Sex Workers at Risk: The Use of Condoms as Evidence in Four US Cities

Sex Workers at Risk: The Use of Condoms as Evidence in Four US Cities

Human Rights Watch. (July, 2012) [public health, HIV, United States]

From the Summary:

Human Rights Watch interviewed more than 300 persons for this report, which focuses on police use of condoms as evidence to enforce prostitution and sex trafficking laws, as part of an investigation into barriers to effective HIV prevention for sex workers in the four cities covered by this report. Those interviewed included nearly 200 sex workers and former sex workers as well as outreach workers, advocates, lawyers, police officers, district attorneys, and public health officials. In New York, Washington, DC, and Los Angeles our investigation focused on complaints of police using condoms as evidence while targeting sex workers on the street. In San Francisco, condoms were used as evidence for street enforcement to some extent, with police photographing rather than confiscating condoms, in what appeared to be a dubious nod to public health concerns. In San Francisco, much of the anti-prostitution enforcement using condoms as evidence targeted women working in businesses such as erotic dance clubs, massage businesses, and a nightclub with transgender clientele.

Police use of condoms as evidence of prostitution has the same effect everywhere: despite millions of dollars spent on promoting and distributing condoms as an effective method of HIV prevention, groups most at risk of infection—sex workers, transgender women, and lesbian, gay, bisexual, and transgender (LGBT) youth—are afraid to carry them and therefore engage in sex without protection as a result of police harassment. Outreach workers and businesses are unable to distribute condoms freely and without fear of harassment as well.

No Lectures or Stink Eye: The Healthcare needs of People in the sex trades in New York City

No Lectures or Stink Eye: The Healthcare needs of People in the sex trades in New York City.”

Persist Health Project, April 2014.

Persist (Providing Education and health Resources in Support of Individuals in the
Sex Trade) Health Project (Persist) is a New York City-based (NYC) organization, made up
of nurse practitioners, health educators, community organizers, and social workers, who
are/have been in the sex trade (or are committed allies). We believe that people in the sex
trade, regardless of our experiences, are entitled to health care spaces that are supportive and
affirming of the realities of our lives. We work to build our own spaces to serve other
community members; we also work with health care professionals to better serve us and
others in communities involved with or impacted by the sex trade.

This study is the result of focus groups conduced in New York City with sex workers of various backgrounds in the needs and barriers to accessing health care.

Associations Between Sex Work Laws and Sex Workers’ Health: A Systematic Review and Meta-Analysis of Quantitative and Qualitative Studies

Platt L, Grenfell P, Meiksin R, Elmes J, Sherman SG, Sanders T, et al. (2018) 

Associations Between Sex Work Laws and Sex Workers’ Health: A Systematic Review and Meta-Analysis of Quantitative and Qualitative Studies

PLoS Med 15(12): e1002680. [Global, international, criminalization, stigma] https://doi.org/10.1371/journal.pmed.1002680.

Abstract

Background. Sex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised evidence on the extent to which sex work laws and policing practices affect sex workers’ safety, health, and access to services, and the pathways through which these effects occur.

Methods and findings. We searched bibliographic databases between 1 January 1990 and 9 May 2018 for qualitative and quantitative research involving sex workers of all genders and terms relating to legislation, police, and health. We operationalised categories of lawful and unlawful police repression of sex workers or their clients, including criminal and administrative penalties. We included quantitative studies that measured associations between policing and outcomes of violence, health, and access to services, and qualitative studies that explored related pathways. We conducted a meta-analysis to estimate the average effect of experiencing sexual/physical violence, HIV or sexually transmitted infections (STIs), and condomless sex, among individuals exposed to repressive policing compared to those unexposed. Qualitative studies were synthesised iteratively, inductively, and thematically. We reviewed 40 quantitative and 94 qualitative studies. Repressive policing of sex workers was associated with increased risk of sexual/physical violence from clients or other parties (odds ratio [OR] 2.99, 95% CI 1.96–4.57), HIV/STI (OR 1.87, 95% CI 1.60–2.19), and condomless sex (OR 1.42, 95% CI 1.03–1.94). The qualitative synthesis identified diverse forms of police violence and abuses of power, including arbitrary arrest, bribery and extortion, physical and sexual violence, failure to provide access to justice, and forced HIV testing. It showed that in contexts of criminalisation, the threat and enactment of police harassment and arrest of sex workers or their clients displaced sex workers into isolated work locations, disrupting peer support networks and service access, and limiting risk reduction opportunities. It discouraged sex workers from carrying condoms and exacerbated existing inequalities experienced by transgender, migrant, and drug-using sex workers. Evidence from decriminalised settings suggests that sex workers in these settings have greater negotiating power with clients and better access to justice. Quantitative findings were limited by high heterogeneity in the meta-analysis for some outcomes and insufficient data to conduct meta-analyses for others, as well as variable sample size and study quality. Few studies reported whether arrest was related to sex work or another offence, limiting our ability to assess the associations between sex work criminalisation and outcomes relative to other penalties or abuses of police power, and all studies were observational, prohibiting any causal inference. Few studies included trans- and cisgender male sex workers, and little evidence related to emotional health and access to healthcare beyond HIV/STI testing.

