Commercial Sexual Exploitation

What is commercial sexual exploitation?

Commercial Sexual Exploitation. What health workers need to know

Commercial sexual exploitation (CSE) includes sexual activities which objectify and harm others (usually women) such as prostitution, phone sex, stripping internet sex/chat rooms, pole dancing, lap dancing, peep shows,  pornography, trafficking, sex tourism and mail order brides.

The Scottish Government includes prostitution, pornography and other forms of involvement in the ‘sex industry’ in its definition of violence against women.  It considers that the exploitation of women through these forms of ‘entertainment’

legitimises negative attitudes towards women and is inextricably linked to gender  inequality and sexual violence.

Who is at risk?

The key risk factor for experiencing CSE is being female.

Commercial sexual exploitation can happen to both women and men.  Women involved are often on low incomes, are substance users and there is strong evidence that they have experience of other forms of gender based violence.

It is difficult to quantify the numbers of women involved in commercial sexual exploitation, partly because some activities, such as pole dancing, are seen as ‘normal’ and others, such as trafficking into prostitution, are criminal and hidden.

Although much fewer men are involved in prostitution than women, the evidence suggests that those involved become so for reasons similar to women i.e. lack of options available, previous experience of abuse, drug misuse, and homelessness.

Health impact

Commercial sexual exploitation adversely affects physical, sexual and mental health and is a serious public health issue.

The health impact of CSE can be profound, both as a result of coping with the consequences of exploitation and because of the greater exposure to violence and other forms of abuse inherent in this activity.

Some of the signs to look out for include:

  • Substance misuse
  • Headaches, fatigue, dizzy spells and back pain
  • Depression, anxiety, hostility, dissociation and signs of post traumatic stress disorder
  • Suicidality
  • Signs of physical assault
  • Signs of rape and sexual assault
  • HIV, STIs and urinary tract infections
  • Repeated terminations of pregnancy

Other factors may alert you to the possibility of commercial sexual exploitation:

  • Difficulty in getting to health services during normal working hours
  • Inability to keep appointments (through drug addiction/intoxication)
  • Lack of money to travel to appointments or pay for prescriptions
  • Disclosure of child sexual abuse or domestic abuse
  • Homelessness
  • Evidence to suggest control or domination by a partner or pimp

Your role as a health worker

As a health worker you are in a unique position to respond to patients affected by commercial sexual exploitation by treating them with respect and dignity and by:

  • Being aware that patients may be affected by CSE
  • Recognising possible indicators of abuse
  • Initiating discussion
  • Providing clinical care if necessary
  • Assessing safety
  • Documenting your findings (not in handheld notes)
  • Giving correct information
  • Be sensitive to different needs and ensure all patients can access services equally, for example by providing professional interpreting services

Further information on what to look for and what you can do to help can be found in the guidance.

Help and information

Rape Crisis Scotland Helpline:
08088 01 03 02 (daily 6pm – midnight)

Domestic Abuse Helpline:
0800 027 1234 (24 hours)

Scottish Refugee Council:
0141 248 9799

Women’s Support Project:
0141 552 2221

Open Road Project
For men involved in prostitution
0141 420 7284

Male Prostitution Network
Contact Open Road Project for information

Trafficking Awareness Raising Alliance (TARA)
0141 287 8307

The United Kingdom Human Trafficking Centre (UKHTC)
0114 252 3891 (24 hours)

POPPY Project
0207 840 7129

International Organisation for Migration (IOM)
0207 233 0001

Migrant Helpline
07766668781 (24 hours)

Support for Survivors

If you are looking for support for your own experiences of GBV you can call:

Scottish Domestic Abuse Helpline
0800 027 1234

Rape Crisis Scotland
08088 010302

or click on:

Scottish Womens Aid

Survivor Scotland

Galop National LGBT Domestic Abuse Helpline


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