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Education as Action: Supporting the Sexual Health of Sex Workers

by Sarah Elspeth Patterson


December 8, 2011

Sexuality education is, in many ways, an esteem-building practice. Knowledge of any kind, but especially of one's own body and its functions, allows individuals to make healthier and more informed decisions. It empowers people to decide what works for their specific set of health needs.

As a community organizer for the Sex Workers Outreach Project of New York City, I conduct safer sex workshops for sex workers, and I consult with them about their sexual health needs. I believe that the ability of sex workers to have direct access to sexual health information is a political and human rights issue. I want sex workers to be afforded the same level of health care as every one else. As a human sexuality educator, I know that to accomplish that, sex workers have to be advocates for their own sexual health first and to be able to inform their medical providers about their specific needs.

The legal stigmatization of sex work goes beyond the criminalized nature of prostitution itself. For instance, since 2003, the U.S. government has required that international non-governmental organizations (NGOs) receiving federal funding for their anti-HIV/AIDS efforts take an anti-prostitution pledge, which proclaims that they have an organizationwide policy against prostitution. In 2005, this requirement was extended to NGOs based nationally, making U.S. NGOs equally unable to “promote, support, or advocate the legalization or practice of prostitution” in any way. Unsurprisingly, this pledge to abolish sex work by simply denying its existence has made it difficult, if not impossible, for many groups to offer health care services to sex workers, regardless of the need for them.

I also talk to health care providers about their ability to serve and communicate with sex workers about their sexual health. With the exception of such amazing health care organizations as St. James Infirmary in San Francisco, very few providers have honest and open interactions with sex workers.

Sex workers receive limited attention from the medical community, and when they do, it is generally negative. Most medical-related discussions of sex work frame sex workers as either victims or vectors of disease. Instead of considering how medical providers can be more sensitive to the needs of sex workers – clients, after all -- many medical providers make a lot of assumptions about sex workers, contrary to the broad spectrum of experience within the sex industry. Providers tend to generalize the sex worker experience as being inherently problematic or unsafe rather than treat sex workers as a special population with its own needs.

There are some signs that people are tired of misinterpretations of the sex industry. In a recent Utne Reader article, X-Rated Ethics, writer Anna Simpson discusses the public’s growing interest in a “socially sustainable” sex industry: one where those who access sex or pleasure from those in the sex industry know that the folks they interact with want to be there and are well paid for it. These sex workers need to have a strong working knowledge of sexual health and to be able to educate their clients about sexual health, as well. Access to this information, of course, varies depending on their circumstances, but medical providers are certainly a starting point.

In the current political climate, in which sexual victimization and sex trafficking are hot-button topics, understanding that there is a side of the sex industry that is consensual, informed and educated is essential to discerning the vast spectrum of sex trade experiences. In order to be empowered as workers, sex workers must be able to receive culturally competent and sensitive care from their medical providers without fear of shaming or discrimination for their work.

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Sarah Elspeth Patterson is a freelance writer and community organizer with the Sex Workers Outreach Project of New York City. She conducts workshops for sex workers on safer sex practices. She has previously worked as the Online Blog Editor for Babeland, the feminist, sex-positive adult toy company. She was also a media columnist and staff writer for the Utne Reader award-winning $pread Magazine, the sex worker advocacy publication. She holds a Masters in Human Sexuality Education from Widener University and lives in Brooklyn, New York.

Also see ”Stopping Police and DAs from Using Condoms to Convict Sex Workers” by Crystal DeBoise in the Cafe of this edition of On The Issues Magazine.

”Patient Power – The Reluctant Revolution” by Merle Hoffman in this edition of On The Issues Magazine.


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