Torture and its sequelae among prostituted women in the United States

Eur J Psychotraumatol. 2024;15(1):2404307. doi: 10.1080/20008066.2024.2404307. Epub 2024 Oct 1.

Abstract

Background: Extreme violence and psychological abuse have been extensively documented and are pervasive in prostitution. Survivors of prostitution report high levels of posttraumatic stress disorder, dissociation, depression, and self-loathing. These are the same sequelae reported by torture survivors.Objective: Severe forms of violence have been categorized as torture by experts. The authors note that torture is commonly suffered during prostitution and should be appropriately named.Method: Using standardized measures and including a new measure of torture, we interviewed 45 women in the United States about their torture experiences in prostitution and their symptoms of PTSD, dissociation, childhood trauma, health status and somatic symptoms. The interviewees had exited prostitution and were in supportive programmes.Results: Formerly prostituted interviewees reported acts of physical, sexual, and psychological torture, including strangulation, rape, beatings, restriction of movement, denial of privacy, sleep, or food, and being forced to witness the torture of others. The 45 women had high levels of PTSD and dissociation. They endorsed needs for individual counselling, substance abuse treatment, and other medical care.Conclusions: A recognition of the physical, sexual, and psychological torture experienced in prostitution would strengthen psychological and medical interventions for survivors. Naming specific acts of prostitution as torture will reduce the survivor's shame and self-blame. Holistic treatment includes medical and psychological interventions and peer support, as seen in torture rehabilitation programmes for survivors of state-sponsored torture. This research supports the perspective that private or non-state-sponsored torture against women and marginalized populations should be clinically and legally understood in the same way as state-sponsored torture.

Antecedentes: La violencia extrema y el abuso psicológico han sido ampliamente documentados y son generalizados en la prostitución. Los sobrevivientes de la prostitución reportan niveles altos de estrés postraumático, disociación, depresión y autodesprecio. Estas son las mismas secuelas reportadas en los sobrevivientes de la tortura.

Objetivo: Los expertos han catalogado como tortura las formas graves de violencia. Los autores señalan que la tortura es una práctica habitual en la prostitución y que debería recibir un nombre apropiado.

Método: Utilizando medidas estandarizadas e incluyendo una nueva para medir la tortura, entrevistamos a 45 mujeres en los Estados Unidos sobre sus experiencias de tortura en la prostitución y sus síntomas de TEPT, disociación, trauma infantil, estado de salud y síntomas somáticos. Las entrevistadas habían salido de la prostitución y estaban en programas de apoyo.

Resultados: Las entrevistadas que habían abandonado la prostitución reportaron actos de tortura física, sexual y psicológica, incluido estrangulamiento, violación, palizas, restricción de movimiento, negación de privacidad, sueño o comida, y ser obligadas a presenciar la tortura de otras personas. Las 45 mujeres tenían niveles altos de TEPT y disociación. Reconocieron la necesidad de recibir consejería individual, tratamiento para el abuso de sustancias y otras atenciones médicas.

Conclusiones: El reconocimiento de la tortura física, sexual y psicológica que se experimenta en la prostitución fortalecería las intervenciones psicológicas y médicas para las sobrevivientes. Denominar actos específicos de prostitución como tortura reducirá la vergüenza y culpabilización de las sobrevivientes. El tratamiento holístico incluye intervenciones médicas y psicológicas y apoyo de pares, como se observa en los programas de rehabilitación para sobrevivientes de tortura patrocinadas por el estado. Esta investigación respalda que la tortura privada o no patrocinada por el estado en contra de las mujeres y las poblaciones marginadas deben entenderse clínica y legalmente de la misma manera que la tortura patrocinada por el estado.

Keywords: Prostitution; Tortura; prostitución; rape; torture; trafficking; tráfico; victimización; victimization; violación; violence; violencia.

Plain language summary

Using international legal definitions of torture, we assessed the prevalence of acts of torture perpetrated against formerly prostituted women in the United States.We found an extremely high prevalence of acts of torture perpetrated against prostituted women, as well as symptoms of traumatic stress common to other torture survivors.Two-thirds of the prostituted women in this study were beaten by sex buyers.Torture has been well documented when it committed by a state government’s military or prison system, but it has not been well documented when perpetrated as a private, non-state act, for example, incest, battering, rape, and prostitution.Prostitution’s harm is increased when it is perpetrated against economically and ethnically marginalized women.

MeSH terms

  • Adult
  • Dissociative Disorders / psychology
  • Female
  • Humans
  • Middle Aged
  • Sex Work* / psychology
  • Sex Work* / statistics & numerical data
  • Stress Disorders, Post-Traumatic* / psychology
  • Survivors / psychology
  • Torture* / psychology
  • United States

Grants and funding

The publication fees for this article were supported by the University of Nevada, Las Vegas University Libraries Open Article Fund.