Gender Disparities in Street-Level Prostitution
METHODS: Using a mixed methods approach, we examined administrative data from 616 arrestees of street level prostitution in Baltimore City regarding the self-declared needs of SPD referrals and supplemented these findings with semi-structured qualitative interviews with program participants and professional criminal justice stakeholders.
RESULTS: A binomial logistic regression analysis was conducted to test the hypotheses that whether a defendant was transgender or female predicted the self-report of substance abuse history, mental health history and eligibility for the SPD. Analysis of parameter estimates showed that whether an SPD participant is transgender is predictive of substance abuse and mental health histories. The odds of those participants reporting substance abuse history change by a factor of .14 for being transgender compared to female, holding all other variables constant. This represents an 86% decrease in the odds of participants with a substance abuse history being transgender, (p<.001). The odds of those participants reporting mental health history change by a factor of .50 for those being transgender compared to those being female, holding all other variables constant. This represents a 50% decrease in the odds of those reporting mental health problems for participants who are transgender (p=.03). The odds ratio for differences in eligibility between transgender and female participants was not significant (p=.28). Qualitative analysis of interviews with program participants and professional criminal justice stakeholders helped to explain the quantitative data. Transgender participants and criminal justice professionals reported that they were primarily in need of material assistance related to employment and discrimination, such as legal name changes that would match their gender presentation and help with job placement. Because of this, they often find the screening process, which focuses on substance abuse, to be offensive and embarrassing. These participants also seem to reap fewer benefits from the program, which focuses primarily on drug treatment and mental health services but has fewer job-related resources.
IMPLICATIONS FOR PRACTICE AND POLICY: These results clearly identify differences between transgender and female street level sex workers in the amount of substance abuse and mental health issues facing each group. Since transgender participants' motivation for street level prostitution is more financial than as a result of substance abuse or mental health issues, services for workforce development and policies addressing discrimination of transgendered persons in the workplace need to be explored. Our findings also support the creation of individualized program plans to address the varied strengths and goals of program participants.