Conclusions. Together, the qualitative and quantitative evidence demonstrate the extensive harms associated with criminalisation of sex work, including laws and enforcement targeting the sale and purchase of sex, and activities relating to sex work organisation. There is an urgent need to reform sex-work-related laws and institutional practices so as to reduce harms and barriers to the realisation of health.

Negotiating safety and sexual risk reduction with clients in unsanctioned safer indoor sex work environments: a qualitative study

Authors: Krüsi, Andrea, Jill Chettiar, Amelia Ridgway, Janice Abbott, Steffanie A. Strathdee, and Kate Shannon.

Negotiating Safety and Sexual Risk Reduction with Clients in Unsanctioned Safer Indoor Sex Work Environments: A Qualitative Study.

American Journal of Public Health 102 (6): 1154–59.

Abstract:

Objectives: We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions.

Methods: We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All interviews were transcribed verbatim and thematically analyzed.

Results: Women’s accounts indicated that unsanctioned indoor sex work environments promoted increased control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use, and avoid violent perpetrators. Despite the lack of formal legal and policy support for indoor sex work venues in Canada, the environmental-structural supports afforded by these unsanctioned indoor sex work environments, including surveillance cameras and support from staff or police in removing violent clients, were linked to improved police relationships and facilitated the institution of informal peer-safety mechanisms.

Conclusions: This study has drawn attention to the potential role of safer indoor sex work environments as venues for public health and violence prevention interventions and has indicated the critical importance of removing the sociolegal barriers preventing the formal implementation of such programs.

HIV Criminalization Beyond Non-Disclosure: Advocacy Toolkits on Intersections with Sex Work and Syringe Use

HIV Criminalization Beyond Non-Disclosure: Advocacy Toolkits on Intersections with Sex Work and Syringe Use

The Center for HIV Law and Policy and National LGBTQ Task Force (2017)

Description:

The Center for HIV Law and Policy (CHLP) and the National LGBTQ Task Force are pleased to announce the release of an exciting new resource that can help foster more intersectional advocacy for HIV criminal law reform. HIV Criminalization Beyond Non-Disclosure: Advocacy Toolkits on Intersections with Sex Work and Syringe Use is the sum of two toolkits designed for advocates who care about ending the disproportionate criminalization of people living with HIV.

The toolkits highlight the intersections between advocacy for HIV criminal law reform, decriminalization of sex work, and safe syringe access. These different advocacy communities share many common goals and constituencies, yet do not generally work in close collaboration or collectively strategize. The toolkits underscore the ways in which certain HIV criminal laws specifically target sex workers and people who inject substances, but also how these laws and those that prohibit sex work and drug use represent the systemic criminalization of safety and survival of Black and Brown bodies and of sexual and gender minorities. 

Police-Related Correlates of Client-Perpetrated Violence Among Female Sex Workers in Baltimore City, Maryland

Police-Related Correlates of Client-Perpetrated Violence Among Female Sex Workers in Baltimore City, Maryland

Authors: Footer KHA, Park JN, Allen ST, Decker MR, Silberzahn BE, Huettner S, Galai N, Sherman SG.

Police-Related Correlates of Client-Perpetrated Violence Among Female Sex Workers in Baltimore City, Maryland.

Am J Public Health. 2019 Feb;109(2):289-295. doi: 10.2105/AJPH.2018.304809. Epub 2018 Dec 20. PMID: 30571295; PMCID: PMC6336048.

