Abstract
Sex work and trafficking for the purpose of sexual exploitation have been linked since the origins of human trafficking. Nonetheless, deeper insights into the role sex work plays in the life of trafficking survivors, following a trafficking experience are lacking. This research explores how sex work is approached in the context of (re) integration of persons trafficked, how service providers view sex work, and what the implications are for the survivors and their recovery. A total of 52 qualitative interviews were conducted in Europe (Southeastern Europe, the Netherlands, and Italy) with service providers who have been in direct contact with survivors of human trafficking, as well as survivors of trafficking for the purpose of sexual exploitation. Themes were derived based on how sex work was conceptualised by both service providers and survivors. Findings show that return to sex work following a trafficking experience is considered to be an undesirable outcome of the (re) integration process. Sex work is stigmatised by both service providers and victims, openly and subtly, in the context of trafficking and generally. It is seen as ‘not normal’ by all groups interviewed, and trafficking victims in particular seek to distance themselves from the experience, whether they entered it knowingly or not. Long-term recovery and (re) integration of victims of trafficking may be difficult if stigmatisation in regard to involvement in sex work persists, both from the perspective of survivors as well as service providers.
Introduction
I was once interviewing two prostitutes, which have been trafficked and we arrested the trafficker, and after the statement, I asked them, where do you want to go? Do you want to go to the shelter, or where should we drop you off? Well, you can drop me off at the red light district, she said. (Police official, The Netherlands, 2013)
Sex work and trafficking for the purpose of sexual exploitation have been linked since the origins of human trafficking in the form of ‘white slavery’ in the late 1900s (Outshoorn, 2005). Primarily, discussions have been focused on whether sex work can be a choice or if it should always be considered as forced and thus indistinguishable from human trafficking (Doezema, 2005; Gallagher, 2001). Scholars have also looked at whether the legal status of sex work has any impact on the occurrence of human trafficking (Cho et al., 2013). However, what seems to be missing is a closer look at how sex work is conceptualised based on perceptions of both trafficking survivors and those involved in their recovery and (re)integration. As the introductory quote demonstrates, it is undeniable that some women after being trafficked, choose to re-enter sex work. Thus, this leads to the question, how is sex work approached in the context of (re) integration of persons that are victims of trafficking for the purpose of sexual exploitation? How do service providers and victims view the issue of sex work? What kind of implications do these attitudes have for the (re) integration process of victims? These are the questions that will be explored throughout this article.
This article will not attempt to resolve the decades long discussion on whether all sex work constitutes violence against women, nor whether sex work can be considered as a legitimate form of labour. It will simply look at the way the issue of sex work is viewed by service providers, but also by survivors. The target group under discussion will mostly be Southeastern European women who have been identified as victims of trafficking for the purpose of sexual exploitation with European countries as destinations.
As the overview of empirical literature below will show, much of current academic research that discusses both the topics of sex work and sex trafficking tries to show the interconnectedness between sex work and sex trafficking – the legalisation of one (sex work) leads to a rise in the other (sex trafficking). However, such studies are based on large-scale quantitative research with data and methodological challenges that are hard to overcome when dealing with hidden populations (Weitzer, 2015). The research in this article is a valuable contribution to the literature as it is based on extensive, albeit explorative, qualitative work. It aims to better understand the evolving relationship between sex work and sex trafficking through the perceptions of trafficking survivors and service providers.
First, this article will present a brief historical review of the relationship between sex work and human trafficking, based on existing literature, to give appropriate context to the topic. Thereafter, the empirical studies that try to show relationships between the legal status of sex work and sex trafficking will be presented. The paper continues with an outline of the methods used and then a presentation of the main findings based on responses regarding sex work, primarily by service providers, but also by survivors. Four themes have been identified and will be explored in detail: (1) only tell a trusted few; (2) getting back to ‘normal’; (3) stigma and sex work go hand in hand; and (4) sex work and sex trafficking. The first and second theme will explore how service providers approach sex work in the context of the (re) integration process of victims. The third theme will look at how service providers and victims view sex work, and whether it is still an issue surrounded by stigma. The fourth and final theme will look at whether service providers make a distinction between sex work and sex trafficking in the context of their work. The article will conclude with a discussion of the findings and their implications.
