Sex workers say the greatest threats to their well-being come from government policy.

Image Credit: Photo by Sally T. Buck via Flickr, Creative Commons licensed

Sex work is the most fulfilling job Rae has ever had. Colleagues and clients in Victoria were more welcoming than other professions had ever been to a transgender and autistic woman like herself.

Her first professional job after moving to Victoria seven years ago involved discrimination — she was asked to wear a man’s shirt, for example — low paycheques and mistreatment.

“One day, I was just like, ‘Screw this I’m running an ad,’” Rae said, deciding to explore sex work. The response was immediate and positive.

“I was overwhelmed. I was super busy. I was loved, I was treated with respect.”

What makes life difficult and dangerous for people like Rae, according to a recent report by and about sex workers in the Lower Mainland and southern Vancouver Island, is the criminalization of some aspects of sex work, the stigma against it in health care and housing, and intersections with the toxic drug crisis. Though there are no counts of how many sex workers have died of toxic drug poisoning, the crisis has anecdotally had a disproportionate impact on the community.

These insights are part of the first study of its kind in B.C., in which peer workers were trained to conduct interviews and be part of the research as well. Participants worked at or accessed services at various Lower Mainland and southern Vancouver Island organizations, including PACE Society, WISH Drop-In Centre Society and Peers Victoria. It did not include SWAN Vancouver, which supports migrant sex workers, for logistical reasons, which led to BIPOC people being underrepresented in the final report.

In total, 239 sex workers weighed in on health care, housing and toxic drug crises and the unique challenges that come with doing sex work, and recommended solutions to make sex work safer. The majority of interviewees who had done sex work in the past year said they did street-based work, solicited or worked online, saw regulars, or a mix of the three. Only six per cent said they used dating apps or escort agencies.

The recommendations include decriminalizing sex work — selling sex is legal in Canada, but paying for sex isn’t, so customers can be charged. Services like providing advertising, a safe place to work or security are also illegal.

They also include adequately funding solutions identified by the National Inquiry into Missing and Murdered Indigenous Women and Girls final report, increasing disability assistance rates, addressing the toxic drug crisis in B.C., and funding more accessible public washrooms and sex workers to maintain their own “bad date” registries.

Seventy-three per cent of participants reported being disabled and over a third did not have stable housing. As a solution, the study also identified a need for a 24-7 space for sex workers to see clients, either at a drop-in community centre with a clean room and a harm reduction approach, or at a shared suite.

This could provide a safe space for people to work and offer specialized supports for sex workers, like mental health and substance use treatment, they said.

COVID-19 and increasingly toxic drugs have added to health and safety risks for sex workers in Vancouver’s Downtown Eastside.

Nearly 40 per cent of participants said that during the pandemic their clients were more demanding about the kinds of services they wanted, and half said clients were pushier about rates.

“When I first started street sex work in 2016 at the start of the overdose crisis, the streets were packed and now the streets are pretty empty,” said Jasmine, an outdoor sex worker in the DTES who worked on the report. She knows at least 15 people who have died in the past few years.

Almost exactly four years ago, Rae lost her best friend, roommate and colleague to toxic drugs.

“That really affected me terribly. I left that place,” Rae said. “I tried to get out of the sex work industry and I got treated horribly in transition houses. I ended up homeless.”

Both women called for sex work to be decriminalized — which is the first recommendation in the report — and supported the rest of the recommendations. They also said the job is difficult to leave for those who wish to, despite having training and skills in other professions, due to stigma and disabilities.

Jasmine’s fibromyalgia, a condition causing chronic fatigue that makes productivity difficult, is one of the biggest reasons she’s a sex worker. The other is the province’s disability benefit rates and rules.

“I’m in a lot of pain, very low energy and that’s really one of the only things that I can do, outside of a couple hours of peer work here and there,” she said.

In addition to disability rates — $1,358 per month for a single person — being too low to live on, the annual earning limit at which benefits are cut off in B.C. is $15,000 a year for a single person.

“I go to work just to afford the basics; just my food, my clothes, my medical cannabis, household stuff,” Jasmine said. “The majority of my co-workers outside are on disability… and are living in SROs in the Downtown Eastside.”

Seeing a traditional doctor and accessing health care as a sex worker was difficult for Rae until she found a street nurse in Victoria.

“Unprecedented amounts of stigma towards our community makes it difficult to access health-care settings [and] clinics,” she said. “I’ve had doctors… treat me like I was just the dirtiest thing, they couldn’t even touch me, it was just really awful. I’m also trans, so that’s another level of it.”

But Rae is grateful for a street nurse and a community care clinic where she has been treated well and able to get tested for STIs regularly, without judgment. This clinic, she said, serves various marginalized communities including sex workers.

Expecting violence

For Rae, as an indoor sex worker, the legal justice system has been less of a problem. She felt supported by police in Victoria when reporting assaults, but knows people in the street community have a different experience.

Jasmine said sometimes when she has tried to report assaults to the Vancouver Police Department she felt her case was not taken seriously. She recalled an officer once telling her to expect violence for being a sex worker, after she reported a client who had kicked her repeatedly in the torso for refusing to provide services.

The officer said “I should expect to get beat up and physically harmed every single night that I go to work,” Jasmine said. “Having that said to me was really fucking dehumanizing.”

Overall, the report found people had mixed experiences with police but similar complaints: that officers were not responsive enough, did not pay attention to sex workers’ cases, and that this was likely due to their workload.

The report therefore recommended more sex worker liaison officers in police departments who are trained by staff at sex worker support organizations.

According to lead author Sylvia Machat, who was a researcher at a University of British Columbia-based project about sex worker health access for a decade, these types of studies are usually run out of universities and institutions.

“In this case, we were able to run a project that was developed by and run by sex workers,” Machat said. “I used a very community-based approach to doing this work, because I think it’s important to uplift people’s voices and to develop their professional skills… and add to people’s resumes.”

The study and surveys were conducted in 2021 with funding from the City of Vancouver’s Emergency Community Support Fund. The next step Machat hopes for is a meeting with city staff who plan Vancouver’s sex work response.

Those who wish to see the report’s recommendations implemented, she said, should make it known through political action.

“If the public wants to see these things happen, they’re going to need to make this an issue with policy-makers,” Machat said. “And they’re going to have to vote in ways that show that they support these kinds of initiatives."

— This story was originally published by The Tyee.

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