Understanding the Experiences of Coercive Control and Sexual Exploitation
Andrea Silverstone
Chief Executive Officer
Sagesse Domestic Violence Prevention Society
Carrie McManus
Director of Innovation and Programs
Sagesse Domestic Violence Prevention Society
Rod Dubrow-Marshall, PhD
Professor, Co-Programme Leader,
Masters of Science Psychology of Coercive Control
University of Salford and RETIRN, UK
Executive Summary
Summary of Recommendations
Introduction
Scope of Sexual Exploitation
Understanding Sexual Exploitation versus Trafficking
Methodology
Qualitative Study
Policy, Practice and Legislative Review
Approaches and Legislative Models
Policy and Legislation Review
Practices/Interventions Review
Voices of Lived Experience – Qualitative Study Review
The participants
Superordinate Themes
Journey of Sex Work
Wellbeing
Coercive Control
Interventions and Services
Protection and Enforcement
COVID-19
Recommendations
Recommendation #1: Recognize the Continuum of Sex Work in Policy, Legislation and Practice
Recommendation #2: Update Trafficking Definitions in Legislation, Policy and Practice
Recommendation #3: Inclusion of Sex Work Within Coercive Control Definitions and Practice
Recommendation #4: Service & Support Provision Funding and Accessibility
Recommendation #5: Inclusion of Sex Work within Canadian Coercive Control Legislation
Conclusion
References
This paper presents a policy, practice and legislative review in jurisdictions similar to a Canadian context while also exploring a qualitative Interpretative Phenomenological Analysis (IPA) study presenting perspectives of 7 women with lived experience of sexual exploitation and coercive control, describing their journey of sex work, experiences of wellbeing, the impact of coercive control, the efficacy of intervention, services, protection, and enforcement and the impacts of COVID-19 on their experiences. The study offers a unique perspective of lived experience individuals who have been engaged in sex work, their loss of personal agency (capacity to act or exert power over their own actions) while recognizing the complexity of the continuum of voluntary and involuntary sex work. Implications for legislative and intervention practices are offered that include the suggested inclusion of coercive control legislation into the Canadian Criminal Code (CCC) that encompasses sexual exploitation, interventions that recognize the need for strengths bases, long- term, multi-agency approaches and practice frameworks that are multi-faceted and recognize the complexity of the lived experiences of women who engage in sex work.
WARNING: This research paper contains details some may find disturbing. Discretion is advised.
Trafficking of women for sexual exploitation has been viewed through a variety of lenses including the lens of illegal migration (IOM, 2021), the global marketization of sexual representation (Taylor & Jamieson, 1999), organized crime (Mameli, 2002), human rights issues (Worden, 2018), and lastly as an innate part of the question of involuntary (forced) prostitution and the sex trade (Askola, 2007, Demleitner, 1994, Leidholdt, 1996). Trafficking of women has been broadly defined as the “transport or sale of women, with or without the consent of the victim, use of enticement, deception, force or intimidation, for the purposes of prostitution or other sexual abuse” (Kelly & Regan, 2000, P3). The main factor that distinguishes trafficking for the purposes of sexual exploitation from more generalized trafficking or forced migration is that women trafficked for the purpose of sexual exploitation are delivered both to a location and to an individual and/or organization who are a party to the trafficking transaction and, who after the women’s arrival at a location, coerce them into sexual exploitation. In addition, since a fee has been paid for the individual, often this fee is then translated into a debt that the women is coerced to pay through sexual exploitation. In some jurisdictions this activity is viewed both as trafficking for the purposes of sexual exploitation and modern slavery (Askola, 2007). In the case of generalized migration, it is most often limited to delivering the individual to the country they wish to enter at which time the individual is then left to fend for themselves (Kelly & Regan, 2000).
Enslaved sexual exploitation is exploitation that is often conflagrated with trafficking (Kelly and Regan, 2000). In many jurisdictions worldwide if an individual is held against their will, transported from ‘point a to point b’ and forced into sex work, this is defined as trafficking (Hepburn and Simon, 2013). However, for victims of sexual exploitation, the trafficking definition does not feel like it fits their experiences, an example of this would be the ‘homegrown slaves’ that Bales & Soodalter (2009) describe. These are women that are kidnapped off American streets and forced into involuntary sex work. There are similar stories of ‘average middle class’ and disadvantaged women being kidnapped and forced into sexual exploitation in other western countries such as the UK and Italy (Lloyd, 2012, Bowley, 2012, Hayes, 2012, Patterson, 2018). Enslaved sexual exploitation, is perhaps more than any other type of sexual exploitation tied into the economic or ‘pull’ drivers of sexual exploitation. These drivers best describe sexual exploitation as a “monopolistically competitive industry with many sellers offering many buyers differentiated products based on price and preferences of the individual employers.” (Wheaton, Schauer & Galli, 2010 p. 117). In this case the seller is the kidnapper, the buyer is the individual purchasing sex aka ‘the trick or john’, the product is the sexually exploited individual and the employer is the pimp.
Sexual exploitation as a consequence of intimate partner violence is a result of the intersection of domestic abuse and sexual exploitation. Bruggerman & Keyes (2009) found that some victims of domestic abuse report being forced to engage in sexual exploitation as part of the abuse. In addition, Roe-Sepowitz et al, (2014) found that women who were coercively controlled into sexual exploitation by individuals whom they view themselves as being intimate, have the same experiences of love and intimacy as abused women have with their abusers. The pimp-prostitute relationship can hold the same characteristics as an abusive relationship (Williamson & Cluse-Tolar, 2002, Roe-Sepowitz et al. 2014, Hickle, Dahlstedt, & Gallagher, 2014). Intimate partner sexual exploitation includes coercively controlling tactics that include “secrecy, violence, dominance and power, rules, psychological abuse and instability, relationship-based, grooming, traumatic events, economic control, barriers to disclosing victimization, consequences of victimization and challenges of escaping/leaving.” (Roe-Sepowitz et al., 2014 p. 887 & 888).
Sexual exploitation through coercively controlling groups such as cults and religious groups occurs as part of a broader framework of coercive control perpetrated by these groups. Lalich (1997) asserts that the “sexual exploitation of women in cults of all types is widespread, and, to date, is possibly the least talked about, and certainly the least researched, aspect of cult life” (p. 7). Sexual exploitation in the context of coercively controlling groups can take different forms including coerced engagement with the group’s leaders, coerced involuntary prostitution on behalf of the group, coerced engagement with other members of the group, and in some cases also includes coerced reproduction (William, 1998, Stein, 2017). In most western countries sexual relations between consenting adults is not viewed as coerced or exploitive, however, in recent years both scholars and courts have recognized that sexual relations that occur within the framework of coercively controlling groups need to take into account the sociological characteristics of the group which can impair a woman’s ability to provide informed consent (Dayan, 2018, US District Court Eastern District of NY, 2019). According to Stein (2017), leaders of cults perpetrate a form of coercive control similar to that seen in domestic abuse. The leader gains control of the women’s personal agency, cutting her off from close relationships and portraying themselves as the sole ‘safe haven’. The resulting ‘trauma bond’ is created through these experiences in which everything and everyone outside of the group feels threatening and compromises a victim’s ability to attend to her own survival needs.
Sexual exploitation as a result of structural violence is often described as the factors that ‘push’ women into sexual exploitation. Structural Violence, introduced in 1969 by Johan Galtung, refers to a form of violence in which social institutions harm people by preventing them from meeting basic needs. These ‘push’ factors are mechanisms that coerce women into involuntary sex work such as addictions, mental health issues, political instability, homelessness, racism and the legacy of colonialism, gang involvement, and poverty (BC Government, 2021). The idea of ‘push’ factors originated in the concept that individuals who are structurally discriminated against in their home society are pushed to leave their jurisdiction of origin for the promise of better opportunities (Bales, 2007, DiRienzo & Das, 2017). Researchers have taken this idea of ‘push’ factors as a result of structural discrimination and extended them to include all factors that can be considered to be perpetrate structural violence (Kelly & Regan, 2000, Stanojoska & Petrevski, 2012, CPHA, 2014).
Each of these five distinct forms of sexual exploitation intertwine and overlap with each other, creating a complex web of understanding, defining the experience and impact of sexual exploitation. The experiences of sexual exploitation of women will be explored in focus in the qualitative study that follows.
In attempting to understand sexual exploitation, it is important to differentiate it from voluntary sex work. According to the Canadian Public Health Association (CPHA) (2014), sex work can be understood as the “consensual exchange of sexual services between adults for money or goods.” (CPHA, 2014 p. 3). This exchange of services can happen in a variety of venues (private homes, online, in public, etc). It is important to note that delineating the difference between involuntary and voluntary sex work is contentious and there are numerous moral debates occurring among scholars, service providers, and those with lived experience as to the validity of the concept of voluntary sex work (Gerassi, 2015). The debate around voluntary sex work is split into two ‘opposing camps’, neo-abolitionist, who believe that all sex work is involuntary and coerced and “postulate that prostitution is never entirely consensual and cannot be regarded as such” (p. 2), and sex positivists who assert that voluntary sex work can be a chosen career (Ferguson, Phillipson, Diamond, Quinby, Vance & Snitow, 1984). Opponents of the sex positivist position argue that consent and voluntary engagement in sex work needs to be viewed within the context of the high rates of sexual assault and abuse histories of sex workers and in the context of structural violence (Hughes, 2005, Potterat, Rothenberg, Muth, Darrow & Phillips-Plummer, 2001, Weitzer, 2007). Sex positivists argue that women should have self-determination to make the decisions that they choose around engagement in any form of work, including sex work, and that there is a strong negative correlation between the criminalization of sex work and sex workers health and safety (Platt, Grenfell, Meiksin, Elmes, Sherman, Sanders, Mwangi, Crago, 2018, SWARM Collective, 2021, English Collective of Prostitutes, 2021, NSWP, 2021, Peng, 2005). In recent scholarship the notion that all sex work is exploitation analysis, has attracted strong criticism. It has been argued that “prostitution is not always inherently exploitative; it can also be well paid (especially as far as ‘women’s work’, typically systemically undervalued, is concerned) and hard work, which should be a matter of individual choice.” (Akola, 2007 p. 25). These issues will be explored further in the study which is reported later here.
The existence of sexual exploitation, especially trafficking, has not been fully recognized in many countries (Kelly, 2002). The current estimates that exist, lack empirical data to back the numbers, and are at best ‘educated guesses’ (Askola, 2007, Kelly & Regan, 2000). Current numbers that have been postulated vary widely from 500,000 women trafficked in Western Europe annually (Galiana, 2000), 142 to 1,420 women sex trafficked in UK per year (Kelly & Regan, 2000) and 45 – 50,000 women and children sex trafficked in the United States per year (Tiefenbrun, 2001). With one study in the UK noting that 11% of men in the UK between the ages of 16-74 had accessed a sex worker in 2016 (Home Affairs Committee, 2016). The study does not identify how many of those sex workers were voluntary and how many were sexually exploited.
Scholars, practitioners, and those with lived experience of sexual exploitation appear to use the terms prostitution, sexual exploitation, involuntary (forced) sex work and sex trafficking interchangeably across Canada and globally. A 2014 study conducted by Native Women’s Association of Canada (NWAC) noted that sex workers and practitioners, in referring to sexual exploitation, “made no discernible statements indicating a difference in view of women who have been sexually trafficked and women who have been prostituted” (p. 8). Nijhoff (2014), highlighted the critic of the ‘exploitation analysis’ in their research on trafficking in women in the EU, as it lumps together exploited, trafficked, and voluntary sex works, in effect “reducing all women in prostitution to nothing but passive victims of patriarchal society and denying their agency in making informed choices about engaging in it.” (p. 25).
The trafficking definition is too narrow, the exploitation analysis is too broad, and each jurisdiction (local, provincial, federal and international) calls the same act, a different thing, making it almost impossible to truly know the scope of the issue. The study which follows intends to allow the voices of sex workers themselves to be heard with the aim to add clarity to definitions moving forward.
Askola, (2007) offers the caution that if you view the issue narrowly, you will create an insufficiently narrow response. If the issue of exploitation is only a gender bias issue, as identified through an ‘exploitation analysis’ (Nijhoff, 2014), then the response created will be a gender bias analysis response. In addition, the feminist underpinnings of our definition of sexual exploitation have led to this issue being viewed through a binary lens of “oppression of women by ‘men and their laws’, which conceals the complexity of and variations in subordination, overemphasises the role of the sexual and is insufficient to alter the diverse motivations of the actors in prostitution.” (Nijhoff, 2014, p. 25). The binary view of oppression of women by men has also led to an under representation and dearth of research in the area of men and trans people in voluntary and involuntary sex work. As early as 1987, Robert Connell was offering up a systematic framework of marginalized expressions of gender and sexuality that offer wider definitions than a binary framework of women oppressed by men, yet despite this there has been an adherence in among both scholars and practitioners serving sexually exploited individuals to the binary nature of exploitation. Scarce research exists around the scope or experience of men, trans, and non-binary individuals and their experiences of sexual exploitation, however it is clear from the research that does exist that further exploration of this area is missing. A 2008 report titled, “Under the Radar: The Sexual Exploitation of Young Men”, found that young men have comparable experiences of sex work to young women, except for generally entering sex work at an older age, (over the age of 18) and that they work in the sex trade for a longer period of time than women (McIntyre, 2008). Trans and non-binary people are overrepresented based on population in sex work, with 72% of respondents in the 2015 US Transgender Survey reporting they have done sex work (James, Herman, Rankin, Keisling, Mottet & Anafi, 2016), yet most legislation in the US and worldwide only offers protections for women and children who are sexual exploited, or sex trafficked (Platt et al, 2018).
The three-pronged approach to addressing sexual exploitation has led different jurisdictions to one of five different types of legislative frameworks for sex work, both voluntary and involuntary. These are: full criminalization of all sex work, partial criminalization of sex work, criminalization of the purchase of sex, regulatory frameworks for sex work, and lastly full decriminalization.
Jurisdictions like the US and South Africa have followed a full criminalization framework in which all aspects of selling and buying sex or the organization of sex work is prohibited. This legislative framework applies to both voluntary and involuntary sex workers (Platt et al, 2018). In the US, there are some jurisdictional exemptions for this law, such as in the State of Nevada (Brents & Hausbeck, 2001). In the UK (except Northern Ireland) there is a partial criminalization of sex work, in which the organizing of sex work is prohibited, including solicitation, running a brothel, working with others, and the involvement of a third-party selling sex. This framework essentially criminalizes any ‘organization’ of sex work (Platt et al., 2018). This framework applies to both voluntary and involuntary sex workers. Canada, France, Northern Ireland, Ireland, Norway, and Sweden have implemented what is often referred to as the ‘Nordic Model’. This legislative framework criminalizes the purchase of sex, identifying the sex worker as ‘victim’. This model criminalizes the buying of sex as well as penalizing sex workers who work together and any third party who benefits from the ‘avails’ of sex work. This framework applies to both voluntary and involuntary sex workers (Howard, 2018). The regulatory model is a legislative framework that applies only to voluntary sex workers. It is a model that licenses the sale of sex and often includes regulatory practices such as condom use, sexual transmitted infection (STI) and human immunodeficiency virus (HIV) testing, and registration. This regulatory model can be found in some states in Australia, Germany, and the Netherlands. Lastly is the full decriminalization model. In this legislative framework all aspects of adult sex work are decriminalized. This model applies only to voluntary sex workers. The only jurisdiction to currently employ this model is New Zealand, which also requires condom use in some locations (Platt et al, 2018, Howard, 2018, PRA, 2003).
A systemic review and meta-analysis of all five above types of models and their impact on the safety and health of sex workers (voluntary and involuntary) found that no model provided full protections. It found that criminalization (full or partial) interacted with stigma, exposes sex workers to physical and sexual violence, and limits the ability of sex workers to resist or challenge the violence. It found that criminalization of clients did not facilitate access to services or minimize violence. Regulatory models were associated with better physical health and safety, however the stigma attached to being registered had a detrimental effect on mental health. The decriminalization model, in New Zealand, had led to sex workers reporting greater safety, better mental health, more choice over who they see as clients, what sex acts they engage in, and improved relationships with police. These outcomes in both the regulatory and decriminalized models did not include involuntary sex workers (sexually exploited women) as they remain under a system of criminalization (Platt et al., 2018). The question of how this is experienced by sex workers will be explored further in the study.
Despite the variance in legislative frameworks worldwide, the focus of all intervention frameworks are aligned, supporting sexually exploited women to experience health and safety and, in some cases, exit sex work. Most of the intervention models have a harm reduction lenses, even when driven by abolitionist principles and often intersect with other types of gender-based violence interventions (Gerassi & Nichols, 2017). The experiences of women who have been sexually exploited in regard to interventions and services and what worked for them, will be explored in the study that follows.
Sex work in Australia is predominately governed by each territory and states legislation except for laws related to slavery, sexual servitude, and trafficking, which are governed by federal legislation. Legislation varies across Australia’s nine jurisdictions, with each legislative framework varying widely from decriminalization models to making most forms of sex work illegal. Most jurisdictions in Australia have criminalized specific forms and aspects of sex work such as street-based sex work and solicitation. The exception to this is New South Wales. The laws around brothels and two or more sex workers working together vary from state to state, with most allowing some sort of brothel, that is often regulated. In all jurisdictions, except Victoria, it is an offence to procure an individual for the purposes of sex work (Pinto, Scandia & Wilson, 1990. Stardust, 2014). All state laws apply to both voluntary and involuntary sex workers, with involuntary or coerced sex workers also being governed by an additional set of federal legislation, the Slavery and Sexual Servitude Act 1999. This Act added the following offenses to the Australian Criminal Code, Division 270: sexual servitude, sexual slavery, and deceptive recruiting. Sexual servitude under the code is defined as “'the condition of a person who provides sexual services and who, because of the use of force or threats is not free to cease providing sexual services; or is not free to leave the place or area where the person provides sexual services” (Parliament of Australia). Human trafficking offenses in Australia are primarily tied to coerced exit and entry into Australia, making it illegal to exit someone from Australia for sexual services or exploitation and entry into Australia for sexual services under the guise of deception (Australia Criminal Code Act 1995, Section 271.2).
Canada, unlike Australia, has only one set of federal laws that govern sex work which can all be found within the Canadian Criminal Code. Bill C-36, the Protection of Communities and Exploited Person’s Act, defines sexual exploitation of an adult as: “use or threats to use violence; abuse of a position of trust, power, or authority; providing an intoxicating substance to encourage the sale of sexual services; engaging in conduct that would amount to procuring; receiving the benefit in the context of a commercial enterprise that offers sexual services for sale provides protections for victims of sexual violence” (Casavant & Valiquet, 2014). The purpose of the Act was to stop the exploitation of individuals “who engage in prostitution activities” (Casavat & Valiquet, 2014, p. 1). The Act assumes that most sex workers are involuntary and require protections as exploited individuals. The Act allows for ‘out of public view’ street-based sex work and sex work at a designated location (Canada Department of Justice (CDOJ), 2017). In addition, Canada also has provisions through the Trafficking in Person’s section of the Criminal Code to address sexual trafficking. Trafficking as defined by the Criminal Code does not have to involve physical movement of the individual and is broadly defined as causing someone to provide a service by engaging in conduct that, in all the circumstances, could reasonably be expected to cause the other person to believe that their safety or the safety of a person known to them would be threatened if they failed to provide, or offer to provide, the service (CCC, 1985).
In 2003 New Zealand passed the Prostitution Reform Act (PRA, 2003), making it the first jurisdiction in the world to fully decriminalize adult sex work. The intent of the Act was to shift policy from a moralistic to human rights and public health approach, with a focus on safeguarding the human rights of sex workers, protection from sexual exploitation, promoting the welfare and occupational health and safety of sex workers, and prohibiting childhood sexual exploitation (Abel, Healy, Bennachie & Reid, 2010). It allows for sex work to operate under the same industry rules as any other business in New Zealand, with the exception of non-residents not being able to be given operating permits. The sex industry is governed by its own regulatory guidelines developed by the Department of Labour (DOL, 2004). The PRA also prohibits certain types of solicitation and has made illegal sexual exploitation which can include force, inducing or compelling to another to provide services, claim earnings derived from sex work and/or use of a prior relationship with a sex worker to bribe or force them to provide sexual services. The Act allows for consent to sex work to be withdrawn at any point during a transaction (Abel et al, 2010).
England and Wales has a series of laws that address sexual exploitation of adults which are included in the Sexual Offences Act 2003, and Modern Slavery Act 2015. The approach of these acts is to focus on the prosecution of individuals who force others into prostitution, exploitation, and perpetrate abuse and harm. Sexual exploitation is addressed by the Crown Prosecution Services as part of the Violence Against Women and Girls portfolio. The Sexual Offences Act, 2003, 53A criminalizes paying for sexual services of a sex work subject to force. Force is defined as threats or any other form of deception and/or coercion. The Modern Slavery Act 2015 criminalizes trafficking for the purpose of sexual exploitation.
Voluntary sex work in the Netherlands is legal between consenting adults and adheres to a regulatory model (Outshoorn, J, 2012). Involuntary sex work is a criminal act that can be found in Netherlands Criminal Code Serious Offences Against Personal Liberty Section 273f. It criminalizes sexual exploitation through abduction, force, induction, profiting from the exploitation of another, and compelling or inducing an individual to provide to a third party their proceeds from sex work. The legal framework in the Netherlands understands human trafficking to be a modern-day form of slavery (Government of Netherlands, 2018).
