995; Waldram, 1997). Today, the
continued displacement of women who are poor, rural and indigenous
may be understood as trafficking in which women are moved from the
reserve to the city for the purpose of prostitution (Lynne, 1998).
Just as wife beating was historically viewed as having been provoked by
the victim, prostitution is still viewed by some as a job choice to which the
victim ‘consents.’ Ninety-five percent of our interviewees said that they
wanted to escape prostitution, while also telling us that they did not feel
that they had other options for survival. Another report found that 90%
of women in prostitution wanted to leave prostitution but could not
(Elizabeth Fry Society of Toronto, 1987). Social scientists have begun to
address the harms of incest, rape and family violence. We hope to see more
research that examines prostitution as part of the surround of violence
against women, specifically including First Nations women. We also hope
to see investigations of interventions that promote healing from prosti-
tution.
Acknowledgements
Thanks to Rudolph Ryser, PhD, Center for World Indigenous Studies, Olympia,
Washington, for invaluable information about colonization and geopolitics.
Notes
1. In phone sex, a person verbally provides explicit sex talk for pay for a
customer who typically masturbates during the call. It can include what in
other settings would be verbal sexual harassment, as well as sexist and racist
epithets and other verbal abuse. Commonly, women who engage in phone
sex, like women in strip clubs, also prostitute in other ways.
2. British Colombia surveys found the average age of entry into prostitution to
be 14–15.5 years, and a Vancouver survey found average age of entry into
prostitution to be 16.3 for girls and 15.6 for boys (Lowman & Fraser, 1989).
3. Aboriginal and First Nations, are words used to refer to indigenous peoples
of Canada. No doubt some will disagree with our choice of terms. We are not
using terminology that refers to a persons legal status. Instead, we are
attempting to use respectful words as spoken by both insiders and outsiders
in the Downtown Eastside community of Vancouver. When an author in a
cited work uses the term Aboriginal, we use the word Aboriginal in connec-
tion with their work. However, we prefer not to use the term Aboriginal
because the Oxford Dictionary currently lists a second descriptor for the word
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Aboriginal as ‘primitive. We use the term First Nations interchangeably with
Aboriginal throughout the article, as Brunen does in her 2000 article on the
marginalization of Aboriginal women with addictions in the Canadian
healthcare system.
4. Similar health consequences of colonialism on indigenous people are seen in
health data from the United States. American Indians and Alaska Natives have
the second highest infant mortality rate in USA, and the suicide rate of
American Indians is 50% higher than the national rate (U.S. Dept of Health
and Human Services, 2001, p. 82; U.S. Dept of Health and Human Services,
2001a, p. 17).
5. Other descriptions of violence included:
[I have a] long history of physical abuse. I was beaten by my mother’s
boyfriend, ran away from home to a pimp who beat me, I left him for
a man who beat me up, and so on....
A 13-year-old told us she had: ‘disalignment in my neck, cuts, and
scratches, bruises caused by bad dates. Also deafness.
A stalker hit me with his car on purpose.
Date tried to assault me with steel-toed boots because I wouldn’t do
something he wanted.
A bad date hit my head on a wall.
I was beaten with stones by a couple of women.
[A pimp] locked me in a room and beat me 30 times with baseball bat.
My boyfriend pushed me downstairs and broke my arm, [I’ve had]
multiple beatings by various boyfriends, broken kneecaps, broken
limbs. I’m scared of men.
Two years ago, I was beat and raped for 45 minutes.
6. Wayne Christian, Director of the First Nations Round Lake Treatment Centre
in Armstrong noted that most of his clients have used drugs and alcohol to
deaden the pain of emotional and physical trauma. ‘Up to 95% of clients at
Round Lake reported a history of some kind of trauma, personal trauma,
whether it was residential school, sexual abuse, physical violence, abandon-
ment – those types of issues . . .’ (Rees, 2001).
7. One woman at first answered ‘no to the question, before you were 18 years
old, did you experience any unwanted sexual touching or any sexual contact
between you and a grown up?’ Then she thought about it briefly and asked
(without interviewer prompt): ‘does this question mean for when I was
prostituting underage?’ After the interviewer said yes, the young woman said
every time a john touches me, it’s unwanted. She started prostituting at
age 12.
