The media spotlight has been on the sex industry since Amnesty International proposed its decriminalization, with Hollywood A-listers including Meryl Streep and Emma Thompson calling Amnesty to reject its own proposal. Meanwhile, Northern Ireland has proposed the Human Trafficking and Exploitation Bill, which criminalizes the men who buy sex, rather than the women in the sex industry—a proposal otherwise known as the Swedish model. Just a few miles over in Scotland, lawmakers are currently in consultation over a law to do just the opposite and decriminalize sex work.
But away from policy making and politics—and regardless of which model they believe works best—women in the sex industry all face the same stigma when it comes to healthcare. When they're raped, they're told it's a 'work hazard'; when they have health checks, they're told they're a strain on the health service. They're treated without pain relief and routinely shamed, judged, and treated as sub-human.
While some women may report these incidents, the truth is that many will never go back to a hospital or GP clinic where they've been treated as a problem, rather than a patient. Some will travel across the country to see a doctor who doesn't judge them, others risk misdiagnosis by lying about the cause of their injuries—and then there are those who'll avoid medical attention altogether, even when the pain is so bad they can't block it out.
While there are medical professionals who treat everyone with the same degree of compassion and respect, the dismissive and derogatory attitudes of some mean that women in the sex industry are not getting the healthcare they need. Here are the stories of seven women who span the political spectrum, who have all had experiences with medical professionals that are saddening and sometimes horrifying.
I'm 28 and I'm a porn actress.
When I first started in the industry, seven years ago, I went to the free clinic in Paddington, London, which is supposed to specialize in seeing sex workers and porn actors. They used to drum into me the health issues behind my job and made me feel I was a burden on the National Health Service. It was condescending and judgemental. I felt like they were attacking me, so I started going to a private clinic, where I had a great doctor.
I've been going to Dean Street [a sexual health clinic in Soho, London] for the last 18 months. At first, a lot of the nurses hadn't dealt with sex workers before. They were judgemental and made me feel bad. Now they're used to it—it's better every time I go.
In the past, I've suffered from depression. When I've seen my GP, he's blamed my job. I feel like he's palming me off, and not giving me the attention I'd get if I didn't do porn.
I'm 22. I'm an escort and the President of the Sex Workers Solidarity Society at Goldsmiths.
When I was 19, I was raped. I was in a vulnerable state and I went to see my local GP in New Cross. She was supportive and said I was brave, but when I told her what I did for a living, she completely changed. She was dismissive of me and said it was a work hazard. She said: "You know the risks when you're working as an escort."
The day previously, I'd spoken to the police and they said there was no point in reporting it—he wouldn't get prosecuted. I felt like I didn't matter. I felt judged and marginalized, like: "Prostitutes are all crazy drug addicts!" It reinforced that no one cared about me.
I was numb and trying to cope with what had happened. I thought my doctor would ask how I'd been affected physically but she didn't ask if I was hurt or injured. I had been hurt, and I couldn't walk properly for a long time. I needed an STI test but she told me to book another appointment. I asked if anyone could help me, and she wrote me a prescription for Prozac.
I didn't get any help at all and it's really affected me. Doctors have a duty to be impartial, instead of deciding who's human, and putting some of us into a category of people who can be abused. I get really angry about it. We're all human beings.
The doctor told her to give me anesthetic—but she stitched up my anus without it, as a kind of punishment.
I'm 53. I'm an exited prostituted woman and campaigner for abolition.
I always avoided hospitals but I had to go. The nurse went through my purse and I had about £300 because I'd just been paid. She shouted to people in the waiting room that I was a prostitute. It was Saturday night in A&E and the waiting room was full. Part of me felt like: "Well yes, I am!" The other part of me felt like: "So what? You should be treating me!" She said I was wasting her time, and tried to make people laugh at me. It was horrible and embarrassing. The doctor told her to give me anesthetic—but she stitched up my anus without it, as a kind of punishment. I wasn't worth it. That really hurt. The doctor was nice—he tried to find me a bed, but as soon as she finished, I left. I was kind of paralyzed for three days.
After that, when I was in pain or had injuries, I carried on like I was OK, because it took me a long time to trust doctors again. Sometimes the pain was so bad, I couldn't block it out, but I pretended I was alright, because I didn't want to be seen by anyone. I feel really angry about doctors. If they were trained properly and listened, most prostitutes would get help sooner. There's a feeling that the medical profession think prostitutes bring it on themselves, like you're wasting their time. If you come more than once, it's: "Oh God, you're here again." That's what really gets to me—you feel like you're getting in the way of real patients.