Abstract:

Objectives. To characterize interactions that female sex workers (FSWs) have with the police and explore associations with client-perpetrated violence.

Methods. Baseline data were collected April 2016 to January 2017 from 250 FSWs from the Sex Workers and Police Promoting Health in Risky Environments (SAPPHIRE) study based in Baltimore, Maryland. Interviewer-administered questionnaires captured different patrol or enforcement and abusive police encounters, experiences of client-perpetrated violence, and other risk factors, including drug use. We conducted bivariate and multivariable analysis in Stata/SE version 14.2 (StataCorp LP, College Station, TX).

Results. Of participants, 78% reported lifetime abusive police encounters, 41% reported daily or weekly encounters of any type. In the previous 3 months, 22% experienced client-perpetrated violence. Heroin users (70% of participants) reported more abusive encounters (2.5 vs 1.6; P < .001) and more client-perpetrated violence (26% vs 12%; P = .02) than others. In multivariable analysis, each additional type of abusive interaction was associated with 1.3 times (95% confidence interval [CI] = 1.1, 1.5) increased odds of client-perpetrated violence. For patrol or enforcement encounters, this value was 1.3 (95% CI = 1.0, 1.7).

Conclusions. Frequent exposures to abusive police practices appear to contribute to an environment where client-perpetrated violence is regularly experienced. For FSWs who inject drugs, police exposure and client-perpetrated violence appear amplified.

A systematic review of the correlates of violence against sex workers

A Systematic Review of the Correlates of Violence Against Sex Workers

Authors: Kathleen N. Deering, PhD, Avni Amin, PhD, Jean Shoveller, PhD, Ariel Nesbitt, MPH, Claudia Garcia-Moreno, MD, MSc, Putu Duff, MSc, Elena Argento, MPH, and Kate Shannon, PhD

A Systematic Review of the Correlates of Violence Against Sex Workers

American Journal of Public Health vol. 104,5 (2014): e42-54. doi:10.2105/AJPH.2014.301909

Abstract:

We conducted a systematic review in June 2012 (updated September 2013) to examine the prevalence and factors shaping sexual or physical violence against sex workers globally.

We identified 1536 (update = 340) unique articles. We included 28 studies, with 14 more contributing to violence prevalence estimates. Lifetime prevalence of any or combined workplace violence ranged from 45% to 75% and over the past year, 32% to 55%. Growing research links contextual factors with violence against sex workers, alongside known interpersonal and individual risks.

This high burden of violence against sex workers globally and large gaps in epidemiological data support the need for research and structural interventions to better document and respond to the contextual factors shaping this violence. Measurement and methodological innovation, in partnership with sex work communities, are critical.

Sex work is an LGBTQ Issue

Sex workers have been a long standing, and often erased, part of the LGBTQ community. Sex work has offered a life line for those marginalized to not just survive but thrive, formed the backbones of nascent organizations and a sub-community for many who have been invisibilized by respectability politics. It is important to look at sex work and its place within the LGBTQ community and in the history of LGBTQ liberation. For an issue which encompasses issues of economic justice, labor, criminalization and policing, sexuality, racial justice, immigration, gender identity and complex other frameworks, sex worker rights can be a lynchpin issue impacting the most marginalized in our communities. Caring about LGBTQ survival means caring about the lives, health and safety of sex workers.

Why is Sex Work an LGBTQ Issue?

Sex Work has kept us housed and fed in the face of discrimination and Oppression. Criminalization makes that survival harder.

With discrimination in jobs, education and services, poverty has long been a queer issue. The trans community are twice as likely to be unemployed compared to cisgender individuals. For homeless and housing unstable youth, the disparities are even more  pronounced, with some cities reporting that 40-50% of homeless young people reporting to be LGBTQ-identified.

Contributing to and exacerbating this economic disparity is the discrimination in traditional employment and social services. Ninety percent of the trans community report some form of harassment, mistreatment and discrimination in the workplace. One survey found that for homeless shelters, only 30% were open to housing transgender women, while structural barriers such as identification documents with different names and gender markers can make accessing to benefits and services even harder.

As a result, LGBTQ-identified individuals have often relied on sex work as a means of survival. The most recent Transgender Discrimination survey found that 11% of respondents report having done sex work. Broken down by race, the study found that 33% of Latinx respondents and 40% of black respondents reported participation in the sex trade. Homeless LGBTQ-identified youth are seven times more likely than heterosexual-identified peers to trade sex for a place to stay.

