Literature on prostitution is limited, although with the recent advent of Federal legislation against human trafficking, research is becoming more prevalent. To battle the trafficking of women, the U.S. government has spent about $300 million in the first four years of this decade. Worldwide, attempts increase to inform legislators about the traumatic and widespread effects of international prostitution and trafficking. In addition, laws are increasingly being passed to inhibit the trafficking of women and children for prostitution purposes.
Two of the most relevant criminological theories regarding how women slide into prostitution, for few women who work in the sex trade will declare that their life-long career goal was to become a sex worker, are the theories of general strain and labeling.
Prostitutes do not become sex workers in a vacuum. In African American women who seek services to leave the life of prostitution, for example, there is a high “prevalence of multiple health-related conditions, including depression [and] post-traumatic stress disorder….” Studies have found that posttraumatic stress afflicts women involved in the sex trade regardless of race, national boundaries, or socioeconomic differences.
In a study of 100 street prostitutes male, female and transgender, more than 60 percent of the responders had experienced violence during prostitution; 44 percent were raped while engaging in their work; and 42 percent met post traumatic stress disorder (PTSD) criteria. Most researchers, however, would argue that this number is probably low. Generally, other studies have found that women and transgendered men are more likely to be assaulted when working as prostitutes than are their male prostitute counterparts.
One of the most prolific researchers in this area is Dr. Melissa Farley. In her well-respected book Prostitution, Violence against Women, and Posttraumatic Stress Disorder, Farley contends from her study of 130 San Francisco prostitutes, 68 percent met the criteria for PTSD. Logically, the higher the number of times raped, the higher the incidence of PTSD among the prostitutes.
The levels at which prostitutes suffer PTSD rivals Vietnam Veterans, according to a paper written by Melissa Farley and presented at the American Psychological Association’s 106th annual convention. Farley and her team interviewed prostitutes both in brothels and on the streets in San Francisco and six large cities in Asia, Africa and Europe.
According to the New York Times, which synopsized the article, “In a study to be presented today at the annual meeting of the American Psychological Association in San Francisco, researchers interviewed almost 500 prostitutes from around the world and discovered that two-thirds suffered from post-traumatic stress disorder. In contrast, the condition is found in less than five percent of the general population. Studies of veterans of combat in the Vietnam War have found that the disorder may be diagnosed in 20 percent to 30 percent, about half of whom have long-term psychiatric problems.”
Street prostitutes appear to be particularly vulnerable to attack and therefore it would follow that they would suffer higher levels of PTSD than their counterparts who work in brothels, escort services, or in countries or areas where prostitution is legal. However, whether study participants operated in brothels or worked the streets and although less physical violence occurred in brothels, Farley found in her study that the frequency of the disorder is found uniformly among the various groups of prostitutes.
It is clear from Farley’s disturbing study that posttraumatic stress is of momentous concern to prostitutes, whether they realize they suffer from it or not. Often, diagnosis is missed by social workers or medical providers who fail to ask important questions to learn if a person seeking help is involved in the sex industry. Shame often prevents current or former prostitutes from speaking out, much research shows. In fact, increasingly social workers are receiving training in detecting prostitution to correctly provide appropriate services by using non-threatening questions such as “Have you ever traded sex for drugs, food or shelter?”
Trafficked women face a daunting reality. Rarely able to speak the language of the country where they are shipped, loaded into containers or otherwise concealed, some suffering certain death—this is the truth of international trafficking in women. As Dr. Judith Herman said in her groundbreaking work on trauma, “People who have endured horrible events suffer predictable psychological harm. There is a spectrum of traumatic disorders, ranging from the effects of a single overwhelming event to the more complicated effects of prolonged and repeated abuse.” Certainly, studies show, both qualitatively and quantitatively, that prostitutes endure unimaginable abuse.
Taking age into consideration, one study supported other literature that found that those under the age of 18 who had undergone childhood sexual or physical abuse and teenage commercial sexual activity are likely to have higher rates of PTSD than average.