This work is part of a broader study on the recovery and re-integration of women trafficked for the purpose of sexual exploitation (Meshkovska et al., 2015, 2016, 2021, 2023). Whereas previous papers focused on mapping the recovery and (re) integration process (Meshkovska et al., 2021) and defining what recovery and (re) integration means for service providers and survivors (Meshkovska et al., 2023), the current article focuses on how sex work is perceived and conceptualised.
Background
The issue of sex work has been part of the discussion on human trafficking from its very inception (Doezema, 1999). Human trafficking draws its roots from a phenomenon called ‘white slavery’, identified in the 1900s whereby women who migrated would fall victim to trafficking and be forced into sex work. However, some scholars have identified ‘white slavery’ as ‘largely mythical’ and a ‘moral crusade’ against women who have decided to migrate to do sex work (Weitzer, 2015). Similarities have been drawn between the timing of the ‘white slavery’ of the past and ‘anti-trafficking’ movements of today as simply attempts to stop women from migrating, and in particular from migrating with the purpose of engaging in sex work. It is thus to be expected that the issue of human trafficking today would certainly draw the attention of two divergent camps of thought – the abolitionists and the sex workers rights camp.
Some scholars have tried to find a so-called ‘third way’, accepting some of the arguments from the abolitionist camp and some of the arguments of the pro-sex work camp (Shelley, 2010). The third way attempts to recognise that structural factors and limited options may be what drive some women into sex work, and consequently is not the choice that they would make in an ideal situation or even in slightly better circumstances. However, it also acknowledges that women do exercise agency, even when making decisions to enter sex work, and their choices should be respected. In the spirit of the third way, some studies recognise that regardless of whether or not sex work can be a choice, it is work that involves significant dangers and possible harms to health, and thus these issues should be addressed and women assisted, regardless of whether or not one belongs to the abolitionist or pro-sex work camp (Decker, 2013). Along the same lines, a study by Saunders (2005) notes that trafficking should be seen as one of the ‘occupational hazards’ of sex work.
In empirical literature
There is a limited number of studies based on empirical evidence which try to look at the interconnectedness of sex work and sex trafficking. A study by Busza (2004), based on interviews with Vietnamese sex workers in Cambodia, tries to identify some of the impacts of anti-trafficking activities on sex work. It finds that through raids, women were often arrested and would have to go into further debt to be released from prison. Furthermore, the presence of police or NGO workers in their communities made it more dangerous for clients, thus decreasing possible profits for the women by driving customers away. Finally, in such conditions, negotiations about the use of condoms were more difficult, and thus the health of the women was compromised to a greater degree than in conditions where anti-trafficking activities are lacking (Busza, 2004).
Worthen (2011) looks at the programmes offered by service providers to sex trafficking victims, based on interviews with service providers in Nepal. Worthen identifies the so-called ‘prostitution framework’ rooted in abolitionist policies and the ‘labor framework’ rooted in the pro-sex work camp and notes that most of the anti-trafficking programmes implemented by Nepalese organisations belong to the ‘prostitution framework’. In this regard, programmes offered do not recognise any agency that women may exercise when entering sex work. Brunovskis and Surtees (2008) conduct an important study focused on Southeast Europe. It investigated the values and attitudes that are ‘inherent’ in anti-trafficking assistance programmes and found that assistance programmes tend to ‘pathologize’ the choice of the woman to migrate, and entry into sex work is a way to explain this ‘deviant behaviour’. They find significant stigmatisation of the issue of sex work, which this present work will show still persists today, many years after their study. This occurs not only in Southeastern European countries, but also in Western Europe (in the case of this work, in The Netherlands).
