German psychologists and the scientific case against prostitution

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An 18-year-old Bosnian Muslim war survivor recovering after abortion of a rape-induced pregnancy, September 1992. Photo: Nina Berman, Sipa Press.

Even as German politicians are coming under heavy pressure from the local pimp lobby to do away with all laws around prostitution, another group of voices is rising up to join the opposition to that very wealthy and powerful force. They are trauma therapists who have worked extensively with women and girls in the trade, and what they have seen in the course of their careers is enough to convince them that prostitution is not, and never will be, a normal job for the vast majority of those who do it:

“Prostitution is in no way a job like any other. It is degrading, torturous, exploitive. On the side of the prostituted, there is a lot of horror and disgust at play, which they have to repress in order to get through it at all.” So says Michaela Huber, psychologist and head of the German Society for Trauma and Dissociation.

“In this system of prostitution, women are systematically put down, used, and degraded into objects.” So says Lutz Besser, head of the Centre for Psychotraumatology and Trauma Therapy of Niedersachsen.

“Prostitution has its roots in the violence that is done to children. And society must not block out or whitewash this violence!” So demands Susanne Leutner, vice-president of the trauma-therapists’ association, EMDRIA.

Leading German trauma therapists speak out sharply for societal awareness and support the “Stop Sex-buying” initiative. The organization, a coalition of citizens and centres of expertise, demands that johns be punished, in line with the Swedish model: “It is our goal, not to criminalize the prostituted, but to turn the focus on the johns, whose demand creates the market. They are actually responsible for the fact that increasing numbers of young women from the poorest countries in the world are brought to Germany to work in prostitution here.” Because “The reality of women in prostitution is being glorified or trivialized and ignored — and the sexual exploitation of women in this manner is being normalized and cemented.”

This offensive position in the treatment of traumatized persons by specialized therapists is, to put it mildly, a sensation. Among the therapists who have joined the initiative is Prof. Günter Seidler, head of psychotraumatology at the University of Heidelberg and a pioneer of German trauma research. “There are already more than enough psychologically traumatized people. The mental wounds of prostitution are avoidable,” says Seidler, one of the first 90 signatories of the EMMA appeal to do away with prostitution.

“Prostitution is violence, not a profession!” charges Prof. Wolfgang U. Eckart, director of the Institute for History and Ethics in Medicine at Heidelberg, in the journal Trauma and Violence. He argues: “Little is free in prostitution on the whole, and nothing in mediated prostitution. Because the striking asymmetry of power and the potential for violence in the relationship between the mediator and the practitioner generates in this oldest form of the enslavement of women constitutionally dependent relationships, which almost automatically deliver all the façades and backgrounds for the practice of traumatizing acts of violence of every sort.”

Dr. Ingeborg Kraus is the initiator of the therapists’ protest. The trauma therapist from Karlsruhe has dealt with victims of war rape in Bosnia, and after her return to the German trauma clinics, she realized: “Even here, every other female patient has experienced sexual violence.” At some point, Kraus got fed up with the “constant task of patching them back together”. She vowed: “I want to work preventively as well!” For her, too, the fight against prostitution is part of that. “In my long years of psychotherapeutic experience, I have accompanied prostituted women and learned their backgrounds. It thus became clear that prostitution was, in all cases, the continuation of violent experiences in their biographies.”

Michaela Huber can only confirm that, from her own therapeutic experiences and those of “many, many colleagues.” “Who even gets the idea to sell their own body? The prerequisite for that is to be alienated from one’s own body.” She continues: “You have to picture it: One has to let oneself be penetrated, again and again. One has to have practiced it, or one can’t do it. One leaves behind just a shell that can still go through certain motions, certain gestures.”

This beaming-oneself-away — dissociation, in specialists’ jargon — is forcibly learned, early on, by victims of violence. Not coincidentally, studies show that the majority of women (and men) in prostitution have suffered sexual abuse or other traumatic violence, eg. neglect, as children.

Traumatologist Lutz Besser demands a rethink of the acceptance of prostitution. He fears that “we are in danger of sliding into an Ice Age of ethics. Morality is one part,” says Besser. “But ethics also poses the question: What happens to another person if I do something?” This question, however, is one the johns don’t ask. “The men who go to prostitutes don’t realize that most of the women in this trade are doing so under pressure and duress. A society that legitimates that, demands the stance that prostitution is the most normal thing in the world,” says the therapist. “And it is a scandal that we as a society don’t have a clearer position on this!”

