Background

First off, let’s go over what sex work is and who does sex work.

What is sex work?

Sex work is an umbrella term used to describe selling sex for money or other goods and resources. This includes escorts, people who do camming, adult film actors or people in the porn industry, dominatrixes and other fetish workers, and strippers - among others. However, not everyone who does sex work uses this term for various reasons that are often personal to them. The words “prostitute” or “prostitution” are often used in legal documents related to sex work, but these terms are considered by many people to be stigmatizing. Sex work is a consensual act. 

Who are sex workers?

Sex workers come from all backgrounds and identities. Sex workers come from all genders, sexual orientations, races, ethnicities, ages, educations, and abilities. Some sex workers use drugs, some do not. While the media often focuses on sex workers who work outdoors, the majority of sex workers are engaged in some form of indoor sex work. Sex workers have various reasons for doing sex work, just like any other job. For some people, sex work provides flexible work hours, which may be especially appealing to folks with disabilities who face barriers to other employment. Other people enjoy providing emotional services to their clients or the financial benefits.  Regardless of their reasons for doing sex work, sex workers are important members of our communities and deserve to be treated with respect.

What shapes sex workers’ access to healthcare?

Evidence has consistently shown that sex workers face barriers to accessing healthcare. Sex workers experience various levels of direct and indirect stigma, and unfortunately this often comes from healthcare providers who may not be aware how their words and behaviours can discriminate against sex workers. Stigma is also a complex topic, and is perpetuated by the media, by institutions, and by laws and policies. Actions can be stigmatizing without having the intention of discrimination. Examples of this include assuming that sex workers are being trafficked, need ‘saving’, or that sexual health is their primary health concern and reason for their health visit. When people experience stigmatizing healthcare environments, they are less likely to seek care in the future.

Policies and structures within a healthcare setting can also deter sex workers from accessing care. These include policies that do not ensure sex workers’ privacy and confidentiality are being respected, having limited choice in their healthcare provider, inappropriate hours of operation, mandatory full STBBI screening (rather than giving patients choice), and reception areas that make it difficult for people to share their health concerns confidentially - to name a few. Sex workers are also diverse and may experience distinct barriers to care based on their personal identities and experiences, including homophobia, racism, ableism, or not having services offered in their language. Throughout the remainder of our modules, we will be going into these barriers to care more in depth and potential solutions to some of these issues.