The collateral consequences of a prostitution arrest can also make access to resources and economic stability further challenging. A prostitution conviction can mean disqualification from public housing, deportation or the inability to adjust one’s immigration status, violating a code of conduct to lead to expulsion from higher education, civil consequences such as eviction or removal of children from the home, among many other collateral consequences.

Supporting the health and safety of those who trade sex will necessarily improve the well-being of members of the LGBTQ community, especially those most hard-hit by economic marginalization and injustice.

Criminalization of sex work promotes surveillance, policing and incarceration for LGBTQ individuals. [ix]

In the United States, prostitution, as well as all the mechanisms around that act, is fully criminalized in every state[x]. This is primarily defined as outlawing the exchange of sex for resources, with nuances as to what that encompasses as defined by different jurisdictions and local jurisprudence. As LGBTQ communities experience disproportionately higher levels of policing, prostitution laws are often a significant part of that over policing and incarceration. For youth, LGB young women are twice as likely and LGB young men are ten times as likely to be incarcerated in juvenile detention for prostitution charges, as compared to their peers.[xi]

Particularly harmful are laws against loitering for the purposes of prostitution. Evidence for arrest and conviction can include what a person is wearing, waving at cars, being in an area that law enforcement considers “known” for prostitution, or even having been arrested before – all of which being protected behavior in other contexts. Loitering for the purposes of prostitution has colloquially come to be known as “walking while trans,” because of the frequency with which trans women are subjected to their policing. During his time at the Sylvia Rivera Law Project, Dean Spade reported that 80 percent of the trans women of color he worked with “had experienced police harassment or false arrest based on unfounded suspicion of prostitution.” (Make the Road, 2012, p.13) This practice was further documented by Amnesty International in 2005 and again by Human Rights Watch in 2012.

Third-Party Laws are about destroying our tools to stay safe – like harm reduction and community

Criminalization of the sex trade also goes beyond simply the exchange, but through proxy laws such as soliciting, pandering, or promoting criminalize other sex workers, peers, family members and community support. As these laws are often over-broad and require no victimization, acts such as sharing information, driving someone to an appointment, or receiving rent money can lead to charges. Peer support and harm reduction techniques such as giving referrals for potential clients and acting as a bodyguard for one another become a misdemeanor or, in cases of youth, a felony.

Laws such as promoting prostitution can be used against one person who helps another by posting an advertisement, or acting as a booker to interface with clients. Pandering for the purposes of prostitution can, for example, criminalize information sharing about how to find clients between peers in similarly precarious life situations. For a community which has survived by relying on each other when the world has turned its back, these networks are put in jeopardy through third-party laws. Removing these support systems do not disincentivize someone from engaging in sex work, but instead force many to trade sex under worse and more dangerous circumstances.

LGBTQ people have been fighting HIV for decades. Criminalization of sex work compromises that fight.

The decriminalization of sex work is an essential element to the fight against HIV transmission. In the most extensive study available, decriminalization of the sex trade could reduce HIV transmission 33 – 46% across the globe within the next decade. Sexual violence, which is exacerbated by criminalization, poses a significant risk to the health and safety of those trading sex. In addition, when policing practices involve sting operations, negotiation of things like condom use become criminalized activities, and sex workers must either avoid those conversations or try and use vague references to try and avoid arrest.

The use of carrying condoms as evidence of prostitution, a policing practice which has been documented around the world, has led to sex workers in policed areas to not carry condoms, regardless of whether they were going to engage in sex work. In a New York City-based study on the issue, 75% of transgender women said they had not carried condoms for fear of arrest.

Sex workers are also disproportionately impacted by the implementation of HIV criminaliaztion law through mandatory felony upgrades for those who are arrested for prostitution-related crimes while HIV positive.

Sex work has always been part of LGBTQ history. It’s how we’ve cared for each other.

Many LGBTQ icons of history have used commercial sex to not only provide for themselves, but care for others in the community. Marsha P Johnson and Sylvia Rivera were outspoken sex workers who not only catalyzed the modern LGBTQ movement, but also founded STAR, Street Transvestites Action Revolutionaries. Just like so many of our organizations today, STAR was founded after a protest/sit-in in 1970. The group focused on street-based LGBTQ, but especially trans young folks. The group eventually opened the sex work-funded STAR House, the first LGBTQ-specific shelter in North America.