In Berlin, politicians are currently seeking advice. Not only as to how prostitution should be legally regulated; they will also decide how our society stands in regard to it: Whether prostitution should continue to be “a job like any other” — or whether prostitution goes against human dignity and destroys human beings. The signatory therapists hope that the politicians don’t just consign even more traumatized people to them, but finally take the side of prevention.

Translation mine.

I have often seen prostitution referred to not only as the “oldest profession”, but also likened to several actual professions: nursing, for one; various medical and psychological therapies, for another. Often the excuse is trotted out that “sex workers” serve a clientele which is disabled, and thus unable to form normal sexual and romantic relationships — an excuse that, to my mind, demeans the disabled as well as those tasked with disposing of their sexual needs. I know a fair number of disabled men who have happy relationships, and so are not reliant on prostitution — far more of them than of those of the other sort! Then there are the quite-able-bodied men who go to prostitutes because the women in their lives are disabled and they just can’t seem to get it up for them — a strange “disability”, that. And on top of that, the vast majority of johns are not disabled in the least, whether physically, mentally or even socially. They’re just lazy when it comes to seeing women as people, or treating them as something other than conveniences that might cost a couple hundred dollars at most for the kind of sexual servicing that a “regular” woman or girl, being the “sexually repressed bitch” that she is, won’t provide.

Considering that my own sister, a registered massage therapist whose job emphatically does not include rubbing anyone’s genitalia, has worked in clinics that had panic buttons installed in case a client came in expecting a different kind of massage, I find all talk of prostitution-as-profession to be something rather worse than a dirty joke. The creeps who wander into massage therapy clinics expecting bawdy-house prostitution are a real and constant menace to public safety. So are those who expect sexual servicing from nurses, or from women doctors. Such things are not on the list of training requirements in any actual health-related profession, no matter how much those who talk of prostitution-as-profession would like to blur that distinction.

My sister went through four years of specialized training at a pricey massage-therapy school. She even had to dissect preserved human cadavers in anatomy class. Nurses, too, require college or university degrees these days in order to advance professionally and be hired by hospitals. Some take Ph.Ds in nursing science, putting them on a level with actual medical doctors, as far as education and training goes. As for medical doctors, it’s not unusual to see one with a long string of degrees after their name. B.A., B.Sc., M.A., M.Sc., M.D., Ph.D., etc. At a bare minimum, it takes six years to graduate as an M.D. in Canada: two years’ university at the bachelor level (preferably in the sciences), followed by four years’ med school. (Something similar, I imagine, pertains to dentists and eye specialists.) And none of that time is devoted to learning how to sexually service a “client”.

This is what is meant and generally understood by a “profession”: A long period of training in a specialty that requires extensive and in-depth knowledge. And one is graduated with a certificate that states that this person is qualified to work as a physician, surgeon, nurse, dentist, optometrist, etc. Or as an assistant to any of the above. Or, like my sister, a Registered Massage Therapist (RMT).

What professional training and certification does it take to work in prostitution?

As far as I know, there is no real certification process for prostituted persons at all. Maybe, if one works in a country where some health regulations are in place, you are required to get regular gynecological exams and be declared STD-free, but that’s about it. And even that is unusual. It seems to be the case mainly in Holland, where, as we now know, the liberal laws legalizing prostitution have come into question by local authorities seeing a surge in organized crime. If the current anti-trafficking laws are a joke to the mafia networks supplying girls to work in the “windows” (and they are), what must health regulations be? And how many euros a month does it cost to get fake HIV status certification for all the girls in one’s stable? If johns insist, as they so often do in Germany, upon “AO” sex — “alles ohne”, meaning “everything without [condoms]”, then how long can any girl in the trade reasonably expect to pass her HIV tests and obtain a clean bill of health? After all, being prostituted alone does not magically transmit the virus; it has to come from someone else. And that “someone else” is usually the buyer. (Or, if the prostitute is also an addict, from sharing needles with someone who is infected, as many street junkies do. And, in fact, a lot of prostitutes are junkies themselves; it’s one of their key coping strategies, as drug use facilitates mental dissociation.)

So much for certification. Now what about professional training?

