Updated: a day ago
Written by Brittany Pompilii, BA (Hons) & Kyra Keer, HBMSc, MSc (Master of Physiology and Pharmacology)
Illustrations by Alex McPhail, BA (Hons)
Hello reader! My name is Kyra and I reside in the geographical confines of what is currently known as Canada. This post was written on the traditional territory of the Anishinabewaki, Attiwonderonk, and Missisauga First Nations, in what is currently known as London, Ontario. I want to acknowledge my privilege as a white, heterosexual, cis-woman, and of my access to post secondary education. My intention is to utilize my education and this platform 1) to help increase awareness of important topics in women’s health and 2) to explore social determinants of health and their impact on women. I do not intend to speak on behalf of LGBT2SQA+, BIPOC, or any other communities that I am not a part of. I am committed to lifelong learning, and continuously educating myself on responsible and effective allyship. I hope that if my writing misrepresents communities which I am not a part of that I will be corrected so I can properly represent these communities in my writing.
Hi there! My name is Brittany Pompilii, and my pronouns are she/her. I reside on the traditional territory of the Haudenosaunee, Anishinabewaki, Attiwonderonk, Mississauga, and the Mississaugas of the Credit First Nations peoples. This land is currently known as Niagara, Ontario. As the author of this post, I acknowledge that my privilege, and therefore my experiences, inform my perspectives on sex work and COVID-19. I am a white, able-bodied, heterosexual, cisgender woman. I do not intend to speak on behalf of all women sex workers. I also want to acknowledge that I have not worked in the sex industry, therefore my perspectives on sex workers and the sex industry are informed by my personal research on this subject.
As a research team member, I am committed to using my research and writing skills to contribute to helping all women access public health information - a right that all women are entitled to yet do not always receive. I hope that one day, the public health system represents all peoples’ experiences and treats all people equitably. Until that day, I hope to continue advocating for women and their health and safety in any way I can.
In this post, I worked to shine light on the experiences of women who have worked as sex workers during the COVID-19 pandemic. However, the data published on this topic did not include disaggregated demographic information, meaning there is no confirmation that these research findings represent all sex workers experiences during COVID-19.
The COVID-19 pandemic has drastically impacted communities globally. Public health measures such as stay-at-home orders, lockdowns, social distancing, and social isolation have changed the lives of many individuals. For racialized, criminalized, and other historically oppressed groups, these measures exacerbate vulnerabilities and worsen conditions (1). One group that has been disproportionately affected is women and gender diverse sex workers.
Sex workers have faced discrimination, oppression, and structural violence in North America even prior to COVID-19. These inequities have only worsened during the pandemic due to government-imposed safety regulations (2*). Sex workers are dealing with severe decreases in income, higher risks to personal safety, and exclusion from government protection and support. Furthermore, migrant sex workers are among the most vulnerable individuals in our communities. They are further persecuted by xenophobia, racism, language barriers, and the threat of deportation (1).
The following brief outlines how women and gender diverse sex workers are impacted by COVID-19. We will address topics related to
Prior to COVID-19, sex workers had opportunities to work in safe spaces and build relationships with regular, trusted clients. As pandemic guidelines set into place, sex workers lost access to their safe workplaces such as bars, massage parlours, spas, and nightclubs (3*, 4*). As a result, some sex workers have been forced to operate in unsafe, unfamiliar environments (ie. new clients’ houses or street corners). Some sex workers have been able to move their services to an online platform (2*). However, this was not an option for many sex workers who do not have access to the necessary technological equipment (i.e. laptops, webcams etc.) or stable internet connection.
Some workers are unable to stop offering in-person services in order to survive, which increases their risk of contracting COVID-19. Working in-person also increases sex workers’ interactions with police, since there is an increase in police surveillance within the community due to COVID-19 safety measures. This is harmful to folks working in the sex industry, as it is well-documented that police have participated in acts of discrimination, violence, and hatred towards sex workers prior to the pandemic (8). During COVID-19, sex workers have experienced more arrests, fines, raids, violence, and deportation at the hands of police (2*).
