The Effect of Decriminalizing Prostitution on Public Health and Safety

In the United States, prostitution has long been declared illegal for moral, safety, and public health concerns. Recently, states like New Hampshire and California are challenging these laws, opening the topic for public debate. The effects of legalizing prostitution are still largely unknown because they have primarily been studied in controlled settings. Observing the effects of legalized prostitution on a society can provide evidence to either legitimize or delegitimize public concerns of health and safety. However, for empirical effects to be observed, legislators need to first relax laws banning prostitution, which is politically infeasible as long as prostitution continues to be taboo.

Recently, researchers Scott Cunningham of Baylor University and Manisha Shah of the University of California, Los Angeles, estimated the real impact of decriminalizing prostitution by studying six years of legal indoor prostitution in Rhode Island, including data from massage parlors, escort agencies, and the online market. Examining local crime reports, health records from the CDC, and marketing for sex work from 2003 to 2009, they found that while the size of the indoor sex market in Rhode Island increased, reported rape offenses and female gonorrhea incidence declined.

This decriminalization of indoor prostitution in Rhode Island occurred more or less by accident. In 1980, in an effort to reduce the prevalence of street prostitution, Rhode Island legislators altered a phrase in a law that described prostitution sex acts, explicitly forbidding street prostitution but inadvertently deleting the phrasing that described indoor sex work. This loophole was exploited and made public in 2003 when a district court judge dismissed prostitution charges against a group of massage parlor employees because their actions did not fall within the existing definition of prostitution. Indoor prostitution was recriminalized in 2009, providing a natural experiment of the health impact of legal prostitution.

The authors chose to evaluate gonorrhea incidence as a measure of public health impact due to its strong association with heterosexual contact and prostitution. Previous studies have argued both that decriminalization could increase the incidence rate of gonorrhea by expanding potential exposure to high risk sex workers, but it could also decrease the incidence rate by encouraging new, lower risk sex workers into the market, diluting the potential for infection. Findings revealed that decriminalization led to a 40 percent decrease in female gonorrhea incidence and a 30 percent decrease in reported rape offenses.

Several factors were associated with the decrease in gonorrhea rates, which fell at a greater rate in Rhode Island than the rest of the United States over the same period. First, the authors found that Asian sex workers entered the Rhode Island indoor prostitution market at a greater rate than workers from other races. Asians have the lowest rates of gonorrhea incidence, so the overall risk for gonorrhea in Rhode Island’s sex market decreased. Second, legalizing prostitution empowers sex workers to seek support of law enforcement, allowing them to engage in less risky behaviors such as sex without condoms.

From 1999 to 2003, the rate of reported rape offenses in Rhode Island was about the same as it was in the rest of the country. However, during the period when indoor prostitution was legal, the rate of reported rape offenses fell below both historical rates in Rhode Island and the average rates in the U.S. The authors found no evidence of changes in police employment, data collected, or data definitions during this time period that would impact these findings. Therefore, they attribute this reduction in sexual violence to improvement in the bargaining power of sex workers to report incidences of rape against them and demand safer work environments since they are no longer at risk for legal ramifications.

The impact of decriminalizing prostitution continues to be a difficult subject to study. State governments rarely lift regulations on prostitution. As a result, it is difficult to envision the unintended consequences that could result from a long-term shift in legislation. For example, existing economic theories argue that legalized prostitution could increase human trafficking. Nevertheless, the natural experiment from Rhode Island provides a snapshot of information and reveals that legalization can help improve the health and safety of sex workers and have positive effects on public health.

Article source: Cunningham, Scott, and Manisha Shah. “Decriminalizing Indoor Prostitution: Implications for Sexual Violence and Public Health.” The Review of Economic Studies (2017): 1-33.

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