Well, there’s where we start getting into some seriously murky territory. And that’s precisely the bailiwick of the trauma therapists mentioned in the EMMA article I linked and translated above. All of them have found that the only real prerequisite to working in the sex trade is previous experience, usually in childhood, of severe malign neglect and/or sexual abuse. And dire poverty in one’s immediate present. That’s it! Well, that, plus a round of rape if the girl is not already broken down enough to take whatever abuse is dished out to her. Gang rape is the only “professional training” that practitioners of the “oldest profession” receive in the trafficking networks. It takes, at most, just a couple of intensely traumatic days. There are no professional colleges, no formal training programs, no exams, no boards to certify that one is proficient in “sex work”.

Does that sound like a profession to you? For that matter, does it sound like the training you’d get for any other job? After all, the “oldest profession” is supposed to be a “job like any other”…

Even the most menial joe jobs out there entail longer training periods than that of a trafficked prostitute. At a fast-food joint, on average, it’s two weeks. And the training is far more humane. If scrubbing toilets by hand were paid at the same rates as prostitution, those in prostitution would jump at the chance to become toilet-scrubbers. At least a toilet won’t grab you by the neck and rape you, sodomize you, try to kill you, or just beat the shit out of you. A toilet won’t demand that you play the all-obliging “girlfriend” or fake an orgasm in order to satisfy it. And you don’t have to dissociate mentally in order to face the next toilet, either. You don’t need crack, meth or heroin to numb you in anticipation of yet another damn toilet.

I’m not surprised that there is so little pride in being of the “oldest profession”, outside of the usual highly vocal designated spokespersons for the “sex workers’ unions” (i.e., the pimp lobby) who still insist on pushing the “Happy Hooker” fairytale as somehow representative of the trade as a whole. Just as I’m not surprised that nine out of ten people in prostitution — predominantly women and girls, cisgendered or trans — have expressed the wish to get out again, as soon as they can. Who would not want to get out of a “profession” where one’s “job” entails so much dissociation, often through drugs, in order to escape the reality that one is being repeatedly sexually abused? And where the PTSD rates are comparable to those of women who have been raped in a war zone like Bosnia?

In fact, a lot of the rape victims of the Bosnian genocide were forced into prostitution. The only real difference between a “rape camp” and a brothel was that in the latter, money was changing hands. And, most shamefully, a large part of the “clientele” were the same UN troops charged with peacekeeping in the region. That just laid insult on top of injury for the Bosnian women and girls. Because if you couldn’t trust a UN peacekeeper to keep you safe from your tormentors — and indeed, if the peacekeepers were complicit in the abuses, as they were later shown to be, in Bosnia and Kosovo — whom could you trust at all?

The trauma therapists of Germany have worked with two groups of traumatized women: survivors of war rape in the Balkans, and survivors of prostitution at home. They have seen similar patterns at work in the lives of both. They can no longer dissociate from the disturbing reality that sexual abuse is not just an ugly episode from these women’s pasts, it is also an ongoing fact of their present. Flashbacks can strike at the most unexpected moments, leaving the victim incapacitated and vulnerable to even more abuse than she has already endured. They require drugs, often hard and dangerous street drugs, to numb out and dissociate again. The cycle becomes more vicious with every turn. And when all the coping strategies evolved during one’s time in the “life” stop working, that’s when they land in the psychiatric clinic, if they are lucky, to unpack it all for someone who will listen, care, and not judge them moralistically for what they have done in order to survive.

And when someone whose job it is to listen and care nonjudgmentally comes out in favor of abolition, you can be sure that this person’s conclusion is the product of long reflection upon what they have seen in their own profession. One can’t call them “repressed Victorian moralists”, as these therapists are the beneficiaries — and in some cases, pioneers — of the most modern psychotherapeutic and psychosexual training in the world. These are no buttoned-up church ladies and ignorant backwoods preachers of abstinence and procreation-only; these are urbane specialists with the highest educations, and the best training, that the highly reputable German university medical system has to offer. If they speak out against prostitution, and do so precisely on the basis of what they have learned from those in the thick of it — you can take their word to the bank. They have made the scientific case against a “profession” that has no real scientific basis whatsoever.

Now, I wonder if the politicians are also listening — caringly, and without judgment, as the therapists have learned to do.

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