Women Who Trade Sexual Services from Men: A Systematic Mapping Review

Abstract

Most research on transactional sex frame men as buyers and females as sellers of sex. We conducted a systematic mapping review of the empirical research on transactional sex where women form the demand (buyer) and men the supply (seller). We included 46 studies, of which 25 explicitly researched women as buyers of sex from male sellers, and 21 studies where this topic was a subset of larger topics. The majority of research on women who trade sexual services from men is published in the last 15 years, by female researchers, using cross-sectional or qualitative/ethnographic design, and from the perspective of males as sellers. While the women appear to be mature and financially independent, the men are young and socioeconomically vulnerable. Men’s main motivation for the sexual-economic exchanges with women is financial, whereas women’s motivations are largely satisfaction of sexual needs and a stereotyped erotic fantasy of black male hypersexuality. Condoms are often not used. Our review shows that there is a – possibly growing and diversifying – female consumer demand for male sexual services, and transactional sex where women trade sex from men is a complex social phenomenon firmly grounded in social, economic, political, and sexual relations.

Background

Transactional sex is generally defined as the trading (buying and selling) of sex for material benefit, i.e. exchanging money, drugs, food, shelter, or other items for sex. This includes informal bartering by individuals whose primary income is not derived from transactional sex (Carael, Slaymaker, Lyerla, & Sarkar, 2006; Dennis, 2008; Stoebenau, Heise, Wamoyi, & Bobrova, 2016). While the instrumentality of the exchange is the linking factor, the boundaries of transactional sex are vague. For example, individuals may occasionally and opportunistically exact a fee or gift for a sexual service without perceiving themselves as someone who trades sex (Carael et al., 2006; Dennis, 2008; Harcourt & Donovan, 2005; Stoebenau et al., 2016). (For a discussion of various terms used for selling sex, see e.g., McMillan, Worth, & Rawstorne, 2018).

Carael et al.’s (2006) estimates of commercial sex, based on 78 national representative household surveys and nine city based surveys, found that between 1% and 14% of men had paid for sex in the last 12 months, with large discrepancies between regions. Although transactional sex varies enormously in its forms and transcends gendered, cultural, class and other boundaries, Carael and colleagues’ review (2006) and most other research on sexual-economic exchanges frame men as buyers and females as sellers of sex, with the growing body of research on men who trade sex with other men as an exception. In Harcourt and Donovan’s (2005) extensive typology of sex work, identified according to worksite, principal mode of soliciting clients, and sexual practices, there is little indication that women trade sexual services from men. However, as a type of indirect sex work, the authors acknowledged that men and boys—they name beachboys, bumsters, and gigolos—can be engaged by women for sexual purposes. As an example, ‘Chicken: Self-portrait of a young man for rent’, by Sterry (2002), is a memoir of the author’s experiences working as a teenage gigolo with a primarily female clientele in the early 1970s. Sterry recounts the circumstances leading up to his situation, characterized by desperation, need for love, and sexual assault. According to a recent comparative study (McCarthy, Benoit, & Jansson, 2014), both immediate circumstances like limited education, and negative experiences from early life, especially childhood poverty, abuse and family instability, are independently associated with adult sex work.

According to reviews, paid male sexual services are largely invisible in the global sex trade, but in growing demand. Dennis (2008) concluded that in Western countries, more adolescent boys than adolescent girls participate in sex exchange for money, and men comprise about 20–30% of the individuals arrested as vendors of sexual services each year. Recently, a content analysis of 499 male escort websites across 60 countries found that while most escorts advertise to other men, 11% of the sites were specifically for female clients and 10% for heterosexual couples (Kumar, Minichiello, Scott, & Harrington, 2017). Another website survey found comparable numbers (Scott & Minichiello, 2017). Similarly, Lee-Gonyea, Castle, and Gonyea’s (2009) review identified 17% of websites that advertised male escorts as catering to female clientele only and an ongoing study conducted in the UK found that 66% of escorts advertised to female clients (Smith & Kingston, in Kumar et al., 2017).

Indications of a growing market for women who seek paid sexual services with men are not only found online. Since the 1990s, Japan has seen a rapid increase in the number of host clubs – venues where men work as hosts to ‘entertain’ a mostly migrant female clientele – with over 200 clubs in Tokyo alone (Mahdavi, 2018). The entertainment varies by club and location, but most hosts describe it as selling romance, love and sex to their clients (Mahdavi, 2018; Takeyama, 2008). Further, several researchers (Bauer, 2014; Berdychevsky, Poria, & Uriely, 2013; Hamid-Turksoy, van Zoonen, & Kuipers, 2014; Meszaros & Bazzaroni, 2014; Miller, 2011; Sanders, 2010) have reported that increasing numbers of Western women travel to developing countries where romance and sex, including transactional sex, with local men is a central attraction. While sex has been linked to travel for centuries, after World War II, changes to women’s travel patterns co-occurred with broader changes in mass tourism, the sexual liberation movement, and women’s movement (Bauer, 2014) to the point where the four S’s (sun, sea, sand, and sex), have become hallmarks of the tourist experience (Berdychevsky et al., 2013; Miller, 2011). Gezinski, Karandikar, Levitt, and Ghaffarian (2016), who reviewed 21 sex tour websites, most of which advertised services in the Caribbean and Southeast Asia, found the majority used marketplace mythologies concerning race, class, and imperialism to appeal to travelers’ desires for fantasy experiences, power, and a White, “first-world” sense of identity. The websites, including four that depicted male sex workers, went to great lengths to sell the illusion of romance rather than sex-for-money, by using terms like “companion” and “escort” with whom the tourist would have “dates.” Specific to women, Meszaros and Bazzaroni’s (2014) review described how the growing commercialized sexual economy that White women engage in with Black men, highlights complex power relations based upon gender, class, nationality, and race.

To date, it is research on transactional sex that occurs between women as suppliers and men as clients that has been the most visible, while research on transactional sex where women are clients of men who trade sex appears limited and scattered. This systematic mapping review addresses a research gap in the literature about transactional sex by mapping and synthesizing the empirical research on transactional sex that occurs between men as suppliers and women as buyers, in order to better understand the scope of the current state of research and identify research gaps. Consolidating the existing research is an important step in the scientific process that extends past research and enables the construction of knowledge that is up-to-date with changing ideas and conceptual frameworks around transactional sex. This research has the potential to challenge common perceptions of the gendered behaviors in the sexual economy, and direct those interested in the subject, particularly in a sociocultural perspective.

