This is a lightly edited excerpt from Tlaleng Mofokeng’s Dr T: A Guide to Sexual Health & Pleasure (Pan Macmillian, 2019), R290.
I was walking across the street on Broadway in New York City and saw a massive billboard with Pretty Woman in neon red lights. I immediately felt nostalgic as Pretty Woman is one of my top two movies of all time. It was only a few weeks prior that I had watched the movie, for what must be the hundredth time, and had live Tweeted using the hook, “sex work is work”.
For anyone who hasn’t seen the movie (which is highly unlikely), the film centres around Vivian Ward, infamously played by Julia Roberts, and Edward Lewis, played by Richard Gere. Their first encounter sets the scene for a business transaction; the exchange is cheeky and happens on the street before Vivian agrees to leave with Edward. They navigate various issues during their week-long rendezvous and go on to develop a romantic relationship.
It was only when I had watched Pretty Woman a few times that I realised what the first encounter between them was really about; a businessman acquiring the services of an escort.
Although many people do not necessarily identify themselves as sex workers, sex work in its many forms is considered work. The adoption of the use of the term “sex work” was in the 1970s and the International Labour Organisation (ILO), a specialised agency of the United Nations, affirmed and recognised sex work as work.
In my work as a medical doctor and in the area of medical policy, many people in public health view sex workers through a narrow lens of HIV. This conjures gross stereotypes about sex work, in all the various gender and sexualities, are not “vectors of disease”. Not all sex workers engage in sexual contact and those who do are not all performing penetrative sexual acts. Though, undeniably, that is a big part of sex work. Not all sex workers are HIV positive and HIV is not the only concern that sex workers have. Public health does not need to be safeguarded from sex workers and even governments who boast HIV programmes for key populations at risk of HIV, still fail to provide lubricants and internal and external condoms and facilities remain inaccessible for the majority of sex workers. Sex workers have needs beyond HIV such as treatment of other sexually transmitted diseases, cervical cancer screening, trauma counselling, contraceptives and safe abortion care.
The need for states to protect, uphold and defend the rights of sex workers is an urgent global feminist issue. One that has been eclipsed by global health politics, economic crises and migration, yet these very issues are well documented as structural drivers of HIV, human rights abuses and women are always adversely affected. Global efforts have been growing in specific countries such as South Africa, led by the biggest sex worker-led movement, Sisonke, and the advocacy and policy work of Sweat (Sex Workers Education and Advocacy Taskforce).
It was with much vigour that Sisonke, Sweat and members of the Asijiki Coalition, were involved in a march in solidarity with Proud, the Dutch union of sex workers in Amsterdam, as they delivered a memorandum to city officials demanding protection of the right of sex workers to work in safe working conditions in the city. We have been a part of several protests, highlighting several issues affecting women, and of course sex work decriminalisation, and at previous protests we resorted to throwing sanitary towels on stage to protest the VAT placed on sanitary products.
We cannot divorce the human rights of dignity, safety and bodily integrity from sex work. Sex worker rights are women’s rights, health rights and labour rights and are the litmus test for intersectional feminism. The impact of continued criminalisation of the majority of sex workers, who are mostly women and transgender women, means that sex worker rights are a feminist issue.
Global and local feminists and organisations must support efforts to address structural barriers and ensure implementation of a comprehensive health service package for sex workers as advised by the world health organisation (WHO) and fund public campaigns to decrease stigma.
In an op-ed recently published in Teen Vogue, I asserted that governments ignore the nuanced histories and contexts in different countries and thus continue to wrongfully offer blanket solutions and “rescue” models, which are rooting for partial decriminalisation or continued criminalisation of sex work. They also ignore the wishes of sex workers, who want full decriminalisation, as supported by the Global Commission on HIV and the law, and The Lancet journal, as well as human rights organisations like Amnesty International. They often fail to accept the evidence for the economic and social bases for sex work; the ILO estimates that “sex workers support between five and eight other people with their earnings. Sex workers also contribute to the economy”.
As a medical doctor, I exchange payment in the form of money to provide people with advice and treatment for sex-related problems; therapy for sexual performance, counselling and therapy for relationship problems and treatment of sexually transmitted diseases. Basically, I am a sex worker.
I make this statement not devoid of the appreciation of the violent workplaces, or the harsh environmental conditions that outdoor sex workers endure and because of this privilege, I ask the question, is a medical degree really the right measure of who is deserving of dignity, autonomy, safety in the work place, fair trade and freedom of employment? No. This should not be so. Those who engage in sex work deserve those things too.
I do not believe it is right or just that people who exchange sexual services for money are criminalised and that I am not for what I do. Sex worker services can include everything from companionship, intimacy, counsel, to non-sexual role playing, dancing, escorting and stripping. It does not, I repeat, it does not always include penetrative sex. Many do not necessarily identify as sex workers, and that is also okay. Many take on multiple roles with their clients and some may get more physical while others may have started off as sexual may evolve into more emotional and psychological bonding. The clients vary, and they’re not just men.
The idea of purchasing intimacy and paying for the services can be affirming for many people who need human connection, friendship and emotional support. Some people may have fantasies and kink preferences that they are able to fulfil with the services of a sex worker. Evidence, not morality, should guide law reforms and sex work policy for full sex work decriminalisation. Sex work is real work.