At this time, there are few shelters available for teenage sex workers hoping to leave the industry; instead, most services are geared to adult sex workers. Early intervention for youthful sex workers might alleviate the degree of PTSD they suffer if an earlier escape from a life of prostitution was available.
General Strain Theory
There is little literature on prostitution as it relates to the general strain theory, but there is literature on juvenile delinquency and drug use which examines the general strain theory (GST) which was developed by Emile Durkheim in his study on suicide and refined by Robert Merton and later by Ronald Agnew in the 1990s.
Agnew in his work Pressured Into Crime states that, “According to GST, people engage in crime because they experience strains or stressors. For example, they are in desperate need of money or they believe they are being mistreated by family members, teachers, peers, employers, or others. They become upset, experiencing a range of negative emotions, including anger, frustration, and depression. And they cope with their strains and negative emotions through crime. Crime may be a way to reduce or escape from strains.”
The strain theory proposes that crime, especially delinquency, occurs as a result of the feelings generated by negative relationships with others. Prostitution frequently begins in adolescence and is considered a delinquent act. The average age of entry into prostitution, according to Farley’s study, is 15. More current studies show the average age at about 13.5 years of age, although I am unable to cite them specifically at this time.
Much of the literature on sex workers paints a portrait of early childhood abuse, neglect and confusion. It is important to note, however, according to the strain theory that it is the experience and feelings of anger and frustration from failed attempts at achievement, failure of primary relationships with caregivers, or victimization that leads to the experience of strain. How people cope with that strain appears to be one of two ways. The coping may be inner directed, with depression, or through substance abuse to mute emotional pain. The coping may be directed outwardly, such as violent anger, aggression, etc. Clearly with sex workers, the strain is mainly inner directed.
The labeling theory found its roots in the early 1930s with studies of symbolic interactionist George Herbert Mead, who believed that the self was totally constructed in relationship to others in society. The labeling theory, however, which had its roots in a theory developed by Frank Tannenbaum in the 1930s known as the “dramatization of evil,” didn’t fully materialize until Howard Becker presented it in the 1960s in his groundbreaking book The Outsiders: Studies in the Sociology of Deviance. Labeling has been called one of the most prominent theories in criminology, but it has many critics. One of the biggest criticisms is that labeling focuses on lower classes while ignoring white-collar crime.
Once a woman enters into prostitution, often as a result of difficulties in childhood or her teen years and often coerced by relatives or pimps, it is very difficult for her to exit this lifestyle. This is where the labeling theory enters the picture. Once labeled as promiscuous or as a sex worker by the police or peers, the road to a normal way of life for these women is often virtually impossible to navigate successfully.
The labeling theory may apply especially in the case of transgendered prostitutes who are doubly stigmatized both by their gender differences and their prostitution, where they experience a “a host of issues ranging from sexual identity conflict, shame, and isolation ….”
There is little literature on point regarding labeling theory and prostitution; however, there is a great deal of literature available regarding labeling and drug use. A more deviant self-label at baseline predicted greater drug use at research follow-up, giving direct support to the labeling concept of resulting deviance. Once self labeled, it is extremely difficult for the labeled person to shed his or her stigma. In addition, self-label and drug use was found to be cyclical, indicating that once adolescents categorize themselves as drug users after that behavior has occurred, they are likely to stay stuck in that mindset and to limit their associations to cohorts who engage in like criminal behavior.
Drug use goes hand-in-hand with prostitution, whether the drug use occurs prior to prostitution and drug users drift into prostitution, or it is used antiseptically post prostitution to numb feelings of self loathing or rage. It appears that self labeling whether as a drug user or as a prostitute is a self-perpetuating and vicious cycle.
According to the conflict theory, those practicing certain behaviors are “labeled” by those in power. Once labeled, it is extremely difficult to avoid internalizing that label and escaping it. Among Black women who are prostitutes, they face the double bind of the cultural stereotypes of Black women as hypersexual and “animalistic.” Black women are more heavily fined, more often convicted of the crime of prostitution and given longer jail sentences than their White counterparts. This makes escape from this life for Black women even more difficult. Indeed, they often remain trapped in a systemic pattern of racism. 