Download this page as a printable two-pager.

*****

[ix] Prostitution and loitering laws are one part of the larger fight against quality of life policing which targets and profiles people of color and other marginalized communities.

[x] In Nevada, prostitution is legal within a highly-regulated brothel system, which is only allowed to operate in specific locations. Working independently or outside of this system remains criminalized and as of this drafting, Nevada had the highest arrests for prostitution per capita in the country, at a rate of almost 10:1 to the second and third highest states.

Sex work is about LGBTQ survival.

Sex workers have been a long standing, and often erased, part of the LGBTQ community. Sex work has offered a life line for those marginalized to not just survive but thrive, formed the backbones of nascent organizations and a sub-community for many who have been invisibilized by respectability politics. It is important to look at sex work and its place within the LGBTQ community and in the history of LGBTQ liberation. For an issue which encompasses issues of economic justice, labor, criminalization and policing, sexuality, racial justice, immigration, gender identity and complex other frameworks, sex worker rights can be a lynchpin issue impacting the most marginalized in our communities. Caring about LGBTQ survival means caring about the lives, health and safety of sex workers.

Why is Sex Work an LGBTQ Issue?
Sex Work has kept us housed and fed in the face of discrimination and Oppression. Criminalization makes that survival harder.

With discrimination in jobs, education and services, poverty has long been a queer issue. The trans community are twice as likely to be unemployed compared to cisgender individuals. For homeless and housing unstable youth, the disparities are even more  pronounced, with some cities reporting that 40-50% of homeless young people reporting to be LGBTQ-identified.

Contributing to and exacerbating this economic disparity is the discrimination in traditional employment and social services. Ninety percent of the trans community report some form of harassment, mistreatment and discrimination in the workplace. One survey found that for homeless shelters, only 30% were open to housing transgender women, while structural barriers such as identification documents with different names and gender markers can make accessing to benefits and services even harder.

As a result, LGBTQ-identified individuals have often relied on sex work as a means of survival. The most recent Transgender Discrimination survey found that 11% of respondents report having done sex work. Broken down by race, the study found that 33% of Latinx respondents and 40% of black respondents reported participation in the sex trade. Homeless LGBTQ-identified youth are seven times more likely than heterosexual-identified peers to trade sex for a place to stay.

The collateral consequences of a prostitution arrest can also make access to resources and economic stability further challenging. A prostitution conviction can mean disqualification from public housing, deportation or the inability to adjust one’s immigration status, violating a code of conduct to lead to expulsion from higher education, civil consequences such as eviction or removal of children from the home, among many other collateral consequences.

Supporting the health and safety of those who trade sex will necessarily improve the well-being of members of the LGBTQ community, especially those most hard-hit by economic marginalization and injustice.

Criminalization of sex work promotes surveillance, policing and incarceration for LGBTQ individuals. [ix]

In the United States, prostitution, as well as all the mechanisms around that act, is fully criminalized in every state[x]. This is primarily defined as outlawing the exchange of sex for resources, with nuances as to what that encompasses as defined by different jurisdictions and local jurisprudence. As LGBTQ communities experience disproportionately higher levels of policing, prostitution laws are often a significant part of that over policing and incarceration. For youth, LGB young women are twice as likely and LGB young men are ten times as likely to be incarcerated in juvenile detention for prostitution charges, as compared to their peers.[xi]

Particularly harmful are laws against loitering for the purposes of prostitution. Evidence for arrest and conviction can include what a person is wearing, waving at cars, being in an area that law enforcement considers “known” for prostitution, or even having been arrested before – all of which being protected behavior in other contexts. Loitering for the purposes of prostitution has colloquially come to be known as “walking while trans,” because of the frequency with which trans women are subjected to their policing. During his time at the Sylvia Rivera Law Project, Dean Spade reported that 80 percent of the trans women of color he worked with “had experienced police harassment or false arrest based on unfounded suspicion of prostitution.” (Make the Road, 2012, p.13) This practice was further documented by Amnesty International in 2005 and again by Human Rights Watch in 2012.