8. Although there is a common misconception that street prostitution is the
most harmful type of prostitution, there is no research evidence for this. In
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fact, women have told us that they felt safer in street prostitution compared
with legal brothels or massage parlors where they were not permitted to reject
customers for any reason. Others commented that on the street they could
refuse dangerous-appearing or intoxicated customers. Some told us that they
considered it a deterrent to violence when a friend made a show of writing
down the johns car license plate number. Raphael and Shapiro (2002) noted
that women in Chicago reported the same frequency of rape in escort and in
street prostitution. Although more physical violence was reported in street
compared with brothel prostitution in South Africa – there was no difference
in the incidence of PTSD in these two types of prostitution, suggesting that
the experience of prostitution is intrinsically traumatizing (Farley et al.,
1998). A Canadian study comparing strip club and street prostitution found
that women prostituting in strip clubs had significantly higher rates of disso-
ciative and other psychiatric symptoms than those in street prostitution
(Ross, Anderson, Heber, & Norton, 1990). Strip club/massage, brothel and
street prostitution were compared in Mexico. There were no differences in the
incidence of physical assault and rape in prostitution, childhood sexual abuse
or symptoms of PTSD, and no differences in the percentages of women in
brothel, street, or strip club/massage prostitution who wanted to escape
prostitution (Farley et al., 2003).
We have begun inquiry about different locations where prostitution
occurs. A checklist rather than open-ended questions about location of
prostitution is recommended. In a 2003 study, Farley used the following list
of categories of prostitution, asking each participant regardless of the location
of the current interview, to check off each kind of prostitution she had previ-
ously been in. Types of prostitution included: escort, massage, phone sex,
street, Internet, brothel, prostitution as a child under age 18, strip club, bar,
table dance club, peep show, prostitution associated with a military base,
trafficked (moved) from another country to New Zealand for prostitution,
trafficked (moved) from one part of New Zealand to another for prostitution,
and other. Kramer (2003) found a range of street, escort and strip club prosti-
tution experiences among interviewees in southwestern USA. Across these
three types of prostitution, 90% of Kramer’s respondents described the
experience of prostitution as negative or traumatic. We suggest that any study
of prostitution report the length of time in prostitution and the number of
customers seen by respondents. These factors, more than the physical location
of the prostitution, are correlated with harm (Parriott, 1994; Vanwesenbeeck,
1994).
9. Not only has there been a lack of attention to prostitution as a form of
violence against First Nations women, but the RCAP report has been
generally criticized for its failure to take into account the viewpoint of Abor-
iginal women (Frideres, 1996). Frideres in the same article also comments
that two-thirds of the presenters at the RCAP hearings were male (Note 18,
p. 264).
Farley et al.: Prostitution in Vancouver
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M
ELISSA FARLEY, PhD completed the edited volume Prostitution, Trafficking, and
Traumatic Stress in 2003. She is a clinical and research psychologist whose research
on prostitution has been used by states’ governments, advocates and organizations
providing services to prostituted and trafficked women. Address: Prostitution
Research and Education, P.O. Box 16254, San Francisco CA 94116–0254, USA.
[E-mail: mfarley@prostitutionresearch.com]
J
ACQUELINE LYNNE, MSW is a social worker in the field of addictions.
A
NN COTTON, PsyD is a clinical psychologist at the Addiction Treatment Center,
VA Puget Sound Health Care System, Seattle, Washington. She is also acting
instructor for the Department of Psychiatry and Behavioral Sciences, University
of Washington School of Medicine.
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... stress associated with the activity, social shame, and stigma); and aspects related to physical health (e.g. sexually transmitted infections (STIs), HIV/AIDS, effects of substance abuse, etc.) (Ulibarri et al. 2014;Harris, Nilan, and Kirby 2011;Farley, Lynne, and Cotton 2005;Surrattet al. 2004;Dalla, Xia, and Kennedy, 2003). In past years, people engaged in farming, hunting, and other menial jobs with their households in order to earn a living, but the age of technology and the current situation in Nigeria have changed peoples' mindset. ...
... Rossler et al. (2010), in their study of the mental health of sex workers in Switzerland, found that posttraumatic stress disorder, depression, and anxiety were the most frequent and common mental health challenge confronting sex workers, and this could advance to a stage that harms their physical health. Some studies evaluated the presence of psychological changes among sex workers and found that prostitutes have challenges with memory and concentration, unlike non-prostitutes (Farley, Lynne, and Cotton 2005;Gilchrist et al. 2001), as well as challenges with sleeping (incidence of 79%), irritability (64%), anxiety (60%), phobias (26%), panic attacks (24%), compulsions (37%), obsessions (53%), fatigue (82%), and concerns with physical health (35%) (Gilchrist et al. 2001). People who engage in begging also have to strategize on how best to operate in their day-to-day activities. ...
