Evidence based policy

Michael — Thu, 13 Mar 2008 19:30:44 -0700

The subject of prostitution produces instant 'experts' and this column is no exception. It is frankly polemic and only refers to 'evidence' when it suits the argument. There is no ‘overwhelming’ evidence about prostitution in the US. Kristof relies on Farley as his sole source of information, a writer whose work is very problematic and self-serving (1), and ignores mainstream academic work.

In citing a 2004 epidemiological study Kristof adds padding, describing this as ‘meticulous’ without stating the scientific criteria he used for such an assessment. The study is in fact quite misleading, taking women in trouble with the police, and who were in clinics getting treatment and admitted to having been involved in sex work (which few do) and then comparing them with the general population. Apart from problems with misclassification in studies using self reporting, there is a failure to control for all the other factors likely to affect mortality. If they had compared these women to other women of a similar socio-economic group with police records and in treatment, the results of the study would have been very different. These women represent a subgroup of women selling sex on the street, which in itself only represents about 10-20% of all women selling sex. To conclude that this data is typical of sex work in general is a very serious error.

Interestingly it never seems to occur to Kristof that selling sex on the street is dangerous, not because selling sex is in itself dangerous - it is not, but because of the criminal law (that he champions) and social stigma which we impose on these women. One wonders just how many countries Kristof did look at - did he look at Finland or New Zealand, and why did he assume that the approach of Amsterdam’s mayor is some sort of proof that a more liberal approach is a failure. What exactly does he know about Bulgaria other than its plan to liberalise the laws came under attack from some US radicals?

Kristof seems a fan of Sweden, a country radically different socially and legally from the US. In fact there is no evidence whatsoever that Sweden’s approach achieved any benefit, including a recently released report from the National Board of Health of Welfare (2). No country has succeeded in changing the extent of prostitution through legislation, indeed it is difficult to see how they could, but many have succeeded in creating a good deal of harm.

Kristof’s intemperate vocabulary - “rape a 13 year old” “pubescent flesh” does not suggest he is interested in an objective analysis of evidence, as opposed to pursuing moral ideology. Calmer minds might realise that such things as human rights and public health deserve equal consideration rather than waging war on something one decides one does not like.

Michael Goodyear, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada B3H 2Y9

References
1. Weitzer R. Flawed theory and method in studies of prostitution. Violence against Women 2005 11(7) 934-949
2. Kännedom om Prostitution. Socialstyrelsen Artikelnr 2007-131-48. Stockholm

Sex In The Public Square - Nicholas Kristof - Comments

Evidence based policy