Sex workers have experienced massive losses of income since the beginning of COVID-19 (1, 4*). The government safety measures put in place to stop the spread of COVID-19 mandated individuals to stay home and reduce social contact. For sex workers, this resulted in the loss of clientele and decreased demand for in-person sexual services. Even sex workers who moved services online faced a considerable decrease in income, as they generally make less money with online services compared to in-person services (2*). This loss of income has pushed many sex workers into extreme poverty (3*). This financial strain is further amplified by a lack of governmental support for folks working in the sex industry, which is outlined in the ‘Government Supports’ section below.
There have been some government financial initiatives supporting sex workers in other
countries. In Bangladesh, food supply packages were provided to sex workers in need (2*). In England and Wales, sex workers have been provided emergency housing. In Thailand, the Netherlands, and Japan, sex workers have been provided with governmental financial benefits. While these might seem like great solutions, these initiatives rarely reach sex workers who are unhoused, use substances, are transgender, or are migrants.
The pandemic guidelines also threaten the health and safety of sex workers. Inability to access safe locations to work due to business closures leaves sex workers having to choose to either engage in sex work in unfamiliar, potentially unsafe locations or substantially cut their income (4*).
As previously mentioned, social distancing and stay-at-home orders makes sex workers less likely to interact with their regular customers (5). As a result, they are more likely to have to engage in sex work with strangers. This creates an environment with increased risk of physical and/or sexual violence, unsafe situations, sexually transmitted infections, and COVID-19 (5).
With less secure income, many sex workers are unable to purchase items for safe sex, such as condoms (3*). This problem is worsened by the fact that sex workers are less likely to access health supports. Fear of social stigma may cause sex workers to avoid seeking health services until they reach health crisis (10*). Sex workers who do access healthcare are likely to withhold discussing their involvement with sex work in for fear of discrimination by healthcare workers. By withholding this information, they are more likely to receive non-judgemental care, but health needs and opportunities for support may be missed as a result. This is especially true for sex workers who are unhoused, use drugs, or are migrant workers (2*). In fact, sex workers who are HIV positive have lower rates of antiretroviral use than average, and this is true for both low- and high-income sex workers. Additionally, sex workers are more likely to have underlying health conditions (2*). Taken together, sex workers experience an increased risk of having severe complications if they contract COVID-19.
Overall, it is clear that the pandemic guidelines put sex workers at increased personal, financial, and health-related risk. But what about the government support and policies to help all workers during this time? There was massive job loss due to the pandemic, but the government stepped in with financial support so that ‘no one [would] be left behind’.
Sadly, this wasn’t the case. The governmental support has left sex workers behind completely. Sex workers are not recognized as self-employed or small business under Canadian law. As a result, they are unable to access employment insurance, CERB payments, or other government financial support (1, 4*). This has left many sex workers with little to no income since pandemic guidelines were put in place. Prior to the pandemic, it was estimated that roughly 20% of sex workers engaged in survival sex, and are now especially vulnerable as they are forced to put themselves in unsafe situations to meet their needs (4*). Excluding sex workers from access to social health and financial services means they are less likely to be able to stay home, social distance, or temporarily stop working so they can survive.
Calls to Action
Immediate action needs to take place to support sex workers both during and after the pandemic. The Canadian government needs to recognize sex work as legitimate work and allow sex workers to access employment insurance and emergency financial supports. Additionally, harm reduction programming needs to be put in place immediately. Harm reduction supports could include (but are not limited to) personal protective equipment, condoms, dental dams, safe injection kits, and at home HIV and HPV tests (4*, 5). Sex workers should also have accessible, free COVID-19 testing.
The support shouldn’t end here. Long-term social and policy changes need to take place. Policies surrounding sex work are often created using the ‘rescue model’ (1). This model frames sex workers as victims that need to be ‘rescued’ by social workers and law enforcement. It completely fails to distinguish sex workers from human trafficking victims. There are many factors that contribute to involvement in sex work, which may include personal choice, individual circumstances, and coercion. Human trafficking victims differ from sex workers because the former are involved in sex work entirely through coercion or force (9*). The rescue approach undermines the autonomy and dignity of sex workers, and perpetuates stigma around sex work. Rather than using this approach, governments and policymakers should adopt a social justice and human rights focus instead (1). Social workers should use their position to create new policies and support systems that are informed by sex worker-led organizations.
