‘I miss being honest’: sex workers’ accounts of silence and disclosure with health care providers in Ireland

Abstract

In this paper, female sex workers tell stories of their interactions with health care providers (HCP) in four cities in the Republic of Ireland. While Irish society has made great progress in listening to the sexual stories of women that were historically silenced (e.g. stories of abortion, sexual abuse), sex workers have not benefited from this new climate. Regularly silenced by parliamentarians and non-governmental organisations who speak upon their behalf, sex workers are consigned within a narrative of victimhood and coercion. This paper draws from a participant action research study conducted in 2019–20 and explores women’s motivations in whether to disclose their sex work, and the strategies deployed to conceal it while seeking access to sexual health care. These strategies included traveling beyond their own communities for health care and STI home testing. The paper identifies women, particularly, migrants who felt their precarious position made it impossible for them to be truthful about their sex work to health care providers, exposing them to greater health risk. The paper understands this marginality within a context of structural violence where sex worker health is shaped by institutional power relations creating unequal health outcomes but is also challenged by stories of solidarity.

Keywords:

• Sex work
• structural violence
• health care
• sexual story telling
• Ireland

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 In Ireland, there exists a pre-dominance of exit-based services for sex workers, with organisations governed by a religious ethos, such as Ruhuma, receiving substantial government funding for work with victims of trafficking and those exiting sex work. Ruhuma, an agency dealing with victims of sexual exploitation including prostitution and trafficking, was a key player in the Turn off the Right Light (TORL) campaign to introduce a sex purchase ban in Ireland. The Department of Justice is reported to have written to the leading front-line advocacy group Sex Work Alliance Ireland (SWAI), telling them that they will never receive government funding if SWAI continues to deny that sex work is gender-based violence (letter seen by the authors – see also https://www.irishexaminer.com/news/arid-40028396.html, accessed August 25th 2020)

Additional information

Funding

This project was funded by HIV Ireland supported by a grant from the Open Society Foundations.