Streetwalkers are generally the lowest-paid of all prostitutes. They are also in the most danger. As a result, those who work as streetwalkers are likely to be more desperate than other prostitutes, suggesting that, regardless of chosen profession, they would experience greater levels of mental distress than the normal population.
What is fascinating is that when research does not look at streetwalkers, but at higher status prostitutes, prostitutes do not seem to suffer from a greater rate of mental health issues than women in other professions. Ine Vanwesenbeeck examined burnout levels of indoor sex workers in the Netherlands and compared them to nurses and to mental health patients. Her results suggested that prostitution did not necessarily lead to psychological issues. "Female indoor sex workers in the Netherlands do not exhibit a higher level of work-related emotional exhaustion or a lower level of work-related personal competence than a comparison group of female health care workers (mostly nurses)."
They did exhibit higher levels of depersonalization and cynicism than the nurses in the control group, but, while that might be a sign of mental illness in a different population, depersonalization may be a positive adaptation for sex workers.
Furthermore, even if prostitution does have a negative impact on the psychological health of sex workers, would that be a compelling reason not to legalize prostitution? There are a lot of horrible and demeaning jobs that negatively impact mental health that are perfectly legal. Should the state be able to suggest that because prostitution may have a negative impact on the mental health of some prostitutes that all people should be prohibited from engaging in prostitution? Moreover, there is no suggestion that legalization of prostitution makes prostitution more harmful for a prostitute's psychological health. Oh the contrary, indoor sex workers seemed to have better psychological health than streetwalkers.
When taken as a whole, the public health dimensions seem to support legalization of prostitution. There is no evidence that legalizing prostitution increases violence rates, either towards prostitutes or in the population as a whole. On the contrary, evidence suggests that access to prostitutes may result in reduced violent crime rates in the general population. There is substantial evidence that prostitutes working in legal brothels have lower rates of sexually transmitted diseases than prostitutes working in illegal conditions, supporting the idea that legalization and regulation of sex workers helps reduce the spread of disease. Finally, there is no evidence that legalizing prostitution would negatively impact the mental health of prostitutes. Instead, it appears that indoor sex workers, who are working in legal situations, have better mental health than sex workers working in illegal conditions. Therefore, from an overall public health perspective, the results suggest that prostitution should be legalized.
However, legalizing prostitution is not simply a question of public health. The city also has to consider the overall impact of legalized prostitution on the city. Will legalizing prostitution in New York City discourage tourists from visiting? This is a legitimate concern, as the seedy nature of Times Square prior to the clean-up efforts of the 1980s and 1990s kept many tourists from visiting the area. If legalizing prostitution is likely to have a negative economic impact for the city, then positive public health benefits may not be enough to justify legalization.
Legalizing prostitution would have immediate positive impacts for the city. First, the city would be able to place sales or use tax on the services, which would immediately benefit the city. However, the economic benefits of prostitution are not limited to taxation; the police spend a significant amount of money trying to stop prostitution and those expenses would be eliminated under legalization. Furthermore, by removing the criminal penalties from prostitution, the possible reduction in overall crime rates against prostitutes may result in even greater savings by reducing police investigations and emergency medical care costs for prostitutes impacted by violent crime.
Taxes are only one component of the economic benefits of legalization. Legalization would also allow New York City to be a legitimate destination for sex tourists, much as parts of Nevada are legitimate destinations for sex tourists. The question, then, becomes whether a legitimate and open sex trade would discourage other types of tourism. The answer to that question is complicated. Yes, it seems clear that turning Times Square or other popular tourists' destinations into a red light district would be bad for family tourism and have a negative impact on the city's economic status. However, legalization of prostitution implies regulation. It would certainly be possible to strictly control the location of legalized brothels, as well as the types of advertisements and enticements these establishments could use to find customers. There is no reason that sex-based businesses could not be confined to specific areas so that they would not impact tourism rates.
The one thing this paper has not examined is the morality of prostitution. This omission was intentional because the morality of prostitution is not a valid consideration when looking at legalization. This is not because the author views prostitution as moral or immoral but because prostitution has occurred since the beginning of human relationships, and is going to continue in New York City regardless of whether or not it is legalized. Because legalization would have positive impacts on public health and on the city's economy, New York City should legalize prostitution.
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