Today there is a great deal of controversy surrounding the attitude of the media, including music, toward women. According to Venita Carter, who runs the only prostitution reentry program geared to women of color, “Black men need to unlearn the lessons which are the legacy of white slave masters — Black women are not ‘bitches’ and ‘whores.’ Black women are not the property of white men on the plantations, and they are not the property of Black men in the ‘hood.”
Telling their stories: prostituted women speak out
It is through the telling of these exploited women’s stories that we see how these theories appear to reinforce sex workers’ entry into and their inability to exit the world of sex work. Across the globe and largely thanks to the feminist movement, women’s stories of prostitution, trafficking, rape, abuse and torture have surfaced. In response to these horrific tales, there is more emphasis on international trafficking and the plight of young women tricked or forced into prostitution. I draw from this growing body of research to state unequivocally — the stories of these women support the two general theories of both the general strain and labeling theories. Women’s entry into prostitution often starts with strain and is exacerbated by labeling.
Many women who become sex workers come from the working-class poor and encounter many problems in their families of origin. These researchers found from their study of other research that women’s relationships with their mothers were “severely conflicted.” These women reported few attachments to a male parental authority. Most of their childhoods, they felt unwanted and rejected. Lacking money and resources to find shelter, many of these women drifted into prostitution while running from foster homes or juvenile institutions.
Many studies have found female prostitutes had suffered incest and physical childhood abuse, which in turn “contributed to their entry” into prostitution. In one landmark San Francisco study by Delancey Street founder Dr. Mimi Silbert, 62 percent of the women studied had been physically abused as children and 60 percent had been sexually abused by either a family member or family friend. These numbers, however, may be low. In Farley’s study of 854 people currently or recently in sex work, 65-to-95 percent of respondents were assaulted sexually in childhood, depending on country of origin.
It is little wonder, then, that these women suffer strain and drift into prostitution. Once labeled, most find themselves stuck in a self-perpetuating cycle of violence, fear and despair. That first step into prostitution is often a consequence, according to many researchers, of a process of violence, psychological abuse, stigmatization and estrangement. These researchers say a drift into prostitution is central to their model of how women become prostitutes. Drift in my opinion, does not occur in a vacuum and research bears this out. The ground must be laid to force a woman to consider entering this life-slide trajectory.
It is precisely through this damaged self image that a perpetrator can persuade a young woman to sell herself. One women in a study Farley commented upon said that her “prostitution mentality” began after, at age nine, she was sexually abused by neighbors and family members.
Regarding the labeling theory, stories abound of the difficulty of shaking a label once a ‘good’ girl has gone ‘bad’. And like much of the genesis of laws against drugs, laws against prostitution were enacted to prevent the corruption of ‘good’ women, women of virtue, higher up the socio-economic ladder, by lower-class ‘bad’ girls.
Much like gang members are identified and catalogued, so are street prostitutes. Once a woman is found in the company of other prostitutes on the street, police often take her picture and her label as a prostitute becomes official. The label of “whore” or “hooker” is one that most women, once so named, cannot shake. One study in Trinidad among an offending population not limited to sex workers found that self-labeling, parental labeling and labeling by officials of the offender were particularly important correlates of participation in crime for women more so than men.
In addition, any prostitution conviction follows a woman throughout her life. She may find herself explaining these convictions, even if they are misdemeanors, decades after she has left the industry, and often to unsympathetic future employers who may never get that image out of their minds. Once labeled a whore, the shame, stigma and shadow of this term may well follow her throughout her lifetime.
While feminists have sought to change the label of prostitute to victim, the debate in feminist circles has been intense. There are those feminists such as Margo St. James, founder of Call Off Your Old Tired Ethics (COYOTE), who view prostitution existentially—a woman has the right to choose her profession. Others who work to strengthen international trafficking laws and protect women by offering alternatives to a life of prostitution view all prostitutes as victims of a process that, once a woman or child is entrapped, there is little chance of escape. This view enrages feminists such as those working in organizations like COYOTE and other pro-prostitution organizations. The anger is mutual with feminists committed to their role in helping women escape prostitution.
