Dear Ms. Harm Reduction,
I’ve been escorting and doing pro domme work for a year and a half. Sometimes I do a gram of coke with regulars, or even do drugs with new clients on occasion. I’d like to be smart about this, but I feel like I can’t ask the the sex workers I know for advice because none of them would ever take that risk in the first place. Do you have any tips on how to stay safe while partying with clients?
Wilder Than (my) Friends
Bareback sex feels fucking amazing.
I know, we’re not supposed to talk about that. We’re not supposed to talk about bareback fucking without following it up with that ubiquitous “but use a condom!” statement. However, many communities face significant barriers to condom use and have very legitimate reasons for foregoing them—and these are the communities whose voices have largely been excluded from broader conversations defining “safe sex.”
That’s a big problem. As harm reductionists and sex educators, we can’t talk openly about what people are really doing behind closed doors. We aren’t supposed to legitimize sex without a condom as an option, or rather, we aren’t supposed to acknowledge that it may be the only option for many marginalized people. And that’s exactly the kind of dishonesty that allows HIV stigma to proliferate.
As an HIV counselor and longtime public health activist, as well as an ex-sex worker and IV drug user, I want this attitude to change. We need to re-open the conversation around what safe sex means in America and internationally, because while condoms can be an excellent means of STI protection, they are by no means a realistic option for every person in every situation. And sex workers in particular need to be involved in this conversation, since it is the most marginalized groups among us—drug-using sex workers, sex working trans women, street workers, sex workers of color, and people who fit into many or all of the above categories—who most often find ourselves in situations in which providing bareback services is our only option if we want to make a living.
Ask A Pro is a our column focusing on work and health, intended to share straightforward information about what you can do to keep yourself as safe as possible while on the job. Questions will be answered by sexual health expert Sarah Patterson, M.Ed. (See full bio below.) Questions you’d like to have answered can be sent to our info (at) titsandsass address. Full anonymity is guaranteed.
Dear Ask A Pro,
My question is: what are the best ways to avoid getting sick when working? I find that when I am seeing multiple clients in a night it is emotionally and physically exhausting and I seem to be more susceptible to picking up colds or the flu. I’m sure this is a combination of a lowered immune system from the stress and pace of working mixed with swapping fluids and germs with unknown men.
Thanks,
Juliet
Dear Juliet,
Great question! You are correct in thinking that stress and exposure to infection can increase your chances of getting sick, but there are many things that can be done to deal with both stress and boosting your immune system.
In January 2012, Sarah Elspeth Patterson and a group of other sex worker activists in NYC went to work offering health care and social services to sex workers. The much needed outcome, Persist Health Project, is the 2nd sex worker only health clinic in the United States, after Saint James Infirmary in San Francisco.
While there is limited funding for it as of yet, the Persist team are diligently working on their labor of love and helping to put an end to the lack of non-biased services for sex workers. Sex workers have a history of being subjected to discrimination, stigma, and forced hospitalization and testing in the mainstream healthcare system. NYC’s Persist strives to be a safe space where sex workers can be open and receive the care they need. You can help contribute to the growth of Persist by donating here. Every little bit helps!
I got a chance to speak with Sarah about the project upon her return from this year’s Desiree Alliance conference.
How would you describe Persist and it’s work?
Persist Health Project (Persist) is a peer-led organization that connects folks in the sex trade in New York City with providers who are either from the community themselves or awesome allies. In addition to coordinating care for people —people can call us and have a provider hand-picked for them, based on their needs —we also offer workshops on health topics, such as burnout, sexual health, and general health. To keep enhancing our network of providers, we offer trainings for health care professionals on how to work with folks in the sex trade better.
Persist was co-founded in January of 2012 by a group of sex worker activists, nurse practitioners, and social workers who are also current workers, former workers, or very committed allies. I brought together people I knew were valuable members of sex worker organizing groups, who were either interested in health for sex workers because of their own experiences with sex work or had transitioned from sex work to health or social services. Many of us had been doing organizing together, were friends or peers, and saw a collective need. Others had dreamed for a long time of opening a clinic space just for sex workers.
What was your motivation for working on this project?
I didn’t give my health a lot of thought until I became a healthcare professional and was expected to be an “expert” on these things. After I got my degree, I found myself doing sexual health education and thinking, what about my own personal health decisions? Am I really being “safe” all the time, or do I do things that are “risky?” Are there better ways to think about this, outside of thinking about everything —drugs, alcohol, smoking, sex, food, so on—as a “risk”? What’s realistic for my life, rather than what is generally taught as the “best” thing to do? Of course, the concept of making health choices that fit your life is one the fundamentals of harm reduction. But it was only after getting the “right” answers from education that I wondered about the value of what I already knew from my own life experience, and how that might be useful to others.
I think it’s incredibly valuable to be offering positive, affirming peer support to one another from within communities involved with or impacted by the sex trade. In addition to creating communities and shared life experiences, trading sexual services can also be very competitive, anxiety-inducing and isolating. So part of Persist’s goal is to break the feeling of isolation in health care by shifting ideas of what support can look like.
Being a crazy whore is kind of like being the meanest dog at the pound: out of all of the rejects, you’re the least wanted, and your very existence makes your peers look bad. I say this from experience. I used to work at a pound, and I’m definitely a bitch (HEY-O). I’m also a crazy whore—a pro-switch with disabling, medication-resistant Major Depression, to be precise. Society has made clear to me that it would prefer if I were euthanized, and a lot of folks within the disability rights and sex workers rights communities don’t want me around either. I give credence to some of the most persistent, prejudiced assumptions people in each group encounter. Namely, that women with mental illnesses are sexually promiscuous damaged goods, and sex workers are mentally unhealthy damaged goods. What better way to argue against those stereotypes than to deny the existence of those of us who fulfill them?
And there are a lot of us, more than most folks realize. We frequently stay closeted about one or both of these marginalizations, partly because we may lack the physical energy or emotional stamina to brazenly insert ourselves into the activist communities that dislike us. I rarely mention to other people with disabilities what I do for work, and I am equally reluctant to test the reactions of fellow sex workers by discussing my experiences as a crazy ho. Just the idea of walking into a sex worker empowerment meeting and telling everyone that I’m doing this job because I’m too nuts to work full time and I kind of hate it, makes me feel exhausted.
Exhaustion is also why a lot of disabled sex workers don’t work independently. Houses, agencies, clubs, and brothels take on more of the workload associated with sex work, such as finding clients and providing space and security. But houses, agencies, clubs, and brothels are also (usually) more concerned with profit than with their employees’ well being, so you’re likely to find that more agency girls hate their jobs. People who hate their jobs don’t often organize around that identity, which is another reason disabled sex workers lurk in the shadows.
It can get pretty dark hiding out in here. That’s why I like to liven the mood sometimes with some equally dark humor.