A 2018 study Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies found that laws that criminalized street-based sex work, solicitation, and communication about sex work in public places compromised sex workers safety. It also found that criminalization of all aspects of sex work, institutionalized violence, coercion, extortion of sex workers, and restricted their access to justice, in addition criminalization also restricted the access of sex workers to health and social services and other forms of support. It also recognized that criminalization increased the stigma that sex workers experienced (Platt et al, 2018). In addition, it is of note, that with the exception of New Zealand, none of the jurisdictions have a legislative framework for understanding the framework of coercive control as it relates to sexual exploitation. It is hoped that the study which follows will shine additional light on the nature of these lived experiences.
As a result of the lack of agreed upon language and meaning around the definition of sexual exploitation of an adult, there is a gap in our understanding around the scope of sexual exploitation (Casavant & Valiquet, 2014). Without this understanding it is challenging to develop services and interventions for women who are sexually exploited (Minister Leela Aheer, Minister of Culture & Status of Women, Government of Alberta, personal communication, July 10, 2020). As such it is hoped that the new study reported below will contribute to enhanced understandings in this area.
Similar to the development of legislation, practitioners often look to find best and promising practices in other legislations that reflect similar contexts. In Canada, the jurisdictions that are often looked to for best and promising intervention practices in addressing sexual exploitation are Australia, New Zealand, the Netherlands, England and Wales. To contextualize the experiences of participants of the study, it is helpful to understand best and promising practices in other jurisdictions, their relationship to the legislation and potential implications for the Canadian context. In Canada, New Zealand, Australia, England and Wales, and the Netherlands interventions and services for sex workers primarily focus in the areas of health and safety, supporting women to exit sex work, addiction, and mental health services, and providing access to health, justice, and social services. Interventions and services primarily take a trauma-informed, harm reduction approach. Many interventions intersect with other gender-based violence supports and services and/or consider themselves to be part of the continuum of gender-based violence services. (Strega, Casey, Rutman, 2009, Kurtz, Surratt, Kiley, & Inciardi, 2005, Argento, Goldenberg, Braschel, Machat, Strathdee & Shannon, 2020, Cusick, Brooks-Gordon, Campbell & Edgar, 2010 Jordan, 2005, Mayhew & Mossman, 2007, Howard, 2018 McCann, Crawford & Hallett, 2021).
Although Canada has a robust continuum of services to address gender-based violence, there is a shortage of supports and services for sexually exploited women, with some women having to travel across Canada to access programming, especially residential programming (Carrie McManus, Sagesse Domestic Violence Prevention Society, personal communication May 10, 2021). Sex workers in Canada have experienced significantly reduced access to health and community-based services as a result of the implementation of recent laws that specifically criminalize the purchase of sex, solicitation, and street-based sex work (Agento et al, 2020). Canada has a national human trafficking hotline and a continuum of service delivery organizations funded through federal, provincial, and local governments, foundations, and faith communities across Canada to address victims of sexual exploitation and trafficking. Services include accommodation, vocational training, addiction and mental health supports, and access to health, legal, and financial support (Government of British Columbia, 2020). The primary approach of most sexual exploitation and trafficking services in Canada is a trauma informed harm reduction model (McManus, 2021).
In England and Wales, the focus for sexually exploited women is a hybrid model of safeguarding and exiting sex work approach with services that include accommodations, education and vocational training, psychological interventions, and access to legal and health services. In some cases, these are multi-agency responses with a focus on ‘anti-slavery’ aligned with the Modern Slavery Act 2015 (Human Trafficking Foundation, 2021). According to the Human Trafficking Foundation, in 2020 over 10,000 potential victims of human trafficking/modern slavery were referred for support (British Home Office, 2020).
Australia’s National Action Plan to Combat Modern Slavery 2020-25 has, as a key component, a support for trafficked people program (Australian Government, 2020). The program is a comprehensive program delivered by the Australian Red Cross and provides accommodation, vocational training, psychological supports, financial supports, and accesses to health and legal services (Australian Department of Social Services, 2020). Australian based Project Respect and the Coalition Against Trafficking in women have suggested that there is a need for ‘women focused’ social services in Australia to work more closely with sexually exploited women, recognizing that sexually exploited women are having similar experiences of rape and sexual assault as women who experience domestic abuse (Fergus, 2005).
Similar to Australia, New Zealand has a national plan to combat modern forms of slavery. The Plan of Action Against Forced Labour, People Trafficking and Slavery 2020-25, outlines prevention, protection, and prosecution goals to address the drivers of exploitation, within a framework of understanding the impacts COVID-19 on exploitation (PAAFLPTS, 2020). The plan engages a cross ministerial approach. Victims of sex slavery in New Zealand are offered government and community-based supports that include accommodation, psychological supports, financial supports, access to legal and health services, and vocational support. In addition, New Zealand also offers compensation or reparation and/or repatriation to victims that have been exploited in relation to prostitution or other sexual services. The plan notes that services will be trauma informed recognizing that victims can be traumatized by their experiences (PAAFLPTS, 2020). The experiences of interventions, such as the ones notes above, for sexually exploited women will be explored in the study that follows.
Like Australia and New Zealand, the Netherlands has a national trafficking action plan. The Together Against Human Trafficking program is a multi-pronged approach that includes ‘made-to-measure’ interventions and supports at the municipal level for victims of human trafficking (Government of Netherlands, 2018). Victims of human sex trafficking are offered accommodations and care coordinators that provide wrap around services including access to health and legal supports, psychological services, financial supports, and gender-based violence supports (Government of Netherlands, 2018). In addition, victims may be offered compensation through the Violent Offences Compensation Fund (VOCF) (Government of Netherlands 2018).
According to Gerassi and Nichols (2017) the most successful services for victims of sexual exploitation are offered from a theoretical framework in which their intersecting identities and needs are recognized. In reviewing different theoretical models, Gerassi and Nichols (2017) found that certain models such as strengths-based practice, that incorporates cultural competency, have been empirically found to have successful outcomes for sexually exploited adults, while other models such as the Trans Theoretical Model (TTM) which is often paired with Motivational Interviewing are widely used, yet lack empirical support. Harm reduction models have been found to be particularly successful when addictions are involved as part of the experience of sexual exploitation, this is particularly applicable to sexually exploited women as it is estimated that approximately 80% also experience substance abuse issues (Farley & Barkan, 2008). Similar to the strengths-based approach, a survivor defined empowerment practice model builds on an individual’s strengths and addresses the need for a specialized model that recognizes intersecting identities and needs. Survivor defined models have been recommended for adults who have been sexually exploited (Nichols & Heil, 2014, Sidun et al, 2014). Menaker and Franklin (2013) note that rapport building with sexually exploited individuals is critical as they are more likely to experience fear, stigmatization, and judgement.
In addition to the above theoretical models, there is research that has shown that trauma-based treatment is a promising practice for survivors of sexual exploitation. (Gerrasi & Nichols, 2017). In a review of trauma informed treatment models, Seeking Safety - focusing on cognitive, behavioural, interpersonal, and case management, and Trauma Recovery and Empowerment Model - focusing on cognitive restructuring, psychoeducation, and coping skills to address mental health and addictions, have been found helpful for sexually exploited individuals with addictions and mental health issues (Gerassi & Nichols, 2017). Additional evidence based mental health treatments that have been found to be helpful in treating victims of sexual exploitation include Cognitive Behavioural Therapy (Van Dam, Ehring, Vedel & Emmelkamp, 2013), Cognitive Processing Therapy (Vickerman & Margolin, 2009), Eye Movement Desensitization and Reprocessing Therapy (EMDR) (Schubert & Lee, 2009), and Mindfulness (Gerassi & Nichols, 2017).
It is clear from the research that what is critical within any intervention and service delivery framework, is a model in which intersecting identities and needs are recognized (Gerrasi & Nichols, 2019). Although there has been extensive research on trauma informed and evidence based mental health models, there appears to be gaps in research around models that explore a client’s spiritual practices such as the HOPE Spiritual Assessment Tool (Anandarajah & Hight, 2001) or response-based models such as the Power Threat Meaning Framework (Johnston & Boyle, 2018) and the Response Based Model (Wade, 1997). Both the legislation and interventions recognize the coercive and controlling nature of sexual exploitation, however, interventions and services have not yet widely accepted response-based models that have been proven effective in addressing the impacts of coercive control on victims. The interviews with sex workers which follow will allow an exploration of the personal lived experience with regards to these matters.
In each of the above jurisdictions mentioned, the laws and interventions appear to recognize the nature of coercion and control in relation to sexual exploitation. Third party exploitation whether by force or other means is a recognized criminal act and the intervention services appear to be offered to any individual who meets the legal criteria for being sex trafficked or exploited. It should be noted that both England - Wales and Canada, in the absence of national strategy, have services for any individual who identifies as sexually exploited. In addition, regardless of whether or not a jurisdiction adheres to a criminalization, partial or full decriminalization or regulatory model of sex work, all jurisdictions have legislation that criminalizes coerced or forced sex work. It is however of interest that New Zealand, who has a regulatory model of sex work with the highest reported positive outcomes around health and safety for voluntary sex workers, also has the most comprehensive laws and approach to address sexually exploited women that includes a robust framework for protection, prevention, and prosecution of sex work (Argento et al, 2020, Platt et al, 2018, Jordan, 2005, Abel et al, 2010, McCann et al, 2021, Howard, 2018, PAAFLPTS, 2020, PRA, 2003). The study that follows will explore the impact of Canadian legislative frameworks for participants and their experiences of the implementation of those legislative frameworks.
The majority of the participants of this study entered sex work over the age of 18 with three of the women having reported being sexually exploited as children.
Participants described the following:
“My parent, my adoptive parents, had adopted the other kids before me, and my brother, I guess, started wanting sex. And he would pay me for it. Um, I also had a grandfather, who was my mom's father, who was sexually abusing me for a few years then he would give me money to stay quiet… I think I must have been around five, six. I have no recollection. I can't even remember the first time.”
“16 was when I went to the bar with my aunties and my mom…the higher the heel, the shorter the skirt, [the] more men you got.”
“I was 13. And I gotten involved with these older men, one of them was kind of my boyfriend…who was like, 22. And then he, you know, he introduced me to his group of friends. And I don't know, it was kind of exploiting child porn and different things.”
For the other four women in the study, their entry point into sex work and sexual exploitation happened for them as adults.
Participants described experiences such as:
“…at first it was a boyfriend of mine who pimped me out. So, um, he, he kind of manipulated me into doing it. …I was 22.”
“I was 18. And a friend of mine suggested that we do stripping…So that's kind of how I got into it.”
“So, my ex had left me, and I was working two jobs, super stressed out. And my biggest fear was not being able to pay rent. So, I heard that I was going to be losing my full-time job. And I panicked. So, I said, might as well just start escorting like, I was a h* when I was a kid. So, I might as well just get paid for it”
“…when I was 19, I picked up meth for the first time... I would do anything to get it. So, the guy that sold it to me for the first time. I went and lived with him and to live with him I didn't pay rent. I slept with him to live with him. And I slept with him to get drugs”
The research on the number of years the average sex worker is active varies from 13.6 years to less than one year (Potterat, Woodhouse, Muth & Muth, 1990, Ward & Day, 2006). In the case of the participants of the study the number of years engaged in sex work varied from one year to 31 years, with the average number of years active being 11.
Harcourt and Donovan (2005) have broadly categorized sex work into direct and indirect work. Direct sex work is usually characterized by the exchange of sex for money. Direct sex work can include street-based sex work, brothels, escorts, private clients, clubs, and solicitation. Indirect sex work is sometimes not recognized as sex work because it either does not include a fee for service and/or the actual touching of genitals. These types of sex work can include trading sex for food, shelter, drugs, etc or be things like stripping and creation of porn content for movies or live cams. In Canada, where the participants in this study live, for adults, most forms of indirect sex work are legal, whereas direct sex work has a more robust legislative framework as noted above. All forms of sex work that are exploitative according to the framework set out by Canada’s Bill C-36 are illegal. In Alberta, Canada, where all the participants live according to the Protection of Sexually Exploited Children Act (2020) anyone under the age of 18 years old, is considered to be sexually exploited regardless of the type of sex work or the presence of consent.
The participants of this study engaged in a variety of different types of sex work, with the majority of them engaging in more than one type of sex work dependent on their needs at the time of engaging in the sex work, the coercion they were experiencing, and their sense of personal agency. There was only one participant who only engaged in indirect sex work as a stripper in different clubs.
“I started stripping in mid-sized city in British Columbia… my plan was to stay as a stripper till I was 30 and then try to go to medical school…Like I’ve never, I've never wanted to be paid for sex. I like sex. And if I want to have sex, I have sex.”
Another participant described below her experience of direct sex work:
“Like, I can remember the girl that introduced me to like, actually, exchanging sex for money, I can remember that. And I remember like, not wanting to do that. But she made it sound like it would be very, very easy. And all you have to do is just sleep with this guy, and you'll get money. And it's just like, it's pretend he's your boyfriend. And that's what she made it sound like. And it was not something that I wanted to do, though, because it just, it was just really frightening to think that I would be, like what if these people could hurt me? And what if they robbed me, and but it never did happen. Nothing bad ever happened with those people. And I was lucky. But the people that I exchanged like drugs for sex, those people were not nice… And it was just like a long cycle of like, oh, I can sleep with a drug dealer, or I can have sex with someone for money.”
Another participant reflected on her experiences of direct sex work:
“But then at an early age, I learned that the body can be a powerful thing. So, when I had started living in the city, I was deep into addiction. And that's how I survived in the world [through trading sex for money] …. I guess I found that even selling pictures of myself online was, I don't want to say beneficial, but I don't really know what word I want to use there. But it was a survival skill that I have learned from an early age.”
A further participant described her experiences of direct sex work, combined with other ways of making money:
“…it was kinda like, oh, like… we need money. And then it started with just getting sugar daddies. And then he [my boyfriend/pimp] was like, Oh, well, you can just like, um, give him a b***j**. I won't be mad at you. Just like put a covering on, you know, condom. And so, I started doing that. ..Then I started doing like, calls where I would, I would rob the tricks. And then he was like, Oh, well, that's too dangerous, just sleep with them kind of. So, then I ended up sleeping with them.”
And lastly, this participant shared her impetus into direct sex work:
“I'd always find a rich man that did drugs. They take care of me… when I was smoking crack for a really long time. I was like, holy shit this stuff's expensive like this is ridiculous I can't do this without s**king d**k.”
In addition, some of the participants in the study, only retrospectively after exiting sex work, viewed their engagement in different aspects of sex work, as sexual exploitation, having identified it as something different in the moment of the experience.
“I exchanged, like, sleeping with people for drugs before. But it would like be like, exchanging drugs for sex, not money for sex…. I do now [consider that to be sex work] since coming to [residential treatment program]. I never did before.”
A further participant described her emerging understanding of what was happening to her:
“I had no idea, I was being trafficked until last year, actually…I just started dating this guy who I thought the world of. And I just thought he loved me, I guess. And, of course, I didn't really know what love was. I didn't, I had no clue that I was being trafficked. I didn't even know that thing existed. I thought I was just voluntarily doing favours to this guy who I thought loved me … and because I loved him… I entered a women’s shelter after I was badly beaten one day [by boyfriend/pimp]. And my story just fell. And that's when I was told [by the women’s shelter staff] that that was human trafficking.”
The journey and decision to exit sex work for each of the participants was motivated by factors that included their safety and mental and physical health. For some of them the journey to exiting was interconnected with their journeys to sobriety from substance abuse. Mayhew and Mossman (2007) recognize that the decision to exit sex work is often more as a result of the risk involved with sex work and not for economic reasons, especially since sex work, as noted by some of the research participants, can be beneficial in term of offering both financial rewards and flexibility. Heinz (2020) notes that high financial compensation in the sex trade are the “golden handcuffs” that keep women in sex work. For three of the participants of the study, this was their reality, as they each of them estimated they were making over $85,000 per year. The process of leaving sex work is therefore complex and multiple attempts to leave are common before women successfully exit. Research has acknowledged that it is difficult to exit sex work and that many of the factors that lead women to enter sex work are the same things that act as barriers to exiting sex work (Mayhew & Mossman, 2007, Menezes, 2019, Heinz, 2020)
In the study one participant said about her experience of exiting:
“When I went to jail this last time and I called [exiting sex work program] and I said, I need to change. I need to do something. This is not working for me anymore. I've lost everything this time. Everything, everything. My son, I lost my family.”
For another, a traumatic event led to her exit and withdrawal from substances as well:
“I had a sister commit suicide this past summer. And I was down in the dumps, I guess, in a very dark world…after my sister committed suicide, I got into heavy drugs which is heroin and stuff like that. And everybody in the mid-sized Ontario city in my support network became very worried for my life because that's where I was heading was for death. And they had an intervention out on me with just bringing me to the hospital against my will, and they got the police services involved. So, I was brought to the hospital, really against my will. And I stayed at the hospital for nine …days and pure withdrawal and they decided that I was to go to treatment. I didn't really have a say.”
A further participant described another event which led to her exiting:
“So, he [boyfriend/pimp] went to jail and then that's when I stopped. Um, so it was, it was easy, because I didn't have to, you know, I didn't have to have an excuse. I didn't have to explain myself. And I kind of did it so that, you know, he would be happy with me, because he complained all the time... but yeah, him going to jail made it so much easier. I was just like, okay, I'm done one day, and I didn't have to fear that I would be in trouble. Or that I couldn't provide for him. And myself.”
For one of the participants who was being held against her will, the process of exiting was a moment of opportunity.
“Um, so he [pimp] had left me with this, how do I say it in a politically correct way, an addict in small sized town Ontario, for about five days. And I was just, like, f**ked up the whole time. And …they left the phone for me and left a phone with me so he [pimp] could get a hold of me. And luckily, I remember my mom’s phone number by heart, and I called her. And I said, Mom, like you have to get me out of here. Like, this is what's happening… And so, she immediately got her car and drove down to the address that I gave her…And [she] came and got me and I ran. I remember running out bolting out of that place before anybody could catch me. and running, running to the street barefoot to my mom.”
Three of the seven women in the study attempted multiple times to exit, with both expressing that they believe that this exiting experience will be more successful than past experiences due to the supportive programming they are currently receiving from the residential exiting sex work programs they are currently involved with.
“…the previous times [exiting sex work], it was just kind of, because I was, I was still a teenager, it was kind of, you know… removing me from the unsafe situation where I was, you know, where it was actually, like, trapped in and, you know, forced to do these things, and then moving into a safe place. And that's kind of what allowed me to escape. And then once I was an adult, it was like, those resources weren't there.”
All the participants had addiction issues and those issues were integrally tied into their experiences of sexual exploitation either as a mechanism that pushed them into sex work or as a coping mechanism for the experience of providing sex for a fee.
“I couldn’t do it sober. I was drunk all the time”
“I was in my addiction, active addiction, and I didn't have money for drugs. And a girl who was doing sex work, told me that I can get money for my drugs, if I did what she was doing. And she introduced me to doing that. I didn't realize at the time that she was pimping me out. And she was taking most of the money. That’s how I first got introduced to it. So, but I was just wanting money for drugs.”
Five of the seven participants in the study reported having some sort of disability that hindered their day-to-day activities. These included being hard of hearing, attention deficit hyperactivity disorder (ADHD), dyslexia, gastrointestinal issues, and obesity. Six of the seven participants reported having a mental health issue that impacted functioning. These included PTSD, bipolar, borderline personality disorder, anxiety and depression, compulsive sexual disorder, agoraphobia, and hypersomnia. In particular, some participants, echoing the research of Roe-Sepowitz (2014), noted that their complex trauma made them more susceptible to coercive control in the context of sexual exploitation, with five of the participants reflecting on the impact that childhood trauma had on their experiences of being sexually exploited and identified those childhood experiences as potential push factors into sex work. Most of the participants discussed how the disability preceded their experiences in the sex trade whereas the mental health issues were in part as a result of or made worse by their experiences of sexual exploitation.
“It was almost like, you know…like men could almost like see… it was written on me… that I had a history of sexual trauma… men or a group of men that would, you know , have the power and it [sexual exploitation] was to control me and what I do with my body.”
“When I was in that lifestyle, I had a very negative self-image. I'm worthless nobody cares about me. Nobody loves me. Nobody cares. I'm all alone. I was actually suicidal as well…there were times where … I just wanted to die. Because I saw no hope and getting out of what I was doing”
Two of the participants talked about how physical limitations were ignored by their pimp, forcing them to perform, regardless of their health status.
“I have gastrointestinal issues and like I got the runs really bad once… they [the pimp] just got me some Imodium and told me to suck it up.”
“A number of times, I came up with chlamydia, gonorrhea, syphilis, herpes and stuff like that. And even though this was happening, I was still doing it [sex work]”
Participants also discussed how their sense of physical safety was jeopardized as a result of coercive control and lack of personal agency, often leaving them battered, bruised, and traumatized.
One participant shared a near death experience that jeopardized her safety:
“I can remember one time, we [her and her pimp] got caught in a drive by shooting, and the guy used me as a body shield, and I remember a bullet… grazed my forehead… it was terrifying.”
Another participant described a sexual assault that happened, making her fear for her life:
“I knew I was f**ked. And because human trafficking is like, you know, pretty insane out there. And that was, um, that was scary because I got raped by all of them. I was in a room, they weren't gonna let me go”
A further participant described her assault at the hands of an intimate partner:
“I ended up going back to this guy [boyfriend/pimp] and until I was beaten to a point where my face was literally bruised right up”
“I actually went back [to sex work after exiting]. Not because of drugs, just because I was, like, really stressed about money…Like, I sexually exploited myself.”
