Paying for Sex: A Way of Coping with Shame at Having a Sexual Problem after Cancer

At least 4 of the over 50 men we interviewed before creating our first version of our self-help program, Sexual Health and Fatherhood after Cancer, told us that they went to sex workers instead of approaching their wives to have sex after cancer caused erection problems. They actually felt ashamed to be unable to get firm erections. Another factor was their perception that their wives had very narrow ideas of what would be “normal” sexual play. They did not believe that a wife would have the patience to use hand caressing or oral sex to bring a man to orgasm if he did not have a firm erection, yet they longed for some kind of sexual contact. These stories saddened me. I hate to sound preachy, but as a woman, I know that very few sex workers enjoy their jobs.

In fact, the happy hooker is a myth. Prostitutes in the United States have miserable mental health and do not enjoy their sexual encounters. In the United States alone, 100,000 to 300,000 children under age 18 have been trafficked for sex. Most women working as prostitutes in our country were sexually abused in childhood and were introduced to “the trade” between the ages of 12 and 14. Many were deliberately given drugs so that their pimps could use addiction to control them. Prostitution is by far the most risky American job. The rate of murder in the workplace is 51 times higher than the next most dangerous profession–working in a liquor store. The average prostitute only lasts about 5 years in the sex trade. Their average age at death is 34.

It may be hard to enjoy buying sex if you have a lot of empathy for the woman involved. In a survey of English men who paid for sex, the majority knew that some of the women were forced into sex by pimps and that the women did not enjoy the sex. However, many felt these women deserved to be used, since they were sluts who were “asking for it.” About a third of the men believed that women were chronic liars who hated men and wanted to take advantage of them. Many also believed that prostitution was needed to keep men from raping “good” women out of sexual frustration.

One of the best arguments for giving accurate sex education to children and teens is so that they can develop good relationships, with open communication between partners and responsible use of contraception to prevent unintended pregnancy or sexually-transmitted infections. I believe that regarding sex as “dirty” fosters ignorance and interferes with the kind of intimacy that can help relationships weather life’s toughest times–including coping with a life-threatening illness like cancer.

Leslie R. Schover, PhD

This educational material is intended for informational purposes only and is not intended to replace, or substitute for, professional advice, counseling, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a condition. Never disregard professional advice or delay in seeking treatment because of something you have read in this educational material.

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