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A narrative exploration of the process of transitioning out of street sex work Klubben, Laura M. 2014

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    A NARRATIVE EXPLORATION OF THE PROCESS OF TRANSITIONING OUT OF STREET SEX WORK by Laura M. Klubben B.S. North Dakota State University, 2006 M.A. The University of Missouri-Kansas City, 2009  A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF  THE REQUIREMENTS FOR THE DEGREE OF  DOCTOR OF PHILOSOPHY   in  THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES  (Counselling Psychology)     THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) April 2014 © Laura M. Klubben, 2014    ! ! ! !""!Abstract Women’s experience of entering, involvement in, and exiting street sex work is frequently confounded by issues such as addiction, poverty, abuse, trauma, and disempowerment. Many female street prostitutes report a lack of choice in entering sex work as well as a desire to leave the sex industry. While considerable quantitative research exists on aspects of involvement in the sex industry, there is a dearth of qualitative literature on exiting the street sex industry. Furthermore, few studies take a critical perspective, leaving out a contextual understanding of the process. To support female street sex workers wanting to exit, it is imperative to learn from those who have successfully left the sex industry. Using an indigenous feminist theoretical framework to inform a collaborative narrative research design, this study explored eight women’s stories of the process of exiting the street sex trade in Vancouver’s Downtown Eastside. Results revealed the following seven themes: (a) relapsing and readiness to change, (b) a need for stability and time for reflection, (c) goal setting and perspective, (d) systemic and structural barriers, (e) support and community, (f) mental and emotional health, and (g) finding meaning and purpose. This study provides an in-depth and critical understanding of the exiting process in Vancouver’s Downtown Eastside for female street prostitutes. Potential implications concerning the Downtown Eastside community, counselling psychology training, theory, and research are discussed in attempt to make the transition out of the street sex trade easier for women who desire to do so in the future.    ! ! ! !"""!Preface  This dissertation is original, unpublished, independent work by the author, L. Klubben. The University of British Columbia Behavioural Research Ethics Board (BREB) granted permission (Certificate #H12-00586) for the fieldwork with human subjects described in the following manuscript.   ! ! ! !"#!Table of Contents Abstract ........................................................................................................................................... ii Preface ............................................................................................................................................ iii Table of Contents ........................................................................................................................... iv List of Tables  ................................................................................................................................ ix List of Figures ................................................................................................................................. x Acknowledgements  ....................................................................................................................... xi Dedication ..................................................................................................................................... xii  Embarking On A Research Journey: Letter One—An Opening Letter to the Reader ................. xiii  CHAPTER ONE Introduction: Curiosities and Potential Journeys ............................................................................ 1 Co-Constructing A Research Journey: Letter Two—A Letter to My Personal World ......... 1 Female Street Sex Workers  .................................................................................................. 6 Entry Into and Involvement in Street Sex Work .......................................................... 8 Exiting the Street Sex Industry  ................................................................................. 11 Street Sex Work in Vancouver’s Downtown Eastside (DTES)  ......................................... 13 Rationale and Objective for the Study ................................................................................. 14  CHAPTER TWO Review of the Relevant Literature ................................................................................................ 17 Co-Constructing A Research Journey: Letter Three—A Letter to the Academic World  .. 17 Historical Background of Sexuality and Prostitution Research  ......................................... 20 Historical Background of Sexuality ........................................................................... 20 History of Prostitution Research ................................................................................ 23 Conclusion  ................................................................................................................ 24  Entry Into Prostitution ......................................................................................................... 25  Conclusion  ................................................................................................................ 29  Experience of Being Involved in Prostitution  .................................................................... 29  Violence and Other Risks  ......................................................................................... 30  Psychological and Emotional Aspects of Prostitution ............................................... 31  Relationships  ................................................................................................... 32  Stigma ............................................................................................................... 34  Stress and Trauma  ........................................................................................... 35  Coping  ............................................................................................................. 36  Substance Use and Abuse ................................................................................. 37  Conclusion  ................................................................................................................ 39 ‘Choice’ Involved in Entry into and Continued Involvement in Prostitution  .................... 39 ! Conclusion  ................................................................................................................ 42  Exiting Prostitution .............................................................................................................. 43 Models and Frameworks for Understanding the Process of Exiting Prostitution ...... 43 Psychological and Emotional Aspects of Exiting Prostitution  ................................. 50 Conclusion  ................................................................................................................ 54  Vancouver’s Downtown Eastside (DTES) .......................................................................... 55 ! ! ! !#!Conclusion  ................................................................................................................ 60 Chapter Summary and Conclusion ...................................................................................... 60  CHAPTER THREE Co-Authoring a New Story Together ............................................................................................ 63 Co-Constructing A Research Journey: Letter Four—A Letter to My Co-Authors ............. 63 An Introduction to Indigenous and Feminist Philosophies  ................................................ 66  Feminist Ontology and Epistemology ........................................................................ 67 History of Feminism Ontology and Epistemology ........................................... 68 Description of Feminist Ontology and Epistemology ...................................... 69 Rationale for Feminist Ontology and Epistemology ........................................ 71 ! Situating Myself Within Feminist Ontology and Epistemology ...................... 72 Conclusion ........................................................................................................ 74  Indigenous Ontology and Epistemology .................................................................... 74  History of Indigenous Ontology and Epistemology ......................................... 75  Description of Indigenous Ontology and Epistemology .................................. 75 Rationale for Indigenous Ontology and Epistemology .................................... 76 Situating Myself Within Indigenous Ontology and Epistemology .................. 78 Conclusion ........................................................................................................ 79  Indigenous Feminist Ontology and Epistemology .............................................................. 80  History of Indigenous Feminist Ontology and Epistemology ................................... 81  Description of Indigenous Feminist Ontology ........................................................... 82 Description of Indigenous Feminist Epistemology .................................................... 84 Rationale for Indigenous Feminist Ontology and Epistemology ............................... 85 Situating Myself Within Indigenous Feminist Ontology and Epistemology ............. 86 Conclusion ................................................................................................................. 87  Collaborative Narrative Methodology ................................................................................. 87 History of Collaborative Narrative Method ............................................................... 88 Description of Collaborative Narrative Method... ..................................................... 88 Rationale for Collaborative Narrative Method  ......................................................... 89 Situating Myself Within Collaborative Narrative Method  ....................................... 91 Conclusion  ................................................................................................................ 91 Research Procedures ............................................................................................................ 92 Ethics  ......................................................................................................................... 92 Recruitment ................................................................................................................ 92 Co-Authors: Inclusion and Exclusion Criteria ........................................................... 92 Informed Consent Procedures .................................................................................... 94 Compensation ............................................................................................................. 95 Procedures for Collaborative Narrative Method  ................................................................ 95 Phase 1: Research Interview 1. .................................................................................. 96 Phase 2: Research Interview 2  .................................................................................. 96 ! $%&'(!)*!Transcription Process .................................................................................. 97 Phase 4: Collaborative Narrative Review and Analysis  ........................................... 98 Phase 5: Composing the Narratives  .......................................................................... 99 Phase 6: Cross-Narrative Thematic Analysis  ............................................................ 99 Phase 7: Collaborative Review of the Narratives and  ! ! ! !"#!Member Check of Overall Analysis ......................................................................... 100 Credibility and Trustworthiness ............................................................................... 100 Power and Privilege ........................................................................................ 101 Assumptions and Pre-suppositions ................................................................. 101 Reflexivity ...................................................................................................... 102 Criteria for Evaluating Worth of the Study  ................................................... 103 Data Management Procedures ........................................................................................... 105 Data Representation ........................................................................................................... 105  Chapter Summary and Conclusion .................................................................................... 106  CHAPTER FOUR Results of My Journeys with My Co-Authors ............................................................................ 107  Co-Constructing a Research Journey   Letter Five: A Letter to My Actual Co-Authors ................................................................ 107  The Co-Authors ................................................................................................................. 108  The Narratives ................................................................................................................... 110  Jean’s Story .............................................................................................................. 110  Jean’s Story of Transitioning Into Street Sex Work ....................................... 111  Jean’s Story of Transitioning Out of Street Sex Work ................................... 112  Jean’s Story of Transitioning Into Indoor Sex Work ..................................... 113  Jean’s Story of Transitioning Out of Indoor Sex Work .................................. 113  Jean’s Story of Transitioning Into Sexual Slavery ......................................... 114  Jean’s Story of Transitioning Out of Sexual Slavery ..................................... 115  Jean’s Current Situation and Future Goals ..................................................... 116  Crystal’s Story .......................................................................................................... 117  Crystal’s Story of Transitioning Into Street Sex Work .................................. 117  Crystal’s Story of Transitioning Out of Street Sex Work .............................. 118  Crystal’s Current Situation and Future Goals ................................................. 121  Mary Joe’s Story ...................................................................................................... 122  Mary Joe’s Story of Transitioning Into Street Sex Work ............................... 122  Mary Joe’s Story of Transitioning Out of Street Sex Work ........................... 124  Mary Joe’s Current Situation and Future Goals ............................................. 125  Nita’s Story .............................................................................................................. 127  Nita’s Story of Transitioning Into Street Sex Work (Time 1) ........................ 128  Nita’s Story of Transitioning Out of Street Sex Work (Time 1) .................... 128  Nita’s Story of Transitioning Into Street Sex Work  (Time 2) ....................... 130  Nita’s Story of Transitioning Out of Street Sex Work (Time 2)  ................... 131  Nita’s Current Situation and Future Goals ..................................................... 132  Owl Woman’s Story ................................................................................................. 133  Owl Woman’s Story of Transitioning Into Street Sex Work (Time 1) .......... 133  Owl Woman’s Story of Transitioning Out of Street Sex Work (Time 1) ...... 134  Owl Woman’s Story of Transitioning Into Street Sex Work (Time 2) .......... 135  Owl Woman’s Story of Transitioning Out of Street Sex Work (Time 2) ...... 136  Owl Woman’s Current Situation and Future Goals ........................................ 137  Spirit’s Story ............................................................................................................ 138  Spirit’s Story of Transitioning Into Child Prostitution and Street Sex Work  139 ! ! ! !"##! Spirit’s Story of Transitioning Out of Street Sex Work ................................. 140  Spirit’s Current Situation and Future Goals ................................................... 141  Survivor’s Story ....................................................................................................... 143  Survivor’s Story of Transitioning Into Indoor Sex Work (Time 1) ............... 143  Survivor’s Story of Transitioning Out of Indoor Sex Work (Time 1) ............ 144  Survivor’s Story of Transitioning Into Street Sex Work  ............................... 144  Survivor’s Story of Transitioning Out of Street Sex Work ............................ 144  Survivor’s Story of Transitioning Into Indoor Sex Work (Time 2) ............... 146  Survivor’s Story of Transitioning Out of Indoor Sex Work (Time 2) ............ 147  Survivor’s Current Situation and Future Goals .............................................. 147  M’s Story .................................................................................................................. 148  M’s Story of Transitioning Into Street Sex Work .......................................... 149  M’s Story of Transitioning Out of Street Sex Work ...................................... 151  M’s Current Situation and Future Goals ......................................................... 152  Conclusion of the Narratives .................................................................................... 153  Shared Journeys: Themes of Transitioning Out of the Street Sex Trade  ......................... 153 Theme 1: Relapsing (the ‘Yo-Yoing Effect’) and Readiness to Change in Transitioning Out of Street Sex Work ..................................................................... 155  Relapsing and Yo-Yoing Effect ..................................................................... 156  Individual Readiness for Change .................................................................... 157 Theme 2: The Role of Stability, Security, and Safety in Transitioning Out of  Street Sex Work: Space and Time for Reflection and Decision-Making  ............... 159  Stable, Safe, and Secure Housing ................................................................... 160  Turning Point/Wake Up Call .......................................................................... 160  Knowledge and Questioning .......................................................................... 162  Theme 3: The Role of Goal Setting, Perspective, and Optimism in   Transitioning Out of Street Sex Work  .................................................................... 163  Goal Setting .................................................................................................... 164  Changing Perspective ..................................................................................... 165  Hope/Optimism and Positivity/Humour ......................................................... 166  Theme 4: The Role of Systemic and Structural Barriers in   Transitioning Out of Street Sex Work ..................................................................... 166  Money and Class ............................................................................................ 167  Legal ............................................................................................................... 168  Social Stigma and Judgment  .......................................................................... 169  Theme 5: The Role of Relationships in Transitioning Out of Street Sex Work ...... 169  Support Systems ............................................................................................. 170  Children and Motherhood  .............................................................................. 171  Negotiating the ‘Old Community’ and ‘Lifestyle’ ......................................... 172  Issues of Trust in New Relationships and New Community .......................... 173  Relationship with Self  ................................................................................... 174  Theme 6: The Role of Mental and Emotional Health in   Transitioning Out of Street Sex Work  .................................................................... 175  Substance Use and Addiction ......................................................................... 176  Abuse, Violence, Trauma, and Fear  .............................................................. 177  Mental and Emotional Processing .................................................................. 179 ! ! ! !"###! Theme 7: The Role of Finding Meaning and Purpose in   Transitioning Out of Street Sex Work  .................................................................... 181  Skills, Education, and Employment  .............................................................. 182  Giving Back: Advocacy, Activism, and Educating Others  ........................... 183  Conclusion of the Themes  ....................................................................................... 184 Laura’s Story  .................................................................................................................... 184  Laura’s Story of Transitioning Into the Research Process  ...................................... 185  Laura’s Story of Transitioning Out of the Research Process ................................... 187  Chapter Summary and Conclusion .................................................................................... 191  CHAPTER FIVE Conclusion: Closing Thoughts and Discussion About My Journeys with My Co-Authors ....... 192  Co-Constructing a Research Journey:   Letter Six—A Closing Letter to My Personal World ........................................................ 192  Contributions and Significance Of the Research ............................................................... 193  Implications for Theory ..................................................................................................... 202  Implications for the Community  ...................................................................................... 203  Implications for Counselling Psychology and Training .................................................... 205  Implications for Future Research  ..................................................................................... 207  Strengths and Limitations .................................................................................................. 209  Overall Summary and Conclusion ..................................................................................... 211  Concluding A Research Journey: Letter Seven—A Closing Letter to the Reader ..................... 212  REFERENCES  .......................................................................................................................... 214  APPENDICES Appendix A: Recruitment Poster ................................................................................................ 228 Appendix B: Telephone Screening Form  .................................................................................. 229 Appendix C: Consent Form  ....................................................................................................... 231 Appendix D: Demographics Form .............................................................................................. 234 Appendix E: Low Cost/Free Counselling Referrals  .................................................................. 235     ! ! ! !"+!List of Tables  Table 1: Co-Author Demographics ............................................................................................. 109    ! ! ! !+!List of Figures  Figure 1. Indigenous Feminist Ontology  ..................................................................................... 83  Figure 2. Indigenous Feminist Epistemology ............................................................................... 85    ! ! ! !"+!Acknowledgements   I would first and foremost like to acknowledge and express my enduring gratitude to my eight co-authors. Jean, Crystal, Mary Joe, Nita, Owl Woman, Spirit, Survivor, and M, thank you for sharing with me your stories, your insights, and wisdom on the process of transitioning out of the street sex trade. It has been a true pleasure getting to know and learning from each of you.   I would also like to express my upmost appreciation for my main supervisors, Dr. Marla Buchanan and Dr. Anusha Kassan, for their continued support throughout the research process and their incredible feedback along the way. Thank you for taking my numerous phone calls and responding to my all of my emails along this journey. Thank you also to my supervisory committee members, Dr. Judith Daniluk and Dr. Carl Leggo. The two of you have been fundamental in helping me to see alternative perspectives as well as to open my mind to what research might be more beneficial for the population I am studying. I have so appreciated the encouragement the four of you have provided me when, at times, I thought it was nearly impossible to finish such a project.  Furthermore, I want to thank supportive members in the Downtown Eastside community for providing me with information about what the community needs in terms of research and how this study can be utilized to support the community. You have been pivotal in allowing me to see some of my own blind spots as a researcher coming from a university into the DTES culture and for that I am forever grateful.  Finally, I would like to express a special thanks to all of my supportive family members, friends, and colleagues along the way. Thanks for providing me with the support and encouragement to keep going in times I needed to endure and also to take breaks in times I needed to rejuvenate my body, heart, and mind. Much love to you all.  ~L  ! ! ! !"++! To Jean, Crystal, Mary Joe, Nita, Owl Woman, Spirit, Survivor, and ‘M’   ! ! ! !"+++!Embarking On A Research Journey: Letter One—An Opening Letter to the Reader  To the Reader, I would first like to take a moment to acknowledge that I sit here composing this document as a guest on Coast Salish territory. Being born of European ancestry in a middle-class household in the US, I have experienced many privileges in my life, which I will expand on within this document, so I wanted to begin by first expressing my gratitude for being able to write this piece as a visitor in such a beautiful part of the world. Before introducing the remainder of this document I would like to take a moment to introduce myself and my interest in this topic to you. I’m originally from a small town in North Dakota. I moved to Vancouver to do my PhD in counselling psychology in 2009. Prior to moving here I was living and going to school in Kansas City, MO. It was there that I met my initial inspiration for this project. I had been working on a group project on prostitution when I came across an organization called Veronica’s Voice (VV), which provides services to women in the sex trade to help them exit prostitution. Kristy Childs, a survivor of prostitution, started VV in remembrance of her friend Veronica who was murdered at the age of 21. During my masters, Kristy was kind enough to meet with my team and I and guest lecture in our class. I had spent that summer immersed in the literature on prostitution. I thought I knew SO MUCH, but within minutes of talking with Kristy, I realized that words could only provide a person with the tiniest snapshot of the reality that Kristy told. And I discovered that, oftentimes, the pieces that are written about women like sex trade workers are written by people who swoop in and leave with little consultation on how the women feel about the stories that are being told about them. Since meeting Kristy and completing that project, I feel a passion to continue learning more and contributing to what’s being talked ! ! ! !+"#!about on the subject. However, after this experience and volunteering in Vancouver’s Downtown Eastside, I’ve determined that I want to contribute in way that is as relevant, respectful, and reciprocal to the street prostitution community as I can make it. And thus I believe strongly in collaborative research, which I will expand on more in this document.   People often ask me what makes me passionate about this subject. And I would have to say that initially the readings on the subject were engaging, and while they still are, mostly what keeps me interested is working in Vancouver’s Downtown Eastside (DTES). I spent the first two years of my doctoral degree volunteering at a drop-in centre in the area and getting to know many of the participants (the women’s chosen term for themselves) who utilize the services. I know it is my job to help the participants, but I often found that their insights and sense of community inspired me more than I’d helped them at the end of the day. One woman, for example, told me that she’d recently moved out of stable housing to the streets because her landlord was allowing people with addiction issues to live in the facility (where children were residing) and use substances in the presence of children. She said she confronted the landlord and left after the landlord refused to acknowledge the problem. Afterward she told me that the world’s children are our little angels and that we have to take care of our angels unti l  they’re big enough to take care of themselves. I left that night wondering if I could have sacrificed a bed and four walls for the betterment of others and the values that I claim to have.  Throughout my time working in the DTES, I’ve found myself questioning a lot of my values and assumptions. And at the same time I’ve wondered how I can use the benefits of my education and my dissertation to generate more understandings of these women’s worlds in a way that can hopefully change lives for the better. Thus, I’ve decided to write to you to tell you first about me and then write to others who are involved in this journey. I’ve ! ! ! !+#!decided to do this to hopefully break down the barrier between you and I. In addition, one of my main aims with this piece of work is respect—respect for you, the reader, respect for the women involved in the study, respect for myself, and all of our relationships—our relationships with ourselves, with our backgrounds, with the earth, with our spiritual worlds, our physical worlds, etc. Thus, particularly given the indigenous focus of this study and the importance of relationships and ancestry in indigenous research, I would like to open such a document with an expression of gratitude and respect for one special person who helped shape my way of thinking about and being in the world, my mom, my original teacher. Though I’ve had many instructors, mentors, and important people and relationships in my life all of whom I am incredibly grateful for, my mother has been a guiding force since the moment her body started providing nourishment for my own. I thus, feel one cannot get to know me fully without also getting to know a bit about her.  ~Laura !!"!CHAPTER ONE Introduction: Curiosities and Potential Journeys Co-Constructing A Research Journey: Letter Two—A Letter to My Personal World   Hey Mama, I hope your day’s going well and that you’ve spent the day out in the open air and under that big beautiful sun that you love so much. It’s crazy to think how far away you are with me being in Vancouver and you back home in the rural Midwest. Yet we look upon the same sun each morning.  I love it here, as you know, in Vancouver but can’t help missing you and the rest of the family as I reflect on growing up back home… ~Back home where everyone knows me and the generations who came before. You taught me to respect elders and the ways in which things have been done in the past. ~Back home where you taught me the importance of our culture and how to be in this world. You taught me to work hard and enjoy life to the fullest while being true to who I am and who we are. ~Back home in the open spaces where as kids we ran free spending our days gardening, filling our pockets with dandelion seeds, or watching spiders spin their webs. You taught us how to appreciate nature and bask in all that she provides.  It’s a much different place from where I am now in many ways, and yet I’m so grateful for the numerous opportunities to continue to grow and learn in this new, beautiful place. As you know, my life over the past few years has been focused on my learning through my studies and my research in prostitution as well as my experiences working in the DTES. Throughout this process of researching and being in graduate school, I’ve become quite aware of what some call academia’s “Ivory Tower,” or the disconnect academia can have !#!from the everyday experience. I’ve even noticed that aspect in myself as I get absorbed in my readings and sometimes forget about the people behind the stories. It’s been a bit of internal battle for me because sometimes it feels as though I exist in two different worlds both of which I enjoy and value. As you taught me, interacting with people provides a richness of understanding unattainable through reading about them. Through my volunteering in the DTES, I’ve had the pleasure of getting to know some of the women currently in the trade. I’ve read so much about the sex trade but I have to say, and not surprisingly so, most of my learning and passion to do this work has come from these experiences. Hearing their stories often filled with a resilience and strength that shakes me to the core has been a constant inspiration for my desire to learn more about this experience and to understand how to make some of their experiences easier.  Thus, as I write this I want to give back to those women who have shared their stories as well as to those, like you Ma, who have given so much to making me the person I am today, and also to the academic world, which has provided me with the space to learn and grow in a way that wouldn’t have been possible otherwise. That being said, I know, Mom that you’re proud of what I’ve done and who I’ve become but I also know you and many others get tired of some of the academic jargon I sometimes use. You find it irrelevant to the way in which many actually live their lives. Many call this lingo a foreign language and a friend of mine actually termed it academise. (I thought you’d find that funny.) Thus, I thought rather than writing this document fully in academise, I’d open each chapter with a more personally written letter. I’m hoping that in doing so I can communicate with those who aren’t fluent in academise. To begin, I’d first like to tell you what I’ve learned from my readings or, rather, what I haven’t learned—that is the introduction to the problems that I see with what we currently know (or the gaps in the research) and where I’m hoping to contribute.  !$!First of all, Mom, you wouldn’t believe the number of young women and girls who enter into prostitution everyday. There are many people who live this life and yet the majority of people who aren’t in the industry don’t have any knowledge of it. Yet, there are so many people in academia writing about this experience—the experience of entering and working in the industry. One problem is that this information hardly ever gets to people outside of academia and it rarely gets back to the women in the sex trade. Another problem is, often, these papers are often written with little feedback from or collaboration with the women themselves. And thus, I would like to do what’s called a ‘collaborative study,’ incorporating the women’s voices in how the study is conducted and how their stories are interpreted and heard. Finally, it seems that there are so many people who didn’t fully choose this life and want to leave but find the process of exiting the sex trade considerably difficult. But, Mom, very few people are writing about this process of exiting the sex industry and those who do are leaving out important factors like racial prejudice and poverty. Maybe that’s where I feel I can add something important to the literature on this topic. I think it would be valuable to learn more about how women who have left the sex industry did this given all of the challenges they face and what kinds of things helped or blocked them from getting out.  As you know, in addition to my research in prostitution, I’m training to be a psychologist. As part of my education, I’ve read a lot about how to work in therapy with different groups of people but again, Mom, few people in my field are talking about how to help women in the sex trade in a mental health type of setting. Thus, if someone came into my office and told me, “I am a prostitute and want to get out of the sex industry,” how am I supposed to know what might help them? How am I supposed to know what barriers they might face in this process of getting out of the sex trade? How would I know what I could do to potentially help them remove some of those obstacles? That’s why I feel it’s so important !%!to learn more about this process from a counseling psychology lens – one that focuses on people’s strengths and abilities to deal with difficult life challenges. The sex industry is not only large but it is also quite diverse and includes women and men who exchange sex for money or goods in a variety of settings like brothels, massage parlors, peep shows, strip clubs, out of their homes, and on the streets. Street sex workers work in what academics call ‘outdoor’ prostitution, meeting clients on the street and in cars, for example. They make up a small percentage of the sex trade. But, conducting most of their ‘work’ outdoors, they are highly exposed to hazardous situations and are often considered the most disadvantaged and at-risk of violences and other harmful circumstances. Indoor prostitution is made up of women working in brothels, massage parlors, and out of their homes, for example. While indoor sex work also has its risks, women working indoors often have more safety precautions in place like emergency buzzers, security personnel, and STD checks. In terms of exiting, the additional risks involved in street sex work (e.g., homelessness, poverty, and addiction) make the process of exiting the sex industry more challenging so these women who want to exit may need more support to get out. Also, as you and I have discussed, while there are certainly male prostitutes, women make up the majority of sex workers and most of their clients are men. Female sex workers also tend to stay in the sex industry longer and experience more risks than male sex workers. As we’ve chatted about and many researchers have found, this gender difference in prostitution is quite symbolic of the larger social picture in terms of women continuing to be objectified by men and this objectification being almost acceptable by society. Given this gender difference (e.g., more female sex workers) and the larger societal piece involved in the process of entering and exiting the sex industry, I would like to focus my research on !&!female prostitutes. In the language of academise, I am meant to pose a question to answer as part of this manuscript. Given all of the above, Ma, I think I’d like to ask: What do women’s stories or narratives reveal  about the process of exit ing the street sex trade? I’m hoping that by seeking answers to this question, we can better understand the exiting process—the how’s and the whys—the resources these women need and the barriers they face, so that hopefully we can remove some of the barriers, increase their resources, and make it easier for sex trade workers to get out of the industry should they choose to do so. As I begin this next piece, Ma, I must tell you that I will be throwing a lot of names and numbers your way. I hope you or other readers don’t feel like I’m trying to define every woman in the trade nor what every woman’s experience is. I’m simply describing what past researchers have discussed. I hope I can do this in a way that is congruent with who I am and how you taught me to be, as well as respectful and in line with the women’s needs. So with that let me close this letter and tell you what I have and haven’t learned from my readings. Enjoy that sunshine, Mama. Know that each time I look upon it and feel its rays, I feel your love. I am and forever will be grateful for the lessons you’ve taught me, the gifts you’ve bestowed upon me, and the love you’ve felt for me. Love you, ~Laura  Throughout this introductory section, I will highlight the research problem through discussing the challenges and issues faced by sex workers as well as the gaps in the prostitution literature. I will begin by briefly illustrating a picture of the diversity that exists in the sex trade. Following this, I will introduce the literature on prostitution, which I will expand upon in !'!Chapter Two, including a discussion on entry into the sex trade, involvement in prostitution, as well as exiting sex work. I will then narrow in on my rationale for the location and work setting for which this study took place. Finally, I will summarize my research objective as well as provide a rationale for this study.  Author’s Note: I first need to clarify some terminology as I have been using the terms ‘sex work’/‘sex worker’ and ‘prostitute’/‘prostitution’ fairly interchangeably. I do this because neither the women that I have talked to in the sex trade nor the academics who write about those who work in prostitution agree on the term. There are some (e.g., Farley, Lynne, & Cotton, 2005) who argue that those who enter the sex industry do not do so by choice and are being exploited and thus, they believe the term ‘prostitute’ or ‘victim’ and/or ‘survivor’ of prostitution is more appropriate than sex worker. Others (e.g., Weitzer, 2005) argue that sex work is a job like any other and thus, the term sex worker should be used. As Tomura (2009) states, “the word prostitute already evokes negative stereotypes, calling an individual a “prostitute” can be offensive at times, even if the person’s profession matches the legal definition of prostitution” (p. 5). My perspective on this issue of language is to defer to the women living this lifestyle, and, in my experience working in the DTES and conducting this study, women use both the term sex worker as well as prostitute depending upon their circumstances. Therefore, to reduce further stigma and to facilitate feelings of control and choice, I will continue to use these terms interchangeably and allow the women’s own language and choices around terminology to come through in their narratives.  Female Street Sex Workers Unlike some groups of people, it is challenging to research the world of sex work due to the illegality of prostitution in most countries as well as the mobility of sex trade workers (i.e., !(!transitioning in and out of prostitution as well as working in various settings and locations). Thus, many (e.g., Farley et al., 2005; McKeganey & Barnard, 1996) say that no study can claim a random or representative sample of prostitutes because we do not know the entirety of the population of sex workers. I thus, must give forewarning that when providing statistics and/or themes both in the literature review and my own findings they should not be interpreted as generalizable or transferable to all geographical locations or sex work settings. For example, cultural as well as socio-political differences that exist across the globe impact the lifestyles of sex workers (see Farley, Baral, Kiremire, & Sezgin, 1998). In some countries, such as Sudan, Pakistan, and Iran, for instance, prostitution is not only a crime but is punishable by death (Akhavan, Caparula, DeFrancesco, Goodman, Hendricks, Hirn, Inda, Sun, & Young, 2008).!Women in these countries rarely leave the brothels they work in because they are afraid of being arrested. Some are confined to one room their entire lives because they are expected to work whenever clients arrive. Typically, these women do not have the opportunity to learn about pregnancy prevention, so they often have many children. Many daughters of these women will most likely take over their mothers’ careers around the age of fifteen (Brown, 2005).   Prostitution and various aspects of prostitution including entry, the lifestyle, and exiting also differ drastically by type of ‘work’ setting (see Williamson & Baker, 2009). For instance, those entering the indoor industry tend to be higher in socioeconomic status and often enter prostitution for different reasons (e.g., job flexibility, higher income) than those in the outdoor industry who have lower SES and tend to enter the sex trade as a last resort option (see Rosen & Venkatesh, 2008). In addition, as an example of the diversity that exists even in street work, in a quantitative study, comparing pimp versus non-pimp-controlled sex workers (using percentages only) who were incarcerated in a northeastern city in the US, Norton-Hawk (2004) found that of !)!the 50 women she surveyed, 40% had been pimp-controlled. When comparing the differences between groups, she found that compared to women who did not have pimps, women who were pimp-controlled were more likely to be non-white, to be runaways (having run away by age 12), to never have held legal employment, to not have a high school diploma, to be single, to experience sexual activity at a younger age, to have been victims of physical, sexual, and/or verbal abuse, and to come from family backgrounds with drug and alcohol addiction. Therefore, is it is important to keep in mind that female sex workers’ experiences can be quite different depending upon work setting as well as geographical location.  Entry into and involvement in street sex work. While it is difficult to provide blanket statistics on prostitution for the reasons discussed above, researchers report that some women enter prostitution in their early teens with involvement lasting anywhere from a single ‘trick’ to the rest of their lives (Coy, 2009; Dalla, Xia, & Kennedy, 2003). Researchers have found that many factors influence women’s entry into prostitution. For example, 50 to 60% (Bagley & Young, 1987; Farley et al., 1998; Kramer & Berg, 2003) and up to as high as 80% (Dalla et al., 2003; Farley et al., 2005) of women in the street sex trade are estimated to have histories of childhood physical, emotional, and sexual abuse. In addition, many women in the street sex trade state that they ran away or left home at an early age (e.g., 10 to 13) to get away from the abuse and neglect (Bagley & Young, 1987; Dalla, 2000; McClanahan, McClelland, Abram, & Teplin, 1999; Nadon, Koverola, & Schuldermann, 1998; Schissel & Fedec, 1999) as well as the frequently, coinciding parental substance issues (Bagley & Young, 1987). Running away from home at an early age (often to the streets or friends’ couches) can make these young girls vulnerable to poverty, homelessness, drug abuse, and sex work (see Abel & Fitzgerald, 2008). In fact, the majority of women involved in street-level sex work experience unstable housing and !*!often homelessness, which can be concurrent with entry into the sex trade as well as a result of their work in prostitution (Dalla, 2000; Farley et al., 2005; Kuyper, Palepu, Kerr, Li, Miller, Spittal, Hogg, Montaner, & Wood, 2005). In addition to the common childhood victimization that exists amongst street sex workers, many women continue to experience physical violence and psychological abuses upon entry into the sex industry (Comack & Seshia, 2010; Dalla et al., 2003; Farley et al., 2005; Lewis, Maticka-Tyndale, Shaver, & Schramm, 2005; Nixon, Tutty, Downe, Gorkoff, & Ursel, 2002; Raphael & Shapiro, 2004; Romero-Daza, Weeks, & Singer, 2003; Sanders, 2001) with 75% to 90% of women reporting having been victims of physical and sexual violence by customers and/or partners/pimps while they were involved in street prostitution. To elaborate on that, Farley et al. (1998) did a comparison of violence across different sex trade contexts (i.e., geographic location and work setting) in five countries and found that street prostitutes experience more physical violence than those involved in indoor prostitution. However, when comparing street to brothel workers, they found that both groups were equally as likely to experience PTSD, which the authors suggest could indicate that psychological trauma may well be intrinsic to prostitution. Thus, exiting the sex industry may be further complicated as it is often entangled with issues of physical violence and psychological trauma. This relationship between psychological trauma and involvement in the sex trade suggests a need for a better understanding of the mental health aspects of exiting the trade. Drug use is also prevalent particularly in street-level prostitution (Coy, 2009; Cusick & Hickman, 2005; Kuyper et al., 2005; Murphy, 2010; Romero-Daza et al., 2003) although it is often difficult to ascertain whether this is a precipitating factor or a consequence of sex work (see Kuyper et al., 2005). As Jessica, a 17-year-old woman in Coy (2009)’s study stated: “I do this !"+!work to earn the money to buy gear and I take the gear to block out the work I’m doing” (p. 69-70). Drug use often is initially used to decrease the woman’s feelings of powerlessness and control but as dependence on a drug grows, the sex trade worker’s feelings of powerlessness and lack of control begin to increase (Coy, 2009). It is not uncommon for women leaving the sex industry to be dealing with an addiction or be in the process of addiction treatment. Thus, the process of exiting the trade is frequently complicated by the woman’s ability to access addiction treatment services and remain clean and sober. Unfortunately, as Kuyper et al. (2005) found many women in Vancouver’s DTES reported seeking addiction treatment services but had been unable to access these necessary services. Addiction, and the access to treatment, may well be important factors in women’s transitions out of the street sex trade – factors that may need to be addressed in supporting street sex workers who want to exit the sex industry. Furthermore, women working in street sex work in Canada (the location for this study) are engaging in illegal activity when they are soliciting customers, which often results in criminal records that make it difficult to access legal and financially secure employment (see Rickard, 2001). Therefore, when exiting, these women are likely to experience challenges in securing safe and affordable housing and employment. A better understanding of these pragmatic realities and very real physical barriers is needed if we are to assist women in making the transition out of street prostitution.  Due to the considerable amount of risk involved in street prostitution discussed above, including physical violence (see Farley et al., 2005), substance abuse (see Kuyper et al., 2005), and psychological trauma (see Farley et al., 1998), some people wonder what drives women to enter and stay in the industry. The simplest answer seems to be economics (see Rosen & Venkatesh, 2008), however, several other factors seem to be at play and will be elaborated on in !""!Chapter Two. These include but are not limited to restricted employment choices due to finances and associated issues with poverty (e.g., homelessness and employment struggles) (see Rosen & Venkatesh, 2008), childhood abuse/neglect (see Bagley & Young, 1987), addiction (see Kuyper et al., 2005), and larger societal issues including patriarchy, racism, and classism (see Dworkin, 1997). Furthermore, many women enter at a young age and get sucked into the ‘glamorized’ perception of the lifestyle of a prostitute where one can make quick money and spend the majority of their time socializing and using drugs (Abel & Fitzgerald, 2008). These factors impact women’s ability to choose to enter and stay involved in the street sex industry. In addition, for those who do want to leave the street sex industry, these issues complicate the process and women’s ability to exit, which will be introduced briefly below. Exiting the street sex industry. Given the above discussion, including the confounding factors and risks involved in entry into and continuing involvement in the street sex industry, it is not surprising that street sex workers often want to get out of the industry. For example, in Farley et al.’s (2005) quantitative study of 100 female prostitutes in the DTES, 95% reported that they wanted to exit the sex industry. In a qualitative study of 43 women in the process of exiting the sex trade, which will be explored further in Chapter Two, Dalla (2000) found that none of the women had planned to enter the sex industry, nor had they planned to make prostitution a long-term career. According to one woman in this study, Amy: “Anybody that says that they like doing it [prostitution] is in denial” (p. 352). While many prostitutes may want to leave the industry, it would appear that exiting is typically not achieved with a single attempt, nor is it a linear process. The limited available research and anecdotal accounts (e.g., Mansson & Hedin, 1999; Sanders, 2007) suggest that exiting the sex trade is often a challenging, lengthy journey that can involve a cycle of exiting !"#!and re-entering over many years or as some call it a ‘yo-yoing effect’ (Sanders, 2007). From the little that we do know on exiting the sex trade, which will be discussed in greater detail in Chapter Two, the process often involves many barriers at the societal, structural, individual, and relational level at different points along the way (see Baker, Dalla, & Williamson, 2010). In addition, motivations for exiting are frequently psychological requiring formal support services (see Mansson & Hedin, 1999). Therefore, we know that there is a need for mental health services but we do not know how these services are helpful and/or hindering in the exiting process.  To assist in understanding the exiting process, four main models have been proposed (Baker, et al., 2010; Mansson & Hedin, 1999; Prochaska, DiClemente, & Norcross, 1992; Sanders, 2007). These will be discussed in detail in Chapter Two. However, of the few available models on the process of exiting the sex trade, only two (Mansson & Hedin, 1999; Sanders, 2007) are based on research of exiting prostitution and both (consistent with qualitative method standards) had small sample sizes. Thus, while they provide a glimpse into the experience and some of the common aspects of exiting the industry, the results do not necessarily transfer to all women exiting the street sex trade. Also both studies were conducted in Europe. Given the discussion above on how geographical location influences various elements of the experience of working in the sex industry (e.g., legal concerns, age of entry, ethnicity, etc.), more contextually relevant research is needed to better understand this experience for different populations of sex trade workers. Research and programs aimed at assisting women to exit the sex trade need to be relevant to the geographical and cultural contexts within which sex trade workers must negotiate this process. The cultural and geographical context of this study and rationale are explored next.   !"$!Street Sex Work in Vancouver’s Downtown Eastside (DTES) It is often the case that women who are less educated, members of non-dominant ethnic groups, and lower SES make up the majority of the street sex work population (Kramer & Berg, 2003; Medrano, Hatch, Zule, & Desmond, 2003; Schissel & Fedec, 1999; Tyler, 2009). In a quantitative study of 309 female street sex workers in Arizona, Kramer and Berg (2003) found that non-white women as well as those with less education entered the sex industry at significantly younger ages than white women and those with more education. The dominant ethnic group within street sex work, however, appears to be geographically dependent (see Farley et al., 1998). For example, in parts of the U.S., African American women make up the majority of street prostitutes (see Rosen & Venkatesh, 2008).  