For voluntary sex workers, push factors might not be experienced in the context of coercive control. For some of the participants whose journey began voluntarily, sex work was a good answer to the push factors such as poverty, homelessness, and no employment options.
One participant’s solution to economic challenges was described as follows:
“Like my parents kicked me out. I had no money. What was I going to do? I dropped out of high school.”
For another participant, sex work was a family business:
“My mum always said, if you have five sugar daddies, you charge them $1,000 a week each - five grand a week. That's all you need, you know, you don't go out all over the place”
The most commonly discussed push factors that participants shared were addictions, poverty, and homelessness. For the most part the engagement in sex work due to these push factors alone did not create for participants an experience of sexual exploitation. It was when pull factors such as a third party like a pimp or boyfriend demanding they engage in sex work, to address poverty or addictions issues, that their experience became an experience of coercion.
One participant’s description of a third party coercing her into sex work was:
“I was by choice at first, until I got into my abusive relationship, then it felt like I had to, because he would not get a job. He would go and spend all of our income support money on booze. And he would always, he'd always say, he hated me doing the job. But yet, he would be like, “oh, go post an ad.” You know, we need money, or, you know, he'd go and spend all the money. So, I had no other choice but to do it. So, it was more when I was in the abusive relationship, it felt like I had to”
Another participant described her third party coercion the following way:
“If I owe money to say … my mom because she takes care of my son, she pushes me to work [referring to sex work].”
With a third participant describing her coercive control by a third party, her boyfriend/pimp, in regards to her ability to engage safely in sex work.
“I wasn’t allowed to have sex with them, but I was allowed to give them b***j***… it was stressful at time because… what if they [the john] wants to have sex? I can’t go buy condoms.”
Pull factors that influenced participants’ engagement were primarily coercion perpetrated by third parties who were exploiting participants for financial gain. In the case of the study’s participants the third parties included sex traffickers, pimps, intimate partners, and in one case a parent. The third parties used a variety of coercive and controlling tactics to create a sense of fear in the participants trapping them into sexual exploitation.
One participant described how physical threat acted as a coercive mechanism for her:
“I loved him from the first moment I saw him. So, it was just hope that it [him pimping her out] would get better… and he would make all these empty promises [to stop pimping her out]. I think he would have really hurt me.
Another participant shared a very similar experience:
“I didn't have that choice. Not only that, there were times I was forced to take on two guys at once, and he would watch or sometimes the money didn't even come in my hands go straight in his hands... the guy [boyfriend/pimp] would get mad if I… said anything. Or a beating, or a lot of stuff being talked down…”
Two of the participants discussed how the oil and gas economy in Alberta played a role in influencing sexual exploitation. There is a well-researched link between extractive industries such as oil and gas and sexual exploitation and assault (US Department of State, 2017, Finn, Gadja, Perin, & Fredricks, 2017). In Alberta, the economic boom provided by the oil and gas sector, prior to 2018, led to rapid population growth in communities close to oil and gas extraction sites, a transient population, a gender imbalance with more men in the community, and high pay - leading to disposable income amongst a younger demographic of men (Hill, Alook, Hussey, 2017). All these factors have led to an additional economic pull factor influencing sexual exploitation.
“It’s because of oil and gas money. Yeah, if you go up to [town close to oil and gas extraction site], like I can go up … and make like $2-3,000 and tips for the week.”
“You got to feel safe first before you can talk about trauma…. As I started to feel safe, I started to, my body kind of started to like, stop being in survival mode and start healing. [I have been here] for 13 months”
Participants also commented on the necessity of services that addressed the right issue. For some of the participants their entry into services was via addictions treatment, which although it addressed issues of substance abuse, it did not address the underlying trauma experienced as a result of sexual exploitation, making it hard for participants to successfully engage in the programs and services.
“Well, I know that when I was using more than half the woman that I knew …, they have all been sexually exploited. Those people that I knew they were being sexually exploited. And whether it was exchanging themselves or prostitution escorting. So, if that many people are doing that, and then they're going to [addiction] treatment centers, if they do end up in treatment centers, and that's not being talked about in treatment centers. Then how is anyone supposed to get help or healing for this problem that's happening out there that like, how is anyone supposed to get healing for being sexually exploited? If no one's ever talking about it in [addiction] treatment centers.”
Three of the participants noted trauma experienced at the hands of the social services system, especially as children with one participant sharing the following experience of a conversation with her child welfare worker after expressing suicidal ideation as a teenage:
“… as a teenager, while I was a ward of the Alberta government, and I remember being told at one time, if I tried to kill myself, they were going to charge me with destruction of government property, because I was a property of the government.”
Six the participants reported the intimate partner violence was an aspect of their experiences of sexual exploitation and in some cases was the entry point into services, however they also commented that, in some cases, intimate partner violence based programs turned them away as they did not fit the typical profile of an abused woman.
“Most of the women’s shelters didn’t even want to take me. They’re like, well, you have a fentanyl addiction you have a history of prostitution, “you’re not right for our facility.”
“He strangled me. And like don't get me started on the court system...he got assault, causing bodily harm and then reduce to assault and only got 43 days in jail, if it was a pimp, he'd be charged with it [sexual exploitation]. So why is it any different in a domestic violence situation? Because they [boyfriends who coerce partners into sexual exploitation] are pretty much the same as pimps.”
The coercive control that is experienced by this population can lead to a woman acting as an agent of her perpetrator in everything from sexual exploitation to drug trafficking and other illegal acts (Eriksson & Ulmestig, 2017, Moe, 2004). For three of the women in the study, this was the case which led to the participants experiencing conflict with the law, that in some of the cases led to imprisonment. This included experiences of the participants trafficking drugs and weapons and committing fraud for the perpetrator as part of the overall experience of coercive control.
“There were other things that they had me do that wasn’t like just sex work. Like carry around drugs and smuggle firearms. Stuff like that, that I felt… if I don’t do this… they’re going to really hurt me.”
“I would end up arrested… with possession of drugs. I mean like the cops always treated me with, like, no respect… the emotional abuse like “you stupid whore”, you know, like, the degradation.”
For now it can be noted that participants said the following:
“I think the reason why [had to work more] for that because it was COVID, and it was harder to get clients at that point. But they would encourage me to work, like, as much as I could and to work at certain times of the day. Like, if I slept, they [pimps] got mad.”
“Especially with COVID because the numbers are so high and some girls just feel so trapped.”
One participant in referring to the STI testing she was subjected to as part of the exploitation shared:
“They kept saying, oh we should, we’ll get you tested… and then they never did. This was during COVID… So everything was shut down…”
To adequately address experiences of sex work and sexual exploitation it is necessary to move beyond a binary model of voluntary and involuntary sex work with narrow definitions and solutions. In addition, it is critical that this issue is viewed through not through a moralistic lens, but through a human rights and public health lens that is evidenced based. Policy, including legislative frameworks and the justice system response should recognize the coercive and controlling nature of sexual exploitation, including this framework of understanding as part of the criminal code. In viewing sexual exploitation with narrow lenses such as trafficking and/or prostitution, it ignores the true experiences of sexually exploited women who often find themselves at the intersections of criminality, domestic abuse, prostitution, and/or trafficking. Practice considerations should also move beyond a binary understanding of this issue and recognize that interventions need to be broad enough to address the intersections noted above as well as ensuring that, they too, have a coercive control lens and are multi-agency approaches that are long-term, strengths-based, wrap around, and address complex trauma. Lastly, there should be a robust prevention strategy to address and negate push and pull factors, working to stop sexual exploitation before it begins. The experiences and implications of the experiences of sex work and sexual exploitation on both the individual and society are complex, and the solutions crafted need to reflect that complexity taking a tri-pronged lens of prevention, protection, and prosecution.
Adler, F. (1975). Sisters in Crime. New York, McGraw Hill.
Anandarajah, G. & Hight, E. (2001) Using the HOPE Questions as a Practical Tool. American Family Physician, 63(1), 81–88.
Argento E, Goldenberg S, Braschel M, Machat S, Strathdee SA, et al. (2020) The impact of end-demand legislation on sex workers’ access to health and sex worker-led services: A community-based prospective cohort study in Canada. PLOS ONE 15(4)
Askola, Heli (2007). Legal Responses to Trafficking in Women for Sexual Exploitation in the European Union. Worcester, UK, Hart Publishing.
Australian Government (2020). Combatting Modern Forms of Slavery, Plan of Action against Forced Labour, People Trafficking and Slavery, 2020-25. Retrieved from https://www.mbie.govt.nz/dmsdocument/13568-combatting-modern-forms-of-slavery-plan-of-action-against-forced-labour-people-trafficking-slavery
Australian Government, 2020, National Action Plan to Combat Modern Slavery 2020-25
Australian Government, Department of Social Services (2020). Support for Trafficked People Program. Retrieved from https://www.dss.gov.au/women/programs-services/reducing-violence/anti-people-trafficking-strategy/support-for-trafficked-people-program
Bales, K. (2007). What predicts human trafficking? International Journal of Comparative and Applied Criminal Justice, 31, 269-279
Bales, K., & Soodalter, R. (2010). The slave next door: human trafficking and slavery in America today (2nd ed.). University of California Press
Benoit, C., Atchinson, C., Casey, L., Jansson, M., McCarthy, B., Phillips, R., Reimer, B., Reist, D., and Shaver, F.M., (2014). Contexts of Vulnerabilities, resiliencies, and care among people in the sex industry: a working paper prepared as background to Building on the Evidence: An International Symposium on the Sex Industry in Canada. Canadian Institutes of Health Research; Institute of Gender and Health.
Brents, Barbara and Hausbeck, Kathryn (2001) State-Sanctioned Sex: Negotiating Formal and Informal Regulatory Practices in Nevada Brothels, Soc. Persp. 44 (307)
British Home Office, 2020. Modern Slavery: National Referral Mechanism and Duty to Notify Statistics.
Bowley, Mary Frances (2012). The White Umbrella: Walking with Survivors of Sex Trafficking. Chicago, IL, Moody Publishers
Canadian Criminal Code, 1985 Sections 279.01, 279.011, subsection 279.02(1), 279.02 (2), 279.03 (1), 279.03 (2).
Canada Department of Justice (CDOJ). (2017) Technical Paper: Bill C-36, Protection of Communities and Exploited Person’s Act. Retrieved from https://www.justice.gc.ca/Eng/Rp-Pr/Other-Autre/Protect/P1.Html
Canadian Public Health Association, 2014, Sex Work in Canada – A position paper.
Casavant, L. and Valiquet, D., (2014). Bill C-36: An Act to amend the Criminal Code in response to the Supreme Court of Canada decision in Attorney General of Canada v. Bedford and to make consequential amendments to other Acts. Library of Parliament, Publication No. 41-2-C36-E
Clark, J. L. (2006). Listening for Meaning: A Research-Based Model for Attending to Spirituality, Culture and Worldview in Social Work Practice. Critical Social Work, 7(1).
Commission on the Status of Women A/RES/59/166, 10 Feb 2005
Connell, R.W., (1987) Gender and Power: Society, the Person and Sexual Politics. Stanford University Press, Stanford, CA.
Creswell, J. (2013). Qualitative inquiry and research design: Choosing among five approaches. (3rd ed.). Thousand Oaks, CA: Sage.
Cunningham, Fiona & Jacquin, Kristine. (2018). Age of Entry into Sex Work is a Myth.
Cusick, L., Brooks-Gordon, B., Campbell, R. & Edgar, F., (2011) ‘Exiting’ drug use and sex work: Career paths, interventions and government strategy targets, Drugs: Education, Prevention and Policy, 18:2, 145-156
Cusick, L., and Martin, A., (2003). Vulnerability and involvement in drug use and sex work. Home Office Research, Development and Statistics Directorate. Study 268
Dando CJ, Walsh D, Brierley R (2016) Perceptions of Psychological Coercion and Human Trafficking in the West Midlands of England: Beginning to Know the Unknown. PLoS ONE 11(5)
Dayan, Hava, (2018). Sexual abuse and charismatic cults. Aggression and Violent Behaviour 41 25-31
Deering, K. N., Amin, A., Shoveller, J., Nesbitt, A., Garcia-Moreno, C., Duff, P., Argento, E., & Shannon, K. (2014). A systematic review of the correlates of violence against sex workers. American journal of public health, 104(5).
Demleitner, N., (1994) Forced Prostitution: Naming and International Offence’. Fordham International Law Journal 18.
Department of Labour (2004) A guide to occupational health and safety in the New Zealand sex industry, Wellington: Department of Labour
DiRienzo, C. E., Das, J. (2017). Human trafficking and country borders. International Criminal Justice Review.
Edinburgh, L. D., and Saewyc, E.M. (2008). A novel, intensive home-visiting intervention for runaway, sexually exploited girls. Journal for Specialists in Paediatric Nursing, 14 (1), 41-48
English Collective of Prostitutes (2020) retrieved from, http://www.prostitutescollective.net/
Eriksson, M., & Ulmestig, R. (2021). “It’s Not All About Money”: Toward a More Comprehensive Understanding of Financial Abuse in the Context of VAW. Journal of Interpersonal Violence, 36(3–4)
Farley, M., and Barkan, H. (2008). Prostitution, violence, and posttraumatic stress disorder. Women and Health, 27 (3). 37-41
Fergus, L, (2005). Trafficking in women for sexual exploitation. Australian Centre for the Study of Sexual Assault. Briefing No. 5.
Ferguson A, Philipson I, Diamond I, Quinby L, Vance CS, Snitow AB. (1984) Forum: The feminist sexuality debates. Journal of Women in Culture and Society, 10 (1), 106–125
Finn, K., Gadja, Erica, Perin, Thomas, and Fredericks, C., (2017). Responsible Resource Development and Prevention of Sex Trafficking: Safeguarding Native Women and Children on the Fort Berthold Reservation. Harvard Journal of Law and Gender 40 (1).
Frischer, M., Haw, S., Bloor, M., Goldberg. D., Green, S., McKeganey, N. and Covell, R. (1993). Modelling the behaviour and attributes of injecting drug users: a new approach to identifying HIV risk practices. The International Journal of Addictions, 28, 129-152.
Galiana C., (2000) Trafficking in Women. European Parliament Working Paper, Brussels.
Galtung, Johan (1969). Violence, Peace and Peace Research. Journal of Peace Research. 6 (3): 167–191.
Gerassi L. (2015). A Heated Debate: Theoretical Perspectives of Sexual Exploitation and Sex Work. Journal of sociology and social welfare, 42(4), 79–100.
Gerassi, L., Edmond, T., and Nichols, A. (2016). Design strategies from sexual exploitation and sex work studies among women and girls: Methodological considerations in hidden and vulnerable populations. Action Research Journal.
Gerassi, Laura and Nichols, Andrea (2017). Sex Trafficking and Commercial Sexual Exploitation: Prevention, Advocacy and Trauma Informed Practice. Springer Publishing, NY.
Government of Alberta (2020). COVID-19 Opioid Response Surveillance Report. Retrieved from https://open.alberta.ca/dataset/f4b74c38-88cb-41ed-aa6f-32db93c7c391/resource/e8c44bab-900a-4af4-905a-8b3ef84ebe5f/download/health-alberta-covid-19-opioid-response-surveillance-report-2020-q2.pdf
Government of Alberta (2020) Protection of Sexually Exploited Children Act.
Government of British Columbia. (2021) Retrieved from https://www2.gov.bc.ca/gov/content/justice/criminal-justice/victims-of-crime/human-trafficking/human-trafficking-training/module-1/vulnerabilities
Government of British Columbia. (2021) Human Trafficking -National List of Organizations. Retrieved from https://www2.gov.bc.ca/gov/content/justice/criminal-justice/victims-of-crime/human-trafficking/human-trafficking-training/resources/national-organizations
Government of Canada.(2017). Technical Paper: Bill C-36, Protection of Communities and Exploited Persons Act. Retrieved from https://www.justice.gc.ca/eng/rp-pr/other-autre/protect/p1.html#sec2a
Government of Netherlands, 2018. Together against human trafficking: An integrated programme approach to tackling sexual exploitation, labour exploitation and criminal exploitation. Retrieved from https://english.wegwijzermensenhandel.nl/binaries/Programme%20Together%20against%20Human%20Trafficking%20(def)_tcm116-385111.pdf
Government of Netherlands 2018, Violent Offences Compensation Fund. Retrieved from https://english.wegwijzermensenhandel.nl/Organisations/schadefondsgeweldsmisdrijven.aspx
Hayes, Sophie. (2012). Trafficked: The Terrifying True Story of a British Girl Forced into the Sex Trade. Harper Collins.
Harcourt, C., & Donovan, B. (2005). The many faces of sex work. Sexually transmitted infections, 81(3), 201–206.
Heil, E. C. (2017). It is God’s will: Exploiting religious beliefs as a means of human trafficking. Critical Research on Religion, 5(1), 48–61.
Heinz, Andrea (2020) "On Exiting from Commercial Sexual Exploitation: Insights from Sex Trade Experienced Persons," Dignity: A Journal of Analysis of Exploitation and Violence: 5 (1) Article 8.
Hill, N., Alook, A., Hussey, I., (2017). How gender and race shape experiences of work in Alberta’s oil industry. Parkland Institute retrieved from https://www.parklandinstitute.ca/how_gender_and_race_shape_experiences_of_work_in_albertas_oil_industry
Hepburn, Stephanie & Simon, Rita. (2010). Hidden in Plain Sight: Human Trafficking in the United States. Gender Issues. 27. 1-26.
House of Commons Home Affairs Committee (2016-17) Prostitution: Third Report of Session. Retrieved https://publications.parliament.uk/pa/cm201617/cmselect/cmhaff/26/26.pdf
House of Commons Canada (2021). The Shadow Pandemic: Stopping Coercive and Controlling Behaviour in Intimate Relationships: Report of the Standing Committee on Justice and Human Rights. Retrieved from https://www.ourcommons.ca/Content/Committee/432/JUST/Reports/RP11257780/justrp09/justrp09-e.pdf
Howard, S. (2018). Better health for sex workers: Which legal model causes least harm? BMJ: British Medical Journal (Online)
Hughes D.M., (2005) The demand for victims of sex trafficking. Chicago Alliance Against Sex Trafficking
Human Trafficking Foundation (2021) Mapping Trafficking Survivor Services. Retrieved from https://www.humantraffickingfoundation.org/support-services
IOM UN Migration retrieved from https://www.iom.int/
James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016) The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.
Jordan, J, (2005) The Sex Industry in New Zealand: A Literature Review. New Zealand Ministry of Justice
Kelly, E., (2002) Journeys of Jeopardy: A Review of Research on Trafficking in Women and Children in Europe. IOM Migration Research Series.
Kelly, L., & Regan, L. (2000). Stopping Traffic: Exploring the extent of, and responses to, trafficking in women for sexual exploitation in the UK. British Home Office. 1-62
Kurtz, S. P., Surratt, H. L., Kiley, M. C., & Inciardi, J. A. (2005). Barriers to health and social services for street-based sex workers. Journal of health care for the poor and underserved, 16(2), 345–361.
Lalich, J., (1997). Dominance and submission: They Psychosexual Exploitation of Women in Cults. Cultic Studies Journal, 14 (1) pp. 4-21
Lange, A. (2010) Research note: Challenges of identifying female human trafficking victims using a national call 1-800 call centre. Trends in Organized Crime, 14(1). 47-55
Leidholdt, D. (1996) Sexual Trafficking of Women in Europe. A Elman (editor). Sexual Politics and the European Union. Berghahn Books, Providence, NJ.
Lloyd, Rachel (2011). Girls Like Us: Fighting for a World Where Girls Are Not for Sale, an Activist Finds Her Calling and Heals Herself, Harper Perennial
Mameli, P., (2002). Stopping the Illegal Trafficking of Human Beings. How Transnational Police Work Can Stem the Flow of Forced Prostitution. Crime, Law & Social Change 38(67)
Mayhew, Pat and Mossman, Elaine (2007) Exiting Prostitution: Models of Best Practice. New Zealand Ministry of Justice.
McCann, J., Crawford, G., & Hallett, J. (2021). Sex Worker Health Outcomes in High-Income Countries of Varied Regulatory Environments: A Systematic Review. International journal of environmental research and public health, 18(8).
McIntyre, S (2008) Under the Radar: The sexual exploitation of young men. www.hindsightgroup.com
Menaker, T., and Franklin, C. (2013). Commercially sexually exploited girls and participants perceptions of blameworthiness: Examining the effects of victimization history and race disclosure. Journal of Interpersonal Violence, 28, 2024-2051.
Menezes, S. (2019). A Thesis on Exiting Prostitution: Implications for Criminal Justice Social Work. International Journal of Criminal Justice Sciences, 14, 67.
Miller, J. (1995). Gender and power on the streets: street prostitution in the era of crack cocaine. Journal of Contemporary Ethnography, 23, 427-452
Modern Slavery Act (2015). UK Government. Retrieved from https://www.legislation.gov.uk/ukpga/2015/30/contents/enacted
Moe, A. M. (2004). Blurring the Boundaries: Women’s Criminality in the Context of Abuse. Women’s Studies Quarterly, 32(3/4), 116–138.
Native Women’s Association of Canada (2014) Sexual Exploitation and Trafficking of Aboriginal Women and Girls: Literature Review and Key Informant Interviews
Nichols, A. J. and Heil, E.C. (2014). Challenges to identifying and prosecuting sex trafficking cases in the Midwest United States. Feminist Criminology, 10 (1), 7-35.