Method

We conducted a systematic mapping review to consolidate any quantitative and qualitative research. Mapping reviews capture and describe the literature in one specific topic area (Arksey & O’Malley, 2005). Such reviews are suited to take stock of the research available in any given area and to map out the existing research, in order to establish tendencies and gaps that can identify future research opportunities (Arksey & O’Malley, 2005; Armstrong, Hall, Doyle, & Waters, 2011; Bates, Clapton, & Coren, 2007; Clapton, Rutter, & Sharif, 2009; Levac, Colquhoun, & O’Brien, 2010). It differs from a conventional systematic review in that the topic area is usually broader, methodological study quality is not an important issue, and the analysis may be crude (need only be fit for purpose) (Clapton et al., 2009).

We followed the guidelines in the Cochrane Handbook for Systematic Reviews of Interventions (Higgins & Green, 2011) with regard to defining the review question, searching for studies, selecting studies, and collecting data. Cochrane specialises in the synthesis of evidence concerning the effectiveness of interventions. Thus, we also followed the criteria that experts (Arksey & O’Malley, 2005; Armstrong et al., 2011; Bates et al., 2007; Clapton et al., 2009; Levac et al., 2010) apply to systematic mapping reviews and report in accordance with the PRISMA-ScR reporting guideline (Tricco et al., 2018).

Identification of Literature

The stages of the data selection process are presented in Figure 1. An information search specialist (JN) conducted the search in the following electronic databases: EMBASE, MEDLINE In-Process & Other Non-Indexed Citations (PubMed), PILOTS, POPLINE, PsycINFO (EbscoHost), Social Services Abstracts (ProQuest), Sociological Abstracts (ProQuest), Web of Science, from 1970 to April 2018, using neither language nor methodology search filters. The time period was chosen because our knowledge of the subject matter told us that research on this topic is unlikely to exist prior to 1970. The piloted, pre-tested search incorporated subject headings (e.g., MeSH terms in MEDLINE) and free text terms (in title and abstract) relating to transactional sex (e.g., bumster, escort, female sex tourism, beach boys, call boy, hustler, money boy). Additionally, we searched reference lists of relevant reviews, articles and included studies for further relevant references. The complete strategy is available upon request. We stored retrieved references in an Endnote database and deleted duplicate entries.

Figure 1. PRISMA flow diagram of literature reviewing process. k = number of studies.

Selection of Literature

To ensure accuracy and consistency of study selection, two reviewers (RB and SM/JN) independently screened first titles and abstracts and secondly full texts of identified studies for relevance, according to the inclusion criteria. For each of the two screening levels, we used pre-designed inclusion forms. We resolved differences in opinion in the screening process through re-examination of the study and subsequent discussion.

Inclusion and Exclusion Criteria

Given the aim of the review, the main inclusion criterion was that the study, using quantitative and/or qualitative methods, addressed transactional sex that occurs between men as sellers and women as buyers as a subject matter, but not necessarily the main one. Transactional sex was defined as the trading (buying or selling) of sex for material benefit (Stoebenau et al., 2016). Thus, the population in the studies could be men who trade sex to women, and women who trade sex from men, or both. We enforced no limitations on age, race/ethnicity, nationality or other participant characteristics. Unpublished reports, theses, abstracts, brief and preliminary reports, in any language, were considered for inclusion on the same basis as published works. Full texts of studies that were not available in the public domain we attempted to retrieve by contacting the main author.

Data Extraction and Synthesis

One reviewer (RB) extracted data from the included sources using a pre-designed data recording form to enable consistency, and SM checked the extraction. The extraction tool identified general information and study characteristics (author, year of publication, country, study design, aim, sample size), population characteristics (gender, age, other relevant demographics), and study results (frequency, motivation, consequences of transactional sex and other characteristics of the transaction). By keywording (Clapton et al., 2009) each study by such variables, and compiling the data in a single spreadsheet, we could group them according to their chief characteristics and carry out descriptive analyses by using frequencies and cross-tabulations. The grouping included sorting the variables into clusters according to how they were seen to relate to each other, following a data driven approach (Arksey & O’Malley, 2005; Clapton et al., 2009). Similarly, we copied the main findings, restricted to instances across the data with relevance to transactional sex, of the qualitative and ethnographic studies in a word document. To classify patterns (themes) within data, we used manual thematic analysis, as outlined by Braun and Clarke (2006). We looked for repeated patterns, responses, or meaning across the data set that captured seemingly important issues linked to the data themselves (Braun & Clarke, 2006; Ryan & Bernard, 2003). We did not assess studies’ methodological quality because that is not a prerequisite in systematic mapping reviews.

Results

The searches identified 19,615 individual records, of which 134 were considered potentially relevant (Figure 1). We included 46 studies, presented in 54 publications, on transactional sex where women formed the demand (buyer) and men the supply (seller). Most publications (76%) were journal articles, but we also included seven book chapters, three conference abstracts, and three theses/dissertations. All were in English.

Characteristics of the Included Studies

The 46 studies covered a time span of 40 years, from 1978–2017, although three quarters of the studies were published in the last 15 years (Tables 1 and 2). The lead author was typically female (63%). The studies’ perspectives varied, from public health (54%) to anthropology (24%), sociology (11%), feminism (4%), and psychology (3%); it was unclear in two studies. By extension, the dominant study designs were cross-sectional (40%), ethnographic (26%), and qualitative (23%). Although the 46 studies covered a total of 21 countries, the setting was largely the Caribbean (31%), Africa (31%), and Asia (18%). Most of the studies included only male study participants (67%) and based on the 28 studies that provided information about sample size, 5,690 participants were included (range 1–1,087, average 217) of which 5,109 (90%) were male. The ages of the study participants ranged from 11 to 75 years; 15 studies gave no information about participants’ age.