One need look no further than late night talk shows to hear what both men and women think of prostitutes. The terms “hooker” and “whore” are attached freely to adjectives like “cheap,” “easy” and, in crime shows that litter network television, “dead.” The prostitute is the perfect societal scapegoat, for who can’t feel superior to a tragic woman who haunts the streets for her very survival? It is little wonder that women who are caught in this vicious cycle find little chance of escape. One Canadian study found that prostituted women and girls were 40 times more likely to be killed than women who were not prostituted. That figure is simply staggering.
However, until we can reeducate society about prostitution and its real consequences and put more resources such as re-entry programs geared to sex workers into place, the future looks bleak for prostitutes, whether in the United States or abroad.
 Weitzer, Ronald. "The Growing Moral Panic over Prostitution and Sex Trafficking." The Crimininologist 30, 5(2005): 1-4.
 Carter, Vednita. "Providing Services to African American Prostituted Women." Journal of Trauma Practice 2(2003): 213-222.
 Valera, Roberto; Sayer, Robin; Glenn Schiraldi. "Violence and Post Traumatic Stress Disorder in a Sample of Inner City Street Prostitutes." American Journal of Health Studies Summer(2000):
 Farley, Melissa. Prostitution, Trafficking and Post-Traumatic Stress. 1st. Binghamton, NY: Haworth Press, 2003.
 Zuger, Abigail. "Many Prostitutes Suffer Combat Disorder, Study Finds." New York Times, August 18, 1998.
 Herman, M.D., Judith. Trauma and Recovery: The aftermath of violence -- from domestic abuse to political terror. 2nd. New York: Basic Books, 1997.
 Ecpat International, NZ, "Posttraumatic Stress Disorder and Under Age Sex Work." Ecpat International, NZ (unk): abstract.
 Angew, Robert. Pressured Into Crime: An Overview of General Strain Theory. 1st. Oxford, OH: Oxford Press, 2007.
 Neff, Joan L., Dennis E., and Waite. "Male versus Female Substance Abuse Patterns Among Incarcerated Juvenile Offenders: Comparing Strain and Social Learning Variables." Justice Quarterly 24(2007): 106-132.
 Crosby, Richard, and Nicole L. Pitts. "Caught Between Two Worlds: How Transgendered Women May Be Forced Into Risky Sex ." Journal of Sex Research 44(2007): 43-48.
 William R., Downs. "Control theory, labeling theory, and the delivery of services for drug abuse to adolescents." Adolescence Spring(1997): unk.
 Carter, Vednita. "Providing Services to African American Prostituted Women." Prostitution, Trafficking and Post Traumatic Stress (2003): 215.
 Carter, p. 221
 Ulla, Carin Hedin, and Sven Axel Mansson. "The Importance of Supportive Relationships Among Women Leaving Prostitution." Journal of Trauma Practice 2(2003): 223-237.
 Ibid, p. 224.
 Ibid., p. 225.
 Ibid., p. 226.
 Hedin., p. 226
 Farley, p. 57
 Margo, St. James, Helen Buckingham, Dolores French, and Xaviera Hollander. "How It Was: Recollections By Well Known Prostitutes and Madams." Prostitution: On Whores, Hustlers and Johns. 223-237(1998): 118-131.
 Karen, Ramoutur, and David P. Farrington. "Are the Same Factors Related to Participation and Frequency of Offending By Male and Female Prisoners?" Psychology, Crime & Law 12(2006): 557-572.
 Christine, Stark, Carol Hodgson. "Sister's Oppression: A Comparison of Wife Battering and Prostitution." Prostitution, Trafficking and Traumatic Stress. Ed. Melissa Farley. Binghamton, NY: Haworth Press, 2003.