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The impact of the problems of destitution and prostitution on the moral fabric of society cannot be overemphasized and thus calls for the attention of the relevant stakeholders (the government, civil society, and professionals) in restoring moral values and decency to our societies. This study is centered on the psychological, social, and economic impact that the activities of the destitute and prostitutes have both on the individual and the society at large. The study found that many individuals resort to begging on the streets because they are either physically challenged, lack basic necessities for decent living, have many dependents, or are the breadwinners of their families while at the same time receive little or no support from family and friends. While the above was the case for the destitute, others engaged in prostitution due to peer pressure, financial pressure from family and friends, greed, and marital issues, etc. It was also found that the problems of destitution and prostitution tend to be more prevalent in urban areas due to the increasing levels of economic activities in the cities, which therefore leads to more patronage. To avert the negative effects of the problems of destitution and prostitution in society and to completely wean those involved away from it, the study recommends the coordination of efforts by the government, psychologists, and social workers to help train and equip the victims with the skills necessary to assist them in forgoing their old lifestyle completely.
... Researches mentioned that depression, anxiety, post-traumatic stress disorders (fear, insomnia, irritability, emotional numbness and memory flickers (Farley et al. 2005). and suicidal ideation. ...
... Researches mentioned that depression, anxiety, post-traumatic stress disorders (fear, insomnia, irritability, emotional numbness and memory flickers (Farley et al. 2005). and suicidal ideation. ...
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Prostitution has been a part of human culture since ancient times, and it is still practiced practically everywhere in the world, though it is considered a sin in some countries (Tome et al. 2015). The presence of sex labour has been a source of concern for civilizations throughout history. It’s also one of the most complicated topics in feminist rhetoric. Prostitution has been characterized as the practice of offering one’s body for licentious sexual intercourse for hire, among other things. Sex work is the process of exchanging sex for the sake of money or drugs resulting in a far-reaching social, psychological, and medical consequences. Considering it as a crucial issue places women participants as pawns in the male dominating societies. Being sex work illegal in many countries, this industry has been driven underground thus leaving sex workers legally vulnerable section. Female sex workers are chiefly vulnerable to violence due their status, that might be unlawful, resulting in their marginalization. Commercial sex workers are linked with multiple psychosocial vulnerabilities such as childhood physical abuse and childhood sexual abuse experience, interpersonal violence, and substance use (Burnette et al., 2008). The main reason for sex workers’ undercoverage in India is an unfavourable legal environment and discrimination against women in particular. Women engaged in sex work within society occupy a marginalized position and face social, economic and psychological difficulties (Smirnova, 2012). There is little attention for their specific health needs, especially regarding their psychosocial health (Susan & Asir, 2014).
... 99 A prostituting woman explained, 'what rape is to others is normal to us'. 100 Because of its extremely high rates of rape, prostitution can be challenged as a violation of human rights conventions that assert women's rights to be free from rape and prostitution. Rape has been designated a crime against humanity by the International Criminal Court. ...
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This article describes the connections between resource extraction, prostitution, poverty, and climate change. Although resource extraction and prostitution have been viewed as separate phenomena, this article suggests that they are related harms that result in multiple violations of women's human rights. The businesses of resource extraction and prostitution adversely impact women's lives, especially those who are poor, ethnically or racially marginalised, and young. The article clarifies associations between prostitution and climate change on the one hand, and poverty, choicelessness, and the appearance of consent on the other. We discuss human rights conventions that are relevant to mitigation of the harms caused by extreme poverty, homelessness, resource extraction, climate change, and prostitution. These include anti-slavery conventions and women's sex-based rights conventions.
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Violence against women is a growing health problem, especially when perpetrated in intimate relationships. Despite increasing attention, there is little comparative evidence on the different types of violence involved and there is a paucity of research on sexual femicides. This study examines cases of violence against women in northern Italy, focusing on sexual and non-sexual femicides and comparing them with rape that does not result in femicides. The sample included 500 women who were victims of sexual and non-sexual femicides, and of rape. Results show sexual femicides mostly involved unknown victims or women who were prostitutes. Sexual femicidal offenders used improper weapons to kill their victims, acted in secluded locations, and fled the crime scene; their crime was more likely the result of predatory intentions, with antisociality and sexual deviance being the most significant factors related to this type of femicide. The criminal and violent pattern that characterized sexual femicides in this study shared significant similarities with the pattern of violence involved in rape. Rape victims were in fact mostly unknown, or involved in a brief relationship with their killer. When the victim was known it was more likely that the abuse occurred at home and in front of the woman's children. Rapists were often under the effect of alcohol or drugs. Non-sexual femicides mainly involved known victims, and they were more often committed in the context of domestic disputes. It was not seldom that the long relationship between the victim and perpetrator was likely to be characterized by contentiousness, suggesting that the woman was often victim of an oppressive climate of emotional tension and domination. Morbid jealousy contributed to aggravating the tone of a controlling relationship. Non-sexual femicides bore more similarities to cases of rape within the pattern of intimate partner violence. Findings are discussed in terms of their implications for prevention and intervention. KEYWORDS violence against women, sexual femicide, non-sexual femicide, intimate partner violence, rape Frontiers in Psychology 01 frontiersin.org Zara et al.