Nijhoff, M. (2014). Feminism, Prostitution and Trafficking: A Complex Approach. Legal Responses to Trafficking in Women for Sexual Exploitation in the European Union.
Network of Sex Work Projects (NSWP) (2020) retrieved from https://www.nswp.org/
O’Brien E., Hayes S., Carpenter B. (2013) Causes of Trafficking. In: The Politics of Sex Trafficking. Critical Criminological Perspectives. Palgrave Macmillan, London.
O'Doherty, Tamara. (2011). Criminalization of Off-Street Sex Work. Canadian Journal of Criminology and Criminal Justice.
Orchard, T., Salter, K., Bunch, M., & Benoit, C. (2020). Money, Agency, and Self-Care among Cisgender and Trans People in Sex Work. Social Sciences, 10(1)
Organization for the Security and Cooperation in Europe, motion on trafficking 24, July 2003
Oselin, S. (2014). Leaving prostitution: Getting out and staying out of sex work. New York University Press: New York.
Outshoorn, J. (2012) Policy Change in Prostitution in the Netherlands: from Legalization to Strict Control. Sex Res Soc Policy 9, 233–243.
Parliament of Australia, 2021. Retrieved from https://www.aph.gov.au/Parliamentary_Business/Committees/Joint/Former_Committees/acc/completed_inquiries/2002-04/sexual_servitude/report/c04
Patterson, Kelly R. (2018). From Trafficked to Treasured. Red Door Sentinel
Peled, E., and Cohavi, A. (2009). The meaning of running away for girls. Child Abuse & Neglect, 33 (10), 739-749
Peng, Yenwen (2005) Of course they claim they were coerced: On voluntary prostitution, contingent consent, and the modified whore stigma. Journal of International Women’s Studies. 7 (2).
Pietkiewicz, I., and Smith, J., (2014). A practical guide to using Interpretative Phenomenological Analysis in qualitative research psychology. Czasopismo Psychologiczne – Psychological Journal, 20 (1) 7-14
Pinto, S., Scandia, A. and Wilson, P., (1990) Prostitution Laws in Australia. Australian Institute of Criminology No. 22
Platt L., Grenfell, P., Meiksin, R., Elmes, J., Sherman, S.G., Sanders, T., Mwangi, P., Crag, A.L., (2018) Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies. Plos Medicine 15 (12)
Pringle, J., Drummond, J., McLafferty, E., & Hendry, C. (2011). Interpretative phenomenological analysis: a discussion and critique. Nurse researcher, 18(3), 20–24
Prostitution Reform Act (2003) Government of New Zealand. Retrieved from https://www.legislation.govt.nz/act/public/2003/0028/latest/DLM197815.html
Potterat, J.J., Rothenberg, R.B., Muth, S.Q., Darrow, W.W., Phillips-Plummer, L. (2001) Pathways to prostitution: The chronology of sexual and drug abuse milestones. Journal of Sex. 35(4) 333–340
Potterat, J.J, Woodhouse, D.E., Muth, John B., and Muth, Stephen Q., (1990). Estimating the Prevalence and Career Longevity of Prostitute Women. The Journal of Sex Research, 27 (2), 233-243
Roe-Sepowitz, Dominique E, Hickle, Kristine E, Dahlstedt, Jaime, & Gallagher, James. (2014). Victim or Whore: The Similarities and Differences between Victim's Experiences of Domestic Violence and Sex Trafficking. Journal of Human Behavior in the Social Environment, 24 (8), 883-898.
Roe-Sepowitz, D., Gallagher, J., Hickle, K., Perez, M., and Tutelman, J. (2014). Project ROSE: An arrest alternative for victims of sex trafficking and prostitution. Journal of Offender Rehabilitation, 53 (1), 57-74
Sagesse Domestic Violence Prevention Society, 2021. Retrieved from www.sagesse.org
Schubert, S., & Lee, C. W. (2009). Adult PTSD and its treatment with EMDR: A review of controversies, evidence, and theoretical knowledge. Journal of EMDR Practice and Research, 3(3), 117–132
Sidun, D.L, Alejano-Steele, A., Burke, M. C., Contereas, M., Finckenauer, J.O., Liss, M.B., Pierce, A.S., (2014). Report of the task force on trafficking of women and girls. American Psychological Association.
Singer, Margaret Thaler (1995) Cults in Our Midst; The Continuing Fight Against Their Hidden Menace. (2003 Revised and Updated Edition). San Francisco, CA: A Wiley Imprint, Jossey- Bass.
Sloss, C.M. and Harper, G.W. (2010). Legal services needs and utilization of women who trade sex. Sexuality Research and Social Policy, 7(3)
Smith, J. A., Flowers, P, & Larkin, M. (2009). Interpretive Phenomenological Analysis: Theory, method, and research. London, UK: Sage Publications
Smith, J., & Osborn, M. (2008). Interpretative Phenomenological Analysis. In J. Smith (Ed.), Qualitative psychology: A practical guide to research methods (2nd ed., pp. 53-80). Los, Angeles, CA: SAGE Publications
Snow, Natalie & Steely, Mollee & ten Bensel, Tusty. (2020). The Right to Life, Liberty and Security for Prostitution: Canada v. Bedford. Women & Criminal Justice. 1-8.
Stanjoska, A & Petrevski, B., (2012) Theory of Push and Pull Factors: A New Way of Explaining the Old
Stardust, Z., (2014) Protecting Sex Worker Human Rights in Australia. International Bar Association, Public and Professional Interest Division.
Stark, E. (2010). Do Violent Acts Equal Abuse? Resolving the Gender Parity / Asymmetry Dilemma. Sex Roles, 62 (3-4) 201-211.
Statistics Canada. (2019). Family violence in Canada: A statistical profile, 2018. Retrieved from https://www150.statcan.gc.ca/n1/en/pub/85-002-x/2019001/article/00018-eng.pdf?st=EUfB0iMz
Strega, S., Casey, L., and Rutman, D., (2009) Sex Workers Addressing Treatment. Women’s Health and Urban Life 8 (1), 42-53
Stein, Alexandra (2017). Terror, Love and Brainwashing: Attachment in Cults and Totalitarian Systems, Routledge
SWARM Collective (2021) retrieved from https://www.swarmcollective.org/
Taylor, I. and Jamieson, R., (1999). Sex Trafficking and the Mainstream of Market Culture. Crime Law and Social Change 32(257)
Tiefenbrun, S. (2001) Sex Sells but Drugs Don’t Talk: Trafficking of Women Sex Workers. Thomas Jefferson Law Review 27 (199)
UK Sexual Offences Act 2003. Retrieved from https://www.legislation.gov.uk/ukpga/2003/42/section/53A
United States Department of State, Office to Monitor and Combat Trafficking in Persons (2017). The Link Between Extractive Industries and Sex Trafficking. Retrieved from https://www.state.gov/wp-content/uploads/2019/02/272964.pdf
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK, 18-CR-204-1 (NGG) (VMS) United States v. Ranier
Usher, K., Bhullar, N., Durkin, J., Gyamfi, N., & Jackson, D. (2020). Family violence and COVID-19: Increased vulnerability and reduced options for support. International journal of mental health nursing, 29(4), 549–552.
Van Dam, D., Ehring, T., Vedel, E., and Emmelkamp, P.M.G. (2013). Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: A randomized controlled trial. BMC Psychiatry, 13, 172.
Vickerman, K. A., & Margolin, G. (2009). Rape treatment outcome research: empirical findings and state of the literature. Clinical psychology review, 29(5), 431–448.
Wade, A. (1997). Small Acts of Living: Everyday Resistance to Violence and Other Forms of Oppression. Contemporary Family Therapy, Vol. 19 (1), 23-39
Ward, H., & Day, S. (2006). What happens to women who sell sex? Report of a unique occupational cohort. Sexually transmitted infections, 82(5), 413–417.
Weitzer R. (2007) The social construction of sex trafficking: Ideology and institutionalization of a moral crusade. Politics & Society.35(3) 447–475
Wheaton, E. M., Schauer, E. J., & Galli, T. V. (2010). Economics of Human Trafficking. International Migration, 48(4), 114–141.
Williams, Miriam (1998). Heaven’s Harlots: My Fifteen Years as a Sacred Prostitute in the Children of God Cult; William Morrow & Company, NY, NY.
Williamson, Celia, & Cluse-Tolar, Terry. (2002). Pimp-Controlled Prostitution. Violence against Women, 8(9), 1074-1092.
Worden, Danielle (2018) Sex trafficking: towards a human rights paradigm, The International Journal of Human Rights, 22(5), 709-732
World Health Organization (2021). Work to prevent sexual exploitation and abuse. Retrieved from https://www.who.int/about/ethics/sexual-exploitation-abuse
Chief Executive Officer
Sagesse Domestic Violence Prevention Society
Carrie McManus
Director of Innovation and Programs
Sagesse Domestic Violence Prevention Society
Rod Dubrow-Marshall, PhD
Professor, Co-Programme Leader,
Masters of Science Psychology of Coercive Control
University of Salford and RETIRN, UK
Table of Contents
Understanding the Experiences of Coercive Control and Sexual ExploitationExecutive Summary
Summary of Recommendations
Introduction
Scope of Sexual Exploitation
Understanding Sexual Exploitation versus Trafficking
Methodology
Qualitative Study
Policy, Practice and Legislative Review
Approaches and Legislative Models
Policy and Legislation Review
Practices/Interventions Review
Voices of Lived Experience – Qualitative Study Review
The participants
Superordinate Themes
Journey of Sex Work
Wellbeing
Coercive Control
Interventions and Services
Protection and Enforcement
COVID-19
Recommendations
Recommendation #1: Recognize the Continuum of Sex Work in Policy, Legislation and Practice
Recommendation #2: Update Trafficking Definitions in Legislation, Policy and Practice
Recommendation #3: Inclusion of Sex Work Within Coercive Control Definitions and Practice
Recommendation #4: Service & Support Provision Funding and Accessibility
Recommendation #5: Inclusion of Sex Work within Canadian Coercive Control Legislation
Conclusion
References
Executive Summary
Sexual exploitation of women is recognized worldwide as an issue of significant concern (WHO, 2021). Sexual exploitation of adults happens through a variety of means, causing trauma to those who are victims of the exploitation. There is not a common understanding or definition of what sexual exploitation is across jurisdictions or even sectors, with current definitions and scope being either too narrow, or too broad, making it almost impossible to know the scope of the issue (Kelly and Regan, 2000). Societally there is a debate about the best way to address the sex trade ranging from legalization and regulation to criminalization. Although a commonality of definition and understanding of scope is absent, there is a common experience of coercive control reported by those with lived experience of sexual exploitation. Little is understood around the intersection of the experience of sexual exploitation and coercive control.This paper presents a policy, practice and legislative review in jurisdictions similar to a Canadian context while also exploring a qualitative Interpretative Phenomenological Analysis (IPA) study presenting perspectives of 7 women with lived experience of sexual exploitation and coercive control, describing their journey of sex work, experiences of wellbeing, the impact of coercive control, the efficacy of intervention, services, protection, and enforcement and the impacts of COVID-19 on their experiences. The study offers a unique perspective of lived experience individuals who have been engaged in sex work, their loss of personal agency (capacity to act or exert power over their own actions) while recognizing the complexity of the continuum of voluntary and involuntary sex work. Implications for legislative and intervention practices are offered that include the suggested inclusion of coercive control legislation into the Canadian Criminal Code (CCC) that encompasses sexual exploitation, interventions that recognize the need for strengths bases, long- term, multi-agency approaches and practice frameworks that are multi-faceted and recognize the complexity of the lived experiences of women who engage in sex work.
WARNING: This research paper contains details some may find disturbing. Discretion is advised.
Summary of Recommendations
Recommendation #1: Recognize the Continuum of Sex Work in Policy, Legislation and Practice
All study participants expressed their experiences of sex work as a continuum from voluntary to involuntary sex work, including in some cases moving back and forth along the continuum within the same day. Legislation and policy related to sex work needs to be built off the understanding of the issues as a continuum of experiences, voluntary to involuntary (including sexual exploitation and trafficking), with the understanding that most individuals engaged in sex work are at many places on the continuum throughout their experiences.Recommendation #2: Update Trafficking Definitions in Legislation, Policy and Practice
Practice/interventions that require participants to identify as victims of trafficking create barriers to entry, or require individuals to code switch (i.e. identifying as what the service requires in order to access the necessary programs and services). Legislation and policy related to sex work needs to move away from trafficking focused definitions to adopt above mentioned expanded definitions providing context of the continuum from sex work that is voluntary to sex work that is involuntary.Recommendation #3: Inclusion of Sex Work Within Coercive Control Definitions and Practice
Sexual exploitation has been frequently understood within the framework of push and pull factors. While this is a valuable framework for understanding sexual exploitation, it does not fully acknowledge the role coercive control plays in driving push and pull factors. Implement a new nation-wide working definition of sex work to reflect coercive control within the sex work continuum of voluntary to involuntary, allowing for contextualization of experiences of loss of personal agency and the implications of that loss on emotional and physical liberty.Recommendation #4: Service & Support Provision Funding and Accessibility
Services for sexually exploited women need to be long-term, strengths-based, non-judgmental, address addictions issues, provide specialization in addressing the experiences of sexual exploitation, and address complex trauma (Gerassi & Nicols’, 2017). Individuals engaged in sex work should not be made to access programming that does not match their self-perceived experiences of sex work along the continuum of voluntary to involuntary.Recommendation #5: Inclusion of Sex Work within Canadian Coercive Control Legislation
As per the recommendations from the Standing Committee on Justice and Human Rights report The Shadow Pandemic: Stopping Coercive and Controlling Behaviour in Intimate Relationships (2021), Canadian criminal laws should be changed to reflect the harms of coercive and controlling behaviours which are not currently captured in criminal laws.Introduction
Sexual exploitation, of an adult, happens through a range of means including the abuse of a position of trust, threats, and/or the forcing of the sale of sexual services (Casavant & Valiquet, 2014). Sexual exploitation can broadly be categorized into 5 types of coercion that include forced migration and trafficking, enslaved sexual exploitation, intimate partner violence, sexual exploitation through coercive groups, and structural violence.Trafficking of women for sexual exploitation has been viewed through a variety of lenses including the lens of illegal migration (IOM, 2021), the global marketization of sexual representation (Taylor & Jamieson, 1999), organized crime (Mameli, 2002), human rights issues (Worden, 2018), and lastly as an innate part of the question of involuntary (forced) prostitution and the sex trade (Askola, 2007, Demleitner, 1994, Leidholdt, 1996). Trafficking of women has been broadly defined as the “transport or sale of women, with or without the consent of the victim, use of enticement, deception, force or intimidation, for the purposes of prostitution or other sexual abuse” (Kelly & Regan, 2000, P3). The main factor that distinguishes trafficking for the purposes of sexual exploitation from more generalized trafficking or forced migration is that women trafficked for the purpose of sexual exploitation are delivered both to a location and to an individual and/or organization who are a party to the trafficking transaction and, who after the women’s arrival at a location, coerce them into sexual exploitation. In addition, since a fee has been paid for the individual, often this fee is then translated into a debt that the women is coerced to pay through sexual exploitation. In some jurisdictions this activity is viewed both as trafficking for the purposes of sexual exploitation and modern slavery (Askola, 2007). In the case of generalized migration, it is most often limited to delivering the individual to the country they wish to enter at which time the individual is then left to fend for themselves (Kelly & Regan, 2000).
Enslaved sexual exploitation is exploitation that is often conflagrated with trafficking (Kelly and Regan, 2000). In many jurisdictions worldwide if an individual is held against their will, transported from ‘point a to point b’ and forced into sex work, this is defined as trafficking (Hepburn and Simon, 2013). However, for victims of sexual exploitation, the trafficking definition does not feel like it fits their experiences, an example of this would be the ‘homegrown slaves’ that Bales & Soodalter (2009) describe. These are women that are kidnapped off American streets and forced into involuntary sex work. There are similar stories of ‘average middle class’ and disadvantaged women being kidnapped and forced into sexual exploitation in other western countries such as the UK and Italy (Lloyd, 2012, Bowley, 2012, Hayes, 2012, Patterson, 2018). Enslaved sexual exploitation, is perhaps more than any other type of sexual exploitation tied into the economic or ‘pull’ drivers of sexual exploitation. These drivers best describe sexual exploitation as a “monopolistically competitive industry with many sellers offering many buyers differentiated products based on price and preferences of the individual employers.” (Wheaton, Schauer & Galli, 2010 p. 117). In this case the seller is the kidnapper, the buyer is the individual purchasing sex aka ‘the trick or john’, the product is the sexually exploited individual and the employer is the pimp.
Sexual exploitation as a consequence of intimate partner violence is a result of the intersection of domestic abuse and sexual exploitation. Bruggerman & Keyes (2009) found that some victims of domestic abuse report being forced to engage in sexual exploitation as part of the abuse. In addition, Roe-Sepowitz et al, (2014) found that women who were coercively controlled into sexual exploitation by individuals whom they view themselves as being intimate, have the same experiences of love and intimacy as abused women have with their abusers. The pimp-prostitute relationship can hold the same characteristics as an abusive relationship (Williamson & Cluse-Tolar, 2002, Roe-Sepowitz et al. 2014, Hickle, Dahlstedt, & Gallagher, 2014). Intimate partner sexual exploitation includes coercively controlling tactics that include “secrecy, violence, dominance and power, rules, psychological abuse and instability, relationship-based, grooming, traumatic events, economic control, barriers to disclosing victimization, consequences of victimization and challenges of escaping/leaving.” (Roe-Sepowitz et al., 2014 p. 887 & 888).
Sexual exploitation through coercively controlling groups such as cults and religious groups occurs as part of a broader framework of coercive control perpetrated by these groups. Lalich (1997) asserts that the “sexual exploitation of women in cults of all types is widespread, and, to date, is possibly the least talked about, and certainly the least researched, aspect of cult life” (p. 7). Sexual exploitation in the context of coercively controlling groups can take different forms including coerced engagement with the group’s leaders, coerced involuntary prostitution on behalf of the group, coerced engagement with other members of the group, and in some cases also includes coerced reproduction (William, 1998, Stein, 2017). In most western countries sexual relations between consenting adults is not viewed as coerced or exploitive, however, in recent years both scholars and courts have recognized that sexual relations that occur within the framework of coercively controlling groups need to take into account the sociological characteristics of the group which can impair a woman’s ability to provide informed consent (Dayan, 2018, US District Court Eastern District of NY, 2019). According to Stein (2017), leaders of cults perpetrate a form of coercive control similar to that seen in domestic abuse. The leader gains control of the women’s personal agency, cutting her off from close relationships and portraying themselves as the sole ‘safe haven’. The resulting ‘trauma bond’ is created through these experiences in which everything and everyone outside of the group feels threatening and compromises a victim’s ability to attend to her own survival needs.
Sexual exploitation as a result of structural violence is often described as the factors that ‘push’ women into sexual exploitation. Structural Violence, introduced in 1969 by Johan Galtung, refers to a form of violence in which social institutions harm people by preventing them from meeting basic needs. These ‘push’ factors are mechanisms that coerce women into involuntary sex work such as addictions, mental health issues, political instability, homelessness, racism and the legacy of colonialism, gang involvement, and poverty (BC Government, 2021). The idea of ‘push’ factors originated in the concept that individuals who are structurally discriminated against in their home society are pushed to leave their jurisdiction of origin for the promise of better opportunities (Bales, 2007, DiRienzo & Das, 2017). Researchers have taken this idea of ‘push’ factors as a result of structural discrimination and extended them to include all factors that can be considered to be perpetrate structural violence (Kelly & Regan, 2000, Stanojoska & Petrevski, 2012, CPHA, 2014).
Each of these five distinct forms of sexual exploitation intertwine and overlap with each other, creating a complex web of understanding, defining the experience and impact of sexual exploitation. The experiences of sexual exploitation of women will be explored in focus in the qualitative study that follows.
In attempting to understand sexual exploitation, it is important to differentiate it from voluntary sex work. According to the Canadian Public Health Association (CPHA) (2014), sex work can be understood as the “consensual exchange of sexual services between adults for money or goods.” (CPHA, 2014 p. 3). This exchange of services can happen in a variety of venues (private homes, online, in public, etc). It is important to note that delineating the difference between involuntary and voluntary sex work is contentious and there are numerous moral debates occurring among scholars, service providers, and those with lived experience as to the validity of the concept of voluntary sex work (Gerassi, 2015). The debate around voluntary sex work is split into two ‘opposing camps’, neo-abolitionist, who believe that all sex work is involuntary and coerced and “postulate that prostitution is never entirely consensual and cannot be regarded as such” (p. 2), and sex positivists who assert that voluntary sex work can be a chosen career (Ferguson, Phillipson, Diamond, Quinby, Vance & Snitow, 1984). Opponents of the sex positivist position argue that consent and voluntary engagement in sex work needs to be viewed within the context of the high rates of sexual assault and abuse histories of sex workers and in the context of structural violence (Hughes, 2005, Potterat, Rothenberg, Muth, Darrow & Phillips-Plummer, 2001, Weitzer, 2007). Sex positivists argue that women should have self-determination to make the decisions that they choose around engagement in any form of work, including sex work, and that there is a strong negative correlation between the criminalization of sex work and sex workers health and safety (Platt, Grenfell, Meiksin, Elmes, Sherman, Sanders, Mwangi, Crago, 2018, SWARM Collective, 2021, English Collective of Prostitutes, 2021, NSWP, 2021, Peng, 2005). In recent scholarship the notion that all sex work is exploitation analysis, has attracted strong criticism. It has been argued that “prostitution is not always inherently exploitative; it can also be well paid (especially as far as ‘women’s work’, typically systemically undervalued, is concerned) and hard work, which should be a matter of individual choice.” (Akola, 2007 p. 25). These issues will be explored further in the study which is reported later here.
