Good intentions, bad outcomes. How to choose the fights that actually work for the people you want to protect.
In 2018, the US Congress passed FOSTA-SESTA, a law designed to combat human trafficking by shutting down online platforms that facilitated sex work. The intention was sound. The results were not: multiple studies published in the years that followed show that the law pushed sex workers toward more clandestine channels, reduced their ability to screen clients and negotiate safer conditions, and cut them off from community support networks. Reports of violence increased. A law passed to protect women had left them more exposed.
This paradox is not an isolated accident. It illustrates a tension found in many social movements: between taking the right position and producing good outcomes. Between principled activism and strategic activism. That distinction is exactly what this article explores, through a concrete case study and a question that bears directly on how we choose causes to support and organisations to fund.
Rutger Bregman is a Dutch historian, the author of several internationally translated books, and co-founder of the School for Moral Ambition. In Moral Ambition, he starts from a simple and uncomfortable observation: many people who want to change the world spend their energy on fights that do not produce the effects they hope for, not from lack of conviction, but from lack of method.
He distinguishes two ways of being engaged, which we summarise as follows:
Measures their commitment by the consistency of their position. They defend the right cause, call out the right injustices, make sure their values are clearly on display. For them, the fight itself is a form of fulfilment. Bregman does not challenge this stance on moral grounds: it often stems from legitimate outrage and deep conviction. But he points to a real risk, what he calls "purity politics": preferring to be morally right rather than producing measurable impact. In extreme cases, this can lead to defending positions or laws that, in practice, worsen the situation of the very people they wanted to help.
Starts from the same values, but systematically asks one additional question: does what I am advocating for actually work for the people affected? They do not abandon their convictions. They put them to the test of evidence. And when the data shows that their methods are not producing the intended effects, they are willing to change tactics without changing their goal.
Both sides may claim to be strategic. This distinction is not an invitation to cynicism or inaction. Bregman says so explicitly: the great social advances of history, from the abolition of slavery to civil rights to feminist struggles, were driven by deeply committed people. But the movements that succeeded are those that were able, at a certain point, to subordinate symbolic consistency to concrete effectiveness.
The question is not "am I on the right side?" It is "does what I am doing actually improve the situation?" That is an uncomfortable question, because it requires looking at the evidence even when it contradicts our moral intuitions.
Let us start by being fully clear that sex work causes an enormous amount of harm.
A meta-analysis published in PLOS Medicine (Beattie et al., 2020), drawing on 56 studies and more than 24,000 participants across 26 countries, documents very high rates of depression, anxiety, PTSD and suicidal behaviour among sex workers, strongly associated with exposure to violence. These findings are robust and are not contested, including by researchers who favour decriminalisation.
The intuition that follows is understandable: since we would like to see sex work disappear, one might think that prohibiting or criminalising it is the logical way to achieve that and to protect the women involved. That is a morally coherent position. But the practical questions that flow from it are considerably more complex.
Different legal approaches exist: legalisation and regulation (as in Germany or the Netherlands), criminalising buyers only while decriminalising sex workers (the Nordic or Swedish model), criminalising all parties (the prohibitionist model), or full decriminalisation (as in New Zealand). Each rests on different values and assumptions about its real-world effects.
Which legal model actually reduces the suffering of women in the system today? That is not the same question as "is sex work a form of violence?" And on the practical questions of what we can concretely do, most of the available studies cannot answer this, and sometimes do not even try.
Some studies adopt an abolitionist stance, meaning they aim to eliminate sex work, primarily through prohibition. Researchers in this tradition are often not trying to measure the concrete consequences of a legal framework on the lives of women in the system, but to defend a position: that sex work is inherently violent and all policy should aim to eliminate it. That is not an illegitimate approach on moral grounds, but it is a different exercise from empirically comparing the effects of different laws.
The work of Melissa Farley, an American researcher widely cited in abolitionist literature, has produced data on the trauma experienced by women in sex work. But her studies recruit participants from victim support centres and exit programmes. This is a documented selection bias: a woman who is actively seeking to leave sex work and has ended up in a support centre is not representative of the full population of people who sell sex. It is like measuring the effects of alcohol only in detox centres. The data obtained document an extremely painful reality, but they cannot support generalisable conclusions about the comparative effects of different legal models.
For topics like this, scientific literature tools such as Consensus.app can be useful. The tool aggregates only peer-reviewed research papers, noting quality levels, citation counts, and the type of studies featured. Rather than relying on a single paper, it offers an overview of what emerges from a broader body of work. A few important caveats: Consensus only aggregates freely available papers, which represents just a fraction of the total scientific output. On some topics, vested interests can shape research funding and skew available results. And an apparent consensus can rest on a body of studies sharing the same selection bias. Volume of papers is no substitute for methodological quality.
