Rebecca Mott entered the sex trade when she was 14. There was a club in her town which welcomed in girls under the age of 16 at the end of the night. She went with a friend, thinking it was strange but glamorous that they were given cocktails. Later that evening, she was taken to a flat and raped by a gang of men.
This, she says, seemed like a "test" to see if she would make it in the trade. She ended up staying in the industry until she was in her late 20s.
“I had quite a lot of health problems,” Rebecca, who is now 55, says. “I had different sorts of injuries because I was working with men who were quite sadistic, so I had internal injuries as well as bruises and cuts. The way I dealt with it was to ignore it.”
Understandably, Rebecca’s experience had a significant impact on her mental health.
“I have bad trauma,” she says. “It has a massive effect on your mental health because you are being treated as if you’re not human, so it’s hard to hold on to your health. Things other people think are terrible happen to women in the industry over and over again.”
Despite being injured several times, Rebecca rarely sought medical help. She ended up in hospital once, after sustaining a terrible injury after anal sex.
“This guy hurt me really badly, he made me bleed so much that I was fainting,” she says. “I ignore things, so when it was over I would do something else – like go for a walk.
“I always thought pain was my own fault, so I never did anything about it,” she says. “I just walked straight to a party on the other side of town. And then when I sat in a chair, I fainted and everyone panicked. They took me to hospital.”
It was a busy Saturday night and the doctor who saw Rebecca was kind but rushed off his feet. “I got this nurse who was horrible. The first thing she did was look at me and judge me before I had even opened my mouth,” Rebecca says.
“She said at the top of her voice that she thought I was a prostitute and she thought people like us were wasting NHS time and money. It made me so humiliated and angry that I just got a taxi out of the hospital. I ended up in bed at home for three days. It was horrific.
“To know you were made subhuman is something no human can cope with really,” she adds.
Although Rebecca can recall the general trauma she experienced, she finds it difficult to recall everything.
“I had bad fragmented memory. I remember it was bad, but I can’t remember every detail,” she says.
A traumatic event has a powerful effect on the memory, and there are a number of reasons why people may not remember the details of their experience. When caught up in a traumatic incident, the brain strips down to its fight-or-flight mode, which can interrupt the process of memory-making.
Dissociation is a common defence mechanism that kicks in, which can lead to the individual distancing themselves mentally from the situation and can disrupt perception and memory. Some people even report experiencing the traumatic event from a third-person viewpoint.
“People ask me where it happened and I say, don’t you know all the rooms become the same? I remember it was flats and hotels but that’s it,” Rebecca explains.
Post-traumatic stress disorder has also been an issue. “A lot of women I’ve met experienced PTSD and it’s in the extreme,” Rebecca says. “They have problems with sleep and with trusting people.”
Making new relationships can also be difficult, she explains. “Being alone with men is a real problem – even men that you like.”
At the time, Rebecca buried her feelings to cope. “You tend to freeze up your emotions and you might look like you’re fine, but you’ve learned to hide it.
“You don’t talk about mental health when you’re in the trade,” she says. “When women do talk, they stick to trivia because it’s easier.”
“Our service is non-judgemental. We want to ensure that sex workers and other marginalised groups are provided with the best healthcare possible by reaching out to them,” a spokesperson for the Central and North West London NHS Trust says.
“It is made up of a mixture of health promotion specialists who provide one-to-one advice and information, informal counselling for sex workers, a specialist sexual health walk-in clinic for female sex workers, offering health services and advice – particularly around addressing risky behaviours such as condom use, safer sex, safety at work, drug and alcohol use – and sexual health outreach services, improving knowledge of effective and reliable contraception.”
Yet substantial cuts to these essential services have pushed many to breaking point, or even forced them to close, leaving women at greater risk of violence and ill health.
“They got rid of the Poppy Project which was in London, which was really good,” Rebecca says.
The project was run by the charity Eaves, which supported women leaving prostitution, fleeing trafficking and survivors of domestic violence. After nearly 40 years of service, it closed its doors in 2015, which was a huge setback for women’s services.
And it’s not the only service to have suffered. In 2016, the Guardian reported that funding for Open Doors, a long-established service for women in the sex industry in east London, was to be cut by 43%.
These services provide essential, specialist support and advice for women, which – crucially – is confidential and non-judgemental.
“I think a few women trust public services, but the majority feel everyone is judging them,” Rebecca says. “You’re so embedded in a world where you are told everyone is going to judge you and see you as a nasty person.
“There is a lack of belief they will keep it confidential.”
Rebecca, who is now a women’s rights activist and campaigner who supports other women who have left the industry, exited the sex trade in her late 20s.
She had gone to a sexual health clinic after being assaulted. “They saw me for a lot longer than they should have,” she says. “It was the first time I started talking properly.”
Rebecca now works with organisations such as women’s rights charity Equality Now and campaigns against the exploitation of women in the sex trade. She says women who have left the industry need to be a key part of services for women.
“A lot of women who have exited have a lot of knowledge about trauma and violence and they need to be included,” she says.
“If there is going to be real progress, it should be informed or led by exited women.”
One of the charities Rebecca works with, Equality Now, campaigns to end sex trafficking and the exploitation of women in the sex trade. While it promotes listening to and learning from survivors’ stories in order to change attitudes towards trafficking and develop policies, the organisation also works with groups to support survivors and their needs. Organisations such as Beyond the Streets also support women directly affected.