A mixed-methods study of mental health and trauma among women in the sex work industry in Spain

Background The sexual commerce industry significantly impacts the psychological health of prostituted women. This study examines mental health damages and complex trauma in 12 women exposed to this commerce. The goal of this work was to evaluate the mental health damage and trauma-related symptoms of these women at the beginning of an intervention. Methods A mixed methodology was used. Quantitatively, four measures were administered to assess subjective distress, the depression-anxiety-stress triad, post-traumatic stress disorder, and cumulative trauma in everyday life. For qualitative analysis, McAdams's Life Story interview was employed to triangulate data and determine the presence of complex trauma. The data was collected during the years 2023–2024. Results The study showed that all of these women exhibited baseline subjective distress and scored within the clinical range for anxiety and stress, while almost all of them showed clinical symptoms of depression, and 8 displayed symptoms related to post-traumatic stress disorder. Complex trauma was present in women exposed to traumatic situations within the sexual commerce industry and who had a history of traumatic interpersonal violence throughout their lives. Conclusions Engaging in prostitution exposes women to traumatic situations that are linked to mental health difficulties. Furthermore, those who have suffered sexual abuse during childhood and adolescence exhibit greater clinical symptoms in response to subsequent trauma.