In Vancouver’s DTES, a common stroll for street sex workers in the city as well as a place renowned for its illicit drug use, poverty and sex work, there is a significant overrepresentation of indigenous women engaged in prostitution. For example, in their quantitative study, Farley and associates (2005) surveyed 100 women in Vancouver’s DTES who were engaged in prostitution and found that 52% were indigenous. This is a significant ethnic disparity when compared to the rest of the city of Vancouver, BC, which reports an estimated 1.7 to 7% of the population being indigenous (Farley et al., 2005). In fact, it is estimated that 70% of Vancouver’s Aboriginal community resides in the DTES (Boyd, 2008). Similarly, researchers found that half (approximately forty percent) of the DTES residents are indigenous to Canada with the majority of the DTES population being male (Benoit, Carroll, & Chaudhry, 2003; Boyd, 2008). In fact, Benoit and colleagues (2003) reported a 3:1 male to female ratio in the DTES. Furthemore, studies have documented rates as high as 60 to 70% of the DTES sex work population being Aboriginal women (see Boyd, 2008).  !"%!Taking into account the overrepresentation of women and individuals of non-dominant ethnic backgrounds (as well as individuals of lower SES backgrounds) discussed above, it is difficult to ignore the larger societal issues, including patriarchy and other aspects of power and social privilege (e.g., race/ethnicity, class, etc.), that contribute to the preservation of demand for prostitution (Farley et al., 2005; Jeffreys, 2008). Therefore, it seems imperative to take a critical theoretical lens when researching prostitution to enhance our understanding of how power and privilege impact the process of entry and exiting the sex industry. When doing research in the DTES where indigenous women are over-represented, it is necessary to take into consideration the historical impacts of colonization, residential schooling, and intergenerational effects of these events for women in this context. Given the economics involved in prostitution, it is also important to acknowledge the element of class privilege when exploring reasons for entry into street prostitution. In addition, the disproportionate percentage of male clients and female prostitutes suggests an inherent imbalance of sexual power relations in the sex industry.  Rationale and Objective for the Study As articulated above, there is an abundance of research in the area of sex work in terms of factors that lead women into the sex trade and their experiences while engaged in prostitution. We know that many women who enter the sex trade do not necessarily choose this life and choice in this case is often confounded by issues such as addiction, abuse, disempowerment, and colonization. Clearly, there is a complex array of factors that drive women into and keep women working in the sex trade industry. However, the literature on the experience of exiting the sex trade is quite limited and has been primarily conducted by sociologists, social workers, and criminologists. Research on exiting has not been addressed within the counseling psychology literature. Consequently, we know little about what our role as counselling psychologists might !"&!be in supporting female street sex workers as they attempt to exit the sex trade. We lack knowledge about the actual process of exiting the trade for street sex workers or what factors facilitate or impede this transition out of the industry. It seems imperative then, that to support those women who want to exit the sex trade, we must learn from those who have transitioned out of the street sex trade. Such an inquiry is necessary to better understand the resources women who have exited the sex trade accessed and needed, as well as the barriers they faced in making this transition. The question, then, that has guided this study is: For women who have been out of the street sex trade for at least two years, what do their narratives reveal about the process of exiting street sex work? Approaching this subject from a counselling psychological perspective adds a new lens to the research on exiting the trade as counselling psychology approaches human development through a non-pathological, holistic lens that takes into consideration the contextual influences on individuals’ lives and choices. I took such a critical lens in examining the contextual elements (e.g., intergenerational trauma resulting from residential schools) influencing women’s experiences of transitioning out of the street sex industry in Vancouver’s DTES. I chose to conduct this study in Vancouver’s DTES due to the high number of female street sex workers in that neighborhood and the challenges they experience, which will be elaborated upon in Chapter Two. This study provides information on the supports and services that these women found helpful as well as obstructive in getting out of the street sex trade. Given the subject matter, about which relatively little is known, and the question I am attempting to answer, a qualitative form of inquiry is most appropriate. Specifically, a narrative method allows for a more in-depth understanding of these women’s process of exiting street sex work in the DTES and identifies the factors that facilitated and hindered their transition out of !"'!sex work. As we construct much of our lives and meaning through stories, exploring women’s stories of exiting using a narrative methodology helps to enhance our knowledge of their lives, the exiting process, and the meaning they make out of transitioning out of the street sex trade (Buchanan, 2010a). Of the limited available research on exiting the sex industry, no researchers have utilized a collaborative narrative approach to their data analysis and interpretation. This lack of collaborative research in the area has the potential to create a divide between what academia may deem is important in sex work and what is actually salient to the women involved in the sex trade. Using a collaborative narrative approach, the women in this study have been able to tell their stories in their own way and have voice in the way in which the data are analyzed and interpreted as well as the way in which their stories are told. In addition, the use of an indigenous feminist way of knowing, or epistemology, facilitates a critical theoretical lens that emphasizes power structures, colonial histories, and relational aspects of their experiences. This approach will be elaborated on in Chapter Three. I will now turn to a review of the salient research literature.   !"(!CHAPTER TWO Review of the Relevant Literature Co-Constructing A Research Journey: Letter Three—A Letter to the Academic World  To the Academic Community, I have been living and breathing university life for almost ten years now. It has been an experience—one that I am truly grateful for—both the gifts as well as the challenges it has presented. It has been a privilege to not only be able to attend university and learn at an undergraduate level but then to continue my learning through two graduate programs. I feel in many ways I have done the majority of my main ‘growing up’ and transitioning into adulthood while in university. My learnings throughout my studies and the culture of university itself have significantly shaped the woman I am today.  Through academia, I have learned how to write a certain way, how to think a certain way, and how to be a certain way—it is a culture like any other with language/discourse, norms, rules, rituals, and ideologies. I think the biggest lesson for me has been coming to understand just this—that academia is a culture in and of its own. I, therefore, sometimes feel that when I step out of my academic ‘box’ or life that I find that there is a divide between academia and the ‘real world’ much like there is when transitioning from any culture into another. Sometimes I don’t necessarily feel that the way I think, feel, talk, and act fits within this academic culture but then when I step out of my academic box I don’t necessarily feel like my academic side of me is accepted in other cultures. It almost feels like a constant negotiation of roles with one foot in the academic world and another in the ‘real world.’ I doubt I am alone in this experience.  I know I would not be the person I am today without being immersed in the academic culture. At times I have faced resistance from this culture (and as the reader may pick up on !")!at times, I have certainly had to negotiate my own resistance to academic culture). Yet it is this resistance and the challenges stemming from these moments of resistance that have been some of the best learning opportunities for myself personally and professionally. Through these times, I have engaged in a continuous process of self-reflection to explore the academic culture itself as well as my own values and needs to determine what aspects of this culture fit within my own framework—my own way of thinking and being—and how I fit within the academic culture. Thus, through these explorations and challenges, I have explored who I am and who I want to be. As I embrace challenge and opportunities for growth, I am forever grateful for being pushed in these ways and for being granted the gift and privilege of learning.  I am also grateful for the people in the academic community and in my overall academic ‘upbringing’ who have supported me and challenged me in ways I would not have been otherwise. Through these experiences I have learned how to critically explore and understand human behaviour, to communicate in ways considered ‘effective,’ and to better understand how to critically evaluate my own process and experience.  I must also express my sincere appreciation for the support I have received from my supervisors and my supervisory committee to engage in this research process in a way that best fits with my own style and identity. I am also grateful for the challenges they have posed and will continue to pose along the way so that I can engage in ongoing self-reflection as well as personal and professional growth. I have truly taken this dissertation journey, as a process of growing as a researcher and thus, their supportive feedback has been incredibly helpful to feel nurtured while at the same time pushed to my fullest potential as a novice researcher. !"*!I will now end this letter and begin the second chapter of this manuscript, which focuses on the relevant literature on the topic written from a primarily academic perspective. I open with quotes that will hopefully help situate the reader.  Thanks again and all the best in your own research journeys, ~Laura We are Aboriginal women. Givers of life, we are mothers, sisters, daughters, aunties, and grandmothers. Not just prostitutes and drug addicts. Not welfare cheats. We stand on our Mother Earth and we demand respect. We are not there to be beaten, abused, murdered, ignored. [From a flyer distributed at Downtown Eastside Women's Memorial March, February 14, 2001, Vancouver, British Columbia, Canada (as cited in Culhane, 2003)]. Academic life is premised on the notion that there is a tomorrow and a next day and a next day; or that someone can come inside from the cold for time to study; or that there is some kind of discourse of ideas and a year of freedom in which you can have disagreements that will not cost you your life. These are premises that those who are students here or who teach here act on every day. They are antithetical to the lives of women who are in prostitution or who have been in prostitution. If you have been in prostitution, you do not have tomorrow in your mind, because tomorrow is a very long time away. You cannot assume that you will live from minute to minute. You cannot and you do not. (Dworkin, 1997, p. 139)  The above quotes shed light on some of the experiences in prostitution as well as the discourse surrounding these experiences. In this section, I will review the literature relevant to the topic of prostitution and exiting the sex industry. I will first briefly discuss the history of sexuality and prostitution research and the links between these historical pieces. Then I will be addressing issues related to entry into prostitution and involvement in prostitution, as well as choice regarding entry and involvement in prostitution.!Finally, I will review the research on !#+!exiting the sex industry as well as the history of and the current state of the street sex trade in Vancouver’s Downtown Eastside.  Historical Background of Sexuality and Prostitution Research: How Modern Prostitution Came to Be To provide the reader with some context for sex work in today’s society, I will first provide some historical background to demonstrate how modern prostitution and the research in the field came to be what it is today. In this section, I will briefly review the history of sexuality and its impact on perceptions of prostitution, which I will then follow with the history of prostitution research as well as a discussion of the link between human sexuality history and research in prostitution.  Historical background on sexuality. Through his exploration of the history of sexuality, Foucault (1978) suggested that humans were once openly sexual beings but since the Victorian era, humans have repressed sexuality and silenced discussions of sexuality. Societal views toward prostitution throughout the Victorian era changed from compassion to unbearable hatred (Hickenbottom, 2002).  As Foucault (1978) illustrated, during the Middle Ages, people’s concern surrounded the flesh and practicing penance. The Counter Reformation, inspired by Christian spirituality, was an era during which every detail of each and every sexual encounter had to be disclosed. This included transforming every sexual thought, desire, and interaction into a discourse with the new pastoral’s purpose being that all sexual desires and interactions could be tracked. While originally inspired by Christian spirituality, beginning in the eighteenth century, the public’s interest in sex remained high due to emerging economic, political, and technical incitement in sex discourse. This discourse was related to the classification, specification, and quantification of !#"!sexuality in causal studies. It became essential for the state to know what its citizens’ sex lives involved and to know that each individual had control over her or his sexual activity. Toward the end of the eighteenth century, there were three main governing bodies of sexual practices: Christian pastoral, canonical law, and civil law, with all parties focusing primarily on marital sexual relations. It was during this time that the societal perspective on prostitution evolved from unbearable hatred to pity on prostitutes and a desire to ‘save’ them through religion (Rosen, 1983). What was once a ‘necessary evil’ transformed into a ‘social evil’ needing to be exterminated. Two groups of people known as abolitionists (made up of Christians and reformers who wanted to rid society of prostitution and educate people to avoid it) and regulationists (made up of police and doctors who wanted to regulate and control spreading of disease) led this movement. The nineteenth century marked “the age of multiplication: a dispersion of sexualities, a strengthening of their disparate forms, a multiple implantation of ‘perversions.’ Our epoch has initiated sexual heterogeneities” (Foucault, 1978, p. 37). Sinners of this era included rapists, adulterers, those engaging in carnal or spiritual incest, sodomizers, homosexuals, hermaphrodites and prostitutes. While the severity of punishment for sexual offenses diminished during this time, repression of sex as well as societally branding and dismissing sexual sinners continued.  During what is known as the second wave of industrialization (1950-1990), prostitution evolved into a highly visible business (Hickenbottom, 2002) and reached its peak likely due to women being unable to be a part of the labor force during a surge in heavy manual labor (Rosen, 1983). While prostitution declined for a period of time as the labor market began to diversify into more clerical positions, this era of repression and social branding of ‘sexual sinners’ in the nineteenth century has drastically impacted the way in which society’s members have viewed !##!and continue to perceive and stigmatize sex workers. As Hickenbottom (2002) states, contemporary society still see prostitution as a crime against morality. This stigmatization and its impacts will be elaborated upon in sections below.  Today, women continue to face dilemmas in terms of sexuality. Sabella (2011) stated “if women stray outside the very narrow boundaries provided to them for intimate acts, they run the risk of being viewed as immoral and disreputable” (p. 187). Language and labels, such as slut and whore, continue to be used to demean women suggesting that open prejudice and discrimination toward prostitutes and sex work is still considered acceptable, if not encouraged. In female social circles, to get caught being sexually open and promiscuous can result in these labels (i.e., slut and whore), which still have strong negative connotations.  At the same time, as Sinacore and Lech (2011) discussed, sexuality and objectification of students’ bodies (both men and women) is becoming commonplace in college campuses and in popular media. With young people gauging their sexual compass based on their peers, sexuality and ‘hooking up’ are considered to be the new ‘rights of passage’ for young men and women. Further, this sexuality seems to be starting younger and younger (e.g., rainbow parties where high school girls wearing different shades of lipstick attend and perform oral sex on their male counterparts). However, again this open sexuality remains conflictual, as the authors found when studying college prostitutes and stated that “female students are sexualized and objectified and yet, when they use their sexuality for their own personal gain, they are condemned” (Sinacore, & Lech, 2011, p. 262). Thus, even though people are becoming more open about their sexuality, society’s members still seem to require a boundary between being sexually promiscuous and being a prostitute, however gray and undefined that line is. This stigmatization of prostitutes and prostitution, which will be discussed in sections below, has greatly impacted the experience of !#$!women who are involved in the sex trade and their process of attempting to exit the sex industry (see Oselin, 2010). History of prostitution research. With historical accounts of prostitution dating back to the Old Testament and the ‘frozen’ city of Pompeii, prostitution is often said to be the oldest ‘profession’ in human history. As Moore (2011) outlined, historically, prostitution tends to occur more frequently in male-dominated, rigid environments culturally rooted in patriarchal practices where masculine heterosexual desire is privileged. In addition to patriarchy impacting prostitution, religious morals have also impacted prostitution and research on prostitution. As Sabella (2011) illustrated in the Old Testament with the stories of Adam and Eve, Eve was made of the rib of man. She later became responsible for original sin and “since that time, women have been blamed for many of men’s shortcomings and as a source of men’s downfall. The cultural root of male dominance and supremacy is a universal occurrence” (Sabella, 2011, p. 182).  A search on psychinfo of “prostitution” with publication dates prior to the 1960s revealed titles such as the following: “The psycho-pathology of prostitution,” “A new conscience and an ancient evil,” ”Social problems,” “Indications of increasing moral degradation,” “Preventives of delinquency,” “Crusade against the evil,” “The social evil,” “The problem of prostitution,” and “A case work approach to sex delinquents.” If we refer to Foucault’s discussion surrounding the history of sexuality we can see that the research topics on prostitution throughout this era fit with the church’s belief that prostitution was a sin and the state’s desire to ‘manage’ sexuality. Beginning in the 1960s and 1970s, with the introduction of feminism into the academy, language used in regard to prostitutes, at least in academia, began to take the focus off of it being a social evil and/or a sexual delinquency. Slowly, researchers began studying the psychology behind !#%!prostitution, such as childhood sexual abuse and addiction (Barclay & Gallemore, 1972), as well as the victimization of women in prostitution (James, 1978).  Research on this population (in the 1960s and 1970s) seemed to be headed toward understanding the experience of sex workers and finding ways to improve their lives. However, in the late 1980s and early 1990s with the HIV/AIDS epidemic, studies on prostitution shifted again, this time toward aspects of sexual behavior, such as condom usage (Gilchrist, Taylor, Goldberg, Mackie, Denovan, & Green, 2001), sexual risk behaviours (Inciardi, Surratt, & Kurtz, 2006) and knowledge of STD transmission (Fritz, 1998). While these are important areas to explore, this research epidemic created a shift back to treating prostitutes as subjects to be studied. While language, such as social delinquents, during this time was not explicitly used, some researchers (e.g., Dworkin, 1997) have argued that this shift in prostitution research seemed to be inspired more by society’s concern that prostitutes were a main cause of the spread of HIV/AIDS and other STDs rather than concern for the prostitutes themselves suffering and dying from HIV/AIDS or other STDs. While research on prostitution continues to be dominated by sexual health, other topics, which I will discuss below, have arisen that allow us to understand the experience of prostitutes, such as their reasons for entry into prostitution, potential violence, and choice involved in working in the sex trade. Conclusion. Being influenced by the changing times and larger socio-political systems, human sexuality is in a constant state of evolution. Similarly, the perceptions of prostitution and those involved in the sex trade are also changing. The dynamic state of these constructs has influenced the research on sex work over time. As discussed above, the main focus on research in the sex trade has been on sexual risk behaviours but, as will be elaborated upon next, factors influencing entry into prostitution have recently become a highlight within research on sex work. !#&! Author’s Note: Given the socio-political differences that exist across the globe, which impact the lifestyles and choices of sex workers (discussed in Chapter One) as well as the amount of literature on prostitution, in the next four sections (on entry, involvement in, choice, and exiting), I will limit my focus to research conducted with female sex workers in the western world (i.e., North America, Europe, and Australia/New Zealand). In addition, as discussed in Chapter One, women’s experiences in sex work is quite different than that of their male counterparts, and thus, I shall be focusing as much as possible on women’s experiences in prostitution. Entry Into Prostitution As discussed in the previous section, beginning in the 1980s, research on prostitution has focused primarily on quantitatively exploring sexual health risk behaviours amongst prostitutes. In the past decade, however, researchers have begun to explore further what leads people into the sex trade. In this section, I will explore the process of entering the sex trade, including the multitude of factors that have been shown to influence or correlate with women’s entry into prostitution. It is important to explore this process of how women get into the sex trade to aid in our understanding of the complexities of exiting prostitution. Given the focus of this study on exiting (which has been explored using qualitative methods), in this section, I will only summarize the main factors that have been found (through quantitative methods) to impact entry into the sex trade. I will provide more in-depth study information and critiques on the qualitative studies on entry into prostitution.  Researchers have found that the following factors have statistically significant influence on or correlations with entry into prostitution: (a) demographics, such as ethnic minority status, lower education levels, and low socioeconomic status (Kramer & Berg, 2003; Medrano et al., !#'!2003; Schissel & Fedec, 1999; Tyler, 2009); (b) Childhood histories of physical, sexual, and emotional abuse as well as neglect (Bagley & Young, 1987; Dalla et al., 2003; Kramer & Berg, 2003; McClanahan et al., 1999; Sanders, 2001; Schissel & Fedec, 1999; Stoltz, Shannon, Kerr, Zhang, Montaner, & Wood, 2007; Vaddiparti, Bogetto, Callahan, Abdallah, Spitznagel, & Cottler, 2006); (c) experiencing sexual assault from multiple assailants and often times more serious assaults (Bagley & Young, 1987; Dalla et al., 2003); (d) familial drug and/or alcohol abuse (Bagley & Young, 1987); (e) running away or leaving home in adolescence to get away from abuse, neglect, and substance issues (Bagley & Young, 1987; McClanahan, et al., 1999; Nadon et al., 1998; Schissel & Fedec, 1999); (f) personal substance abuse (Kuyper et al., 2005; Martin, Hearst, & Widome, 2010; McClanahan et al., 1999); (g) having family and/or friends involved in the sex trade (Abel & Fitzgerald, 2008); and (h) low self-esteem and mental health issues (Bagley & Young, 1987; Schissel & Fedec, 1999; Tyler, 2009). Based on these quantitative findings, it seems that many women who are involved in the sex trade have had a multitude of challenges, such as childhood abuse and addiction issues, that influence their entry into prostitution.      In 2003, Tutty and Nixon conducted a narrative study on the experience of entering prostitution by interviewing 47 female street sex trade workers in Canada. Similar to the majority of studies on street sex workers (e.g., Dalla, 2000), a high number (33 of 47) of these women had been victims of childhood abuse with the majority (i.e., 91% of the 33) reporting sexual abuse by multiple offenders. Nearly two thirds of these women had been involved in the child welfare system prior to entering prostitution. Some women grew up in environments where sex work was commonplace with ten of the women having family members who had been involved in the sex trade. The authors found that almost all of the women they interviewed had someone in their life !#(!who normalized prostitution and educated them on the ‘tricks of the trade.’ Typically this person was not a pimp but a female peer. However, a quarter of the participants were later ‘groomed’ by ‘boyfriends’ or pimps. Similar to other findings (see Rosen & Venkatesh, 2008), these authors reported that money was the main reason for entering prostitution but that women disclosed different purposes for their financial needs including: (a) survival, (b) alcohol and drugs, and (c) a more glamorous lifestyle. The majority of women in this study, however, reported needing money for drugs. Survival was the second main financial need stated. These findings illustrate the multitude of factors (addiction, childhood abuse, and poverty) often involved in entering prostitution, and are further suggestive of how complex the process of exiting the sex trade can be as it may involve physical, emotional, and spiritual challenges. Abel and Fitzgerald (2008) explored, using semi-structured interviewing and thematic analysis (no other methodological information provided), the reasons for entry of 17 street-level sex workers in New Zealand who had entered prostitution before age 18. All of the participants stated that money was the main motivation for entering prostitution. In addition, many of the individuals in this study had run away from home or foster care stating that their home life lacked support and stability. Most became homeless or transient where they moved from place to place, such as hotels or friends’ couches. Many reported that they had friends on the streets who were engaged in sex work who introduced them to the lifestyle. (Some also had family members involved in prostitution making it seem normal.) Often a liminal period of freedom and excitement of drug use and socializing occurred making sex work appealing in the beginning. However, quickly the participants in this study became aware of the need to support themselves financially to ensure survival and, for many, to support a drug habit. Thus, sex workers in this study reflected that leaving the sex trade would be difficult for many reasons including the need !#)!to support themselves financially, the need to support a drug addiction, as well as the difficulty of leaving their new sex work identity and ‘street family’ community. This study highlights the multitude of factors that lead some adolescents into prostitution; it also illustrates how difficult the process of exiting the street sex industry is given the many elements involved including economics, drug addiction, and community. This study provides a fairly linear perspective, however, and may not necessarily be every woman’s experience of entering street sex work during adolescence. While it should not be mistaken as an illustration of every adolescent street sex worker’s process of entry into sex work, it is a useful model in understanding entering prostitution. To explore the rich experience of entering the sex industry, Cobbina and Oselin (2011) conducted a qualitative study from a feminist perspective using semi-structured interviews with 40 female street prostitutes in five different cities in the US. In their inductive analysis (no other method or analysis information was provided), they found several common themes surrounding motivations for entering the sex trade, which, similar to Abel and Fitzgerald’s (2008) study were dependent upon age of entry. Many who entered in adolescence discussed entering sex work to reclaim control after running away from home to escape abuse, neglect, and parental substance issues. In addition, forty percent of the women who entered the sex trade in adolescence stated that prostitution within their neighborhoods and/or family life was a normal activity and even perceived as glamorous. For adults, on the other hand, women reported entering to sustain a drug habit and/or to earn money to survive (i.e., to pay for food, clothes, and housing). This study illustrates the common experiences of entering prostitution. It also emphasizes the notion that not all women enter the sex trade for the same reasons, and it is possible that these reasons could !#*!later have an impact on the experience of being involved in the sex trade as well as exiting prostitution.  Conclusion. Given the studies discussed above, it seems that the process of entering prostitution is often complex and non-linear. While there are several commonalities in the process of entry into prostitution, it is important to note that each woman’s experience is different often dependent upon reasons for entry and age of entry. Many women who enter the sex industry have histories of childhood abuse, have left home at an early age, and often enter prostitution in adolescence. In addition, issues surrounding addiction and poverty commonly co-occur with entry into the sex industry. Given the diversity of reasons for entering prostitution, it seems imperative that services for female street sex workers fit with the various reasons women entered the industry including basic survival assistance for childhood runaways, trauma counselling, and drug addiction treatment. To better understand these needs as well as the complexities involved in the process of exiting the sex trade, we first need to understand women’s experiences once they get involved in prostitution, which will be discussed next. Experience of Being Involved in Prostitution  In this section, I will explore the various experiences of involvement in sex work to provide the reader with some context for which to understand the various factors involved in exiting the sex trade. I have broken this section into smaller subsections based upon the foci of prostitution literature that is relevant to this study. In the first section I will discuss violence and other risks street prostitutes have reported, which is a highly researched area in sex work and segues into the second section on the psychological and emotional aspects of prostitution. In this section, I will explore the various mental health experiences of street sex workers including relationships, stigma, stress and trauma, coping, as well as drug use and abuse. As discussed !$+!above, there are numerous qualitative studies in the area of prostitution, and thus, to remain as concise as possible, for each section, I will first summarize the major themes that have arisen in the literature and provide one in-depth example and critique of a study for each section. I have chosen to review and conduct an in-depth discussion of the studies that are the most highly cited and most relevant to each area. Violence and other risks. Street prostitutes are at high risk for violence, as evidenced by many females’ accounts that provide testimony to repeated suffering of violence in all forms (including physical, sexual, and emotional) at the hands of clients, pimps, intimate partners, and even police (Comack & Seshia, 2010; Dalla et al., 2003; Lewis et al., 2005; Nixon et al., 2002; Raphael & Shapiro, 2004; Romero-Daza et al., 2003; Sanders, 2001). This repeated victimization while working in the sex trade (and for some beginning in childhood) is frequently linked to a diminishing sense of security and agency (Dalla et al., 2003) and, for many, emotional trauma (Cooper, Kennedy, & Yuille, 2001; Romero-Daza et al., 2003).  One leading researcher, Melissa Farley, who takes a radical feminist perspective and who has studied prostitution in several different countries (see Farley & Barkan, 1998; Farley et al., 1998) including Vancouver’s DTES (see Farley et al., 2005), holds the belief that violence and psychological trauma are intrinsic in prostitution (Farley & Barkan, 1998; Farley et al., 1998; Farley et al., 2005). In Farley and colleagues’ (1998) quantitative study (using chi square analyses) comparing 475 male, female, and transgendered sex workers working in brothels or on the streets across five countries including the USA, Zambia, Thailand, Turkey, and South Africa, she found that violence of all kinds (i.e., physical, sexual, emotional, and spiritual) is the norm for women involved in the sex trade. For many, this abuse began in childhood, their involvement in prostitution started in adolescence, and the violence continued throughout their time in the sex !$"!trade. This study is frequently cited in prostitution literature as it provides readers with a large sample of diverse sex workers across the globe and highlights the frequency of violence and trauma in the sex trade.  Psychological and emotional aspects of prostitution. Due to the violence experienced as well as the various psychological factors involved in entry into the sex trade, many female street sex workers have reported feelings of low self-worth (Jackson, Bennett, & Sowinski, 2007; Tomura, 2009), challenges in relationships (Dalla, 2001), internalized stigmatization (Oselin 2010; Sanders, 2007), as well as stress (Jackson et al., 2007) and even psychological trauma (Farley & Barkan, 1998; Farley et al., 1998, Farley et al., 2005). These factors, as well as ways in which street prostitutes cope with these various emotional and psychological aspects including dissociation (Cooper et al., 2001; Cooper, Yuille, & Kennedy, 2002; Coy, 2009) and substance use and abuse (Coy, 2009; Cusick & Hickman, 2005; Kuyper et al., 2005; Murphy, 2010; Romero-Daza et al., 2003), will be explored in the following subsections. Gorry, Roen, and Reilly (2010) conducted an interpretative phenomenological analysis of seven female street prostitutes in the UK. One of the women in this study had exited the sex industry and the rest were currently involved in the sex trade but all were utilizing support services. They found four main themes highlighting the psychological and emotional aspects of street prostitution. Many of the women discussed feelings of disempowerment and fear surrounding the lack of choice and control they felt in many aspects of sex work. Another theme that arose was formulating a ‘prostitute identity’ as well as developing feelings of low self-worth and low self-respect. Many stated that they had internalized societal stigma and judgment about their work, which influenced the emotional and psychological aspects of prostitution for them. All of the women in this study described coping with these emotional aspects through !$#!dissociating or emotional distancing, often through drug use. Many described a need for support, both through formal services and interpersonal relationships, to deal with the emotional and psychological aspects of sex work. They stated that qualities they thought necessary in a mental health support service include a nonjudgmental atmosphere, flexibility, a willingness to develop a trusting therapeutic relationship, as well as awareness of the challenges faced by street sex workers. Many of the women in this study stated they had reached a crisis point before they could consider exiting. These women discussed feelings of hope and optimism for the future while at the same time thinking that exiting the sex trade seemed to be an unreachable target and described the strong link with exiting prostitution and treating drug addiction. This research is one of the few studies in prostitution that has been conducted by psychologists with the purpose of understanding the mental health aspects of sex work. It emphasizes some of the mental and emotional challenges that women engaged in prostitution may experience as well as the need for support to assist with these mental and emotional concerns. More research is needed that explores the psychological aspects of being involved in as well as exiting prostitution.  Relationships. Through qualitative analyses, researchers have found that sex workers experience the following relational challenges: (a) chaotic and dysfunctional parental/guardian relationships (i.e., lack of attachment and closeness, abuse, physical or symbolic abandonment, neglect, and parental substance abuse) growing up and often remaining unchanged throughout their lives (Dalla, 2001; Jackson, Augusta-Scott, Burwash-Brennan, Karabanow, Robertson, & Sowinski, 2009); (b) lack of connection with siblings frequently due to separation in childhood, incarceration, and drug addiction (Dalla, 2001); (c) early development of intimate relationships with males (Dalla, 2001); (d) blurred boundary lines between pimps and boyfriends (Dalla, 2001; Jackson et al., 2009; Jackson et al., 2007); (e) intimate partnerships with pimps, boyfriends, and !$$!clients frequently characterized by violence and abuse (Dalla, 2001; Jackson et al., 2009; Jackson et al., 2007); (f) a mixture of competitive and yet supportive alliances with other sex workers (Jackson et al., 2007; Murphy, 2010); and (g) unintentional repetition of familial patterns with their own children (i.e., parental substance abuse, domestic violence, child abuse, and parent-child separation) (Dalla, 2001, 2004; Jackson et al., 2007). In their qualitative study using inductive analysis as well as semi-structured interviews (no other methodological information provided) with 16 mothers who were also street sex workers in the Midwestern US, Sloss and Harper (2004) found that on average these women had been pregnant four times with more than half of them first becoming pregnant before age 16. While not every woman continued working in the sex industry while pregnant, many who did stated they felt immense shame and stigma as well as feelings of regret and guilt due to the risks they took with their own bodies and their children. Others’ sex work experiences including drug usage did not change during pregnancy (as some women hid their pregnancy) and, for some, even increased (due to reports of men being more sexually attracted to pregnant woman). Women in this study had had an average of three live births. The experience of becoming a parent altered women’s worlds in different ways depending on the individual woman. Some stated that it made sex work more bearable to know they were focusing on their children. Others reported extreme stress and worry over their children’s well-being and safety (particularly while they were working). Finally, some discussed that parenting did not change their sex work experiences as they could focus on their work and drug usage rather than their kids. Many participants had lost custody of at least one child. For many, losing custody of their child(ren) was a devastating process; whereas, some expressed feelings of relief because they felt a sense of freedom and/or recognized a potential for harm for their children given their involvement in the !$%!sex industry. This study helps to highlight the differences in the role of mothering for sex workers as well as some of the challenges faced. The experience of mothering is an important one to understand when researching exiting the sex industry as many women who exit prostitution state that a primary reason they chose to leave was to better the lives of their children (see Sander, 2007; Tutty & Nixon, 2003). Further studies are therefore needed that explore this relational component of engaging in and leaving prostitution. It seems particularly important to understand what supports may be necessary to help facilitate an easier transition out of the sex trade for the many women in prostitution who are mothers and are desiring to leave to better the lives of their children.  Stigma. As discussed in previous sections, perceptions and attitudes toward prostitutes continue to be quite negative. Even the definition of prostitute holds negative connotations and values. Merriam Webster, for example, defines a prostitute as “a woman who engages in promiscuous sexual intercourse for money: whore” or “a person (as a writer or painter) who deliberately debases his or her talents (as for money).” The valuing system is even prevalent when describing examples of the usage of the term prostitute in the dictionary, such as the following statement “the town was horrified to discover that she had once been a prostitute.” Women involved in prostitution are thus, subject to the continued stigma that exists in society. Researchers have found that this stigma frequently becomes internalized and can lead to psychological and emotional stress (Jackson et al., 2009; Jackson et al., 2007; Lewis et al., 2005; Tomura, 2009; Vanwesenbeeck, 2005) as well as feelings of low self-esteem (Jackson et al., 2007; Tomura, 2009). In addition, as will be discussed further in the section on exiting, societal stigma makes the process of exiting the sex trade even more challenging as sex workers often feel the need to hide their past identity as a prostitute from potential new social support !$&!networks, employers, and landlords (see Oselin 2010; Sanders, 2007). Furthermore, the internalized stigmatization and the stress and feelings of low self-esteem that go along with identifying as a prostitute further complicate the exiting process psychologically (see Oselin 2010; Sanders, 2007).  Using a phenomenological method (focusing on life history, experience, and meaning) to explore sex workers’ lived experiences of stigma by interviewing one sexual service provider, Tomura (2009) found the following psychological themes: (a) having an awareness of sex work being perceived as bad and negatively labeled by society; (b) lying about and hiding one’s prostitute identity from others to avoid negative labeling; (c) feeling stressed and anxious about having to hide and lie about their identity; (d) objecting to and questioning stigma; (e) managing stigmatization through focusing on valuable qualities of sex work; (f) feeling compassion for others who are stigmatized; and (g) experiencing resiliency. This study is beneficial in shedding light on prostitutes’ lived experience of stigma. However, the results of this study stem from a single interview of someone who works with prostitutes. More research is therefore, needed in this area that incorporates sex workers’ voices. Stress and trauma. As introduced in the previous sections, researchers have found that street sex workers endure a multitude of emotional stressors (see Jackson et al., 2007) surrounding the violences they experience (Comack & Seshia, 2010; Dalla et al., 2003; Raphael & Shapiro, 2004; Sanders, 2001), the efforts made to hide their prostitute identity and deal with stigma (Jackson et al., 2007; Tomura, 2009), and the pressure to make money (Jackson et al., 2007). Often this stress results in burnout (Vanwesenbeeck, 2005) and, for many, psychological trauma (Farley & Barkan, 1998; Farley et al., 1998, Farley et al., 2005). !$'!Jackson and colleagues (2007) qualitatively explored emotional stressors in the lives of 68 female sex workers in an Eastern port city in Canada. Through semi-structured interviewing and a process of coding and uncovering subthemes and main themes (no other methodological information was provided), the authors found that emotional stressors for women in the sex trade stemmed from the conditions of sex work itself including constantly having to evaluate potential clients to avoid violence, serving undesired clients (e.g., those who were perverse, verbally abusive, and/or physically dirty), as well as the financial inconsistency of prostitution. However, others stated that they found sex work to be less stressful than other jobs and the money earned provided them with stress relief. In addition, many women reported stress over the ‘mood’ in the sex work community. Other sex workers represented competition, which could sometimes result in fighting and other conflicts. Yet, for many street sex workers, the ‘competition’ or the other sex workers were often their allies and closest friends, their safe and secure community, and their support network. Home life could also be stressful as the definitions of boyfriend and pimp frequently became similar and boundary lines became blurred. Furthermore, the majority of women in this study had children and their children’s care was a major stress especially given that some women in this study no longer had custody of their children. Finally, as discussed above, societal stigma and the fears surrounding one’s prostitute identity being revealed to the general public were huge sources of stress for street workers. This research is valuable as it demonstrates the many causes and layers of stress experienced by those women working in street prostitution. Further studies are needed to explore these emotional aspects of prostitution as well as what female sex workers may find useful in reducing the stressors in their lives.  Coping. To deal with this stress and psychological trauma that results from the violence that sex workers experience (see Cooper et al., 2001; Farley et al., 1998), many female !$(!prostitutes engage in coping mechanisms such as dis-embodiment and dissociation (Cooper et al., 2001; Cooper et al., 2002; Coy, 2009), drug use (Coy, 2009; Dalla, 2000, 2002, 2004; Romero-Daza et al., 2003), self-harm (Bagley & Young, 1987; Coy, 2009; Schissel & Fedec, 1999; Tyler, 2009), manufacturing a new identity when ‘on the job’ (Sanders, 2005), and humour (Sanders, 2004).  For example, Coy (2009) used a feminist participatory approach to study the life story narratives of 14 women with backgrounds in local authority care and sex work (both indoor and outdoor). Women in this study discussed dissociating, or leaving their body emotionally when they were unable to physically escape, as a means of coping when ‘turning tricks.’ For many, this coping process began in childhood during times of physical, sexual, and/or emotional abuse. Many also reported engaging in drug use and self-harm to further dissociate from their present situation. This study highlights the common experience of disembodiment amongst street prostitutes through a narrative method. More research similar to this study is needed that incorporates prostitutes’ stories and voices to provide a more in-depth understanding of the experience of being a street sex worker. Substance use and abuse. Drug use and abuse in prostitution, particularly amongst street-level sex workers, is quite prevalent (Coy, 2009; Cusick & Hickman, 2005; Kuyper et al., 2005; Murphy, 2010; Romero-Daza et al., 2003) although it is difficult to fully ascertain whether drug use is a precipitating or consequential factor of prostitution. Some researchers have used terms like ‘trapping’ to refer to the notion of getting ‘sucked in’ to the prostitution lifestyle. This process often involves socializing and substance abuse (see discussion on entry into prostitution), and then once addicted to substances, sex work becomes necessary to financially sustain drug and alcohol addictions (see Abel & Fitzgerald, 2008; Coy, 2009; Cusick & Hickman, 2005; !$)!Murphy, 2010).!Furthermore, as introduced above,!many researchers have found that substance use helps women who are engaged in prostitution to cope with the stress and trauma surrounding their work (Coy, 2009; Dalla, 2000, 2002, 2004; Romero-Daza et al., 2003). !Rochelle Dalla has conducted a number of studies on sex work primarily in the Midwestern US. In one such study (data from these analyses are reported in Dalla, 2000, 2002, 2004), she researched the experiences of 43 street-level female sex workers (who also worked in massage parlors, as escort workers, and in strip clubs) using a phenomenological descriptive analysis. In this study, she found that the majority (31 of 43) of women reported experiencing severe abuse from clients and pimps/boyfriends. In addition, for the women in this study, drug addiction strongly impacted timing and type of sex work. Almost all of her participants (41 out of 43) reported drug abuse with only 16 of these women stating that they entered the sex trade to support their drug use and eight reporting that entering prostitution and drug abuse began simultaneously. She found that those who entered with a drug addiction started working on the streets; whereas, others who entered out of financial need began in other types of work and eventually, typically coinciding with increased drug use, they started working for less and less money and turned toward street work. Drug use, for women in this study, seemed to be a means of coping or escape that “allowed them to psychologically accept the label ‘sex-worker’ and move into more daring (and admittedly lower status) forms of prostitution (i.e., street-level)” (Dalla, 2002, p. 66). While sex workers may use drugs for a variety of reasons, this study illustrates how substance use can serve as a coping mechanism to deal with the psychological aspects of prostitution. In addition, it is important to understand the strong correlation between addiction and sex work as many prostitutes describe addiction as a primary barrier for exiting. !$*!Conclusion. As articulated in the above sections, women’s experiences in the street sex trade are diverse and many face challenges such as relational issues, addiction, internalized stigma, as well as trauma and stress. That said, we must take these qualitative pieces with some caution, as consistent with qualitative research, small sample sizes were often used making the results not necessarily transferable to other geographical locations or contexts. The studies above, however, illustrate barriers that not only impact prostitutes’ experiences while working in the sex industry but also impede their ability to exit prostitution if they so choose. This notion of choice and female sex workers’ ability to choose their lifestyle in the sex trade, given all of the factors discussed in the above sections, has been highly researched and debated within the prostitution literature. I now turn to an exploration of the complexities involved in the ability to choose to engage in sex work, which can impact women’s ability to exit.  ‘Choice’ in Entering and Staying in Prostitution   As indicated in the previous sections, there is a considerable amount of physical and psychological risk involved in prostitution as well as many layers complicating the ‘choice’ of entering and staying in the sex industry. Thus, many have debated this notion of choice and researched the multitude of factors complicating choosing to enter and engage in the sex industry. Some seminal studies will be explored next. Rosen and Venkatesh (2008) engaged in participant observation of a low-income apartment complex in Southern Chicago where 50 of the total 75 residents were sex workers. In addition, they conducted formal interviews with 38 participants (7 males and 31 females) all of whom self-identified as African American. Through coding and analysis of themes (no other methodological information provided), they found that people described their experience in sex work as involving choice. However this choice was highly limited particularly with regard to !%+!economics. For example, many who were addicted to substances reflected how sex work not only met their financial need but also allowed them to work and make an income while using drugs. The authors, therefore, discussed that some sex workers do report making a conscious choice but within the confines of poverty, addiction, and other life circumstances. These participants often stated that sex work, for them, was a better option than other low-wage jobs, as it offered more flexibility and autonomy. This notion of limited choice within given confines is important to consider and this study demonstrates the complexities involved in choice.  Interestingly, while the women and men in Rosen and Venkatesh’s (2008) study reported feelings of empowerment over their ‘career choice’, these findings go against the voices of researchers, such as radical feminists, who state that prostitution should never be considered a choice due to the larger systemic issues involved in such ‘choice.’ One such radical feminist, Melissa Farley (introduced above), has termed prostitution “a gendered survival strategy” (Farley et al., 2005, p. 243) However, Rosen and Venkatesh (2008) have labeled this a ‘perversion’ of choice because there are significant factors involved in making this choice but the sex workers, themselves, stated that they felt they had agency.  Similar to Farley, Andrea Dworkin (1997) who along with Catherine MacKinnon developed an anti-pornography civil rights ordinance in Minneapolis, Minnesota, stated that Prostitution is intrinsically abusive. Let me be clear. I am talking to you about prostitution per se, without more violence, without extra violence, without a woman being hit, without a woman being pushed. Prostitution in and of itself is an abuse of a woman’s body…In prostitution, no woman stays whole. It is impossible to use a human body in the way women’s bodies are used in prostitution and to have a whole human being at the end of it, !%"!or in the middle of it, or close to the beginning of it. And no woman gets whole again later, after. (p. 141) While this may be true in many cases in sex work and it is important to not glamorize prostitution, it is the author’s belief that this position tends to take away from those sex workers who feel they do have agency, such as those in Rosen and Venkatesh (2008)’s study. It also has the potential to instill hopelessness for those who are desiring to exit but are told they will never be ‘whole’ again. Again, the voices of prostitutes are needed to validate or negate these claims. Similarly Coy (2009) focused on women’s experience of (dis) embodiment but often the subject of choice and empowerment arose in her interviews. Her findings (see above for study methods and analyses procedures) regarding women’s feelings about choice were quite mixed. For example, only two stated that they experienced increased feelings of control and power over their bodies when working in the industry and that being a prostitute increased their feelings of confidence. But, many expressed feelings of hopelessness and worthlessness with regards to their experiences in the sex industry. This study provides the complex picture of ‘choice’ involved in sex work illustrating that the same woman may feel that she has choice and control in her decisions while at the same time struggle with feelings of disempowerment and hopelessness. Weatherall and Priestly (2001) conducted a feminist discourse analysis of the key themes of feminist theories in sex work in New Zealand utilized by 19 individuals who were currently or had been involved in the sex industry. Many of the participants in this study alluded to the demand for sex work being increased by male sexual ‘need’ and prostitution serving as a cheap and convenient ‘outlet’ for males to ‘relieve’ themselves. Similar to Coy (2009), the authors found contradictory accounts regarding sex workers feelings of power and agency where often participants would describe feelings of powerlessness when discussing certain topics, such as !