Table 1. Characteristics of included studies (N = 46)

Author, year	Study design	N	Country	Aim
Bergan, 2011	ethnography	ns	Kenya	understand the motives behind beach boys’ desire to enter into romantic relationships with elderly female tourists
Bowring et al., 2017	qualitative	31	Laos	explore behaviorally bisexual men’s experience, motivations, and perceptions related to transactional sex
Bowring, van Gemert, et al. 2015	cross-sectional	88	Laos	explore occurrence of transactional sex among behaviorally bisexual men
Busari et al., 2011	cross-sectional	62	Nigeria	describe female clients and partners of MSM-SW and determine risk factors for unprotected sex between women and MSM-SW
Cai et al., 2010	cross-sectional	394	China	investigate HIV infection prevalence and risk factors among MSW
Caldwell & de Wit, 2017	qualitative	21	Australia	explore women’s experiences buying sex
Chege, 2017	ethnography	21	Kenya	research male beach workers with regard to the intimate relationships many of them seek to establish with foreign white female tourists
Choudhry, 2014	cross-sectional	1087	Uganda	determine the prevalence of transactional sex among university students and assess the possible relationship between transactional sex and sexual coercion, physical violence, mental health, and alcohol use
Dahles & Bras, 1999	qualitative	100	Indonesia	address the extent to which the opportunity to enter into a sexual relationship with Western female tourists poses a challenge to the vast number of self-employed young men in Indonesian tourism destinations
de Albuquerque, 1999	observational ^1	ns	Barbados, Jamaica	explore relationship between beachboys, rent-a-dreads, and female tourists in the Caribbean
Embleton et al., 2015	qualitative	45	Kenya	describe the sexual behaviors of street-connected children and youth
Estcourt et al., 2000	cross-sectional	94	Australia	assess prevalence of HIV and STIs, risk behaviors, and demographics in male commercial sex workers
Ford et al., 1995	cross-sectional	80	Bali	describe the AIDS/STD knowledge and risk behaviors, and to determine factors related to condom use among male commercial sex workers and male tourist clients
Frohlick, 2013	ethnography	63	Costa Rica	explore the particularities of how North American women give money to men with whom they are having sex on holiday and what that giving means
Gil-Llario et al., 2015	cross-sectional	100	Spain	identify the influence of perceived probability of HIV infection, associated fear, and history of STI, on condom use in MSW
Green et al., 2017	ethnography	25	India	investigate sex tourism
Haley et al., 2004	cross-sectional	542	Canada	compare HIV risk factors of male street youth involved in survival sex with those of their never involved peers and to describe their sexual activities
Herold et al., 2001	qualitative	66	Dom. Republic	analyze the types of interactions occurring between beachboys and female tourists
Johnson, 2016	ethnography	54	Jamaica	assess how sex tourism is understood and experienced
Karch & Dann, 1981	qualitative	ns	Barbados	highlight role negotiation with respect to beachboy phenomenon; examine tourist-beachboy encounters from an interactionist standpoint
Katsulis & Durfee, 2012	cross-sectional	40	Mexico	investigate prevalence and correlates of sexual risk behaviors among male and female sex workers
Kibicho, 2004	cross-sectional	41	Kenya	explore the MCSWs roles as commercial sex workers and to evaluate their dependency levels on the tourism industry when conducting their business
Lion et al., 2017	cross-sectional	201	South-Africa	identify correlates of sex trading for tik or money in male and female methamphetamine users
Liu et al., 2012a	cross-sectional	418	China	analyze money boys’ condom use behaviors with various partners
Liu et al., 2012b	qualitative	28	China	evaluate money boys’ role for transmitting HIV and STIs
Mai, 2017	ethnography	17	Tunisia	present an authoethnographic account of young men working as ‘professional boyfriend’ in the tourist intimate industry in Sousse
Mannava et al., 2013	cross-sectional	867	Kenya	investigate self-reports of heterosexual anal intercourse among MSM-SW, and to identify the socio-demographic characteristics linked with the behavior
Martis, 1999	qualitative	ns	Curaçao, St. Maarten	examine the relationship between tourism and prostitution in St.Maarten and Curaçao
Meekers & Calvès, 1997	qualitative	ns	Cameroun	examine current types of sexual relationships among urban youths, and to examine the marriage prospects of these premarital relationships, as well as male-female differences in emphasis placed on formal unions
Meiu, 2015	ethnography	ns	Kenya	describe how the commodification of the moran’s sexuality generated new contradictions in the temporalities of ageing among the Samburu
Nyanzi & Bah, 2010	ethnography	ns	Gambia	explore the sub-theme of sex tourism
Odunlami, 2009	ethnography	62	Ghana	focus on African male perspectives and various issues that arise from their participation in sex tourism such as power relations, gender inequality and empowerment
Phaswana-Mafuya et al., 2014	qualitative	135	South Africa	explore sugar mommy practices regarding their occurrence, acceptability, and perceived reasons
Phillips, 2002	ethnography	30	Barbados	explore issues of gender identification and negotiation between the white female tourists and black beachboys
Pisani et al., 2004	cross-sectional	250	Indonesia	establish the prevalence of HIV, syphilis, and sexual risk behavior among three groups of MSM; investigate sexual links between these men and broader heterosexual populations
Pleak & Meyer-Bahlburg, 1990	cross-sectional	50	USA	assess sexual behavior patterns and AIDS knowledge among young male prostitutes
Press, 1978	qualitative	ns	Barbados	describe and examine male heterosexual prostitution and its relationship to male socio-sexual identities
Pruitt & Lafont, 1995	ethnography	ns	Jamaica	examine the negotiation of gender identity as foreign tourist women engage local men in Jamaica in emotional and intimate relationships
Reilly et al., 2014	cross-sectional	394	USA	examine the prevalence and correlates of selling sex among male IDUs
Sethi et al., 2006	cross-sectional ^2	628	England	describe changing characteristics of men who sold sex
Smith et al., 2015	descriptive ^3	82	Kenya	compare sexual risk behavior of MSM-SW with female partners to MSM-SW with only male partners
Takeyama, 2008	ethnography	ns	Japan	investigate Japan’s host clubscene, where working class men ‘sell’ romance, love, and sex to their female clients
Taylor, 2006	ethnography	~233	Jamaica, Dom. Republic	research the sexual-economic exchanges between tourist women and local men and boys in the informal tourist economy
Taylor & Sunderland, 2003	descriptive ^4	1	na	examine how masculinities are represented by analyzing an article about a male escort
Wagner et al., 2013	cross-sectional	170	Mexico	examine the extent to which drug-using male clients of female sex workers have also been paid for sex
Ziersch et al., 2000	cross-sectional	80	England	evaluate the effectiveness of a pilot peer education STI prevention program with male sex workers

