Skip to main content

Advertisement

Log in

Sex Work and Mental Health: A Study of Women in the Netherlands

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

This study examined how characteristics of prostitution and quality-of-life factors related to symptoms of depression and post-traumatic stress among 88 women engaged in prostitution in the Netherlands. Numerous factors were associated with elevated mental health concerns, including the experience of violence in prostitution, engaging in street prostitution, being motivated to engage in prostitution for financial reasons, having less confidence in one’s ability to find alternative work, desiring to leave prostitution, and sense of self-transcendence. In contrast, focusing on achievement, having a sense of fair treatment from others and society, and self-acceptance were associated with better mental health outcomes. Finally, mediation analyses indicated that post-traumatic stress associated with engaging in prostitution against one’s deeper desire to exit prostitution was, in part, the result of a lack of self-acceptance. The analyses controlled for relevant demographic factors, including age and level of education. The effect sizes for each of the findings ranged from medium to large. Implications for mental health care and public policy are included.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well-older adults: Evaluation of a short form of CES-D (Center for Epidemiological Studies Depression Scale). American Journal of Preventive Medicine, 10, 77–84.

    PubMed  Google Scholar 

  • Barry, K. (1995). The prostitution of sexuality. New York: New York University Press.

    Google Scholar 

  • Beekman, A. T. F., van Limbeek, J., Deeg, D. J. H., Wouters, L., & van Tilburg, W. (1994). Een screeningsinstrument voor depressive bij ouderen in de algemene bevolking: De bruikbaarheid van de Center for Epidemiologic Studies Depression Scale (CES-D). Tijdschrift voor Gerontologie en Geriatrie, 25, 95–103.

    PubMed  Google Scholar 

  • Burnette, M. L., Lucas, E., Ilgen, M., Frayne, S. M., Mayo, J., & Weitlauf, J. C. (2008). Prevalence and health correlates of prostitution among patients entering treatment for substance use disorders. Archives of General Psychiatry, 65, 337–344. doi:10.1001/archpsyc.65.3.337.

    Article  PubMed  Google Scholar 

  • Choi, H., Klein, C., Shin, M., & Lee, H. (2009). Posttraumatic stress disorder (PTSD) and disorders of extreme stress (DESNOS) symptoms following prostitution and childhood abuse. Violence Against Women, 15, 933–951. doi:10.1177/1077801209335493.

    Article  PubMed  Google Scholar 

  • Chudakov, B., Ilan, K., Belmaker, R. H., & Cwikel, J. (2002). The motivation and mental health of sex workers. Journal of Sex and Marital Therapy, 28, 305–316. doi:10.1080/00926230290001439.

    Article  PubMed  Google Scholar 

  • Comte, J. (2014). Decriminalization of sex work: Feminist discourses in light of research. Sexuality & Culture, 18, 196–217. doi:10.1007/s12119013-9174-5.

    Article  Google Scholar 

  • Dutch Ministry of Foreign Affairs. (2012). Dutch Policy on Prostitution (AVT12/BZ106006). The Hague: Dutch Ministry of Foreign Affairs.

    Google Scholar 

  • El-Bassel, N., Schilling, R. F., Irwin, K. L., Faruque, S., Gilbert, L., Von Bargen, J., … Edlin, B. R. (1997). Sex trading and psychological distress among women recruited from the streets of Harlem. American Journal of Public Health, 87, 66––70. doi:10.2105/AJPH.87.1.66.

  • Eller, L., & Mahat, G. (2003). Psychological factors in Nepali former commercial sex workers with HIV. Journal of Nursing Scholarship, 35, 53–60. doi:10.1111/j.15475069.2003.00053.x.

    Article  PubMed  Google Scholar 

  • Farley, M. (2006). Prostitution, trafficking, and cultural amnesia: What we must not know in order to keep the business of sexual exploitation running smoothly. Yale Journal of Law and Feminism, 18, 101–136.

    Google Scholar 

  • Farley, M., Baral, I., Kiremire, M., & Sezgin, U. (1998). Prostitution in five countries: Violence and post-traumatic stress disorder. Feminism & Psychology, 8, 405–426. doi:10.1177/0959353598084002.

    Article  Google Scholar 

  • Farley, M., & Barkan, H. (1998). Prostitution, violence, and posttraumatic stress disorder. Women and Health, 27, 37–49. doi:10.1300/J013v27n03_03.

    Article  PubMed  Google Scholar 

  • Farley, M., Cotton, A., Lynne, J., Zumbeck, S., Spiwak, F., Reyes, M. E., … Sezgin, U. (2003). Prostitution and trafficking in nine countries: An update on violence and posttraumatic stress disorder. Journal of Trauma Practice, 2, 33–74.

  • Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford.

    Google Scholar 

  • Hong, Y., Fang, X., Li, X., Liu, Y., Li, M., & Tai-Seale, T. (2010). Self-perceived stigma, depressive symptoms, and suicidal behaviors among female sex workers in China. Journal of Transcultural Nursing, 21, 29–34. doi:10.1177/1043659609349063.