Scope of Sexual Exploitation
The current number and scope of sexually exploited women is largely unknown. In great part this is a result of the wildly varied legislative frameworks and definitions across jurisdictions (Grassi, 2015, Kelly and Regan, 2000). In addition, sexual exploitation is not conformable to traditional forms of research and data collection due to the hidden nature of the issue and the vulnerability of sexually exploited women. (Kelly & Regan, 2000). Most research is based on a thin slice of information provided by the police, and it is unknown what percentage of victims report to police (Kelly & Regan, 2000, Askola, 2007). However, inferences can be drawn from other types of similar crimes such as domestic abuse and sexual abuse where between 12-20% of women report to police, (Statistics Canada 2019) meaning that the scope of the issue is most likely much larger than reported in government documents and research.The existence of sexual exploitation, especially trafficking, has not been fully recognized in many countries (Kelly, 2002). The current estimates that exist, lack empirical data to back the numbers, and are at best ‘educated guesses’ (Askola, 2007, Kelly & Regan, 2000). Current numbers that have been postulated vary widely from 500,000 women trafficked in Western Europe annually (Galiana, 2000), 142 to 1,420 women sex trafficked in UK per year (Kelly & Regan, 2000) and 45 – 50,000 women and children sex trafficked in the United States per year (Tiefenbrun, 2001). With one study in the UK noting that 11% of men in the UK between the ages of 16-74 had accessed a sex worker in 2016 (Home Affairs Committee, 2016). The study does not identify how many of those sex workers were voluntary and how many were sexually exploited.
Scholars, practitioners, and those with lived experience of sexual exploitation appear to use the terms prostitution, sexual exploitation, involuntary (forced) sex work and sex trafficking interchangeably across Canada and globally. A 2014 study conducted by Native Women’s Association of Canada (NWAC) noted that sex workers and practitioners, in referring to sexual exploitation, “made no discernible statements indicating a difference in view of women who have been sexually trafficked and women who have been prostituted” (p. 8). Nijhoff (2014), highlighted the critic of the ‘exploitation analysis’ in their research on trafficking in women in the EU, as it lumps together exploited, trafficked, and voluntary sex works, in effect “reducing all women in prostitution to nothing but passive victims of patriarchal society and denying their agency in making informed choices about engaging in it.” (p. 25).
The trafficking definition is too narrow, the exploitation analysis is too broad, and each jurisdiction (local, provincial, federal and international) calls the same act, a different thing, making it almost impossible to truly know the scope of the issue. The study which follows intends to allow the voices of sex workers themselves to be heard with the aim to add clarity to definitions moving forward.
Understanding Sexual Exploitation versus Trafficking
The conflagration of sex work, sexual exploitation, prostitution, and trafficking has not only led to a deficit in understanding of the scope of these issues; it has also led to other systemic issues in addressing sexual exploitation.Askola, (2007) offers the caution that if you view the issue narrowly, you will create an insufficiently narrow response. If the issue of exploitation is only a gender bias issue, as identified through an ‘exploitation analysis’ (Nijhoff, 2014), then the response created will be a gender bias analysis response. In addition, the feminist underpinnings of our definition of sexual exploitation have led to this issue being viewed through a binary lens of “oppression of women by ‘men and their laws’, which conceals the complexity of and variations in subordination, overemphasises the role of the sexual and is insufficient to alter the diverse motivations of the actors in prostitution.” (Nijhoff, 2014, p. 25). The binary view of oppression of women by men has also led to an under representation and dearth of research in the area of men and trans people in voluntary and involuntary sex work. As early as 1987, Robert Connell was offering up a systematic framework of marginalized expressions of gender and sexuality that offer wider definitions than a binary framework of women oppressed by men, yet despite this there has been an adherence in among both scholars and practitioners serving sexually exploited individuals to the binary nature of exploitation. Scarce research exists around the scope or experience of men, trans, and non-binary individuals and their experiences of sexual exploitation, however it is clear from the research that does exist that further exploration of this area is missing. A 2008 report titled, “Under the Radar: The Sexual Exploitation of Young Men”, found that young men have comparable experiences of sex work to young women, except for generally entering sex work at an older age, (over the age of 18) and that they work in the sex trade for a longer period of time than women (McIntyre, 2008). Trans and non-binary people are overrepresented based on population in sex work, with 72% of respondents in the 2015 US Transgender Survey reporting they have done sex work (James, Herman, Rankin, Keisling, Mottet & Anafi, 2016), yet most legislation in the US and worldwide only offers protections for women and children who are sexual exploited, or sex trafficked (Platt et al, 2018).
Methodology
This report includes:- A literature review of policy, practice and legislation from five global jurisdictions with similarities to the Canadian context
- A qualitative IPA study presenting perspectives of 7 women with lived experience of sexual exploitation and coercive control. Qualitative data collected and shared through this paper are taken from a concurrently created Masters of Psychology in Coercive Control dissertation through the University of Salford.
Qualitative Study
The questions asked focused on a history-taking of the participants’ experiences in sex work; if they perceived themselves to be choice based or coerced; their experiences of sex work as conceptualized in a coercive control framework reflecting both ‘push’ and ‘pull’ factors endemic to sex work; and their experiences of social services and the justice system as sex workers. Intending to encourage participants to share of their experiences, the protocol included 17 open-ended questions that elicited participants lived experiences and held space safely and comfortably for ‘humble reflexive inquiry’ (Clark, 2006). Interviews were semi-structured as this method is understood to be an effective method in encouraging participants to engage in conversation (Smith & Osborn, 2008). A systematic approach to data analysis was taken to capture themes and clusters of these as superordinate themes that also referred to the participants’ narratives.Policy, Practice and Legislative Review
Approaches and Legislative Models
Sexual exploitation in its complexity requires a comprehensive approach to ensure that sexually exploited women are safe and healthy. According to Askola (2007), in referring to the UN Resolution on Trafficking and the EU Action Plan to Combat Trafficking in Human Beings, a comprehensive plan needs to have three components: prevention, prosecution, and protection. Prevention is about stopping sexual exploitation before it occurs. This aspect of a comprehensive plan would address the root causes of sexual exploitation with a focus on the ‘push’ aspects, building responses and frameworks that would eliminate the ‘push’ aspects related to sexual exploitation. Prosecution is the enforcement aspect of any response to sexual exploitation. This is ensuring that there is criminalization and implementation of enforcement strategies to safeguard victims of sexual exploitation, addressing some of the ‘pull’ aspects of sexual exploitation. In any comprehensive plan it would be critical that this aspect correctly addresses the true scope of the issue. Askola (2007) notes that when too narrow an analysis is placed on the scope of sexual exploitation it can lead to a less than sufficient response from the justice systems, i.e., a narrow “migration analysis would lead to an insufficient and lopsided ‘migration response”. Protection would be the aspect of any comprehensive plan that would address the need for intervention practices and policies for women who are currently trapped in sexual exploitation. The gradual realization on behalf of international and transnational bodies of the complexity and scope of sexual exploitation has led to the knowledge that only a comprehensive, three-pronged plan, will be sufficient to stop, or even reduce, sexual exploitation (UN Commission on Status of Women, 2005, OSCE, 2003).The three-pronged approach to addressing sexual exploitation has led different jurisdictions to one of five different types of legislative frameworks for sex work, both voluntary and involuntary. These are: full criminalization of all sex work, partial criminalization of sex work, criminalization of the purchase of sex, regulatory frameworks for sex work, and lastly full decriminalization.
Jurisdictions like the US and South Africa have followed a full criminalization framework in which all aspects of selling and buying sex or the organization of sex work is prohibited. This legislative framework applies to both voluntary and involuntary sex workers (Platt et al, 2018). In the US, there are some jurisdictional exemptions for this law, such as in the State of Nevada (Brents & Hausbeck, 2001). In the UK (except Northern Ireland) there is a partial criminalization of sex work, in which the organizing of sex work is prohibited, including solicitation, running a brothel, working with others, and the involvement of a third-party selling sex. This framework essentially criminalizes any ‘organization’ of sex work (Platt et al., 2018). This framework applies to both voluntary and involuntary sex workers. Canada, France, Northern Ireland, Ireland, Norway, and Sweden have implemented what is often referred to as the ‘Nordic Model’. This legislative framework criminalizes the purchase of sex, identifying the sex worker as ‘victim’. This model criminalizes the buying of sex as well as penalizing sex workers who work together and any third party who benefits from the ‘avails’ of sex work. This framework applies to both voluntary and involuntary sex workers (Howard, 2018). The regulatory model is a legislative framework that applies only to voluntary sex workers. It is a model that licenses the sale of sex and often includes regulatory practices such as condom use, sexual transmitted infection (STI) and human immunodeficiency virus (HIV) testing, and registration. This regulatory model can be found in some states in Australia, Germany, and the Netherlands. Lastly is the full decriminalization model. In this legislative framework all aspects of adult sex work are decriminalized. This model applies only to voluntary sex workers. The only jurisdiction to currently employ this model is New Zealand, which also requires condom use in some locations (Platt et al, 2018, Howard, 2018, PRA, 2003).
A systemic review and meta-analysis of all five above types of models and their impact on the safety and health of sex workers (voluntary and involuntary) found that no model provided full protections. It found that criminalization (full or partial) interacted with stigma, exposes sex workers to physical and sexual violence, and limits the ability of sex workers to resist or challenge the violence. It found that criminalization of clients did not facilitate access to services or minimize violence. Regulatory models were associated with better physical health and safety, however the stigma attached to being registered had a detrimental effect on mental health. The decriminalization model, in New Zealand, had led to sex workers reporting greater safety, better mental health, more choice over who they see as clients, what sex acts they engage in, and improved relationships with police. These outcomes in both the regulatory and decriminalized models did not include involuntary sex workers (sexually exploited women) as they remain under a system of criminalization (Platt et al., 2018). The question of how this is experienced by sex workers will be explored further in the study.
Despite the variance in legislative frameworks worldwide, the focus of all intervention frameworks are aligned, supporting sexually exploited women to experience health and safety and, in some cases, exit sex work. Most of the intervention models have a harm reduction lenses, even when driven by abolitionist principles and often intersect with other types of gender-based violence interventions (Gerassi & Nichols, 2017). The experiences of women who have been sexually exploited in regard to interventions and services and what worked for them, will be explored in the study that follows.
Policy and Legislation Review
Legislative frameworks and the legislation that follows those frameworks have a large influence on the experiences of sexually exploited women. Often, when developing legislative frameworks, jurisdictions seek to understand best practices and practical experiences of legislative frameworks in sister jurisdictions with similar values, approaches, and philosophies. Canada, when developing legislation, often looks to Australia, New Zealand, Netherlands, England and Wales. This is especially evident in Canada’s review of its prostitution and coercive control legislation. In the development of Canada’s prostitution legislation time was spent, in particular, reviewing Nordic and decriminalization models (Government of Canada, 2017) and recently Canada has looked to England and Wales in relation to exploring the inclusion of coercive control into the CCC (House of Commons Canada, 2021). This study is focused on the experiences of Canadian women who have experienced sexual exploitation and therefore a review of legislative frameworks in jurisdictions Canada often looks to, is important to contextualize the experiences of the study participants. Reviewing and comparing the legislation around sex work, sexual exploitation, and trafficking in five progressive jurisdictions; Australia, Canada, England and Wales, Netherlands, and New Zealand, who have committed to address structural discrimination through their governmental approaches, can provide insight into best and promising practices in addressing the sexual exploitation of women in Canada. The lived experiences of sex workers, as will be reported later, can also be interpreted in the context of these legislative frameworks.Sex work in Australia is predominately governed by each territory and states legislation except for laws related to slavery, sexual servitude, and trafficking, which are governed by federal legislation. Legislation varies across Australia’s nine jurisdictions, with each legislative framework varying widely from decriminalization models to making most forms of sex work illegal. Most jurisdictions in Australia have criminalized specific forms and aspects of sex work such as street-based sex work and solicitation. The exception to this is New South Wales. The laws around brothels and two or more sex workers working together vary from state to state, with most allowing some sort of brothel, that is often regulated. In all jurisdictions, except Victoria, it is an offence to procure an individual for the purposes of sex work (Pinto, Scandia & Wilson, 1990. Stardust, 2014). All state laws apply to both voluntary and involuntary sex workers, with involuntary or coerced sex workers also being governed by an additional set of federal legislation, the Slavery and Sexual Servitude Act 1999. This Act added the following offenses to the Australian Criminal Code, Division 270: sexual servitude, sexual slavery, and deceptive recruiting. Sexual servitude under the code is defined as “'the condition of a person who provides sexual services and who, because of the use of force or threats is not free to cease providing sexual services; or is not free to leave the place or area where the person provides sexual services” (Parliament of Australia). Human trafficking offenses in Australia are primarily tied to coerced exit and entry into Australia, making it illegal to exit someone from Australia for sexual services or exploitation and entry into Australia for sexual services under the guise of deception (Australia Criminal Code Act 1995, Section 271.2).
Canada, unlike Australia, has only one set of federal laws that govern sex work which can all be found within the Canadian Criminal Code. Bill C-36, the Protection of Communities and Exploited Person’s Act, defines sexual exploitation of an adult as: “use or threats to use violence; abuse of a position of trust, power, or authority; providing an intoxicating substance to encourage the sale of sexual services; engaging in conduct that would amount to procuring; receiving the benefit in the context of a commercial enterprise that offers sexual services for sale provides protections for victims of sexual violence” (Casavant & Valiquet, 2014). The purpose of the Act was to stop the exploitation of individuals “who engage in prostitution activities” (Casavat & Valiquet, 2014, p. 1). The Act assumes that most sex workers are involuntary and require protections as exploited individuals. The Act allows for ‘out of public view’ street-based sex work and sex work at a designated location (Canada Department of Justice (CDOJ), 2017). In addition, Canada also has provisions through the Trafficking in Person’s section of the Criminal Code to address sexual trafficking. Trafficking as defined by the Criminal Code does not have to involve physical movement of the individual and is broadly defined as causing someone to provide a service by engaging in conduct that, in all the circumstances, could reasonably be expected to cause the other person to believe that their safety or the safety of a person known to them would be threatened if they failed to provide, or offer to provide, the service (CCC, 1985).
In 2003 New Zealand passed the Prostitution Reform Act (PRA, 2003), making it the first jurisdiction in the world to fully decriminalize adult sex work. The intent of the Act was to shift policy from a moralistic to human rights and public health approach, with a focus on safeguarding the human rights of sex workers, protection from sexual exploitation, promoting the welfare and occupational health and safety of sex workers, and prohibiting childhood sexual exploitation (Abel, Healy, Bennachie & Reid, 2010). It allows for sex work to operate under the same industry rules as any other business in New Zealand, with the exception of non-residents not being able to be given operating permits. The sex industry is governed by its own regulatory guidelines developed by the Department of Labour (DOL, 2004). The PRA also prohibits certain types of solicitation and has made illegal sexual exploitation which can include force, inducing or compelling to another to provide services, claim earnings derived from sex work and/or use of a prior relationship with a sex worker to bribe or force them to provide sexual services. The Act allows for consent to sex work to be withdrawn at any point during a transaction (Abel et al, 2010).
England and Wales has a series of laws that address sexual exploitation of adults which are included in the Sexual Offences Act 2003, and Modern Slavery Act 2015. The approach of these acts is to focus on the prosecution of individuals who force others into prostitution, exploitation, and perpetrate abuse and harm. Sexual exploitation is addressed by the Crown Prosecution Services as part of the Violence Against Women and Girls portfolio. The Sexual Offences Act, 2003, 53A criminalizes paying for sexual services of a sex work subject to force. Force is defined as threats or any other form of deception and/or coercion. The Modern Slavery Act 2015 criminalizes trafficking for the purpose of sexual exploitation.
Voluntary sex work in the Netherlands is legal between consenting adults and adheres to a regulatory model (Outshoorn, J, 2012). Involuntary sex work is a criminal act that can be found in Netherlands Criminal Code Serious Offences Against Personal Liberty Section 273f. It criminalizes sexual exploitation through abduction, force, induction, profiting from the exploitation of another, and compelling or inducing an individual to provide to a third party their proceeds from sex work. The legal framework in the Netherlands understands human trafficking to be a modern-day form of slavery (Government of Netherlands, 2018).
A 2018 study Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies found that laws that criminalized street-based sex work, solicitation, and communication about sex work in public places compromised sex workers safety. It also found that criminalization of all aspects of sex work, institutionalized violence, coercion, extortion of sex workers, and restricted their access to justice, in addition criminalization also restricted the access of sex workers to health and social services and other forms of support. It also recognized that criminalization increased the stigma that sex workers experienced (Platt et al, 2018). In addition, it is of note, that with the exception of New Zealand, none of the jurisdictions have a legislative framework for understanding the framework of coercive control as it relates to sexual exploitation. It is hoped that the study which follows will shine additional light on the nature of these lived experiences.
Practices/Interventions Review
As noted by Platt et al (2018) there are a variety of negative health and safety outcomes that involuntary and voluntary sex workers experience. Sex workers, especially sexually exploited women, are generally considered to be a marginalized and isolated group of individuals with all of the negative mental and physical health outcomes that arise as a result of that marginalization (Snow, Steely, Bensel, 2020).As a result of the lack of agreed upon language and meaning around the definition of sexual exploitation of an adult, there is a gap in our understanding around the scope of sexual exploitation (Casavant & Valiquet, 2014). Without this understanding it is challenging to develop services and interventions for women who are sexually exploited (Minister Leela Aheer, Minister of Culture & Status of Women, Government of Alberta, personal communication, July 10, 2020). As such it is hoped that the new study reported below will contribute to enhanced understandings in this area.
Similar to the development of legislation, practitioners often look to find best and promising practices in other legislations that reflect similar contexts. In Canada, the jurisdictions that are often looked to for best and promising intervention practices in addressing sexual exploitation are Australia, New Zealand, the Netherlands, England and Wales. To contextualize the experiences of participants of the study, it is helpful to understand best and promising practices in other jurisdictions, their relationship to the legislation and potential implications for the Canadian context. In Canada, New Zealand, Australia, England and Wales, and the Netherlands interventions and services for sex workers primarily focus in the areas of health and safety, supporting women to exit sex work, addiction, and mental health services, and providing access to health, justice, and social services. Interventions and services primarily take a trauma-informed, harm reduction approach. Many interventions intersect with other gender-based violence supports and services and/or consider themselves to be part of the continuum of gender-based violence services. (Strega, Casey, Rutman, 2009, Kurtz, Surratt, Kiley, & Inciardi, 2005, Argento, Goldenberg, Braschel, Machat, Strathdee & Shannon, 2020, Cusick, Brooks-Gordon, Campbell & Edgar, 2010 Jordan, 2005, Mayhew & Mossman, 2007, Howard, 2018 McCann, Crawford & Hallett, 2021).
Although Canada has a robust continuum of services to address gender-based violence, there is a shortage of supports and services for sexually exploited women, with some women having to travel across Canada to access programming, especially residential programming (Carrie McManus, Sagesse Domestic Violence Prevention Society, personal communication May 10, 2021). Sex workers in Canada have experienced significantly reduced access to health and community-based services as a result of the implementation of recent laws that specifically criminalize the purchase of sex, solicitation, and street-based sex work (Agento et al, 2020). Canada has a national human trafficking hotline and a continuum of service delivery organizations funded through federal, provincial, and local governments, foundations, and faith communities across Canada to address victims of sexual exploitation and trafficking. Services include accommodation, vocational training, addiction and mental health supports, and access to health, legal, and financial support (Government of British Columbia, 2020). The primary approach of most sexual exploitation and trafficking services in Canada is a trauma informed harm reduction model (McManus, 2021).
In England and Wales, the focus for sexually exploited women is a hybrid model of safeguarding and exiting sex work approach with services that include accommodations, education and vocational training, psychological interventions, and access to legal and health services. In some cases, these are multi-agency responses with a focus on ‘anti-slavery’ aligned with the Modern Slavery Act 2015 (Human Trafficking Foundation, 2021). According to the Human Trafficking Foundation, in 2020 over 10,000 potential victims of human trafficking/modern slavery were referred for support (British Home Office, 2020).
Australia’s National Action Plan to Combat Modern Slavery 2020-25 has, as a key component, a support for trafficked people program (Australian Government, 2020). The program is a comprehensive program delivered by the Australian Red Cross and provides accommodation, vocational training, psychological supports, financial supports, and accesses to health and legal services (Australian Department of Social Services, 2020). Australian based Project Respect and the Coalition Against Trafficking in women have suggested that there is a need for ‘women focused’ social services in Australia to work more closely with sexually exploited women, recognizing that sexually exploited women are having similar experiences of rape and sexual assault as women who experience domestic abuse (Fergus, 2005).
Similar to Australia, New Zealand has a national plan to combat modern forms of slavery. The Plan of Action Against Forced Labour, People Trafficking and Slavery 2020-25, outlines prevention, protection, and prosecution goals to address the drivers of exploitation, within a framework of understanding the impacts COVID-19 on exploitation (PAAFLPTS, 2020). The plan engages a cross ministerial approach. Victims of sex slavery in New Zealand are offered government and community-based supports that include accommodation, psychological supports, financial supports, access to legal and health services, and vocational support. In addition, New Zealand also offers compensation or reparation and/or repatriation to victims that have been exploited in relation to prostitution or other sexual services. The plan notes that services will be trauma informed recognizing that victims can be traumatized by their experiences (PAAFLPTS, 2020). The experiences of interventions, such as the ones notes above, for sexually exploited women will be explored in the study that follows.