Legend: 1 = observations of interactions and informal interviews; 2 = cohort but article provides cross-sectional results; 3 = prospective behavioral diary study; 4 = critical discourse (textual) analysis of a magazine article; ns = not stated; IDU = injection drug user; MCSW = male commercial sex worker; MSM = men who have sex with men; MSW = male sex worker; STI = sexually transmitted infections; SW = sex worker

Table 2. Summary characteristics of the included studies (N = 46)

Characteristics	All studies (N = 46)	Women clients (n = 25)	MSM (n = 14)^3	Other (n = 7)
Year of publication
2015–2017	12 (26)	7 (28)	5 (36)
2010–2014	13 (28)	5 (20)	4 (29)	4 (57)
2005–2009	4 (9)	3 (12)	1 (7)
2000–2004	8 (17)	4 (16)	2 (14)	2 (29)
1990–1999	7 (15)	4 (16)	2 (14)	1 (14)
1980–1989	1 (2)	1 (4)
1970–1979	1 (2)	1 (4)
Country/Setting ^1
Australia	2 (4)	1 (4)	1 (7)
Bali	1 (2)		1 (7)
Barbados	4 (9)	4 (16)
Cameroun	1 (2)			1 (14)
Canada	1 (2)			1 (14)
China	3 (7)		3 (21)
Costa Rica	1 (2)	1 (4)
Curaçao & St.Maarten	1 (2)	1 (4)
Dominican Republic	2 (4)	2 (8)
England	2 (4)		2 (14)
Gambia	1 (2)	1 (4)
Ghana	1 (2)	1 (4)
India	1 (2)	1 (4)
Indonesia	2 (4)	1 (4)	1 (7)
Jamaica	4 (9)	4 (16)
Japan	1 (2)	1 (4)
Kenya	6 (13)	4 (16)	1 (7)	1 (14)
Laos	2 (4)		2 (14)
Mexico	2 (4)		1 (7)	1 (14)
Nigeria	1 (2)	1 (4)
South Africa	2 (4)	1 (4)		1 (14)
Spain	1 (2)		1 (7)
Tunisia	1 (2)	1 (4)
Uganda	1 (2)			1 (14)
USA	2 (4)		1 (7)	1 (14)
Study design
Cross-sectional	17 (37)	1 (4)	11 ()	5 (71)
Ethnography	12 (26)	12 (48)
Qualitative	12 (26)	8 (32)	2 (14)	2 (29)
Other ^2	4 (9)	3 (12)	1 (7)
Gender of participants
Male	30 (65)	11 (44)	14 (100)	5 (71)
Female	1 (2)	1 (4)
Male and female	14 (30)	13 (52)		1 (14)

Legend: 1 = three studies took place in two countries 2 = see Table 1; 3 = two studies with MSM-SW specifically investigated the women clients and are counted there.

We categorised the studies by objective/aim. Just over half of the studies (k = 25) explicitly researched women as buyers of sex from male sellers. Another 14 studies were on MSM-SW (men who have sex with men and sell sex) who also had female paying clients. The remaining seven studies concerned diverse populations, but all provided some data on women as buyers of sex from men. We detail the characteristics and the findings of these three categories of studies below.

Studies in Which the Main Research Focus was Women as Buyers of Sex from Men

There were 25 studies with a main research focus on women as buyers of sex from men. The large majority dealt with women who traded sex abroad (k = 19) (Bergan, 2011; Chege, 2017; Dahles & Bras, 1999; Davidson & Taylor, 2005; De Albuquerque, 1998; Frohlick, 2013; Green, Scrase, & Ganguly-Scrase, 2017; Herold et al., 2001; Johnson, 2016; Karch & Dann, 1981; Kempadoo, 2001; Kibicho, 2004; Mai, 2017; Martis, 1999; Meiu, 2015; Nyanzi & Bah, 2010; Odunlami, 2009; Phillips, 2002; Press, 1978; Pruitt & Lafont, 1995; Taylor, 2001, 2006). Additionally, two studies investigated women as clients of MSM-SW (Busari, Nakayima, & Busari, 2011; Smith et al., 2015), and the remaining ones examined the motivations of Australian women buying sex (Caldwell & de Wit, 2017), sugar-mommy practices (Phaswana-Mafuya et al., 2014), male escorting (Taylor & Sunderland, 2003), and Japan’s host clubscene (Takeyama, 2008).

Studies that Involved Tourist Women as Buyers of Sex from Men

The setting for the 19 studies about sexual-economic exchanges between tourist women from the global north and local men—termed beachboys, rent-a-dreads, jungees, gigolos, hustlers, bumsters, sanky pankies, and professional boyfriends, depending on the country—was the Caribbean (k = 10)¹ , Kenya (k = 4), Gambia, Ghana, India, Indonesia, and Tunisia. The data were collected over a 40-year time span (early 1970s to 2014). Most of the studies had a female lead author (k = 11), an anthropological or sociological perspective (k = 14), accompanied by an ethnographic or qualitative research approach (k = 18) that conveyed mostly the men’s but also women’s viewpoints (k = 12). That is, most of the studies presented largely male sellers’ subjective perspectives. The only studies indicating a particular conceptual framework were found in this group of studies and they included social constructivism (k = 2), feminism (k = 2), neoliberalism, interactionism, and postcolonialism. Eight of these 19 studies did not state the sample size, but in those that did it ranged from 17–233 (total n = 712).

Common for all 19 studies was that the setting was a coastal town or beach resort, where the sexual exchanges were between white tourist women from rich developed countries (North America or Europe) and dark-skinned local men from economically underdeveloped countries. While the tourist women were of various ages (but mostly 40 and above), middle-class, well educated, and well-traveled, the local men were young (late teens to early 30s), poorly educated, and from low socioeconomic backgrounds. They were working-class or underemployed with few qualifications, and typically worked in the informal beach economy, exchanging sex part-time.

