Selling sex can be a self-injury behaviour among adolescents

Selling sex or putting oneself in other risky sexual situations can be a way for an adolescent to self-injure, comparable to cutting or burning oneself. This is according to a doctoral thesis from Linköping University. 

Prostitution Photo credit josé amorimIt is the first scientific study to confirm the relationship between sex and self-injury.
Specialist physician Cecilia Fredlund has studied the incidence of young people selling sex, and specifically, how they use sex to harm themselves. Her results show that roughly 1.5 per cent of upper secondary students have sold sex, and that their reasons for doing this vary. In her thesis she identifies three groups:

• Those who sell sex for emotional reasons, e.g. they long for intimacy or attention, or suffer from mental ill-health
• Those who need money for drugs or other things
• Those who sell sex for more positive reasons, e.g. that it is seen as fun or exciting

Cecilia FredlundCecilia FredlundIn the first two groups the distribution between boys and girls is even; the third group includes slightly more boys.
“For the healthcare system to prescribe the right treatment, it’s important to understand that young people can sell sex for a range of reasons. If they do it because of mental ill-health, they need treatment such as psychotherapy. If they’re abusing drugs and need quick cash, the abuse must also be addressed. If they’re selling sex because it’s exciting or fun, again, other measures might be required, such as risk prevention or advice on contraceptives”, says Cecilia Fredlund.

The thesis shows that roughly 25 per cent of the adolescents who sold sex did it mainly to harm themselves. Selling sex in order to self-injure is one strategy. Other examples are having sexual contacts that one is not interested in, or exposing oneself to physical violence and pain.
Sex as self-injury is a way to manage difficult emotions and reduce anxiety. The injury leads to a temporary regulation of emotion, which provides relief at the moment.
One conclusion of the thesis is that adolescents who sell sex and use it as self-injury often have more trauma symptoms than their peers. They usually have personal experience of sexual abuse or other difficult events earlier in their lives.

“People who use sex to self-injure seek healthcare for many different problems and there appears to be a huge need for support and treatment. Many people feel their behaviour is shameful, and in healthcare we don’t ask. If we can learn more about the mechanisms that drive behaviour, we can give better and faster help”, says Cecilia Fredlund.

She stresses that awareness of sex as a self-injury behaviour should be spread in the school and legal systems. Schools should discuss it in sexual education, and the legal system needs to know more about the psychological mechanisms behind sexually risky actions, in order to make a correct legal assessment.

The thesis: Adolescents selling sex and sex as self-injury, Cecilia Fredlund, Linköping University Medical Dissertations, No. 1645, ISSN 0345-0082

Cecilia Fredlund is affiliated with the Research Unit for Child and Adolescent Psychiatry (BUP) at the Center for Social and Affective Neuroscience (CSAN), Linköping University.

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