Like Australia and New Zealand, the Netherlands has a national trafficking action plan. The Together Against Human Trafficking program is a multi-pronged approach that includes ‘made-to-measure’ interventions and supports at the municipal level for victims of human trafficking (Government of Netherlands, 2018). Victims of human sex trafficking are offered accommodations and care coordinators that provide wrap around services including access to health and legal supports, psychological services, financial supports, and gender-based violence supports (Government of Netherlands, 2018). In addition, victims may be offered compensation through the Violent Offences Compensation Fund (VOCF) (Government of Netherlands 2018).
According to Gerassi and Nichols (2017) the most successful services for victims of sexual exploitation are offered from a theoretical framework in which their intersecting identities and needs are recognized. In reviewing different theoretical models, Gerassi and Nichols (2017) found that certain models such as strengths-based practice, that incorporates cultural competency, have been empirically found to have successful outcomes for sexually exploited adults, while other models such as the Trans Theoretical Model (TTM) which is often paired with Motivational Interviewing are widely used, yet lack empirical support. Harm reduction models have been found to be particularly successful when addictions are involved as part of the experience of sexual exploitation, this is particularly applicable to sexually exploited women as it is estimated that approximately 80% also experience substance abuse issues (Farley & Barkan, 2008). Similar to the strengths-based approach, a survivor defined empowerment practice model builds on an individual’s strengths and addresses the need for a specialized model that recognizes intersecting identities and needs. Survivor defined models have been recommended for adults who have been sexually exploited (Nichols & Heil, 2014, Sidun et al, 2014). Menaker and Franklin (2013) note that rapport building with sexually exploited individuals is critical as they are more likely to experience fear, stigmatization, and judgement.
In addition to the above theoretical models, there is research that has shown that trauma-based treatment is a promising practice for survivors of sexual exploitation. (Gerrasi & Nichols, 2017). In a review of trauma informed treatment models, Seeking Safety - focusing on cognitive, behavioural, interpersonal, and case management, and Trauma Recovery and Empowerment Model - focusing on cognitive restructuring, psychoeducation, and coping skills to address mental health and addictions, have been found helpful for sexually exploited individuals with addictions and mental health issues (Gerassi & Nichols, 2017). Additional evidence based mental health treatments that have been found to be helpful in treating victims of sexual exploitation include Cognitive Behavioural Therapy (Van Dam, Ehring, Vedel & Emmelkamp, 2013), Cognitive Processing Therapy (Vickerman & Margolin, 2009), Eye Movement Desensitization and Reprocessing Therapy (EMDR) (Schubert & Lee, 2009), and Mindfulness (Gerassi & Nichols, 2017).
It is clear from the research that what is critical within any intervention and service delivery framework, is a model in which intersecting identities and needs are recognized (Gerrasi & Nichols, 2019). Although there has been extensive research on trauma informed and evidence based mental health models, there appears to be gaps in research around models that explore a client’s spiritual practices such as the HOPE Spiritual Assessment Tool (Anandarajah & Hight, 2001) or response-based models such as the Power Threat Meaning Framework (Johnston & Boyle, 2018) and the Response Based Model (Wade, 1997). Both the legislation and interventions recognize the coercive and controlling nature of sexual exploitation, however, interventions and services have not yet widely accepted response-based models that have been proven effective in addressing the impacts of coercive control on victims. The interviews with sex workers which follow will allow an exploration of the personal lived experience with regards to these matters.
In each of the above jurisdictions mentioned, the laws and interventions appear to recognize the nature of coercion and control in relation to sexual exploitation. Third party exploitation whether by force or other means is a recognized criminal act and the intervention services appear to be offered to any individual who meets the legal criteria for being sex trafficked or exploited. It should be noted that both England - Wales and Canada, in the absence of national strategy, have services for any individual who identifies as sexually exploited. In addition, regardless of whether or not a jurisdiction adheres to a criminalization, partial or full decriminalization or regulatory model of sex work, all jurisdictions have legislation that criminalizes coerced or forced sex work. It is however of interest that New Zealand, who has a regulatory model of sex work with the highest reported positive outcomes around health and safety for voluntary sex workers, also has the most comprehensive laws and approach to address sexually exploited women that includes a robust framework for protection, prevention, and prosecution of sex work (Argento et al, 2020, Platt et al, 2018, Jordan, 2005, Abel et al, 2010, McCann et al, 2021, Howard, 2018, PAAFLPTS, 2020, PRA, 2003). The study that follows will explore the impact of Canadian legislative frameworks for participants and their experiences of the implementation of those legislative frameworks.
Voices of Lived Experience – Qualitative Study Review
To add context to the literature review it is critical that there is an understanding of the experiences of coercive control for sexually exploited women through their own voices and meaning making. This was accomplished through an interpretive phenomenological analysis (IPA) approach that guided the analysis of the interviews with participants. The focus of an interpretive phenomenological analysis (IPA) is to understand how an individual makes sense of their experiences (Pietkiewca & Smith, 2014). Emergent themes were identified through the transcripts of the interviews with participants and then were seen to be associated through the identification of convergent and common superordinate themes. These superordinate themes that were identified included the journey of sex work, wellbeing, coercive control, interventions and services, protection, and enforcement, and lastly, the intersections of COVID-19 and sex work. Each of the superordinate themes embodied multiple subordinate themes that deepened the analysis and understanding of the experiences of participants. Although each participant had unique experiences, there are also evident common experiences woven through their experiences of sex work and sexual exploitation.The participants
Eleven participants enrolled in the study, with only seven completing the interview. Four participants dropped out after signing the informed consent and before the interview after deciding that it would be too difficult to revisit their experiences of sexual exploitation for the research project. Sagesse approached the 350 partner organizations that are a part of its network across Alberta to participate in this study. Interviews were arranged by Sagesse to ensure that all participants had pre and post interview supports in place. To be eligible for inclusion in the study participants had to be female identified individuals, eighteen and over, who identified as having experienced sexual exploitation. Written consent was provided prior to the interview and verbal consent was video recorded as outlined in ethics approval for this project through the University of Salford. All the participants in the study were born in Canada with their primary or secondary language being English. One of the participants identified Cree as her first language, another reported French as the alternative language spoken in her home and a third also reported speaking German at home. The participants’ age ranged from 25 to 38 with five of the participants being in their 30s. All the participants, except one who identified as Indigenous with Status, were Caucasian, and all currently living in a large city in Alberta, Canada with two of them having relocated from Ontario and one having relocated from British Columbia. Half of the participants had experiences of living and working in rural and remote Alberta and one participant had lived On Reserve, a geographic area defined by the Canadian government as legally affiliated with First Nations or Indian bands where Registered Indians and First Nations people live. Two of the participants had children and all the women, except one who was divorced, identified themselves as being single. All the participants, except one, expressed having a mental or physical health issue that impacted their day-to-day functioning.Superordinate Themes
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Superordinate Theme |
Subordinate Themes |
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Journey of sex work |
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Wellbeing |
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Coercive control (push and pull factors) |
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Intervention and services |
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Protection and enforcement |
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COVID-19 |
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Journey of Sex Work
The first superordinate theme is identified as ‘journey of sex work’ which reflects the experiences of the participants’ entry into sex work, the length and type of sex work they engaged in, and their experiences of exiting sex work. There is an oft reported statistic that the average age of entry into sex work is 13 years old (Cunningham & Jacquin, 2018). This statistic is often used to inspire and incite policy makers to create protective legislation for sexually exploited women and children but can lead to assumptions about sex workers and sex exploitation that are harmful and end up creating “barriers to justice, social services and healthcare.” (Cunningham & Jacquin, 2018 p. 1). According to a study conducted by O’Doherty (2011) the majority of sex workers entered into sex work between 19 and 24 years of age. A 2014 Canadian study commissioned by the Canadian Institute of Health Research found that the average age of entry into sex work was 24 years old and a 2013 systematic review of the correlates of violence against sex workers found that the average age of entry into sex work was 20 years old (Deering, Amin, Shoveller, Nesbitt, Garcia-Moreno, Duff, Agento, & Shannon, 2013, Benoit, Atchison, Casey, Jansson, McCarthy, Phillips, Reimer, Reist, & Shaver, 2014).The majority of the participants of this study entered sex work over the age of 18 with three of the women having reported being sexually exploited as children.
Participants described the following:
“My parent, my adoptive parents, had adopted the other kids before me, and my brother, I guess, started wanting sex. And he would pay me for it. Um, I also had a grandfather, who was my mom's father, who was sexually abusing me for a few years then he would give me money to stay quiet… I think I must have been around five, six. I have no recollection. I can't even remember the first time.”
“16 was when I went to the bar with my aunties and my mom…the higher the heel, the shorter the skirt, [the] more men you got.”
“I was 13. And I gotten involved with these older men, one of them was kind of my boyfriend…who was like, 22. And then he, you know, he introduced me to his group of friends. And I don't know, it was kind of exploiting child porn and different things.”
For the other four women in the study, their entry point into sex work and sexual exploitation happened for them as adults.
Participants described experiences such as:
“…at first it was a boyfriend of mine who pimped me out. So, um, he, he kind of manipulated me into doing it. …I was 22.”
“I was 18. And a friend of mine suggested that we do stripping…So that's kind of how I got into it.”
“So, my ex had left me, and I was working two jobs, super stressed out. And my biggest fear was not being able to pay rent. So, I heard that I was going to be losing my full-time job. And I panicked. So, I said, might as well just start escorting like, I was a h* when I was a kid. So, I might as well just get paid for it”
“…when I was 19, I picked up meth for the first time... I would do anything to get it. So, the guy that sold it to me for the first time. I went and lived with him and to live with him I didn't pay rent. I slept with him to live with him. And I slept with him to get drugs”
The research on the number of years the average sex worker is active varies from 13.6 years to less than one year (Potterat, Woodhouse, Muth & Muth, 1990, Ward & Day, 2006). In the case of the participants of the study the number of years engaged in sex work varied from one year to 31 years, with the average number of years active being 11.
Harcourt and Donovan (2005) have broadly categorized sex work into direct and indirect work. Direct sex work is usually characterized by the exchange of sex for money. Direct sex work can include street-based sex work, brothels, escorts, private clients, clubs, and solicitation. Indirect sex work is sometimes not recognized as sex work because it either does not include a fee for service and/or the actual touching of genitals. These types of sex work can include trading sex for food, shelter, drugs, etc or be things like stripping and creation of porn content for movies or live cams. In Canada, where the participants in this study live, for adults, most forms of indirect sex work are legal, whereas direct sex work has a more robust legislative framework as noted above. All forms of sex work that are exploitative according to the framework set out by Canada’s Bill C-36 are illegal. In Alberta, Canada, where all the participants live according to the Protection of Sexually Exploited Children Act (2020) anyone under the age of 18 years old, is considered to be sexually exploited regardless of the type of sex work or the presence of consent.
The participants of this study engaged in a variety of different types of sex work, with the majority of them engaging in more than one type of sex work dependent on their needs at the time of engaging in the sex work, the coercion they were experiencing, and their sense of personal agency. There was only one participant who only engaged in indirect sex work as a stripper in different clubs.
“I started stripping in mid-sized city in British Columbia… my plan was to stay as a stripper till I was 30 and then try to go to medical school…Like I’ve never, I've never wanted to be paid for sex. I like sex. And if I want to have sex, I have sex.”
Another participant described below her experience of direct sex work:
“Like, I can remember the girl that introduced me to like, actually, exchanging sex for money, I can remember that. And I remember like, not wanting to do that. But she made it sound like it would be very, very easy. And all you have to do is just sleep with this guy, and you'll get money. And it's just like, it's pretend he's your boyfriend. And that's what she made it sound like. And it was not something that I wanted to do, though, because it just, it was just really frightening to think that I would be, like what if these people could hurt me? And what if they robbed me, and but it never did happen. Nothing bad ever happened with those people. And I was lucky. But the people that I exchanged like drugs for sex, those people were not nice… And it was just like a long cycle of like, oh, I can sleep with a drug dealer, or I can have sex with someone for money.”
Another participant reflected on her experiences of direct sex work:
“But then at an early age, I learned that the body can be a powerful thing. So, when I had started living in the city, I was deep into addiction. And that's how I survived in the world [through trading sex for money] …. I guess I found that even selling pictures of myself online was, I don't want to say beneficial, but I don't really know what word I want to use there. But it was a survival skill that I have learned from an early age.”
A further participant described her experiences of direct sex work, combined with other ways of making money:
“…it was kinda like, oh, like… we need money. And then it started with just getting sugar daddies. And then he [my boyfriend/pimp] was like, Oh, well, you can just like, um, give him a b***j**. I won't be mad at you. Just like put a covering on, you know, condom. And so, I started doing that. ..Then I started doing like, calls where I would, I would rob the tricks. And then he was like, Oh, well, that's too dangerous, just sleep with them kind of. So, then I ended up sleeping with them.”
And lastly, this participant shared her impetus into direct sex work:
“I'd always find a rich man that did drugs. They take care of me… when I was smoking crack for a really long time. I was like, holy shit this stuff's expensive like this is ridiculous I can't do this without s**king d**k.”
In addition, some of the participants in the study, only retrospectively after exiting sex work, viewed their engagement in different aspects of sex work, as sexual exploitation, having identified it as something different in the moment of the experience.
“I exchanged, like, sleeping with people for drugs before. But it would like be like, exchanging drugs for sex, not money for sex…. I do now [consider that to be sex work] since coming to [residential treatment program]. I never did before.”
A further participant described her emerging understanding of what was happening to her:
“I had no idea, I was being trafficked until last year, actually…I just started dating this guy who I thought the world of. And I just thought he loved me, I guess. And, of course, I didn't really know what love was. I didn't, I had no clue that I was being trafficked. I didn't even know that thing existed. I thought I was just voluntarily doing favours to this guy who I thought loved me … and because I loved him… I entered a women’s shelter after I was badly beaten one day [by boyfriend/pimp]. And my story just fell. And that's when I was told [by the women’s shelter staff] that that was human trafficking.”
The journey and decision to exit sex work for each of the participants was motivated by factors that included their safety and mental and physical health. For some of them the journey to exiting was interconnected with their journeys to sobriety from substance abuse. Mayhew and Mossman (2007) recognize that the decision to exit sex work is often more as a result of the risk involved with sex work and not for economic reasons, especially since sex work, as noted by some of the research participants, can be beneficial in term of offering both financial rewards and flexibility. Heinz (2020) notes that high financial compensation in the sex trade are the “golden handcuffs” that keep women in sex work. For three of the participants of the study, this was their reality, as they each of them estimated they were making over $85,000 per year. The process of leaving sex work is therefore complex and multiple attempts to leave are common before women successfully exit. Research has acknowledged that it is difficult to exit sex work and that many of the factors that lead women to enter sex work are the same things that act as barriers to exiting sex work (Mayhew & Mossman, 2007, Menezes, 2019, Heinz, 2020)
In the study one participant said about her experience of exiting:
“When I went to jail this last time and I called [exiting sex work program] and I said, I need to change. I need to do something. This is not working for me anymore. I've lost everything this time. Everything, everything. My son, I lost my family.”
For another, a traumatic event led to her exit and withdrawal from substances as well:
“I had a sister commit suicide this past summer. And I was down in the dumps, I guess, in a very dark world…after my sister committed suicide, I got into heavy drugs which is heroin and stuff like that. And everybody in the mid-sized Ontario city in my support network became very worried for my life because that's where I was heading was for death. And they had an intervention out on me with just bringing me to the hospital against my will, and they got the police services involved. So, I was brought to the hospital, really against my will. And I stayed at the hospital for nine …days and pure withdrawal and they decided that I was to go to treatment. I didn't really have a say.”
A further participant described another event which led to her exiting:
“So, he [boyfriend/pimp] went to jail and then that's when I stopped. Um, so it was, it was easy, because I didn't have to, you know, I didn't have to have an excuse. I didn't have to explain myself. And I kind of did it so that, you know, he would be happy with me, because he complained all the time... but yeah, him going to jail made it so much easier. I was just like, okay, I'm done one day, and I didn't have to fear that I would be in trouble. Or that I couldn't provide for him. And myself.”
For one of the participants who was being held against her will, the process of exiting was a moment of opportunity.
“Um, so he [pimp] had left me with this, how do I say it in a politically correct way, an addict in small sized town Ontario, for about five days. And I was just, like, f**ked up the whole time. And …they left the phone for me and left a phone with me so he [pimp] could get a hold of me. And luckily, I remember my mom’s phone number by heart, and I called her. And I said, Mom, like you have to get me out of here. Like, this is what's happening… And so, she immediately got her car and drove down to the address that I gave her…And [she] came and got me and I ran. I remember running out bolting out of that place before anybody could catch me. and running, running to the street barefoot to my mom.”
Three of the seven women in the study attempted multiple times to exit, with both expressing that they believe that this exiting experience will be more successful than past experiences due to the supportive programming they are currently receiving from the residential exiting sex work programs they are currently involved with.
“…the previous times [exiting sex work], it was just kind of, because I was, I was still a teenager, it was kind of, you know… removing me from the unsafe situation where I was, you know, where it was actually, like, trapped in and, you know, forced to do these things, and then moving into a safe place. And that's kind of what allowed me to escape. And then once I was an adult, it was like, those resources weren't there.”
Wellbeing
The next superordinate theme identified in this study is wellbeing and this related to previous findings that sexually exploited women experience lower than average mental and physical health, and higher levels of depression, anxiety, stress, Post-Traumatic Stress Disorder (PTSD), disabilities, and other factors that contribute to poor outcomes in mental and physical health. A study conducted by Benoit et al. (2014), noted that 29% of Canadian sex workers had a history of childhood trauma related to being in the care of children’s services, that just 38% of sex workers reported have good mental health, 53% reported having good physical health, and 35% reported have a long-term disability. This is significantly lower than the general Canadian population of whom 75% report having good mental health, 69% who report having good physical health and 14% who report having a long-term disability.All the participants had addiction issues and those issues were integrally tied into their experiences of sexual exploitation either as a mechanism that pushed them into sex work or as a coping mechanism for the experience of providing sex for a fee.
“I couldn’t do it sober. I was drunk all the time”
“I was in my addiction, active addiction, and I didn't have money for drugs. And a girl who was doing sex work, told me that I can get money for my drugs, if I did what she was doing. And she introduced me to doing that. I didn't realize at the time that she was pimping me out. And she was taking most of the money. That’s how I first got introduced to it. So, but I was just wanting money for drugs.”
Five of the seven participants in the study reported having some sort of disability that hindered their day-to-day activities. These included being hard of hearing, attention deficit hyperactivity disorder (ADHD), dyslexia, gastrointestinal issues, and obesity. Six of the seven participants reported having a mental health issue that impacted functioning. These included PTSD, bipolar, borderline personality disorder, anxiety and depression, compulsive sexual disorder, agoraphobia, and hypersomnia. In particular, some participants, echoing the research of Roe-Sepowitz (2014), noted that their complex trauma made them more susceptible to coercive control in the context of sexual exploitation, with five of the participants reflecting on the impact that childhood trauma had on their experiences of being sexually exploited and identified those childhood experiences as potential push factors into sex work. Most of the participants discussed how the disability preceded their experiences in the sex trade whereas the mental health issues were in part as a result of or made worse by their experiences of sexual exploitation.
“It was almost like, you know…like men could almost like see… it was written on me… that I had a history of sexual trauma… men or a group of men that would, you know , have the power and it [sexual exploitation] was to control me and what I do with my body.”
“When I was in that lifestyle, I had a very negative self-image. I'm worthless nobody cares about me. Nobody loves me. Nobody cares. I'm all alone. I was actually suicidal as well…there were times where … I just wanted to die. Because I saw no hope and getting out of what I was doing”
Two of the participants talked about how physical limitations were ignored by their pimp, forcing them to perform, regardless of their health status.
“I have gastrointestinal issues and like I got the runs really bad once… they [the pimp] just got me some Imodium and told me to suck it up.”
“A number of times, I came up with chlamydia, gonorrhea, syphilis, herpes and stuff like that. And even though this was happening, I was still doing it [sex work]”
Participants also discussed how their sense of physical safety was jeopardized as a result of coercive control and lack of personal agency, often leaving them battered, bruised, and traumatized.
One participant shared a near death experience that jeopardized her safety:
“I can remember one time, we [her and her pimp] got caught in a drive by shooting, and the guy used me as a body shield, and I remember a bullet… grazed my forehead… it was terrifying.”
