This article originally appeared on VICE Netherlands
I've been going to the same GP for over 30 years and I don't think she knows what I do for a living. But why should any healthcare worker be interested in my job, if it's nothing to do with why I’m there? But for sex workers, that 'interest' can cross over into judgment and prejudice, according to Humanitas ESSM, a Dutch organisation that specialises in sexuality, sex work and human trafficking. Together with former sex workers, they’ve developed the ‘Help and Care for Sex Workers’ course, to educate gynaecologists, GPs, counsellors, social workers and others about treating sex worker patients with dignity. I spoke to sex workers about their experiences with stigma in the healthcare system, and how it can prevent people asking for help altogether.
Agneta Lakens* (36), escort
It's very rare to find a healthcare worker who doesn’t have prejudices about sex work. They’re often a bit anxious about what I do. They're more alert, a little uncomfortable and they don't know how to handle themselves when I tell them what I do for a living. It's like they think I’m a bit scary and treat me accordingly.
For every single ailment or illness I’ve ever had, from a runny nose to an ingrown toenail, all of my previous GPs have pointed towards my line of work to find a cause. I once went to see a GP for an eye infection. She immediately assumed I'd caught sperm in my eye.
I explained to her that I never let that happen, but she wouldn't change her mind. Eventually, we went through a whole series of tests to determine whether it was an STD. I don't mind being extra cautious and ruling out that it’s an STD, but in the end it caused a lot of hassle and delay only because my GP couldn't separate me from my work.
I told another GP, a man this time, that I was a sex worker. He gave me a lecture about how I didn't realise what I was doing to my body and that he “couldn't agree to it”, morally or physically. Obviously, I got out of there pretty quickly.
Hella Dee* (29), works in a brothel
Given the choice, I don't tell doctors or counsellors anything about my job. One GP I visited was convinced that brothels were downright dirty and unsanitary. It’s not very practical to see a GP who instantly thinks that anything you have must be highly contagious and directly linked to an STD.
Another doctor insisted on putting my job description in my medical file. I told him it was private information and it had nothing to do with why I was in his office. Since he found out about my job, he’s always linked it to my health. He asked me point-blank if maybe my panic attacks were caused by my line of work instead of explaining what panic attacks are and how to treat them. I was too scared to ask another person for help and in the end I spent six whole years struggling with my anxiety.
Luckily, I’ve had some good experiences as well. When I finally managed to seek advice about my panic attacks again, I found out I have ADD [attention deficit disorder]. I was sent to a cognitive behavioural therapist and I finally decided to open up about what I do for a living. She responded surprisingly well, didn’t make a big deal out of it and didn’t discuss any details with her colleagues at my request. After my treatments her notes ended up in the shredder and she never once suggested that I quit my job. I really loved that.
Yvette Luhrs (34), porn and webcam performer
Yvette helped develop ‘Help and Care for Sex Workers’ program.
I had a tiny bump on my vulva that wouldn't go away. My GP referred me to a gynaecologist. That’s when I told her that I worked in the sex industry and that I masturbated on camera several times a day, so it was important to have this bump checked out.
The gynaecologist took it very seriously. She wanted a second opinion from her co-worker who was busy treating another patient, so my gynaecologist told me she would be back in ten minutes or so.
I mentioned that in that case, I’d quickly grab my phone. She immediately stopped what she was doing and asked me, “Oh, you’re not planning on doing any work here, are you?” I was a bit shocked by that question and I told her, “I’m not able to do my work, that’s the reason I’m here”.
When she came back, she apologised. But the point is she didn't trust me, when I was already in a vulnerable situation. If I weren't a sex worker, she wouldn't have made that comment. If I were a lawyer, and had wanted to answer an email, she wouldn't have told me not to work.
I had another bad experience at a mental health clinic. I showed up with symptoms relating to burnout, because I was working more than 80 hours a week and had experienced a traumatic incident in my personal life. After my intake interview, they treated me with specific therapy sessions that felt like they had no connection whatsoever to what I needed.
After a year and a half of therapy, I asked to see the files on my intake interview and noticed that it didn’t mention burn-out or trauma, and only said: “does sex work, specifically porn”.
Things can only improve once healthcare workers acknowledge the stigma. This doesn’t mean everyone needs to approve of sex work or think it’s a good choice. It’s about realising that sex workers are all individuals who deal with their work in different ways.
Samantha (27), former sex worker
Once my GP asked about why I was taking monthly STD tests, so I explained that I was involved in sex work and did it for my own safety and the safety of my clients. From that moment on he kept giving me excuses, saying things like he was too busy to have me tested so I had to do it myself. Even when I came to see him for a simple fungal infection I caught after taking antibiotics for a cold, he made me take the test myself.
You should be able to feel safe with your GP, but it felt like he no longer wanted anything to do with me. He wouldn't look me in the eye.
Eventually I found another GP, a very kind man. He treats me like everyone else. I didn’t confront my old GP about his behaviour – I didn’t feel like defending myself.
I've also dealt with prejudice at the hospital. I had HPV [human papillomavirus], a [common] virus you can contract through sex. I got it before I started sex work, from my steady partner, but each and every time I had to explain to my gynaecologist that I didn’t get it from one of my clients. That’s what they all assumed. From then on, I demanded to see only one gynaecologist, a woman, who never looked at me weirdly because of my job.
She also never told me to quit my job, something I’d heard quite often before. The fact that I did quit sex work in the end was my own decision and no one else’s.