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Re: Contributors and Sources
 

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Re: Sex workers make a valuable contribution to society
 

Thank you for your excellent article. The SFC sent an 86 page response to the Home Office Paying the Price team and didn't even get an acknowledgement. We argued the case for decriminalisation, promoting the New Zealand model. We pointed out that if this were any other business, the client's health and safety would be a priority, unlike the 11 lines the HO devoted to "users". What I want to add is that sex workers can and do provide invaluable services to clients: obese, disabled and widowed and people rejected for not being in jobs, good looking and fit. I recently brought Pru, Sex Worker of the Year in the Erotic Awards along to speak at the Different Strokes conference, making the point that no stroke survivor should be left to sit without speech or friends during years of recovery. A sex worker, master or mistress of non-verbal communication, should be part of the rehabilitation team. Pru spoke eloquently, and in the audience, Leonard Levy, responsible for NHS Stroke provision, smiled. We're a long way off combating the stigma, but between us, a little toe is in the door. Dr Tuppy Owens Sexual Freedom Coalition

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Re: Correction
 

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Re: Remembering Gemma and other Ipswich Victims
 

The parents of Gemma Adams (one of the Ipswich victims) have set up 'Gemmas Gift'in memory of Gemma to raise funds for a local children's hospice. You can find out more and donate here: http://www.justgiving.com/gemmasgift

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Re: Liberal sexual 'realities' can also be social constructions
 

It is disappointing that Goodyear and Cusick are so confusing in their attitude to what they term 'the moral debate on sex work'. They claim it to be divisive and yet in the next paragraph, focus on what they select as the 'real moral issues'.

A major issue, moral or otherwise, which they do not tackle is why there is such a demand for commercial sex in the UK. Indeed they merely (and mistakenly) assume the 'inevitablity ..of sex work'. However feminist writer, Laurie Shrage, points to evidence that 'our high level of sexuality is a purely cultural phenomenon and not the inevitable result of human biology.' (1)

If the social rationalization for the supposed 'inevitability' of prostitution is seen for what it is, perhaps this would help us to find more effective ways to help those involved in it, whether it is decriminalised ot not?

1. Shrage L Should feminists oppose prostitution? Ethics 1989 99 347- 61

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Re: Advocacy for health in sex workers
 

We welcome the timely call for decriminalisation of sex work in the editorial by Goodyear and Cusick. The murders of sex workers in Ipswich have led to the repetition of stereotypes which only serve to dehumanise women in the industry and make them more vulnerable. We wish to highlight some further flaws in the evidence used by government and others in justification of their demonising of sex workers.

There is no evidence that 90% of UK sex workers are addicted to heroin and/or crack, or that 45% were abused as children. These data, along with numerous alternative versions in the media, are attributed to the Home Office consultation exercise, Paying the Price (2004), but we have heard nothing about the many responses that refuted these stereotypes in detail. Our research in London has followed sex workers from the mid- 1980s to 2000 and, to our knowledge, is the only study to provide evidence of the impact of prostitution on women's lives over time. We have shown that:

Drug use is widespread and problem drug use is associated with multiply disadvantaged women. Injecting drug use was uncommon in our studies (for example, 7% of women attending our project from 1998-2002 reported ever injecting drugs) and crack use declined towards the end of the 1990s. Alcohol use, however, is a condition of work in some sectors such as clubs and 'addiction' has become more common, as indeed among the rest of the UK population.

Violence is found throughout the industry. In our study, two women were murdered and both worked indoors. One murder was never resolved; the other woman was murdered by her boyfriend who then killed himself. (Ward et al. 1999) Research participants described assaults across all sectors of the industry but experiences of violence outside work, when their children were taken into care or when they suffered domestic violence, were the most harrowing. (Day and Ward 2001)

Street workers do not form a discrete workforce: they also work indoors and in jobs outside the industry. In our follow-up of sex workers to 2000, street workers had greater occupational mobility than women working in other sectors of the industry (Ward and Day 2006).

Among the women we followed to the year 2000, 37% (31/84) undertook further, higher, or vocational education which they funded through their own earnings. However, only half of these women then left the sex industry, despite the occupational choices this training had presented - and, of course, it is always assumed that sex workers would never continue their work if they had any other options.(Ward and Day 2006)

The most significant health problems reported in our studies related to stigma and criminalisation. Reports in the press and other media this week about drug-abused victims from broken families forced to expose themselves to madmen on the streets, without any reference to the laws, policies or damaging stereotypes about 'bad women' that put sex workers at risk simply exacerbate their problems. Reports about regulation elsewhere have been misleading about the possible solutions. Thus, the so-called failure of street toleration zones in The Netherlands has nothing to do with 'drug abuse': it is impossible for the great majority to work legally as they are undocumented migrants. (Day and Ward 2004) Similarly, the recent reforms in New Zealand have provided an important model since they were the first to allow women to work together indoors freelance without requiring them to raise substantial capital, acquire a license and manage the business (through which employees are commonly exploited heavily in 'legal' businesses elsewhere). Similar changes have been recommended, but not acted upon, in the UK.