A theme in most of the studies was that the young men resisted the activity as prostitution or sex work, euphemistically labeling themselves as “players” (Martis, 1999, p. 211) or “besness men” (Mai, 2017, p. 492) and the activity as beach bumming, hustling or “showing female tourists a good time” (De Albuquerque, 1998, p. 108). Yet, researchers like Bergan (2011) found that “they emphasize that it is a way of making money like any other job” and that constantly securing attention, romancing, keeping the women’s trust, and juggling several women simultaneously was “hard work” (p. 96). Further, a common finding in the studies was that the men used “consciously applied tactics” to seduce the women (Bergan, 2011, p. 53). The men were exceptionally adept at sweet-talking, using rehearsed flattery and traditional gendered “mating” roles. Relatedly, the sexual exchanges—often occurring within a short period after having met—were typically staged as courtship around heterosexual codes of sexuality, with the men initiating the contact to these short-lived liaisons. Some connections lasted longer, with women continuing as financial provider from their home country (see e.g. Frohlick, 2013). A “discourse of romance” (De Albuquerque, 1998, p. 107) and giving a “good impression of love” (Mai, 2017, p. 487) were part of the men’s performance patterns. A Ghanaian beach boy stated: “Some of the guys can fool the white ladies. They pretend to love which is not really true” (Odunlami, 2009, p. 68).

All of the studies found that the men’s main motivation for the liaisons with women tourists was financial, with sexual pleasure and peer status as secondary reasons. For some, it was a short-term subsistence strategy to supplement their meagre incomes and for others to increase long-term economic mobility, including escaping poverty by way of marriage and visa sponsorships. As one Kenyan man said: “Poverty motivates black guys to hustle for white ladies” (Odunlami, 2009, p. 74). However, as part of the staged affectionate involvement, the men would underplay the commercial side of the relationship and not directly ask for payment. Rather, at a carefully chosen time, they would insinuate an expectation of gifts or indicate a lack of money, often telling false plight stories or financial responsibilities for relatives. In turn, women “helped out” financially by paying for expenses, giving cash or buying items such as clothes, electronics, cars, and similar. That is, payment for sexual services was generally couched as a gift, donation, sponsorship, or an expression of generosity. Occasionally, however, “tourist women offer cash payment outright to them for sexual services” (Frohlick, 2013, p. 157). Herold et al.’s (2001) informants said they generally received $100–500 from each woman. Kibicho (2004)—the only quantitative study on transactional sex between tourist women and local men—found that the price for sexual services depended on the type of sexual service, from about 10 US$ for short-term intercourse to 95 US$ for a full day.

It should be mentioned that regarding the theme of safe sex, several studies found that condoms were not consistently used. The men were often reluctant to use condoms, explaining that it reduced their pleasure, but they would oblige their tourist partner if she insisted on it. One exception is the commercial sex workers in Kibicho’s (2004) study, who all stated that they used condoms for penetrative sexual services because of fear of HIV and because it gave the “clients confidence in my services” (p. 135).

The majority of the studies found that the men had a hierarchy of preferred tourist clients, with the most sought after being Canadian or European women with long straight hair. Additionally, most of the studies concluded that men preferred “old white women” (Meiu, 2015, p. 483), because, as one man explained “They are happy to spend money more than the young ones” (Nyanzi & Bah, 2010, p. 566). In India, the Jungees labelled such women “ATM Amamajis” (i.e. ATM grandma. Green et al., 2017, p. 110). Herold et al.’s (2001) informants stated that their main target groups were older women—“the older the better,” one beach boy said in Bergan’s study (2011, p. 46)—and younger overweight or unattractive women, because they were likely to provide more money. A Dominican man explained “sex is not for pleasure, but a business, I don’t care if the woman is beautiful or not. I’d rather go out with someone ugly if she’s got money” (Taylor, 2006, p. 51).

Concerning the tourist women’s perspectives, twelve of the studies provided some information. Three of them (De Albuquerque, 1998; Herold et al., 2001; Phillips, 2002) described rather similar typologies of buyers (using slightly different labels), ranging from women who emphasized the romantic element and did not travel with the intention of exchanging sex with a local man, but would when the opportunity presented itself, to women who travelled explicitly for sex. Similar to the men, the women interviewed in these studies were unwilling to acknowledge the pecuniary nature of the liaisons, many labeling their sexual encounters holiday romance or situational romance, while others conceded the relations were “purely physical” with “no commitment” (Taylor, 2006, p. 50). One English woman said: “I come for sex, of course the sun, but mostly the sex … I just want some fun and good sex” (Taylor, 2006, p. 50). Taken as a whole, the studies found that tourist women’s initial motivations for sexual involvement with the local men varied, from mainly romance to mainly sex. Yet, a common theme of motivation in almost all studies (all set in Caribbean and African countries), was the women’s racialized fantasy of black male hypersexuality. Black and/or Caribbean men were the desired exotic Other, considered ‘real’ or ‘authentic’ men, based on stereotypes of black male bodies. An American woman stated: “[in Jamaica] they get what they don’t get back home … It’s like a secret, like a fantasy and then you go home” (Davidson & Taylor, 1999, p. 50).

A prominent theme of the 19 studies about transactional sex between tourist women and local men was the inequalities that underpinned these exchange relationships, not just economic, but also racial, social, political, and structural. Most of the researchers concluded that the sexual-economic exchanges were predicated on women’s economic and social privilege as first world citizens. They noted how the massive disparity in status between the partners in these relationships created opportunities for exploitation, with some (Bergan, 2011; Davidson & Taylor, 1999; Odunlami, 2009; Phillips, 2002) proposing these relationship could be considered neo- or post-colonialist, but others (Herold et al., 2001) denying the relations were exploitative. According to Johnson’s (2016) findings, the men were acutely aware of the socioeconomic inequalities: “participants spontaneously discussed existent asymmetries between them and the wazungu [white] women. Several pointed out that what was a source of livelihood for them was often but a casual distraction for holiday sex-oriented visiting women” (p. 73). Stressing the importance of authority and control, Taylor (2006) wrote: “An American woman, who was a regular visitor to Jamaica, summed up a popular recurring view of many women interviewed and was explicit about the control she enjoyed: ‘Women who come [to Jamaica] like control. They don’t need a man in their lives except for sex … Better to have someone uneducated that acts like a lackey and in your control, so you can say when it starts and when it stops’” (p. 49). Men attempted to make up for the non-traditional gender- and unequal power relations by behaving according to what they perceived as masculine, including sleeping with a lot of women, boasting of their sexual prowess and genital size, deciding what to do, “talking a lot and loudly, consuming large amounts of alcohol and fighting in public places” (Bergan, 2011, p. 44). Yet, the majority of the studies, with Johnson (2016) as an exception, noted how the men’s broader community criticized their hustling as unmanly, subject to ridicule, loss of respect, and gossip.

