Britta Graves considers themself a full-time artist and a part-time sex worker, spending their days making art, playing music, and going to the beach. And at night, they dance. Graves, who uses they/them pronouns, is a Jacksonville, Florida, transplant. They recently left Athens, Georgia, because of pandemic-inspired curfews, which caused them to make only 75 percent of their normal income at the club where they worked. The financial strain left Graves struggling to make up for lost revenue.
“For so many people, their sexuality is a huge part of their identity and to dismiss or ignore that or to be ill-equipped to handle that in the therapy space makes me really sad.”
Even with a scholarship, Graves was paying $6,000 a semester at the University of Georgia. They took a job waiting tables but, when that failed to meet their financial needs, they began stripping, which paid more than any other job they were likely to get after graduation. Graves, twenty-two, has been stripping for three years and calls this their “ten-year plan.” It has its ups and downs.
“The ability that I have to connect with strangers on a very deep, emotional, carnal, personal level reminds me how good it is to be human,” says Graves. “There are aspects of the industry that are really not empowering, and most of those things have less to do with the industry itself, and more to do with the way that other people treat me because of my job.”
For Graves, this includes a lack of access to health care, rejection for housing due to income source, and sexual assault. The fact that sex work is seen as criminal behavior makes matters worse.
“The purpose of criminalization is to enforce the moral law,” says Chris Cuomo, a University of Georgia professor of ethics and feminist philosophy. She calls it a “Puritan model” built to control women.
The connections between criminalization and sex worker health are well documented. One study using data from 1990 to 2018 confirmed the extensive harm, including an increased risk of sexual and physical violence, caused by anti-sex-work laws and policing practices. The World Health Organization recognizes the criminalization of sex work as a health threat as well, noting that decriminalization and other structural interventions would reduce the rate of HIV infections, sexually transmitted infections, and other harms.
Merriam-Webster defines a sex worker as “a person whose work involves sexually explicit behavior.” This broad definition encapsulates a wide range of occupations from stripping, prostitution, and working for escort services to pornography, phone sex operating, and webcam modeling. The legality of sex work varies from state to state.
There are an estimated one to two million sex workers in the United States and more than forty million worldwide.
Fueling criminalization is the taboo around sex, perpetuated by a lack of relevant training for health professionals. The discomfort surrounding this topic causes some professionals to “other” sex workers, making it more difficult to deliver appropriate mental and physical care.
Graves recalls telling a therapist about having been sexually assaulted on the job by a client, only to receive an invalidating response. “She proceeded to ask me if I felt like my job was worth putting myself at risk like this,” Graves recalls. “I proceeded to tell her that what I do for a living is no excuse for someone to lay their hands on me when I told them that they couldn’t.” The therapist’s response was to warn her that this was probably something that would happen again, unless she found a new line of work.
Stella Zine, a currently “inactive” sex worker who worked in Atlanta’s sex industry for around fifteen years, has also faced her share of prejudice and violence. She recalls going to a domestic violence center looking for help after being subject to violence at the hands of her partner. She, too, encountered discrimination based on her line of work.
Because sex work intersects with many issues, centers for domestic violence and sexual assault must provide all-encompassing competency training. Sally Kimel-Sheppard, a licensed clinical social worker and the executive director of The Cottage, a sexual assault center and children’s advocacy center in Athens, explains the plethora of trainings that all employees must complete. It includes a forty-hour, week-long training on working with survivors of sexual assault.
“We’re big on placing the blame where the blame should be, and that’s on the person who did the sexual assault,” she says. “We talk a lot about victim-blaming, rape culture, things like that.”
SJ Dodd, a professor of social work at Hunter College in New York City and author of the 2020 book Sex-Positive Social Work, explains the impact of a therapist’s personal bias toward sex work.
“People let all their biases and all the stereotypes get in the way of meeting the client where they’re at,” she says. “They might not be talking to you about the sex trade at all. They might be coming to you because they’re worried about their kid’s engagement in school, or depression, or whatever it is, right?”
“Sometimes, the police just use [anti-trafficking raids] as a reason to extort money or sexual favors from sex workers. That room for abuse will always exist the moment we give police power over [the] rights of sex workers.”
Stigma prevents sex workers from seeking services from mental health professionals and other medical providers. “Because of the taboo around sex and sexuality and our reluctance to talk about it,” Dodd says, “medical providers don’t raise issues [about sexual well-being] in care.” This may mean sex workers forgoing a blood panel for STIs or HIV.
Sexual well-being is connected to our overall well-being, Dodd argues, even more so for sex workers. “For people engaged in [the] sex trade, it’s literally their livelihood, and yet we’re not prepared to treat or to work with them,” she says. “We are just not well prepared to engage them in treatment.”
Amanda Auchenpaugh, who led a sex worker support group from September 2020 to March of this year and has a private therapy practice at Revolution Therapy and Yoga in Athens, recently earned her master’s in social work from the University of Georgia. She’s currently working toward full licensure in social work as well as sex therapy certification.