It is British policy that makes sex workers vulnerable, whether outdoors or indoors. In the last ten years, these policies have become more punitive through the arbitrary use of ASBOs, street 'cleaning' purges, fines, imprisonment and deportation. We endorse calls for decriminalisation and amnesty from those who organise and work closely with prostitutes, including the International Union of Sex Workers and the English Collective of Prostitutes. These will be key measures towards stopping the violence. They will also be central to wider advocacy for health and health care. Criminalisation and stigma are associated with significant mental health problems; they make workers vulnerable to violence; they foster misinformation about the industry and workers' health needs and they also make contact with health professionals difficult. Without decriminalisation and amnesty, how are we to provide substantial sectors of the UK workforce with basic services including health promotion, screening and treatment?

References

Day S, Ward H Violence in sex work (corr.) British Medical Journal 2001; 323:230

Day S, Ward H (eds) Sex work, mobility and health in Europe. London: Kegan Paul, 2004

Home Office. Paying the Price: A consultation paper on prostitution. London: Home Office, 2004

Ward H, Day S, Weber J. Risky business: health and safety in the sex industry over a 9 year period. Sex. Transm. Inf. 1999; 75:340-343

Ward H, Day S What happens to women who sell sex? Report of a unique occupational cohort. Sex. Transm. Inf. 2006; 82: 413-417

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Re: Sex work and social benefit
 

Dr Owens’ letter “Sex workers make a valuable contribution to society” raises a number of important issues.

As she points out, the Home Office ignored the advice of many experts and of those who work in this area of health, which reinforces the point that this is not an appropriate policy area for that ministry. Hopefully the Liberal Democrats, who have endorsed our position, will make this point more forcefully. (1)

Furthermore the Home Office concluded that sex work has no value, which largely informed many of its recommendations. (2) Dr Teela Sanders, amongst others, has examined the role that sex workers play as therapists and educators (3). She has also demonstrated their role in the care of the disabled, as Dr Owens suggests. These skills have been recognized in other countries, leading to sex workers being hired as care workers in Germany (4), and by physicians in the UK. (5)

References

1. Clegg N. Liberal Democrats: Government must have courage to act on prostitution. 12 January 2007 http://www.libdems.org.uk/news/government-must-have-courage-to-act-on- prostitution-clegg.11685.html

2. Home Office. Regulatory Impact Assessment: A coordinated strategy for prostitution 2006. http://www.homeoffice.gov.uk/documents/cons-paying-the-price/

3. Sanders T. Female sex workers as health educators with men who buy sex: utilising narratives of rationalisations. Soc Sci Med. 2006 May;62(10): 2434-44.

4. Duke K. Project retrains prostitutes as care workers for elderly people. BMJ 2006 332: 685

5. Barrett J. Personal services or dangerous liaisons: should we help patients hire prostitutes? BMJ 2004 329: 985.

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Re: Professional ethic of care
 

We were contacted by a Consultant Obstetrician and Gynaecologist, asking why the Royal College of Obstetricians and Gynaecologists has remained silent on this issue.

One of us (MG) had recently written a letter of support for the position of The Lancet and the Royal College of Nursing, (1) apart from this, the Colleges, Associations and other professional societies have been largely silent.

We note that The Royal College of Obstetricians and Gynaecologists’ banner reads “Setting Standards to Improve Women’s Health”. (2) Our editorial addresses the professional ethic of care and the responsibility of the health professions to advocate for those in their care. As with other public health issues we believe that the health professions should speak with a united voice on this, and follow the lead of the nurses.

References

1. Goodyear M, Lowman J, Fischer B, Green M. Prostitutes are people too. Lancet. 2005 Oct 8;366(9493):1264-5.

2. Royal College of Obstetricians and Gynaecologists. http://www.rcog.org.uk/

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Re: Identifying the real moral issues
 

We welcome the opportunity to reply to Dr Stammers’ letter on the moral issues raised. We fear he has misunderstood the point of our editorial. The issues he raises are also discussed further in the working paper. (1)

Partly in the interests of space, but also as we stated, because we believed it to be the ‘wrong debate’ (2) we did not address the traditional moral debate, but merely outlined the respective positions. We do not claim the moral debate to be divisive, it is divisive, there is no debate over that, (2-6) Julia O’Connell Davidson calls it ‘both heated and bitter’. While informative, and while both arguments in the debate have some legitimacy, it is a debate that obscures the issues eloquently described by Sophie Day and Helen Ward. (7)

Ethics deals with competing values, and we believe that it is crucial to understand that addressing what are essentially social issues with criminal legislation creates a much more compelling moral problem, the dehumanising of women.

The transactions of commercial sex involve both supply and demand, which cannot be treated separately. Stammers claims we did not tackle the issue of demand. In fact we did stress the need to understand the social determinants in any analysis of sex work, in particular emphasizing inequalities, which we believe to be the thrust of his argument.

