Shifting Attitudes:Individuals Engaged in Sex Work//Kayla Bolland-Hillesheim

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Individuals engaged in sex work (IESW) have long been seen through a lens that focuses on the mental illness and stress they experience (1). Even among activist subgroups, the view of IESW can be combative. Sex trafficking is clearly a human rights violation from any feminist perspective. Sex work, in which a person may choose to engage, is a separate issue. There has been debate among feminists over whether sex work is truly empowering or flat out exploitative (2). However, this either-or thinking leaves little room for the acknowledgment of intersecting identities within the sex work industry (3).

While there are common and very real concerns associated with engagement in sex work, such as substance use (4) or sexual abuse (5), there is little attention given to the coping strategies and strengths of IESW (6). Given the rigid, opposing ways in which sex work has been perceived within the feminist debate, it’s time to reconsider our attitudes and how they may be impacting IESW. Majority moral judgments made about their work may contribute to internalized stigma and isolation among IESW (7), which can lead to low self-esteem, shame, despair, and a sense of powerlessness (8).

This change in perspective acknowledges how IESWs’ experiences may vary depending upon the location in which they work and where their occupation falls along the hierarchy within the sex work industry (9). All of this may further be impacted by their various intersecting social identities, such as ethnicity, sexual orientation, gender identity, and socioeconomic status (10).

There are differences between street and indoor sex workers regarding practices, job satisfaction, self-esteem, physical and psychological health, and victimization (11). In qualitative interviews with trans women of color, some considered entering sex work a cultural norm as they began their transition. It allowed them to join in a community of other trans women, especially after many were rejected by their family members (12). Additionally, a participant in a study by Koken (2012) said she saw sex work as an effective way to supplement her income from disability and felt affirmed by the positive attention of clients who value her appearance and do not see her as disabled first and foremost. 

Our attitude shift should include a focus on resiliency and broadening our understanding of this population to encompass their whole experience, not just parts of it.

~Written by Kayla Bolland-Hillesheim


1. Maddux, J. E., Gosselin, J. T., & Winstead, B. A. (2008). Conceptions of psychopathology: A social constructionist perspective. In J. E. Maddux & B. A. Winstead (Eds.), Psychopathology: Foundations for a contemporary understanding (2nd ed., pp. 3–18). New York, NY: Routledge/Taylor & Francis Group.
2. Limoncelli, S. A. (2009). The trouble with trafficking: Conceptualizing women’s sexual labor and economic human rights. Women’s Studies International Forum, 32, 261–269.
3. Benoit, C., & Shaver, F. M. (2006). Critical issues and new directions in sex work research. Canadian Review of Sociology and Anthropology, 43(3), 243-252. doi:10.1111/j.1755-618X.2006.tb02222.x
4. Ward, H., Mercer, C. H., Wellings, K., Fenton, K., Erens, B., Cpoas, A., & Johnson, A. M. (2005). Who pays for sex? An analysis of the increasing prevalence of female commercial sex contacts among men in Britain. Sexually Transmitted Infections, 81, 467– 471. doi:10.1136/sti.2005.014985
5. Abramovich, E. (2005). Childhood sexual abuse as a risk factor for subsequent involvement in sex work: A review of empirical findings. Journal of Psychology & Human Sexuality, 17, 131–146.
6. Burnes, T. R., Long, S. L., & Schept, R. A. (2012). A resilience-based lens of sex work: Implications for professional psychologists. Professional Psychology: Research and Practice, 43(2), 137-144. doi:10.1037/a0026205
7. Sex Worker Education and Advocacy Task Force. (2005). Coping with stigma, discrimination, and violence: Sex workers talk about their experiences. Retrieved from
8. Moane, G. (2003). Bridging the personal and the political: Practices for a liberation psychology. American Journal of Community Psychology, 31(1–2), 91–101. doi:10.1023/A:1023026704576
9. Cusick, L., Martin, A., & May, T. (2003). Findings 207: Vulnerability and involvement in drug use and sex work. Report from the Communication, Research, Development and Statistics Directorate. London, UK: Home Office.
10. Buttram, M. E., Surratt, H. L., & Kurtz, S. P. (2014). Resilience and syndemic risk factors among African-American female sex workers. Psychology, Health & Medicine, 19(4), 442-452. doi:10.1080/13548506.2013.824595
11. Lever, J., & Dolnick, D. (2010). Call girls and street prostitutes: Selling sex and intimacy. In R. Weitzer (Ed.), Sex for sale: Prostitution, pornography, and the sex industry (2nd ed., pp. 187–203). New York: Routledge.
12. Sausa, L. A., Keatley, J., & Operario, D. (2007). Perceived risks and benefits of sex work among transgender women of color in San Francisco. Archives of Sexual Behavior, 36(6), 768-777. doi:10.1007/s10508-007-9210-3
13. Koken, J. A. (2012). Independent female escort's strategies for coping with sex work related stigma. Sexuality & Culture: An Interdisciplinary Quarterly, 16(3), 209-229. doi:10.1007/s12119-011-9120-3

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