Studies that Did Not Involve Tourist Women

This section deals with the six studies that did not involve tourist women (Busari et al., 2011; Caldwell & de Wit, 2017; Phaswana-Mafuya et al., 2014; Smith et al., 2015; Takeyama, 2008; Taylor & Sunderland, 2003). Broadly, the two quantitative studies that investigated women as clients of MSM-SW recruited 144 men from Nigeria and Kenya and found that about 65% of the men’s clients were women (Busari et al., 2011; Smith et al., 2015). Additional details about MSM-SW and their female clients follow below. Relatedly, another study set in Africa explored the phenomenon of sugar-mommy practices, described as younger men having sexual relationships with older women for material gain. This qualitative study recruited 135 men and women from the community. The main finding was that sugar-mommy practices were becoming increasingly prevalent and acceptable (Phaswana-Mafuya et al., 2014).

One qualitative study was only available as an abstract: It described 21 Australian women’s motivations for buying sex from men. About half cited sexual pleasure, eight stated it was for therapy, and two women did it for entertainment (Caldwell & de Wit, 2017). Another unique study was a critical discourse analysis of a men’s lifestyle magazine article about a heterosexual male escort. The authors determined that the article had a strong discourse of hegemonic masculinity, with the escort presented as a professional, a sexual expert, and a man in control, while conversely, the female clients were presented negatively (Taylor & Sunderland, 2003). Lastly, we identified one scholarly work on host clubs, specifically an ethnography of Japan’s host clubscene, where working class men “sell romance, love, and sex” to female clients (Takeyama, 2008, p. 30). Takeyama found that both hosts and clients attempted to “cultivate their desirable selves: occupationally successful men and sexually attractive women” (p. 30), but that this affect economy, as Takeyama called it, essentially underscored gender subordination and social inequality. The “pillow hosts” (makura hosuto = a host who sleeps with his clients) generally denied they were sex workers or prostitutes, presenting themselves instead as self-motivated, desirable entrepreneurs. The clients self-narrated as self-fulfilled women, who were drawn to the lavishly decorated hostclubs to pursue a fantasy of freedom and escape from their everyday lives.

Studies about MSM Who Sold Sex to Men and Sometimes to Women

There were 14 studies about MSM-SW which contained data on women as clients, presumably in their home countries (Bowring et al., 2017; Bowring, Pasomsouk, et al., 2015; Bowring, van Gemert, et al. 2015; Cai et al., 2010; Estcourt et al., 2000; Ford, Wirawan, Fajans, & Thorpe, 1995; Gil-Llario, Ballester-Arnal, Salmeron-Sanchez, Morell-Mengual, & Gimenez-Garcia, 2015; Katsulis & Durfee, 2012; Liu et al., 2012a, 2012b; Mannava, Geibel, King’ola, Temmerman, & Luchters, 2013; Pisani et al., 2004; Pleak & Meyer-Bahlburg, 1990; Sethi et al., 2006; Ziersch, Gaffney, & Tomlinson, 2000). All of the studies on MSM-SW had a public health perspective, most were cross-sectional (k = 11), and they covered ten different countries (Tables 1 and 2). The sample sizes (stated in all studies) ranged from 28–867, with a total of 3,292 MSM between the ages of 14–59 (average about 23 years). Across the nine studies that described the sexual identity of the men, these were 13–76% gay, 13–75% bisexual, 2–25% heterosexual.

Disregarding recall time, which varied from currently to ever, across the ten studies where it could be calculated, we found that an average of 17% (521 of 3,138 men; range 0.4–65%) sold sex to women. Two other studies stated that 58% of the men had female clients. Additionally, while three studies gave no further results related to women clients (Estcourt et al., 2000; Katsulis & Durfee, 2012; Pisani et al., 2004), the findings from the remaining studies showed that the median number of female clients averaged 1–2 per month (range 0–36), sexual behaviors included anal and vaginal sex (very rarely oral sex), and condom use was inconsistent and often lower than with male clients. Liu et al. (2012a), who interviewed Chinese money boys about their sexual practices, concluded that many of the heterosexual and bisexual men eagerly sought sex with women. In contrast, young male prostitutes in New York City explained they had become involved in occasional heterosexual prostitution while soliciting for men (Pleak & Meyer-Bahlburg, 1990). The same appeared to be the case among behaviorally bisexual men in Laos, who in focus group discussions explained that women who paid men for sex were older women (Bowring et al., 2017).

Other Studies with Some Data on Women as Buyers of Sex from Men

Seven public health-oriented studies that examined various groups’ sexual behaviors, including transactional sex, provided some data on women as buyers of sex from men (Choudhry, Ostergren, Ambresin, Kyagaba, & Agardh, 2014; Embleton et al., 2015; Haley, Roy, Leclerc, Boudreau, & Boivin, 2004; Lion, Watt, Wechsberg, & Meade, 2017; Meekers & Calvès, 1997; Reilly, Neaigus, Wendel, Marshall Iv, & Hagan, 2014; Wagner, Pitpitan, Chavarin, Magis-Rodriguez, & Patterson, 2013).

There were three cross-sectional studies on drug-using men. All three found that selling sex to women was more common than to men (average 20% vs 13%). Among Reilly et al.’s (2014) 394 U.S. male IDU participants, correlates of selling sex to women included factors such as having three or more sex partners, crack use, and receptively sharing syringes. Similarly, among 170 drug-using male clients of female sex workers in Mexico, having female paying clients was correlated with being positive for HIV/STIs (Wagner et al., 2013). The last study, with 201 methamphetamine users from South African townships, reported that 25% had sold sex to women in the past 3 months (Lion et al., 2017).