%#!experiences with violence. Yet when responding to different questions, such as the services they provided, they articulated feelings of agency, power, and control in their choices. This contradiction is consistent with the findings of some of the studies discussed above and, through a critical perspective, it provides a more comprehensive picture of the ‘choice’ involved in entering and working in the sex trade.  While some researchers have explored choice of entering and engaging in the sex trade through interviewing female prostitutes (as discussed above), sex workers’ perspectives on this issue are found primarily outside of the academic and traditional research literature domain. For example, political organizations, such as COYOTE (Call Off Your Old Tired Ethics), which is an American-based activist group of sex workers, argue for de-criminalization of sex work as well as acknowledgement that sex work can be a career (see Chapkis, 1997). Similarly, in Canada, women in sex work including Terri-Jean Bedford, Valerie Scott, and Amy Lebovitch, have advocated for de-criminalization of prostitution in Canada in the case of Bedford v. Canada (2010) to increase safety and security for those currently working in the sex trade. Many debates within the media, politics, and the sex work community continue to take place regarding this issue and how choice is impacted by the various factors outlined above. Conclusion. As discussed in the section on entry into prostitution, the notion of ‘choice’ involved in entering and staying in the sex industry is highly debated among sex workers, media, political figures, and researchers. Often, the process of entering and staying involved in the sex industry is complex and intertwined with a variety of factors including financial issues, addiction concerns, and violence. Thus, the process of exiting, which will be discussed next, can be a complicated process for women in the street sex trade. More research is, therefore, needed that explores contextually and critically female street workers’ experiences of exiting the sex trade.  !%$!Exiting Prostitution Given the discussion regarding the factors involved in entry into prostitution, the mixed feelings in terms of choice in entry and involvement in the industry, as well as the risks and violence many face while involved in the sex industry, it is important to explore the process of exiting the sex industry for those who desire alternative lifestyles, which is the case for many. As reflected upon in the previous chapter, Farley and colleagues (2005) conducted a quantitative study using survey questionnaires with 100 female prostitutes in Vancouver’s DTES and found that 95% wanted to exit the sex industry. Similarly, when Farley et al. (1998) studied 475 street and brothel workers across five countries (introduced above), 92% stated that they wanted to exit the sex industry. While these studies suggest that many sex workers have a desire to exit the sex industry, this process is by no means linear and is often quite lengthy and challenging involving many conflicting factors. For example, in Farley et al.’s study (1998) women reported the following needs to exit the sex trade: physical space and safety, job training, health care, individual counselling, peer support, child care, and drug/alcohol treatment. In this section, I will illustrate the models and frameworks that researchers have organized to better understand the process of exiting as well as the psychological and emotional aspects of exiting including social support service needs.  Models and frameworks for understanding the process of exiting prostitution. Similar to addiction rehabilitation, which as discussed above is often involved in exiting, when exploring the process of leaving the sex trade, researchers and community service workers (see Baker et al., 2010) often turn to Prochaska et al.’s (1992) ‘Model of Readiness for Change.’ This model includes the following stages: (a) pre-contemplation, (b) contemplation, (c) decision, (d) action, (e) maintenance, and (f) lapse/relapse. This model is helpful in understanding the process of !%%!exiting in terms of readiness for change particularly as many street workers exiting the sex industry are also struggling with addiction. However, given that the model was based upon addiction and eating disorders, and not exiting the sex industry, it does not necessarily apply to those who are not addicted or to those who are experiencing other conflicting challenges including coping with trauma, identity issues, and homelessness. Six of the more common and frequently cited exiting models that have been proposed will be discussed next. In a qualitative study based on interviews (no other methodological information provided) with 23 women who had exited the sex trade in Sweden in the 80s and early 90s, Mansson and Hedin (1999) outlined the following stages in their ‘Breakaway Model’ for entering and exiting the trade: (a) drifting in, (b) ensnarement, (c) breakaway’s pre-stage, (d) the breakaway, and (e) after the breakaway. In this model, the authors emphasized the importance of coping strategies on a woman’s ability to exit the sex trade. Many of the women in this study also discussed a “turning point” which led to exiting. These turning points included eye-opening events, (e.g., working in a strip club and being asked to make pornography), traumatic events (e.g., rape), and positive life events (e.g., having a child). In addition, the authors found that, upon exiting, women reported facing the following four main challenges: (a) coping with the emotional aspects of prostitution, such as trauma, (b) living as a marginalized person caught between the identify of one’s old life and one’s new life, (c) dealing with shame and stigma surrounding prostitution, and (d) negotiating new intimate relationships. This research is helpful in understanding that psychological aspects are an integral piece to understand in terms of exiting the sex industry both as motivations for, throughout, and after exiting. In addition, this study is seminal in understanding exiting, as it is one of the few models actually based upon research !%&!with sex workers who have left the sex trade. This study, however, has become a bit dated, and thus, more research is needed that captures the current state of exiting sex work.  Williamson and Folaron (2003) conducted a qualitative study using a grounded theory method, which explored 21 women’s experiences of entering prostitution, being involved in sex work, as well as exiting street prostitution. Through their “substantive and theoretical coding” (Williamson & Folaron, 2003, p. 274) as well as constant comparative analysis, the authors provided a comprehensive ‘Phases of the Lifestyle Model’ of the process of entering, involvement in, as well as exiting the street sex trade. They found that enticement into the prostitution lifestyle began with being enticed by the potential for opportunities, primarily financial gain, as well as resolving any moral objections surrounding prostitution. The women in this study then began to overcome barriers by perceiving sex work, not as negative, but as a financial survival strategy as all the women in this study were living in poverty at the time of entry. Many women at this stage reported being motivated to enter the sex industry due to emotional burdens from being raised in a stressful home where many experienced abuse, poverty, and parental substance abuse. Learning the lifestyle or ‘playing the game’ involved learning to survive and thrive (i.e., learning the rules of ‘the game’ or the lifestyle) within the fast-paced lifestyle of sex work. The women described this lifestyle as fascinating where they had newfound financial security as well as a sense of control and accomplishment. In the next phase, the women identified developing protective strategies, such as using intuition to avoid bad dates or arrests from police, wearing condoms, and carrying weapons, to meet the demands of the daily stresses in prostitution (e.g., preventing violence and dealing with police). Living the lifestyle (i.e., developing trust in the game) involved becoming addicted to the game of being continuously positively reinforced through making quick money. During this phase, the women !%'!stated they began distancing themselves from others outside of the lifestyle and increasing their social networks within ‘the game.’ This change in lifestyle typically led to increased drug use, more customer encounters, and thus, more client-related violence. Through this process, many women then became caught up in this lifestyle, which the women described as a time of drug abuse, depression, and learned helplessness. With acquiring drugs and immediate gain being the primary focus of this stage, safety became secondary which increased risk of violence as well as feelings of shame and remorse for choices made. Leaving the lifestyle, as articulated above, was a difficult process requiring introspection on the mismatch between desired way of living and current situations. The authors found that to leave the lifestyle one can be impacted by external forces but must also be personally driven to exit. Leaving the lifestyle frequently took several attempts of exiting and re-entry into the lifestyle. This in and out process was largely impacted by the women’s original reasons for entry. The authors’ findings of the overall process of entering, living in, and exiting the street sex trade provide a comprehensive understanding of the many layers involved in exiting the sex trade that makes the process typically non-linear and occurring over a long period time. Further research is needed that examines in depth what this process of leaving the lifestyle entails including what about the process makes it difficult and what, if anything, could make this transition smoother. Sanders (2007) interviewed 15 female street prostitutes and 15 female indoor workers in the UK. Using a symbolic interactionist perspective, a grounded theory analysis, as well as an inductive thematic analysis, she found that both indoor and outdoor workers generally utilized one of the following four types of transition to exit the sex industry in her ‘Typology of Transitions Model’: (a) reactionary – exiting after a significant life event (e.g., violence, health crisis, birth of a child, etc.); (b) gradual planning – consciously planned exiting over a longer !%(!period of time; (c) natural progression – enough is enough; and (d) “yo-yoing” effect – drifting in and out of the sex industry. For the first and fourth style of transition, few differences existed across setting. However, for street workers, the gradual planning transition typically involved addiction treatment, housing, and welfare support; whereas, for indoor workers this was more of a timed transition that coincided with preparation for financial loss as well as retirement and income tax considerations. Differences also existed across settings for those utilizing the natural progression transition style. For the outdoor workers, this turning point came upon the realization that sex work was too risky and chaotic. Indoor workers, on the other hand, described this transition as a career change and an opportunity to try new things. Similar to Mansson and Hedin (1999), this study has produced one of the few models on exiting the sex trade that is actually based upon research involving sex workers exiting prostitution. It is also one of the only qualitative studies on exiting prostitution that provides an in-depth description of the study’s methods, analysis procedures, and theoretical underpinnings. These findings are helpful in providing an illustration of the differences in exiting prostitution across type of work (i.e., indoor vs. outdoor). More research like this one is necessary that explores the process of exiting street sex work, which takes into account the perspectives of women who have left the sex industry. Based on the models proposed above as well as experience working with women exiting the sex trade, Baker et al. (2010) articulated an ‘Integrated Model’ of women exiting prostitution, which included five stages. The first was immersion in the industry, which the authors equated to Mansson and Hedin’s (1999) breakaway pre-stage as well as Prochaska et al.’s (1992) pre-contemplation stage. The second was awareness, which involved both visceral (i.e., “gut” feelings) and conscious awareness of needing to exit. The authors stated that if this conscious awareness translated into an ability to verbalize her feelings and cognitions, this stage may be !%)!similar to Prochaska et al.’s (1992) contemplation, Mansson and Hedin’s (1999) breakaway pre-stage, and either Sanders’ (2007) stage of gradual planning or natural progression. The third stage, deliberate preparation, involved inquiring about formal and informal resources. The authors stated that this stage was similar to Prochaska et al.’s (1992) preparation stage as well as Sanders’ (2007) gradual planning or natural progression stages. The fourth stage was initial exit where the sex worker actively utilized formal and informal resources. Women in this stage may access services and never return to the sex trade again; whereas, for other women, this stage may be shorter and they may re-enter the sex trade and engage in what the authors call the re-entry stage or what Sanders (2007) terms the yo-yoing effect or entry, exiting, re-entry. This stage, as the author discuss, may be similar to Prochaska et al.’s (1992) action and maintenance stages, Sanders’ (2007) natural progression stage; as well as Mansson and Hedin’s (1999) after the breakaway stage. The fifth and final stage is termed final exit, and typically occurred after a series of exiting attempts. This model is helpful in that it integrates literature that exists on models of exiting the street sex trade. It also provides a fairly comprehensive picture of the exiting process and emphasizes that typically this process is non-linear and often involves a series of exiting attempts and recycling throughout the various stages. However, given that it was based on the authors’ experiences with sex workers as well as literature and not research it needs empirical support to assess its validity. More research is needed on exiting prostitution that incorporates the voices of women who have worked in the sex trade. Cusick, Brooks-Gordon, Campbell, and Edgar (2011) qualitatively interviewed 92 indoor and outdoor sex workers (87% of whom were women) who were also drug-addicted in England. The authors grouped the participants into those (n = 52) who were ‘trapped’ in sex work and drug addiction and those who had exited (n = 40). The data were transcribed and coded !%*!according to emerging themes; however, no other methodological information was provided. They found that within the group who had exited, there were the following ‘Exiting Patterns’: (a) five were intervention-assisted exiters; (b) twelve were opportunistic exiters meaning they had at experienced circumstances that changed their drug use or engagement in the sex industry at times but their underlying lifestyle remained largely stable; (c) sixteen were gradual exiters whose exiting process involved a series of accumulated changes to their circumstances over time; and (d) the remaining seven were strategic exiters who discussed the importance of developing an active plan to stop drug use so that they could enhance their sex work financial opportunities. This study provides a glimpse into the diversity involved in the reasons for leaving and the patterns of exiting sex work. Further research is needed that examines the process of leaving the street sex trade particularly focusing on the resources needed and the barriers faced throughout this transition. Cimino (2012) articulated how the integrative model of behavioural prediction can be applied to exiting street prostitution and termed this a ‘Predictive Theory of Intentions Model.’ This integrative model of behavioural prediction took into account several factors particularly how external variables (i.e., demographics, personality traits, and individual differences) influence attitudes, norms, and self-efficacy, which, in addition to individual agency, are said to have an impact on intention. Cimino (utilizing the research models described above) applied this model of behavioural prediction to exiting street prostitution and how intention, skills, environmental constraints, and societal context impact one’s ability to overall exit street prostitution. This theory is beneficial in understanding how different factors impact individuals’ abilities to exit street prostitution. However, it has yet to be empirically tested with individuals !&+!exiting street prostitution. In addition, it does not necessarily give us a complete picture in terms of how certain aspects, such as mental health issues, influence women’s abilities to exit. Psychological and emotional aspects of exiting prostitution. As demonstrated in the models presented above, there are considerable psychological aspects that play a role in the exiting process. In this section, I will explore the various studies on exiting prostitution that illustrate the mental health challenges involved in exiting prostitution including addiction, trauma, stigma, financial and career factors, as well as identity issues.  Formatting her results in the form of curriculum vitaes, Rickard (2001) conducted life-history accounts of five sex workers in their 30s and 40s in Britain to explore sex workers’ perspectives on sex work as a job, their hopes, their plans for the future, and feelings on retirement. The women in this study felt that their experience in the sex trade had provided them with several transferrable job skills; however, most felt that it would be difficult to obtain legal employment given the stigma attached to sex work and the legal elements of being involved in the sex trade. In addition, the participants had little hopes of ‘retirement’ and stated that it would be difficult for them to give up the trade at their age, as it would involve giving up a lucrative income as well as a lifestyle with which they had grown familiar including people, places, and expectations. This research is helpful in illustrating the ‘career’ elements of sex workers lives, particularly those who have been involved in the sex industry for some time. However, it does not necessarily give us the full picture in terms of our understanding of the mental health needs of those desiring to exit. Furthermore, this study is nearly ten years old, and thus, given how (as discussed above) perceptions on sexuality changes over time, new research is needed on the subject to ensure relevance to today’s world.  !&"!As Tutty and Nixon (2003) found in their narrative study of 47 female sex workers in Canada in which they used semi-structured interviews, almost all had tried to exit the sex trade at least once and these attempts typically occurred after a traumatic or other significant incident, such as rape or pregnancy. However, the majority of participants ended up returning primarily for economic reasons or to support a drug addiction. Many spoke of re-entering because of the addiction to the street life, such as the people, the excitement of the streets, and the ‘ease’ of making quick money. Some also stated their identity became intertwined with sex work. Of the few individuals (8 of 47) who had exited, several reported that they used formal support services to assist them in this process. This study is contextually fitting and gives us an important glimpse into the complexities of exiting the sex trade including identity issues, financial concerns, addiction challenges, and trauma. More research is needed that explores how aspects, such as formal support services, were helpful in exiting and what further elements could be beneficial to potentially overcome some of the challenges these authors illustrated.  Kurtz, Surratt, Kiley, and Inciardi (2005) conducted a mixed methods study of female street sex workers in Miami, Florida, in which they surveyed 586 women and did a focus group interview with 25 women. The authors used survey data to present (in percentages only) various variables including basic demographics, drug use, social service needs (such as shelter, drug treatment, and food), and health characteristics (such as childhood trauma and HIV status). They found that the women’s most urgent needs (presented in order) were shelter, employment, medical care, drug treatment, mental health counselling, food, financial assistance, clothing, education, childcare, and legal assistance. The authors reported that they used a grounded theory approach to analyze the focus group data, which were coded into themes. These analyses revealed the following four categories of needs: (a) physical, such as food, water, clothes, and !&#!shelter; (b) mental/emotional, such as friendship, counselling, crisis intervention, and domestic violence protection; (c) health care, such as drug treatment, medical care, sexual health care; and (d) longer-term needs, such as legal, housing, employment, and longer-term mental health services. This research is further suggestive of the importance of understanding both short- and long-term mental health needs of female street sex workers at a more in-depth level. Women in this study, however, reported experiencing barriers at both an individual and structural level. Some individual barriers included lack of awareness of services, drug use, fear, mental and emotional instability, lack of sense of time (termed street-life distraction), negative attitude, and low frustration tolerance. Structural barriers, on the other hand, included availability, transportation issues, social stigma, program structure, and program target population. These findings suggest a need to better understand these barriers and how to potentially decrease them to hopefully make access and availability of mental health services easier and more attractive for female street sex workers.  Dalla (2006) conducted a longitudinal (data collected in 1998/1999 and then again in 2001/2002), qualitative study using semi-structured interviews. She reported that she began each follow-up interview with 18 (of the original 43) female sex workers inquiring about significant developments in their lives. She used thematic analyses to first organize data according to patterns of experience described, then to identify information relevant to the patterns classified (e.g., significant relationships impacting the exiting process), and finally to organize related patterns into themes. She found that five women had exited the sex trade and, of the five, four of the women’s main motivations had been “hitting bottom” (e.g., experiencing a violent attack, losing custody of children, and imprisonment). The other woman stated that she left because of declining economics involved in prostitution. Two of the five had children and reported that their !&$!motivation to exit was largely tied to wanting to be a good parent. While based on a small sample, this is evidence that often women’s motivations to exit are psychological in nature, and thus, we need to explore further the mental health needs of women desiring to exit the sex industry including their support service needs. In this study, the author found that formal support services (e.g., residential treatment) were necessary in the initial exiting stages, whereas, informal support services (e.g., emotional support from family) were critical for the long-term exiting journey. This research is important as it illustrates the psychological challenges of exiting and points to a need for mental health services. However, we need further research to understand how these mental health services can be helpful and/or hindering in the exiting process.  As discussed in previous sections, the process of exiting becomes further complicated with societal stigma surrounding prostitution. In an ethnographic study of 36 street sex workers in four different American cities, Oselin (2010) found that interpersonal relationships were a main reason for leaving the sex industry. That is, women in this study were motivated to leave so they did not lose their relationships with their partners, friends, and family members. Others stated that they had witnessed mentors leave the sex industry and watching these individuals grow and change was a motivation to leave. While many women desired to leave the sex industry and had the internal motivation to do so, the author discussed that given their economic situations (and the larger social picture that considers prostitution to be, as the author states, a ‘deviant career’) many struggled with the process based on internal alterations alone. These findings demonstrate the impact of social stigma on sex workers’ motivations for exiting the sex trade and are therefore, further suggestive of the need to understand the societal and systemic barriers involved in exiting the sex trade. These findings are also indicative of the need to take into consideration the larger socio-political context in which the research takes place. !&%!Roe-Sepowtiz, Hickle, and Cimino (2012) quantitatively examined the life experiences and trauma symptoms of 49 women (who had primarily been involved in street-level sex work) who were in a residential prostitution-exiting program. They looked at differences of those (n = 22) who had completed the 90-day program and those (n = 27) who had dropped out prior to completion. The authors found that those who had completed the program were older than those who did not complete it. Furthermore, those who had not completed the program tended to report more trauma symptoms (i.e., poor coping, dissociation, and ‘dysfunctional’ sexual behaviour). This study emphasized the need for mental health services (particularly those that are trauma-focused) for women exiting street-level sex work. Additional research is needed that explores how these mental health services can be useful or not throughout the exiting process.   Conclusion. As described above, the process of exiting the street sex trade is complex, often intertwined with addiction, trauma, and poverty, frequently making the process non-linear and involving a yo-yoing effect. Women exiting often face many barriers at the societal, structural, individual, and relational level at different points along the way. This is suggestive of a need for further research that explores the process of exiting the sex trade using a critical lens, which takes into account the various barriers and factors involved in the process. Research in this area suggests that women who are in the process of exiting often benefit from formal support services; however, an in-depth exploration of how these services are helpful has yet to be conducted. Furthermore, several of the qualitative studies (e.g., Cusick et al., 2011; Tutty & Nixon, 2003) in the section of the literature review did not provide details regarding the types of methods and analysis procedures used as well as philosophical underpinnings and rationale for using these methods. This lack of information can make it difficult to replicate research as well as to evaluate the rigor of the studies. Moreover, given the qualitative nature of the research !&&!presented, small sample sizes were utilized making transferability difficult and thus, further studies on the process of exiting street prostitution are needed. In addition, to the best of the author’s knowledge, no research has critically explored the process of exiting the street sex trade within the context of Vancouver’s DTES, and thus, research on this experience that focuses on female sex trade workers in Vancouver’s DTES is imperative. The history of Vancouver’s DTES as well as current research on street prostitution in this geographical location will be discussed next.  Vancouver’s Downtown Eastside (DTES) I, again, would like to acknowledge that I am conducting this study as a guest on Coast Salish territory, in an area of what is now referred to as Vancouver’s Downtown Eastside (DTES), a common stroll for prostitution in the city. The city of Vancouver, including the DTES, was constructed on land once occupied and owned by the Coast Salish First Nations for over 10,000 years. As Culhane (2003) described, the last First Peoples village was displaced to a reserve located north of Vancouver. However, the First Peoples from Coast Salish as well as other First Nations communities continue to have presence (and currently make up almost half of the population) in the DTES. In this section, I will elaborate upon the history of the DTES and how the cumulative effects of racism, classism, sexism, and colonization have led to this neighborhood in Vancouver being known not only as one of the poorest neighborhoods in Canada, but also renowned for illicit drug use and prostitution.  As Farley, Matthews, Deer, Lopez, Stark, and Hudon (2011) discussed in their paper on prostitution and trafficking of Native women in Minnesota, the Native community were forced into boarding schools where they were ripped from their families and cultural ways of knowing. They were then pushed to ‘re-locate’ again to reservations. Later, the Native people who !&'!survived the genocides and intergenerational traumas were encouraged to migrate to urban areas. Often being separated from their families, those who migrated to the DTES frequently did so without extended family and/or culturally familiarity with such urban environments. All of these factors can lead people to vulnerability to poverty, exploitation, and in the case of Farley et al.’s (2011) study of Native women, often prostitution. Farley et al.’s (2011) illustrates a picture of the multitude of layers and contextual factors involved in the sex trade.  Individuals in that time had little family support, were stuck in a culturally unfamiliar setting, and had experienced and bore witness to such trauma. Thus, trying to heal and move forward especially after having been stripped of traditional healing practices and trusted communities seems like an incredibly complicated if not impossible process. Therefore, it makes sense to see how in today’s society sex trade workers in the DTES are predominantly of people from First Nations backgrounds. Furthermore, empowerment and healing becomes further complicated as trauma is now intergenerational and continues in the form of sexual, physical, psychological, and emotional violence (see Farley et al., 2005).  As researchers (see Boyd, 2008; Lowman, 2000) have noted, the DTES is currently one of Canada’s poorest neighborhoods and has been renowned for decades for its poverty, visible drug use, sex trade, and violence against women. In the early 1900s, the media as well as Anglo-Saxon moral reformers viewed the DTES as a racialized place of immorality (Boyd, 2008). They claimed that the DTES was a place where Chinese men were leading white men and women into a world of addiction and sex. Drug use and misuse became even more prevalent in the area following World War II during which time drug policies were enacted. It was not, however, until the 1990s that the media brought public attention to the rapidly increasing health concerns in the !&(!DTES including drug overdose, HIV, and Hepatitis C (Boyd, 2008), as well as having the highest infection rates of HIV and Hepatitis C in the western part of the world (Lowman, 2000). Interestingly, while prostitution has existed in Vancouver for some time, it was not until the early 1990s when street prostitution strolls began to develop (Lowman, 2000). This was primarily due to city movements that pushed prostitutes out of motels on Robson Street in the city centre and residential districts in Mount Pleasant and onto the streets and back alleys, further out of the public eye (see Lowman, 2000; de Vries, 2003). CROWE (the Concerned Residents of the West End) was the first organization in Vancouver formed to rid the neighborhood of street sex work. In 1984 an organization called ‘Shame the Johns’ began to picket street sex workers. This group was ‘successful’ in displacing street prostitutes out of the West End; soon after similar groups emerged in other neighborhoods (i.e., Grandview-Woodlands, Mount Pleasant, Kensington-Cedar Cottage, and Strathcona) (Lowman, 2000). In 1986, the first organized relocation took place, which pushed the sex trade further east; this was the first formal resistance in the DTES to the street sex trade (Lowman, 2000). In 1988, after a negotiation with street sex workers, another move took place relocating the stroll to north of Hastings Street forcing women into a five-block area where they typically worked alone and often in poorly lit areas, such as alleys (Lowman, 2000). As Lowman (2000) described, the residents’ of Vancouver desire to rid their neighborhoods of prostitutes as well as the increased criminalization of prostitution (and thus, perpetuated prostitutes’ fears to report ‘bad dates’) created a ‘discourse of disposal,’ which Lowman (2000) suggested created an “ideological context in which male violence against women is played out” (p. 1004). Expanding on this notion, Dworkin (1997), a radical feminist, described patriarchy and men’s views on the prostitute in the following illustration: !&)!She’s expendable. Funny she has no name. She is a mouth, a vagina, and an anus—who needs her in particular when there are so many others? When she dies, who misses her? Who mourns her? She’s missing—does anybody go look for her? I mean, who is she? She is no one. Not metaphorically no one. Literally, no one. (p. 146) These series of events and new working conditions made women in the DTES even more vulnerable to violence, ‘bad dates,’ and even homicides of prostitutes in the DTES spiking in the early 1990s (Culhane, 2003; Lowman, 2000). It was not, however, until 1999 when international media and police began to attend to the words of the friends and families of these missing women, most of whom were Aboriginal (Culhane, 2003; Lowman, 2000). Attention is now being paid to this area, however this attention, as Culhane (2003) illustrated, still maintains  …a form of ‘race blindness.’ Recognition of the burden of social suffering carried by Aboriginal people in this neighborhood—and in Canada as a whole—elicits profound discomfort within a liberal, democratic nation-state like Canada, evidencing as it does the continuing effects of settler colonialism, its ideological and material foundations, and its ongoing re-production. (p. 593) Female street sex workers in the DTES continue to be victims of physical and sexual violence; many continue to be found missing and some murdered (see Lowman, 2000; Farley et al., 2005). Lowman (2000) suggested that these murders are more than just stemming from a single serial killer but rather a systematic pattern of perpetration and violence by men against females involved in prostitution. In addition, many female prostitutes in the DTES experience physical and sexual health concerns such as heart problems, Hepatitis, and HIV (see Farley et al., 2005) with many of these concerns being related to irregular condom use, drug use, needle sharing, and lack of access to proper health care (see Dalla, 2000).  !&*!As Dworkin (1997), a radical feminist, described  When men use women in prostitution, they are expressing a pure hatred for the female body. It is as pure as anything on this earth ever is or ever has been. It is a contempt so deep, so deep, that a whole human life is reduced to a few sexual orifices, and he can do anything he wants…She has nowhere to go. There is no cop to complain to; the cop may well be the guy who is doing it. The lawyer that she goes to will want payment in kind. When she needs medical help, it turns out he’s just another john. Do you understand? She is literally nothing. Now, many of us have experiences in which we feel like nothing, or we know that someone consider us to be nothing or less than nothing, worthless, but for a woman in prostitution, this is the experience of life every day, day in and day out. (p. 145) Farley et al. (2005) reported that 86 percent of female prostitutes in their study who were working in common strolls in Vancouver including the DTES, Broadway/Fraser, and Franklin, reported past or current homelessness. While drug use continues to be prevalent in the DTES, Kuyper et al. (2005) found that many women in the DTES reported seeking addiction treatment services but had been, for reasons undefined in the study, unable to access such services.  Resources for women currently in the industry (e.g., WISH Drop-In Centre, PACE, etc.) as well as those desiring to exit (e.g., PEERS) do exist in the DTES and have been found to be ‘safe homes’ in this area and helpful in the exiting process (see Campbell, Culbert, & Boyd, 2009). However, at the time of writing this manuscript, PEERS Vancouver had been shut down due to lack of funding and thus, currently the DTES has no programs (of which the author is aware) to support women desiring to exit street sex work. Thus, an exploration of the types of services needed (if any) by women exiting street-level sex works seems imperative. !'+!As Boyd (2008) illustrated this ‘race blindness,’ referred to above, continues to be prevalent in research ‘on’ the DTES as drug users and others in the DTES are frequently the subject of study and media discussion but their voices are silenced and appropriated. This is further suggestive of the need to do collaborative research with rather than on women in the sex trade in the DTES. Conclusion. Vancouver’s Downtown Eastside is rich with history; however, this history is entangled with racism, sexism, and colonization. These intergenerational aspects of the area have drastically impacted the experience of street prostitutes making the process of exiting the sex trade in the DTES further challenging. Thus, a critical exploration of the exiting process in the DTES is necessary. In addition, while a considerable amount of research has been conducted in the DTES, the majority of it has been quantitative research conducted on and about street workers leaving out the voices of the participants. It is, therefore, essential to include the perspectives of female street sex workers to validate or negate the claims made about them. Chapter Summary and Conclusion To provide context for the focus of this study on exiting the street sex trade in the DTES, I have reviewed the literature on the history of sexuality and prostitution research, the experience of entering the sex trade and involvement in prostitution, as well the discourse surrounding ‘choice’ in entering and being involved in sex work. In examining these sections, the challenges and complexity involved in exiting the sex trade are highlighted. In addition to providing an in-depth review of the literature on exiting sex work, I have zoomed in on the current state of the sex trade in Vancouver’s DTES. Throughout this review, I have discussed some of the limitations in the literature on exiting the street sex trade, with the main gaps including the following: (a) difficulty in evaluating rigor and credibility of findings due to the lack of !'"!description of philosophy, methods, and analyses used as well as rationale behind the philosophy, methods, and type of analyses chosen; (b) lack of transferability to Vancouver’s DTES given the lack of research on street sex work in Vancouver’s DTES, small sample sizes used, and qualitative nature of the studies; (c) lack of collaboration with women who have exited the street sex trade and inclusivity of their voices; (d) lack of a critical perspective taking into account the contextual layers involved in exiting street sex work; and (e) a lack of an in-depth understanding of the mental health needs and services (if any) of women exiting street sex work. This study therefore, seeks to address the need to better understand the process of exiting street prostitution in Vancouver’s DTES taking a critical theoretical perspective with an overarching counselling psychological umbrella and utilizing a collaborative narrative method.  As discussed above, context plays a critical role in entry, involvement, and exiting prostitution. Fitting with a counselling psychological lens, mental health services including the process of healing need to be relevant to the population being served. For example, as Benoit and colleagues (2003) articulated in their quote from an Aboriginal participant of one of the DTES health clinics:  If you’re going to do something for Native people, I think you need to be like traditional and spiritual ‘cause that’s what Native people are about, you know? Do they have elders in the VNHS? Do they have Native healers? No, they have doctors! Gee, that’s not my system, that’s not where I come from. You know, for a First Nations organization, how come there’s like, not a lot of Natives working? It’s like the same White system with just a different name on it. (p. 825) In addition, while studies have been conducted on prostitution, there is a scarcity of literature on exiting the sex trade and, due to geographical and contextual differences as well as small sample !'#!sizes utilized, the findings from the current literature cannot necessarily be transferred to the experience of female street prostitutes in Vancouver’s DTES. Furthermore, many of these studies indicated a need to address mental health aspects of exiting including addiction treatment, identity issues, and trauma. Yet none of these studies approached their research from a counselling psychological lens, which offers a critical, holistic, and developmental perspective on entering, involvement, and exiting the sex industry. More research is needed that critically and developmentally explores the exiting process and the mental health needs of those exiting. Thus, the question that has guided this study is: For women who have been out of the street sex trade for at least two years, what do their narratives reveal about the process of exiting street sex work? Furthermore, to answer this question, I have worked from an overarching counselling psychological philosophical umbrella, which has guided my indigenous feminist theoretical framework. I have used an indigenous feminist theoretical lens that takes into account contextual aspects of the women’s lives. In addition, I have utilized a collaborative narrative method (which will be further illustrated in Chapter Three) to co-construct the research with the participants and, in doing so, have facilitated having their perspectives heard and having voice in how their stories are told. This method and the philosophy behind it will be elaborated upon in the next chapter.!  !'$!CHAPTER THREE Co-Authoring a New Story Together Co-Constructing A Research Journey: Letter Four—A Letter to My Potential Co-Authors   To My Potential Co-Authors, Note: This letter was composed prior to conducting the study and thus, before meeting the actual co-authors.  How do I tell you what I will promise you? I am a counselor and a natural caretaker, almost to a fault. People ask me how I will maintain boundaries in this relationship. They say to me, “How will you share yourself with the participants and yet not get overinvolved so that you’re ‘counselling’ or becoming their caretaker?” I was reflecting on this question one day when I came across a quote from a woman who I deeply respect, Rebecca Crawford Foster. While she plays many other roles, she is a wife, a mother and foster mother of a large family, a counsellor, and a researcher. Once she was reflecting upon and sharing with a group of us how she (with all of her ‘hats’ that she has) maintains boundaries. She stated that “I can’t keep you from the consequences of your behaviours, but I will walk with you.” I think that above all this is what I would like to promise you. Through this process, I cannot necessarily directly cause change in your world nor do I necessarily desire to, but I would like to walk with you on this journey. I would like to share with you my research story and hear your story, and together potentially create a new story. And hopefully through this new narrative and this process, change will come about in both our worlds and potentially others. Typically, in research you are referred to as participants in a research study, but as I would like to collaborate with you and co-compose or co-author this journey and this story with you, I would like to use the term co-author instead of participant for the !'%!purposes of this document. I hope you are comfortable with this, and, if not, we can discuss this and determine what other language may be appropriate. I believe strongly in the four R’s in research, which include respect , relevance , reciprocity,  and responsibi l ity.  Throughout this process, my main focus will be to respect you and your relationships, be that your relationship with yourself, your physical world, your spiritual world, etc. as well as to respect my relationships and myself. I want this process to be relevant to your experience and worldviews. I see this as a reciprocal  process of sharing with each other and thus, I may be asking you questions and you can share with me what you feel comfortable disclosing. You can also feel free to not answer a question for any reason. In the same sense, you can ask me questions about my life and myself and I will share with you what I feel comfortable. I know researchers are often perceived as the ‘experts’ but my hope and responsibi l ity to you is to collaborate with you as much as possible as opposed to playing the role of expert. Rather, I believe each person is the expert on her own life and I would be truly honored if you would share this bit of wisdom with me to the extent that you feel comfortable. My goal as we walk this journey of exploration together is to consult with you throughout the process and stay as close to your story and voice as I can when I write up the final manuscript.  I am aware at the same time that I am composing this document in a university setting, and thus, at times the language I use may not necessarily be fitting with your world. As one of my professors, Dr. Peter Cole (2006), stated in his book: …language is among other things a lens through which one experiences the world other languages and ideas are experienced through that lens if your spectacles are halfway down your nose and you look over them  it will be pretty blurry  fuzzy but who’s to say things would be better if the lens were repositioned !'&!perhaps it is the lens that needs changing or the hearing aid  the texturing aid. (p. 50) Thus, as much as possible, I will try to be conscious of my own spectacles, the lenses inside of them, and where they are positioned. I will engage in a continuous process of self-reflection about where my ideas and language are coming from and consult with you throughout this process to ensure that the story told at the end of the day is consistent with your world. And if and when I find myself needing to use language not consistent with your world, I will be highlighting these differences within the final document. With that I will close this letter and begin to describe further the co-authoring process in a more academic voice. I will be telling a bit of a story about my own lenses as they currently sit on my face and how they came to be.  As I write this though, I can’t help but think about where you are in this moment, what you’re experiencing, and what our time will be like together. I look forward to the prospect of getting to know you and developing our relationship together. Until then, all the best in your journey, ~Laura While copious amounts of research has been conducted on street sex workers and on the experiences of individuals living in the DTES (see discussion in Chapter Two), few studies have done so using a collaborative approach to co-construct the research relationship and the data with the participants. While the literature that is currently available is important, with a group, such as female street sex workers in the DTES who have typically experienced a number of hardships (sometimes referred to as a marginalized or disenfranchised population), it is essential to respect the individual person who is sharing their story and allow them the opportunity to share their story in a way in which they choose. Rather than further disempowering an already !''!disenfranchised group, giving individuals choice in their decisions as well as balancing power in research relationships has potential to facilitate a sense of personal empowerment in the research process. The purpose of this study then is to address the following research question: For women who have been out of the street sex trade for at least two years, what do their narratives reveal about the process of exiting street sex work? To answer this question, I utilized a collaborative narrative method through an indigenous feminist epistemology, which brings together both feminist and indigenous ways of knowing. Given my training in counselling psychology, I am also conscious of my overarching counselling psychological lens. In this section, I will thus, begin by providing an introduction to indigenous philosophy followed by feminist philosophy, within which I will briefly integrate aspects of my theoretical umbrella lens of feminist counselling psychology. I will then provide a description of the integration of these two philosophies into my overarching framework for this study, an indigenous feminist way of being and knowing. Following this, I will provide a description of collaborative narrative method (Arvay, 2003). Throughout these sections, I will describe these theories and methods as well as provide a rationale for using an indigenous feminist framework and a collaborative narrative method. In the final section of this study, I will discuss the procedures for this study. !An Introduction to Indigenous and Feminist Philosophies Ontology is one’s theory of being and reality. It is the ‘who’ of who we are—our beingness. It concerns identifying that which exists through answering questions, such as ‘What is existence?’ or ‘What is the nature of existence?’ Epistemology is one’s theory of knowledge. It concerns the nature of knowledge itself including its scope and possibility through answering questions, such as ‘How do we go about knowing things?’ I will be using these terms—ontology !'(!and epistemology—as these are fitting within academic writing. However, I should note that people outside of academia, such as women in the DTES and elders in the community, may share in the beliefs discussed below but may not use the same terminology. Consistent with the opinion of many scholars, such as Maggie Kovach (2009), I believe that an individual’s ontology and epistemology are personal, experiential, and internal processes. Since a person’s way of knowing is exactly that, a personal way of thinking and understanding, it is nearly impossible to merely take up another person’s epistemology. Agreeing with this notion, both feminist and indigenous theorists (e.g., Kovach, 2009; Fine & Gordon, 1992) state that an important component of developing an epistemology involves research preparation throughout which the researcher must locate herself within the research.  Thus, for this section on feminist theory and indigenous theory, I will begin each of these sub-sections with an illustration of the history and definition of the theory. Then I will provide a rationale for why this theory is a good fit for my study. Finally, I will engage in self-reflection in a way that situates myself within the research while articulating my current epistemological positioning. While doing so, I will make the argument that this particular way of knowing is best for this study because it is a good philosophical position to take for the research topic and question, and also because it is fitting with my personal worldview and perspective. I will also provide a rationale for why each philosophy is fitting with a collaborative narrative method, which is a reflexive qualitative method involving co-construction of the research and narratives with participants.  Feminist ontology and epistemology. As women we hold illness—we remove illness from others but we must learn how to remove illness from ourselves. (Mason, 2011) !')!While my research incorporates indigenous ways of knowing from a European indigenous person’s perspective, as I will illustrate below, I am at heart a feminist. Thus, my guiding framework as a researcher and a clinician stems from a feminist way of knowing. Many characteristics of feminist ways of knowing are complimentary to indigenous epistemologies, such as their emphasis on explicit representation of theoretical frameworks, their critical lens and focus on oppression and emphasis on changing systems, as well as self-location within the research (Kovach, 2009). As discussed above and elaborated upon in the next few sections, these characteristics of both feminist and indigenous theory also fit with the research question and topic. In this section, I will review the history and description of feminist ontology and epistemology. I will then situate this theory within the context of the research and conclude with situating myself within the context of the theory. History of feminism ontology and epistemology. Feminist epistemology and methodology originated within the context of the feminist activism that occurred during the second-wave feminist movement in the 1960s and 1970s. Female scholars during this time were recognizing that many research theories and methodologies did not fit with or apply to how they as women experienced the world. This was a time during which positivism was the mainstream philosophy of the social sciences. Positivists and thus, most social scientists at that time, asserted that there is an objective truth or reality that can be discovered through specific, objective, and value-free methodologies in conducting research (see Brooks & Hesse-Biber, 2007). Feminist researchers, such as Haraway (1988), Harding (1986, 1987), and Smith (1987), began to critique positivistic notions and argued that social reality is not static and that acquiring knowledge is not a value-free, objective process. They demonstrated that women’s voices were often underrepresented in research findings and highlighted that when women’s experiences were researched, these !'*!perspectives often contradicted many mainstream research findings. As Brooks and Hesse-Biber (2007) stated “indeed, feminists exposed the dominance of the positivist paradigm as stemming not from its objectivity or its universality, but from its privileged location within a historical, material, and social set of patriarchal power relations” (p. 7).  However, as culture is never stagnant, feminist ways of knowing have also changed across time. In addition to feminist empiricism, there have been three primary strands of feminist philosophy, which include feminist standpoint theory and feminist postmodernism (Olesen, 2005). For the purposes of this manuscript, I will not illustrate each, but instead will focus on my own framework, which has borrowed central tenets from these three epistemologies and termed a third-wave feminist epistemology (Butler, 1990; Enns, 2004). Description of feminist ontology and epistemology. A feminist way of knowing is the extension of the feminist movement as a social change agent into an actual theory that promotes change. As Fine and Gordon (1992) discuss, this worldview originally focused on patriarchy and gender inequality and the structural and systemic barriers and oppression that result from these societal issues. It seeks to better understand women’s experiences and social roles. Third-wave feminist epistemology and counselling psychology acknowledges these societal issues as well, while recognizing the white female dominance of second wave feminism (Butler, 1990). Thus, this third-wave stresses a more all-inclusive version of feminism as well as the importance of intersectionality of identity. That is, it focuses on power differentials and oppression occurring not only due to gender and sex but also other aspects of identity such as race/ethnicity, sexual orientation, and class. It also incorporates less of an essentialist framework (Stanley & Wise, 1983) taking the stance, with which I agree and will discuss in the section of indigenous feminism, that our sense of ‘selves’ is neither essential nor is it completely socially constructed.  !(+!In addition to focusing on intersectionality of identity, third-wave feminist epistemology and third-wave feminist counselling psychological theory share with other feminist epistemologies the following central tenets:  ! Personal is political/Political is personal: “Individual experience does not occur in a vacuum; it is one person’s encounter with the social and cultural context, which acts to inform and transform the inner meaning of that experience” (Brown, 2004, p. 50). Therefore, political aspects, such as gender role socialization and systemic oppression, often have personal implications, such as difficulties in coping and mental health issues (Enns, 2004). Research also, has a political nature, and the political is personal. Thus, in research it is important to de-construct (through further examination or discussion) the systems within which the population (that the researcher is seeking to understand) is operating. ! Power as Categories of Analysis: As stated above, feminism and feminist psychology emphasizes that power differentials impact experience with some historical feminisms focusing solely or primarily on gender and sex (see Bartky, 1990; Ussher, 1997) and more recent feminisms, including third-wave feminism, emphasizing that power differentials result from all elements of identity and community including gender, sex, race, ethnicity, class, sexual orientation, and ableness (see Butler, 1990).  ! Egalitarian Relationship within Research: Feminist theory stresses that there is no value-free research, and thus, feminist researchers must continuously engage in self-reflection about their own values, biases, and privileges (see Fine & Gordon, 1992). In addition, feminist theory emphasizes facilitating a collaborative relationship in which the !("!researcher seeks to balance the power in the relationship and respect the voices and agency of the participants, which will be discussed in more detail next.   ! Empowerment/Giving voice: Feminists believe in valuing and affirming diversity and in ‘giving voice’ to individuals or groups whose voices have been silenced, such as women and sex workers (see Fine & Gordon, 1992). The notions of oppression, empowerment, and ‘giving voice’ are complex. Thus, feminist theory emphasizes that researchers should not take the stance of the ultimate knower and assume individuals are oppressed. Nor should they completely dismiss the idea that oppression exists and can often be invisible to the victim of oppression. Instead, as Maguire (2008) states, the goal of research is about working toward partnership rather than determining who is the ultimate knower. She says, “we both know some things; neither of us knows everything. Working together we will both know more, and we will both learn more about how to know” (p. 421). Rationale for feminist ontology and epistemology. A feminist framework for this study is fitting for a number of reasons. For one, as discussed in previous chapters, this research project is political and has political implications as well as personal implications. There are also a number of power dynamics involved in prostitution that may influence prostitutes and their experiences of identity including race, ethnicity, gender, sex, and socio-economic status. In addition, feminist theory is fitting for this study because it takes a critical perspective. As discussed in previous chapters, it is important, when trying to better understand the experience of exiting the sex trade, to critically explore these dynamics and issues of power. Furthermore, a collaborative narrative method (Arvay, 2003) fits with a feminist framework because it facilitates a critical understanding of the research. In addition, both feminist theory and collaborative narrative method emphasize the importance of a collaborative !(#!relationship and the balancing of power in the relationship. In addition, as others have argued (see Rickard, 2001), a narrative approach constructing sex workers’ life stories is a culturally-appropriate feminist research methodology when doing research with sex workers as it has the potential to facilitate empowerment in the research process by inviting participants to detail their own accounts of their experience. Situating myself within feminist ontology and epistemology. Self-location, as emphasized in feminist philosophy (see Fine & Gordon, 1992), helps provide the reader with insight into the researcher’s beliefs and values about knowledge production. Having said that, I will introduce to the reader some of my own feminist beliefs and how they came to be.  I actually cannot recall the first time I identified myself as a feminist. While it was not until graduate school that I became immersed in political feminism, feminist theory, and the literature and history on feminism, my engagement in dialogues about power differentials and gender dynamics began in childhood. I can say with great ease that my mom and her community of female friends were the primary catalysts for these beliefs. I spent many hours sitting with them—listening to their stories of how they came to be, how they think about the world as it is, and how they thought they, and others, could work to change it. Frequently, the topic of gender would come up as all of my ‘mothers’ were the primary caretakers of their children and yet were members of one of the first generations of full-time working women. They often expressed frustration due to this workload imbalance.  These women did not exactly fit the stereotypes of feminists in the 60’s and 70’s. As far as I know they did not protest human rights violations, they did not read and discuss books like The Bell Jar, and they did not organize social justice groups. They spent most of their youth working alongside men—their fathers, brothers, and ‘hired men’—on the farm, doing ‘man’s work.’ I do believe the close men in their lives, for the most part, treated them !($!as equals, primarily because they could do ‘men’s work.’ However, I know that, growing up in that era and region, equitable treatment was not always the case due to the fact that they were women. While my mother graduated with a university degree, she, to this day, prioritizes relationships. Thus, soon after graduating she married, had children, and became a full-time mother and homemaker. I think it was a combination of this type of upbringing along with her ongoing bonds with her female friends that facilitated the growth of her strong feminist values. It is interesting to reflect back now because I think that through their discussions my ‘mothers’ were, essentially through narrative and community, trying to determine how to deal with a fast changing society and their roles in it. I learned many things through sitting with my mother and her friends. I learned that in many societies men have the power (particularly in ‘old boys clubs’ as my ‘mothers’ would refer to them). I learned that it is incredibly important for me, as a woman, to obtain an education because an education in the current society is a key to power. With a good education, I would never be at the mercy of a man. This message was reinforced as many women in our community at that time were struggling because they weren’t financially able to support themselves or their families. Thus, many had to stay in unhealthy relationships, leaving them feeling quite disempowered. I learned how to ‘play the game’ particularly within the ‘old boys clubs.’ Most of these women worked in fields dominated by men and would share stories about how to ‘succeed’ in these worlds as women. They described the importance of making allies and then choosing their battles. That is, they emphasized being assertive while at the same time not being ‘too high maintenance’ to avoid getting ‘kicked out’ of a club in which they felt they only had partial membership. Finally, I learned that community and relationships are extremely important. Due to all of the power imbalances and oppressions that these women faced, it was of upmost importance to form strong !(%!community amongst women to share with one another, listen to one another, and when necessary to lean on one another for support. These were important lessons, and I am grateful for being taught such things in a supportive environment where I felt free to ask questions and share my input and, in this way, grow as a young feminist woman. Conclusion. As a feminist researcher it is important that I critically understand and, together with the co-authors, de-construct the systems (through reflection and dialogue) within which I am working. For example, in my research with female sex trade workers, my co-authors and I need to unpack the many layers and systems involved (through reflection and discourse) such as colonization, gender, and class oppression to fully understand the community of street sex workers and the experiences of this community. Consistent with feminist theory, I will collaboratively co-construct the research with the co-authors. Through respecting the perspectives of the women involved in the sex trade and facilitating having their voices heard, my hope is to balance the power in our relationship and potentially facilitate feelings of empowerment throughout the research process for the women in this study.  Indigenous ontology and epistemology. While my primary guiding framework stems from a feminist philosophy, I have had the privilege of being exposed to indigenous ways of being and thinking. Throughout these experiences, I have found personal connection with indigenous teachings. In addition, I have seen how relevant these ways of being and thinking are to this study. As a European American continually in the process of learning these teachings, I consider myself a visitor of indigenous ontology and epistemology. In this section, I shall briefly discuss the history of indigenous ways of knowing and the central tenets of the philosophy. I will then provide a rationale for using an indigenous worldview with this study as well as situating myself within the research and articulating my perspective. In this manuscript, I will use the term !(&!indigenous to mean “living in reciprocal relations with one’s place of birth” (Canella & Manuelito, 2008, p. 53). History of indigenous ontology and epistemology. As Kovach (2009) stated:  Colonial interruptions of Indigenous culture continue, and there is no way to address tribal epistemologies and Indigenous research frameworks without considering these relations. It is a dilemma that is distinctively Indigenous and sets us apart from other marginalized groups. It has become part of our collective experience and a burden that our pre-contact ancestors did not have to shoulder. The relationship with the settler society impacts our world daily. (p. 76) As the above quote illustrates, indigenous ways of knowing have existed for centuries; however, they were not incorporated into research until recently. Indigenous research epistemology grew out of this reaction to research being conducted on indigenous people without incorporating an understanding of colonization as well as without utilizing their traditional philosophies, methods, or healing practices (Hart, 2010; Smith, 2005). Indigenous scholars began to argue the importance of understanding a community’s worldview if researchers are to do beneficial, as opposed to harmful, research with a targeted community (Hart, 2010).   Description of indigenous ontology and epistemology. As indigenous scholars (see Kovach, 2009; Smith, 2005; Wilson, 2008) have articulated, indigenous theory is a bottom-up, organic process involving multiple realities and emphasizing the four R’s described in the letter above (respect, relevance, reciprocity, and responsibility) as well as an emphasis on community and relationships. The notion of ‘reality’ is also relational. As Wilson (2008) stated “rather than the truth being something that is ‘out there’ or external, reality is in the relationship that one has with the truth. Thus an object or thing is not as important as one’s relationships to it” (p. 73). !('!Reality and identity is the process of relationships with everything including living and spiritual beings, such as the land and a person’s ancestors. Smith (2005) also stated that indigenous theory is critical and focused on change. In addition, indigenous philosophy is flexible and does not occur in isolation of other theoretical positions (Smith, 2005), which is why I have explored alternative philosophies in addition to indigenous theory. The four R’s of Aboriginal health and research are central tenets to this philosophy (Smith, 2005; Wilson, 2008). As introduced in the letter above, respect is highly important in indigenous philosophy and refers to respecting all relationships (be they physical, spiritual, etc.) and valuing traditional indigenous ways of knowing and healing practices with the rationale being that we are in relations with all other life, and thus, all life and the reciprocal relations we have with one another must be respected and honored (Hart, 2010). Indigenous philosophy also stresses the importance of research being relevant to the culture and the community. This also means the research should be user-friendly and understood by the participants and other relevant individuals in the community. Reciprocity, or the third R, further reflects the relational emphasis, stressing that research, learning, and understanding should be a two-way street. The fourth R, responsibility, highlights the importance of giving back to and working with the community through community engagement and participation as well as empowerment.  Rationale for indigenous ontology and epistemology. Given the over-representation of street sex workers in the DTES (where I conducted my research) who are women indigenous to Canada, it has been ethically essential that I consult the literature on indigenous philosophies.  As stated above, within indigenous philosophy, reality is in the process of relationships with ideas and knowledge. Furthermore, knowledge is culturally-based and this cultural knowledge or these cultural practices guide the way in which Indigenous societies were formed !((!(Wilson, 2008), and thus, it is important to respect these worldviews and these cultural practices when engaging in research with indigenous populations.  One central tenant of indigenous philosophy is the stress on community and relationships both of which have been shown to be imperative in facilitating the exiting process from the street sex trade (Dalla, 2006; Kurtz et al., 2005). Indigenous theory’s critical stance and emphasis on change is also fitting with this study. As I have illustrated in previous chapters, it is nearly impossible to research prostitution without taking a critical lens and collaboratively exploring the multitude of layers involved in the entry and exiting process. It also seems imperative that this study be focused on change, as so many women currently working in the street sex industry are at high-risk of violence (see Dalla et al., 2003), psychological trauma (see Farley et al., 1998), and even death (see de Vries, 2003) As female sex trade workers are sometimes considered a fairly disenfranchised group of women, the four R’s of indigenous philosophy fit well with this study and the population. When working with individuals, such as female street sex workers, who have experienced a lack of power, choice, and respect, it is critical not to further these feelings of disempowerment and disrespect (see Coy, 2009; Rosen & Venkatesh, 2008). Rather, consistent with indigenous theory, it is important to respect them and their relations, to conduct research with them that is culturally relevant, to engage in a reciprocal relationship, and to conduct responsible research with them that is collaborative and potentially empowering. In addition, the use of a collaborative narrative method, which stresses these aspects and engages in a critical understanding of the research, is also fitting with an indigenous perspective. The importance of understanding through narrativity could also be argued to have originated !()!with First peoples whose cultures emphasized story telling and exploration through narration (Smith, 2005) and used story-telling and narrativity as means of healing (Mehl-Madrona, 2007). Situating myself within indigenous ontology and epistemology. Throughout my readings and consultations with members of local Aboriginal communities, I have become quite cognizant that to de-colonize my research, which is an ongoing process, I must be in a continuous process of cultural immersion. I need to conduct research that is culturally-relevant to the community. I must also reflect upon my own cultural background and my own indigeneity and how these relationships will play a role in my research preparation.  My way of knowing stems from a white middle-class heterosexual female’s perspective. I grew up in a rural community in the Midwestern US. My family origins can be traced primarily back to Norway with some ancestors coming from Germany and Ireland.  However, my family is true to the American melting pot as they comically inform me “you’re a mutt” whenever I inquire about my roots. That being said, the northern Midwest, which is primarily populated by individuals of Scandinavian ancestry, has a rich culture of its own that encourages a Protestant work ethic, strong community ties, and plenty of Scandinavian and Lutheran styles of cooking that always involve massive gatherings of people. We are also lovers of land and space who are known to be strong and resilient due to our long and brutal winters.  While my family and ancestors are, and were, lovers of the land, in the Midwestern US, we are lovers of a land upon which we are guests. The First Peoples of this land, the Sioux people, inhabited the land long before my time there. Unfortunately, due to the massacres and other colonizing tragedies, those who survived were forced to move to government-designated areas and many continue to live there today. I must admit this group’s presence was never really made known to me by my elders and public educators except to !(*!acknowledge that they once lived here. In school, we learned the history of the Native American people, but the genocide was glossed over. Interestingly, I was educated in fairly great depth on the Holocaust and the African Slave Trade and the travesties that happened in both contexts. I have often wondered why it is that one tragedy was openly discussed while another remained invisible in my education. Throughout my master’s in counselling program, I was encouraged to explore my privileges, particularly my white privilege. Again, however, the discussion of colonization and the continuous oppression of Native Americans remained, for the most part, absent in the discussion. I must admit it was not until moving to Canada, where colonization is more commonly discussed, that colonization and its devastating intergenerational effects became not only apparent, but an added lens through which I see the world. Thus, my way of knowing and my ‘process’ throughout this project will be very much entrenched in the continuous unpacking of my whiteness and the privileges this affords me as well as my own ancestral and indigenous roots. That being said, I am conscious of the fact that my indigeneity is European, not North American. Therefore, my way of knowing can never fully come from a North American indigenous perspective. However, by being continuously reflexive and open about my cultural background and its effects on my research, as well as engaging in a continuous discussion with indigenous scholars and members of the community, I believe there may be a place for a non-North American indigenous woman to conduct de-colonizing research although I approach this process with great curiosity and openness to learning and feedback.  Conclusion. As stated in previous chapters, it is important to approach research with sex workers from a critical perspective to understand a more comprehensive picture of the !)+!experience including the racism and sexism that is perpetuated in sex work. Particularly, in Vancouver’s DTES, it is important to reflect upon the impact of colonization and its intergenerational effects. Using an indigenous framework and lens, in this study I explored women’s experience of exiting the sex trade using this critical perspective and incorporating these ways of understanding. In addition, as I was raised to value community and continue to emphasize the importance of relationships in my world, an indigenous way of knowing is fitting for my personal worldview and values. It is also fitting with the research topic given the importance of community and support networks when exiting the sex trade. Furthermore, as articulated in the letter at the beginning of this chapter, my intention throughout this study has been to keep the four R’s of indigenous philosophy at the heart of my research—respecting the women involved in the study, their ancestral backgrounds, and the implications the study may have on them and others. I did my best to respect cultural knowledge and practices in my research through self-reflection, consultation with indigenous scholars and the DTES indigenous community, as well as open discussion with my co-authors. I also incorporated other perspectives, such as feminist theory (as discussed above) into my understanding. To bring together the two worldviews (i.e. indigenous and feminist) discussed here, which, as discussed above, are fitting with the research question and topic as well as myself personally, I elaborate upon what is called an indigenous feminist perspective in the next section. Indigenous Feminist Ontology and Epistemology  In this section, I will ally the ideas from the two philosophies discussed above and describing what has been termed indigenous feminist philosophy. This philosophy, however, is a rather new perspective and variable in terms of definition, and thus, I will illustrate the limited discourse that does exist on this topic. Given the newness and thus, limited literature on this !)"!theory and the vagueness and inconsistencies in the descriptions; however, I will draw the central tenets from the two theories to ally the philosophical commonalities while accounting for theoretical inconsistencies. Similar to above sections, I will discuss the history of indigenous feminist ontology and epistemology which will be followed by a breakdown of a description and illustration of indigenous feminist ontology and then indigenous feminist epistemology. Finally, I will provide a rationale for why indigenous feminist philosophy is fitting for this study and as well as for my personal worldview.  History of indigenous feminist ontology and epistemology. As discussed above, throughout feminist theory’s history, many, particularly women of color, began to challenge feminism’s focus on white women’s lives which promoted an ‘othering’ of women of color (see Butler, 1990; Grande, 2004). Thus, numerous women of color began to articulate new feminist epistemologies that were more consistent with their worldviews. Many indigenous female scholars agreed with this discourse and began to determine how feminist theory could be allied with an indigenous model (see Cannella & Manuelito, 2008).  That being said, not all indigenous scholars believe feminism to be a good fit with indigenous worldviews (see Fredericks, 2010; Grande, 2004). As stated above, indigenous philosophy takes a bottom-up approach, and thus, the argument these scholars make is that taking an already conceived western concept, such as feminism, and applying it to indigenous worldviews goes against this bottom-up way of thinking. I agree with this notion, which is why in this section I explore how the two philosophies can be allied as opposed to integrated. As Fredericks (2010) stated “Feminisms, or elements of feminism, can be one vehicle among many for the Aboriginal struggle to reaffirm, reinstate, and reempower who we are as Aboriginal women” (p. 549). In addition, some argue a place for indigenous feminism given that ethnic, !)#!gender, and class issues have determined Native women’s struggles (Castillo, 2010). As stated earlier, the newest wave of feminism, known as third-wave feminism takes into account intersections of identity including race, ethnicity, gender, sex, and socioeconomic status. Using a third-wave feminist approach allied with an indigenous perspective has the potential to allow for affirmation and valuing of all aspects of identity as well as relationships with self, others, and nature. Description of indigenous feminist ontology. While indigenous and feminist theories on beingness and reality are by no means one and the same and have different histories, they share a number of common worldviews. Both ontologies, as well as an indigenous feminist ontology, reject the notion of essentializing (Cannella & Manuelito, 2008) and a single reality and, instead, maintain that there are multiple realities (Wilson, 2008), with these realities being contextually ‘real.’ In addition, one’s individual’s beingness is viewed as being highly relative and contextual (Stanley & Wise, 1983). As Stanley and Wise (1983) stated:  People experience their ‘selves’ neither as complete social constructions nor as essential and ‘uncultured’ sites of unchanging difference. Rather, ‘the self’ is the production of interaction and social construction and is irrevocably social and cultural in its basis. However, although dynamic in its constitution, ordinarily the ‘self’ is experienced as in stating—‘this is me’—at any one point in time. (p. 194)  Both theoretical lenses views the world as having ‘real’ structural barriers, such as patriarchy, oppression, and colonization, in the material world and that both have ‘real’ devastating consequences (see Canella & Manuelito, 2008). Through a traditional feminist theoretical lens, however, these barriers focus primarily on oppression and equity through patriarchy; most leave out the discussion of colonization (Grande, 2004). Whereas, through an !)$!indigenous lens, these structural barriers focus on colonization and the history and experience of being colonized (Grande, 2004). In an indigenous feminist ontology, these ‘real’ systemic barriers of colonialist, capitalist, and patriarchal oppression of women, men, animals, and nature are highlighted (see Cannella & Manuelito, 2008). Thus, indigenous feminist ontology (as illustrated in figure 1) takes the perspective that the self and one’s experience is relational and socially constructed. However one’s identity and experience is contextually ‘real’ meaning that one’s reality and identity exists in a ‘material world’ where oppression occurs through these ‘real’ structural barriers. How one understands and makes meaning of these ‘real’ structural barriers is personally constructed. Figure 1. Indigenous Feminist Ontology  Colonization Patriarchy Indigenous Ontology Feminist Ontology ! Critical Stance (e.g., power, voice, choice, control) ! Equity and human rights ideals ! Activism   " Relationships with Community, Land, Ideas " Nature is Teacher " Reciprocity/ Sharing Indigenous Feminism  Oppression Through Structural Barriers Situated in a Material World !)%!Description of indigenous feminist epistemology. The idea of indigenous ontology is similar to indigenous epistemology. In fact, within an indigenous research paradigm, the ontology, epistemology, methodology, and axiology are circular and intertwined (Kovach, 2009). “All life’s plural, and there are lots and lots of circles, they dither about in circles, all these lives. Within all of those circular, circulars, everything has an interactive capacity with everything else” (Allen, 2008, p. 139). Feminist ways of knowing are also similar to or consistent with ways of being. One main emphasis within a feminist way of knowing is to ‘resist’ oppression by understanding and deconstructing systemic oppressions, raising consciousness within the community, and empowering those who have been silenced.  An indigenous feminist epistemology (see figure 2) then is a critical framework that integrates core ideologies from both indigenous and feminist theory (see Cannella & Manuelito, 2008). Using this framework, I am taking the perspective that knowledge and experiences are socially constructed (including our understanding of institutional power and privilege). However, I am acknowledging and exploring the real effects (e.g., intergenerational trauma) these systemic barriers (e.g., patriarchy and colonialism) have on people. Thus, indigenous feminist epistemology is similar to an indigenous feminist ontology while focused on ‘resistance’ of these real structural barriers through community, relationships, consciousness-raising, and empowerment. Empowerment in the indigenous sense emphasizes rebuilding as well as reviving the breakdown of indigenous women’s cultural and spiritual practices as well as promoting healing (Fredericks, 2010).     !)&!Indigenous Epistemology  Feminist Epistemology  ! Situated Knower ! Empowerment/ Giving Voice ! Raising Consciousness ! Deconstructing Systems   " Relationships with Community, Land, Ideas " Nature is Teacher " Reciprocity/ Sharing  Indigenous Feminism  Resistance of Structural Barriers through Empowerment & Community  Situated in a Material World Patriarchy!Colonization!Figure 2. Indigenous Feminist Epistemology             Rationale for indigenous feminist ontology and epistemology. As I have illustrated in previous chapters, the experience of exiting the street sex trade in the DTES often involves many layers including one’s race, ethnicity, gender, socio-economic status, as well as intergenerational and historical components, such as colonization. These layers thus, need to be understood to fully grasp the experience of exiting the sex industry. It should be noted in using this theory, I make no assumptions that there is a lack of a real world. Rather, this study focuses on how these women’s construct their understandings of their reality and their identity within this real material world, which has real, and sometimes devastating, effects resulting from various factors including systemic oppression. Using an indigenous feminist framework, which facilitates this critical perspective, allows for a deeper understanding and appreciation for the diversity of the !)'!experience of exiting prostitution, such as how these various layers of identity as well as power and privilege. In addition, as discussed in Chapter Two, and consistent with an indigenous feminist approach, many women who have exited the sex trade highlight the importance of relationships and community in making the transition.  Also as discussed in the previous sections, both indigenous and feminist worldviews are consistent with a collaborative narrative method. Both emphasize the importance of empowerment and relationships in research. In addition, both stress the necessity to understand experiences critically, which a collaborative narrative method also highlights. Furthermore, this method is also fitting within an indigenous feminist framework as it emphasizes the importance of disseminating findings in culturally appropriate and collaborative ways. Situating myself within indigenous feminist ontology and epistemology. Consistent with an indigenous feminist philosophy, I believe that there are multiple realities and that our realities are relative and contextual existing in a real material world as described above. Thus, I believe that we are socially constructing our understanding of institutional power and privilege; however, these structural barriers have real effects on individuals. I believe that knowledge construction is political and privileged and that various elements including our gender, sex, race, ethnicity, class, and colonial histories help facilitate our way of being and knowing in the world. I believe strongly in the importance of acknowledging and contesting these privileges and powers of all kinds, as well as challenging dualistic ideas such as masculine versus feminine or black versus white. In addition, I believe that centuries of structural barriers, such as patriarchy and colonization, have complicated these realities and need to be acknowledged when deconstructing power and systemic oppression. As a researcher, I see the need to continuously !)(!explore and deconstruct my values and biases and deconstruct the systems and histories of those systems within which the co-authors and I are operating.  I believe that our way of being and knowing is strongly influenced by our relationships with, or within, our communities (be that our human community, our plant community, our animal community, or, if we choose, our spiritual community). While I have not imposed this belief on my co-authors, I personally agree with this tenet and have been open to the idea that some of my co-authors may also believe in such interrelationships and include discussions of nature, environment, and ancestry in their narratives.  Conclusion. As a feminist researcher who is indigenous to Europe, and not Canada, I use extreme caution when allying these two theories, as I am still learning about my own indigenous background as well as the teachings of First Peoples of Canada. I, do, however, believe that having an understanding of indigenous worldviews is important when working with women who are indigenous to Canada in the DTES. While many women may not have a connection to their ancestral background, those who do may appreciate approaching research and exploration from an indigenous paradigm. While the method I used (and discuss next) does come from a western framework, it allows for openness in terms of co-construction of knowledge and understanding. That being said, I believe that my way of being in the world and knowing the world around me is constantly in flux. Thus, I embrace the opportunity to continue to learn and incorporate such teachings into my epistemological and ontological perspectives.  Collaborative Narrative Methodology “Life is not merely a story text: life is lived, and the story is told.” (Polkinghorne, 1988, p. 154) !))!The quote above provides a segue into the next section on research design where the importance of narrativity and storytelling in understanding experience is discussed. As in previous sections, I will begin with a brief discussion of the history and description of collaborative narrative method, but as I will expand upon this research design in the procedures section, only a brief definition of collaborative narrative method (Arvay, 2003) will be introduced in this section. I will end this section with a discussion of the rationale for using this research design in this study as well as its fit with myself personally as the researcher. History of collaborative narrative method. Arvay (2003) developed the collaborative narrative method out of narrative inquiry (see Polkinghorne, 2008; Riesmann, 1993). Narrative inquiry is rooted in social constructionism, which is an epistemological position emphasizing that realities are socially co-constructed through language and story telling. In addition, within social constructionism and narrative inquiry, power relations and privilege are strongly believed to impact these co-constructions and the meanings derived from them. Within a collaborative narrative research design these beliefs are maintained, but also incorporate a reflexivity piece in the method itself, both of which will be discussed next. Description of collaborative narrative method. As Arvay (2003) described, a collaborative narrative method is a reflexive method that scrutinizes the researcher’s own process and how privilege and power play into the research relationship as well as the co-construction of the research narratives. Thus, it emphasizes researcher self-reflection throughout the execution of the study as well as a collaborative approach to constructing the research and narratives. In addition, following the interviews (discussed in the procedures section) the researcher and participant collaboratively analyze the data by ‘reading’ the narratives for four different interpretations of the story, including: (a) content, (b) who the narrator is, (c) the research !)*!question itself, and (d) the power dynamics involved in the story. To avoid redundancy, I will not elaborate further and direct the reader to the final section of this chapter on procedures. Rationale for collaborative narrative method. I believe a collaborative narrative method is most appropriate to answer my primary research question: For women who have been out of the street sex trade for at least two years, what do their narratives reveal about the process of exiting street sex work? According to Buchanan (2010a), through stories we render meaning, purpose, and intention as humans. Using this approach then, the women in this study have been able to tell their stories in their own way and, as co-creators of the research, they have had voice in the way in which the data were analyzed and interpreted. Having voice in this process thus, has had the potential to facilitate feelings of empowerment in how their stories are told and represented. That said, throughout the study I have been conscious and reflective of the intrinsic imbalances in power and privilege that exist in research given that I am the researcher collecting the data from the co-authors. As I reflect upon in the credibility and trustworthiness section of this manuscript, I continuously engaged in a process of self-reflection on these power and privilege differences to do my best to balance the power in my relationships with the co-authors. This method has been used to study the experience of trauma (Cortes & Buchanan, 2007) and same-sex desire, (Logan & Buchanan, 2008) to name a few.!According to Riessman (1993), a narrative method is well-suited for studies that explore contextual aspects of experience because it allows for the possibility to examine issues such as oppression, gender and racial inequalities, as well as power dynamics that the individual speaker may take for granted. Barthes (1966) agreed, stating that narratives serve a function at two distinct levels including the individual level (i.e., the stories of one’s current, past, and future life) and the sociocultural level (i.e., stories that unify common values and cultural beliefs. !*+!Together then, using Arvay’s (2003) collaborative narrative approach, the co-authors and I have critically deconstructed these aspects and how they have influenced experiences in the sex industry and the exiting process.  Riessman (1993) also argued that a narrative approach is well suited for studies of subjectivity, as this method emphasizes both imagination and human agency. To elaborate, she stated, “Human agency and imagination determine what gets included and excluded in narrativization, how events are plotted, and what they are supposed to mean” (p. 2). Thus, using this method and adding Arvay’s (2003) collaborative element to it, both the co-authors and I, as the researcher, have been able to use our creativity to co-create the stories and determine the ways in which the stories are interpreted.  As Benoit, Jansson, Millar, and Phillips (2005) discussed in their research with sex workers, conducting collaborative studies using community-academic cooperation with this population is necessary to research such ‘hidden’ or ‘hard-to-reach’ populations. Similarly, Boyd (2008) discussed the negative ramifications of ‘helicopter’ style research that dominates Aboriginal peoples and individuals living in the DTES. She described how researchers who are outsiders of the DTES have furthered their own careers through racializing, pathologizing, classifying, and criminalizing the residents of the DTES. Continuing on, she stated that:  People living or associating in the Downtown Eastside may not be familiar with the written work of researchers; however, they certainly understand the dynamic of being under the gaze of Western (mostly white) researchers. (Boyd, 2008, p. 10)  Thus, using a collaborative narrative approach, I worked with the women who participated in this study on the way in which their stories are represented. !*"!Situating myself within collaborative narrative method. I find that this method fits with my personal worldview as I believe strongly in relationships and balancing power in these relationships as much as possible. Thus, through utilizing a collaborative narrative method, my intention has not been to ‘give’ voice. I feel that all people have a voice and it is more a matter of facilitating that voice to be heard in a genuine fashion. I also feel it is important to engage in knowledge translation activities (outlined below) whereby the research ‘findings’ are disseminated to the community appropriately so they can be utilized by this community. Many refer to sex trade workers as disenfranchised or marginalized but, as I have learned through my experience working with this population in the DTES, these terms often do not sit well in the DTES and often facilitate a further feeling of disempowerment. As an Aboriginal participant in the DTES stated: Even though I’m a strong woman on the outside, deep down I’m hurting and many of us women are like that. But we don’t show it because we don’t want people to look at us like we’re less than we are. It’s just our way; we walk with our head high and proud. (Benoit et al., 2003, p. 824) Thus, I have intended to respect that feeling of pride and desire to not be ‘talked down to from the ivory tower’ by allowing them to language their experience in their own words.  Conclusion. Using a collaborative narrative method, which I will elaborate upon in the final section of this chapter, as much as possible, I have co-constructed knowledge and understanding with the women in this study. Together, we have also taken a critical look at their process of exiting the street sex trade. As discussed in the above sections, employing a collaborative narrative research design within an indigenous feminist theoretical framework is consistent with the goals of this study and the main research question investigated as well as also !*#!fitting with my own worldview as a researcher and a person. In the following section, I will be describing the research procedures for a collaborative narrative method. Research Procedures Ethics. The University of British Columbia Behavioural Research Ethics Board (BREB) granted permission for this study (Certificate #H12-00586). After I obtained approval from BREB, I began recruiting based on the inclusion and exclusion criteria described in the next section. Recruitment. The co-authors were recruited through advertising via posters (see Appendix A) in local agencies that assist women and/or sex trade workers in the DTES (e.g., PACE Society, Sheway, Crabtree Corner Program and Services), housing establishments (e.g., RainCity Housing and Support Society), online sources (e.g., Craigslist), and through word of mouth or snowball sampling procedures. I conducted telephone-screening interviews with interested co-authors prior to the first interview to go over study expectations and to determine if the interested co-author met the inclusion criteria (see Appendix B). During this time, potential co-authors had the opportunity to ask any questions that arose regarding the study and their participation. If the potential co-authors met the inclusion criteria (discussed in the following section), an initial interview was scheduled. Co-authors: Inclusion and exclusion criteria. Consistent with this method (Arvay, 2003), co-authors were eight female street sex trade workers who had exited the street sex industry. A small sample size is appropriate for this method because as Riessman (1993) stated: Narrative analysis is not useful for studies of large numbers of nameless, faceless subjects. The methods are slow and painstaking. They require attention to subtlety: nuances of !*$!speech, organization of a response, local contexts of production, social discourses that shape what is said, and what cannot be said. (p. 69) The majority of published narrative studies have a sample size of four to twelve participants. To be eligible to participate in this study, co-authors had to be 19 years of age or older, who were fluent in English, and self-identified as female. Thus, individuals who were transgender but self-identified as female were eligible to participate in the study. However, no persons identified as transgender in this study. Consistent with the majority of studies on sex workers (see Dalla 2001, 2003, 2004), co-authors had to have been involved in street-level prostitution for at least two years. This number ensured that the co-authors had spent a significant amount of time in the industry as opposed to, for example, someone who had turned a single trick. The co-authors had to have been out of the street sex industry for at least two years. Putting restrictions on this helped to ensure that the co-authors had transitioned out of the industry for long enough that they had sufficient time to reflect on their exiting process. Given the strong relationship between sex work and substance abuse (see Coy, 2009), I discussed with potential co-authors their current experience with substances and addiction to determine, together, on a case-to-case basis, capacity to consent. Consistent with research conducted in the DTES (see Bell & Salmon, 2011), which has found that women who use substances in the DTES were critical of the supposition that individuals who use drugs lack the ability and capacity to consent to participate in research, I asked each co-author who reported substance use if they felt they had the capacity to consent. The four women who reported substance use stated that they had the capacity to consent. Similarly, potential co-authors and I conversed about any current mental health concerns to determine capacity to consent. For those who reported current mental health concerns, such as PTSD, I again inquired if they felt they had the capacity to consent. All of the women who !*%!reported current mental health issues stated that they had capacity co consent to participating in research. The actual co-authors’ demographics will be shared in Chapter Four.  Informed consent procedures. The informed consent process began with the telephone screening and was ongoing throughout the study. During the telephone screening, I briefly introduced the purpose of the study and discussed the co-author’s rights. If the potential co-author met the criteria and agreed to participate, she and I met for the first interview where we reviewed and signed the formal consent form (see Appendix C) and completed the background information form (see Appendix D). As I wanted this study to be as collaborative as possible (while being open about the power dynamics that do exist in any researcher/participant situation), I was candid in my description of the study, its purpose, as well as the potential risks involved. I also articulated the study’s procedures and the collaborative nature of the study. I made it clear that this is the co-author’s story and that she was free to not only share what she would like based on her comfortable level, but also to elect not to answer questions during the data collection process, or to withdraw from the study at any time without any consequences. Had a co-author become upset during the interview, which did not occur, I had the skills to resource her and would have stopped the interview to do so. I would not have resumed the interview until she was ready at which point I would have checked to see whether she was able to give informed consent. If a co-author felt she needed to process her experiences and feelings further, which also did not occur, I would have provided her with referrals to low-fee or free counselling agencies (see Appendix E). To protect her identity, I asked each co-author to choose a pseudonym that would be used in this final manuscript. I informed her that her actual stories and themes that go into this final document would be edited versions. I assured her that I would be involved in the process of constructing her narrative and that she would play a significant role !*&!in how her story is represented in this final text (see details below). I articulated, however, that ultimately, I as well as UBC owns the story but that I would do my best to respect her wishes in how her story is depicted. Compensation. In order to defray the costs of any transportation or inconvenience created by involvement in this research and consistent with research with this population (Bell & Salmon, 2011), each co-author received an honorarium of $20 per interview. Each co-author also received compensation in the amount of $5 per interview for transportation to and from interviews as well as any costs for childcare ($20 per interview) while attending meetings with me. Procedures for Collaborative Narrative Method Within a collaborative narrative methodological framework, the research relationship is key (Arvay, 2003) with the research in this paradigm often described as a co-constructed conversation. The person telling the story and the person listening to, and interpreting the story are developing meaning together. Using Arvay’s (2003) collaborative narrative method, I met with each co-author on four separate occasions. Two open-ended individual interviews were conducted sequentially, each lasting approximately one hour. Then, a three-hour data analysis review was collaboratively completed. Finally, an hour-long member checking session was held, where we reviewed the overall data. These are average times for each interview, and, thus a co-author’s total commitment time was approximately six hours.  Consistent with this method, both the narrator and the listener are developing meaning together and freedom must be given to both to do so in an open dialogue. Therefore, I started each initial interview with “Now we are going to begin the interview. To start, I would like to invite you to tell me the story of exiting the street sex trade.” The co-authors were invited to start !*'!where they chose and throughout the meetings I used probes, encouragers, and empathic reflections, to clarify meaning, to inquire further about definitions and examples, to encourage elaboration, and to reflect my understanding of the co-authors’ experiences of exiting the street sex trade. To allow for reflexivity in terms of my reactions to the women’s stories, my role in the research process, as well as my feelings and attitudes regarding the process, prior to and following each interview, I journaled about my experience. I also invited the co-authors to reflect on the interviews and on their exiting process between data collection interviews. The procedure for, and the focus of each of the audio-recorded interviews are detailed below. All meetings took place at the author’s professional office.   Phase 1: Research interview 1. Consistent with a collaborative narrative approach (Arvay, 2003), my role in the research relationship was to invite a story from the co-author in a way that was sensitive to her experiences. As such, the main goal of this first meeting was to build rapport with the co-author. The co-author and I began by discussing the informed consent process (introduced above), which was ongoing throughout the interviews. Moreover, in the first hour-long audio-recorded interview, I worked to establish the relationship and invited the initial narrative by stating: “Now we are going to begin the interview. To start, I would like to invite you to tell me the story of exiting the street sex trade.” At the end of this interview, I also invited the co-author to reflect upon the process of exiting the sex trade and bring with her in the second interview an object (e.g., a photograph or poem) or metaphor that she felt was representative of her exiting process.    Phase 2: Research interview 2. The purpose of the second hour-long audio-recorded interview was to allow the co-authors time for reflection upon their experience of exiting after narrating this exiting process in the first meeting. I began this second interview by reviewing !*(!informed consent. Additionally, as the use of images and metaphors can be a powerful process that can access a whole new way of knowing utilizing a different aspect of the self than the spoken word (see Higgs, 2008), during the second audio-recorded interview, in addition to speaking with me, if she desired, the co-author had the opportunity to bring an object or metaphor that she felt represented her experience of exiting. I invited her to discuss this object or metaphor as well as reflect upon her overall process of exiting the street sex industry. Together we explored in this interview what was helpful, what was hindering, and what advice and/or wisdom she had to share with women currently in the sex trade as well as mental health providers. Following this meeting, I informed each co-author that I would be transcribing the interviews and invited her to meet with me a third time (approximately one month after these initial meetings) to collaboratively analyze the data.  Phase 3: Transcription process. In an effort to prepare the qualitative interviews for the process of data analysis, I transcribed the spoken elements of research interview one and two verbatim, as outlined in Arvay’s (2003) collaborative narrative method. However, there are many other important pieces of data that occur in a conversational interaction, which cannot be transcribed ‘verbatim,’ particularly nonverbal components of language. As much as possible I captured the non-verbal elements of the narratives—coding and transcribing them using the following key: (a) long pauses (more than three seconds): five dots (e.g., …..); (b) short pauses (less than three seconds): three dots (e.g., …); (c) loud voice: bold followed by emotion label (e.g., YES, anger); (d) soft voice: italics followed by emotion label (e.g., Yes, distress); (e) silence: underline with amount of time on top of line (e.g., 1 minute); (f) emotionality expressed: red for anger, orange for confusion, yellow for happy, green for fear, blue for sadness; and purple !*)!for stress or anxiety; and (g) bodily expressions (noted in my self-reflection following each interview): described in brackets (e.g., [arms flailing]).  Phase 4: Collaborative narrative review and analysis. Following transcription of research interview one and two, I met with each participate for approximately three hours to ensure that I had accurately transcribed the two research interviews as well as to collaboratively analyze the data. I audio-recorded this meeting and used any feedback and additional information they provided throughout our conversation to assist in writing up the final narratives and themes. Procedure analysis steps. Consistent with the collaborative narrative method, each co-author and I met and both read, discussed, and coded the two transcripts along the following four interpretations: 1. Reading for Content: At the beginning of the collaborative analysis meeting, I provided each co-author with a copy of the transcripts from research meeting one and two. I then gave each co-author time to read through the transcribed interviews. We first read for content throughout which we made any needed corrections to the transcript and then read for the ‘whole picture’ or the overall story. 2. Reading for the Narrator: Following the initial reading, we read for the narrator where I asked each co-author to reflect on and share with me her experiences as the narrator of the story. In doing so, together we explored how she was situated in the story, what she was feeling, what her struggles have been, what meaning she was trying to convey, as well as what she preferred to keep private.  3. Reading for the Research Question: Throughout the third reading, we read to answer the research question of how she narrated her experience with exiting. During this reading, I asked each co-author to reflect on her process of transitioning out of street !