More recently, a body of literature has been compiled based primarily on large-scale quantitative data or case studies focusing on the connections between the legality of sex work and the occurrence of human trafficking, as well as the legality of sex work and societal attitudes towards sex work. Cho et al. (2013) look at data from 150 countries and find that the legalisation of sex work has two effects – the scale effect, which may increase trafficking due to a rise in demand when sex work is made legal, and the substitution effect, which may decrease trafficking when women enter sex work legally after sex work is made legal. The study finds that the scale effect dominates over the substitution effect. Cho (2016), again using global data from 149 countries, tries to further show that liberal sex work laws do not mean greater victim protection, instead what is of relevance for victim protection is institutional quality and gender empowerment. Thus, Cho (2016) notes that liberal policy makers tend to believe that by liberalising sex work and protecting the rights of all sex workers, they also protect the rights of those that have been forced into sex work, which is not the case. Thus, those forced into sex work are neglected, causing weaker victim protection. On the other hand, (1) commitment of institutions to anti-trafficking policies (institutional quality) and (2) female policy makers that are committed to pursuing initiatives that promote the well-being of women, ensure better victim protection overall (Cho, 2016). Jakobsson and Kotsadam (2013) use global trafficking data from the United Nations Office on Drugs and Crime (UNODC) and International Labour Organization (ILO) and find that the occurrence of trafficking is lowest in countries where sex work is illegal – a relationship, but not necessarily a causal one. They also augment their quantitative work with two case studies of Sweden and Norway and attempt to show that it may be that harsher sex work laws lower the amount of trafficking. Such large-scale studies however can have limitations in using data that has not been standardised in order to compare countries at the global scale, all the while targeting ‘hidden populations’ (sex workers, the trafficked) (Weitzer, 2015).
Another set of quantitative empirical studies use survey data to draw conclusions regarding attitudes towards sex work. Immordino and Russo (2015) use a data set from the World Values Survey to look at how sex work policy may influence attitudes concerning sex work. They find that countries where sex work is legal seem to show more tolerance towards sex work. Jonsson and Jakobsson (2017) use survey data on attitudes towards sex work from the United Kingdom, the Netherlands, Germany, France, Spain, Denmark, Norway, and Sweden. They find that people who come from countries where buying sex is a criminal act are less tolerant towards this practice. They also find that where buying sex is illegal, people who consider gender equality important are not morally accepting of buying sex, whereas those that come from countries where sex work is regulated and consider gender equality important are morally accepting of buying sex. Finally, Jakobsson and Kotsadam (2011) use a 2008 Internet survey to look at attitudes towards sex work in Norway and Sweden, as countries that have criminalised the purchase of sex. They find that people who find gender equality important, have negative attitudes towards sex work.
Methodology
This research is based on a total of 52 qualitative interviews conducted in Europe, more specifically Albania, Bosnia Herzegovina, Bulgaria, Montenegro, Serbia, the Netherlands, and Italy in 2013 to 2015. The target group was service providers (n = 40), trafficked persons (n = 9), family members (n = 1), and those at risk (n = 2). Of the survivors of sex trafficking, eight were female, while one was male.
A qualitative interview as a method was found to be the most adequate approach, considering the sensitivity of the topic of the research. In addition, we see qualitative interviews as a good approach to feminist research, which creates a situation of trust between interviewer and interviewee (Bryman, 2016). Different interview protocols were used for trafficking victims, those at risk of trafficking, and service providers. The interview protocol for trafficked persons covered several areas, including questions having to do with their post-trafficking experiences and participation in assistance programmes. What has been used for this research were all references to sex work by the victims of trafficking.
Service providers were asked about what they see as sex work and what they see as sex trafficking. They were also asked about their position on sex work, as well as the position of their organisation regarding sex work. Finally, they were asked to speak about cases of sex trafficking where the women returned to sex work following a trafficking experience.
The guidelines of the World Health Organization were followed in conducting interviews in the context of this research. The study was reviewed and approved by the Ethical Committee of the Faculty of Psychology and Neuroscience of Maastricht University. Informed consent was received from each interviewee, prior to conducting the interviews, and in addition, permission was sought and granted from every participant to digitally record the interviews.
All interviews were transcribed and transcriptions were entered into QSR NVivo 11.2.2 (1707) for Mac. The analysis consisted of several phases. All data was read and re-read several times to ensure immersion in the material. Open coding was used to isolate segments of each interview that were relevant to the research question (Flick, 2009). Each relevant segment constituted a distinct thematic code, again led by and based on the initial research questions. Each theme resulting from the open coding was then read and in vivo and descriptive sub-codes were used to identify relevant and exploratory concepts within each theme. Axial coding was then used to map relations between identified sub-codes within each thematic code, as well as relations between sub-codes and the main code to which they were assigned. Finally, mind maps were used to identify the final four themes presented in this paper.
Results
The first and second theme will look at how the issue of sex work is approached in the context of (re) integration by service providers and by victims. Do victims share their past, which may have entailed voluntary or involuntary entry into sex work that resulted in trafficking, with others? What is the advice of service providers in regard to sharing the victim’s experience with others? And what about possible return to sex work following a trafficking experience? How is such a return viewed by service providers, and why?
