Dr. Drew Pinsky, a medical doctor who hosts several television and radio programs, claims quite frequently that most people who engage in sex-related industries, such as prostitution or pornography, have experienced sexual abuse as a child.

Is there any evidence to support this claim?

  • Maybe you want to reword the title to "significant proportion" instead of "significant number"? Read Rachel Lloyd's Girls like Us if you want a number of sex abuse and sex trade stories. Or, are you asking about (in a relative sense) self-employed sex workers? Commented Feb 9, 2012 at 19:03
  • @Michael: IMHO "a significant number" isn't really a meaningful metric, and the claim Dr. Drew makes is "most". I edited the title to more accurately portray the claim he makes. I'd imagine it's nigh impossible to prove causality with what little data we have.
    – Patches
    Commented Mar 18, 2012 at 6:54
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    My employer did a study on the sex industry and human trafficking (a study on both things, not a statement that the two are the same). The conclusions of those who worked on it was that, at the very least, hard data on the number of sex workers who are "victims" versus those who are "entrepreneurs" or what have you simply doesn't exist. All claimed numbers they could find demonstrated obvious conflicts of interest and fell into a strongly bimodal distribution: either authors were attacking the sex industry, and so everyone was a victim, or defending it, and almost no one was. Food for thought.
    – KRyan
    Commented Jan 2, 2015 at 16:50
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    @KRyan the same thing happens with research on "literacy". If someone wants more school funding, they will find a way to claim that 90% of the population are "illiterate" using whatever contrived or super-specific definition suits them (e.g must have read entire works of Shakespeare, must have university degree, must not ever misspell words, etc.). Commented Jun 4, 2019 at 20:01
  • Depending on one's definition of "victim of sexual abuse", the vast majority of the general population can qualify. Commented Jan 6, 2020 at 22:07

3 Answers 3


There are significant numbers of studies that back up this claim, and associate childhood sexual abuse with sex work (meaning prostitution).

Specifically studies show that the rate of childhood sexual abuse among prostitutes is > 50%.

For example

  1. Associations between childhood maltreatment and sex work in a cohort of drug-using youth (Social Science & Medicine Volume 65, Issue 6, September 2007, Pages 1214-1221) investigates links in a community of drug users and finds:

Univariate and logistic regression analyses demonstrated that not only was sexual abuse independently associated with sex work, but emotional abuse was as well.


Research has shown that childhood sexual and/or physical abuse significantly predicts engagement in sex work among selected populations, including: adult females.

  1. Juvenile Prostitution and Child Sexual Abuse: A Controlled Study Chris Bagley,Loretta Young of Calgary Alberta Children's Hospital Published on the web 23 April 2009. which finds

The present study indicates 73% of prostitutes were sexually abused in childhood, compared to 29% of a control group obtained in a random population survey.

  1. Prostitution in Vancouver: Violence and the Colonization of First Nations Women Volume: 42 issue: 2, page(s): 242-271 Issue published: June 1, 2005 Melissa Farley, Jacqueline Lynne, Ann J. Cotton of McGill University

We interviewed 100 women prostituting in Vancouver, Canada. [...] Eighty-two percent reported a history of childhood sexual abuse, by an average of four perpetrators.

  1. Simons RL, Whitbeck LS. Sexual abuse as a precursor to prostitution and victimization among adolescent and adult homeless women. Journal of Family Issues. 1991;12(3):361–379.

Previous research indicates that women who were sexually abused as children are more likely to become involved in prostitution and to experience criminal victimization. A sample of 40 adolescent runaways and a sample of 95 homeless women were studied to test direct and indirect models of the impact of early sexual abuse on prostitution and victimization. The results suggest that early sexual abuse increases the probability of involvement in prostitution irrespective of any influence exerted through factors such as running away from home, substance abuse, and other deviant activities.

This answer doesn't address the wider sex industry.

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    Do these studies establish a lower rate of childhood sexual abuse among people who are not prostitutes?
    – phoog
    Commented Jun 2, 2019 at 20:27
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    @phoog "73% compared with 29% of a control group". Commented Jun 2, 2019 at 20:29
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    Do these studies control for sexual abuse by pimps? From what I have read pimps often use the "loverboy" approach: seducing a teenage girl who is often underage (e.g. exploitnomore.org/blog/…, although that is from a campaign website). This is child sexual abuse by definition, but it is a very specific kind of abuse. Would the effect remain if you subtracted out this factor? Commented Jun 3, 2019 at 7:58
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    You can read the studies. But since the question is about childhood sexual abuse, your point would apply only to underage sex workers. Commented Jun 3, 2019 at 13:30
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    The comment about the "loverboy" approach would not apply only to underage sex workers. It would also apply to those who started sex work while underage (but are now older) and to those who were "groomed" while underage with the intent of bringing them into sex work at a later time. Commented Jun 3, 2019 at 14:13

A new study that I just found says that there apparently is no difference between pornography stars and the general population (i.e. the "damaged goods" hypothesis). From the abstract:

The damaged goods hypothesis posits that female performers in the adult entertainment industry have higher rates of childhood sexual abuse (CSA), psychological problems, and drug use compared to the typical woman. The present study compared the self-reports of 177 porn actresses to a sample of women matched on age, ethnicity, and marital status. Comparisons were conducted on sexual behaviors and attitudes, self-esteem, quality of life, and drug use. Porn actresses were more likely to identify as bisexual, first had sex at an earlier age, had more sexual partners, were more concerned about contracting a sexually transmitted disease (STD), and enjoyed sex more than the matched sample, although there were no differences in incidence of CSA. In terms of psychological characteristics, porn actresses had higher levels of self-esteem, positive feelings, social support, sexual satisfaction, and spirituality compared to the matched group. Last, female performers were more likely to have ever used 10 different types of drugs compared to the comparison group. A discriminant function analysis was able to correctly classify 83% of the participants concerning whether they were a porn actress or member of the matched sample. These findings did not provide support for the damaged goods hypothesis.

An article on Slate discusses this a little more, and notes:

Stern’s routine line of questioning has fueled the perception that all porn performers are victims of child sexual abuse, and that their career choices are the result of this unresolved past trauma.

So this is more a case of confirmation bias and (as the Slate article states) some of the actresses lying.

Of course, this is a limited study in pornography (and I think even just the US industry). This does not cover prostitution and other sex industry workers.

This was too long for a comment, but I wanted to add this into the discussion.

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    @DJClayworth Porn actresses have sex with other people for money. The fact that they do it in front of a camera with other performers rather than with paying clients does not change this fact. Therefore the study is about sex workers. Commented Jun 3, 2019 at 7:51
  • @DJClayworth - The first quote from the abstract begins "The damaged goods hypothesis posits that female performers in the adult entertainment industry have higher rates of childhood sexual abuse (CSA),", then later states (comparing porn actresses to the general population), "there were no differences in incidence of CSA". Childhood sexual abuse is specifically listed as a characteristic which was examined and in which no difference was found. That certainly looks like talking about CSA to me. Commented Jun 3, 2019 at 14:09
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    Since there seems to be a huge difference in the results of this study of pornography actresses and the other studies on prostitutes, it's possible the results for the two actually are very different, and we can't lump them together. Commented Jun 10, 2019 at 13:13
  • @DJClayworth There is overlap, but yes, neither subset can on its own describe the entire industry. Take one woman I know, who was sexually abused as a child by her father, then sold as a sex slave to a brothel by her mother, where she was rented out for the purpose of making extreme porn movies it was impossible to find volunteers for. She was later freed when a customer fell in love with her, bought her contract, and got her out of the country she was being held in.Of course the mechanics of the industry are likely different in different countries depending on culture and legal system.
    – jwenting
    Commented Jan 6, 2020 at 5:59

I was able to find a reference for you:

Studies have indicated that childhood abuse characteristics are associated with different sexual behavior outcomes for men and women. For example, Senn et al. (2007) found that for men, sexual abuse with force and penetration was associated with greater frequency of sex trading than it was for those who reported abuse without force and penetration. The term sex trading has been defined as participating in sex in return for food, money, sex, or shelter (Newman, Rhodes, & Weiss, 2004). Senn et al. (2006) found that women were more likely than men were to report exchanging sex for money or drugs and a childhood sexual experience that involved force.

The periodical quoted is: The Developmental Impact of Child Abuse on Adulthood: Implications for Counselors (paywalled).

And the article used by its reference (Senn et al., 2007) can be found on NCBI.

Senn, T. E., Carey, M. P., Vanable, P. A., Coury-Doniger, P., & Urban, M. (2007). Characteristics of sexual abuse in childhood and adolescence influence sexual risk behavior in adulthood. Archives of Sexual Behavior, 36, 637-645.

Note that this links sex trade workers with sexual abuse victims. It does not suggest, as Dr. Pinsky stated, that most people in sex-related industries experienced abuse.

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    Technically it doesn't link sex workers with sexual abuse, it does the opposite. That is duck is a bird, but not all birds are ducks. That's where you're going with that, I just want to make sure it's clear :) Commented Mar 22, 2011 at 20:39
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    @Russell: It is not even that; it is only a correlation, not an implication. That is, there is a correlation between being a bird and quacking, but that is not to say that one caused the other; perhaps there is an underlying cause. Perhaps children of poverty-stricken families are more likely to experience sexual abuse, and perhaps poor people are more likely to trade sex for money. In that case, it's possible the prostitution is unrelated to the sexual abuse; they are both results of an underlying cause. Commented Mar 22, 2011 at 22:28
  • @blue - Good point. Commented Mar 22, 2011 at 22:29
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    Seriously? "The term sex trading has been defined as participating in sex in return for ... sex". Doesn't that, by definition, make all forms of sex, "sex trading".
    – Kibbee
    Commented Nov 29, 2012 at 16:03
  • @BlueRaja-DannyPflughoeft The question is asking only about numbers. Commented Jun 2, 2019 at 18:17

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