    Article  PubMed  Google Scholar 

  • Jaarsma, T. A., Pool, G., Ranchor, A. V., & Sanderman, R. (2007). The concept and measurement of meaning in life in Dutch cancer patients. Psycho-oncology, 16, 241–248.

    Article  PubMed  Google Scholar 

  • Krumrei, E. J., & Fitzgerald, K. (2013, August). The psychological correlates of engaging in prostitution. Poster presented at the meeting of the American Psychological Association, Honolulu, HI.

  • MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614. doi:10.1146/annurev.psych.58.110405.085542.

    Article  PubMed  PubMed Central  Google Scholar 

  • McCarthy, B., Benoit, C., & Jansson, M. (2014). Sex work: A comparative study. Archives of Sexual Behavior, 43, 1379–1390. doi:10.1007/s10508-014-0281-7.

    Article  PubMed  Google Scholar 

  • McDonald, M. J., Wong, P. T. P., & Gingras, D. T. (2012). Meaning-in-life measures and development of a brief version of the personal meaning profile. In P. T. P. Wong (Ed.), The human quest for meaning: Theories, research, and applications (Vol. 2, pp. 357–382). New York: Routledge.

    Google Scholar 

  • Preacher, K. J., & Kelley, K. (2011). Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16, 93–115. doi:10.1037/a0022658.

    Article  PubMed  Google Scholar 

  • Prostitution: A personal choice. (2014, August 9). The Economist, 412, 9.

  • Prostitution and the internet: More bang for your buck. (2014, August 9). The Economist, 412, 16.

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Risser, J. H., Timpson, S. C., McCurdy, S. A., Ross, M. W., & Williams, M. L. (2006). Psychological correlates of trading sex for money among African American crack cocaine smokers. American Journal of Drug and Alcohol Abuse, 32, 645–653.

    Article  PubMed  Google Scholar 

  • Rössler, W. W., Koch, U. U., Lauber, C. C., Hass, A. K., Altwegg, M. M., Ajdacic-Gross, V. V., & Landolt, K. K. (2010). The mental health of female sex workers. Acta Psychiatrica Scandinavica, 122, 143–152. doi:10.1111/j.1600-0447.2009.01533.x.

    Article  PubMed  Google Scholar 

  • Roxburgh, A., Degenhardt, L., & Copeland, J. (2006). Posttraumatic stress disorder among female street-based sex workers in the greater Sydney area, Australia. BMC Psychiatry, 6, 1. doi:10.1186/1471-244X-6-24.

    Article  Google Scholar 

  • Simmons, M. (1998). Theorizing prostitution: The question of agency. Sexuality and Culture, 2, 125–148.

    Google Scholar 

  • Suresh, G., Furr, L., & Srikrishnan, A. (2009). An assessment of the mental health of street based sex workers in Chennai, India. Journal of Contemporary Criminal Justice, 25, 186–201. doi:10.1177/1043986209333590.

    Article  Google Scholar 

  • Tsutsumi, A., Izutsu, T., Poudyal, A. K., Kato, S., & Marui, E. (2008). Mental health of female survivors of human trafficking in Nepal. Social Science and Medicine, 66, 1841–1847. doi:10.1016/j.socscimed.2007.12.025.

    Article  PubMed  Google Scholar 

  • Ulibarri, M. D., Semple, S. J., Rao, S., Strathdee, S. A., Fraga-Vallejo, M. A., Bucardo, J., … Patterson, T. L. (2009). History of abuse and psychological distress symptoms among female sex workers in two Mexico–U.S. border cities. Violence and Victims, 24, 399–413. doi:10.1891/0886-6708.24.3.399.

  • van der Ploeg, E., Mooren, T. M., Kleber, R. J., van der Velden, P. G., & Brom, D. (2004). Construct validation of the Dutch version of the Impact of Event Scale. Psychological Assessment, 16, 16–26. doi:10.1037/1040-3590.16.1.16.

    Article  PubMed  Google Scholar 

  • Vanwesenbeeck, I., de Graaf, R., van Zessen, G., Straver, C. J., & Visser, J. H. (1993). Risky life, risky business? Aidsrisico van prostitutes in het light van geweldervaringen en welzijn. Gedrag & Gezondheid: Tijdschrift voor Psychologie en Gezondheid, 21, 219–226.

    Google Scholar 

  • Weiss, D. S. (2004). The Impact of Event Scale-Revised. In J. P. Wilson, T. M. Keane, J. P. Wilson, & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (2nd ed., pp. 168–189). New York: Guilford Press.

    Google Scholar 

  • Weiss, D. S., & Marmar, C. R. (1997). The Impact of Event Scale-Revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD: A practitioner’s handbook (pp. 399–411). New York: Guilford Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth J. Krumrei-Mancuso.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krumrei-Mancuso, E.J. Sex Work and Mental Health: A Study of Women in the Netherlands. Arch Sex Behav 46, 1843–1856 (2017). https://doi.org/10.1007/s10508-016-0785-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-016-0785-4

Keywords

Navigation