Understanding Sex Work

1. Understanding Sex Work Working together with health care to create a community that is safe and healthy for everyone.

2. The goal of SAFE in Collingwood is to create a community that is healthier and safer for every community member in relation to the issues of sex work and sexual exploitation.

3. Sex work Awareness For Everyone

4. Embrace diversity and respect all people • Enable participation of all people • Foster positive change through learning and capacity building • Stand against exploitation and social injustice • Create understanding and build community • Be open to listening and understanding different perspectives SAFE Values & Guiding Principles:

5. SAFE has a wide diversity of partnerships with local agencies, residents and sex worker organizations. Seniors Living in Community WISH Drop-in Centre Society Local Schools Collingwood Business Improvement Ass’n Youth VCH - Evergreen Community Health Centre Collingwood Neighbourhood House HUSTLE Residents Vancouver Police Department Collingwood Community Policing Centre PACE Society

6. To care for someone,I must know who I am.To care for someone,I must know who the other is.To care for someone,I must be able to bridge the gapbetween myself and the other. Jean Watson

7. Equitable Access to Health Care Every Canadian citizen has the right to health care Sex workers experience significant barriers to accessing health care These include social, structural, and psychological barriers

8. Social Barriers • Research has demonstrated that some members of marginalized communities lose their ability to read any human expression except disgust as that is often the only expression they see ... Martin, L., Clair, J., Davis, P., O’Ryan, D., Hoshi, R. and Curran, H. V. (2006), Enhanced recognition of facial expressions of disgust in opiate users receiving maintenance treatment. Addiction, 101: 1598–1605. doi: 10.1111/j.1360-0443.2006.01574.x

9. Stigma Impacts of stigma: • low self-esteem & diminished self-confidence • demoralization • poor perceived quality of life • social withdrawal • fear of being judged negatively • low expectations & few demands on services Women’s Health Research Network, 2010

10. Impacts of Stigma Many women reported experiences with medical professionals that they found to be disrespectful, punishing, dismissive, judgmental, stereotyping, and condescending • Be conscious of your own values, prejudices, attitudes and your behaviour. If your values interfere with meeting the individual’s needs refer them to someone else. • When providing services to a sex worker, avoid focusing on the work they perform. • Educate yourself about the realities of sex work The Primary Health Care Experiences of Women Who Use Drugs in the Vancouver’s Downtown Eastside WHRI 2009

11. Impacts of Addiction While some sex workers have addiction issues, others do not Assumption of drug-seeking behaviour Failure to disclose drug use Over-prescribed Rejection of harm reduction principles The Primary Health Care Experiences of Women Who Use Drugs in the Vancouver’s Downtown Eastside WHRI 2009

12. Structural Barriers

13. Other Structural Barriers Reception/Security Is everyone greeted with a smile? Have you included security personnel in sensitivity training? Presence of men Can you offer women-only hours? Are your staff trained to monitor the waiting room and intervene if necessary? Irregular scheduling Are your doctors on a regular schedule? Do you allow people to make appointments? Can you offer evening hours?

14. Psychological Barriers Some sex workers have Post Traumatic Stress Disorder and can react strongly to: sudden loud sounds, sudden movements, physical proximity etc. Due regard to personal modesty and boundaries is critical Consider staff training to become “trauma-informed” An excellent resource: www.traumainformed.ca (click on “Toolkit”)

15. Cultural Competence Culture is defined by many factors, such as race, gender, religion, ethnicity, socio-economic status, sexual orientation and life experience. The extent to which particular factors influence a person will vary. In Vancouver, most sex workers are Caucasian but there are a significant number who are of Aboriginal and Asian descent. Seek to broaden your understanding of cultural concepts & issues. An excellent resource: Culturally Sensitive Care (Ontario Nurses Association) http://www.cno.org/Global/docs/prac/41040_CulturallySens.pdf

