According to a photo essay by Andrew Biraj on Bangladesh’s legal brothels, madams dose (often underage) sex-workers with Dexamethasone, a steroid, to make them look older and fatter. The photographs are sexually suggestive and made me uncomfortable, but the issues are worth examining.
These kids, as young as 12, are bought from parents or lured into sex-trade as an escape from penury and then literally fattened before they are pimped to costumers.
Dexamethasone is a powerful corticosteroid. It suppresses inflammation in the body and is used in the treatment of various disease like Rheumatoid arthritis and other AutoImmune diseases.
One of the most visible and early side effects of corticosteroid use is deposition of fat on the upper body. Typically, short term use will result in chubby cheeks, rounder shoulders and some deposition of fat on the chest. This might give the appearance of being chubby or healthy but is a side effect, and not a pleasant one.
Corticosteroids have a darker side, CDC lists some of the side effects
Possible side effects of short-term corticosteroid use:
- Increased fat on the face (rounded face), upper back, and belly
- Upset stomach
- Increased blood sugar
- Increased hunger
- Behavior changes, trouble sleeping, irritability, depression
- Increased risk of pneumonia, thrush (white coating in the mouth), and other infections
- Weight gain, salt and water retention
- High blood pressure
- Stretch marks on the skin, acne, poor wound healing, increased and unusual hair growth
Possible side effects of long-term use (3 months or longer):
- All short-term side effects
- Poor growth in children (can be severe)
- Brittle bones (bones break easily, problems with hips and shoulder joints)
- Muscle weakness
- Eye problems
As you can see, not only are these kids subject to being sex-slaves, but also face a lifetime of illness for a decade of two of sex-work.
There is very little medical data from Bangladesh about steroid abuse, The only people who seem interested are news outlets. UNICEF in its “Background Paper on Good Practices and Priorities to Combat Sexual Abuse and Exploitation of Children in Bangladesh” mentions it in passing and refers to an 2010 BBC story about the same.
Most public health and medical research into sex-work looks almost exclusively at Sexually transmitted infections and HIV/AIDS, a few look at violence, but the longer term health and non-psychoactive drug abuse often gets sidelined.
One could dismiss this problem and say “if you are not going to live to be 40, STI’s are more a priority than Diabetes”.
Read more at
- CDC page on Corticosteroids
- Background Paper on Good Practices and Priorities to Combat Sexual Abuse and Exploitation of Children in Bangladesh Author: Heissler, K.
- Bangladesh’s dark brothel steroid secret BBC
- Sex-trafficking, Violence, Negotiating Skill, and HIV Infection in Brothel-based Sex Workers of Eastern India, Adjoining Nepal, Bhutan, and Bangladesh Kamalesh Sarkar, Baishali Bal, Rita Mukherjee, Sekhar Chakraborty, Suman Saha, Arundhuti Ghosh, Scott Parsons J Health Popul Nutr. 2008 June; 26(2): 223–231. PMCID: PMC2740670