Why Sex Work Is Real Work
The government of Amsterdam, a city known worldwide for its Red Light District, will ban the popular guided tours through that area starting in 2020. The ban stems in part from complaints calling the tours a nuisance that lead to congestion in the narrow canal-side streets. But city officials have also said the ban is out of respect for sex workers. “It is no longer acceptable in this age to see sex workers as a tourist attraction,” city councillor Udo Kock said, according to The Guardian. There’s one problem: Many sex workers are opposing this plan.
Sex work is legal in Amsterdam, but it isn’t in many other places, though some people are working to make it so. In South Africa, where I am based, for instance, sex workers are calling for decriminalization and legal reform. They argue that sex work is work, as affirmed by the International Labor Organization (ILO), a specialized agency of the United Nations. This situation in Amsterdam, and the continued criminalization of sex workers around the world, is yet another example of how we disregard the needs and opinions of the people most impacted by policies. But even more so, it’s another example of how we misunderstand what sex work actually is. I am a doctor, an expert in sexual health, but when you think about it, aren't I a sex worker? And in some ways, aren't we all?
So, what exactly is sex work? Not all sex workers engage in penetrative sex, though, undeniably, that is a big part of sex work. Sex-worker services between consenting adults may include companionship, intimacy, nonsexual role playing, dancing, escorting, and stripping. These roles are often pre-determined, and all parties should be comfortable with them. Many workers take on multiple roles with their clients, and some may get more physical while other interactions that may have started off as sexual could evolve into emotional and psychological bonding.
The clients who seek sex workers vary, and they’re not just men. The idea of purchasing intimacy and paying for the services can be affirming for many people who need human connection, friendship, and emotional support. Some people may have fantasies and kink preferences that they are able to fulfill with the services of a sex worker.
I find it interesting that as a medical doctor, I exchange payment in the form of money with people to provide them with advice and treatment for sex-related problems; therapy for sexual performance, counseling and therapy for relationship problems, and treatment of sexually transmitted infection. Isn't this basically sex work? I do not believe it is right or just that people who exchange sexual services for money are criminalized and I am not for what I do. Is a medical degree really the right measure of who is deserving of dignity, autonomy, safety in the work place, fair trade and freedom of employment? No. This should not be so. Those who engage in sex work deserve those things, too.
Today, online spaces and apps make the interactions and negotiations safer for women sex workers as opposed to soliciting sex outdoors, where the threat of community and police harassment remains a concern. (Recent legislation in the United States that makes it harder for sex workers to advertise online, however, has complicated this.) Apps also make it less intimidating for women who are clients to screen and meet potential sex workers to cater to their needs.
Still, continued criminalization of sex work and sex workers is a form of violence by governments and contributes to the high level of stigma and discrimination. A systematic review and meta-analysis led by the London School of Hygiene and Tropical Medicine (LSHTM), for instance, has found that sex workers who have experienced "repressive policing" (including arrest, extortion, and violence from police) are three times more likely to experience sexual or physical violence.
But governments often fail to accept the evidence for the economic and social bases for sex work; the ILO estimates that “sex workers support between five and eight other people with their earnings. Sex workers also contribute to the economy.” Governments ignore the nuanced histories and contexts in different countries and thus continue to wrongfully offer blanket solutions and "rescue" models that advocate for partial decriminalization or continued criminalization. They also ignore the wishes of sex workers, who want full decriminalization, as supported by the Global Commission on HIV and the Law, and the Lancet, as well as human rights organizations like Amnesty International.
Global efforts toward decriminalization have been growing in some countries, such as South Africa. Here, it is led by the biggest sex worker movement, Sisonke, and the advocacy and policy work of SWEAT. These efforts are mirrored by the Global Network of Sex Work Projects (NSWP) and the Dutch Union for Sex workers, PROUD.
In July 2018, at the International AIDS Conference in Amsterdam, I joined colleagues and allies and marched in solidarity with PROUD as they delivered a memorandum to city officials, demanding protection of the right of sex workers to work in safe working conditions. The moment was important in invigorating the global movement for decriminalization.
Sex workers must be affirmed through upholding and the protection of their human rights to autonomy, dignity, fair labor practices, access to evidence-based care. It is for this and many other reasons that I believe sex work and sex worker rights are women’s rights, health rights, labor rights, and the litmus test for intersectional feminism.
Further, the impact of continued criminalization of the majority of sex workers, mostof whom are cisgender women and transgender women, mean that sex worker rights are a feminist issue. If you support women’s rights, I urge you to support the global demand for sex work decriminalization, and fund evidence and rights-based intersectional programs aimed at sex workers and their clients.
We must support efforts to address structural barriers and ensure the implementation of a comprehensive package of health services for sex workers as advised by the World Health Organization, and fund public campaigns to decrease stigma. Evidence, not morality, should guide law reforms and sex work policy for full sex work decriminalization.