Only ever tell a trusted few
Most service providers noted that the choice of whether or not to share their past, and whom to share it with, is left up to the victim of trafficking. However, some did admit that they would recommend not to share a past trafficking experience with employers after having had experience with victims that were further exploited by their employers once they learned of their past.
Regarding the victims interviewed for this study, two victims noted that they would not tell anyone about their experience, in particular their family, as they would never understand or accept what had happened: Noooo. In my family was not, not, not, never in my life. I don’t speak about prostitution. Never. So, it’s not possible. No. My brother also, never not speak with me. My family is normal people. She work, everybody work. My brother work in hospital. Not doctor, only little function. My sister work in shoes factory. Also, me too, I work. And my big sister work in shop. (Trafficked person, The Netherlands, 13 August 2015)
At the other extreme, two victims spoke about their experience openly, one noting that she tells everybody what has happened to her, and the other saying she has told her family and children as they live in a small community where their experience has become known to all. What should be noted of these two cases is that the woman who pointed out she shares her experience with others openly also claimed to be drugged for the duration of the trafficking and her time in sex work. While the woman who shared her past with her children, despite being physically and psychologically abused by the trafficker, never accepted entering into sex work, and thus did not admit to being sexually exploited. Thus, one might argue that it is easier to share the experience if the victim finds a strong justification for its occurrence or completely distances herself from it.
Between the two extremes, the largest group of four victims remarked that only their family knows about their past. Two of these victims were accepted by their family, while two were rejected and had not reconciled. Finally, the male victim noted that although he is open about his experience, willing to share what happened to him, and talk about it with researchers, he is more reluctant about sharing it with friends or acquaintances, and even less open to sharing it with family: How you going to tell your parents that you were a prostitute. How you will tell your parents that you know it was a problem to do, and you don’t mind it. How you tell them at this time you were kind of happy, because the job was not heavy for you, in a psychological way. (Trafficked person, Bulgaria, 14 October 2015)
Thus, it seems that the largest group of respondents follow a particular pattern of disclosure characteristic of persons that may feel stigmatised – they divide the world into a larger group to which they do not disclose their experience, and a smaller group that they may trust, to whom they do disclose their experience (Goffman, 1963).
Getting back to ‘normal’
It was noted in the introduction of this article that it does occur, although it is not possible to say how often, that women identified as victims of sex trafficking return to sex work following the trafficking experience. This raises the question, how is such a return to sex work following a trafficking experience viewed by both service providers and victims? And further on, how is the overall (re) integration of victims that return to sex work evaluated by service providers?
When asked if they would consider re-entering sex work, all the victims interviewed for this study answered negatively. When service providers were asked if they would consider a woman who goes back to sex work after a trafficking experience as a success case of the recovery and (re)integration process most also answered negatively. The reasons given for such answers, both by victims and service providers, were similar and mentioned that what is needed after a trafficking experience is a return to the ‘normal’ and sex work does not satisfy this need. In addition, it was noted that the return to sex work means exposure to the possibility of exploitation once again.