**!sex work including why she left street sex work, how she was able to make the transition out of the street sex trade, what she found helpful throughout the exiting process, as well as aspects of her experience that she perceived to be barriers along the way. 4. Critical Reading: Finally, we explored how she felt aspects such as power, class, gender, and ethnicity had influenced her experiences in the sex industry and the process of exiting. We collaboratively looked at ways in which her personal realities had been challenged contextually, including her struggles with inequities, ways in which she had been silenced and not able to express her voice, as well as her awareness of power and privileged influences in her life. In addition, this reading explored relational components of her exiting story. Phase 5: Composing the narratives. After collaboratively reviewing the transcripts with each co-author, I composed a narrative (based upon interviews one and two and any additional information from the collaborative analysis meeting) of the co-author’s experience of exiting the street sex trade. This narrative began with an introduction to the co-author, which was followed by the story of her experience of entering and exiting the street sex trade. Finally I provided a summary of the co-author’s current situation and future goals, which included, for those who shared this with me, the meaning that they have made of their story. Phase 6: Cross-narrative thematic analysis. After composing all of the narratives, I integrated any additional feedback discussed during the collaborative analysis meeting into each of the women’s individual analysis. I then coded all of the women’s data according to overall emerging themes (i.e., overarching categories that describe the process of exiting the street sex trade) – highlighting similarities as well as differences in their experiences with exiting the street !"++!sex trade. To conduct this overall analysis, I used Braun and Clarke’s (2006) cross-narrative thematic analysis which involved the following phases of analysis: (a) familiarizing self with the data, (b) generating initial codes, (c) searching for themes, (d) reviewing themes, (e) defining and labeling/naming themes, and (f) writing the final report.  Phase 7: Collaborative review of the narratives and member check of overall analysis. Following the composition of the narratives and execution of the overall thematic analysis, I had a fourth and final meeting with five of the eight co-authors who participated in this study, in order to verify their narrative and member check the data analysis process. Unfortunately, despite several efforts, I was unable to locate two co-authors following the second meeting and a third co-author following the third meeting. I initially met with the co-authors individually to collaboratively discuss their personal narratives and to ensure that I had accurately presented their stories. If a co-author had not agreed with the narrative I had composed, which was not the case in this study, she and I would have discussed this and, if necessary, I would have taken in her additional feedback and re-wrote the narrative or left out the narrative entirely. Subsequently, I conducted a member check with five co-authors where I shared my findings and verified that these findings fit with the women’s experiences. As this was a summary of all co-authors’ information, I discussed with the women that some similarities may exist but the findings may not necessarily match their experience entirely. If a co-author had not seen her experience or her story in the findings she and I would have discussed this, and if necessary, I would have taken in her feedback and re-evaluated the codes I posed. This was not the case in this study.  Credibility and Trustworthiness  Given the qualitative nature of this study, traditional criteria used to evaluate quantitative research (e.g., validity, reliability, and generalizability), cannot be used as measures of rigor as !"+"!these concepts are not applicable to and are inconsistent with the philosophies of qualitative methods. Rather, in qualitative research, it is more relevant to discuss the integrity and value of a study by evaluating its credibility and trustworthiness. Thus, in this section, I will discuss the credibility and trustworthiness of this study with these terms referring to the believability of the source (i.e. myself as the researcher) and the findings. I will attend to credibility and trustworthiness of myself as the researcher and reflect upon the following aspects of myself (as the researcher) and the research process: (a) the powers and privileges I have brought to the research process, (b) my assumptions and pre-suppositions of the research topic, and (c) how I engaged in a continuous process of reflexivity about the research process and myself as the researcher. I will conclude this section by articulating the criteria that I used for evaluating the worth and rigor of the findings.  Power and privilege. As a middle-class educated individual of European descent and American upbringing as well as my position as a researcher and academic, I am aware of the immense privilege and power differentials I have brought to these research relationships. To balance the power in the relationships, I have been open about these power differentials and engaged in continuous self-reflection as well as invited discussion about the co-authors’ feelings regarding these power differentials. I also utilized a collaborative narrative method, which as discussed above invites the co-authors to collaborate on the way in which their stories are told, organized, and presented.  Assumptions and pre-suppositions. As I have been researching as well as talking to women entering, being involved in, and exiting the sex trade, I have become aware of some of my assumptions or pre-suppositions regarding the process of exiting street prostitution. I am also conscious of how my training in counselling psychology has shaped my lens to see psychological !"+#!aspects of people’s worlds including mental health issues, challenges, and needs. That said, many women involved in street prostitution in the DTES are dealing with addiction issues and, often, concurrent mental health issues, such as anxiety and depression. Thus, one of my biases in this project has been that many women who are exiting the sex industry may need mental health services including addiction treatment and counselling to work through their challenges. Similarly, many women who are involved in street-level sex work in the DTES have histories of childhood abuses and have often experienced further violences and traumas while working in the sex industry. Thus, one of my assumptions has been that my co-authors may need to process the many layers of trauma through counselling or other healing traditions, such as sweat lodges and smudging. Given the high rate of female prostitutes in the DTES who are indigenous to Canada and the historical effects of colonization and residential schooling, one of my biases has been that many women may be seeking healing for this intergenerational trauma and may desire to do so through their traditional healing practices or in conjunction with more western mental health counselling. Given the research on exiting that emphasizes the need for social support throughout the process, one of my assumptions has been that these women may discuss a need for relational connections whether this be through family, friends, support services workers, or others. Finally, due to the high rate of homelessness amongst street workers in the DTES as well as the legal status and stigma surrounding prostitution in Canada, one of my pre-suppositions has been that many women in the process of exiting may be needing assistance finding legal employment, housing, and potentially dealing with criminal backgrounds if they had been arrested for soliciting while working in the sex industry.  Reflexivity. Consistent with the method (Arvay, 2003), I have engaged in a continuous process of reflexivity and have been critical about my own research process throughout the !"+$!study, which has included de-constructing myself and my actions, engaging in ongoing self-reflection, journaling, and taking field notes throughout the research experience. I have continuously engaged in a process of examination of how power and privilege relations are impacting the research relationships as well as the co-construction of narratives. As the co-authors are the experts in this study, to provide feedback and verify that I have not merely ‘found’ my anticipated results, I conducted member checks with the co-authors themselves as well as sought feedback from expert peer reviewers, which will be discussed below. I have also engaged in an informal process of debriefing with colleagues where I have, when necessary, consulted with my supervisors and dissertation committee members throughout the research process.  Criteria for Evaluating Worth of the Study. Given that this study used an indigenous feminist epistemology and a collaborative narrative method, the criteria for evaluating worth of the study could not be based on traditional post-positivist ideas of validity. Narrative method is interpretative and about revealing relative, contextual truths of the co-authors’ experiences. Thus, consistent with this type of method and philosophical framework (Arvay, 2003), I generated alternative criteria, based on the sample and research question, to evaluate the rigor of the study and examined the themes based on these criteria. These criteria, which will be expanded upon below, included the following: (a) pragmatic value, (b) resonance, (c) verisimilitude, and (d) catalytic. To evaluate these criteria I conducted member checks as well as consulted with experts in the community. I evaluated if this study had pragmatic usefulness (e.g., Can this be applied to the real world?) (Buchanan, 2010b) by having a conversation with community service workers in the DTES to elicit feedback concerning this criterion. These community service workers were a !"+%!group of women who do support work with female street sex workers in the DTES and have expertise and knowledge in the area of exiting street sex work. These workers provide women in the sex trade with counselling and guidance, they refer to appropriate community resources, and they advocate for the women when necessary. They stated that the themes I identified resonated with what they see in their work and that the research does have pragmatic value. They reported that these findings also have the potential to provide support workers in the DTES community with a comprehensive framework to understand the exiting process and thus, better serve women who desire to exit street-level sex work.  I also determined if the findings resonated (Buchanan, 2010b) with the population (e.g., If you lived in this circumstance, does it resonate as truthful?) by conducting a member check with each co-author. The co-authors verified that the stories and themes resonated with their experiences. They shared with me that their narratives were consistent with the stories they told and that the overall themes fit with their own experiences of exiting sex work. Furthermore, as some women were reading through the themes, they sometimes saw pieces of others’ stories that they had not personally shared with me but also recognized as parts of their own journeys. Further, as Stivers (1993) states our interpretations of the stories told are partial and alternative truths. Thus, rather than the goal of research being the demonstration of truth, the aim of narrative is increasing our understanding as well as believability and verisimilitude, which is a likeness for truth – a criteria I utilized in this study. This criterion was also evaluated by conducting member checks with the co-authors where they confirmed that they felt the findings had verisimilitude or had a likeness for the truth of their experiences. Finally, I evaluated if this study was catalytic or facilitating of positive change through self-understanding and potentially self-determination either in the co-authors’ lives or others. !"+&!Catalytic validity “refers to the degree to which the research process re-orients, focuses, and energizes participants” (Lather, 1986, p. 67). I evaluated this criterion through the member checks. Some of the co-authors in this study felt that the research did have a catalytic element to it in that it allowed them to self-reflect further, to come to new understandings, and/or to help them to achieve further personal growth. Many of the women also discussed how they had enjoyed the overall experience of participating in this study, as they wanted to share their stories to potentially help other women who want to leave. Data Management Procedures  The co-authors’ identities have been kept strictly confidential within the limits of the study. That is, only the research team of this project (i.e., research supervisor and supervisory committee) and I have had access to the audio recordings from the interviews for the purposes of the research. All documents have been identified only by code number and kept in a locked filing cabinet in the author’s professional office. Computer data files have been password protected on the author’s computer. All documentation with identifying information (i.e., informed consent forms and demographics form) has been stored separate from the rest of the data. Further, and consistent with BREB requirements, original data (i.e., files and audio recordings) will be kept for at least five years upon which they will be destroyed. I invited each co-author to choose a pseudonym to use in the final manuscript. However, in the end some preferred to use their actual names. Thus, to protect their identity throughout I have used a mix of real names and pseudonyms with no indication of which is which.  Data Representation  Consistent with the method (Arvay, 2003), I will present the findings in Chapter Four in two parts. In the first part, I will share the narratives in the research text that have been !"+'!collaboratively composed as whole accounts. In the second part I will include my overall findings from the cross-thematic analysis. As articulated in previous sections, there are politics involved in representation and I have been open with my co-authors about these politics. As I am conducting this study as partial requirement of a university degree, I am the one who has ultimately composed the final document and I, as well as UBC, own the final story and manuscript. However, in keeping with my desire to make this research journey as collaborative as possible, the co-authors have played a significant role in how their stories are represented in this final text as they have been able to detail their story to me as well as to read through and edit my version of their written narrative. I have done my best to respect their wishes in how their stories are depicted.  The data for this study will be disseminated through community forums with support workers who provide services (e.g., employment, housing, mental health counselling) to women interested in exiting street sex work. In addition, I will be presenting the findings of this research at conferences as well as in published manuscripts. Chapter Summary and Conclusion In this chapter, I have described the indigenous feminist ontology and epistemology that has been used as the overarching framework for this research project. I have also articulated the collaborative narrative method that has been employed in this study in order to collect and analyze data, and have explored in detail the steps I followed throughout the research process. In the next chapter, I will provide the reader with the findings of this study including the narratives of the eight women who participated in this research involved as well as the overall themes that emerged from their stories. First, however, I would like to open Chapter Four with a letter to the actual co-authors of this study.  !"+(!CHAPTER FOUR Results of My Journeys with My Co-Authors Co-Constructing A Research Journey: Letter Five—A Letter to My Actual Co-Authors   To My Co-Authors, It is with much humbleness and gratitude that I compose the following section. I cannot thank each of you enough for letting me into your worlds and sharing your stories with me. You detailed your struggles, your tragedies, and your injustices and yet each of you brought with you a beautiful perspective — a striving to do what you could today and a hope for a better tomorrow —this is a perspective I can only wish to hold. Your stories, to me, were of strength and resilience. For some of you this was with great voice and power, and for others this strength was demonstrated through a quiet peace to continue and try again tomorrow. I am grateful for this opportunity to share in a small fraction of your journey; I only hope that the stories that follow represent the messages you wish to convey of your journeys and the meaning you have made of them. They are stories of tragedy, stories of strength, and stories of beauty, light, and hope in the darkest of places. But most of all they are your stories. These are not necessarily the narratives of all women who have exited the street sex trade, but rather the stories of these eight amazing women.  As each of you told your story in a different way and I wanted each of your voices to come through, I chose to compose your narratives using mostly your voice – your quotes. I also decided against writing your stories in first person as I felt very strongly that I could not take up your voices or speak for you. Rather, I wanted you to speak for yourself. I merely inserted segues if necessary. Each of you narrated different experiences of your life. Some of you emphasized different aspects over others with some of your stories focusing more on exiting the sex trade, some more on entry and involvement, and some more on the !"+)!present and future. To be true to you and the manner in which you chose to focus our conversations, what follows represents those different emphases. In addition, I must mention that the order in which I am presenting the following eight stories gives no weight or preference to any of you. I have merely organized the stories in the order in which I met each of you.  In closing, I would like to thank each of you again for your openness to sharing in this journey with me. I wish each of you all the best with each day that unfolds. ~Laura In the following section, I open this chapter by briefly introducing the reader to the co-authors and context of this project. Then I will share the eight co-authors’ stories. In the second half of this chapter I will share the seven common themes and sub-themes that I found across these eight stories. I will conclude this chapter with my own narrative, which will include my reflection upon the research process. The Co-Authors  This research study took place in Vancouver’s DTES. The co-authors were eight individuals all of whom self-identified as female. (No women identified as transgendered.) The women ranged in age from 34 to 54 with an average age of 41. All of the women spoke English fluently. They had all been involved in street-level prostitution in Vancouver’s DTES and, when conducting the telephone screening, all stated they had been out of the street sex trade for at least two years. During the interviews, one woman stated that she did occasionally still turn tricks for money. Her story is included in this document, because she had exited street level sex work and stayed out for almost seven years and wanted to share that part of her exiting story. Two women had also been involved in indoor-level sex work. In addition, two women had been victims of sexual slavery, one who was enslaved as an adult and one who was prostituted as a child. At the !"+*!time of the interviews, four women reported that they were currently still using substances. Everyone stated, however, that they had the capacity to consent. All but one woman had children. On average, the women in this study had five children; however, only two women had custody of some of their children. (For additional co-author demographics, see Table 1)  Table 1: Co-Author Demographics   Number of Co-Authors  Self-Identified Race/Ethnicity    6 Aboriginal/Native/First Nations  1 Caucasian  1 French Native Housing    5 Shelters/Temporary Housing  3 House/Apartment Employment    5 Unemployed  2 Employed Part-Time  1 Not Stated Education    4 Some University/Diplomas  3 Completed Grade 9 to 11  1 Not Stated Self-Reported Mental Health Issues    5 Post-Traumatic Stress Disorder  2 Mood Disorders  3 Anxiety Disorders Time Since Transitioning Out of Sex Industry    1 Still Turns Tricks Occasionally  1 2 to 3 years  3 3 to 4 years  2 5 years  1 9 to 10 years  Five of the eight women participated in research interview one and two, the collaborative analysis, and the member check. I was unable to locate two of the women following research interview one and two as well as a third co-author following the collaborative analysis meeting.  !""+!The Narratives In this section, I will share the stories of the eight co-authors of this project. To protect their anonymity, I invited the co-authors to choose pseudonyms to go with their stories.  However, some women desired to use their actual names in this final document. Thus, I will use pseudonyms for those who so desired them and actual names for those who wanted me to include them in this final document. These women, in order in which they will be presented are Jean, Crystal, Mary Joe, Nita, Owl Woman, Spirit, Survivor and ‘M.’ Other names and people the co-authors referred to in the narratives are pseudonyms.  Jean’s story.  “I survived my own personal holocaust…” I met Jean, a 54-year old self-identified Caucasian woman, three different times in the summer of 2012 on June 7, June 14, and August 17. She had completed her Graduate Educational Development (GED) and some university. At that time, she was unemployed and living in an apartment. She was still struggling with an addiction to crack. (Note: When we met for the member check in April 2013, she was currently detoxing.) Throughout her life, Jean was involved in the sex trade three different times and had also changed types of sex work. She was recruited when she was 15 into street sex work. During that time, she was mostly engaged in pimp-controlled street-level work. She left the street sex industry for a while when she was around 17 after being arrested. In her 20s she went to college, was married briefly, and worked in various positions in the restaurant and bar business as well as in sales. When she was in her mid-30s she re-entered the sex industry, working indoors for a female-run high-end agency. Throughout this time she was involved in heavy drug use and eventually left the sex trade to get clean. Her third and final time of entering prostitution was !"""!through sexual slavery in the Caribbean when she was 44. She left after 14 months out of fear for her life.  Jean’s story of transitioning into street sex work. Jean was born and raised in Saskatchewan. When Jean was 15, she hitchhiked to Vancouver from Saskatchewan to get away from her family. “I was dropped off at Main and Hastings at the age of 15 years old and basically you know, ’Here you go.’…And I can actually remember this pimp who recruited me who…kind of taught me how to be tough. I don’t know how he did it but I was so scared…I remember that first night…but you can’t show it.” (1011Part50) “I was recruited by a black pimp who called himself Rico…He beat me with wired coat hangers and…blah blah blah…He took me to Calgary…I didn’t know ‘til many years later that a lot of pimps will take the girls across the country or wherever.” (1011Part3, 4) Jean was arrested in Calgary and was sent back home to live with her parents. “And then I came back to Vancouver. I kept coming back and coming back and I was passed from pimp to pimp over the course of a couple years. I may have been sold I don’t know.” (1011Part5)  Jean continued to work for pimps throughout her teens. “It was in the 70s. It was… the glam nightclub age. Black pimps from Portland and Seattle were the ones that basically ran the show up here aside from the white…more organized crime types. Unfortunately I was caught up in that…I didn’t use drugs when I was with those people…They like to keep their product as clean as possible.” (1011Part42) While Jean was not heavily into drugs during her teens, she drank and used drugs recreationally during that time.  She went on to describe the different types of experiences she had while working in her teens. “There was one guy during my teens that was an old black pimp named Amos…I ended up working for him…The beauty of working for this guy is that he would give us 50% of what !""#!we made. The downside was I was locked in an apartment. I was kept in the bedroom and there were a line up of East Indian men outside the door. My end was $12.50 for each man that had sex with me. That’s an awful lot of men if you want to make some money.” (1011Part46) She described how throughout these times, she believes she just checked out of or dissociated from her experience. “Sometimes I don’t think it was me that was there…I think I’ve done an out of body thing with that…It’s hard to think that it was actually me who was in that position and yet there’s times when I can…I can feel myself there.” (1011Part47)  Jean’s story of transitioning out of street sex work. Jean left street prostitution after getting convicted of credit card fraud. “And then I was about 17…almost 18…I was involved with some white people who were into other kinds of organized crime and I was arrested for something and I realized at that time that I have two choices…I can either clean up my life or I can go to jail.” (1011Part5) “I was picked up buying something very expensive with someone else’s credit card and it wasn’t long before I would be 18 and I realized at that point that if I get convicted after the age of 18 I’m in big trouble. Then I’ll have a record. I don’t want to go to jail because they put me in jail overnight when they arrested me and I thought to myself, ‘I don’t want to be here…I don’t want to be one of these girls.’” (1011Part102) After initially exiting the street sex trade and with only a grade eight education, Jean took an entrance exam for and completed almost a year at the University of Regina in social sciences. “Psychology was…and sociology were the easiest subjects because I had been studying human behaviour all my life…on the streets.” (1011Part9) She said this did not last long, however, because she was accustomed to a different lifestyle where she was earning considerably more money. She eventually returned to Vancouver to work in the sex trade. “But I got kind of bored !""$!with that because I was used to making money and there I was at $4/hour waitressing in some stupid pub somewhere…so I came back to Vancouver again.” (1011Part10, 11) Jean’s story of transitioning into indoor sex work. At age 36, she re-entered the sex trade, but this time she worked for a female-run indoor agency where her employer screened all her clients for her. “That’s when my cocaine addiction got really bad, eh?” (1012Part12) “In my 30s is when…Well actually I started drinking when I was in my teens and I had a very long-time struggle with alcohol and then the cocaine came into the picture and so by the time I was…35…I was drinking and using a lot of cocaine.” (1011Part107) She stayed in this type of sex work for only a year and a half. Jean’s story of transitioning out of indoor sex work. Jean described this second time of exiting to be very much intertwined with drug use. She stated that she began questioning herself and her choices. “The first time I was making $20 a trick. The second time I was making $300 a trick. It’s not about money. It’s about…I just walked away. I don’t know why I did that. I think…well I was getting really sick too. I was getting very skinny and unhealthy and the friends I was choosing were…I was lowering my standards. But mostly…you know the day that I quit I guess I was looking at myself and saying, ‘What are you doing to yourself?’” (1011Part80) She went on to detail the night she quit using and left the sex trade. “One day I was in the bathtub and I was convinced that there were these people that were going to bang the door down and kill me. I was getting so paranoid and so I remember really clearly I had a gram of cocaine and a bottle of wine and I flushed the wine down the toilet but I had a real struggle with getting rid of the cocaine and I…I just did it…and I ended up doing 8 and a half years of sobriety after that…2929 days…But who’s counting [smiles].” (1011Part 13, 14) !""%!Jean also described how her son, K, was an inspiration for quitting during this time. Jean had given birth to her son, K, when she was 24 years old whom she gave up custody of (to his father) when he was a baby. “So my own son…I gave up my son when he was very young. He was a year and a half. I gave him to his father and his father ingrained in him that ‘Your mother is a bad mother. She’s an alcoholic. She’s a drug addict. She’s no good for you.’ And my son at the age of five would come and tell me these things. ‘My dad says’ And so I think he was 10…and I went over to his dad’s house for his birthday…I went up to my son…I said, ‘You know K. I’ve been a bad mother. I’m a drug addict and I’m an alcoholic and I'm going to rehab tomorrow.’ His father hasn’t been able to say a thing about me ever since because I faced it. I owned it and I stayed sober all that time for my son.” (1012Part43) She said she was able to leave the second time through accessing AA/NA and other recovery programs as well as finding a psychiatrist with whom she felt comfortable to work through some issues. She has continued to see this psychiatrist on a monthly basis.  Jean’s story of transitioning into sexual slavery. Jean shared with me the story of how she became a sexual slave for a man in the Caribbean. “And then in 2002 I had stopped seeing my psychiatrist. I had stopped taking my medication and it had been almost I don’t know…four years or something…and I had three jobs by then…so I had a lot of pressure and a lot of stress…One day I found myself on the internet…on a certain website and I found this man who lived in the Caribbean who was looking for quote ‘a sex slave.’ I thought I had found the perfect mark…Within two weeks the man had written me…247 emails. He told me everything I wanted to hear…I gave [away] everything I owned and hopped on a plane and shipped a bunch of boxes down to the Caribbean and lived there for about fourteen months.” (1011Part16, 17, 18, 19) !""&!Jean then described her horrific experience of being emotionally, physically, and sexually tortured by this man. “During the course of time I lived there he was slowly and methodically breaking me down and brainwashing me…and it was basically psychological torture I went through…and that was the most horrific thing I’ve ever experienced in my life. I was basically held against my will. He had my passport. I was kept naked most of the time…” (1011Part20) When I reflected that it sounded as though she was forced to stay there, she articulated that while she was allowed to leave and to visit Canada and the US, she felt so terrified of this man that she always returned. “It’s your basic Stockholm Syndrome I guess. And he played me so well that it looked as though…I could leave anytime I wanted to which really wasn’t true.” (1011Part 22, 23) Jean’s story of transitioning out of sexual slavery. With the support of a close and politically connected friend, she eventually escaped. “I knew that if I stayed one more day I’d probably be dead and nobody would know where I was. I’d be at the bottom of the ocean somewhere. By the time I got back to Canada I was a mess. I couldn’t finish a sentence. He had completely…I call it military mind fuck.” (1011Part72) “I got back to Canada and by this time I had a $200 a day crack habit. That was the only thing that was keeping me from feeling anything.” (1011Part24) When Jean returned, she sought out support for herself as well as ways to seek justice for what happened to her from 57 different agencies but got no response for some time. Thankfully, she was able to connect with a few resources (e.g., NA/AA and her psychiatrist), in the end. “Since I’ve been back which was 2004…I’ve reconnected with my psychiatrist…and I still have struggles with substance abuse. However I’ve taken responsibility for it and at this moment…I’m coming closer to ending that chapter in my life. So…but it’s a struggle and it’s just a habit now. !""'!It’s just something I do everyday because I’m bored because…whatever the reasons are but I’m coming to terms with that now. I still have nightmares. I still wake up every hour even though I take sleeping pills. There’s a lot of things that trigger me.” (1011Part32, 33)  Jean’s current situation and future goals. Jean has worked hard at processing all that has happened and has come to a new understanding of it all. “The choices we make shape our destinies. So the choices that I made when I was very young have really influenced the way I live today…can’t change it…have to live with it.” (1013Part14) She has also learned a lot about herself and has psychologically grown considerably throughout the experience. “I’ve learned how to speak my mind now. I’ve learned how to respond rather than react. I think that I’m a survivor now and not a victim, which you know has taken me 54 years to get here but I’m here.” (1011Part36) Jean described to me that while she reaches out to people, she has struggled to make close friends and, as a result, sometimes she feels lonely and socially isolated. However, she has strong support from her psychiatrist and companionship in her cat. “My cat has taught me to stay in the moment…not to live in the past…not to worry about the future. And she was actually kind of prescribed for me (laughs) and I’ve been told if and when she dies I should get another cat…because she keeps me alive. She gives me a sense of responsibility and something to get up for every morning.” (1011Part52) When Jean and I met, she was still struggling with poverty as well as an addiction to crack as at times it helped her to cope with everything that has happened. She was strongly reflecting on her usage and, as stated above, when we met again in the spring of 2013 she was beginning to detox. !""(!Jean wanted to share that she felt this research experience has played a role in helping her to be able to close this chapter of her life and move forward. When we met for the member check, she had started volunteering at a local community centre and stated that she felt as if something good was just around the corner. When we parted, she had a strong smile of hope for what was to come in this new chapter.  Crystal’s story. “It’s like unpacking a row of little boxes…one at a time…” When we met in the summer of 2012, Crystal, a single self-identified Native woman, was 34 years old. She had a grade 10 education, was unemployed, and raising her one-year old daughter in temporary housing. At the time she was not using any substances. We met three different times during that summer on June 13, August 8, and August 16, 2012. I was, unfortunately, unable to get in touch with Crystal following the collaborative analysis meeting. Crystal had entered the street sex trade when she was 24. She exited when she was approximately 30 years old. To Crystal, motherhood was at the centre of her world and one of her main reasons for both entering (when she lost custody of her children) and exiting. She had six children in total. At the time of the interviews she had custody of one daughter, her mother had custody of her oldest three daughters (whom she still saw), and two of her daughters were in care through the Ministry. She was working to regain custody of her five other daughters. Crystal’s story of transitioning into street sex work. Crystal’s entry into sex work was strongly influenced by her role as a mother and the despair she felt after losing custody of her children. “I had three kids in three years. And I was totally stressed out. I just needed one night out. And I gave them to their dad for the weekend. He ended up calling welfare and telling them that I abandoned them. And he got them taken away from me and eventually they got taken away !"")!from him and it just felt like my life went to shit so I picked up the pipe and people were giving me drugs to sell. No problem. Then I started messing that up and then I started owing everybody. And that was the main reason why I went out on the street because nobody trusts me anymore…I had ripped off too many ‘bosses’ or came up short on their money count because I had used too much…So can’t sell drugs no more…sell myself…” (1021Part80) For her, both entering and exiting sex work were very much intertwined with addiction, particularly to cocaine and heroine. “I did it…for drugs and also just like I’d use the money for food…a place to live. I was homeless through that whole ordeal cause…I never wanted to get comfortable downtown because if I got comfortable…than I’d never go home to my real home…my kids” (1021Part4) She explained that once she got clean the temptation to engage in sex work was almost non-existent. “As soon as I had the drug aspect out of my life I was able to stop going out there [on the street].” (1023Part10) Crystal’s story of transitioning out of street sex work. Like many women, Crystal had desired to leave the sex industry for some time, but one of the main catalysts for leaving was a horrific experience with a john. “I had an extremely bad date where I was held captive for the weekend and he just did things to me and I had to escape from him and I had to lay…press charges and the police were helping me do that. And he ended up getting eight years and I came out with my head out to here [motions with hands]. And I escaped butt naked with handcuffs on…with only duct tape on my head. So it was like very terrifying. I should have died there and that was one of the first wake up calls and…I was still addicted to drugs so I still had to go out onto the street to get my money and after a few more times of that happening…like bad dates like that I just realized…I’m gonna end up dying down here if I don’t get out.” (1021Part6)  !""*!While Crystal desired to leave following her bad date, she struggled with PTSD after the incident, which kept her involved in drug use and the sex trade. “I was scared of him [the man who kidnapped her]. What if I straighten out and I’m with my daughters and all of a sudden he comes back and he comes back and kills me or whatever, right? Or rapes my daughters or whatever, right? And that was one of the things that was in my head why I couldn’t leave. I was scared to leave because at least if I’m down there…I’ll get killed by myself. But I didn’t want to bring my family into it and stuff like that…but it’s not fair to my family not to have me too right…I just stopped letting that have power over me. And it was easier to gradually move over once I let the fears go and let reality set in.” (1021Part88) Crystal later became pregnant with her fifth child and got help to get clean through BC Women’s Hospital and Health Centre Fir Square Combined Care Unit. Once in the hospital, she had the space and mental energy to weigh her options. “It was the first place that I actually got free of the drugs, right? Like got it out of my system and I started coming back to reality to think of things, ‘What am I leaving behind? And what am I staying here for?’…The pros overweighed the cons and I just started to shift away and stop just getting involved with everything.” (1021Part7, 8)  One of Crystal’s main motivators for leaving was her daughters. She strongly desired to be a strong role model for them and refused to see them end up on the street like she did. “My oldest daughter is 14…so they’re becoming their own little women too so yeah… it’s about time I smarten up because I see girls come out at 12 years old, right? So my daughter could have been standing beside me, you know? I wouldn’t let her, you know? But it could have happened…could’ve would’ve and definitely should’ve not have.” (1021Part70, 71)  !"#+!Crystal’s family was a huge motivation and source of support for her both while she was on the street and through her recovery and exiting process. At the time, Crystal’s three oldest daughters lived with her mom in a suburb of Vancouver; Crystal had a weekend routine of visiting them. “I was really lucky that I had people that still wanted me and let me know every time they seen me and put it into my head that this is not where I belong.” (1021Part77) “And she [her mom] always kept the door open for me you know, ‘Come home. Come home…whenever.’ No judgment or whatever. And I always knew that it was there but I was just too embarrassed to go home. But she was a very big help.” (1022Part22) When Crystal did leave, she described her process as quite gradual and also fairly independent, which she stated seemed necessary for her at the time but also served as a barrier. “I fell down a lot because I believed that I could do it myself and it’s not that easy to do it by yourself. You actually do need supports. But there’s not really…I don’t know of any supports out there. But I wasn’t really looking for the supports either. I wanted to do it all by myself…But now that I’m…left the street and stuff like that…I see the things that are out there…that I could have used but I didn’t know of.” (1021Part12)  Crystal started her transition in a 3-month treatment program called Heartwood Centre for Women. “A lot of the treatment programs right now…they’re like you know you go into them and if you mess up you’re kicked out. But they are trying a new thing at the hospital. It’s called Heartwood. And you go in there and depending on if you slipped and depending on how you deal with your ‘slip’ will depend on whether you get kicked out or you can stay, right? So basically what they want you to do is be honest with everybody and ‘fess up’ and tell on yourself rather than have it found out. And…cause I did slip while I was in there. But that was at the very !"#"!beginning and I dealt with it okay and everything so I was able to stay and I ended up graduating from there.” (1021Part31, 32, 33) When reflecting on the process, Crystal stated throughout her exiting experience she felt a variety of emotions but mainly fear. She described herself as being a cold and guarded person when she first started transitioning out. “She was just an ice cold person in the very beginning…because of all her bad experiences…and just having to put the wall up and don’t let anything over it and if it does come over…knock it back down.” (1023Part15)  Crystal compared her process of exiting to unpacking boxes — one box at a time. She said that, for her, setting small goals and working toward each goal slowly and patiently has been helpful in her exiting process. “Like small goals…as long as they’re goals working toward a big goal then they’re wonderful goals to have.” (1021Part95) She described her trauma as one of these small goals or ‘little boxes’ that she is a patient and cautious with to prevent relapse. “I’m just keeping it shut but I know it’s there and I’m aware of it…I’m very cautious around it and you know I don’t mess around with it...But I also don’t give it power either, right? It’s a box that I will be opening but just not yet. When I’m more stable…I have my own home…maybe I have my daughters back and stuff like that…maybe I have a year of counselling behind me…before I mess with that…” (1021Part91, 92) Crystal’s current situation and future goals. Crystal reflected that she felt like a survivor for having exited the sex trade alive. “I survived downtown. A lot of people don’t…A lot of my friends that I’ve had when I first came down aren’t…here no more. They all went back to their homes in…boxes.” (1021Part110, 111, 112) At the time I spoke with her, Crystal described feeling socially isolated. She said that her internalized stigma, fears and past trauma, as well as difficulty trusting others kept her from !"##!going out a lot. “I get really self-conscious about stuff like that and I stay inside a lot because of that. And that’s another reason why I don’t come out that much is because for me it doesn’t feel like that long ago since I’ve been on the street but it really has been that long. I’m just scared that my past is going to catch up to me in some bad way or something, right?” (1021Part60, 61) At the time of the interview, however, Crystal was involved with a local organization that provides social and health services to women with children, which she described as a continued source of support for her. Crystal’s goal when I spoke with her in the summer was to look for apartments and find a more permanent home for her and her daughter. She also was working to gain custody of her other five daughters and contemplating future careers, such as nursing. She was working to unpack and sort through each of these boxes one at a time. Mary Joe’s story. “It’s like a baby learning how to walk…” I met Mary Joe, a 52 year-old self-identified Aboriginal woman, in the summer of 2012 on June 13, June 21, and August 4. At the time she had completed some university, was unemployed, and living in temporary housing. She stated that she occasionally smoked crack.  Mary Joe entered the street sex trade when she was 12 years old and had left sex work approximately four years ago after she experienced a bad date. Mary Joe had had nine children while working in prostitution. A friend, who Mary Joe identified as a past ‘regular,’ had raised her children in Alberta, and, when we spoke, she was still in touch with them. Mary Joe’s story of transitioning into street sex work. Mary Joe was 12 when she entered the street sex trade in Edmonton, Alberta. “I worked the street. I worked at a young age but I guess I was more into partying…I made sure I looked after me because you know…There was !"#$!nobody to look after me. I didn’t want to go home.” (1031Part5) When I asked her about home, she said that she had too many brothers and sisters.  When Mary Joe started working the street, she did it mostly for partying and to buy basic things as well as to get new clothes, IDs to get into pubs, and alcohol. “When I first started, for me, it was more like a game and money. And street work it was easy money…and umm, you know…I got drunk a lot.” (1031Part9) “Sometimes the pay wasn’t that good but…I got to meet a lot of other girls.” (1031Part12) Mary Joe described how in the beginning the experience was fun until she got arrested and placed into a youth detention centre. “Then I got myself into trouble. I got nailed for prostitution. The fun part was gone for a while. They threw me in a ‘juvie’ home.” (1031Part14) Mary Joe was in and out of group homes throughout her teenage years. “But I got used to dealing with that…I jumped through their hoops. I did what had to be done, you know?...And I got to meet girls so then I told a few girls at the group home…what it was all about you know. A lot of ‘em ran with me and we worked the streets and hung out and partied…met men…a lot of different men. But you know…it was…like young women at that age 12, 13, 14. We’re not women. We were kids…But we had the parts…We were fresh off the market. You know we were fresh and…you know like…they liked young…very young (laughs).” (1031Part15, 17) She said at that time she was not into drugs and drank occasionally but never heavily. “Just partied and you know met guys and then we bought hotel rooms. We never were homeless. We never had to couch surf.” (1031Part21, 22)  Mary Joe reflected that while the lifestyle was not always a party, she felt that she and her friends supported one another throughout their various experiences. “We all doubled up in one room because you know we shared our clothing and our makeup…We shared shoes. We talked. !"#%!We shared a lot of things. We cried, you know? We were kids. We were young, young prostitutes just learning the tricks of the trade like if we had a john that beat us up or…we’d be sympathetic. We’re all together. We all learnt and we were all young prostitutes. And it was the beginning of a new life and it was [a] wild party…wild, crazy, you know?” (1031Part25)  Mary Joe spoke about how slowly she learned the ‘tricks of the trade,’ which sometimes had a dark side to it. “It’s like you get smarter. You get a little bit more knowledgeable about what you’re doing now. It’s not a new job anymore. You got this trade now.” (1031Part43) “We had to watch where we were working. You know? Times were tough but not that tough. We had to watch out for the pimps. Pimps were bad…guys wanting you…Pimps would want to buy you…As soon as they’d got to know you, they’d want to buy you. They’d buy you stuff…give you stuff, ‘You can come stay with me.’ But you know…I told the girls, ‘You’d be stupid to go live with him. Then you’re going to get beaten. You’re going to have to make money for him. You’ll never see your money.’” (1031Part52, 53)  Mary Joe also discussed how partying slowly transitioned into regular substance use and addiction. “Smoking dope like weed and partying…I became…a real big pill freak. I became one at what? 18?…I took a week or two off because I got sick so I became a pill head…So then I had to buy my pills or I had to sleep on my back for them just to get what I needed, you know? But I became a pill head. And then I started chugging that down with alcohol and that became a big structure in my life.” (1031Part60, 61, 63, 64) Mary Joe’s story of transitioning out of street sex work. Mary Joe emphasized how simple it was for her to enter prostitution when she was a kid and how incredibly difficult her journey of leaving had been. “Well it’s not hard to get into the sex trade but it is to get out of it. How to get out of it is a different thing.” (1031Part67) “I left the sex trade work when I was 49. I !"#&!got seriously hurt…You know where the alley is by the _____ hotel? Well my shoe’s still hanging up there if you look up above the…electrical wires…My shoes’ hangin’ up there as a reminder. They were going to take it down but I told ‘em leave it there. I got raped and seriously hurt in that alley in August…It’ll be three years this year in August [2012]. A guy really beat me up bad…beat me…beat me up…nobody seen nothing. Fuckin’ broad daylight and nobody seen nothing…And that was the day I had to really go to a police officer and say, ‘I need you to arrest somebody.’…That scared me enough to leave the sex trade actually…Well I couldn’t…I couldn’t see…I couldn’t see hardly anything. It just seemed like there was a lot of blood. My vision was blurred with blood and I had to. I had to! I had to! I had to get help. If I didn’t I’d lose my sight probably I don’t know.” (1031Part79, 81, 82) “I felt…he took a part of me that day. He took a lot from me that day when he beat the crap out of me.” (1031Part118)   Throughout our time together, Mary Joe reiterated the importance of asking for help, which she did after her bad date. “I asked for help from Linda Malcolm. She’s a woman cop. I call her Mom. And she helped me out a lot. She helps me out…cause my mom passed away…now a long time ago cause I need a mom every once in a while so and when I actually…I go to her. She was one of them that stepped in…her and two other lady cops stepped in and really became part of my focus actually. When I got out of the sex trade, she was there to help me. She sent me in different directions…She was there everyday for me…She read to me. She talked to me. She took me down to the church…the hospital church, you know? She told me different places where I could go after…for a life skills program.” (1032Part2, 3) Mary Joe’s current situation and future goals. When we met, Mary Joe had come to a new perspective on life and discussed how she had to establish boundaries for herself, develop structure, set goals, and find new trades that she enjoyed, such as beadwork and making dream !"#'!catchers. “I have to cope financially, physically, and emotionally, you know? I have to learn different ways to deal with money and how to get it and, you know? And how financially to budget it…Like you know a $700 check would have been two johns…bang perfect…and it was nothing. And now $700 I have to budget in one month. And that isn’t including my rent…But it’s different you know…like financially it’s, man…You have to learn how to budget. You have to learn…like…it’s a growing up situation…it’s a totally different growing up now. You know? You get outta that prostitution…it’s hard.” (1032Part21, 22, 23) She described that since she exited, she discovered that she really enjoyed spending time alone. “Yeah. I love solitude. I love quietness.” (1032Part51) She stated that while she has encountered some positives there have been some negatives to transitioning out of the sex trade, such as the fears she has developed around night, darkness, and men. Furthermore, she stated that she has some fears around the man who assaulted her. “They say they can keep him a minimum three years and it’s already been three…just about three years and now he’s out. And I gotta watch where I’m…walking cause I don’t know where he is or what he looks like and I don’t want to wish that on anybody.” (1031Part83) She emphasized that healing was important although she believed she would always have scars, “I have scars…inside and out…They heal but I can’t get rid of them because they’re just scars that will be there for the rest of my life. They’re reminders. I can’t forget that.” (1033Part16)  Mary Joe reiterated though that the process of exiting was incredibly challenging and would continue to take work and that she continued to set small goals for herself each day for things she wanted to accomplish. “But time will tell…I don’t know how long it’s going to take but it sure the hell ain’t gonna take a year, two years, three years. You know? It’s gonna take a while. It’s gonna take a long time.” (1031Part131, 132) “There’s goals ahead of you. There’s !"#(!obstacles…my god everything in this world is an obstacle. You know you trip over things everyday sort of thing you know but my god…it’s like a new beginning. It’s like you know when a new baby starts walking…their first steps…It’s like the structure of something new. It’s the beginning of a new life. You fall down lots. You pick yourself up…And if you can’t pick yourself up then you have to ask for that help again. Keep going.” (1032Part57, 58) When we met for the member check, Mary Joe was embarking on a new adventure in a new city. While she expressed her awareness of the potential struggles to come and uncertainty about the future, she did so with her typical wide-eyed smile and optimism still taking each day one baby step at a time.  Nita’s story. “Everyday that I wake up and I wake up breathing and I wake up to a new day…it’s a good day…” I met Nita, a 39 year-old self-identified French Native woman in the summer of 2012 while she was living in a shelter in the DTES. She had a grade nine education and was currently unemployed. We met twice, once on June 14, 2012 and the second on June 21, 2012. I lost contact with her after that second meeting on June 21, 2012. Nita’s story of sex work involved entering and exiting throughout her life. Like many women’s stories, Nita’s experience of being in the sex trade and her process of exiting was very much linked with substance use and addiction, which she described had been something she was exposed to throughout her entire life. She entered when she was seventeen to help pay for her drug usage and left for approximately seven years after getting pregnant, having four more children, and staying clean. She re-entered after becoming re-involved with drug addiction and voluntarily giving up custody of her five children. When I met her she stated that she had been !"#)!out of the sex trade for three years but still occasionally turned tricks for extra cash. At that time, she was continuing to work on getting clean so that she could have surgery on her ankle. Nita’s story of transitioning into street sex work (Time 1). Nita shared the story of how she began sex work to help her pay for drugs, both of which came into her life around the same time. “I started at the age of 17 in Toronto, ON. It all started with drug use because in order to get my drugs I had to find a way of making money. I had my first hit of crack…in Toronto, ON…and Black T was the first one I ever did a hit of crack with…God bless his soul he’s been dead for a few years now. But I asked him, ‘How can I get more of this?’…And he said, ‘Well, I’ll show you.’ And he took me out to the corner and he told me just to stand there, look pretty, and smile, and somebody will eventually pull over and ask me to do something for them and this is how much you should ask for. So he showed me the ropes basically of how…to get more drugs” (1041Part1, 2)  Nita had her first child when she was 15. “I just didn’t believe in abortion. I didn’t care that I was a young kid having a kid. I just didn’t believe in killing somebody. It just wasn’t in my nature. So I gave birth to B. And my mom took care of him.” (1041Part3) B lived with his grandmother, Nita’s mom, until she passed which will be discussed below.  