Another participant described a sexual assault that happened, making her fear for her life:
“I knew I was f**ked. And because human trafficking is like, you know, pretty insane out there. And that was, um, that was scary because I got raped by all of them. I was in a room, they weren't gonna let me go”
A further participant described her assault at the hands of an intimate partner:
“I ended up going back to this guy [boyfriend/pimp] and until I was beaten to a point where my face was literally bruised right up”
Coercive Control
Coercive control, the next superordinate theme identified, can best be understood as a mechanism that strips an individual their identity, connections to supports, and their personal agency (Stark, 2010). The target of the coercive and controlling behavior’s identity becomes colonized by the perpetrator which causes the victim to break with both their subordinate and personal levels of identity (Dubrow-Marshall, 2016). Arnold (2009) best describes this phenomenon as the destruction of a “women’s autonomy, her ability to make decisions and act on her own behalf.” (p. 1435). As noted by Sepowitz et al, (2014), and as illustrated by the participants in this study, the experience of sexual exploitation for women is one that arises as a result of coercive control and is characterized by patterns of behavior that remove a woman’s experience of personal agency. One of the governing features of sexual exploitation is psychological coercion (Dando, Walsh & Brierley, 2016). In addition, for sexually exploited women there is the experience of being forced into an exchange of sex for goods or services, either by pull factor such as a perpetrator for whom the woman is a source of revenue or as a push factor as a result of structural violence (O’Brian, Hayes & Carpenter, 2013, Stanjoska & Patrevski, 2012). It is important to note that push and pull factors are applicable to involuntary, exploited sex workers in a very different way than voluntary based sex workers. For involuntary, exploited sex workers the experience of push and pull factors are similar in that they both compromise the experience of the individual’s autonomy, “her ability to make decisions and act on her own behalf.” (Arnold, 2009, p. 1435). One participant in the study best articulated this when she explained that she had sexually exploited herself.“I actually went back [to sex work after exiting]. Not because of drugs, just because I was, like, really stressed about money…Like, I sexually exploited myself.”
For voluntary sex workers, push factors might not be experienced in the context of coercive control. For some of the participants whose journey began voluntarily, sex work was a good answer to the push factors such as poverty, homelessness, and no employment options.
One participant’s solution to economic challenges was described as follows:
“Like my parents kicked me out. I had no money. What was I going to do? I dropped out of high school.”
For another participant, sex work was a family business:
“My mum always said, if you have five sugar daddies, you charge them $1,000 a week each - five grand a week. That's all you need, you know, you don't go out all over the place”
The most commonly discussed push factors that participants shared were addictions, poverty, and homelessness. For the most part the engagement in sex work due to these push factors alone did not create for participants an experience of sexual exploitation. It was when pull factors such as a third party like a pimp or boyfriend demanding they engage in sex work, to address poverty or addictions issues, that their experience became an experience of coercion.
One participant’s description of a third party coercing her into sex work was:
“I was by choice at first, until I got into my abusive relationship, then it felt like I had to, because he would not get a job. He would go and spend all of our income support money on booze. And he would always, he'd always say, he hated me doing the job. But yet, he would be like, “oh, go post an ad.” You know, we need money, or, you know, he'd go and spend all the money. So, I had no other choice but to do it. So, it was more when I was in the abusive relationship, it felt like I had to”
Another participant described her third party coercion the following way:
“If I owe money to say … my mom because she takes care of my son, she pushes me to work [referring to sex work].”
With a third participant describing her coercive control by a third party, her boyfriend/pimp, in regards to her ability to engage safely in sex work.
“I wasn’t allowed to have sex with them, but I was allowed to give them b***j***… it was stressful at time because… what if they [the john] wants to have sex? I can’t go buy condoms.”
Pull factors that influenced participants’ engagement were primarily coercion perpetrated by third parties who were exploiting participants for financial gain. In the case of the study’s participants the third parties included sex traffickers, pimps, intimate partners, and in one case a parent. The third parties used a variety of coercive and controlling tactics to create a sense of fear in the participants trapping them into sexual exploitation.
One participant described how physical threat acted as a coercive mechanism for her:
“I loved him from the first moment I saw him. So, it was just hope that it [him pimping her out] would get better… and he would make all these empty promises [to stop pimping her out]. I think he would have really hurt me.
Another participant shared a very similar experience:
“I didn't have that choice. Not only that, there were times I was forced to take on two guys at once, and he would watch or sometimes the money didn't even come in my hands go straight in his hands... the guy [boyfriend/pimp] would get mad if I… said anything. Or a beating, or a lot of stuff being talked down…”
Two of the participants discussed how the oil and gas economy in Alberta played a role in influencing sexual exploitation. There is a well-researched link between extractive industries such as oil and gas and sexual exploitation and assault (US Department of State, 2017, Finn, Gadja, Perin, & Fredricks, 2017). In Alberta, the economic boom provided by the oil and gas sector, prior to 2018, led to rapid population growth in communities close to oil and gas extraction sites, a transient population, a gender imbalance with more men in the community, and high pay - leading to disposable income amongst a younger demographic of men (Hill, Alook, Hussey, 2017). All these factors have led to an additional economic pull factor influencing sexual exploitation.
“It’s because of oil and gas money. Yeah, if you go up to [town close to oil and gas extraction site], like I can go up … and make like $2-3,000 and tips for the week.”
Interventions and Services
The third superordinate theme which was identified was interventions and services. It has previously been acknowledged that to be successful for women, services need to address their experiences of sexual exploitation and purposeful programmatic design is critical (Gerassi, Edmond, & Nichols, 2016). Oselin (2014) found that services that offered long-term supports were more successful in supporting sexually exploited women to stay out of the sex trade. One of the critical aspects for successful intervention is long-term interventions (Gerassi & Nichols, 2018). Histories of being failed by the system accompanied by complex trauma makes it difficult for sexually exploited women to believe the system can be helpful and support them. (Lange, 2010). The lived experiences of the study participants regarding interventions and services echoed the finding of Gerassi and Nichols (2018), that the complexity of the trauma and the need that this population experiences, requires specific sexual exploitation focused services and long-term interventions to ensure that there is long-term change. Many of the participants in this study likewise noted that participation in long-term, sexual exploitation services has been the key to them successfully exiting both sex work and addictions.“You got to feel safe first before you can talk about trauma…. As I started to feel safe, I started to, my body kind of started to like, stop being in survival mode and start healing. [I have been here] for 13 months”
Participants also commented on the necessity of services that addressed the right issue. For some of the participants their entry into services was via addictions treatment, which although it addressed issues of substance abuse, it did not address the underlying trauma experienced as a result of sexual exploitation, making it hard for participants to successfully engage in the programs and services.
“Well, I know that when I was using more than half the woman that I knew …, they have all been sexually exploited. Those people that I knew they were being sexually exploited. And whether it was exchanging themselves or prostitution escorting. So, if that many people are doing that, and then they're going to [addiction] treatment centers, if they do end up in treatment centers, and that's not being talked about in treatment centers. Then how is anyone supposed to get help or healing for this problem that's happening out there that like, how is anyone supposed to get healing for being sexually exploited? If no one's ever talking about it in [addiction] treatment centers.”
Three of the participants noted trauma experienced at the hands of the social services system, especially as children with one participant sharing the following experience of a conversation with her child welfare worker after expressing suicidal ideation as a teenage:
“… as a teenager, while I was a ward of the Alberta government, and I remember being told at one time, if I tried to kill myself, they were going to charge me with destruction of government property, because I was a property of the government.”
Six the participants reported the intimate partner violence was an aspect of their experiences of sexual exploitation and in some cases was the entry point into services, however they also commented that, in some cases, intimate partner violence based programs turned them away as they did not fit the typical profile of an abused woman.
“Most of the women’s shelters didn’t even want to take me. They’re like, well, you have a fentanyl addiction you have a history of prostitution, “you’re not right for our facility.”
Protection and Enforcement
A superordinate theme of protection and enforcement was also identified, which resonates with how sexually exploited women experience a multitude of barriers when accessing the legal system, both through police and legislative frameworks (Gerassi and Nichols, 2018). Barriers for sexually exploited women include a general distrust of policy and law enforcement, fear of facing legal repercussions for their engagement in sex work, lack of funds to access applicable representation within the justice system, etc. The framework of viewing sexual exploitation primarily through a trafficking lens has led to law enforcement mischaracterizing “the issue, resulting in victim blaming and stigmatizing those involved in commercial sex who do not meet the image of the ideal victim.” (p. 215). Nichols and Heil (2014) found that there are cases that are investigated as offences of domestic violence and/or rape that co-occur with sexual exploitation, but don’t investigate the sexual exploitation aspect of the events. Two of the study participants reported intervention from the police regarding their experiences of domestic violence but that the police did not explore the sexual exploitation happening as part of the experience of coercive control within the abusive relationship.“He strangled me. And like don't get me started on the court system...he got assault, causing bodily harm and then reduce to assault and only got 43 days in jail, if it was a pimp, he'd be charged with it [sexual exploitation]. So why is it any different in a domestic violence situation? Because they [boyfriends who coerce partners into sexual exploitation] are pretty much the same as pimps.”
The coercive control that is experienced by this population can lead to a woman acting as an agent of her perpetrator in everything from sexual exploitation to drug trafficking and other illegal acts (Eriksson & Ulmestig, 2017, Moe, 2004). For three of the women in the study, this was the case which led to the participants experiencing conflict with the law, that in some of the cases led to imprisonment. This included experiences of the participants trafficking drugs and weapons and committing fraud for the perpetrator as part of the overall experience of coercive control.
“There were other things that they had me do that wasn’t like just sex work. Like carry around drugs and smuggle firearms. Stuff like that, that I felt… if I don’t do this… they’re going to really hurt me.”
“I would end up arrested… with possession of drugs. I mean like the cops always treated me with, like, no respect… the emotional abuse like “you stupid whore”, you know, like, the degradation.”
COVID-19
Amongst the manifest public health response to COVID-19 since March 2020 and the unintended consequences of the pandemic restrictions such as increased domestic violence rates, increased opioid overdoses, and a shrinking economy, (Government of Alberta, 2020, Usher, Bhullar, Durkin, Gyamfi & Jackson, 2020), has been the underexplored impact of COVID-19 on sexually exploited women. Although not initially within the expected scope of the study, some participants shared the impact of COVID-19 on their experiences of sex work and sexual exploitation leading to this being identified as a further superordinate theme. The impacts included increased isolation, a reduction in access to interventions, more work demand, and additional impacts to their mental and physical health. This is an area that warrants further exploration.For now it can be noted that participants said the following:
“I think the reason why [had to work more] for that because it was COVID, and it was harder to get clients at that point. But they would encourage me to work, like, as much as I could and to work at certain times of the day. Like, if I slept, they [pimps] got mad.”
“Especially with COVID because the numbers are so high and some girls just feel so trapped.”
One participant in referring to the STI testing she was subjected to as part of the exploitation shared:
“They kept saying, oh we should, we’ll get you tested… and then they never did. This was during COVID… So everything was shut down…”
Recommendations
This study highlighted five areas, in addressing the needs of sexually exploited women in Canada. Four of the areas emerged through the superordinate themes and one crossed and had implications across all themes, (i) understanding the continuum of sex work; (ii) the implications of the conflagration of trafficking and sexual exploitation; (iii) coercive control manifested through push and pull factors; (iv) best practices in interventions; and (v) legislation that reflects the experiences of coercive control. There is a final superordinate theme, not identified through the study as highlighted area, which is the impacts of COVID-19 on sexually exploited women. This theme was not included as it requires further exploration and research.Recommendation #1: Recognize the Continuum of Sex Work in Policy, Legislation and Practice
All of the study participants expressed their experiences of sex work as a continuum from voluntary to involuntary sex work. In some cases, the participants, depending on the day and the experience moved back and forth along this continuum. This reflects what a recent Canadian study examining Canada’s Protection of Communities and Exploited Persons Act (PCEPA- B36) legislation found, which was that women working in the sex trade do not see themselves in a binary framework of voluntary sex worker or involuntary sexually exploited victim; rather they perceive themselves as moving in and out of money generating transactions to meet economic and other needs (Orchard, Salter, Bunch & Benoit, 2020).- 1.1 Legislation and policy related to sex work needs to be built off the understanding of the issues as a continuum of experiences, voluntary to involuntary (including sexual exploitation and trafficking) with the understanding that most individuals engaged in sex work are at many places on the continuum throughout their experiences
- 1.2 Immediate change to working definitions from sexual exploitation and sex trafficking to sex work within a continuum of voluntary to involuntary experiences
- 1.3 Practice/Interventions provided to individuals engaged in sex work need to take into account the diversity of the experiences of individuals along the continuum of voluntary to involuntary. Individuals should be empowered to define their experiences for themselves through the provision of trauma informed interventions. Diverse experiences or understandings of experiences related to the continuum of sex work should not be used to determine eligibility criteria or readiness for program engagement
Recommendation #2: Update Trafficking Definitions in Legislation, Policy and Practice
The damaging aspects of the conflagration of trafficking and sexual exploitation has been written about and researched extensively (Kelly & Regan, 2000, Askola, 2007, NWAC, 2014, Nijhoff, 2014) with the most concerning aspect of this conflagration being that victims that don’t fit neatly into the trafficking framework are apt to fall through gaps both in relation to legislation and services. This was reflected in two of the experiences of the participants, who were eventually able to get help because their experiences were labeled as trafficking but noted that they did not perceive themselves as trafficking victims and therefore would not have accessed supports and services for trafficking victims. As Askola (2007) noted, if solutions that view sexual exploitation are seen as only one thing, i.e., trafficking, migratory issue, etc., then those solutions will be too narrow to be effective. Practice/interventions that require participants to identify as victims of trafficking create barriers to entry, or require individuals to code switch, identifying as what the service requires in order to access the necessary programs and services.- 2.1 Legislation and policy related to sex work move away from trafficking focused definitions to adopt above mentioned expand definitions providing context of sex work continuum from sex work that is voluntary to sex work that is involuntary
- 2.2 Legislation and policy adopt concise trafficking definitions to depict experience of labour or sex trafficking
- 2.3 Practice/Interventions remove trafficking focus and adopt sex work definitions understanding the continuum of sex work from voluntary to involuntary
- 2.4 Practice/Interventions working with individuals experiencing labour or sex trafficking adopt concise definitions of trafficking
- 2.5 Practice/Interventions adjust entrance criteria, program eligibility and program content where required to be applicable across voluntary-involuntary sex work continuum definitions
Recommendation #3: Inclusion of Sex Work Within Coercive Control Definitions and Practice
Sexual exploitation has been frequently understood within the framework of push and pull factors. Those factors are things such as poverty, homelessness, colonialism, and addictions that push a woman into exploitation and third-party exploitation based on economic drivers that pull women into exploitation. While this is a valuable framework for understanding sexual exploitation, it does not fully acknowledge the role coercive control plays in driving push and pull factors. All the participants discussed experiences of coercive control and each of those experiences could be aligned to a push or pull factor. For the participants, what was important was not the push or the pull, but the experience of the loss of personal agency and the implications of that loss on their emotional and physical liberty.- 3.1 Implement a new nation-wide working definition of sex work to reflect coercive control within the sex work continuum of voluntary to involuntary
- 3.2 Expand coercive control working definitions for policy and legislation to include involuntary sex work
- 3.3 Practice/Interventions build capacity to understand intersections of coercive control and involuntary sex work
- 3.4 Support Recommendation #1 from the Standing Committee on Justice and Human Rights report The Shadow Pandemic: Stopping Coercive and Controlling Behaviour in Intimate Relationships (2021) acknowledging the significant harms that coercive and controlling behaviour causes both in intimate partner relationships and sexual exploitation
Recommendation #4: Service & Support Provision Funding and Accessibility
All of the participants of the study had experiences of engaging in at least one, if not multiple services and interventions. The degree of success the participants experienced in having the desired outcomes from those services was based on the approach of the service, length of time the service was offered, and the specialization of the service. The experience of the participants echoed Gerassi and Nichols’ (2017) research that noted that services for sexually exploited women need to be long-term, strengths-based, non-judgmental, address addictions issues, provide specialization in addressing the experiences of sexual exploitation, and address complex trauma. For victims of sexual exploitation, complex trauma and distrust can be best addressed through long term interventions that provide opportunities for time-consuming rapport building processes with service providers, long-term therapeutic intervention targeted at complex trauma, and intensive case management that includes housing, basic needs, legal assistance, medical care, and vocational training (Peled & Cohavi, 2009, Edinburgh & Saewyc, 2008, Roe-Sepowitz, Gallagher, Hickle, Perez & Tutelman, 2014, Sloss & Harper, 2010 ). Often this requires a multi-agency approach. Research has recognized the link between substance abuse and sex work, understanding substance abuse as both a way to cope with the experiences of sex work as well as a way to facilitate sex work (Young, Boyd & Hubbell, 2000). The question often posed by research to understand the intersection of substance abuse and sex work is a ‘chicken and egg’ debate, with some researchers proposing that substance abuse is a most often precedes sex work, with others asserting that sex work precedes substance abuse (Frischer, Haw, Bloor, Goldberg, Green, & McKeganey, 1993, Miller, 1995, Cusick & Martin, 2003). Adler (1975) understands sex work and substance abuse as simultaneously occurring events. For some of the participants their experiences reflected this reality, finding a lack of success in services only targeted to addressing addictions, commenting that what they needed were interventions that addressed both the addiction and the experiences of sexual exploitation.- 4.1 Service provision for individuals engaged in sex work needs to be funded for long term, wrap around service provision (e.g. services addressing all intersecting social and health issues)
- 4.2 Diverse program models (entrance criteria & programmatic content) should be made widely available to individuals engaged in sex work to be able to choose interventions that meet their unique and diverse needs
- 4.3 Individuals engaged in sex work should not be made to access programming that does not match their self perceived experiences of sex work along the continuum of voluntary to involuntary
Recommendation #5: Inclusion of Sex Work within Canadian Coercive Control Legislation
Three of the participants of the study experienced conflict with the law, but not directly related to charges stemming from Canadian prostitution laws. The experiences of conflict with the law were as a result of coercive control in which a third party, who was also forcing them into sexual exploitation, also forced them into other illegal activities for which they were charged, such as drug trafficking, weapons smuggling, and fraud. The absence of a legal understanding and lack of legislative coercive control framework meant that, for these participants, these acts were seen as isolated incidents, unrelated to the overall coercive control the women were experiencing, a part of which was sexual exploitation. Researchers have clearly been able to make the connection between women who experience coercive control from a third – party and criminal activity, it is imperative that legislation reflects this knowledge (Singer, 1995, Moe, 2004, Ericksson & Ulmestig, 2017, Heil, 2017).- 5.1 As per the recommendations from the Standing Committee on Justice and Human Rights report The Shadow Pandemic: Stopping Coercive and Controlling Behaviour in Intimate Relationships (2021), Canadian criminal laws be changed to reflect the harms of coercive and controlling behaviours which are not currently captured in criminal laws
- 5.2 Include involuntary sex work within above recommended changes to the Canadian criminal laws to criminalize coercive and controlling behaviour
- 5.3 Support Recommendation #3 from the Standing Committee on Justice and Human Rights report The Shadow Pandemic: Stopping Coercive and Controlling Behaviour in Intimate Relationships (2021) to implement measures to combat the challenges present by the justice system for victims of coercive control, particularly equity seeking individuals
- 5.4 Promote and fund a public awareness campaign on coercive and controlling behaviour within involuntary sex work and support training for all judicial system actors
Conclusion
The impetus for this study was to add to and create a contextual understanding of how, and if, the framework of coercive control should and could be applied to women who are sexually exploited. This study examined this issue through both legislative and intervention practice contexts with hope that the findings from this study will be used to inform Canadian legislation and intervention practices through deepening understanding of the lived experiences of sexually exploited women. A qualitative IPA methodology held space for an in-depth exploration of the experiences of the seven study participants that can be understood alongside the legislative and practice review. All of the study participants expressed that part of their desire to participate in the study was to have their voices heard through the research, so that their experiences could have an impact on services and legislation.To adequately address experiences of sex work and sexual exploitation it is necessary to move beyond a binary model of voluntary and involuntary sex work with narrow definitions and solutions. In addition, it is critical that this issue is viewed through not through a moralistic lens, but through a human rights and public health lens that is evidenced based. Policy, including legislative frameworks and the justice system response should recognize the coercive and controlling nature of sexual exploitation, including this framework of understanding as part of the criminal code. In viewing sexual exploitation with narrow lenses such as trafficking and/or prostitution, it ignores the true experiences of sexually exploited women who often find themselves at the intersections of criminality, domestic abuse, prostitution, and/or trafficking. Practice considerations should also move beyond a binary understanding of this issue and recognize that interventions need to be broad enough to address the intersections noted above as well as ensuring that, they too, have a coercive control lens and are multi-agency approaches that are long-term, strengths-based, wrap around, and address complex trauma. Lastly, there should be a robust prevention strategy to address and negate push and pull factors, working to stop sexual exploitation before it begins. The experiences and implications of the experiences of sex work and sexual exploitation on both the individual and society are complex, and the solutions crafted need to reflect that complexity taking a tri-pronged lens of prevention, protection, and prosecution.
References
Abel, G., Healy, C., Bennachie, C., & Reed, A., (2010). The Prostitution Reform Act, in Abel, G., Fitzgerald, L., & Healy, C., (Eds). Taking the crime out of sex work: New Zealand sex workers fight for decriminalisation. Bristol: Polity Press, pp 75-83Adler, F. (1975). Sisters in Crime. New York, McGraw Hill.
Anandarajah, G. & Hight, E. (2001) Using the HOPE Questions as a Practical Tool. American Family Physician, 63(1), 81–88.
Argento E, Goldenberg S, Braschel M, Machat S, Strathdee SA, et al. (2020) The impact of end-demand legislation on sex workers’ access to health and sex worker-led services: A community-based prospective cohort study in Canada. PLOS ONE 15(4)
Askola, Heli (2007). Legal Responses to Trafficking in Women for Sexual Exploitation in the European Union. Worcester, UK, Hart Publishing.