I'm 35 and I'm a sex worker, sexual trainer, political campaigner, radio presenter and performer.
I suffer with back pain, through having two children and putting on a lot of weight during my pregnancies. I went to my GP in Exeter [in the UK], and we were talking normally, then he read my notes and saw my employment status. That's when he looked at me as if to say: "Not you? You're not one of those?" Then he treated me as if my back ache was due to lying on my back getting fucked all day—but it was nothing to do with that. He didn't run me out of town with a pitchfork, but the stigma meant I never went back.
I rarely go to the doctors now. I phone my mum—she's an encyclopedia of illnesses. She tells me what she thinks it could be and I look online. If it's sexually related, I'll go to the GUM [genitourinary medicine] clinic. If I have to go to the doctors, I lie about what I do. If I've got an injury that's in my back or my knees, that's been caused through sex work, I say it's a sports injury. It means I might not get the right diagnosis or treatment, because bouncing around on your feet playing squash is not the same movement as fucking somebody up the ass with a strap-on.
I know other sex workers are in fear of how doctors will treat them. Society's labelled us the lowest of the low and we're not deemed worthy of medical attention.
[Doctors] think we're the problem, instead of seeing us as people in need of support.
I'm 47 and I'm a sex trade survivor. I campaign for the abolition of the sex trade.
When I was 19, my pimp attacked me and left me for dead. I was shoved onto the mental health ward at St. Mary's in Paddington and left there like a freak in the corner. No one spoke to me—not even a psychiatrist. There was no compassion or understanding, and one morning I woke up to find a male patient with his hand up my nightie.
When I was pregnant with my son, I'd been out of prostitution a while, but it was on my medical records and I couldn't get good antenatal care. I felt like I was beneath shit. It was a horrible feeling. When I went to give birth, I was left in a room for days. My cousin found out on the Sunday night and she went ballistic. She's a pediatric doctor and she said: "Why has this woman been left since Friday when the baby's in distress?" I was rushed to theatre for an emergency c-section.
When I was treated like shit, I didn't feel worthy of anything anyway. But since I've been a support worker and I've seen how other women in prostitution are treated, it's broken my heart. I've known a couple of very good doctors, but in general, they don't understand the violence and abuse that women in prostitution go through. They think we're the problem, instead of seeing us as people in need of support.
If you're a doctor, you should be understanding. They're meant to make you feel safe and secure.
I'm 29. I'm a performer in the adult industry and I see clients one-to-one.
I went to my local NHS hospital in Kent, England, for a sexual health check. The doctor asked what I did for a living, and when I told him, he said I needed to change my profession. He said it was a dangerous job and I was putting my health at risk. The nurses in the room were looking at me, and I felt like everyone was judging me. I said: "I enjoy what I do!" But I felt upset and really little.
When I got outside, I cried. I wrote a letter reporting him and they said sorry, but it wasn't much of a response. If you're a doctor, you should be understanding. They're meant to make you feel safe and secure. If girls are new to the industry, being spoken to like that might scare them off getting their tests done—or getting any other help they need. I pay my taxes, and the adult industry is one of the safest because everyone's tested—you're more likely to catch something having a one night stand.
Now I go to clinics for the adult industry, like The Cottage in Paddington, London. They're brilliant and you can talk about anything. I have to travel to London every time. I've been doing that for the last three years and it's annoying, but I'll never go back to my local hospital.
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Diane Martin CBE
I'm a survivor of prostitution and trafficking. I run the Dovetail Initiative.
I've seen judgemental attitudes and terrible things like a lack of painkillers, which is a form of punishment. I've also seen the opposite: doctors with real understanding and care. It just depends who you get. It's important for women in prostitution to have advocacy—to have support workers attending appointments with them. Although sometimes support workers find the medical staff speak to them, instead of the person whose appointment it is! They have to say: "Why don't you speak to Jane? It's Jane's appointment!"
Healthcare professionals have improved their response to domestic violence. They know what questions to ask, to help women disclose that. Similar progress needs to be made for women in prostitution. Often women are sitting there thinking, "Please someone see that I need help." It can be difficult to verbalize. The medical profession needs to ask the right questions, and look past what's presented—join the dots and realize when a woman needs someone to talk to, and access to other services.
56 Dean Street and St. Mary's Hospital in Paddington were all approached for comment but declined to respond.