Nita’s story of transitioning out of street sex work (Time 1). Just before her 23rd birthday, while she was still living in Ontario, Nita started vomiting after she would ‘toke up.’ She realized she was pregnant again. “I thought to myself, ‘Well here I am 22 years old…no one to look to…to help me,’ and all it was was either me or society. You know because society would not let an addict have a child and keep a child so I decided to leave Toronto and I went to Hamilton. And I met this lady. Her name’s V. And she met me through a drop-in centre…She knew that I !"#*!was pregnant and she wanted to help me. So she gave me a place to stay. And she helped me get back on welfare.” (1041Part3, 4) Nita stated that during the time she was living with V, she tried to remain clean but “once in a blue moon I did slip up.” (1041Part4) At this time she was also working in the sex trade. “And I ended up getting arrested for prostitution. I went to jail…And it did me some good because it gave me a month to think about what I really wanted.” (1041Part4) At the time Nita was 6 months pregnant with her second child. “I gave birth to a beautiful little girl. And I ended up staying away from the drugs.” (1041Part4) Nita had also started dating the brother (Dan) of her friend, V’s, partner.   “And I ended up staying clean for almost 7 years…gave birth to another three children…another 3 boys” (1041Part4). She had R with her partner Dan. “We [she and Dan] were together for about five years and I started dating this guy named Roy and I got pregnant with M.” (1041Part4) While dating Roy, Nita was a stay-at-home mother who spent her days taking care of her three kids and her partner. But she stated, “I dealt with a lot of issues with him [Roy]. I’d been dealing with abuse for myself from being younger…He was an alcoholic and he came from an abusive background. He was always really mentally abusive with his words and stuff like that…not physical. It became more physical toward the end. But we brok-…were separated. There were a couple times the cops would come to my house because of him, and they ended up charging him with assault…So he went to jail for a little bit.” (1041Part4) After Roy went to jail, Nita moved and continued to be a stay-at-home mom raising her kids. “And I ended up moving. I reunited with my family after almost 7 years…I saw my sister and my mom again.” (1041Part4) “I moved out to Elgin [ON] and in a little trailer out near a !"$+!cornfield with my kids. It was nice. It was out in the country. So you know I kind of liked that.” (1041Part6)  Things changed a bit, however, when Nita became pregnant one last time. “I ended up getting pregnant by a fluke when I was out in Elgin…I…old high school guy that I used to know…But I ended up becoming pregnant after having sex with this guy. I was thinking, ‘Oh my god! Here I am with one that’s not even 2 yet and R’s like 3, and J’s like 5/6 and I’m pregnant again.’ I’m like, ‘Oh my god what am I gonna do?’ (1041Part6) Throughout this time Nita also used coke intermittently. “I used a couple times…it was maybe a fluke once here and there. But still you know the next day you’d be like, ’Oh god why’d I do that?’ (1041Part6)  Nita’s unexpected pregnancy made her re-evaluate her current living situation, and she moved back to Hamilton, ON. “And V took me in with all the kids. She had a really tiny place but she took me in. We’ve been best friends for many, many years. And she knew I was pregnant. And I was about…three months…so I had to make a decision whether or not I was gonna carry it…And V was never able to carry kids. So I ended up carrying K for her and she’s been raising him since the day he came out of the hospital as her own…as an adoptive mother.” (1041Part7) Nita’s story of transitioning into street sex work (Time 2). In the summer of 2002, Nita’s mom was in a car accident that took her life. As a result, Nita’s oldest son, B moved back in with Nita and her four other kids. During this same summer, “Roy ended up cheating on me and did it right in front of me and it really hurt me big time.” (1041Part8) “So between all that happening and my mom dying and me getting back B I just couldn’t handle all the stress at once. It was just too much on me. And plus, they diagnosed me with abnormal cells on my cervix which could turn into cancer. They say possibly but not always but it scared me enough.” (1041Part12) Nita !"$"!described how all of these incidents culminated into her slipping back into drug use by first starting to use only on the weekends. “On the weekends the kids were gone…so I started slipping up and using crack. Well one weekend it slipped into a Monday. And I should’ve been not using that day. And so I knew that I was falling off the wagon…falling off the wagon hard…so I called V. I told her I’d be sending the kids with B…and I signed over all my kids.” (1041Part9, 10) Nita gave up custody of her four kids to V and V’s partner. Not knowing where to turn and feeling very supported by her friend, V, throughout this time, Nita took V’s advice when V suggested, “’Well Nita, if you wanna get away just you know like get away for a while.’ And she goes, ‘I know you. You be gone, you be gone for a long time.’ And I’ve been gone now for 9 years now this August [2012]. I haven’t talked to my kids in 9 years. And some days it bothers me and some days it doesn’t. Because the fact is you know I’m still working on me and dealing with issues with myself. And my daughter’s now 16. My son’s now 22.” (1041Part13) Nita moved to Vancouver, where she’s been ever since. “So I came down here…First I tried to make an initiative of doing the right thing and trying not to use. So I started looking for work first and I did a couple good jobs.” (1041Part13) Slowly, Nita started using again and got re-involved in street sex work. “And so I started working down here…And I was out there working and everything…making my money and you know using my crack. And that’s all I cared about was just you know me making my money. As long as I had money in my pocket…I was getting high…I was happy…that went on for about 6 years.” (1041Part13)  Nita’s story of transitioning out of street sex work (Time 2). When I met Nita, she was using a cane to walk after having an accident she had had a year prior where she broke her ankle in twelve places. She spoke of this accident as a turning point of sorts for helping her slowly start !"$#!to get out of addiction and sex work. “Last June [2011]…I was climbing down a ladder after shooting up coke after a guy banged down my sugar daddy’s door...And I was just too scared to go down the front. So I went down the ladder…and I lost all my strength. And I fell and right below that ladder there’s a mountain of cement.” (1041Part14) “I landed right on the peak right on the very top and it went like this [motions].” (1041Part15) “It took ‘em five days to figure out how to put my ankle back together.” (1041Part19). Nita had surgery and got into a treatment facility. “And I ended up running from there because…they had a guy running…an all-woman’s treatment house which I think is really not a good thing…They had me on morphine and stuff like that for pain, right?...So he goes, ‘So big daddy’s got what his little girl needs. What’s his girl gonna do for big daddy?’ And I’m like, ‘Oh my god this guy’s hitting on me, right?’” (1041Part19, 20) After Nita left the treatment facility, she was on the run from October 2011 until February 2012 when she got arrested.  Nita’s current situation and future goals. Nita described her most recent time in jail as again a time to reflect on what’s important to her, particularly focusing on her health and her future. “So yeah it’s just taking care of my health, taking care of myself, and finding a place where I know I’m gonna be comfortable. Yeah and I’m not comfortable in the DTES. There’s no way I’d live down here. I’d have to find a place out of the area…I don’t want to be around all that. You know what I mean like if I want to come down here and say hi to people that’s something different. But you know I mean to live there it’d just drive me nuts.” (1041Part48, 49, 50) When I last spoke with Nita, she was still struggling with drug addiction. Nita and I lost touch after that second meeting but the last time I spoke with her [June 2012], she was attempting to find stable housing and get into a treatment program to help her get clean. She described a sense of urgency to get clean so that she could have another surgery on !"$$!her ankle as her ankle was quickly deteriorating. My hope for her is that she was able to succeed in that goal of getting clean and having surgery, as she was in considerable pain due to her ankle when we last spoke. Owl Woman’s story.  “It’s like a snake shedding its skin…”  I met Owl Woman, a 38 year-old self-identified Native woman, in the summer of 2012 on June 20, June 28, and August 30. Owl Woman had completed some diploma programs, was unemployed, and was currently living in temporary housing. At the time, she was not using any substances and had been clean and sober for three years. Owl Woman entered street sex work when she was 15 years old after leaving home to escape family substance use, violence, and abuse. She left the streets initially when she got pregnant with her first child and had four more children. She re-entered street sex work due to the devastation she felt after her five children were taken into custody. Her ‘healing journey,’ as she termed it, of getting off the streets and away from addiction has involved a process of addiction treatment, ceremony, trauma counselling, and education. Owl Woman’s story of transitioning into street sex work (Time 1). Owl Woman spoke of her process of entering street sex work as a cycle of family addiction, violence, and abuse. “I hit the streets at 15 years old. Just anything to get out…I couldn’t handle it anymore. It [home] was just too abusive. I couldn’t take it anymore.” (1051Part21, 22) Throughout her time on the streets, she said, “I never got to be a young adult. I was too busy surviving. I was too busy partying…having good times in the beginning but then escaping. That’s what the drugs…that’s all it was…escaping that pain…hoping it would go away…and I thought going to the streets would do that for me…like I thought it was an answer but it really wasn’t an answer. It’s !"$%!like…jumping…from the frying pan into the fire…There’s a pack of wolves [waiting for you].” (1051Part25, 26, 28)  Owl Woman strongly advocated for prioritizing children’s needs to prevent cycles of abuse, addiction, and violence. She said that children are like seeds that have the potential to blossom into a rose and that, “Children need…the right nurturing…the right water…the right things. A person can blossom [into a rose] but…if you stomp on it and abuse [it]…they can wilt and not die but it’s gonna be a struggle to break free from the weeds and be a beautiful rose.” (1052Part44) She felt in her own life she had been stomped down. She made strong connections between her family upbringing and the lifestyle she sought out as an adolescent on the streets. “But he [her dad] was very abusive…you know scream at me…had nothing good to say…well no wonder…and same with my mom. She was so abusive to me. She’d take all her anger out on me because my dad cause he was drinking. They fought all the time. So growing up in that I thought that was normal. And then when it came to my own life it’s like that’s the kind of partners I chose. I realized…like they were emotionally unavailable…very emotionally, mentally, and physically abusive…and same situation…in their addiction. It makes sense today.” (1051Part17, 18)  She stated that, for her, sex work was all about survival and getting basic needs met. “When I think about how things were like I used to sleep with people for like you know…alcohol… drugs…a place to stay…for food. It was all about survival. It had nothing to do with love or liking. That’s not even there. It’s just about getting a need met…you know whatever I got to do…however I gotta survive…you know?” (1051Part10) Owl Woman’s story of transitioning out of street sex work (Time 1). Owl Woman initially left when she was 17 and then again when she was in detox and found out she was pregnant !"$&!when she was around 18. She stated that she left sex work and addiction, because she felt a responsibility to her son and to herself. “I think when I had my son it was easy to do cause…that’s a new life. That was my child and you know it wasn’t just me anymore. You know when it was me out there I didn’t care but when E was born I just couldn’t do that to him. And I couldn’t do it to me anymore. Like that’s like a little me right?” (1051Part4)  Owl Woman’s story of transitioning into street sex work (Time 2). Owl Woman told a story of how she had four more children and wanted to be the mother to her kids that she felt her parents could not be. She stated, however, that she struggled to do so, because she was still caught up in a cycle of family violence, addiction, abuse, and trauma. “I wanted to be a good mom but I didn’t know how to be a mom…I was just a kid and I understand that today but it was just the fact that…like addiction can be so powerful.” (1051Part6)  She described that due to her and her partner’s addictions and the abusive relationship she had with her partner, she lost custody of her kids. “I was sober for a while with him [E]. It was like you know what enough of this crap…I have this little person. I need to change and because I was willing to change at that time…at least that part of my life…I thought okay I’m doing something right. I’m sober. I quit drinking. I’m doing something good so I was happy…at least for a little bit…you know cause I was motivated by my son, right? Unfortunately I kind of messed that up because I was in an abusive relationship with the stepdad…an abusive situation and I lost my child because I couldn’t see that even though I ended one part of my life I was still in cycles of family violence…and addiction…I hadn’t worked through that stuff, right?” (1051Part49) After losing custody of her five kids, Owl Woman got heavier into addiction and sex work to help cope with the loss and grief she felt. !"$'!Owl Woman’s story of transitioning out of street sex work (Time 2). When I asked Owl Woman what her journey had been like in the past few years as she had been exiting, she described what she called her ‘healing journey.’ She stated that she had went through different programs, such as PEERS and the Native Education College, to help her to heal. She said, regarding her healing journey, “It’s been painful…I went to PEERS first. That was when my healing journey started and I got clean.” (1051Part79) “And since July 2009…haven’t touched anything…no pills…no drugs…no nothing…I don't even smoke.” (1051Part82, 83) Owl Woman spoke of going through a lot of processing and ceremony while at a program at Round Lake and another called Wilp Si'Satxw, both of which she spoke highly of as she was able to participate in healing ceremonies, such as smudging, and giving voice to her ‘inner child.’ “I believe my journey started there [Round Lake] but the real healing journey started when I…went to Wilp Si'Satxw for a while for a trauma program, and I started working on myself…I didn’t realize how angry. I had no self-esteem. I had nothing. I didn’t even like myself. I didn’t even think I was a pretty person. I thought I was fat…And I had like such low self-esteem like I said I was blaming myself for my boys…I thought being out there…hanging around people…I thought that would make it all better. I don’t even know why. I wasn’t making anything better though but that’s how I felt. I was punishing myself because they were hurting.” (1051Part84) Owl Woman emphasized how helpful other support programs had been for her, particularly those that allowed her to re-connect with her indigenous roots. “I’ve done nothing but Native support groups lately. I did two. Like I did Family Violence Program. I made it through Native Education, which I highly recommend to people. I did walking the Circle of Prevention, which is prevention of child abuse. And I really feel like a lot of my healing’s happened because of PEERS and Native Education College Healing Trauma Workshop and Red Cross…And those !"$(!things needed to happen because like I said…on the street…I didn’t know you don’t let people slap you…it’s not okay to be violent…it’s not okay to be abusive…it’s not okay to…threaten people…but…children live what they learn.” (1051Part43) Owl Woman’s current situation and future goals. When I met her, Owl Woman was continuing on her healing journey and doing different support programs. She strongly desired to become a family support worker and was actively taking steps to pursue these goals when I met her. She was taking courses at Native Education Centre so that she could eventually go to Douglas College. She was working to get several different certifications, such as First Aid, Super Host, and Chemical Safety and Whmis. She had also completed her Culinary Arts training at a local college. She spoke of how these programs helped in a number of ways including allowing her to realize her skills and value as a person. “I love it [Culinary Arts Training] and since I’ve done that and applied for going to _____College, I’m like, ‘Wow. I am worth someth-…you know I am a worthwhile person. I’m a good person. I got my flaws but you know realizing wow there’s more to me than I even realized. I’m worth a lot more.” (1051Part111) Owl Woman described to me that she was motivated to stay clean and sober because of her goals, her desire to re-connect with her children, and her respect for herself. “I’ve got goals and not just goals. The thing is if I want my children back in my life and I want my house and I want to be a family support worker, I have to stay clean…There’s no choice. There’s no option. There’s no alternative. It has to stay that way. Because you know what if I picked up I might as well say. I’m basically telling my children, ‘Forget you. You don’t matter.’ School, ‘Who cares?’ Family support worker…making a difference in this world, ‘So what?’ I’m saying, ‘F’ off to me.’ And I’m not willing to do that. I’ve done that…for how many years. It’s like building a !"$)!sandcastle…fall down. And it’s exhausting to do that. Build up and falls down.” (1053Part55) “It’s very painful…but you know what I feel I’m coming back to the real me…” (1051Part96) Owl Woman has continued to actively seek out and reach for her goals. When we met for the member check she said things had been changing for her everyday. In fact the day we met she anticipated she was going to hear about a new place to live. She was going to school at a local college to finish her grade 12 so that one day she could go to college. She said if she could come through all that she has and be where she is today she feels that others can too if and when they feel ready. Owl Woman has shed a lot of her past and has worked to leave it behind her. At the same time, she has discovered a spirit and a fight in her that I can see is already and will continue to make a difference in the world. Spirit’s story.  “Everything negative can be turned to positive…with the right help.”  I met Spirit, a 36 year-old woman in the summer of 2012 on June 17 and June 21. Spirit identified her ethnic background as Irish, Spanish, Native, and Italian. At the time she had a grade 11 education, was unemployed, and living in temporary housing. She was currently using substances and working to get clean. I lost contact with her after that second meeting on June 21. Spirit’s story was unique in that for her addiction and sex work were all she had ever known. She had been born addicted to heroin, which her mom had reportedly maintained until she was able to ‘fix up’ herself. She entered prostitution as a child when her stepfather started selling her to her mom’s dates when she was only five years old. She left the sex trade two to three years ago after a bad date. She also left because even though she did not have custody of her four children, she wanted to provide a better future for them and her future grandchildren. !"$*!Spirit’s story of transitioning into child prostitution and street sex work. Spirit described to me her childhood story of entering addiction and sex work, “I was addicted to heroin at birth. Mom maintained it ‘til I was 5. I would shoot heroin up with my mom…fix my mother and myself by the time I was 5.” (1061Part28) “My mom’s husband…my step-dad is the reason why I got into the sex industry in the first place. Because when I turned 5…because it made more money for him and my mo-…for him and his drug addiction and my mother and her drug addiction and everything. He started going two for the price of one. So they could have my mom and they could have me right after her. Or they could have me first and they could have my mom. So…really…a lot of men…and then his abuse…his sexual abuse on me…” (1061Part34) Spirit stated that her stepfather had abused her throughout childhood. “He hit me with a machete when I was 10. He shot me in the back when I was 9. It was just constant abuse…between me and my mom…the way he abused my mom and me. And how hard it was to protect my little sister from it. It was just…it was really, really hard.” (1061Part34) Spirit said that the reason her stepfather shot her in the back was because he was reportedly going to start sexually abusing her sister, and Spirit stopped him. When I asked if she still had contact with her sister, she responded, “No she’s a prison guard…I choose not to see her because I’m an addict and she’s not. She’s never had a problem with addiction. She lives a life…She was raised by our uncle. She didn’t have the life I had…When my stepdad was gonna start on her I stopped [him]. That’s why I got shot. That’s why she never came home. That’s when she went to live with my uncle.” (1061Part65, 66, 67) Spirit described being addicted to drugs and engaging in sex work throughout her childhood and feeling as though she had little choice after her mom passed away of a drug overdose in Spirit’s arms when Spirit was only 11 years old. “My mother was a street worker !"%+!from way back. She started in ’61. And that’s why I got my little game from…That’s all I knew right. And as I grew up and as I got used to it. I watched her fall prey to the addiction and the death and everything else, right? And when she left it was the only way I could support myself was dealing drugs and prostitute.” (1061Part18) Spirit’s story of transitioning out of street sex work. Spirit explained that there were a few things that occurred in her life that made her want to exit including a bad date, an experience with a young girl on the street, and her children. “I had a couple really bad dates…So remembering those instances keeps me away from it too, right? Because you never know. They may seem like the nicest person when you get in the car. And then as soon as you get away from where you are, they start to change. So you never really know if it’s gonna be a good date or a bad date or what’s it gonna be, right?...When you’re on the date and you say, ‘Okay, well this amount for a blowjob. This amount for having sex. This amount for both.’ They’re like, ‘Well what about anal?’ And you say, ‘No.’ Then they go for anal anyway. And you keep saying, ‘No.’ And they keep going. Right? Things like that. That’s considered rape. Well I had a date that tore my anal cavity so bad that it shattered my tailbone and then I had to have three inches of my bowel removed because my bowel ruptured. And I still suffer everyday from it. Right? And after that that was my last date…That’s the last date I will ever do. I almost died because of a date. And I will suffer for the rest of my life because of that…” (1062Part4, 7, 8) Spirit described an encounter with a young girl that also made her want to leave. “And then one day I was standing…on the corner, a little girl walked by and said, ‘Mommy, nasty.’ And I didn’t like that feeling that gave me. I didn’t want my kids saying that, ‘My Mommy’s nasty. She’s a street worker.’…so I just…walked out and never again.” (1061Part3) !"%"!Spirit stated that her children were a major inspiration to quit working. “Like every time I wanted to go back and make money that way. I look at pictures of my kids and so, ‘No. I can’t. I’ve got them.’” (1062Part4) “My 16 year old lives in Chilliwack. My 13 and 12 year old want nothing to do with me. And my 2 year old is in care in Penticton. Because the Ministry will never give me my kid back because of my past and my childhood. I walked away and I’m gonna allow them to live the life they need to live. They want to find me, they can find me. It’s hard. It’s really hard. But you know what…it’s better for them to have a good life. And not be hindered by my past and my issues…allow them to grow…I’d walk to the end of the earth for those children but right now what they need me to do is to stay away so they can grow and they can build their own lives and that’s what I’m doing. It’s hard. It really is some nights. Like some nights I’ll cry. Some nights I’ll get mad. Some nights I just don’t care.” (1061Part72, 73) Spirit’s current situation and future goals. Spirit described to me that while she no longer worked in the sex trade she continued to be financially supported, at times, by friends and companions. “So what I’s not really a street worker anymore…It’s like I’ll go out and hang out with guys. It’s not like sex or anything like that. It’s just hanging out…They pay for the night in friendship thing. And that’s all it is. Like it’s no longer paying for the sex…paying for the company. It’s actually just going out and having fun and I like that. I just…it was really hard to get out of it for a while cause every time I felt like I was low on money or I was just feeling like I needed a connection to my past to run back to the corner…but it was like, ‘No I can’t do that because I don’t want my kids to think I’m nasty.’ (1061Part6) Spirit was still struggling with addiction when we met. “I’ve gotten clean a few times. But because the addiction…It was born into me…I’ve been addicted since birth in the womb and everything…It’s everything I’ve ever known. So getting away from it sometimes is just hard. So !"%#!sometimes I’m clean. Like sometimes I can get clean. The longest I’ve been clean is three years.” (1061Part28) “I now use…I only use the rock as an escape because it’s the one thing that I know that I can just…I can smoke it and I’m just gone. I don’t feel it. I don’t feel the anxieties anymore. I don’t go out smokin’ up with guys. I don’t smoke up with anybody else. I’m by myself a lot. I go in my room. I smoke a 20 rock and relax.” (1061Part28) Spirit stated that she continued to use substances to cope with anxieties and past trauma. “I just do it when I need to feel numb. And it made me feel numb for a while.” (1061Part29) “But the coming off the ‘down’ is hard because it does get a real physical addiction. So when I choose to quit for a period of time, I lock myself in my room for three or four days. I don’t come out. I’m so sick. I don’t wanna see anything. I don’t wanna hear anything…Just want to be left alone to get over my sick cause then I’m happy again…I sleep hours and hours and hours. Like I think I slept out of 24 hours…probably about 19 hours of the day.” (1061Part31) Spirit articulated that she currently made money by cleaning rooms for people and doing odd jobs for others. She reflected how she felt her role in life was to better the lives of others. “What stopped me from going back into the sex trade is the fact that I’m better on the side teaching them [the girls currently working] how to live and cope with what they have to cope with and tell them about certain…because not everybody’s gonna be stuck in the sex trade forever. I’m gonna be there giving them the courage to get out of it by just words…just by wisdom…just by walking down the street being me.” (1061Part54)  As discussed above, Spirit and I only met two times in the summer of 2012; I lost contact with her after that. When we spoke, she felt her role in life was to continue to bring joy to others each and every day. In fact, she had a daily goal for herself to make at least one person smile !"%$!each day. My hope for her is that she continues to bring her spirit and angelic energy with her to each new day. Survivor’s story. “It’s like swimming through a pool of great white sharks…poverty and sex work are on one side and a home, a job, and education is on the other…” I met Survivor, a 34 year-old self-identified Native woman, in the summer of 2012 on June 20, June 25, and August 23. At the time Survivor was employed part-time, had completed some diploma programs, and was currently living in an apartment. She stated that she had no children. She was not currently using any substances.  Survivor entered sex work during her teenage years. She left and went to college and got a job as a childcare worker. After she was arrested for an incident with a police officer, she began working in the street sex trade because, as she described, she found it difficult to find ‘straight work’ once she had a criminal record. She exited after many attempts and was able to find a job and start her own business. She then re-entered indoor work to see if she could make money doing sex work on the side, but, after a short time, she realized it was not worth it and exited for the final time. When we spoke, she had been out of the sex industry for approximately five years.  Survivor’s story of transitioning into indoor sex work (Time 1). Survivor stated that she had been involved in indoor sex work as a teenager where she sometimes had pimps. “I was in my late teens when I said I started…And they [her pimps] were really good to me. Still it’s prostitution…There were a couple of times when I was like left in dangerous situations. But I mean I never got beat up. I never was you know like emotionally/mentally/sexually assaulted by pimps. I just was sexually exploited. And I guess I’m learning I don’t play the victim but I have learned to identify what it is. So there’s two feelings…there’s a part of me that these people were !"%%!there…They got me out of a bad situations and they took care of me. But there’s another part of anger…when you put it in context and you know what was really happening, you’re like, ‘Those people sexually exploited me. I think I’m kind of mad about that.’” (1073Part25, 26) Survivor’s story of transitioning out of indoor sex work (Time 1). Survivor left the trade in her late teens to early twenties with little difficulty given that she was young, had no addiction issues, and had no criminal record. She stated that she just got tired of it and entered the ‘straight’ workforce. “I actually did go to college and stuff like that. I was a childcare worker. I worked with children. I worked in restaurant work. I did telemarketing. I did a lot of odd jobs here and there. I even ran my own maid company.” (1073Part9) Survivor’s story of transitioning into street sex work. Survivor spoke about feeling as though she had little choice entering the street sex trade the second time, as she had a criminal record for assaulting a police officer. She stated that what actually happened, however, was that the police officer assaulted her and she fought back. “The reason I went into sex work is because I had a criminal record for assaulting a police officer in Calgary, Alberta and I couldn’t get a job doing anything. The 7-eleven wouldn’t even hire me…and so you’re supposed to leave sex work because you know it’s a bad job…morally wrong and all this kind of stuff. Well now what do you do for employment if no one will hire you?” (1071Part17) Survivor’s story of transitioning out of street sex work. Survivor described to me that her second time leaving street sex work was incredibly challenging, because at that point she had developed a heavy drug addiction and felt stuck in a cycle of poverty, abuse, and trauma. She told me that she attempted to exit many times and in different ways. One time she tried to leave after a bad date. “First time I went [to Servants Anonymous Society] I lasted like maybe a couple months and then I got kicked out. And then I went again and it was decided that I’d go to drug !"%&!treatment after I got beat up by a date. I’d go to drug treatment and then I would stay in the housing. And then I screwed up in the drug treatment got kicked out of drug treatment and so then I thought, ‘Oh well I’ll just go to another drug treatment, right?’ And they’re like, ‘No. You actually have to leave our facility because you got kicked out of the program.’ I go, ‘Well is there another program I can go to?’ ‘You can’t hop from program to program.’ ‘Well, why can’t I?’…So then I went and stayed with my mom for a month and a half. I got a job up there working as a maid and I helped take care of my nephew and my sisters. And I got into a fight with my mom and I came back to Calgary, Alberta…got really heavily into crack cocaine and then that’s how I eventually made it to Vancouver. So I did make attempts. I did try. It’s just that the support wasn’t there or it wasn’t the right kind of support.” (1073Part52) Survivor described to me that the process of getting out of street sex work was a long transition from one world to the next. “Other times like when I got out here with PACE, I’d work in the survival sex trade but also I had a part-time job as a peer support worker with them so I’d have two…I had my foot in the underground drug/sex trade world. I had my foot in the real world. So I was slowly inching my way until my other foot was in the real world.” (1073Part44) Survivor stated that her final time exiting the street sex trade was after another a violent attack from a pimp. “The second…final time I decided to exit the survival sex trade was because I got attacked by a pimp. I was living in a hotel but basically it was a brothel and a crack house in the DTES and I was living on welfare. I was living in poverty and I was also overcoming an addiction to crack cocaine and alcohol. And I got attacked by a pimp cause he wanted me to work for him but I didn’t want to work for him and so at that moment due to my safety…I went into three different homeless shelters and I then I went…PACE society got me into PEERS Vancouver to basically exit.” (1071Part1) !"%'!She shared that she utilized a number of different resources and agencies throughout that period of her life, but she began by detoxing at the Union Gospel Mission. She then entered recovery houses to continue her transition out of street sex work. “And I moved into a recovery house for three and a half years when I was just like 10 months clean off of crack cocaine and I lived there and after that…I was able to move into the West End. I was able to move back into society…move out of the ghetto, ’Okay I can do this now. I can be a part of society. I don’t have to hide in the ghetto anymore.’” (1071Part31) She stated that part of the transition involved processing the trauma she had experienced as well as transitioning from the street world to the straight world. To do this, she emphasized that it was important that she felt stable and secure in her surroundings (e.g., housing, employment, and supportive community) and within herself (e.g., processing trauma so that she did not need substances to cope and increasing feelings of self-worth) “I don’t know that’s just what worked for me like spending four years in counselling. I still go to counselling too.” (1072Part17) Survivor’s story of transitioning into indoor sex work (Time 2). Survivor discussed that while she never returned to the street sex industry, she did attempt to work again in the indoor sex industry although this only lasted for a short time. “At that time I hung around a lot of sex worker activists and I wanted to see if I could make it in the indoor sex industry…not as a survival sex worker because before you know I was like drug dependent…I worked in survival sex…like I had to, right? Now I wanted to see if I could do it…something I choose to do and if I could make the same kind of money…I did really good for probably a year and a half. I…ran my own independent massage business…and I didn’t do drugs or drink or anything like that.” (1071Part2) !"%(!Survivor’s story of transitioning out of indoor sex work (Time 2). Survivor stated that she left after a year and a half because as she said, “I just kind of got tired of it all. I just got…I think I got tired of men touching me.” (1071Part2) I asked her what the process of leaving indoor sex work was like after her rigorous process of leaving street sex work. She said, “I had kept my straight job where I worked in social work. Basically I worked with drug-addicted moms and babies and my boss knew that I was working in the trade, right? And so she was okay with it and you know I did my whole sex work thing and when I decided to leave I had a whole other life that was waiting for me to go back to…like I just jumped back into my other life.” (1071Part7) Survivor’s current situation and future goals. When I met Survivor, she was continuing her pursuit of activism for women and sex workers. She stated that activism provided meaning in her life and was a significant help for her as she was leaving. “When you’re quitting something you need to have something to replace it that’s just as good as what you’re leaving so I got really heavy into like protesting…activism.” (1071Part9) When we met, she was running a program that feeds street sex workers as well as an organization that exposes, prevents, and works toward ending police brutality. Survivor also spoke highly of her involvement in and support she received from the Christian community, which she said was quite helpful as she left.  Survivor’s future goals included continuing her work with the two organizations discussed above. She was also actively working to create more services for women who desire to exit the trade, because, as she described, exiting street sex work without proper help and services is “like climbing Mount Everest except you don’t have the right equipment to get up there so you’re not going to make it up there, right? You’re going to die on the way up but when you have the supportive community and when you have social services in place…you have all the equipment to climb the mountain and make it to the top.” (1071Part70) She articulated that while she was !"%)!able to leave, it took her many attempts and going through a number of different services (e.g., addiction treatment, domestic violence shelters, religious exiting services) that she did not feel necessarily fit for her. She stated that organizations usually did not have an understanding of the reason why women engage in sex work and thus, she often felt stigmatized by services that were supposed to be supportive.  When we met for the member check, Survivor was actively continuing her work to change society’s views of sex workers to human beings who deserve the same rights, dignity, and respect that everyone else does. She strongly desired to create more opportunities, or boats if you will, to help women who do desire to leave the sex trade to cross those shark-infested waters. M’s story. “Pick yourself up…just go at it again…” I met ‘M,’ a 38 year-old single self-identified Native woman, in the summer of 2012 on August 15, August 30, and September 16. At that time she was living in an apartment with her three kids and was employed part-time. She was not using any substances.  M entered the street sex industry when she was around 14. She left for a short while after getting pregnant and raising four kids. She re-entered after she lost custody of her four kids when she was 22 years old, which prompted her to get heavier into her drug usage. Sex work became a way to make money for drugs. She spent 16 years following that time caught up in addiction and working in the street sex industry. When I met her, M was a proud mother of eight kids. Her pregnancy with her 9 year old son, D, was an eye opener for M. Along with pressure from the Ministry and wanting to raise her son, about a year and a half after he was born, she was able to get into treatment and get clean. She has been clean and out of the street sex industry since that time. She has had two more children and when I met her she had custody of her three youngest !"%*!kids with a fourth living in White Rock. She had also started to reconnect with her four oldest children. M’s story of transitioning into street sex work. M grew up in Kitimat, BC. She moved to Vancouver with her family when she was thirteen. “I was raised with alcohol…I was with alcohol every weekend…and having a family with an addiction in itself was not great structure either so…I remember when I was maybe nine or ten, I told my brother. I said, ‘I’m not gonna drink. I don’t wanna become an alcoholic if this is how it looks.’ (laughs) Every weekend it just seems like the same video and all of that with the alcohol.” (1082Part12) She entered the street sex trade when she was 14 or 15 after her mom kicked her out of the house. “And I ended up having to stay on the streets for a while. And I never knew about working then. My girlfriend showed me…[she] goes, ‘Well if you want the extra cash this is the way to do it.’…That first date was scary. Like, ‘Okay I can’t do this.’ I just don’t feel comfortable jumping into a vehicle. But after a while I had to do it…do it drunk or smoke a joint or something (laughs) before I went jumping in a date’s car…just didn’t feel right though.” (1083Part17, 18) M stated that back then she would engage in sex work primarily for extra spending money and alcohol. “Yeah it was just something to do…just to get extra money before Friday night or for an outfit or something. Then I didn’t know about drugs. I just smoked weed and maybe drank. That was it.” (1081Part42) M left around age 17 before she had her first daughter. For the next five years, M had three more kids and was a stay-at-home mom with her four kids. “After that I was a mother with a shackle to her legs and everything. That’s how I felt (laughs). Jeez I was 17…19…with four kids at home…never did anything except have my beer on the weekends. I was a single at home !"&+!mother with four kids. I never had any sitters because if I did it’d cost me an arm and a leg for a sitter.” (1083Part22) She then told me the story of how she got into drug use and eventually lost custody of her four oldest kids. “I took back their daddy and he was into drugs and I never knew it. I never seen the signs. I never even knew what the signs were. Daddy kept on coming around. He was always full of money. And I never knew what it was for. Somebody’s just give ‘em to it. And then he started doing drugs in my washroom, which I never even knew he was doing. I was like, ‘Okay. I don’t even know what he’s doing here.’…You know I never even knew what crack and heroine was until he showed me. So one time I just walked in and he was smoking it…the crack and that. And I looked. I was like, ‘What is that?’…And he goes, ‘It’s just…something you don’t want.’ And he deterred me for a couple times. And finally I just started pressuring him into it…Stupid me. Stupid me.” (1083Part24, 25) She said one day two of children walked out the front door. “They wanted to go to the park that day…But I was so cracked out for a week, and two of my kids walked out the door and they almost got hit by a car…I didn’t even know my kids were gone. I came to a couple hours later…like maybe 6 hours later I wake up…I see just my two kids. And I’m like, ‘Where’s the other two?’ And they were gone. They walked out of the house. Our weekly routine was go to the store and then go to Robson Park so that’s what they did…That’s how the Ministry ended up apprehending two of my kids.” (1083Part27, 28)  After losing custody of her kids, she stated she did not want to feel anymore; she got heavier into her drug usage and sex work. “That’s how that started 16 years ago. Yeah after losing ‘em. I felt like my heart was torn into four pieces…and I had no reason to do anything because the first week it was just so hard…just getting up daily and waking up to a three !"&"!bedroom with no kids running…nothing. I’d just look around, I’d be laying there crying. I’m like, ‘Shit.’ So that’s how I ended up getting into that stuff heavier. I started working and everything because I didn’t want to feel anymore…I wanted to numb it. I wanted to numb everything.” (1083Part28) M’s story of transitioning out of street sex work. M stated that one of the main reasons she initially left was due to her physical health and appearance, which she felt were deteriorating with drug use. “I got tired of looking at the pit marks and everything…especially on my face.” (1081Part32) She told a story of leaving addiction and the sex trade, which involved multiple attempts and relapses. “I kept on calling them [detox centres] everyday until I got accepted into detox…My A & D counsellor helped me. She came to my hotel room. She helped me pack. And she drove me to detox.” (1081Part85) “And after that I gave away all my working clothes…everything…I wanted to start over.” (1081Part86)  Following detox, M went into a women’s recovery house for three months. “She [A & D counsellor] got me into a recovery house in Surrey…I was there for 3 months and then I ended up relapsing…so I’ve been up and down…So yeah I had my first relapse. I didn’t like the way I looked. I was just too big after. And that was my excuse too…but then after that…after three months…I went back into detox again and started all over again. I remember them saying at AA & NA, ‘Pick yourself up. Just go at it again.’ So I did. Picked myself up…went back to detox.” (1081Part88) “So yeah…that’s how the cycle went. I’ve relapsed twice during my first time…my first trial…trying to clean up. And everybody says you will have your ups and downs and this and that. Stuff will come up. But I didn’t want to hear that.” (1081Part90) M stated that it was not until she got pregnant with her son and feeling a pressure from the Ministry that she was able to exit. “That’s what totally clicked. After…feeling another person !"&#!growing inside of me. My son being there…just having him and just realizing, ‘Okay, M you know this person here is gonna rely on you and need you for the rest of his life.’ You can’t…like you know live down here with him. I gotta change. After having him it was just really a big eye opener for me too. And being pushed more too by the social services and everything so…I guess I needed them too. Just to go to the residential treatment for three months in Abbotsford with my son. That’s a residential treatment centre for women with children. They get to do their time with their kids there…raise their kids. So they basically just show you how to live and how to cope with little things. But yeah all that stuck with me after a while.’” (1083Part9)  M’s current situation and future goals. At the forefront of M’s life when we met was being a mother to her three youngest kids. She was also re-connecting with her oldest children and grandchildren. “It’s just a frame of mind… where your mindset is. My mind set’s definitely on being a mother and hard worker and everything.” (1082Part4)  M was also working and volunteering which had been and continued to be a huge help in her exiting process. M was also looking into future careers, such as becoming an A & D counsellor. M stated that while she does not use substances anymore, she continued to live in the DTES where she saw drugs everywhere. She said because her children were getting older she was looking to move out of the neighborhood in the upcoming year or so. “So I still live still right downtown. I look at it everyday…My kids see it too. They see all the action happening just right in the back alley. And I look at it and I’m like…Okay this is an eye opener for me. I realize I’m not missing anything.” (1081Part14)  When we met the final time for the member check, M was still actively seeking to move somewhere more kid-friendly, as her kids were getting older. She was also desiring a change in general, which included looking for different volunteer positions, as she had been at the same !"&$!place for many years and wanted something new. M continued to approach every day as a new day of learning and growing as a mother and as a woman. Conclusion of the narratives. I would again like to express my appreciation and gratitude for the eight women who shared their stories with me. In the following section, I will be presenting the common themes or commonalities found across these women’s experiences. As I will detail in the next section, I began to see the process of transitioning out of street sex work as a series of ‘stepping stones’ or ‘building blocks,’ if you will. That is, I noticed that throughout this transition out of the street sex trade that there was a need for certain ‘blocks’ or ‘stones’ to be put into place before others could be touched. While I present these themes in a linear fashion for organization sake, I must emphasize that I came to understand these ‘blocks’ or ‘stepping stones,’ as a process that was not necessarily linear and actually quite cyclical for many of these women. I will now conclude this section of the chapter by once again thanking Jean, Crystal, Mary Joe, Nita, Owl Woman, Spirit, Survivor, and M for their openness in sharing their stories and reflections upon their experiences of exiting street sex work. The overall themes or shared journeys from their experiences will be explored next. I will then conclude the overall chapter with my own story and reflections on my experiences throughout the research process. Throughout this final section, I will re-examine my own pre-suppositions prior to meeting these women. I will compare these to what I actually found and came to understand during my time speaking with these women and after reflecting on these meetings. Shared Journeys: Themes of Transitioning Out of the Street Sex Trade In this section I have identified seven overarching themes that these women shared in their journeys of transitioning out of the street sex trade. Again, I am presenting these themes in a linear fashion for simplicity and organizational sake; however, as I illustrate in the first theme, !"&%!the process of transitioning out of street sex work was for many quite complex, circular, and not linear. The first theme I will discuss is relapsing (‘the yo-yoing effect’) and readiness to change. As I illustrate in this section, ‘exiting’ street prostitution may not actually be the appropriate term to use for this process. Based on these women’s stories it seems it is more a ‘transition’ than ‘an exit,’ as rarely is it a linear, one-time step. More often it is a process of moving in and out of the sex trade often related to addiction relapses. However, many women throughout their transitions described similar experiences along their journeys, such as similar barriers, required steps, and supports needed along the way. The women in this study came to the decision to leave for various reasons but often this decision was initiated by a turning point or a time for reflection whether that was related to a pregnancy, a bad date or a violent incident, or time in rehab or jail. This brings me to the second theme, which is the role of stability, security, and safety with space and time for reflection and decision-making. During this time, the women emphasized the importance of having a stable and safe environment where they had the mental space to reflect on their choices. The women in this study discussed that following this time of reflection, which for some was a short period and for others a considerably longer time frame, they needed to start by setting small, manageable goals as well as altering their perspectives and attitudes (as will be described in the third theme). That is, instead of deciding they were going to quit using and leave sex work (a monumental task), they would set a goal for that day to speak to somebody about getting into a detox centre, for example. Often, though, these women had to learn this through trial and error after attempting to take everything on at once and then relapsing quickly. Many women also spoke of having to overcome systemic and structural barriers (the fourth theme that will be explored) along the way wherein they faced issues of poverty, legal issues, stigma, and discrimination. While not all had the kind of support they needed or would have liked, every !"&&!woman emphasized the importance of having a supportive community of some kind, which is the fifth theme that will be discussed. This support could be from their family, formal support services, the DTES community, a new community, or even being a mother. The sixth and major theme that will be explored is the role of mental and emotional health. All of the women stated that a part of the process of transitioning out of the sex trade involved disentangling themselves from addiction and this often required processing a lot of emotions particularly trauma from experiences on the street, in childhood, or both. These women were quite clear that to be able to process these intense emotions, such as trauma, and thus, to be able to start to detox from addiction, one MUST be in a secure and stable environment and with a support network where they felt a strong sense of physical and emotional safety. Then and only then could they start to work on the emotional, mental, and spiritual aspects of themselves so that they could become less dependent on drugs and alcohol. Many of the women were still actively working on this piece of the puzzle. They further articulated a need to find meaning and purpose, which is the seventh and final theme presented, to aid in the transition since they would be leaving behind a lot when leaving addiction and sex work. This is where things like employment and education came into play for most people. When I inquired about these aspects of their worlds, only a few were able to say that they were at a safe and stable place both emotionally and physically to start to contemplate notions of career, employment, and education. Some had started to pursue this with a few actively working and volunteering or pursuing their educational goals. In this next section I will explore each of these seven themes and related subthemes in further depth. Theme 1: Relapsing (the ‘yo-yoing effect’) and readiness to change in transitioning out of street sex work. A major theme that the women in this study identified was that exiting street sex work was often not a one time, linear attempt and instead took multiple attempts of !"&'!transitioning in and out of the sex trade based on one’s individual readiness for change. This transitioning in and out is something that Sanders (2007) has labeled the ‘yo-yoing effect.’ The women discussed that this ‘yo-yoing effect’ was quite a taxing process, as it took considerable mental and emotional energy each time they would ‘slip’ and start the process over again. Furthermore, due to the incredibly emotionally and mentally draining process of transitioning out of street prostitution, the women emphasized that regardless of external factors, they had to be individually motivated and mentally ready to embark on this journey. Additionally, they articulated that it took a level of awareness and knowledge that leaving sex work could often take several attempts of transitioning in and out before they would start to feel more stable and secure (to be explored below). Some spoke of how their first few ‘slips’ were quite stressful, as they thought they had failed in some way. These women expressed how they had to learn that ‘slipping’ and ‘getting back up again’ was just part of the transition. This yo-yoing effect as well as some of the women’s comments has made me question the language used when discussing leaving street sex work. Jean exemplified this idea that leaving sex work is quite tentative and more a constant life transition than a final ending place when she stated (after not being involved in the sex trade for almost ten years), “So have I exited the sex trade? I suppose I have…” (1011Part34) Two sub-themes emerged within this theme: (a) relapsing and the yo-yoing effect and (b) readiness for change. Also noteworthy in this section is my new understanding of language regarding leaving the sex trade.  Relapsing and yo-yoing effect. Almost all of the women discussed that they experienced this ‘yo-yoing effect’ wherein they went in and out of sex work several times before they were able to exit (often paralleling their addiction relapsing periods). The women in this study emphasized that this process of ‘slipping’ and having to ‘get up again’ was incredibly mentally !"