Two studies concerned street-connected male youth. The first was a cross-sectional study from Canada that investigated survival sex among 542 homeless males (age 14–23). Of the 28% who had ever sold sex, 32% had only sold to women (27% to both genders) with a median number of two female clients (range 1–75). Vaginal sex was the most common sexual activity with women clients (55%) followed by oral sex (52%) and anal sex (16%) (Haley et al., 2004). The second study was qualitative, among 45 street-connected males (age 11–24) in Kenya. The interviewees explained that it was common for adult women to buy sex from boys (Embleton et al., 2015).

Lastly, a qualitative study of urban youth (age 17–25) in Cameroon found that the 1990s’ economic recession had increased the number of young men, especially students, who engaged in sexual relationships with “sugar-mummies.” The three men in the study who disclosed having such relationships explained that they exchanged sexual favors in order to get food or money (Meekers & Calvès, 1997). The last study was cross-sectional and included 1,084 university students in Uganda. Of the 6% of men who had ever sold sex, 4% had sold to women and 2% had sold to men (Choudhry et al., 2014).

Discussion

This systematic mapping review identified 25 studies that explicitly researched women as buyers of sex from male sellers, and 21 studies where it was a subset of larger topics.

Overall Findings

Taken as a whole, this review demonstrates that research on women as sex clients is relatively rare, and the vast majority of studies have focused on the perspective of males as sellers. It also shows that while engaging sexual services from men is likely not a widespread behavior among women, there is a female demand for male sex workers and markets of transactional sex exist to service women.

In our included studies, information about the women who trade sex from men was limited, but they appear to be, relative to the male sellers, older, educated, and economically comfortable. This mirrors findings of about 20,000 male sellers and buyers of sex, which showed that youth was a tradable commodity, with marked sociodemographic differences in the sexual-economic exchanges by payment direction (Berg, Schmidt, Weatherburn, & The EMIS Network, 2015). While women appear to mainly engage male sexual services to satisfy their sexual needs, other motivations also seem be at play and will be further discussed below. Regarding markets, the men who trade sex to women are largely unofficial market procurers who appear to be in a situation of sociostructural disadvantage in which their agency is circumscribed. They are young, uneducated, have low income and unstable housing, and often use drugs. Selling sex is principally an attempt to escape financial constraints. This finding is similar to that of other studies (e.g., McCarthy et al., 2014), particularly Chow, Iu, Fu, Wilson, and Zhang’s (2012) review of 32 papers on sexual risk among Chinese money boys, and Dennis (2008), whose review of 166 papers on males who trade sex revealed most entered sex work through poverty, lack of legitimate marketable skills, and desperation. Although not literally coerced, their “decision” to sell sex was not based on a comparison of options. Thus, our review points to material inequalities and poverty as characteristics of transactional sex in which men trade to women, just as it is when they trade to men (Berg et al., 2015; Dennis, 2008).

Restricted agency notwithstanding, an interesting finding was that in many studies the men used a discourse of hegemonic masculinity concerning their trading of sex. Similar to findings in the review by Dennis (2008), both the Japanese pillow hosts and the beach boys generally denied they were sex workers, renaming the behavior into neutral local or international terms instead, and presenting themselves as self-motivated sexual experts, desirable entrepreneurs and “besness men”. Through narrative manipulations, they re-framed the behavior as a masculine, more socially acceptable one, thus minimizing the stigma associated with a “feminine,” shameful behavior. According to Goffman (1963) and Sanders (2005), name changing is a common coping strategy to reduce stigma. Similarly, both the men and the women, particularly in the studies on women who trade sex on vacation, used a discourse of romance and gender stereotypical strategies regarding the encounters, which framed the interactions within patriarchal heterosexual normativity. This way, although the sexual script was compressed, women’s relations with local men appeared much more acceptable and benevolent. A parallel finding was presented in Lee-Gonyea et al.’s (2009) review of male escorts advertising to women on the internet. The presentation of the male escorts attempted to give the impression that women were simply arranging a date with a man. Relatedly, performance was important in the body of included research. Findings by Taylor (2006), Phillips (1999), and Takeyama (2008) revealed how the men performed masculinity that conformed to preexisting stereotypes. This is reminiscent of the marketplace mythologies that Gezinski et al. (2016) found were used by sex tour websites to appeal to buyers’ desires for fantasy experiences. In the language of Mullings (2000), it could be said the men engaged in product-marketing performances typified by heterosexual intimacy. Such labor that involves performances of love and intimacy as service has been labelled intimate/affect/emotional labour (Brennan, 2007; Mahdavi, 2018; Takeyama, 2008). According to Katsulis and Durfee’s (2010) findings, male sex tourists frequently mistake female sex workers’ gendered performances for racial and cultural differences, believing that such behaviors seen in sex workers apply to all local women. The same may be true for women travelers who trade sex from men.

Findings from all three types of our included studies suggest that condoms are often not used when men trade sexual services to women, and drug-using men often shared syringes and tested positive for HIV/STIs; thus, there is a risk of (among others) HIV/STI transmissions in these sexual encounters. Systematic reviews (Svensson et al., 2018; Vivancos, Abubakar, & Hunter, 2010) have demonstrated that casual travel sex is quite common and women who develop new sexual partnerships abroad have an increased risk of STIs.

Findings from Studies about Transactional Sex between Foreign Tourist Women and Local Men

Our review cannot confirm what Bauer (2014) stated was an increase in the number of women who travel to destinations in developing countries purposefully seeking romance and sex—none of the included studies addressed prevalence—but the number of studies on this topic is certainly expanding. Common to all 19 studies was that the transactional sex was between middle-aged tourist women from the global north and younger local men from economically underdeveloped countries. Given the enormity of their disparate relationships to institutional power and social, political and economic capital, the inequalities that underpin the exchange relationships cannot be ignored. Brennan (2007) used the term “sexscapes” to describe this form of capitalist economy. She described the qualifying characteristics as international travel from the developed to the developing world, consumption of paid sex, and inequality. While the foreign tourist women are temporarily escaping their world of work and daily routine, and may not fully realize that they are part of a sexual-economic exchange, the men’s sexual interactions with tourists are planned and often part of their daily work. They depend on an unpredictable tourism industry and Western women for financial survival, and in the process risk becoming outcasts in their own community.

