Realising Justice for Sex Workers: An Agenda for Change by Sharron A. Fitzgerald & Kathryn McGarry

Author:Sharron A. Fitzgerald & Kathryn McGarry [Fitzgerald, Sharron A. & McGarry, Kathryn]
Language: eng
Format: epub
ISBN: 9781786603951
Google: YOGWswEACAAJ
Amazon: 1786603950
Goodreads: 35546405
Publisher: Rowman & Littlefield International
Published: 2018-01-15T13:10:24+00:00

6

Examining and Challenging the Everyday Power Relations Affecting Sex Workers’ Health

Pippa Grenfell, Lucy Platt and Luca Stevenson

Amid the polarised feminist politics surrounding sex work, public health is often framed as a pragmatic middle ground (Tucker and Tuminez 2011). As alliances have developed between sex workers, academics and practitioners in the fight against HIV, and concern with the social determinants of health has grown (Marmot 2005), public health professionals are increasingly focusing on the social, political and economic conditions that shape sex workers’ health (Shannon et al. 2015). This has drawn their/our much-needed attention to the negative health consequences of sex work criminalisation, police enforcement, stigma and related structural injustices—concerns long voiced by sex worker rights movements (Decker et al. 2015; Crago 2008). It has also led to greater involvement of sex workers in shaping health programmes, research and policies (NSWP 2014) and of public health professionals in advocacy for legal reform and sex workers’ rights (Wolffers and van Beelen 2003; Shannon et al. 2015). However, much research and practice pays insufficient attention to sex workers’ health needs beyond HIV and neglects their agency in negotiating threats to their well-being. Efforts to involve sex workers do not always challenge power relations between public health professionals and people who sell sex, or reflect the diversity of sex worker communities (Busza 2004; Cornish and Campbell 2009). Furthermore, some (public) health professionals appear reluctant to engage in debates surrounding sex work laws amid threats to funding and conflation of sex work and trafficking (Forbes 2010), while others support policies that are likely to compromise sex workers’ safety, health and rights (FitzGerald and McGarry 2016).

Drawing on our multiple perspectives across social science, epidemiology and sex worker rights activism, we examine shifts in public health research, practice and policy and discuss the implications for our understandings of, and possibilities to challenge, the power relations that shape sex workers’ health. We believe that achieving social justice requires a fundamental shift in the power relations that institutionalise, legitimise and normalise suffering and inequalities (Bourgois 2001; Krusi et al. 2016), and we therefore propose an agenda for change in three key ways. First, we call for ‘person-centred’ (Onyango, Schatz and Lazarus 2017) approaches to service provision, research and policy making, situating sex workers’ health and decision making relative to broader structural contexts while recognising their individual and collective agency in negotiating health, safety and well-being. Second, we urge collaboration with sex workers over funding, design, implementation and evaluation of health services, research and policies (NSWP 2014) with critical reflection on contingent power relations. Third, we encourage (public) health professionals to support advocacy for sex work laws and social policies that protect sex workers’ safety and health—efforts that would recognise the intricate links between the health harms and injustices that sex workers face (Overs and Hawkins 2011). Although we focus on what public health practitioners, researchers and policy makers can do to support sex workers’ social justice efforts, our proposals are also relevant to broader medical and health-care communities.

Power, Agency

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