&(!and emotionally draining. They expressed to me that it took considerable effort, resiliency, and self-forgiveness each time a relapse occurred as the process of starting over (often having to get clean again) was quite demanding physically, mentally, emotionally, and spiritually. These women articulated that relapsing often coincided with significant self-judgment. They therefore, reiterated the importance of self-forgiveness when they slipped to avoid getting trapped back in the addiction and sex work cycle and having to start all over again. Some were still in a process of transitioning in and out of the sex trade. For example, one woman reported that she occasionally still turned tricks for money. Others stated that they still hung out with old ‘johns’ or ‘sugar daddies’ and these men paid for the evening but no sex was involved in the exchange. Several others said that over the years they have been tempted to ‘turn tricks’ and questioned the certainty that it would ‘stick.’ Others questioned what ‘exiting’ even meant. As Spirit expressed:  Everybody makes mistakes. It’s just how you deal with them. And how you let them affect your life. And if you let them hold you down. Because if a mistake holds you down…Why? It’s just a mistake. You’re bound to make mistakes. You’re bound to have slips…It’s just the way it goes. It’s part of being a human being. Get used to it. You’re not a god. You’re not perfect. Nobody expects you to be perfect. And by hearing those words, “Nobody expects you to be perfect.”…That opens the door for you to make those mistakes and not feel like you gotta beat the shit out of yourself because you made one single mistake. Hey, change the sheets and try again…Start over. (1062Part59) Individual readiness for change. Almost all of the women discussed a need to be individually ready and motivated to change to have more ‘success’ in getting clean and transitioning out of street sex work. They described this readiness as a mental preparedness and inner motivation (or drive) to leave addiction and sex work. They expressed to me how many !"&)!times they had tried to leave due to external forces, such as pressure from family or support workers. Some spoke of this being helpful, as it served as a motivator to leave, particularly if this pressure was linked to maintaining custody of children. However, for the most part, the women stated that while external pressure could serve as an external reason or motivator for leaving, the individual person also had to be personally motivated and ready to make the transition. They emphasized that given how difficult it was to embark upon and stay on this journey of leaving addiction and prostitution, they needed to be individually motivated and ready to take on these challenges. The women stated that often they had relapsed when they attempted to leave for external reasons only. As Crystal articulated: It all has to be up to the person, right? If you’re not ready or whatever then don’t force yourself to do it because if you’re doing it for somebody else or doing it because somebody else is pushing you…You’re not doing it for your own reasons…then it’s not gonna work…because you’re being told to do something. Nobody likes to be told what to do. (1021Part37) Author’s Note: One thing that I have started to wonder is if the term ‘exiting’ is an accurate term to use given this ‘yo-yoing effect.’ In addition, I have questioned how this term ‘exiting’ can also further perpetuate the negative stigma of sex work. During one of my conversations with my expert peer reviewers they asked me about this term and inquired about why we use the term ‘exiting’ for sex work but not for other types of employment (e.g., Does one ‘exit’ the legal profession? Medicine? Teaching?) I have thus, begun to toy with the term ‘transitioning in and out of the sex trade’ instead of ‘exiting’ the sex trade and will utilize this terminology throughout the remainder of this document. !"&*!Theme 2: The role of stability, security, and safety in transitioning out of street sex work: space and time for reflection and decision-making. While many women discussed this ‘yo-yoing effect’ or transitioning in and out of the sex trade, most also spoke of a pivotal moment that led to their decision to leave as well as a need for stability and safety in making this transition out of addiction and street sex work. Many described how street sex work and addiction involved living in the moment and therefore, when they were ‘caught up’ in this lifestyle they did not have the time nor space to contemplate the future. The women in this study thus, emphasized the importance of mental and physical stability in facilitating a sense of physical, mental, and emotional safety. They stated that this sense of safety helped to provide a space for them to reflect on their options and process mental and emotional health issues (to be explored below). The women reiterated that during times without this safety and stability they often quickly relapsed in both their addiction and sex work as without this physical and mental space, they were unable to take time to reflect and process their options for the future. As Survivor reflected when contemplating how she left:  She needs a place to go to think things, and plan, and decide this is what I want to do. ‘I need to go somewhere and I need to get this in place so I can…cause when you’re in survival sex you’re in the moment. You’re not thinking ahead because you might not be alive in an hour. So you can’t be like, “Yeah I’m gonna go to college tomorrow. I’m gonna go put in an application and go to college tomorrow. I’m gonna go get a job tomorrow.” (laughs) Because you may not be alive tomorrow. (1071Part80)  Three sub-themes emerged within this theme: (a) stable, safe, and secure housing; (b) turning point/wake up call; and (c) knowledge and questioning. !"'+!Stable, safe, and secure housing. Many women discussed a need for safety, security, and stability in their living circumstances so that they could take the time (in a space where they did not have to worry as much about survival) that they needed to reflect on their lives and make decisions. They described that this stability and security needed to be physical (i.e., a physically safe, secure, and clean home that they could return to each day) as well as emotional (i.e., a stable environment that made them feel mentally safe and free from danger) They spoke of how this stable and safe housing provided a sense of structure and security that was necessary in their transition out of street sex work. Most shared with me that the ideal setting for this reflection space was a facility solely for women since many co-authors expressed having difficulty engaging in relationships with men (discussed below) after their time in sex work. Some co-authors stated that they were in the process of seeking stable and secure housing so that they could take the next steps in their transition, such as processing traumas, starting their education, or working to gain custody of their children. For many, however, gaining stable, affordable housing was difficult, as many of the housing facilities that they lived in had time limits. They informed me that as a result they were constantly working to find their next home and had to move frequently, which made it difficult to establish security and a stable routine. Owl Woman articulated the notion of safety well when she said: Safety is huge. A person needs to feel safe. That’s important…When a person is safe and they know that someone’s not gonna abuse or traumatize them…then they have a better chance of getting stronger and start working on those things. (1052Part59) Turning point/wake up call. Many women discussed a turning point in their lives, whether this was a pregnancy, a bad date, time in jail, or physical health concerns where they were given time and space to think about their future. They articulated that these turning points or wake up !"'"!calls were like signs or warnings that alerted them of a need to change due to either a risk of danger (e.g., bad date) or wanting something positive (e.g., pregnancy). They described to me that these times for reflection or wake up calls were often forces or motivators behind their decisions to leave. Some left immediately following these instances without much contemplation required. Others shared that they continued to use and engage in sex work for a while after an incident for varying reasons, such as feeling that they had no other choice, having few resources at the time, or being strongly wrapped up in addiction and needing to continue to work to pay for the addiction. The women emphasized that particularly after a trauma, such as a bad date, they would often not seek help immediately and, instead, as substance use was often their primary coping strategy, they would initially turn to drugs and alcohol to help cope with the trauma. Some of the women had been incarcerated and articulated that often these times of incarceration were periods where they were forced to get clean and thus, were able to clear their heads and reflect on their lives and future choices. While some emphasized that these times of incarceration served as positive forces in their lives, others also articulated the downsides of being convicted of crimes and having legal records (to be explored below). In addition, several women discussed how physical health played a role in both transitioning in and out of street sex work. Some women spoke of relapsing and re-entering sex work after being diagnosed with a physical health issue (e.g., Hepatitis C) and struggling to cope with the diagnosis. Others stated that their wake up call came after recognizing how unhealthy they had become due to drug usage and other aspects of their lifestyles. Some women expressed that while they were working they were physically in pain or at risk of illnesses (e.g., pneumonia and STDs) and recognizing these risk factors sometimes served as motivators for leaving. Many emphasized that they continued to stay out of the sex industry for fear of getting sexually !"'#!transmitted diseases, such as HIV. Two women reflected that the main reason they had left the sex trade and were working to get clean was so that they could have surgery. M shared with me her experience of having a wake up call. When her son was quite young and she was still using crack, she recalled looking up and seeing the expression on her son’s face when he saw her using, which made her re-think her choices. She stated: After me seeing my son the way he looked at me when I was doing that I was like, ‘Ah no. I can’t do this with him. Like you know this ain’t right. This…totally not right…He’s not even supposed to be seeing this at all period cause he don’t even know what’s going on’…After that I…woke up after just seeing the way he looked at me. (1083Part12) Knowledge and questioning. While some women left sex work abruptly after a violent incident or pregnancy, many (and sometimes the same woman in a different time in her life) discussed a need to learn about options and reflect on choices. They emphasized that this knowledge and questioning period allowed them to feel personally empowered and to gain clarity about the future, both of which helped to facilitate their decision-making process and eventual transition out of the sex trade. Many of the women felt trapped in the lifestyle, as they did not know they had alternative options outside of street sex work. Thus, learning about other options and the steps one could take to transition out of street sex work (and into another lifestyle) was pivotal in facilitating feelings of choice and control. The women described feeling personally empowered through learning about options and gaining education on the reasons why people get into prostitution, what trauma and abuse is, and how to handle and cope with all of these factors. Many stated that during this time of reflection they would ask themselves questions like, “What are you doing to yourself?” “What do I really want in life?” “What are the pros/cons of each possibility?” This questioning helped them to gain clarity and sometimes personal !"'$!motivation for wanting to leave. Owl Woman explained that for her this knowledge and questioning period really started when she went to PEERS; they helped her see patterns in her life and alternatives for her future that she was unaware of prior to attending their programs.  It gave me choices. I wasn’t stuck, ‘Oh well I have to be…stuck in my addiction.’…And then also it helped me to really look at…what was it that put me out there?...You know everybody can say a street worker is just because of addiction, drugs, alcohol. But there’s a lot more to it than that…You gotta…go underneath…their core issue. Those are the real issues…That’s the real story of what’s really going on for that person and why they ended up there to begin with. Cause people aren’t born, ‘Yeah I want to be an alcoholic. I want to be an addict. I want to work the streets. I want to be in the sex trade.’ Nobody wants to do that…Those choices that are made…Well why were those choices made? And that’s what I liked about PEERS…It was giving the person an alternative. (1052Part13) Theme 3: The role of goal setting, perspective, and optimism in transitioning out of street sex work. After reflecting on their decisions and coming to a conclusion that they wanted to leave, the next step in the process for many women seemed to be setting small, manageable goals for themselves and changing their perspective and attitude on the situation. They described that this attitude change involved altering the way in which they thought about themselves and the transition as a whole, such as believing for themselves that they could get clean and find alternatives outside of prostitution. The women stated that setting goals and changing their perspective and attitudes helped to facilitate a change in the way in which they looked at their situation; it made the daunting task of leaving addiction and sex work a much more doable process. Many women discussed how they had tried to transition out of prostitution without setting smaller goals and having a more negative attitude and limited perspective. The women !"'%!stated that during these times they quickly relapsed, as they shared with me that it was impossible to do everything at once. They further expressed how challenging it was to try to leave with little hope and engaging in negative self-talk, such as thinking they could never get clean and they could never do anything outside of sex work. Crystal articulated this need to set goals and change one’s perspective when she said:  When I was in treatment they helped me realize that you have to…instead of just saying this is my goal…break that goal down as small as you can like into little baby steps…where you wake up early in the morning and then you break it into ten little different steps…where at least if you get one done, you’re a little bit closer and stuff like that, right? So don’t say, “I’m gonna quit working the streets tomorrow!” Because that’s an unrealistic goal, right? Set realistic goals…where you know I’m gonna see an A & D counsellor today and just talk about the possibility of, you know, getting into a transition house or something, right? So make the goals achievable for yourself. Make them realistic to yourself. Like make the goal for you rather than for this person who’s already been in recovery for a year, right? Like small goals as long as they’re goals working toward a big goal then they’re wonderful goals to have. (1021Part95)  Three sub-themes emerged within this theme: (a) goal setting; (b) changing perspective; and (c) hope, optimism, and humour. Goal setting. Almost all of the women stated that following the reflection time that was explored in theme two, they had to make a plan for their transition in which they set small, meaningful goals for themselves to help them make the process of leaving easier and smoother. As Crystal metaphorically described, her goals in life were a line of boxes that she needed to open and unpack one at a time so she would not get overwhelmed. The women in this study !"'&!expressed that setting these goals allowed them to mentally organize their transition in a way that was more manageable and constructive, which they shared lessened the stress and burden of transitioning out of prostitution. They discussed the importance of letting go of trying to quit everything (i.e., addiction and sex work) or complete all of their goals at one time. Many had attempted to leave with this latter mindset, which they articulated caused them significant distress (and often self-judgment) and frequently led to quick relapses. M elaborated on this process further of needing to let go of the notion of completing everything at one time when she said: I realized…with my relapsing too is that I put too much on my list and overwhelmed myself…looking at it and thinking I needed to accomplish it in one day...Yeah I’m like okay, ‘I didn’t do this. I didn’t do this. I didn’t do this.’ And that’d be my thing too. She [her A & D counsellor] goes, ‘You can do one thing a day and just go on from there. You got the whole week, M.’ (1081Part90, 91)  Changing perspective. Almost all of the women spoke of a need to change their perspective on their situations to help them throughout their transition. They described this change in perspective as an alteration of their mental outlook or perception of themselves and/or the transition overall. Some shared how they began to look at their negative experiences as learning opportunities, which they reflected gave them more power and control over their lives. Some women discussed that they transformed their view of themselves from that of a ‘victim’ to a ‘survivor,’ for example. They said that this change in perspective instilled them with feelings of empowerment that helped to facilitate their transition out of the sex trade. As Jean stated when reflecting on her horrific experience of being sexually, physically, and emotionally tortured in the Caribbean:  !"''!I’m glad I went [to the Caribbean] in many ways. In hindsight it was an unbelievable lesson. In hindsight, I’ve become a stronger person since that experience. I didn’t see it at the time but a lot of good things have come out of it and I guess it’s all about how you…frame things…You know I can look out the window and go, ‘Oh what a crappy day.’ or I can go, ‘Well you know I just got some new rain boots. I guess I could try them out today.’ (1011Part76) Hope, optimism, and humour. Some women stated that having hope and a positive attitude while leaving addiction and prostitution served as an ongoing motivator for them to continue in their transition. They described this sense of hope and optimism as faith or confidence that their circumstances would somehow improve if they kept trying. The women in this study also often used humor, such as joke-telling or laughter, as a means to cope with challenges in their lives and particularly the difficult task of leaving prostitution. For these women, this hope and overall change in attitude seemed to be one of the few pieces throughout their transition that they had choice and control over, which they expressed felt empowering. Many also shared that altering their attitude toward something more positive and bringing optimism and humour into their lives was pivotal in helping them make the transition, as leaving sex work was often a challenging task. Therefore, a sense of humor and positivity brought them lightness throughout some very dark times. Spirit stated that she often used humor to bring this sense of lightness and encouragement to her world and those around her. One of her favorite sayings that she shared with me (and always with a smile) was, “Karma’s like 69. You get what you give.” (1062,Part27) Theme 4: The role of systemic and structural barriers in transitioning out of street sex work. Along the way, many women discussed a multitude of barriers, some that have !"'(!already been articulated, but others that can be classified as more systemic and structural. These barriers are labeled as systemic and structural as they were outside of the women’s control and appeared to be stemming from larger systems and contexts. The women described these barriers as at times making them feel quite helpless and hopeless. Those who were able to overcome these barriers emphasized the importance of letting go of the power these barriers had over their lives, which they stated led to feelings of personal power. Jean expressed her difficulties with barriers in the form of societal inequities when she said: Just by being a woman I’ve struggled with not being equal…Now that I’m on disability and welfare issues and stuff, I’m not treated as a peer and I struggle with that constantly. Always fighting with those people [at the Welfare office]. They treat me like a loser. (1013Part33)  Three sub-themes emerged within this theme: (a) money and class, (b) legal, and (c) societal stigma and judgment. Money and class. Almost all of the women spoke of staying in sex work for the money whether they needed the income to buy drugs or pay for basic living. Everyone talked about how having less money and living in poverty, being a member of a lower socioeconomic class, and living off of welfare and disability were major challenges while leaving and after leaving. The majority reflected how leaving was difficult, because, while working in prostitution, it was ‘quick and easy’ to make money when ‘turning tricks.’ This is consistent with prior discussions about how living in addiction and sex work seemed to be very much about living in the present moment with little thought or ability to think about the future. The women in this study described how difficult and stressful this adjustment was, as they had to learn how to live off of less of an income and to learn how to budget this money for the future. Many shared with me that !"')!budgeting was something they had never learned how to do as it was not necessary given that they were accustomed to being able to get money quickly and whenever they liked. Due to their limited budgets after leaving the sex trade and their lack of skill development in budgeting, many emphasized a need for training programs that taught money management and budgeting. Many felt stigmatized by others (e.g., people in the Welfare office) for not having acquired this particular life skill. Some stated that a big piece of their transition out of street prostitution was to learn how to cope financially and find alternative ways of making money, such as making and selling artwork and cleaning rooms for people. Almost all discussed facing prejudices for being a member of a lower economic class, which they expressed made them feel de-humanized and stigmatized. Crystal, however, articulated one of the most common difficulties, which was to transition away from the fast money. “It was a gradual shift away but the money was always hard too because money’s always out there, right? There’s always somebody who will give me money for something.” (1021Part9) Legal. Some of the women in this study articulated that they faced legal barriers due to having criminal records related to prostitution and/or drug charges. These women stated that due to their criminal records it was difficult to get a job in mainstream society. A few expressed that they were able to get a job but they were then either fired or faced discrimination and prejudice (and sometimes solicitation) after employees discovered their history in the sex industry. They described that this legal barrier caused them significant distress and frustration, as they would be trying to make an effort to make money and be a part of the ‘straight’ world, which was no easy task, and then would face continuous stigmatization and hardships as a result of their past lifestyles. As Survivor, who was arrested for allegedly assaulting a police officer, said, “So…all !"'*!these barriers…and mine comes from assaulting a police officer…That is a whole different kind of barrier cause…when you got a record for violence no one wants to hire you.” (1071Part115) Social stigma and judgment. Many discussed how external stigma for their involvement in sex work and drug addiction served as a barrier in their transition out of street prostitution. Some but not all identified feeling discrimination and stigma due to their ethnic background. They described this stigma as coming in the form of judgment from others in daily life, coping with negative opinions from individuals in treatment programs, being denied jobs due to having criminal records, and/or having difficulty forming relationships with others due to judgment or fear of judgment. Some discussed how this external judgment and stigma often became internalized and a part of their identity. They expressed to me that often this internalized stigma made them feel extensive inner judgment and shame about themselves and their past lifestyles. They reflected that this internalized stigma also negatively impacted their self-esteem and feelings of self-worth. They stated this internalized stigma, shame, and feelings of low self-worth then became a layer to process and unpack when transitioning out of sex work. As Jean said, “The stigma was very hard to live with until I let it go. And I think the bottom line is it’s an inside job for the most part.” (1011Part94) Theme 5: The role of relationships in transitioning out of street sex work. All of the women emphasized the importance of relationships throughout the exiting process. Specifically, they stated that a strong, supportive community was beneficial if not necessary in helping them gain stability so that they could transition out of addiction and street sex work. The women continuously discussed how this transition was extremely difficult in that at times it was physically painful (especially when leaving addiction) as well as quite mentally and emotionally draining. They described how social support helped in a number of ways, such as to maintain !"(+!hope that they could continue in their transition, to provide them with information about different opportunities and resources, and to be a source to lean on during difficult times. However, different relationships and communities provided these women with different inspirations, meanings, and challenges. For example, all but one woman had given birth to multiple children, and these relationships with their children sometimes served as an inspiration to continue with the transition and, at other times (particularly when they had lost custody of their children), a reason to relapse. In addition, several women discussed faced challenges and conflicted feelings in their relationships with old friends and the DTES community in general as well as difficulty developing new relationships and a new community. Finally the women described the importance of coming to a new relationship with themselves throughout the transition. Regardless of conflict it became clear that support throughout the process was required. Survivor exemplifies this overall theme of a need for support when she said, “I found the thing that helped me the most was having community…that understands where you’ve been, what you've been involved with, and want to support you where you want to go.” (1071Part64) Five sub-themes emerged within this theme: (a) support systems, (b) children and motherhood, (c) negotiating the ‘old community’ and ‘lifestyle,’ (d) issues of trust in new relationships and community, and (e) relationship with self. Support systems. Every woman in this study articulated that to make the transition out of the street sex trade, support of some kind (whether this was through formal support services, family, friends, religion, or pets) was necessary, as this transition was extremely challenging and mentally/emotionally demanding. All of the women stated that if you ask for help enough, someone would eventually listen. They had all utilized support through services in one form or another, such as PEERS Vancouver (now closed), PACE Society, WISH Drop-In Centre, !"("!detox/daytox, NA/AA recovery groups, addiction treatment, counselling, indigenous healing, and domestic violence shelters. The women spoke of certain formal support services as being helpful in that they provided them with the knowledge, resources, and support necessary to make the transition out of street sex work and addiction. They also discussed, however, how many of the services out there were not useful. The women told numerous stories of support services that were discriminatory, overly rigid, and lacking knowledge about the lifestyles of and challenges experienced by people involved in street sex work and struggling with addiction, for example. Some women reported that they had very little support from family members or community organizations throughout their transition and this lack of support made it more difficult to make the transition, as they had no one to turn throughout this challenging time. While not all had tons of support, some women spoke up of the gratitude they felt for having family members, friends, support workers or counsellors, religious and spiritual community members, and animals who provided them with support and encouragement throughout their transition out of street prostitution. Others stated that their involvement with community agencies continued to be a source of support. A couple of the women emphasized that connecting with their spirituality through ceremony or a religion was a means of support, healing, and purpose throughout their transition out of street sex work. As Owl Woman stated, support at times came from formal support services. “They [PEERS] were there for me. They listened to me…I did some really good healing there…because I know I’m not alone. I had somebody journeying with me. (1052Part13) Children and motherhood. For many women in this study, motherhood was at the centre of their world and aspects of motherhood such as pregnancy or wanting to serve as role models for their kids became a pivotal reason for leaving sex work. The women in this study stated that !"(#!pregnancy often became an opportunity to reflect on what they wanted out of life and for their future child. For many, losing custody of their children was so devastating that it became a triggering force, which led them into heavier drug usage and more frequent sex work engagements. Two of the women had custody of some of their children and, for these individuals, the role of motherhood provided them with significant meaning and purpose each day. For others who did not have custody of their children, motherhood was also a primary motivator for staying out as they were striving to either get visitation rights back or, from a distance, create a brighter future for their children and grandchildren. Many spoke of wanting to be role models and not wanting their own children to become addicts and sex workers. Owl woman described her fears about this by saying: That’s why I worry about my girls…especially because I don’t want them to walk that path. I really don't want them to do the things I’ve done I really don’t want them to end up drinking and using. I really don’t want them on the streets soliciting, selling, or prostitution…And I get scared as hell because you know it might happen. (1051Part59) Negotiating the ‘old community’ and ‘lifestyle.’  Many women discussed having mixed feelings about the DTES community. Some had left the DTES community but would return occasionally to use it as a reminder of where they could be and a motivator for staying clean and off the streets. Others chose to continue to reside in the DTES community (sometimes by choice and other times because that is where they could afford to live) and also used it as a reminder and motivator. A few of the women in this study emphasized the benefits of having old friends in the community as these individuals provided them with encouragement and praise for the work they had done. Some women strongly desired to move out of the DTES and discussed the importance of leaving behind old friends and making new connections. They stated that this process of !"($!letting go of the past was necessary, as they wanted to start anew in their transition out of street prostitution. A couple of the co-authors, however, felt the DTES community was a piece of who they were and wanted to continue to go back to mentor the girls who were still working.  The women in this study articulated that a major challenge throughout their transition was not only separating themselves from the DTES community and making a new community but also changing their lifestyle and ways of interacting with others. They felt a need to unlearn the ‘norms’ and ‘rules’ of the ‘street’ (e.g., hit someone when they upset you, if someone yells at you, you yell back, etc.) and learn the norms and rules of ‘straight society.’ A few of the women stated that they became addicted to the street lifestyle and routine (i.e., the quick and easy money, going out on the street at night, and the partying), which made it difficult to leave. Others reported that this repetitive lifestyle was their reason for leaving. In fact, one compared it to a tape always on repeat that she got tired of watching. To demonstrate these conflicted feelings that the women expressed toward the DTES community, I have chosen to use two quotes with very different messages. First, Owl Woman discussed the challenges she has experienced living in the DTES, and, second, Spirit articulated her feelings of support from the DTES community. As Owl Woman said, “It sucks…It’s like drugs and alcohol are all over the DTES…And I’m not saying everybody’s like that but you know what it’s the norm. People are drunk…people are dying out there.” (1053Part50) However, Spirit had found comfort in the DTES because as she said, “I have been down here 37 years. These streets are my streets. These girls are my friends. They’re my family. They’re all I have left. I don't have parents anymore and these people make me who I am.” (1061Part21) Issues of trust in new relationships and new community. The co-authors in this study articulated that they often had difficulty trusting others particularly when meeting new people !"(%!after leaving sex work. The women described this notion of trust as being able to rely on others and have faith that these individuals would be there to consistently to support and care for them. Some of the women stated that they had attempted to make friends or establish a new community, but, at times, this was challenging due to this distrust of others, their perceived lack of commonalities with others, and facing prejudices or lack of understanding from others. The co-authors shared that these newfound issues with trust and relationships often made them feel quite lonely and isolated from others. Many women also discussed that they now struggled with interpersonal relationships, particularly with men, due to the experiences they had had on the street. Some women spoke of finding it difficult to engage in relationships with men that were not abusive and therefore, they avoided male relationships altogether. The women expressed how frustrating and saddening this could be at times as many longed for intimate relationships but did not feel they could have the type of ‘healthy’ relationships with men that they desired and saw others having. Spirit exemplified this difficulty with trust and her reason why when she said, “I don't trust anyone…I don’t. I just can’t because you know what it’s too difficult. If I let people in then I’m at risk.” (1061Part38) Relationship with self. The women in this study stated that as a result of this difficulty with trust, they often spent a considerable amount of time alone as they wanted to avoided triggers from their past life, such as darkness, night, and men. The majority of them expressed that after they became clean and sober they had a newfound hyper-vigilance (that many linked to past traumas) of others and situations. A few of the women articulated that they stayed indoors and avoided social contacts quite often due to these fears and difficulties with trust. For some, this avoidance of others, at times, resulted in feelings of loneliness and isolation. Others expressed that through spending this time alone they discovered they quite enjoyed solitude !"(&!and/or making time for themselves. Many emphasized the need to practice self-care throughout their transition out of sex work and addiction. The women expressed the joy they experienced from taking time for and pampering themselves. Some spoke of what one woman termed the ‘chameleon effect,’ which was to ‘become’ others or develop alternative personalities as a means of survival. Thus, aspects of self such as identity and answering the question, “Who am I?” became a necessary understanding of themselves when leaving the sex trade. Many women stated that when they first started to make the transition out of the street sex trade they had little idea of who they actually were or what they enjoyed doing. They emphasized the difficulty they experienced in ‘finding themselves’ and the gratification they felt as they began to connect with themselves and learn about who they were, what they needed, and what they liked to do. As Survivor stated: You get some guy in your car…and you have to change your personality to please them…If you change your personality ten times a day at the end of the day you really don’t know who the hell you are. Yeah I know when I first got out of the sex trade I didn’t know who I was…Cause when I was in the sex trade…I invented an identity of this sweet girl basically…because that’s how I got a lot of dates…I got the dates to you know pick me up and be nice to me and not kill me if you act like a really nice sweet girl. (1072Part60, 61, 64). Theme 6: The role of mental and emotional health in transitioning out of street sex work. For the women in this study, mental and emotional health was a major piece of the transition out of the street sex trade. Many women had mental and emotional health issues that they expressed served as barriers in their lives and as they were making the transition out of street sex work. All of the women in this study struggled with substance abuse and addiction, !"('!which for these women were major barriers in their lives that took a considerable amount of effort to overcome throughout their transition out of street prostitution. They all discussed experiencing violence and abuse that led to trauma, which was another significant source of stress and another impediment in their transition out of street sex work. Almost all of them stated that a big part of their transition involved or would involve getting clean from drugs and processing the emotional experiences of their lives. This mental and emotional processing, however, frequently required getting the previously explored pieces (e.g., individual readiness, stable housing, setting goals, and supportive community) in place and overcoming systemic and structural barriers. Crystal identified with a common emotional experience (i.e., PTSD) amongst these women and the difficulty of living with it and eventually processing it.  My biggest inner struggle was with the PTSD and the fear…That was one of the hardest things and there was nobody that could bring me over that and that was something that I had to bring myself over. And I didn’t even realize that it was so big in my head and it was such a big part of me that when I finally did get it over it, it was just such a relief. It was like (gasp) I don’t have to carry that around no more…This big, useless, frightening bag. But then once I actually let it go, put it down, opened it up, and actually looked at it. It wasn’t that bad. (1023Part25, 26)  Three sub-themes emerged within this theme: (a) substance use and addiction; (b) abuse, violence, trauma, and fear; and (c) mental and emotional processing. Substance use and addiction. For every woman I spoke with, addiction was a leading struggle in her life and particularly in the process of transitioning out of street sex work. As explored above, transitions into and out of sex work almost always coincided with addiction relapses. The women described these ongoing struggles with addiction as extremely challenging !"((!and often stressful as, for many women, the opportunities to use were always there. For these women, at least toward the end of their time in sex work, engaging in prostitution was a means to making money to provide for their addictions. For some, sex work started out as a fun thing they did in their teens; it was part of a party lifestyle and addiction came later. Sex work then became necessary to pay for their addiction. Many of the women that identified with this experience had left home at an early age due to addiction issues in the family home. For others, addiction came first and sex work became the means to pay for their addiction. For Spirit, who was born addicted to heroin and prostituted when she was five, addiction and sex work went very much hand in hand. Regardless of how addiction came into their lives, every woman discussed how drugs played a role of blocking out emotions and traumas that at the time the women did not want to or could not face. All of the women had attempted to utilize addiction treatment services, such as daytox and detox facilities, addiction treatment programs, and recovery groups (NA and AA). The women spoke about working to find what kind of treatment worked for them and how at times this process of finding the right ‘fit’ was extremely frustrating and exhausting. For some, none of these types of programs were helpful and for others, they were pivotal in their transition. As Nita, who was around drugs her entire life, stated: All my life I’ve been around drugs. It’s not an excuse or anything like that but I found all it did was helped to deal with the emotions and feelings that I didn’t want to deal with or feel. So it would succumb me to the point where I would just feel numb and I wouldn’t have to feel those feelings. (1041Part2, 3) Abuse, violence, trauma and fear. All of the women in this study had at some point in their lives experienced physical, sexual, and emotional abuse and violence. For some, this abuse started in childhood (often sparking their move from home to the streets) and continued on !"()!throughout street sex work; whereas, for others this occurred while working the streets. For all co-authors, these abusive acts had left them with mental and emotional trauma and for some intense fears. Many had coped with this trauma and emotional intensity through dissociation (and using) while working.  Many women in this study spoke of experiencing childhood abuse whether that was mental/emotional, physical, or sexual. The majority had left home at a young age, some as young as 13, to get away from the abuse and addiction at home. Many women discussed being scared when they first started working and needing to ‘toughen up’ or raise their internal defenses to keep them from being physically, mentally, or emotionally vulnerable. Almost all of the women had been victims of violences and traumas while working in the street sex trade. For some, these traumatic incidents became the pivotal reasons and force of getting out. The women expressed that the violences they had experienced on the street and the fear they had of a potential bad date in the future (or death) kept them motivated from re-entering. A few were terrified that their perpetrators would come back to harm them. All the women in this study described ‘checking out’ or dissociating from their feelings and bodies (often through drug use) as a means of coping with trauma and other emotions and getting by. Getting out of sex work, and so frequently getting clean, then became further complicated as many had to face horrific traumas without the self-medication that drugs provided. Spirit articulated her own experience of trauma and the overall commonness of PTSD in the DTES in the following quote: A lot of the time I lived a really rough life down here…I can’t count on two hands how many people I watched get shot or killed down here. I can’t count on two hands how many people I’ve watched overdose. I can’t count on two hands or my two feet how many people I’ve held while they’ve overdosed…You can’t live a life…of walking the sex trade in the !"(*!DTES and skid row area and not have some sort of PTSD. Because I’ll tell you when I close my eyes at night sometimes I see those women…I’ve had to hold them in the alleys while they die. And there’s nothing I can do. (1061Part 34)  Mental and emotional processing. Given the amount of trauma and abuse these women had experienced as well as their addiction issues, the women in this study identified that a big piece of what Owl Woman termed ‘the healing journey’ was processing these mental and emotional aspects of their lives. For some, this meant re-visiting childhood experiences and processing negative internalized messages. For all, coping with, and eventually processing trauma, was a significant part of their transition out of the street sex trade. They articulated that to do so, however, the above factors needed to be in place (e.g., stable and secure housing, readiness, and support). Many spoke of the importance of enhancing their feelings of self-love and self-worth, finding their voice, as well as establishing structure and boundaries with others. Many women stated that they explored these mental and emotional elements of their lives with a mental health professional.  Many women had internalized negative messages they received in childhood, (such as, “You’re not good enough,” or “No one’s ever gonna love you,”) which negatively impacted their beliefs about themselves (i.e., self-esteem and feelings of self-worth) throughout their lives. They emphasized how these messages often kept them ‘stuck’ in sex work (and may have even been a factor in their entry process). The majority expressed a need to process and let go of these messages as well as other emotions (e.g., grief over losing custody of their children and trauma from violences) that they had been trying to avoid for so many years in order to clean up without relapse and get out of the sex trade. For many, the trauma they had endured was still very real as they continued to experience triggers, flashbacks, and nightmares. Some relayed how trauma !")+!continued to live in their bodies, and they emphasized the importance of processing these traumas so they could be comfortable with their bodies again. A few of the women spoke of doing ‘inner child’ work when processing trauma in different treatment programs; they expressed how this process was quite empowering as they were able to ‘give voice’ to their ‘inner child’. The women articulated that they needed to let go of the anger and feelings they had toward their abusers to prevent their abusers from having power and control over them anymore. For Owl Woman, healing through ceremony (e.g., healing circles, smudging, sweat lodge) was pivotal in her transition out of the street sex trade, as she was able to re-connect with her indigenous roots.  Many women discussed a need to get more in touch with themselves and find more self-love, self-compassion, and self-empowerment. They also emphasized having to learn how to communicate their needs, set boundaries, and establish structure. The women in this study expressed the importance of being compassionate toward themselves when getting clean and transitioning out of street prostitution particularly in times of relapse. Many co-authors also talked about the feelings of empowerment they experienced when they were able to ‘find their own voice’ after feeling silenced for many years. Some stated that through the process of learning how to process their emotions and cope differently, they often learned how to be more authentic, open, and honest in their communication styles. Many felt that they were now more capable of expressing themselves and their needs, which they reflected made their interactions and relationships smoother and more genuine. The co-authors shared the importance of learning to set boundaries, because, while working in the sex trade, they felt they had to constantly stretch these boundaries to do the work that they did. Some even reflected how individuals in the sex trade, such as pimps, intentionally worked to expand or eliminate their boundaries. The majority of the women also articulated that as part of their transition out of sex work they had to learn !")"!how to establish routine and structure in their lives so that they could stay focused in their goals for the future.  Many women were able to process their emotional experiences and learn how to cope differently through services such as counselling or addiction treatment. They emphasized a need for more mental health service providers who understood the hows and the whys of prostitution as many had experienced discrimination and stigma from mental health professionals in the community when they disclosed their backgrounds in sex work.  Owl Woman described her own struggles with mental and emotional health issues when she said: It’s more than just addictions. It’s about nourishing…about giving voice to that inner child…facing your abuser without actually physically having to and then realizing, ‘Hey, I got my power back. I got me back.’ You know being able to say the things that happened to me…being able to speak freely, safely, and being able to say that was not right what happened…being able to cry about it...being able to let go… so important because when you carry that for as many years as I’ve carried it that’s what kept me sick in addictions. That’s what kept me out there and a lot of the time that was not my stuff. (1052Part68) Theme 7: The role of finding meaning and purpose in transitioning out of street sex work. A final theme that arose from this study was the need to find meaning and purpose in one’s life when working to overcome addiction and transitioning out of the street sex trade. They described this search for meaning and purpose as a process of seeking significance and intention for themselves and their lives. This process was different for everyone. For some, this discovery came at the beginning of the transition and became their guiding light for leaving. This was often the case for those whose meaning and purpose came from spirituality and motherhood, which !")#!was discussed above. For others, particularly those who found meaning and purpose through education, employment, and giving back, this was something that they were able to explore once certain aspects of their lives were in place such as stability, support, and mental and emotional processing. For the women in this study, this sense of meaning and purpose served as a motivator, whether that was something to keep them driven throughout their transition (e.g., children) or a larger goal that they were working toward (e.g., a career). Some metaphorically identified this meaning and purpose as their reason for getting up in the morning. Survivor exemplified this theme as she stated that she also had this need to find meaning and purpose and that, for her, this was Christianity.  I really wanted to find meaning in life …I mean you need something…you need something there…I mean like I tried coming off crack cocaine many times for the three years I was addicted. That didn’t work out…NA…AA…nothing worked…I tried everything and so finally I decided to try Jesus. Okay we haven’t tried him out yet. Let’s see if he can fix the situation. And…you realize that when you’re involved in that kind of lifestyle…there is a real spiritual battle going on and you need the extra protection to help you get through. (1071Part37)  Two sub-themes emerged within this theme: (a) skills, education, and employment and (b) giving back. Skills, education, and employment. Almost all of the women discussed a need to become aware of and utilize their transferable skills. That is, they learned to recognize the skills they learned from the streets (e.g., sales, advertising, and customer service) and how they could transfer these to jobs or work in mainstream society. For many, recognizing that they had these transferable skills brought them great satisfaction, as many felt that they lacked job skills !")$!entirely, particularly those who had never been legally employed. Some women shared that they also found great joy and purpose in learning new skills (e.g., cooking and beadwork). Most of the women spoke of how it was difficult to get and keep a job given all the experiences they had been through. The few who were employed stated that they had to gradually transition into other types of employment outside of sex work after finding stable housing, working to overcome addiction, developing strong support systems, and striving to gain mental and emotional stability. The women reiterated that it was not just as simple as ‘getting another job,’ and they felt quite frustrated when people (particularly those in positions of power) expressed this to them. In fact, getting a job and advancing one’s education seemed to be one of the most difficult and final steps in transitioning out of sex work after many other pieces were put into place. Mary Joe discussed her experience of trying to find new skills and finding humour in the process.  I learned how to cook. Actually, I’m not that bad of a cook (laughs). But the first time…when I first quit doing prostitution, I never cooked. I always ate at restaurants or somebody cooked for me, right? Well I didn’t know how to boil eggs. So I put so much water in this pot and I put four eggs in. Well I check it and it’s not boiling so I go take a shower and come back. And I hear this ‘pop, pop, pop.’ (laughs) I look at the ceilings and here’s my four eggs. ‘Well we’re going out for breakfast.’ (laughs) (1032Part75) Giving back: Helping and educating others. Several woman discussed the importance of finding meaning and purpose in their lives through giving back whether that was giving back through activism and volunteering in the DTES, educating others about sex work (e.g., at the John’s School), or just giving back through daily, simple acts of kindness. The majority of the women in this study stated that they want to participate in the present study so that they could educate others about the process and help other women who do want to leave sex work. A few !")%!women spoke of how helping and educating others served as a way to help themselves. They shared with me that giving back made them feel as though they were making a difference in the world and thus, helped them to further heal and feel proud of themselves and their accomplishments. Spirit reiterated that she found meaning and purpose through helping to protect the girls who are still working.  I’ll watch the girls and make sure they’re all okay…making sure they’ve got a jacket or they got socks or they’re safe. I know what car picked what girl up and I know where they’re dropped back off and when they’ve been dropped off, right? Just because I know how risky the DTES can be. And I don’t want any of these girls ending up beaten or anything…If I can stop it from happening…lots of people stopped it from happening to me and now it’s my turn to give back now that I’m not doing it anymore. (1061Part19)  Conclusion of the themes. In this section, I have illustrated the seven overall main themes and sub-themes across the women’s experiences. In the next section, I will share with you my own story regarding the research process. In this piece, I will reflect on myself as the researcher (including my own privileges and power), my own experiences throughout the research process, as well as my reflections on my pre-suppositions and assumptions that I detailed in Chapter Three.  Laura’s Story I am a 27-year old European American woman with mixed European ancestry primarily from Scandinavia. I am currently not married with no children, am living in an apartment, am employed, and am currently completing my second graduate degree.  I entered this research process in the summer of 2009 when, during my Master’s coursework, I began working on a project about prostitution and started to see the complexity !")