In debates of this kind, a fundamental tool from epidemiology is worth recalling: the evidence pyramid. Not all studies carry equal weight, and their reliability depends largely on their methodology.
Most abolitionist studies cited in this debate sit in the lower levels of this pyramid. That is not without value, but it is not sufficient to draw conclusions about the comparative effects of different laws.
The meta-analysis published in 2018 in PLOS Medicine by Lucy Platt and colleagues at the London School of Hygiene and Tropical Medicine is the methodologically strongest reference on this subject to date. A peer-reviewed systematic review, it combines quantitative and qualitative studies and explicitly compares the effects of different legal frameworks on the health and safety of sex workers. Its conclusion is consistent: criminalisation in all its forms, including the Nordic model which only penalises buyers, worsens risks for women in the system. It pushes them to work more covertly, reduces their ability to screen clients, and discourages them from reporting violence to police for fear of the consequences.
This may be the most important point for understanding that this debate does not pit feminists against the indifferent, or activists against pragmatists.
Amnesty International, Human Rights Watch, the WHO, UNAIDS, and the Sex Worker Inclusive Feminist Alliance, a coalition of eight global feminist organisations, all support decriminalisation. Not because they deny the violence of sex work, or consider the current situation acceptable. But because the evidence they have shows that criminalisation concretely worsens the safety of the most exposed women: too afraid to report assaults to police, too constrained to choose their own conditions.
A deep feminist commitment and a position in favour of decriminalisation are not contradictory. They can flow from exactly the same goal, reducing the suffering of the most vulnerable women, simply by asking the question differently: not "which law sends the right message" but "which law actually improves their situation." This is not a disagreement about values. It is a disagreement about what works.
This case study on sex work laws is not just a public policy debate. It illustrates a broader problem that bears directly on how we choose to support causes and direct our donations.
Whether it is time, money, or political attention, the resources devoted to a cause are limited. Every pound donated to a criminalisation campaign is a pound that did not go to an organisation supporting women who want to leave the system, funding education programmes, or tackling the economic inequalities that fuel sex work. That opportunity cost is real, even when it is invisible.
This is one of the founding principles of Mieux Donner: the impact of a donation is not measured by the nobility of the intention, or the legitimacy of the cause in the abstract. It is measured by the expected effects produced by the supported intervention, on the people concerned, in the world as it actually is. This applies just as much to reducing animal suffering, where the same logic of prioritisation produces significant differences in impact.
Supporting a cause does not necessarily mean campaigning in the traditional sense. Street activism, awareness campaigns, and supporting frontline organisations are useful forms of engagement, but they are not the only ones. Depending on the context, other levers may prove more effective, or complement them.
Direct political advocacy, targeting parliamentarians or local governments, can shift a legal framework or secure public funding for programmes with documented effectiveness. Corporate advocacy is another often underestimated tool.
Sometimes multiple approaches need to combine to achieve major progress. It is worth asking whether more coordination is needed, or whether one approach is more neglected than the others, so that additional support could make a greater difference.
A cause can be entirely just, and an intervention within that cause can be ineffective, or even counter-productive. That is precisely what the sex work case illustrates: no one disputes that reducing the suffering of women in the system is a just cause. The disagreement is about the means chosen to get there.
The same logic applies across many other domains. Wanting to reduce poverty in the Global South is a just cause. But some forms of emergency food aid destroy local agricultural markets and deepen long-term dependency. Wanting to raise public awareness of inequality is a just cause. But some communication campaigns reinforce the very stereotypes they claim to challenge, presenting beneficiaries as passive victims rather than agents of their own lives. This is never a question of bad faith. It is a question of method.
Beyond the choice between organisations, the question of prioritisation also arises at the level of causes. Bregman puts it clearly in Moral Ambition: the most important decision for someone who wants to have an impact is not "how" to act, but "on what" to act.
A rigorous way to prioritise is to evaluate each cause or intervention across three dimensions:
Financially supporting a cause according to the principles of effectiveness is a concrete act with concrete effects. It is not merely a moral signal. It means taking the trouble to ask the right questions, to seek out contradictory evidence, and to be willing to revise your choices if the data warrant it. That is what Bregman calls moral ambition: combining the conviction of people who want to change the world with the rigour of those who want to make sure their actions actually do.
Our giving guide and charity recommendations are built around exactly these principles: measurable impact, solid evidence, neglected causes.