“For so many people, their sexuality is a huge part of their identity and to dismiss or ignore that or to be ill-equipped to handle that in the therapy space makes me really sad,” Auchenpaugh says. “It makes me feel like people aren’t going to get their needs met.”
Auchenpaugh wasn’t always so comfortable talking about sex; she once led an evangelical Christian lifestyle, initially majored in religion, and planned to go to seminary. But after she was introduced to new perspectives outside and inside the social work program, she realized the damage that purity culture could cause. When she tried finding a sex therapist for herself, Auchenpaugh saw that there weren’t a lot of options. “I wanted to change that,” she says. “So that’s where I decided I wanted to go.”
The University of Georgia’s psychology department has just one course on human sexuality. Its marriage and family therapy graduate program and department of women’s studies offer a couple of courses on sexuality, but not ones that center on clinical work. Most are not mandatory for those going into social work.
The criminalization of sex work has wide ripple effects. It makes sex workers less inclined to seek help at the same time that it makes them more vulnerable to abuse.
Graves recalls dealing with undercover police in Athens and Jacksonville. “We would always know when they were undercover cops because they were trying to get us to sell them drugs. Or they were trying to get us to overlook our boundaries, physically, and let them touch us in places where we didn’t want to be touched,” Graves says. “They were overwhelmingly aggressive, more aggressive than the civilians would be because they really don’t give a fuck about us.”
Kim Watson, the executive director and co-founder of Community Kinship Life in New York City, aims her services toward trans people of color. Trans survival sex workers, or those who are doing sex work out of an extreme need, have exceptional difficulties receiving help. Watson, a former sex worker herself who identifies as a “post-op anatomical woman who has trans experience,” notes that her arrests created what she calls a “revolving door.”
Watson talks about the difficulties that trans people face when it comes to their line of work: “How many places where [trans] sex workers can really go and say, ‘OK, I did not eat today. Can I get some food?’ How many places can trans sex workers say, ‘Oh, I don’t have any clothes. This is all I got.’ ” She says her efforts to partner with different New York City Police Department precincts to instill a sense of empathy toward sex workers have led to only minor change.
The Atlanta massage parlor shootings in March illustrate the precariousness of Asian and migrant women, amid a rise in anti-Asian hate during the pandemic. They also highlighted the world of police bias, as reflected in the much-criticized response of the Cherokee County Sheriff’s Office captain who said the killer was having “a really bad day.”
The Atlanta Police Department declined to comment on its possible use of sensitivity trainings or the use of other means to keep those arrested for sex work out of jails.
In 2013, Zine co-founded the Coyote Georgia Chapter, a nonprofit that helps improve the lives of current and former sex workers, and advocates on behalf of sex workers in many other organizations. She has also been part of the mental health peer movement in Georgia for several years, having worked as a peer specialist at the Central State Hospital as well as having facilitated arts-based support groups in Athens. Since the pandemic and the burgeoning of virtual meeting spaces, Zine has been able to extend her work outside of Georgia.
“What happens is that U.S. anti-trafficking laws re- victimize and retraumatize survivors,” Zine says. “And the people in a lot of consensual situations become collateral damage and get channeled into the prisons.”
Sharmila Parmanand, a teaching fellow in gender and human rights at the London School of Economics and Political Science, recently wrote an article in the Journal of International Women’s Studies on sex work in the Philippines. She found that criminalization opens the door to other abuse.
“Sometimes, the police just use [anti-trafficking raids] as a reason to extort money or sexual favors from sex workers,” Parmanand says. “That room for abuse will always exist the moment we give police power over [the] rights of sex workers.”
Parmanand worked at an anti-trafficking nonprofit, where she noticed the absence of sex workers in conversations about trafficking for sexual exploitation. Again, the invisibility of these workers makes their exploitation easier.
There are two forms of harm reduction from which sex workers might benefit. One provides essentials like clean syringes, condoms, HIV testing, and community-based services. The other involves what are called “prostitution diversion programs,” which assume underlying issues, such as substance abuse, to be the cause of choosing sex work as a profession.
The positive effects of decriminalization can be seen in New Zealand, where the Prostitution Reform Act was passed in 2003. Although stigma was not eradicated completely, sex worker health and safety increased, according to a 2007 study that reviewed the legislation’s impact.
Until the U.S. legal system reckons with the need to decriminalize, some harm reduction measures can and should be taken. Zine emphasizes a vital piece to this conversation: sex worker input. “Legislation needs to be sex-worker informed and co-created by us,” says Zine. “We are the experts of our own lives.”
Zine is currently enrolled in a Massachusetts-based program called Group Peer Support. She’s working on creating a trauma- and sex-worker-informed curriculum outlining the realities of being a sex worker or survivor of trafficking. It includes some techniques for use in support groups, most importantly how to treat sex workers like everyone else.
“We’re over-criminalized and impacted by crippling stigma, which creates multiple barriers for accessing health care, education, and housing,” Zine says. “Another reality is that, in the United States, we’re not able to call the police for ourselves or our coworkers when we’re being harmed, trafficked, or when we’re overdosing, without the fear of arrest.”