One victim voiced the need to feel ‘normal’ in the following way: I think I need work. And I am happy, because now I can start in this restaurant. Maybe it’s two times, you know two times per week, but its OK, because after this, I can have you know, I can stay with normal people, I can do some normal stuff. . . . I said myself, maybe, I don’t know, good job. Let’s say this, good job, to stay to the floor [to stay grounded]. To little bit, to be normal life, you know. Little bit. Change. (Trafficked person, The Netherlands, 13 August 2015)
A service provider similarly stated, And the re-trafficking, or prostitution, is a thing of failure of (re) integration, (re) integration failure I think. Because if a victim of trafficking, she is going to prostitute, or re-trafficked again, that means that she has not the sources to live in a normal way, I think, with their family. (Service provider, Albania, 23 October 2015)
Exposure to violence and possibly falling victim to exploitation once again, was perceived by both victims and service providers as another reason why a return to sex work following a trafficking experience would not be recommendable: Because it’s a dangerous job. And if I do this problem for these people, if I work again in sex job, she [trafficker] meet me everywhere. In internet. (Trafficked person, The Netherlands, 13 August 2015) I really think that this is a big risk. Especially, here, there are many different risks. Risks of re-trafficking, to different types of risks, health wise and other. Risks from violence, as such. (Service provider, Serbia, 30 October 2014)
Service providers also emphasised the attempts they make throughout the recovery and (re) integration process to direct women towards the ‘right path’ or direct them in the ‘right way’, which would not include returning to sex work: Of course, we do not judge such persons, who even after trafficking, and recovery, enter the world of prostitution. We accept them, before anything else, as human beings who need help and understanding, and a conversation that tells them that they are again in big problems and they should try to come out of them, with professional help, and the help of humanists who deal with this, and understand this. (Service provider, Montenegro, 7 December 2015) Our work as a group is to show her the right way. So, by providing her with all the services, is to show her the right way. Then is the choice of the person, if she chose either this path, or this one. But this cannot be considered as our success or failure, but as the choice of the person herself. So, it’s either her success or her failure. (Service provider, Albania, 23 October 2015) So, the moment that they want to continue their life, not staying in this shelter all the time, but when they say, I can’t stay all the day without doing anything, I want to work, I want to find something, then it’s this point, this very important point, that the people here try to direct them in the right path. (Service provider, Albania, 25 November 2013)
It should be pointed out, however, that in situations where the women persisted in their decision to remain in sex work, either due to financial reasons or in some instances mentioned by responders to finance an addiction such as alcohol and drugs, service providers did not pull away their support but still tried to assist in the limited ways they could: Our organisation, we are very liberal. In these cases, what is important, when someone works in this, we would say, it is OK for us. I mean, it is not OK, but we try to understand. And we ask that she tells us where it happens, how it happens etc. And we try to work with her again, to work through everything, to see how to take her away from that. But, we would not judge her. That is key. We would understand her. When they are in the shelter, they are banned from being in prostitution, while accommodated with us. But, it often happens. The permanent decision about exiting, it’s like with addicts. It happens very often. A lot of them go back to it, as a source of income etc. (Service provider, Serbia, 2 November 2015)
The return to sex work following a trafficking experience is often seen as a failure of the (re) integration process by service providers (Meshkovska et al., 2023). Part of the reason is that sex work involves many dangers and may put the victim in a situation of exploitation once again. However, both victims and service providers view sex work as something that is not ‘normal’ and service providers make attempts, throughout the (re) integration process, to set victims on what they see as the ‘right path’, which means away from further sex work. Once again, these are all attitudes that show sex work to be a source of stigmatisation.
Stigma and sex work go hand in hand
Stigmatising attitudes towards sex work were outlined in the preceding section, in the context of discussing sex work with victims and service providers, as it relates to the (re) integration process. However, existing and persisting stigma towards sex work was also discussed more openly with service providers, as well as identified when expressed more subtly through their references towards the stigmatised group – in this case female sex workers.
Primarily, service providers openly observed that stigma goes hand in hand with sex work and sex work is a profession that is highly stigmatised by society, even in places where it is legal: The problem is that there are still a lot of stigma around prostitution . . . Then it’s also very difficult, because you have a lot of, you have to get a bank account, or you want to finish your rent, or you want to buy a house, it makes it all more difficult. So, it’s a little bit difficult in the Netherlands, because we legalised it, but it’s still a difficult subject. (Service provider, The Netherlands, 4 November 2013)
However, what is perhaps of even greater importance are the more subtle, personal vocalisations of stigmatisation of sex work that were expressed through the references made by service providers towards sex workers and sex work. Some service providers noted that some of the character traits of sex workers are a strength because they are used to harsh conditions and must learn to survive, having power, and being freer than ‘we are’. Still, character traits that were expressed with negative connotations were present. Namely, a few respondents (both male and female police officials/service providers) described sex workers as flirtatious, looking for thrills and high adrenaline, lazy, manipulative, promiscuous, and prone to blackmail.