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This chapter examines how one particular group of people within Canada, indigenous women, experiences both a higher rate of victimization and a lower rate of case clearance. Indigenous women in Canada are three times more likely to be killed by a stranger than non-Aboriginal women, and as of 2010, clearance rates for cases involving missing and murdered Indigenous women are consistently lower across Canada. Despite these statistics, other measures show that Indigenous women show similar satisfaction with their personal safety from crime as non-Aboriginal women as well as other measures indicating a similar confidence in the criminal justice system as non-Indigenous women. In this chapter, it is argued that the dissonance between certain measures is indicative of the settler-colonial heritage that informs both the perception of violence against indigenous women in Canada, as well as the phenomenon of violence against indigenous women themselves.
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En este ensayo elaboro un marco teórico para comprender la violencia sexual y el significado político de la prostitución forzosa trasnacional de mujeres nigerianas en Europa. Tomo como referencia la literatura feminista radical y la geopolítica feminista para comprender las dimensiones de la violencia patriarcal inherente al sistema de explotación sexual establecido en este caso de estudio. Para indagar en los orígenes de las mujeres prostituidas acometo un examen de la ecología política del Delta del Níger, que me permite explorar el extractivismo en la zona y el consecuente empobrecimiento estructural, factores que catapultan la dinámica de expulsión. Realizo una revisión crítica y disidente de la narrativa del «trabajo sexual» desarrollada dentro de la disciplina geográfica para, finalmente, proponer una interpretación abolicionista en la investigación de la prostitución actual.
Chapter
This chapter examines how one particular group of people within Canada, indigenous women, experiences both a higher rate of victimization and a lower rate of case clearance. Indigenous women in Canada are three times more likely to be killed by a stranger than non-Aboriginal women, and as of 2010, clearance rates for cases involving missing and murdered Indigenous women are consistently lower across Canada. Despite these statistics, other measures show that Indigenous women show similar satisfaction with their personal safety from crime as non-Aboriginal women as well as other measures indicating a similar confidence in the criminal justice system as non-Indigenous women. In this chapter, it is argued that the dissonance between certain measures is indicative of the settler-colonial heritage that informs both the perception of violence against indigenous women in Canada, as well as the phenomenon of violence against indigenous women themselves.
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The object of this study was to identify potential risk and protective factors associated with psychological distress among the Cree of James Bay, through a secondary analysis of data on 1136 Cree (aged 15–85) from a random general population health survey in 1991. In multiple linear regression models, factors significantly associated with reporting more distress in the past week included: younger age, female gender, early loss of a parent or close relative, more life events in the year before the survey, a serious illness or drinking problem in the past year, ever having used cannabis, having more than elementary education, having fewer than five close friends/relatives and residing in an isolated or inland region. Having a good relationship with others in the community and spending more time in the bush were both associated with less dis- tress. The relative importance of these factors varied across age/gender cohorts. We conclude that gender and generational differences should be considered when planning mental health promotion strategies for this population. In addition to more conventional approaches to reduce alcohol abuse, improve coping with loss and increase social support, tar- geted programs should be developed addressing the impact of edu- cation and role strain for women.
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Etude de la nature contradictoire et ambigue du statut politique des femmes indigenes vis-a-vis des hommes dans les processus politiques internes des communautes de reserves indiennes canadiennes depuis 1990. L'analyse du lien entre l'economie, l'organisation domestique et les processus politiques d'une part et les relations entre les femmes indiennes et l'Etat d'autre part montre que la position ambivalente des femmes s'explique en grande partie par les resultats contradictoires des pratiques de l'Etat-providence qui diminue le pouvoir de la parentele des hommes en limitant leur controle sur l'acces des femmes aux moyens d'existence et par des politiques patriarchales des strategies assimilationnistes