We are surprised that Stammers did not think we had considered Laurie Shrage’s work (which should also include her later book – Moral Dilemmas of Feminism, 1994). We actually cite her directly, stating that prostitution requires no unique legal remedy (p. 360). We not only considered Shrage and the sources she used such as Pateman (8) and Ericsson (9), but the article Stammers refers to is used in teaching at this university (MG).

We did not assume the inevitably of sex work, we stated that that was one of the positions in the debate. Citing one work from an extensive feminist and philosophical canon does not inform the discussion much. While Shrage’s assumptions and reasoning can be debated, her central argument is that the analysis of the morality of an act cannot be made considering that act in isolation, but only after considering the cultural context and political and social meaning, specifically how others perceive the act, whether rational or not (p. 351). In this context it underpins Public Order law, with an important exception. Both in the UK and Canada (10), a moral act can be considered indecent and hence criminal if it causes offence, but only if the intent to offend is demonstrable. In that regard, sex work fails the test.

Shrage uses familiar arguments that sex work fails to subvert patriarchy and sustains inequality (p. 359), but admits that her reasoning leads to supporting decriminalisation (p. 361). Where we differ fundamentally from her is that while we accept that women are degraded and oppressed in sex work (p. 349), it is because of the alienation imposed by the state, not merely the existence of patriarchy (p. 352), and what she refers to as our tolerance of it (p. 356). We do not tolerate it, any more than the oppressive cultural attitudes she describes, and whose inevitability, unlike her, we reject.

We stressed that decriminalisation was a necessary but not sufficient condition for fulfilling our ethical obligation to support these women. Shrage herself implies a meeting place for the proponents in the debate. Real life rarely fits neatly into simple binaries. Decriminalisation to restore human rights does not exclude the equally necessary need to address inequality and other social determinants.

Hilary Kinnell (11) makes the most compelling argument of all for the immorality of our treatment of sex workers. Throughout history we have rationalised our prejudices by alienating groups, be they defined by religious, racial, disability, occupational or caste criteria, in order to dehumanise them and reconcile actions that would otherwise be abhorrent. Thus it becomes a relatively simple step to move from what we do not like, or believe to be wrong, to believing that those involved are not truly human, and can therefore be disposed of as commodities. Such social cleansing becomes intensified if we believe that we are actually threatened, such as Home Office mythology about sex workers as reservoirs of disease (social pollution). She demonstrates that both acts and attitudes by authorities, media and the police inflame hatred against sex workers leading to increased crime against women, that is rationalised, less likely to be reported and less likely to be acted on.

We called for decriminalisation, based on the lived realities of women, because criminalisation dehumanises all of us, is ineffective and harms women, not because we support sustaining patriarchy. Criminal law is never a substitute for failure to address social ills.

References

1. Remembering Ipswich: a plea for human rights. http://myweb.dal.ca/mgoodyea/files/rememberingipswich.doc

2. Davidson JO. The rights and wrongs of prostitution. Hypatia 2002 Spring 17(2): 84-98

3. Miriam K. Stopping the traffic in women: power, agency and abolition in feminist debates over sex-trafficking. Journal of Social Philosophy 2005 Spring 36(1): 1-17

4. Sullivan B. Rethinking prostitution, in Caine B, Pringle R (eds.) Transitions: New Australian Feminisms Allen & Unwin, Sydney 1995 184- 197 http://www.atc.org.yu/data/File/Prostitucija/feminism%20and%20prostitution.pdf

5. Weitzer R. New directions in research on prostitution. Crime, Law & Social Change 2005 43: 211-235

6. O’Neill M. Prostitution and feminism: Towards a politics of feeling Polity Press, Cambridge 2001 ISBN-10: 0745612040

7. Day SE, Ward H. Advocacy for health in sex workers. Rapid Response January 15

8. Pateman C. Defending prostitution: charges against Ericsson. Ethics 1983 93: 561-65

9. Ericsson L. Charges against prostitution: an attempt at a philosophical assessment. Ethics 1980 90: 335-66

10. R v. Labaye, [2005] 3 S.C.R. 728, 2005 SCC 80

11. Kinnell H. Murder made easy: the final solution to prostitution?, in Campbell R, O’Neill M (eds.) 2006 Sex work now. Willan, Cullompton, Devon 2006 ISBN 1-84392-096-4, pp. 141-168

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Re: Sex Health in Australia
 

Just a brief word about sex work and sexual health in Australia:

Each state has its own laws governing what is, and is not, legally permissible. (Generally outdoor v. indoor work)

There are OH & S standards that apply to what is legally permissible.

I worked as a medical practitioner for some time at a free, walk-in sexual health clinic that was run as part of the public health system. Many of the clientele were sex workers. (Other client groups included university students... gay men... cheating husbands... international travellers... etc.)

All pts received the same - high - standard of clinical care.

I believe such a service is essential in all communities, and reflects the fact that sexual health is an important part of life.