The claim that “Prostituted women and ex prostituted women have some of the highest per capita rates of PTSD for any job, including military.” Is frequently made and the work of Melissa Farley is cited.
However the population of prostitutes she examined was particularly disadvantaged and her claims wilted (under cross examination in Bedford v Canada ) that the PTSD resulted from uniquely prostitution (i.e.sex for money) rather than some pre-existing trauma-such as drug addiction or childhood abuse).
Nevertheless, there are a number of other pieces of research find higher levels of PTSD or depression in prostitutes-but again they mostly suffer from confounding effects (so for instance comparing PTSD in drug users who do or do not sell sex, or those trafficked for labour and those trafficked for prostitution) and attempts to remove such confounders by statistical tools are fraught with difficulty.
What is clear from much of this research is that the reported levels of PTSD in prostitutes is very variable and invariably lower than that reported by Farley and very low in those that are independent working indoors and not drug addicted and have control over their working conditions where levels of PTSD of the majority may match that in aged matched non-prostituting women but there are a minority who have problems.
So for instance for instance Donovan et al 2012 The Sex industry in New South Wales www.acon.org.au/wp-content/uploads/2015/04/NSW-Sex-Industry-Report-CSRH-2012.pdf p26)
“On the whole LASH respondents appear to be well adjusted and comfortable with their occupation, however 10% had high scores on the Kessler-6 psychological distress scale that indicates that they were likely to have a serious mental illness (Table 14). This was consistent across all states, and is about twice the rate for similar- aged women in the general population.”
There are other pieces of research that back this up-for instance Exner, J. et al. (1977). Some psychological characteristics of prostitutes. Journal of Personality Assessment, 41 (5), 474-485.
What it suggests is that there is in prostitution a subset who are either particularly vulnerable or who have had extreme experiences in prostitution (e.g. subject to rape or violence ) or possibly entered prostitution as its low hours/relatively high reward is more tolerable for those with preexisting mental health problems who would find a conventional job difficult.
In this regard it is particularly welcome that a new project funded by the Wellcome trust (the largest medical charity in the UK) is “funding a research project which will compare the experiences of violence and mental health amongst sex workers with other ‘risky’ occupational groups”
Perhaps at the end of this we might have a clearer view as to whether the sale of sex is inherently traumatic.