Service providers also characterised sex work as not being a ‘normal’ profession and not a way to make an ‘honest living’: We still don’t think it’s a normal profession. So, it will always be difficult. So, as long as we don’t accept it as a society that it’s a normal profession, then it’s really difficult to get accepted. (Service provider, The Netherlands, 4 November 2013) She is trying a project now, for women to get work experience and eventually they can get a job in another line of work and make an honest living, not as much as she would earn as a prostitute, but . . . (Police official, The Netherlands, 4 November 2013) The salary they would earn from an ‘honest’ job, let’s say, is very low. It always helps them with the payments, the house, the children. (Service provider, Albania, 27 November 2013)
Service providers often tried to explain why women would be sex workers. Some of the respondents who believe that sex work can never be voluntary noted that women became sex workers because of structural reasons and a society that would not give them any other option. Or, from the same group of respondents who did not believe sex work can be a choice, it was perceived that it was always due to the existence of some form of sexual exploitation in the woman’s past. In these cases, women may become promiscuous as a way of gaining back some control in their life. In this regard, for some women sex work becomes the only thing they know. However, other respondents also saw sex work as a trap, where once captured, it would be very difficult to exit largely due to getting used to a ‘lot of money’: How do you say it, prostitution is a . . . a lot of the girls think, I do this for a short time, and then I have enough money, and then I can go home, or give to my family, or go to school. But they earn more money, they spend more money, they stay in prostitution, they need stuff to do the work, and it’s a trap. That is the word. It can be a trap. And that’s a big danger I think. (Service provider, The Netherlands, 28 March 2014) There are women who can perform this action and they are able to separate love from sex, they are able to act like a mechanism just to get the money. And I think that’s the biggest issue, is the money. (Police official, The Netherlands, 4 November 2013)
Stigma towards sex work was expressed also by the victims interviewed for this research. Once again, what is most prominent is the view that sex work is not something that is ‘normal’: Because I see what is prostitution, it’s not for me. I like job, normal job. . . . prostitution, this is not one job for old woman, or is not job for young woman normal. (Trafficked person, The Netherlands, 13 August 2015) They all say, ‘I am voluntarily doing it’. How can you be doing it voluntarily, it is not normal for me. But, they don’t know. According to me, they simply fall in love with the pimps. (Trafficked person, Bulgaria, 15 October 2015)
In addition, some of the victims interviewed for this study tried to present reasons as to why they may have entered sex work knowingly. Namely, two respondents noted that they would have never considered being sex workers if it were not for financial reasons – for one it was to pay for an electricity bill, for the another it was to provide milk for her infant.
The remaining respondents did not remark at any point that they were willingly entering sex work and made attempts to go a step further and distance themselves from sex workers and sex work. In this regard, one respondent noted that she was drugged and does not remember anything related to the experience of being a sex worker. Another respondent was physically forced to be a sex worker, while yet another victim stated that despite being severely physically and mentally abused, she never became a sex worker. In one instance, a victim made a reference to female sex workers as ‘whores’.
It was only the single male victim of sex trafficking who did not try to distance himself from the experience of sex work, stating that: It was really funny, because people really liked me. In this moment, I fixed a lot of my debts. It was really good for me. And maybe because I was young, maybe because I was hungry for money, or I don’t know how to say, I wanted more more more. It’s like drug addiction, when you are good in something, you want to do it again, and go more and higher, and things like that. (Trafficked person, Bulgaria, 14 October 2015)
It seems that even outside of the context of (re) integration, sex work is heavily stigmatised by both service providers and victims alike. It is not seen as ‘normal’ and as an ‘honest way’ to make a living. Service providers stereotype sex workers as lazy, manipulative, and promiscuous. In addition, both service providers and victims try to justify entry into sex work, even when such entry was done knowingly.
Sex work and sex trafficking, let’s agree to always disagree
Finally, this last theme explores the view of service providers regarding distinctions, if any, between sex work and sex trafficking, and is reflected upon in light of the current debates on these issues between the abolitionist and pro-sex work camp.