16. Social Determinantsof Health Income & Income Distribution Education Unemployment & Job Security Employment & Working Conditions Early Childhood Development Food Insecurity Housing Social Exclusion Social Safety Network Health Services Aboriginal Status Gender Race Disability

17. Intersecting Oppressions Beyond the social determinants of health, sex workers’ health is impacted by many intersecting oppressions: • Ethnicity • Sexual orientation • Gender identity • Class, poverty & gender • Criminalization • Stigmatization • Marginalization POWER: The Toolkit 2011

18. What can I do? When providing services to a sex worker, avoid focusing on the work they perform. Be conscious of your own values, your prejudices, your attitudes and your behaviour. Work to make your workplace sex worker friendly. Create a resource bank in your organization that will address sex workers’ specific needs. Be cognizant of sex work/worker stereotypes. Recognize sex workers’ expertise. POWER: The Toolkit 2011

19. What can I do? When doing a sexual history intake, remember to ask questions about personal relationships rather than focusing on work relations. Validate and focus on the individual’s needs and expectations. Inform the individual of health care services available, and do so in a nonjudgmental way. Be especially vigilant in guarding the confidential information provided by sex workers. Remember that the occupational health and safety needs of sex workers are not restricted to sexual health. POWER: The Toolkit 2011

20. What Sex Workers Need To be recognized as full citizens To be listened to without being judged To be taken seriously To be integrated into the community To have their human rights recognized and respected To have access to public services without discrimination To have access to work-related social & judicial services The Toolkit: Ottawa Area Sex Workers Speak Out

21. Next steps ... Organizationally Organizational change process Physical environment Observation of clients (who comes and who doesn’t) Individually Examine your personal beliefs Seek more information Don’t be afraid to reach out and ask questions What do you and your organization need to know or understand better in order to provide more accessible services?

22. Reality Myth Selling or purchasing sexual services is legal; However, some activities associated with sex work are not. Sex work is ILLEGAL In Canada

23. Reality Myth No one ever deserves to be assaulted, sexually assaulted, or murdered. Sex workers set themselves up for violence

24. Reality Myth While it may be true that some sex workers have experienced abuse as children, the same can be said of any occupation. All sex workers were sexually abused as children

25. Reality Myth Sex work is as diverse as any other occupation where some workers have addiction issues and some do not. All sex workers are drug addicts

26. Reality Myth Sex workers practice safe sex at much higher rates than the general public. Sex workers are no more responsible to prevent the spread of HIV than any other sexually active person. Sex workers spread HIV and other sexually transmitted infections to the public.

27. Reality Myth While some sex workers do want to get out, many others do not. Furthermore, for those who do want to get out, there is a lack of services to assist them in doing so. All sex workers want to get out of the industry

28. Reality Myth While the majority of sex workers are believed to be female, there are large numbers of male and transgender sex workers as well. Some sex workers continue working right up to retirement age. All sex workers are young women

29. Reality Myth Individuals enter sex work for a variety of reasons, most often economic. Those who are forced or exploited are very isolated and there is limited knowledge about who they are and how best to support them. All sex workers are forced into the sex industry

30. Reality Myth Empowering sex workers to work with law enforcement to identify and assist those people who have been coerced is an effective way to support sex workers. Raids of brothels and massage parlours rescues sex workers and victims of trafficking

31. Reality Myth Remuneration for sex work varies with the type and location of work. Income can fluctuate widely from day to day. Sex work is an easy way to make a lot of money

32. Reality Myth Not all sex workers are women. Clients come in all ages and from all walks of life. Much of sex work does not involve violence. All clients of sex workers are men who want to hurt women.

33. Reality Myth Let people name their own experience. We are all the experts in our own lives. This is a value judgment that leads to discrimination and dehumanization. Sex work is degrading

34. For more information ... There are sex work support organizations throughout Canada who are happy to provide information to members of the public. An excellent start: www.powerottawa.ca and download their “toolkit”.

35. Acknowledgements Kerry Porth, Sex Trade Educator SAFE Public Education Committee Brette Little, Model