Sex Work and Social Work Biases: We Need to Be Better
By: Sarah Wilson
“You lied to me. Why didn’t you tell me you worked there? How could you possibly make good choices working in a place like that.”
artwork: @sarah.epperson
As I sat across from this white male doctor in his office, the walls quickly began to cave in as the realization set in that I had been found out. He knew my secret - that I was a stripper. This was something I generally didn’t keep to myself, but one that I kept from all medical and social service professionals because I understood the repercussions.
I left this man’s office feeling incredibly embarrassed, belittled, ashamed, and worthless. Panic began to set in as I knew I could never go back to him. I had been battling an opioid addiction for years and had recently been sober for the first time with the help of Suboxone - Suboxone that was being prescribed to me by this man. A doctor. Who instead of being understanding and empathetic, was judgmental and hurtful. I never went back to see him and reverted to buying Suboxone off the street.
Just like the time I tried to seek therapy, but was told by my white female counselor that I should look for a job that wasn’t “degrading”. I could feel the heat in my cheeks and I began to perspire. I wanted to run out of that room, the feeling of worthlessness and judgment seeping from my pores. I never went back to her either.
This is the reality of why over 60% of sex workers in America distrust medical and social service professionals. This is why we, as social workers, need to do better.
Dissecting Sex Work and Stigma:
Sex work is defined by Open Society Foundations as “adults who receive money or goods in exchange for consensual sexual services or erotic performances, either regularly or occasionally”. (Open Society, 2019) It is important to highlight the term consensual because sex work is often conflated with human trafficking, which are two very different things. This conflation only further perpetuates the stigma surrounding sex work. Examples of sex work include, but are not limited to: street prostitution, stripping, camming, only fans, phone sex operating, escorting, and pornographic film acting - all of which are done with full bodily autonomy and zero coercion. Historically, sex workers have been a marginalized community due to a general disdain for women who do the work. For years and years, sex work has been linked unjustly with the spread of sexually transmitted infections, HIV/AIDS, an escalation in crime, drug use, a cause for breakdown of traditional families, and greatest of all: sex workers have generally been viewed as uneducated, immoral and unclean. (Peers, 2024) This stigma has led to discrimination when it comes to these women attempting to obtain social services, legal services, basic healthcare, and housing.
artwork: @lizar_tistry
The Intersectionality of Social Work Values and Sex Work:
It is important to note that the NASW code of ethics explicitly states that we, as social workers, are to not discriminate against anyone on the basis of race, ethnicity, sexual orientation, gender identity or expression, or immigration status. (NASW, 2024) One of our social work core values, according to our code of ethics, is “Dignity and Worth of the Person”. Given this core value alone, we are to treat all individuals with dignity and respect regardless of their profession. Since the mid 1800s, social workers have viewed sex workers as people who need saving and often “intervened” by promoting diversion programs. (Wahab, 2002) In nearly every period of time since the conception of social work, sex workers have been viewed as women who “need protection for their own good”. (Wahab, 2002) Again, this societal conflation of sex work and sex trafficking, combined with the notion that sex work is socially unacceptable, continues to harm individuals choosing to engage in this work and keeps social workers from identifying their own internal biases when it comes to working with sex workers. Because ultimately, sex work is not the problem; the criminalization, societal hatred of sex workers, and cultural incompetency and stigma of healthcare and social service professionals are the problem.
The Reality of Sex Work:
Women involved in street sex work are 60-100 times more likely to be murdered than non-street working females. (Lucy, 2021) What makes sex work so dangerous, aside from criminalization and the general public’s lack of empathy for women who do this work, is sex workers inability to safely report any assaults they may experience. When asked, one sex worker reported, “All of my worst experiences happened because of the police.” (Lucy, 2021) There have been numerous reports of law enforcement using coercion to abuse sex workers. For example, arresting a sex worker but stating they will let them go in exchange for a sexual service. “Research shows that sex workers are often physically or sexually coerced by police through threat of detention, violence (including rape), or extortion.” (Sakha, 2020) BIPOC women, trans women, and immigrants are disproportionately targeted by law enforcement leaving them more vulnerable to police harassment and less likely to report violence experienced at work. (Open Society, 2019) This population is also disproportionately affected due to the compounded stigma of being a minority and being a sex worker. The United Nations Population Fund reported that a whopping one in four sex workers have been denied access to healthcare as a direct result of their occupation. Additionally, an upward of 60% of sex workers fear healthcare workers and social service workers and generally do not seek care due to this fear. (Kirkegaard, 2022) They continue to be neglected by our systems; systems which were put in place by a patriarchal society of white supremacy.
Call to Action for Social Workers:
Now, more than ever, sex workers need our advocacy and unbiased care. Due to such an uncertain future with the reign of Donald Trump’s Presidency upon us threatening our civil and human rights, it is imperative we challenge our own biases when it comes to the profession and fight for the rights of sex workers. Now, more than ever, social work professionals need to be safe human service professionals who will not only help on a micro level but will advocate for sex worker rights and safety at mezzo and macro levels. We need to hold each other accountable when we see wrongdoing, whether the wrongdoing is intentional or not. We need to take critical action and question not only society's historic view on sex work, but biases linked to the profession of social work. We need to reflect on our own internal biases regarding not only sex work, but sex workers in marginalized communities who are disproportionately affected and targeted by stigma and hate. A focus on a liberation health model of social work and trauma informed care is imperative in helping us come together to understand how socioeconomic, political, history, and culture shape an individual's life and circumstances. We must resist oppressive theories and oppressive practices which have continued to harm sex workers since the 1800s. (BLH, 2024) The most important voice in the room is the one of the oppressed. We will never learn if we are unwilling to listen, unwilling to unpack our own internalized racism and biases, and unwilling to unlearn the unconscious teachings of white supremacy culture and the patriarchy. It is not up to us to place judgment or blame, and it never should have been.
artwork: @theovalcenter
References
Boston Liberation Health. (2024). Introduction to the Liberation Health Model. BOSTON LIBERATION HEALTH. https://bostonliberationhealth.org/
Kirkegaard, D. (2022, July 27). Like everyone else, Sex Workers Deserve Health Care. USA for UNFPA. https://www.usaforunfpa.org/like-everyone-else-sex-workers-deserve-health-care/#:~:text=A%20UNFPA%20report%20found%20that,them%20to%20the%20doctor’s%20office.
Lucy. (2021, January 13). Facts and statistics about sex workers in the USA. Submit Infographics. Retrieved February 1, 2023, from https://submitinfographics.com/all-infographics/facts-and-statistics-about-sex-workers-in-the-usa .html
NASW. (2024). Code of Ethics. NASW, National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English/Social-Workers-Ethical-Responsibilities-to-Clients
Open Society. (2019, April). Understanding Sex Work in an Open Society. Open Society Foundations. https://www.opensocietyfoundations.org/explainers/understanding-sex-work-open-society
Peers. (2024, March 27). Peers Victoria Resources Society. Peers Victoria. https://www.safersexwork.ca/
Sakha, S., Greytak, E., & Haynes, M. (2020). Is Sex Work Decriminalization the Answer? What The Research Tells Us. ACLU RESEARCH BRIEF. Retrieved February 1, 2023, from https://www.aclu.org/sites/default/files/field_document/aclu_sex_work_decrim_research_brief.pdf
Wahab, Stéphanie (2002) ""For Their Own Good?": Sex work, social control and social workers, a historical perspective," The Journal of Sociology & Social Welfare: Vol. 29: Iss. 4, Article 4. DOI: https://doi.org/10.15453/0191-5096.2847 Available at: https://scholarworks.wmich.edu/jssw/vol29/iss4/4