As an extension of inequality, our review found there is an underlying power imbalance between female tourist buyers of sex and male sellers. We recognize that power differentials are pervasive and in constant negotiation (see e.g., Foucault, 1998). However, as concluded also by Brennan (2007), Mullings (2000), and Hamid-Turksoy et al. (2014) – who conducted an analysis of the relationships between older British women and the younger Turkish lovers they met on their holidays—globalized neo-colonialistic hierarchies of race, class, citizenship and mobility create a power inequality between the foreign tourist women and the men, that women, wittingly or unwittingly, take advantage of. Although authentic romantic relationships can and do develop, within these sexual encounters women are in charge, which means there is a reversal of traditional gender roles. According to Brennan (2007), sex between white tourist women and black men in a postcolonial context is a transfer point of power. Weichselbaumer (2012), building on interviews with female travelers who had been involved with Caribbean males during their holidays, used the concept of the “carnivalesque.” Similarly, Thomas (2005) used the term “liminoid period” to describe this temporary suspension of the established order and inversion of hierarchies in such relationships.

With regard to tourist women’s motivations for sexual-economic exchanges with local men, this seemed to vary, but prime among them was a stereotyped erotic fantasy of black male hypersexuality. Related to the topic of gendered performances mentioned above, the women appeared to ascribe the darker male body a sexual prowess not found in Western White men. Looking and being different from Western men, their “otherness,” was a strong attraction. From the vantage point of Brennan (2007) and more recently, Meszaros and Bazzaroni (2014), cultural and racial differences are exoticized and eroticized. That is, women travelers are motivated by racialized desire. In the same way, the women tourists, often blond and blue eyed, represented an exotic trophy for the local men. Meszaros and Bazzaroni’s (2014) work described how over time, interracial relationships have become fetishized commodities on the transnational market, noting particularly how Black men’s historically dangerous hypersexuality has now become a valuable commercial commodity available to women from the global north. As also proposed by others (e.g., Berdychevsky et al., 2013; Davidson & Taylor, 1999; Yokota, 2006), rather than seeking a purely sexual experience, many tourists who engage in sex while on vacation appear to seek a fantasy experience. Pursuit of sexual pleasure and fantasy was expressed also among Japanese host club patrons. According to Gezinski et al. (2016) and Johnson’s (2007) research, sex tourists often arrive at their vacation destination with preconceived myths about the place and the people, for example that sex is more natural in “undeveloped” countries, and indeed select specific locations because of these myths.

Strengths and Limitations

The main strength of our review was our systematic approach, including searches, selection, and data extraction. The explicit inclusion/exclusion criteria and the standard data extraction framework ensured consistency, and the data analysis enabled us to identify commonalities and trends in the individual study results. Yet, limitations to our systematic mapping review should be noted, including the fact that new studies may have been published after our last search and that three potentially relevant dissertations could not be located. We consider it likely that other studies of MSM-SW with data on women clients exist, but without mention of women in the title, abstract or keywords, such studies are near impossible to identify. It must also be noted that while different researchers can interpret what counts as transactional sex slightly differently, we included only studies where it was stated that payment was exchanged for sex (list of study statements is available upon request). It was not within the scope of this review to compare women as customers of sexual services to men as customers. For a discussion of differences in online escort websites, see Lee-Gonyea et al. (2009), and for sex tourism, see Bauer (2014).

Implications

The size and spread of the populations involved in transactional sex where women trade sexual services from men are impossible to specify, but the basic characteristics of these populations are beginning to emerge. While the women appear to be mature and financially independent, the men are young and socioeconomically disenfranchised. Thus, the behavior cannot be addressed outside of the context of poverty and socioeconomic differentials prevailing within and across countries. When women travelers engage in transactional sex in the global south, the behavior appears to be partially built on notions of racial hierarchies and colonial legacies. As highlighted by other researchers (Miller, 2011; Ward & Aral, 2006), poverty and inequalities have led to a rise in the number of people involved in transactional sex. Our results therefore argue for a continued social and cultural focus on this phenomenon, recognizing that it is embedded within and subject to historical circumstances, socialization, and different sociocultural contexts.

While it is difficult from available research to make inferences about health implications, our review indicates that when men trade sexual services to women, this may carry important sexual health implications. Lastly, we are in agreement with Gezinski et al. (2016), who concluded that attention to the power of language, cultural myths and framings that surround paid-for sex transactions is important.

Given this study is summative in nature, it is not only useful in arriving at a general understanding of the phenomenon, but it also gives rise to further research avenues. Our review demonstrates that there is a scarcity of studies from high income countries, areas such as law and medicine, and on the perspective of women buyers of sexual services. The latter is likely due to difficulties in gaining access to a sample of such individuals and cultural blindness to the existence of female sex clients. As true for most behaviors, selling sex is entrenched in and shaped by sociocultural contexts, historical conditions, patterns of inequalities, and political realities. To gain a deeper understanding of these forces, it would be fruitful to compare transactional sex in locales with different sociocultural contexts, and male and female sellers of sex. Other useful ways forward include examining women’s use of the internet for locating males selling sex, different categories of female buyers, women’s fantasies of racial difference, the extent to which buying and selling sex is influenced by situational circumstances, and women and men’s thoughts about safe sex strategies. Almost all included studies were cross-sectional or ethnographic/qualitative; thus, it would be useful to employ a greater range of research designs, which should include not only control groups but also comparisons among sub-groups and longitudinal studies.

Conclusions

This systematic review shows there is a—possibly growing and diversifying—female consumer demand for male sexual services. Female buyers of male sexual services have likely existed throughout history, but the phenomenon has received scant empirical attention. The perspective of women has largely remained invisible. Yet, the current body of evidence seems sufficient to say that commerce and inequalities of power and socioeconomics are strongly influential in transactional sex where women form the demand and men the supply.

Notes

¹ k = number of studies