&!involved in entering and exiting street-level sex work. When I started my doctoral studies, I initially entertained the idea of exploring women’s experiences of choice when entering and leaving the sex trade. The more I studied this topic the more I became aware of the importance to conduct research that can be applied to and utilized within the community. I was then invited by a committee member to think about exploring the notion of exiting. After reviewing the literature and talking to members of the community, it became apparent to me that this is a subject we know little about and have few (and now no) programs in the DTES community that help women who do desire to exit street-level sex work. I encountered these eight courageous women in the summer of 2012 and kept in touch with most of them through the spring of 2013. These women have touched me in unforgettable ways. They have provided me with knowledge and understandings in the area of exiting street sex work. They have also altered my perspective on my own life, my privilege, and my understandings of notions such as struggle, strength, resiliency, and hope. Again, gratitude is hardly the word to describe what I feel for the experiences I have had over this past year with these eight women. Laura’s story of transitioning into the research process. I recall the nervousness and insecurities I felt going into that first meeting with Jean. I was questioning myself, my privilege, my abilities, and my knowledge. Thoughts of self-doubt such as, “What is she going to think of me and this project?” frequently came to mind. While I had spent the last few years immersed in the literature on prostitution and exiting sex work, I suddenly felt like a small, very privileged child who knew nothing on the topic. Each time I had similar thoughts whirling around and found my mind stripped of the literature on the subject, as I became immersed in each of the women’s stories.  !")'!While I have been quite aware of the privilege I have as an educated, middle-class white woman throughout this project, I found having open discussions about power and privilege with each of these women seemed beneficial for both parties. These conversations typically came out quite organically and very often by the women themselves when they would ask me questions around my own experiences in life. I remember some, like Mary Joe who said she thought it was courageous of me to come out and try to understand their perspectives. Courageous I thought? How could she find me courageous, as she is mostly certainly the one with the courage having lived through those experiences? Others stated that they were happy to share their story but wondered if I could ever fully understand given that I have never lived it. I relayed to them that most certainly I could never fully grasp what it felt like to walk in their shoes, feel what they have felt, or live what they have lived but that I would try to understand as best as I could as an outsider looking into their worlds.  I also found myself quite drawn to these women and their stories as each of the co-authors brought with them such a strength and beautiful perspective. I would find myself leaving our meetings with a reminder of the appreciation for the little things in life. I remember after I left that first meeting with Jean, I hurriedly got into my car as I scoured for paper and a pen with my head full of thoughts and emotions that I needed to put into ink. I remember the flood of tears that came to my eyes after leaving a meeting with Spirit where she spoke of her lifelong struggle with prostitution and addiction and then looked at me and told me that she felt her purpose in this world is to make a difference in the lives of others. I conducted the majority of these first and second interviews within a few week timespan, and while I am normally prone to a bit of insomnia, I must admit there were several nights throughout those few weeks that my heart and mind had difficulty resting at night.  !")(!As the interviews progressed I began to notice shared themes arising across their stories, which I detailed in the previous section, while at the same time recognizing distinctions and uniqueness within each story. As I articulated in a previous section, I entered this project with the pre-suppositions that these women may be dealing with addiction issues, concurrent mental health issues including abuse and trauma, which may require services related to addiction treatment and mental health counselling. I also assumed that many of these women may be homeless and potentially dealing with legal issues and thus, may require assistance with housing, employment, and legal services. Furthermore, coming into this study, I believed that many women may require relational connections and support throughout their transition out of the street sex trade. Finally, given the high number of women in the street sex trade in the DTES who are indigenous, I assumed that many women would find traditional healing practices beneficial in their transition out of street prostitution. Some of these assumptions I did find, but many new and different understandings also became clear to me, both of which I will discuss in the next section. Laura’s story of transitioning out of the research process. While conducting this project, I have been engaged in a number of other activities. I have been teaching at the University of British Columbia, working in a local university counselling centre, and applying for internship opportunities for my final year of my PhD. I must admit that throughout this process, one of the biggest challenges, at times, for me has been to have my feet in so many different worlds but particularly one in the academic world and another in this research world. (Here, I cannot help but think of Survivor’s story where she discussed a difficulty of having one foot in the straight world and one foot in the street world, as for me it has felt like a constant balancing act of different people’s needs and ideas while being true to myself and my co-!"))!authors.) I have had numerous conversations with my supervisory committee, community leaders, and my co-authors about this balancing act, as I have been trying to negotiate my own position within this process. I have become quite aware of the need to attend to my body, mind, and heart. I have strived to listen to what feels ‘right’ for me, for the project, and for my co-authors when making decisions along the way. I feel much gratitude toward all of the people who have shared their wisdom with me and provided me with guidance along this journey. While I would love to share all of the questions I have had, this would take up considerable time and space. I found myself feeling quite humored, however, by a recent conversation with a supervisor when I shared with her my stress about terminology. As I discussed in the previous section, I realized that I am not entirely comfortable with this term ‘exiting’ any longer as I am not sure what this word means given the experience many women have of transitioning in and out of the sex trade. My supervisor laughed slightly at me when I expressed my worries about this finding. She said something to the extent of, “Well one would hope that the point of engaging in this process would be that you learn something.” I laughed myself and thought this is indeed true.  As illustrated above, I had many pre-suppositions coming into this study, some of which I did find. As I discussed in the previous section on shared journeys, I did find that these women were struggling with addiction issues, abuse and trauma-related difficulties, and, for some, concurrent mental health disorders. I saw these as major pieces of these women’s lives and journeys. Many had sought help for these issues through formal support services. Some had found these services helpful; others had mixed feelings about their experiences. While I believed that these women may need assistance with housing services, I had no idea how pivotal stable and secure housing would be in the transition out of the street sex trade until speaking with these !")*!women. I started to see this as a major ‘stepping stone’ in making the transition away from addiction and prostitution. Furthermore, I had assumed that legal services would be much more at the forefront of these women’s journeys and, while it was important, many other pieces seemed to be more salient. I had also assumed that employment would be a big piece of making the transition out of street sex work and while it was, I found this piece to be almost the final step in the transition out the industry after many other pieces, such as emotional, mental, physical, and financial stability were put into place. One aspect that I had assumed would be important was support and relational connections. The need for this community and support was confirmed by the women in this study and was actually quite a necessary part of their transition. Contrary to what I had thought, while the majority of the women in this study identified as indigenous to Canada only a few women had found traditional Native healing practices helpful in their transition out of street-level sex work. I have wondered since if this was because only a few had had an opportunity or an invitation to engage in this type of healing (given the limited space and waitlists at many of these facilities) or if it was due to a lack of interest or desire.  This process for me has been eye opening in many ways but one of the major pieces that stood out for me was perspective. When I would talk to these eight women who have been through some horrific incidents and then hear from them that they believed their purpose on this earth was to help other people, I was often quite startled and shook up. Many times, I have found myself thinking, “How?...When for some of these women, few people have extended a hand to them…How can they find it in their hearts to not only forgive and let go of what has happened but then also to feel such a rich compassion for others when some days I struggle to appreciate the bed I sleep in at night…or the roof over my head…or find myself getting irritated when I have to go into work?” I found myself thinking, “What a privilege these things are…to have !"*+!shelter…to have safety…to have stability…to have a job…to have family that supports me…to be able to pursue my education…to be able to express my opinion to others and to have that respected because of my background…all because of my privilege.” Working on this project has brought me a tremendous amount of gratitude for the things that I have and the work that I do. Sometimes I feel the word honour can be overused but, to me, it has been an absolute honour to have had the opportunity to sit with each of these women and listen to their stories. Sometimes I would be sitting there hearing their struggles and their plights and even as they told me how they got out of the situations, how they left their addiction, and how they transitioned out of the sex trade, I would still find myself looking at them and thinking to myself, “But really how could you muster the amount of strength to do that?” It’s a strength and resiliency that I believe few people have. These women battle multiple entrenched systems everyday – some with little support – and they continue to conquer them one baby step at a time. I say this not to dismiss the tragedies they have experienced but rather to emphasize their strength for not only living through the horrors that they have seen but to come out of these experiences with an optimistic and humorous perspective on the world.  As Survivor said transitioning out of sex work and addiction is like swimming through shark-infested waters without a life vest or a boat. I realize that this process is going to be incredibly difficult regardless but as I sit here I wonder with much anger at times, “Why can’t there be a boat? A life raft? Even some additional life vests thrown their way? Why can’t we make this challenging process a little easier?” Why is it that we as a society cast these women aside instead of lending a hand? As the reader will hear in the next section many of these women experienced common barriers as they transitioned. I strongly believe after doing this research !"*"!that while there are always going to be barriers in this process that these obstacles do not have to be as high as they are now. Dear Reader, I wonder if you too are starting to wonder as well… Chapter Summary and Conclusion In this chapter, I have shared the backgrounds and stories of the eight women who co-authored this research project. I have also detailed what my co-authors and I saw as the seven major themes across these eight stories. I, as the researcher, have also reflected on my own research process including my privileges, my own experiences throughout the research journey, and my own understandings of the research findings. In this next and final chapter I will compare and contrast my research findings to that which is already in the literature. I will also detail my thoughts and perspectives around what all of this means in terms of implications for the DTES community, for counselling psychology training, for theory, and for future research.     !"*#!CHAPTER FIVE Conclusion: Closing Thoughts and Discussion About My Journeys with My Co-Authors Co-Constructing A Research Journey: Letter Six—A Closing Letter to My Personal World Dear Mom,  Well here we are again at the end of this journey. I have thought of you often throughout this process especially as I reflected on these women’s experiences of motherhood and childbearing. I thought of the challenges you faced as a mother…some that I know…others that I’m sure you keep to yourself. I see parallels in these women’s lives to ours and sometimes wondered if one small decision was made differently where you and I might be today. One never knows I guess. I thank you though for your strength throughout your own journey as a woman, a daughter, a granddaughter, a sister, and a mother. I know these roles are no easy paths to walk. Much like the women in this story, I know that at the forefront of your world is motherhood. I’m sure you can relate, as I can, to the devastation so many of these women have endured when their children were taken from them just as I’m sure you can relate to the sense of urgency they felt to make changes in their lives when they had that little person growing inside of them. I wonder what you must’ve been thinking during the times you were pregnant with my brother, my sister, and I. Were you scared of what was to come? Excited of this new little person being in the world? I’m sure you felt and thought a great mixture of things. Like you, these women also play a number of roles. Most are mothers. They are daughters to their parents, granddaughters to their grandparents, sisters to their siblings, and nieces to their aunts and uncles. They are people as you and I are. They may not have been born to the privileges that you and I were born to, but they are people. They are worthy of the same gifts that have been bestowed upon us…the gift of safety…the gift of unconditional love by others and themselves…the gift of acceptance by !"*$!others…the gift of hope for a brighter tomorrow…the gift of opportunity for themselves and for their children and grandchildren. We are different from them and yet so the same. My hope after doing all this is to lessen this divide. I don’t think Mom, that just because a woman stands on a street corner and sells sex for money that she is less of a human than you or I, that she deserves less privileges that you or I, or that she needs less support than you or I. I’m sure if for some reason that had been me or Sister out there that you would have wanted people to support us…to love us still. If you had heard that someone had thrown rocks at us for doing so (an experience Survivor shared with me) I’m sure you would be the first to pick up a stone and throw back. Thank you for your continued love, kindness, and patience, Mom. It means everything in the world to me. Some days it is what gets me out of bed in the morning as I’m sure Sister and Brother would say the same. All my love, ~Laura  In this section, I will first briefly discuss the overall main findings of this study. Then I will review the current models on ‘exiting’ and how this study is similar to and/or unique from these existing models. Next I will explore the applicability of this study including the implications for theory, the community, counselling psychology and training, and future research. I will then examine the overall strengths and limitations of this study and conclude with final comments regarding this dissertation. Contributions and Significance of The Research  This study provides an in-depth understanding and structure of how eight women who desired to leave street sex work were able to do so. It demonstrates what resources along the way have been helpful and what barriers have obstructed their process. These women’s stories and experiences helped to narrate the various ‘steps’ taken by these women desiring to transition out !"*%!of street work in the DTES. These women illustrated the following non-linear ‘stepping stones’ that needed to be put in place to help facilitate transitioning out of the street sex trade: (a) a need to understand that this process is a transition, that slips often do occur, and thus, that people need to be individually ready to make this transition; (b) a need for physical and emotional stability and safety to allow time for reflection, knowledge seeking, and questioning; (c) a need to set small, manageable goals; (d) a need to recognize and work to overcome systemic and structural barriers; (e) a need for support and community; (f) a need to understand and process mental and emotional health issues; and (g) a need to find meaning and purpose which can be through things such as education and employment. These ‘steps’ are similar to what have been found in the past by previous authors who have articulated models, which will be re-examined next. They are unique in that they provide a rich description of how one might transition from one stage to the next including what can be helpful and/or hindering in making this transition. Furthermore, the depth of which the mental and emotional health aspects have been explored in these findings provide a new, rich perspective on the psychological aspects of transitioning out of street sex work. Prochaska’s et al. (1992) ‘Model of Readiness for Change,’ which identified the following stages: pre-contemplation, contemplation, decision, action, maintenance, and lapse/relapse, has been cited in the literature as a framework for understanding the exiting process. Other researchers (e.g., Baker et al., 2010; Dalla, 2006) have utilized this model to understand exiting prostitution. Some (see Baker et al., 2010) have argued that its linear progression is not necessarily applicable to exiting due to the ‘yo-yoing effect’ seen in women’s transitions out of the sex trade. Others, such as Dalla (2006), emphasized the need for further research that draws from Prochaska’s et al.’s (1992) model while incorporating the unique experiences of leaving !"*&!prostitution. In this study, many co-authors emphasized the importance of being individually motivated and ready to change. They had all experienced going through the different stages of readiness or skipping right from one stage (e.g., contemplation) to a later stage (e.g., action). The women also discussed the challenges of the different stages, particularly the maintenance stage, and how easy it was to relapse. I believe the results from my study elaborate upon this model in that they suggest potential barriers that might keep female sex workers stuck in a stage, how they can move from one stage of readiness to the next, and what might need to be put into place to do so. For example, to move from the contemplation stage to a decision or action stage, women may, require amongst other things, safe and secure housing, a change in perspective, information about alternatives to sex work, and a strong support network. The themes identified in the previous chapter also illustrate some of the challenges of the different stages. Applying these findings, we see that in the maintenance stage women may experience barriers, such as structural barriers (e.g., financial struggles and employment issues), having to unlearn rules from the street and learn rules from straight society, as well as coping with mental and emotional trauma. These findings also provide information about resources to help to overcome some of these barriers and challenges, such as working to establish a solid support network, establishing structure, setting small and manageable goals, finding meaning and purpose, practicing self-compassion, as well as unpacking trauma.  Mansson and Hedin’s (1999) ‘Breakaway Model,’ outlined the following stages in entering and exiting sex work: (a) drifting in, (b) ensnarement, (c) breakaway’s pre-stage, (d) the breakaway, and (e) after the breakaway. They also identified how many women move in and out of the sex trade, that many experience a ‘turning point’ that led to their exit, and that they faced a number of barriers as they were in the breakaway and particularly in the after the breakaway !"*'!stage. This model is a highly cited piece of research in the exiting literature (see Baker et al., 2010; Dalla, 2006; Sanders, 2007). Many studies have paralleled the work by Mansson and Hedin (1999) in that they found a similar ‘yo-yoing effect’ (e.g., Sanders, 2007), a need to overcome a multitude of barriers (e.g., Dalla, 2006; Sanders, 2007), and that many women experienced a turning point that motivated their exit (e.g., Dalla, 2006). This research was also relevant to the women’s experiences in the present study particularly those who entered in adolescence and/or those who got caught up in drug addition. Similar to Mansson and Hedin’s (1999) study, in this study many women also discussed a turning point, such as a pregnancy or a bad date, which led to their transition out of sex work. Furthermore, I also identified the same four challenges the authors reported (i.e., coping with emotional aspects of prostitution, living as a marginalized person and navigating the old and new life, dealing with shame and stigma, and negotiating new intimate relationships.) I believe this study can be useful to expand on the ‘Breakaway Model’ as it is a more up-to-date illustration of the steps women take in leaving sex work. In addition, the findings demonstrate potential ways in which one could move from one stage (e.g., pre-breakaway) to another (e.g., breakaway). For example, using the findings from the present study, women might require emotional and physical stability prior to moving from the pre-breakaway to the breakaway stage. I also saw additional barriers that might not necessarily fit under the categories identified by the authors, such as a lack of social support, overcoming structural and systemic barriers, and the need for stable and secure housing. These barriers are important to understand to help make the transition out of the sex trade smoother and to potentially prevent relapse. The current study also helps to better understand what is needed to support them in the after the breakaway stage, which the authors identified was a particularly difficult phase. Some resources that were found in this study were a solid support system, a need !"*(!to continue to set boundaries and establish a routine, and a need to find purpose outside of the sex work lifestyle.  The findings from the current study also paralleled Williamson and Folaron’s (2003) ‘Phases of the Lifestyle Model’ of entering and ‘exiting’ prostitution, particularly those who entered in adolescence. This model identified the following phases: (a) enticement into the prostitution lifestyle, (b) overcoming barriers, (c) learning the lifestyle, (d) developing protective strategies, (e) living the lifestyle, (f) getting caught up in the lifestyle, (g) leaving the lifestyle, and (h) re-entry into the lifestyle. It further emphasizes the importance of social support and attitude changes while leaving prostitution as well as the multitude of barriers faced throughout the process. This model has been utilized as a comprehensive framework for understanding the process of entering, being involved in, leaving the sex trade, as well as re-entering (see Cimino, 2012; Dalla, 2006). The women in the present study also identified with the various stages of this model particularly the re-entry phase, which is consistent with the ‘yo-yoing effect’ theme in this study. These findings also paralleled the need for social support, changes in perspective, and overcoming barriers. The present study expands on this model as it has explored what it is about this process of leaving the lifestyle that is difficult, such as facing financial challenges, dealing with stigma (both external and internal), losing custody of children, as well as letting go of the old community and having difficulty trusting new people. These findings also illustrate ways in which to make the process of leaving easier, such as developing physical and emotional security, setting manageable goals, coping with internalized stigma and negative messages, as well as working to feel more personally empowered. Sanders’s (2007) ‘Typology of Transitions Model’ is also highly cited in the literature (see Baker et al., 2010; Cimino, 2012) on exiting prostitution as it identified differences in exiting !"*)!between indoor and outdoor workers as well as the diversity in types of exiting including reactionary, gradual planning, natural progression, and the ‘yo-yoing’ effect. Baker et al. (2010), for example utilized Sanders (2007) different types of transition to create their integrated model of exiting. Many (e.g., Mansson & Hedin, 1999) have also found what Sanders (2007) coined the ‘yo-yoing effect. This ‘yo-yoing effect’ was also quite evident in these women’s experiences of the current study. Also, her distinction between types of ‘exiting’ (i.e., reactionary versus gradual planning) was seen in this study. In the current study, however, many women attempted different types of transition throughout their ‘exiting’ experiences with differential levels of success depending on a multitude of factors, such as individual readiness, having supportive community, and residing in safe and stable housing. The present study elaborates on this model as it helps to understand what can be hindering in making the transition out of street sex work including attempting to make the transition abruptly without proper structure or supports in place, setting unrealistic and unattainable goals, and being overly self-critical and self-doubting throughout the process. The findings from this current study also illustrate what can be helpful in making these different types of transitions, such as having structure and stability in place, working to change perspective and overall attitude on the transition, and finding a supportive community to aid in the transition.  Baker’s et al. (2010) ‘Integrative Model,’ which is based on some of the above-identified models could also be seen for some of the women in this study (except for those who left without much thought or preparation). Many women in this study discussed experiencing the different stages of immersion, awareness, deliberate preparation, initial exit, re-entry, and final exit. This study elaborates upon Baker’s et al. (2010) model in that it helps to illustrate resources needed (e.g., physical and emotional stability and security, change in perspective, setting small and !"**!attainable goals, and having a strong support network) to transition from one stage to the next as well as barriers that could obstruct this transition (e.g., lacking a supportive community, facing stigma and discrimination, coping with trauma and addiction issues, as well as unlearning ‘street culture’ and learning ‘straight culture’). While Baker et al., (2010) cautioned using this term ‘final’ in their stage of ‘final exit’ as they too saw exiting as a process of exiting and re-entry, I think the findings from the present study illustrate that there may not necessarily always be a final exit. Rather, it is more a transition, which can sometimes involve going in and out of the sex trade for years with no certainty or finality in leaving.  Similar to Sanders’s (2007) ‘Typology of Transitions Model,’ pieces of Cusick’s et al. (2011) ‘Exiting Patterns Model’ study were evident in this study. Cusick et al.’s (2011) Model identified the following exiting patterns: (a) intervention-assisted exiters, (b) opportunistic exiters, (c) gradual exiters, and (d) strategic exiters. In the present study, there were some women who had at one point or another utilized a more gradual and strategic approach and some who were more opportunistic. All of the women in this study, however, could be classified as intervention-assisted exiters given that they had all at some point utilized some sort of formal support services. This study is expansive on this model as it provides an in-depth understanding of the resources needed (e.g., safe and stable housing, a strong support network, and knowledge about the process of exiting and alternatives to sex work) and barriers faced (e.g., addiction issues, coping with grief and trauma, and lack of structure and support) in these different ‘exiting’ patterns.  Finally, the results of my study yielded parallel results to what Cimino (2012) proposed in her ‘Predictive Theory of Intentions Model,’ such as how things like norms (i.e., relationships and individual readiness), attitudes (i.e., perspective), self-efficacy, environmental constraints, !#++!agency (i.e., perceived choice), skills, and societal context impact women’s ability to ‘exit’ street sex work. This study expands on this model as it provides an in-depth exploration of how mental health issues impact the process of transitioning out of street-level prostitution. For example, the findings in the present study illustrate how women transitioning out of street sex work often face mental health issues that serve as a significant barrier in the process of ‘exiting,’ which include but are not limited to the following: (a) coping with addiction issues, trauma, and a resulting heightened hyper-vigilance of situations and others; (b) lacking boundaries and structure, and (c) as well as struggling with feelings of low self-esteem and low self-worth. Furthermore, it not only demonstrates that these factors have an impact but also how some of these barriers can be overcome and what resources might be needed to help along the transition. As an example, addiction issues can become less intensified with the proper support services including a physically and emotionally stable and secure environment, assistance in setting goals and establishing structure and routine, as well as education about the reasons why people use substances and alternative coping techniques. Overall, this study’s findings have echoed much of what prior researchers have discovered about the process of transitioning out of the street sex trade in terms of the different stages that women go through when their making this transition. While other researchers have identified some of the barriers along the way, this study is unique in that it provides an in-depth illustration of not only what the obstacles are when transitioning out of the street sex trade but also what resources (e.g., a safe and stable environment, setting goals, changing perspective and attitude, having a supportive community, understanding identity-related aspects of self, processing internalized negative messages, and finding meaning and purpose) may be necessary to help women overcome these challenges. These findings therefore, add to the literature in that they !#+"!paint a picture of how women might be able to go from one stage to the next including what might serve as impediments to make this transition and what could potentially be useful in working through these difficulties to make a smoother transition through the stages.  In addition, this study utilized a critical perspective, which provides an illustration of some of the systemic and structural aspects of the transition of street sex work. As noted previously, the role of class, socioeconomic status, educational background, and, for some, ethnic and racial background were frequently highlighted as systemic and structural barriers faced along the way. Interestingly, the co-authors in this study did not identify their gender or sex as being a major part of their stories of transitioning out of street sex work. When I inquired about how they felt their gender or sex played a role in their stories, most of the women reported that they felt that sex workers who identified as transgendered faced considerably more hardships than themselves and thus, they did not feel they had it ‘bad’ as women necessarily. That being said, the role of motherhood was a major part of these women’s stories. Thus, gender and sex did play a role to a degree, as these women’s lives were often significantly impacted by pregnancies, losing custody of their children, and/or desiring to gain visitation and custody rights of their children. Finally, this study provides a rich description of the emotional and mental health issues faced by these women, such as how trauma and past victimization can bring about a newfound hyper-vigilance and a lack of trust for others, how internalized negative messages may impact their reason for entry and overall self-esteem, and how externalized stigma can become internalized and negatively impact one’s transition out of the sex trade. This study also illustrates the mental health needs of women working to transition out of street prostitution including a need to simultaneously process trauma while getting clean from addiction, a need to practice self-compassion and self-care while making the transition, a need to learn how to set boundaries !#+#!with others, a need to develop structure and routine, as well as a need to reflect on identity, values, interests, and needs to connect more with the self and potentially start to explore career-related aspects.  Implications for Theory As discussed above, some important and valuable models of ‘exiting’ (Baker, et al., 2010; Cimino, 2012; Cusick, et al., 2011; Mansson & Hedin, 1999; Prochaska, et al., 1992; Roe-Sepowtiz, et al., 2012; Sanders, 2007; Williamson & Folaron, 2003) currently exist in the literature. Few, however, have been developed using data from women’s experiences of transitioning out of sex work.  The present study, which provides a framework to understand the steps taken throughout the transition, elaborates upon and provides depth to those already in place. That is, while many of the stages are similar to what has been found in the past, it provides an understanding of how a woman desiring to transition out of the street sex trade can move from one stage to the next. It provides an in-depth perspective on what might be helpful in transitioning to the next stage and what might prevent them from getting there. The findings illustrate, for example, the need for a safe and stable environment so women can take the time to learn about alternatives to the sex work lifestyle and reflect on these options to potentially prepare to take action. It further provides a rich description of how certain barriers, such as poverty, addiction, stigma, and trauma, can present obstacles along the way and keep women from making the transition. This study also brings with it a counselling psychological umbrella lens which is unique to ‘exiting’ theory since current models posed have utilized other theoretical lenses, such as medical (Prochaska, et al., 1992), criminal justice and policy (Cimino, 2012; Sanders, 2007), and social work (Mansson & Hedin, 1999; Roe-Sepowtiz, et al., 2012; Williamson & Folaron, 2003). !#+$!This study thus, provides richness and depth on the psychological elements (identified in the summary above) of transitioning out of the street sex trade and shines a light on the mental health aspects of ‘exiting’ theory.  Implications for the Community For many women who do desire to transition out of the street sex trade, it often takes several attempts of moving in and out of the sex trade and frequently coincides with addiction relapse. It thus, seems necessary for those who work with women who have been involved in the street sex trade, such as support service providers, housing authorities, and employment service workers, to have a better understanding and appreciation of the difficulty to transition out of prostitution and this tendency for women to ‘relapse.’ Furthermore, given the discussion around the need to be individually ready and motivated to transition out of prostitution as well as a need to set small, manageable goals, it seems that training in Prochaska’s et al. (1992) model of readiness for change as well as in interventions, such as motivational interviewing and goal setting techniques, could be quite beneficial for support service providers working with women who have been involved in street sex work. In addition, due to the significant theme of needing stability and safety to help women who desire to transition out of street sex work to process their options, it seems evident that we need more affordable housing that is stable, safe, and secure for women to be able to take the time to gain physical and emotional safety and stability.  Considering the discussion about the impact of structural and systemic barriers, such as stigma and poverty, as well as the importance of having a strong support system that is understanding and nonjudgmental, we need more support service providers who have knowledge about prostitution (i.e., reasons why people enter and what needs to be put in place to help them to make the transition) and are empathic toward and nonjudgmental of sex workers desiring. Due !#+%!to the high level of stigma experienced by sex workers, the community might even consider developing ‘Safe Space’ stickers similar to those developed for the LGBTQ community so when a women enters a facility she knows whether or not she can disclose her sex work experiences without discrimination.  In addition, taking into consideration the significant theme and inter-relatedness of addiction, abuse, and trauma, we need supports, such as trauma and mental health counselling, put into place that help women cope with trauma, internalized messages, self-esteem issues, and others while working to overcome drug addiction. Furthermore, and given the discussion around the difficulty of seeking out and acquiring employment and furthering one’s education while transitioning out of the street sex trade, we need employment services put in place that are again going to be understanding and knowledgeable about this transition. That is, it needs to be understood that many pieces need to be in put in place for these women before they can even start to consider transitioning into the workforce.  Moreover, given the emphasis on the role of motherhood in the present study, it seems necessary to continue to support the programs in the community that due exist (such as Sheway, Crabtree Housing, and BC Women’s Hospital and Health Centre Fir Square Combined Unit) that provide assistance for women who have children and are struggling with issues such as drug addiction and poverty. Due to the difficulty that many women had accessing these services as they were located in different places and not always sex worker friendly, it seems necessary to have more comprehensive services for sex workers who are wanting to transition out of the sex trade that deal with all of these issues. Comprehensive ‘exiting’ programs (see Farley, 2008) have been put in place in cities across Canada and the US but currently Vancouver is lacking such a program. !#+&!As the results of this study suggest a more comprehensive approach to transitioning out of the street sex trade, it seems advisable that such a program is necessary. Consistent with the findings of this study, this program should have a place with stable and safe housing that allows women to gain security and safety and have time to process their options. This same facility needs mental services available for women to slowly process mental health, trauma, and addiction issues. It is also advisable that this centre should offer domestic violence counselling that not only specializes in domestic violence issues but also sex worker-related violences such as pimping and gang violence. Finally, we need these services to include employment and educational assistance for these women to gradually transition (if desired) into other types of employment.  Implications for Counselling Psychology and Training The women in this study repeatedly emphasized how mental health issues played a significant role in their entry, involvement in, and ‘exiting’ process. Thus, it seems imperative that the field of counselling psychology takes a more active role in training clinicians to have a better cultural understanding of this population. Unfortunately, many women in this study articulated that they had experienced verbal and nonverbal discrimination from the mental health community. Therefore, it seems further necessary to provide more education in the counselling psychological community around how and why women enter the sex trade, what makes it difficult for them to leave, and how we, as mental health professionals, can help in this realm. Given the discussion about the need for safety and security to process emotional and mental health aspects of prostitution, it seems imperative that mental health professionals start by creating a safe, secure, and trusting space in the relationship formed with sex workers so that they can slowly start to feel safe to open up as they desire. Due to the women’s reports of feeling !#+'!highly stigmatized and consistent with our ethical mandate to be multiculturally competent counsellors (see Arthur & Collins, 2010; Sue & Sue, 2003), counselling psychologists need to reflect on their own biases and values surrounding sex work and understand how these might impact the relationship. As illustrated by the co-authors’ emphases on individual readiness for change, it seems further necessary (just like when working with any other client) that we need to work to meet the client where they are at and help them to weigh their options. If and when the client is ready (and consistent with the findings in this study that to transition out of the sex trade one must gradually process traumas and work to get free of addiction), it seems imperative that the counsellor and client work together in a trusting relationship to gradually unpack the mental and emotional aspects of these women’s worlds.  Furthermore, many of these women reported that they had experienced significant family violence, poverty, and addiction (which often led them to leave home at a young age), and eventually they began struggling with their own issues of addiction, poverty, and, often, abusive relationships. These intergenerational aspects of violence, poverty, and addiction were typically reported as the reasons they had lost custody of their own children, a devastating experience that led many women into further addiction, sex work, and poverty. Thus, it seems that the counselling community could serve a significant role in working to help heal these intergenerational pieces and support these women and their children in potentially repairing relationships as these families begin to re-connect.  In addition, and consistent with these findings, it seems that some common needs of women transitioning out of street sex work are to establish new coping techniques, to integrate self-compassion and increase self-esteem, to learn to set boundaries for oneself, and to learn new ways of communicating. Furthermore, as the women in this study articulated, working through !#+(!mental health issues is not something to be done separate from getting free of drug dependency. Rather, it is best done concurrently and thus, as mental health professionals we should not expect to separate one from the other. Also, given the emphasis on structural issues related to housing, employment, and legal issues and our ethical mandate to advocate for our clients, it seems necessary to consider what we as mental health professionals can do in our role of advocates for clients desiring to transition out of street sex work. This could be as simple as picking up the phone and seeing what services might be available for a particular client or maybe playing an activism role and speaking up for the rights of women in poverty, those currently in sex work, or those women desiring to transition out of street prostitution.  Implications for Future Research Future research in the area of prostitution and particularly transitioning out of sex work could look a number of different ways. First, one of the limitations of this study was that it was conducted with women only. As most research has examined women’s experiences in prostitution, further research is needed that examines the experiences of men and transgendered individuals who have transitioned out of street sex work.  Second, this study focused primarily on women who had been involved in street-level prostitution. Thus, additional studies are needed that look at how individuals who have worked in indoor prostitution (such as brothels and massage parlors) make the transition out of sex work.  Third, while poverty and addiction was not an inclusion criterion in this study, all of the women who participated had been drug-addicted and were living in poverty. Thus, future studies need to look at the experiences of those who are not drug-addicted and potentially those who are members of higher socioeconomic classes.  !#+)!Fourth, all of the women in this study were over the age of 30 and thus, more research is needed that seeks to understand youth’s experience of transition out of street-level sex work. Furthermore, the majority of the women in this study were from Aboriginal and First Nations backgrounds and therefore, additional research is needed that explores the experience of transitioning out of street sex work with individuals of other cultural backgrounds (e.g., Canadians from African, Asian, Eastern European, and Middle Eastern descent) and in different geographical contexts. Fifth, this study provides a framework for the steps taken by women who were transitioning out of the street sex trade. However, this framework and other models have yet to be empirically tested. Thus, more research is needed that incorporates these models into practice with women who are making the transition while quantitatively and empirically examining the models’ validity, reliability, and overall applicability and utility. Sixth, throughout preparation of this manuscript, I have had numerous conversations with support workers in the DTES community. These individuals have had tremendous insights into what resources they have seen to be helpful in making the transition as well as some of the barriers they have observed. Additional research is needed that incorporates the perspectives of support workers on the transition out of the street sex trade including what they have found to be useful or not in this process.   Finally, the women expressed dealing with significant mental health issues and had shared some particular psychological needs throughout the transition. Therefore, future research is needed that explores what clinical techniques and tools may be useful in counselling to better understand our roles as practitioners in these women’s lives.   !#+*!Strengths and Limitations  The study provides a framework for understanding the different steps taken by women who have transitioned out of the street sex trade. The findings describe some of the obstacles faced throughout this journey of transitioning out of prostitution, such as residing in an unsafe and chaotic home, having unrealistic goals and expectations of oneself, lacking a supportive community, living in poverty, coping with external stigma and discrimination, and having to cope with trauma and addiction without the proper resources or support. The results also illustrate the resources or ‘stepping stones’ the women in this study found helpful in making this transition smoother, such as living in a safe and stable environment, getting education about the reasons people engage in prostitution and alternatives to working in the sex trade, setting small and achievable goals, having a supportive community, letting go of the stigma, processing internalized negative messages and traumas with the proper resources and support, as well as working to find meaning and purpose. This study also sheds light on the psychological needs of women transitioning out of the street sex trade which include but are not limited to the following: (a) the need to have emotional and physical security in order to safely process trauma; (b) the need to process addiction issues and trauma simultaneously rather than independently; (c) the need to develop structure, routine, and set goals; (d) the need to reduce internal judgment and be self-compassionate throughout the transition; (e) the need to have social support to turn to in times of struggle; and (f) the need to explore identity-related issues including interests, values, needs, and aptitudes to connect further with the self, to increase feelings of self-worth and self-esteem, as well as to potentially begin to explore career-related aspects of the self. This study, however, does have some limitations. The exclusion criteria of the study limits the scope to females over the age of 19, and thus, does not provide an understanding of the male !#"+!or transgender perspective on transitioning out of street prostitution nor what the experience is like for youth. Furthermore, given the focus of women who have been involved in street sex work, living in poverty, and drug-addicted, it leaves out the voices of individuals who have been involved in indoor prostitution, members of high socioeconomic classes, and not drug addicted. In addition, consistent with research on prostitution, this study utilized a snowballing recruitment method, which may not necessarily provide a ‘representative’ sample of women who have transitioning out of street prostitution in the DTES. Additionally, the stories and overall findings of this study came from the women’s retrospective accounts of the process of transitioning out of street sex work. Therefore, the stories recalled may not provide us with the entire picture of their experiences. However, in using retrospective accounts of the women’s stories, the co-authors were able to reflect on their process of transitioning out of street prostitution and highlight the most important points of their stories. Moreover, this study utilized a collaborative narrative method, in which I attempted to create as collaborative and equal of relationships with my co-authors as possible. However, I have been aware and reflective of the intrinsic power and privilege imbalances between myself, as the researcher (who, as the person collecting information from the co-authors, intrinsically has more power in the relationship), and my co-authors. That being said, I have engaged in an ongoing process of self-reflection and discussion with my co-authors to create as collaborative of research relationships as possible. Furthermore, as this study was conducted with women who have left street sex trade in Vancouver’s DTES, the results may not necessarily be transferable to understand ‘exiting’ in other geographical locations and sex work settings. Finally, given the qualitative nature of the research, this study had a small sample size, which makes the results not necessarily generalizable to the larger !#""!population. However, it provides an in-depth exploration of the process of transitioning out of the street sex trade.  Overall Summary and Conclusion  Using an indigenous feminist framework with an overarching counselling psychological umbrella to explore women’s experience of transitioning out of the street sex trade in Vancouver’s DTES through a collaborative narrative method has allowed me to formulate possible answers to for women who have been out of the street sex trade for at least two years, what do their narratives reveal about the process of ‘exiting’ street sex work? Doing so using a critical framework has facilitated a more in-depth understanding of this experience taking into account potential factors that may challenge the process of transitioning out of street-level sex work, such as race, ethnicity, gender, histories of trauma, and addiction. By seeking answers to this research question, we have a richer understanding of the process of transitioning out of street sex work including the hows and the whys, the resources needed and the barriers faced. From the stories and themes presented in Chapter Four, I hope some learning has taken place. I hope we have learned what some of the needs for the DTES community are and how we can seek to provide for those needs. I hope we in the counselling psychological and mental health community have learned ways in which we can improve our practice and training. I hope we have learned ways to apply this knowledge to ‘exiting’ theory. I also hope these findings can help to guide future research. Overall with this information, I hope we can work to remove some of the barriers, increase the resources, and thus, make the transition out of the sex trade easier for sex trade workers in the future. I would now like to close this document with a final letter to the reader.   !#"#!Concluding A Research Journey:  Letter Seven—A Closing Letter to the Reader Dear Reader, I want to take this moment to thank you for sharing this journey with me. I feel honored that you have taken the time to walk with me on this path of better understanding these eight women’s experiences of transitioning out of street prostitution. It has been a true gift to get to know each of these women and to share in their worlds in the time that we had together. Perhaps you have even felt the same gift as you were reading through the stories. As I have been conducting this research, I have found myself repeatedly putting myself in these women’s shoes (as best as I possibly could) to better understand what it was that they had experienced. In doing so, a range of emotions have come up including great anger and outrage for the tragedies they have endured with sometimes little support. I often get angry at the world, society at large, and even at myself for my own ignorance. I frequently question how we, as a society, can not only dismiss but also de-humanize these women so easily? I wonder why we feel we can abuse them with words, our hands, our lack of awareness, or, worse, our turning of the other cheek. I think of how female prostitutes have experienced significant stigmatization and violence for centuries, and I am left wondering if it is even possible to change societal views on the situation and the people living this lifestyle. I certainly hope so for as you and I have learned few of these women had explicitly chosen this lifestyle. As I shared with you earlier, my heart broke when I heard some of the stories of abuse and victimization, such as Spirit’s childhood experiences with drug addiction and prostitution. How could we blame this young woman and think of her as ‘less than’ the rest of us when she had little opportunity to choose her own path? And yet, as she described, people would in fact judge her for how she lived. I must admit this divide or lack of desire on !#"$!society’s part to understand and empathize with these women torments me a great deal particularly since I have gotten to know them and the horrors they have experienced. As I have emphasized repeatedly I have also felt great admiration for these women and the way in which they have faced and overcome a significant number of these barriers along the way. While I have experience immense anger and frustration at times for the obstacles these women have faced throughout their journeys, I must say that those intense feelings have provided me with a motivation and a drive to help make changes for the women still working to make the transition out of street prostitution. My hope is that through this document, through conversations with others, and through my advocacy work, that I can potentially improve the number of alternatives out there for women desiring to leave street sex work by increasing the resources and supports out there as well as removing as many of the barriers as possible. Who knows maybe you’ll even join me on this crusade of sorts. Again, I would like to express my sincere gratitude to you for embarking on this path with me. I hope it has been a learning experience for you as it certainly has been for me. 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