According to one group of respondents, sex work can never be voluntary. However, the reasons that would push women into sex work vary. According to an interviewee, even when a woman says that she has voluntarily entered sex work, it is not voluntary. The reasons are a system and a society that has forced her into the choice because she cannot find a job, take care of her family, and provide the basics for her children: For me, prostitution, a woman that ‘voluntarily’ is in prostitution, it is not voluntary. Because if we lived in a healthy society, a society where you have possibilities, this would not happen. (Service provider, Serbia, 2 November 2015)
However, for another respondent the reasons sex work is never freely chosen is because women that enter sex work are usually victims of sexual violence prior to entering sex work. It is being a victim of sexual exploitation that has led them along one of two paths, being promiscuous or avoiding any sexual relationships: According to me, girls that have been victims of sexual violence, go into prostitution. And this is a way to keep control. They had lost control, before, so they now try to get back that control, and they want to say ‘I am deciding to do this’. (Service provider, Bulgaria, 16 October 2015)
Still, it should be noted that one of the interviewees, while presenting the view that sex work is never voluntary, did make a slight distinction between sex work and sex trafficking: There are cases where a girl that works in prostitution, is forced . . . she realises that she has to behave a certain way with the customer, because he paid, the sexual experience is his personal choice. So . . . this also happens, in prostitution. But, in human trafficking, she has to additionally bare the trafficker. That her freedom of movement is not there, that she is blackmailed, that in case she does not do something that they are asking from her, her family will be killed. Or that she will be killed. Both cases, the problems are very complex. (Service provider, Serbia, 2 November 2015)
A second group of respondents noted that although they do see a distinction between sex work and sex trafficking, society does not. The impression given by this group is that regardless of whether the two phenomena differ, society and the communities to which the victims return, as well as many families of victims, see no difference. Thus, distinctions that may be made become irrelevant, especially when placed alongside the stigmatisation that victims face from their surroundings due to equating sex trafficking with sex work. It should be noted that it is implied in these statements that respondents believe society sees sex work as something voluntary and immoral, condemns it, and thus when associated with sex trafficking, the stigma it gives rise to has a negative impact on recovering victims: According to me, most people look at victims of trafficking, as prostitutes. They don’t understand that this is something forced, and women didn’t want that to happen to them. And according to people, if a woman wanted to be a prostitute, then this is a reason why trafficking happened . . . This is sad. (Service provider, Bulgaria, 16 October 2015) Well, here in Albania, it is, if the people know that you were trafficked, they label you prostitute, not only we can say the relatives, the neighbours, the people that surround you, but even your family. In most of the cases, family members, they do not accept their daughters back home. (Service provider, Albania, 23 October 2015)
Finally, a third group of respondents made a distinction between sex work and sex trafficking by noting that sex work may be voluntary and can be a choice, while sex trafficking is a criminal activity that implies the use of force. Even if a woman had entered sex work because she did not see any other alternative, it was still seen as her choice, while sex trafficking was a criminal act that was done through force and violence: The difference is that the trafficking is a criminal thing and can operate through criminal cases, through the judiciary. The prostitution is the activity that is free, must be free. It is not a victimisation of people. (Service provider, Albania, 23 October 2015)
It was mainly within this group of respondents that the term ‘sex worker’ was used: Prostitution, is especially, is a profession that she does willingly. She is a sex worker. It’s her choice. Meanwhile, the victim of trafficking suffered from this. While a prostitute she does this profession because she wants to get incomes from this profession. (Service provider, Albania, 23 October 2015)
To summarise, three distinct groups of service providers were identified based on the distinctions they made (if any) between sex work and trafficking for the purpose of sexual exploitation. Although one group of respondents said that they clearly distinguish between sex work and trafficking, the other two either remarked that they do not make any distinction or that whether they make a distinction or not is irrelevant when you consider that for society, the two concepts are one and the same.
Discussion
The goal of this article was to explore how the issue of sex work is viewed in the context of (re) integration processes, how sex work is viewed in general as well in comparison to sex trafficking, and on the basis of that, discuss what kind of implications this may have for the (re) integration of persons trafficked.
Based on the results presented in themes one and two, a return to sex work following a trafficking experience would be considered an undesirable outcome of the (re) integration process. Thus, service providers expressed their attempts to ‘set victims on the right path’, which means away from prostitution. This is in line with research conducted in Nepal, which found that service providers working in anti-trafficking followed more a ‘prostitution framework’ rooted in abolitionist policies in their (re) integration efforts, rather than a ‘labour framework’ rooted in the policies of the pro-sex work camp (Worthen, 2011). It also resonates with previous research on the topic in Southeastern Europe (Brunovskis and Surtees, 2008). Abolitionist views on sex work were expressed by service providers also in the last theme, where one group of respondents did not recognise any distinctions between sex work and trafficking and another noted that society does not make such distinctions, so their own personal view is irrelevant. This finding may be better understood through the lens of identity process theory (Breakwell and Jaspal, 2014). Namely, identity process theory claims that identity is shaped by society and culture, and it is a fluid concept that may change over time. Heavy stigmatisation and negative attitudes of trafficking victims towards sex work in the context of this study may be due to the societal views of the moment. Still, one significant reason already mentioned by service providers, in the context of this study, for not wanting victims to return to sex work was the health hazards such an environment may pose. Once again, that sex work is a dangerous working environment has been recognised by other research in the field (Saunders, 2005).