Australian Government (2020). Combatting Modern Forms of Slavery, Plan of Action against Forced Labour, People Trafficking and Slavery, 2020-25. Retrieved from https://www.mbie.govt.nz/dmsdocument/13568-combatting-modern-forms-of-slavery-plan-of-action-against-forced-labour-people-trafficking-slavery
Australian Government, 2020, National Action Plan to Combat Modern Slavery 2020-25
Australian Government, Department of Social Services (2020). Support for Trafficked People Program. Retrieved from https://www.dss.gov.au/women/programs-services/reducing-violence/anti-people-trafficking-strategy/support-for-trafficked-people-program
Bales, K. (2007). What predicts human trafficking? International Journal of Comparative and Applied Criminal Justice, 31, 269-279
Bales, K., & Soodalter, R. (2010). The slave next door: human trafficking and slavery in America today (2nd ed.). University of California Press
Benoit, C., Atchinson, C., Casey, L., Jansson, M., McCarthy, B., Phillips, R., Reimer, B., Reist, D., and Shaver, F.M., (2014). Contexts of Vulnerabilities, resiliencies, and care among people in the sex industry: a working paper prepared as background to Building on the Evidence: An International Symposium on the Sex Industry in Canada. Canadian Institutes of Health Research; Institute of Gender and Health.
Brents, Barbara and Hausbeck, Kathryn (2001) State-Sanctioned Sex: Negotiating Formal and Informal Regulatory Practices in Nevada Brothels, Soc. Persp. 44 (307)
British Home Office, 2020. Modern Slavery: National Referral Mechanism and Duty to Notify Statistics.
Bowley, Mary Frances (2012). The White Umbrella: Walking with Survivors of Sex Trafficking. Chicago, IL, Moody Publishers
Canadian Criminal Code, 1985 Sections 279.01, 279.011, subsection 279.02(1), 279.02 (2), 279.03 (1), 279.03 (2).
Canada Department of Justice (CDOJ). (2017) Technical Paper: Bill C-36, Protection of Communities and Exploited Person’s Act. Retrieved from https://www.justice.gc.ca/Eng/Rp-Pr/Other-Autre/Protect/P1.Html
Canadian Public Health Association, 2014, Sex Work in Canada – A position paper.
Casavant, L. and Valiquet, D., (2014). Bill C-36: An Act to amend the Criminal Code in response to the Supreme Court of Canada decision in Attorney General of Canada v. Bedford and to make consequential amendments to other Acts. Library of Parliament, Publication No. 41-2-C36-E
Clark, J. L. (2006). Listening for Meaning: A Research-Based Model for Attending to Spirituality, Culture and Worldview in Social Work Practice. Critical Social Work, 7(1).
Commission on the Status of Women A/RES/59/166, 10 Feb 2005
Connell, R.W., (1987) Gender and Power: Society, the Person and Sexual Politics. Stanford University Press, Stanford, CA.
Creswell, J. (2013). Qualitative inquiry and research design: Choosing among five approaches. (3rd ed.). Thousand Oaks, CA: Sage.
Cunningham, Fiona & Jacquin, Kristine. (2018). Age of Entry into Sex Work is a Myth.
Cusick, L., Brooks-Gordon, B., Campbell, R. & Edgar, F., (2011) ‘Exiting’ drug use and sex work: Career paths, interventions and government strategy targets, Drugs: Education, Prevention and Policy, 18:2, 145-156
Cusick, L., and Martin, A., (2003). Vulnerability and involvement in drug use and sex work. Home Office Research, Development and Statistics Directorate. Study 268
Dando CJ, Walsh D, Brierley R (2016) Perceptions of Psychological Coercion and Human Trafficking in the West Midlands of England: Beginning to Know the Unknown. PLoS ONE 11(5)
Dayan, Hava, (2018). Sexual abuse and charismatic cults. Aggression and Violent Behaviour 41 25-31
Deering, K. N., Amin, A., Shoveller, J., Nesbitt, A., Garcia-Moreno, C., Duff, P., Argento, E., & Shannon, K. (2014). A systematic review of the correlates of violence against sex workers. American journal of public health, 104(5).
Demleitner, N., (1994) Forced Prostitution: Naming and International Offence’. Fordham International Law Journal 18.
Department of Labour (2004) A guide to occupational health and safety in the New Zealand sex industry, Wellington: Department of Labour
DiRienzo, C. E., Das, J. (2017). Human trafficking and country borders. International Criminal Justice Review.
Edinburgh, L. D., and Saewyc, E.M. (2008). A novel, intensive home-visiting intervention for runaway, sexually exploited girls. Journal for Specialists in Paediatric Nursing, 14 (1), 41-48
English Collective of Prostitutes (2020) retrieved from, http://www.prostitutescollective.net/
Eriksson, M., & Ulmestig, R. (2021). “It’s Not All About Money”: Toward a More Comprehensive Understanding of Financial Abuse in the Context of VAW. Journal of Interpersonal Violence, 36(3–4)
Farley, M., and Barkan, H. (2008). Prostitution, violence, and posttraumatic stress disorder. Women and Health, 27 (3). 37-41
Fergus, L, (2005). Trafficking in women for sexual exploitation. Australian Centre for the Study of Sexual Assault. Briefing No. 5.
Ferguson A, Philipson I, Diamond I, Quinby L, Vance CS, Snitow AB. (1984) Forum: The feminist sexuality debates. Journal of Women in Culture and Society, 10 (1), 106–125
Finn, K., Gadja, Erica, Perin, Thomas, and Fredericks, C., (2017). Responsible Resource Development and Prevention of Sex Trafficking: Safeguarding Native Women and Children on the Fort Berthold Reservation. Harvard Journal of Law and Gender 40 (1).
Frischer, M., Haw, S., Bloor, M., Goldberg. D., Green, S., McKeganey, N. and Covell, R. (1993). Modelling the behaviour and attributes of injecting drug users: a new approach to identifying HIV risk practices. The International Journal of Addictions, 28, 129-152.
Galiana C., (2000) Trafficking in Women. European Parliament Working Paper, Brussels.
Galtung, Johan (1969). Violence, Peace and Peace Research. Journal of Peace Research. 6 (3): 167–191.
Gerassi L. (2015). A Heated Debate: Theoretical Perspectives of Sexual Exploitation and Sex Work. Journal of sociology and social welfare, 42(4), 79–100.
Gerassi, L., Edmond, T., and Nichols, A. (2016). Design strategies from sexual exploitation and sex work studies among women and girls: Methodological considerations in hidden and vulnerable populations. Action Research Journal.
Gerassi, Laura and Nichols, Andrea (2017). Sex Trafficking and Commercial Sexual Exploitation: Prevention, Advocacy and Trauma Informed Practice. Springer Publishing, NY.
Government of Alberta (2020). COVID-19 Opioid Response Surveillance Report. Retrieved from https://open.alberta.ca/dataset/f4b74c38-88cb-41ed-aa6f-32db93c7c391/resource/e8c44bab-900a-4af4-905a-8b3ef84ebe5f/download/health-alberta-covid-19-opioid-response-surveillance-report-2020-q2.pdf
Government of Alberta (2020) Protection of Sexually Exploited Children Act.
Government of British Columbia. (2021) Retrieved from https://www2.gov.bc.ca/gov/content/justice/criminal-justice/victims-of-crime/human-trafficking/human-trafficking-training/module-1/vulnerabilities
Government of British Columbia. (2021) Human Trafficking -National List of Organizations. Retrieved from https://www2.gov.bc.ca/gov/content/justice/criminal-justice/victims-of-crime/human-trafficking/human-trafficking-training/resources/national-organizations
Government of Canada.(2017). Technical Paper: Bill C-36, Protection of Communities and Exploited Persons Act. Retrieved from https://www.justice.gc.ca/eng/rp-pr/other-autre/protect/p1.html#sec2a
Government of Netherlands, 2018. Together against human trafficking: An integrated programme approach to tackling sexual exploitation, labour exploitation and criminal exploitation. Retrieved from https://english.wegwijzermensenhandel.nl/binaries/Programme%20Together%20against%20Human%20Trafficking%20(def)_tcm116-385111.pdf
Government of Netherlands 2018, Violent Offences Compensation Fund. Retrieved from https://english.wegwijzermensenhandel.nl/Organisations/schadefondsgeweldsmisdrijven.aspx
Hayes, Sophie. (2012). Trafficked: The Terrifying True Story of a British Girl Forced into the Sex Trade. Harper Collins.
Harcourt, C., & Donovan, B. (2005). The many faces of sex work. Sexually transmitted infections, 81(3), 201–206.
Heil, E. C. (2017). It is God’s will: Exploiting religious beliefs as a means of human trafficking. Critical Research on Religion, 5(1), 48–61.
Heinz, Andrea (2020) "On Exiting from Commercial Sexual Exploitation: Insights from Sex Trade Experienced Persons," Dignity: A Journal of Analysis of Exploitation and Violence: 5 (1) Article 8.
Hill, N., Alook, A., Hussey, I., (2017). How gender and race shape experiences of work in Alberta’s oil industry. Parkland Institute retrieved from https://www.parklandinstitute.ca/how_gender_and_race_shape_experiences_of_work_in_albertas_oil_industry
Hepburn, Stephanie & Simon, Rita. (2010). Hidden in Plain Sight: Human Trafficking in the United States. Gender Issues. 27. 1-26.
House of Commons Home Affairs Committee (2016-17) Prostitution: Third Report of Session. Retrieved https://publications.parliament.uk/pa/cm201617/cmselect/cmhaff/26/26.pdf
House of Commons Canada (2021). The Shadow Pandemic: Stopping Coercive and Controlling Behaviour in Intimate Relationships: Report of the Standing Committee on Justice and Human Rights. Retrieved from https://www.ourcommons.ca/Content/Committee/432/JUST/Reports/RP11257780/justrp09/justrp09-e.pdf
Howard, S. (2018). Better health for sex workers: Which legal model causes least harm? BMJ: British Medical Journal (Online)
Hughes D.M., (2005) The demand for victims of sex trafficking. Chicago Alliance Against Sex Trafficking
Human Trafficking Foundation (2021) Mapping Trafficking Survivor Services. Retrieved from https://www.humantraffickingfoundation.org/support-services
IOM UN Migration retrieved from https://www.iom.int/
James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016) The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.
Jordan, J, (2005) The Sex Industry in New Zealand: A Literature Review. New Zealand Ministry of Justice
Kelly, E., (2002) Journeys of Jeopardy: A Review of Research on Trafficking in Women and Children in Europe. IOM Migration Research Series.
Kelly, L., & Regan, L. (2000). Stopping Traffic: Exploring the extent of, and responses to, trafficking in women for sexual exploitation in the UK. British Home Office. 1-62
Kurtz, S. P., Surratt, H. L., Kiley, M. C., & Inciardi, J. A. (2005). Barriers to health and social services for street-based sex workers. Journal of health care for the poor and underserved, 16(2), 345–361.
Lalich, J., (1997). Dominance and submission: They Psychosexual Exploitation of Women in Cults. Cultic Studies Journal, 14 (1) pp. 4-21
Lange, A. (2010) Research note: Challenges of identifying female human trafficking victims using a national call 1-800 call centre. Trends in Organized Crime, 14(1). 47-55
Leidholdt, D. (1996) Sexual Trafficking of Women in Europe. A Elman (editor). Sexual Politics and the European Union. Berghahn Books, Providence, NJ.
Lloyd, Rachel (2011). Girls Like Us: Fighting for a World Where Girls Are Not for Sale, an Activist Finds Her Calling and Heals Herself, Harper Perennial
Mameli, P., (2002). Stopping the Illegal Trafficking of Human Beings. How Transnational Police Work Can Stem the Flow of Forced Prostitution. Crime, Law & Social Change 38(67)
Mayhew, Pat and Mossman, Elaine (2007) Exiting Prostitution: Models of Best Practice. New Zealand Ministry of Justice.
McCann, J., Crawford, G., & Hallett, J. (2021). Sex Worker Health Outcomes in High-Income Countries of Varied Regulatory Environments: A Systematic Review. International journal of environmental research and public health, 18(8).
McIntyre, S (2008) Under the Radar: The sexual exploitation of young men. www.hindsightgroup.com
Menaker, T., and Franklin, C. (2013). Commercially sexually exploited girls and participants perceptions of blameworthiness: Examining the effects of victimization history and race disclosure. Journal of Interpersonal Violence, 28, 2024-2051.
Menezes, S. (2019). A Thesis on Exiting Prostitution: Implications for Criminal Justice Social Work. International Journal of Criminal Justice Sciences, 14, 67.
Miller, J. (1995). Gender and power on the streets: street prostitution in the era of crack cocaine. Journal of Contemporary Ethnography, 23, 427-452
Modern Slavery Act (2015). UK Government. Retrieved from https://www.legislation.gov.uk/ukpga/2015/30/contents/enacted
Moe, A. M. (2004). Blurring the Boundaries: Women’s Criminality in the Context of Abuse. Women’s Studies Quarterly, 32(3/4), 116–138.
Native Women’s Association of Canada (2014) Sexual Exploitation and Trafficking of Aboriginal Women and Girls: Literature Review and Key Informant Interviews
Nichols, A. J. and Heil, E.C. (2014). Challenges to identifying and prosecuting sex trafficking cases in the Midwest United States. Feminist Criminology, 10 (1), 7-35.
Nijhoff, M. (2014). Feminism, Prostitution and Trafficking: A Complex Approach. Legal Responses to Trafficking in Women for Sexual Exploitation in the European Union.
Network of Sex Work Projects (NSWP) (2020) retrieved from https://www.nswp.org/
O’Brien E., Hayes S., Carpenter B. (2013) Causes of Trafficking. In: The Politics of Sex Trafficking. Critical Criminological Perspectives. Palgrave Macmillan, London.
O'Doherty, Tamara. (2011). Criminalization of Off-Street Sex Work. Canadian Journal of Criminology and Criminal Justice.
Orchard, T., Salter, K., Bunch, M., & Benoit, C. (2020). Money, Agency, and Self-Care among Cisgender and Trans People in Sex Work. Social Sciences, 10(1)
Organization for the Security and Cooperation in Europe, motion on trafficking 24, July 2003
Oselin, S. (2014). Leaving prostitution: Getting out and staying out of sex work. New York University Press: New York.
Outshoorn, J. (2012) Policy Change in Prostitution in the Netherlands: from Legalization to Strict Control. Sex Res Soc Policy 9, 233–243.
Parliament of Australia, 2021. Retrieved from https://www.aph.gov.au/Parliamentary_Business/Committees/Joint/Former_Committees/acc/completed_inquiries/2002-04/sexual_servitude/report/c04
Patterson, Kelly R. (2018). From Trafficked to Treasured. Red Door Sentinel
Peled, E., and Cohavi, A. (2009). The meaning of running away for girls. Child Abuse & Neglect, 33 (10), 739-749
Peng, Yenwen (2005) Of course they claim they were coerced: On voluntary prostitution, contingent consent, and the modified whore stigma. Journal of International Women’s Studies. 7 (2).
Pietkiewicz, I., and Smith, J., (2014). A practical guide to using Interpretative Phenomenological Analysis in qualitative research psychology. Czasopismo Psychologiczne – Psychological Journal, 20 (1) 7-14
Pinto, S., Scandia, A. and Wilson, P., (1990) Prostitution Laws in Australia. Australian Institute of Criminology No. 22
Platt L., Grenfell, P., Meiksin, R., Elmes, J., Sherman, S.G., Sanders, T., Mwangi, P., Crag, A.L., (2018) Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies. Plos Medicine 15 (12)
Pringle, J., Drummond, J., McLafferty, E., & Hendry, C. (2011). Interpretative phenomenological analysis: a discussion and critique. Nurse researcher, 18(3), 20–24
Prostitution Reform Act (2003) Government of New Zealand. Retrieved from https://www.legislation.govt.nz/act/public/2003/0028/latest/DLM197815.html
Potterat, J.J., Rothenberg, R.B., Muth, S.Q., Darrow, W.W., Phillips-Plummer, L. (2001) Pathways to prostitution: The chronology of sexual and drug abuse milestones. Journal of Sex. 35(4) 333–340
Potterat, J.J, Woodhouse, D.E., Muth, John B., and Muth, Stephen Q., (1990). Estimating the Prevalence and Career Longevity of Prostitute Women. The Journal of Sex Research, 27 (2), 233-243
Roe-Sepowitz, Dominique E, Hickle, Kristine E, Dahlstedt, Jaime, & Gallagher, James. (2014). Victim or Whore: The Similarities and Differences between Victim's Experiences of Domestic Violence and Sex Trafficking. Journal of Human Behavior in the Social Environment, 24 (8), 883-898.
Roe-Sepowitz, D., Gallagher, J., Hickle, K., Perez, M., and Tutelman, J. (2014). Project ROSE: An arrest alternative for victims of sex trafficking and prostitution. Journal of Offender Rehabilitation, 53 (1), 57-74
Sagesse Domestic Violence Prevention Society, 2021. Retrieved from www.sagesse.org
Schubert, S., & Lee, C. W. (2009). Adult PTSD and its treatment with EMDR: A review of controversies, evidence, and theoretical knowledge. Journal of EMDR Practice and Research, 3(3), 117–132
Sidun, D.L, Alejano-Steele, A., Burke, M. C., Contereas, M., Finckenauer, J.O., Liss, M.B., Pierce, A.S., (2014). Report of the task force on trafficking of women and girls. American Psychological Association.
Singer, Margaret Thaler (1995) Cults in Our Midst; The Continuing Fight Against Their Hidden Menace. (2003 Revised and Updated Edition). San Francisco, CA: A Wiley Imprint, Jossey- Bass.
Sloss, C.M. and Harper, G.W. (2010). Legal services needs and utilization of women who trade sex. Sexuality Research and Social Policy, 7(3)
Smith, J. A., Flowers, P, & Larkin, M. (2009). Interpretive Phenomenological Analysis: Theory, method, and research. London, UK: Sage Publications
Smith, J., & Osborn, M. (2008). Interpretative Phenomenological Analysis. In J. Smith (Ed.), Qualitative psychology: A practical guide to research methods (2nd ed., pp. 53-80). Los, Angeles, CA: SAGE Publications
Snow, Natalie & Steely, Mollee & ten Bensel, Tusty. (2020). The Right to Life, Liberty and Security for Prostitution: Canada v. Bedford. Women & Criminal Justice. 1-8.
Stanjoska, A & Petrevski, B., (2012) Theory of Push and Pull Factors: A New Way of Explaining the Old
Stardust, Z., (2014) Protecting Sex Worker Human Rights in Australia. International Bar Association, Public and Professional Interest Division.
Stark, E. (2010). Do Violent Acts Equal Abuse? Resolving the Gender Parity / Asymmetry Dilemma. Sex Roles, 62 (3-4) 201-211.
Statistics Canada. (2019). Family violence in Canada: A statistical profile, 2018. Retrieved from https://www150.statcan.gc.ca/n1/en/pub/85-002-x/2019001/article/00018-eng.pdf?st=EUfB0iMz
Strega, S., Casey, L., and Rutman, D., (2009) Sex Workers Addressing Treatment. Women’s Health and Urban Life 8 (1), 42-53
Stein, Alexandra (2017). Terror, Love and Brainwashing: Attachment in Cults and Totalitarian Systems, Routledge
SWARM Collective (2021) retrieved from https://www.swarmcollective.org/
Taylor, I. and Jamieson, R., (1999). Sex Trafficking and the Mainstream of Market Culture. Crime Law and Social Change 32(257)
Tiefenbrun, S. (2001) Sex Sells but Drugs Don’t Talk: Trafficking of Women Sex Workers. Thomas Jefferson Law Review 27 (199)
UK Sexual Offences Act 2003. Retrieved from https://www.legislation.gov.uk/ukpga/2003/42/section/53A
United States Department of State, Office to Monitor and Combat Trafficking in Persons (2017). The Link Between Extractive Industries and Sex Trafficking. Retrieved from https://www.state.gov/wp-content/uploads/2019/02/272964.pdf
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK, 18-CR-204-1 (NGG) (VMS) United States v. Ranier
Usher, K., Bhullar, N., Durkin, J., Gyamfi, N., & Jackson, D. (2020). Family violence and COVID-19: Increased vulnerability and reduced options for support. International journal of mental health nursing, 29(4), 549–552.
Van Dam, D., Ehring, T., Vedel, E., and Emmelkamp, P.M.G. (2013). Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: A randomized controlled trial. BMC Psychiatry, 13, 172.
Vickerman, K. A., & Margolin, G. (2009). Rape treatment outcome research: empirical findings and state of the literature. Clinical psychology review, 29(5), 431–448.
Wade, A. (1997). Small Acts of Living: Everyday Resistance to Violence and Other Forms of Oppression. Contemporary Family Therapy, Vol. 19 (1), 23-39
Ward, H., & Day, S. (2006). What happens to women who sell sex? Report of a unique occupational cohort. Sexually transmitted infections, 82(5), 413–417.
Weitzer R. (2007) The social construction of sex trafficking: Ideology and institutionalization of a moral crusade. Politics & Society.35(3) 447–475
Wheaton, E. M., Schauer, E. J., & Galli, T. V. (2010). Economics of Human Trafficking. International Migration, 48(4), 114–141.
Williams, Miriam (1998). Heaven’s Harlots: My Fifteen Years as a Sacred Prostitute in the Children of God Cult; William Morrow & Company, NY, NY.
Williamson, Celia, & Cluse-Tolar, Terry. (2002). Pimp-Controlled Prostitution. Violence against Women, 8(9), 1074-1092.
Worden, Danielle (2018) Sex trafficking: towards a human rights paradigm, The International Journal of Human Rights, 22(5), 709-732
World Health Organization (2021). Work to prevent sexual exploitation and abuse. Retrieved from https://www.who.int/about/ethics/sexual-exploitation-abuse
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