Additionally, Canada’s current laws surrounding sex work needs to be reformed. The current law, the Protection of Communities and Exploited Persons Act (PCEPA) is based on the idea that sex work is inherently exploitative, violates human dignity, and refutes the idea that buying sex is inevitable in our society (6*). It adopts an end-demand approach, where communication for the purpose of selling sex, advertising, and targeting clients is all illegal. It also prohibits the purchase or attempted purchase of sex. This model is dangerous for a number of reasons. First, the PCEPA was created only with the consideration of cisgendered women sex workers in mind. It fails to acknowledge gender and sexual diversity of folks who sell sex, and the unique vulnerabilities of LGBTQ2S+ and gender diverse folks (7). Secondly, the end-demand approach forces sex workers into the shadows. Fear of criminalization leads to rushed transactions, which heightens the potential precarities of sex work. This includes improper screening prior to sex, and sex work occurring in risky locations. Since PCEPA was established in 2014, there has been significantly reduced odds of sex workers accessing health and community supports and services (7).
The United Nations development program suggests three steps that would help include sex workers as a focus of public health interventions (3*). First, examine the reasons that trigger discrimination of sex workers. Second, work to empower equity deserving populations. Lastly, reform policies nationwide that address the needs of structurally vulnerable populations, especially sex workers.
Migrant sex workers are folks who cross international borders to work in the sex industry
Xenophobia refers to fear of strangers
Antiretroviral use refers to drugs that are used to treat HIV infection
Survival sex is the exchange of sexual favours in order to meet basic human needs such as food, shelter, rent, and maintenance levels of illicit drugs.
*These sources do not specify the gender identity of the women included. Historical representation leads us to believe only cisgender women were included.
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Lam E. Pandemic sex workers’ resilience: COVID-19 crisis met with rapid responses by sex worker communities. International Social Work; 2020, 63(6): 777-781. Available from: https://journals.sagepub.com/doi/10.1177/0020872820962202
* Platt L, Elmes J, Stevenson L, Holt V, Rolles S, & Stuart R. Sex workers must not be forgotten in the COVID-19 response. The Lancet; 2020, 396(10243): 9-11. Available from: https://doi.org/10.1016/ S0140-6736(20)31033-3
* Kawala BA, Kirui BK, & Cumber SN. Why policy action should focus on the vulnerable commercial sex workers in Uganda during COVID-19 fight. Pan African Medical Journal; 2020, 35(2), 102. Available from: https://www.panafrican-med-journal.com/content/series/35/2/102/full/
* Jozaghi E & Bird L. COVID-19 and sex workers: human rights, the struggle for safety and minimum income. Canadian Journal of Public Health; 2020, 111, 406-407. Available from: https://link.springer.com/article/10.17269/s41997-020-00350-1
Singer R, Crooks N, Johnson AK, Lutnick A & Matthews A. COVID-19 Prevention and Protecting Sex Workers: A Call to Action. Archives to Sexual Behaviour; 2020, 49, 2739-2741. Available from: https://link.springer.com/article/10.1007%2Fs10508-020-01849-x
* Government of Canada. Protection of Communities and Exploited Persons Act. Justice Laws, 2021. Available from: https://laws-lois.justice.gc.ca/eng/annualstatutes/2014_25/page-1.html
Argento E, Goldenberg S, Braschel M, Machat S, Strathdee SA, & Shannon K. The impact of end-demand legislation on sex workers’ access to health and sex worker-led services: A community-based prospective cohort study in Canada. PloS ONE, 2020, 15(4), 1-10. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225783
Allan S, Chettiar J, & Bennet D. My work should not cost me my life: The case against criminalizing the purchase of sex in Canada. Gender and Sexual Health Initiative, 2014. Available from: https://books-scholarsportal-info.subzero.lib.uoguelph.ca/en/read?id=/ebooks/ebooks0/gibson_cppc/2014-10-25/1/10900991
* Albright E, D’Adamo K. Decreasing human trafficking through sex work decriminalization. AMA J. Ethics, 2017. Available from: https://journalofethics.ama-assn.org/article/decreasing-human-trafficking-through-sex-work-decriminalization/2017-01
* Phillips R, Benoit C. Social determinants of healthcare access among sex industry workers in Canada. Research in the Sociology of Health Care, 2005, 23: 79-104. Available from: https://www.emerald.com/insight/content/doi/10.1016/S0275-4959(05)23005-3/full/html