However, the main overwhelming finding of this work is that sex work is stigmatised by both service providers and victims, openly and subtly, whether in the context of trafficking or outside of it. This goes against the assumption that service providers working in anti-trafficking would not exhibit stigmatising attitudes towards sex work. Unfortunately, this corroborates with research from other fields as well, such as on health care professionals who interact with patients who live with HIV and who stigmatise their patients, even though they may have good intentions overall (Stutterheim et al., 2014). Sex work has been labelled as ‘not a normal profession’ and ‘not an honest way’ of making a living, by respondents. Sex workers have been stereotyped as lazy, manipulative, promiscuous, flirtatious, and prone to blackmail. Such distinctions between what is seen to be ‘normal’ and ‘not normal’ and the construction of stereotypes which are then linked to the label of sex worker are the very basis of a stigmatisation process (Goffman, 1963; Link and Phelan, 2001). In addition, both service providers and victims, regardless of whether the entrance into sex work was conducted knowingly, try to explain and justify that entrance through the creation of ‘stigma theories’ (Goffman, 1963) – in the examples of this article, these were structural factors, financial reasons, or in some cases being drugged.
The fact that victims tried to distance themselves from the sex work experience and in some way explain or justify it through the creation of stigma theories may also suggest the presence of self-stigma (Bos et al., 2013). The occurrence of self-stigma in regard to sex work may also be traced in the majority of victims preferring to share the trafficking experience in which they may have been involved in sex work with only a small group of people they trust and try to hide it from the rest of the world. In addition, service providers sometimes advised victims to not disclose their past to employers. Also, as already noted, some pointed out that society does not distinguish between sex work and sex trafficking- in that, if victims of sex trafficking were exposed, they would be viewed as sex workers and blamed for what had happened to them. Such attitudes may show the presence of both public and structural stigma concerning sex work (Bos et al., 2013). This finding, in particular in regard to structural stigma may be further understood through the concept of ‘hostile worlds’ in the work of Zelizer on the encounters between intimacy and economy (Zelizer, 2005). The concept of hostile worlds frames economic activity and intimate relations as distinct arenas that should not be mixed, as when they intercept, chaos and disorder may occur (Zelizer, 2005). In this way, structural stigma towards sex work may be further enforced in a society which does not find it acceptable that intimacy, in particular sexual intimacy, can be exchanged for monetary benefit, in the sex worker–client relationship. These types of exchanges are sanctioned however, if the relationship is one of partners, or through marriage.
Also interesting, however with a note of caution due to the small sample of respondents, is that in the context of this study, stigmatisation of sex work was still expressed and evident by respondents coming from countries where sex work is not illegal (the Netherlands and Bulgaria). This is contrary to research presented at the beginning of this article, which has shown more tolerant attitudes towards sex work in countries where sex work is legal (Immordino and Russo, 2015; Jonsson and Jakobsson, 2017).
The relevance of trust and the presence of stigma in the context of recovery and (re) integration processes of victims of trafficking, are significant not only in regard to non-institutional social relationships that the victim forms following a trafficking experience, but also in regard to the relationships built specifically with service providers. The establishment of such relationships, which may aid long-term recovery and (re) integration would seem difficult if victims perceive the stigmatisation expressed by service providers in regard to their involvement in sex work.
A group of respondents not captured by this study was in fact victims that return to sex work following a trafficking experience. Their perceptions in regard to sex work, as well as regarding how sex work is approached and handled throughout the (re) integration process of trafficking victims may be significant in reforming and improving anti-trafficking efforts, and is a good direction for future research. Unfortunately, this is also a group which is difficult to track and find, and even more challenging to have participated in research. Continued stigmatisation of sex work may be part of the reason why this is the case.
Finally, an additional direction for future research may be to look at the experience of male sex workers and male victims of trafficking for the purpose of sexual exploitation. The one interview conducted as part of this research indicated that there may be significant differences in how men and women approach sex work. However, there were also significant similarities, such as the feeling of stigma. Of course, conclusions cannot be drawn from this, and thus further exploration of male experiences of sex work and sex trafficking would be necessary.