Third-Party Laws are about destroying our tools to stay safe – like harm reduction and community

Criminalization of the sex trade also goes beyond simply the exchange, but through proxy laws such as soliciting, pandering, or promoting criminalize other sex workers, peers, family members and community support. As these laws are often over-broad and require no victimization, acts such as sharing information, driving someone to an appointment, or receiving rent money can lead to charges. Peer support and harm reduction techniques such as giving referrals for potential clients and acting as a bodyguard for one another become a misdemeanor or, in cases of youth, a felony.

Laws such as promoting prostitution can be used against one person who helps another by posting an advertisement, or acting as a booker to interface with clients. Pandering for the purposes of prostitution can, for example, criminalize information sharing about how to find clients between peers in similarly precarious life situations. For a community which has survived by relying on each other when the world has turned its back, these networks are put in jeopardy through third-party laws. Removing these support systems do not disincentivize someone from engaging in sex work, but instead force many to trade sex under worse and more dangerous circumstances.

LGBTQ people have been fighting HIV for decades. Criminalization of sex work compromises that fight.

The decriminalization of sex work is an essential element to the fight against HIV transmission. In the most extensive study available, decriminalization of the sex trade could reduce HIV transmission 33 – 46% across the globe within the next decade. Sexual violence, which is exacerbated by criminalization, poses a significant risk to the health and safety of those trading sex. In addition, when policing practices involve sting operations, negotiation of things like condom use become criminalized activities, and sex workers must either avoid those conversations or try and use vague references to try and avoid arrest.

The use of carrying condoms as evidence of prostitution, a policing practice which has been documented around the world, has led to sex workers in policed areas to not carry condoms, regardless of whether they were going to engage in sex work. In a New York City-based study on the issue, 75% of transgender women said they had not carried condoms for fear of arrest.

Sex workers are also disproportionately impacted by the implementation of HIV criminaliaztion law through mandatory felony upgrades for those who are arrested for prostitution-related crimes while HIV positive.

Sex work has always been part of LGBTQ history. It’s how we’ve cared for each other.

Many LGBTQ icons of history have used commercial sex to not only provide for themselves, but care for others in the community. Marsha P Johnson and Sylvia Rivera were outspoken sex workers who not only catalyzed the modern LGBTQ movement, but also founded STAR, Street Transvestites Action Revolutionaries. Just like so many of our organizations today, STAR was founded after a protest/sit-in in 1970. The group focused on street-based LGBTQ, but especially trans young folks. The group eventually opened the sex work-funded STAR House, the first LGBTQ-specific shelter in North America.

Download this page as a printable two-pager.

*****

[ix] Prostitution and loitering laws are one part of the larger fight against quality of life policing which targets and profiles people of color and other marginalized communities.

[x] In Nevada, prostitution is legal within a highly-regulated brothel system, which is only allowed to operate in specific locations. Working independently or outside of this system remains criminalized and as of this drafting, Nevada had the highest arrests for prostitution per capita in the country, at a rate of almost 10:1 to the second and third highest states.

Sex work is an Economic Justice issue.

The United States is a country rife with economic injustice. Commercial sex, as a low-barrier, informal economy which provides access to unrestricted resources. Many people who face a range of structural marginalization and inequity relay on the sex trade to make ends meet and provide.

LGBTQ individuals, and especially trans folks, face a range of barriers to formal employment and basic services. Almost 22% of LGBTQ individuals live in poverty – a combination of circumstances from abuse to discrimination which can span a lifetime. For trans individuals, that number is almost 30%. LGBTQ individuals are more likely to be pushed out by families and face discrimination and abuse at school, meaning that from youth, there are obstacles to economic stability. In June of 2020 the Supreme Court determined that it is a violation of federal law to fire someone for their sexual orientation, but problems still persist in implementation. In the National Transgender Discrimination Survey from 2015, almost 70% of people who had traded sex reported previous discrimination in the workplace. LGBTQ people also face discriminations in basic services such as homeless and domestic violence shelters and regularly encounter barriers to social services such as lacking documentation which reflects their name and gender identity or because of homelessness. For LGBTQ people of color, overlapping forms of structural violence and marginalization compound.

For people who are formerly incarcerated, people with disabilities, caregivers, students, substance users or people who face a range of other barriers, access to stable, living-wage employment can be challenging, if not impossible. The sex trade is one way that many people resist in the face of economic injustice.

Other forms of economic justice: resource redistribution, informal economies.