Sex Work, Sex Workers and Forms of Inequality: A Policy Brief 1

Sex work has always been here. It has many types and expressions. According to existing scholarship, sex work is associated with a variety of inequalities. Evidence from academic literature shows that, worldwide, sex workers face serious inequalities with severe effects on their lives. Through this policy brief, inequalities are classified by context in some main categories. Social, economic, racial/ethnic, gender, age and “beauty” as well as health inequalities, as demonstrated by international literature, plague sex workers at a global scale. Taking all the above into account, conclusions are drawn and possible solutions are recommended for the mitigation and -if possible-elimination of these inequalities, utilizing means at a local, national and international scale.


Introduction
Sex work refers to the exchange of sexual services for financial compensation.Commercial sex seems to have almost since the very dawns of humanity been a part of human activity, in various societies, epochs and periods of history, or maybe before it too.Only during some really extreme social situations, such as the Cultural Revolution in 1960s China (Cohen et al., 1996;Harcourt & Donovan, 2005) and the Taliban regime in Afghanistan has commercial sex probably been quantitatively suppressed (Larsen, 1996;Harcourt & Donovan, 2005).Sex work in general, is deeply ubiquitous.
It has so many expressions and takes so many different forms of service and activity (Harcourt & Donovan, 2005;Bernstein, 2007;O'Connell Davidson, 2014).The topic of sex work is often shrouded in stigma and taboo, leading to a lack of understanding and misrepresentation of the experiences of sex workers.Sex workers face a range of forms of inequality, including discrimination, violence, and barriers to accessing health and social services.Social marginalization, human trafficking, poverty, and bad health are affecting sex workers' lives and experiences worldwide.
Societies and states have to take more intensive action in order to confront these serious issues and combat inequity.

Defining Sex Work
Initially, sex work as a term, already makes a statement.It does so by recognizing and identifying sexual labor as work.Sex work is identified as the exchange or provision of sexual services, 1 To cite this paper in APA style: Tsertekidis, G. (2023).Sex Work, Sex Workers and Forms of Inequality: A Policy Brief.HAPSc Policy Briefs Series, 4(1), 22-32.https://doi.org/10.12681/hapscpbs.35180 2 Department of Social Work, Democritus University of Thrace, Greece.performances, or products for compensation of money or other goods (Overs, 2002;Harcourt & Donovan, 2005;Lutnick & Cohan, 2009;O'Connell Davidson, 2014;Benoit et al., 2019).A sex worker is a cis woman, cis man or a transgendered person who offers sexual services for the receival of money or other goods, and consciously define that activity as income generating, even if she or he does not consider sex work as their occupation (Overs, 2002;Harcourt & Donovan, 2005).Harcourt and Donovan (2005) identify at least 25 different types of sex work.Types of differentiated worksites, workplaces, ways of attracting and soliciting clients and of course different sexual practices implicated.Some include the so called third parties and others include only the sex workerclient's interaction and transaction.In those procedures clients play a significant role as it is rational to assume."Clients are people (usually men) who pay with cash or other resources for sexual services either explicitly or within an agreed package that includes other services such as entertainment or domestic service" (Overs, 2002: 2).In many cases though, the transaction between the sex worker and the client does not come without any other participant in many different forms."Third parties are people who play ancillary roles in commercial sex.These include arranging meetings between sex workers and clients and/or providing resources and services.These roles vary from place to place and in terms of influence and power over commercial sex and sex workers" (Overs, 2002: 2).
The dominant type of sex work in terms of numbers, significance and historicity worldwide, is what is widely known as prostitution.Prostitution can be defined as the sexual access to one's body in exchange of something of value (money, goods, drugs etc.) (Monto, 2004).It is necessary though to be mentioned that this term is considered to be extremely deep stigmatized and quite offensive in many cases (Pheterson, 1989;O'Connell Davidson, 2014;Benoit et al., 2019).
Another really useful term that plays a major role in the legal and the illegal sex industry is that of human trafficking.MacKinnon's (2011: 299) definition of trafficking is characterized by the following: "transportation, transfer, harboring, or receipt of a human being for purposes of sexual exploitation: it is straight-up pimping".This phenomenon is likened by many scholars and academics as a modern form of slavery.

Social inequalities
Sex work and inequalities share a long series of common ground and space within the social reality.
Sometimes the one is the cause of the other and vice versa.Whatever inequalities mean for a society sex work can make it even deeper, even more serious for the commonly shared social life.The various social, economic and structural inequalities are being reinforced by sex work (Bernstein, 2007;Benoit et al., 2019).
It is proven through various studies and researches that sex work worldwide in the neo-liberal capitalist societies works both as a reason and as an outcome of social and structural inequalities.
That is because the already existing social inequalities can act as push factors to women, men and transgendered people to sex work and vice versa; people within the sex industry worldwide are being affected by inequalities that exist in the sex labor, and their occupation in it reinforces and reproduces these inequalities at a large scale (Pruitt & Lafont, 1995;Monroe, 2005;Padilla et al., 2008;Benoit et al., 2019).
Studies around the world indicate that even though violations of sex workers' human rights, occur at a global context, the very heaviest violations and mistreatments occur in countries and states where sex work is criminalized by the legal framework and status quo.Taking that as a basis, increasing HIV vulnerability and weakening intervention programs, are very realistic as observations (Corrêa & Parker, 2004;Decker et al., 2015).Criminalization also makes it more difficult for sex workers to assert their rights, as they are often reluctant to report violence or exploitation for fear of arrest.For example, in a study of street-based sex workers in Canada, it was found that criminalization made it more difficult for sex workers to seek help when they were victims of violence, as they were afraid of being arrested or facing discrimination from the police (Outshoorn, 2005).

Economic inequalities
Economic inequalities are an absolute and indisputable reality of the world.Inequalities between populations, countries, citizens of the same state, and of course citizens of the same towns or cities.
Poverty devastates huge numbers of the human population all around the planet.Poverty in particular, is in so many cases the main push factor for someone to work in the sex industry (Monroe, 2005;Della Giusta et al., 2009;O'Connell Davidson, 2014).So many women in the developing as well as in the developed capitalist world are pushed to sex work as a result of extreme poverty conditions and lack of opportunities for any career in another field of work (Cusich & Berney, 2005).Those are the women (sometimes men and transgendered people as well) who do not choose willingly the way of sex work, but they follow it as a necessary means of survival for themselves or even at the same time for their families.There are so many cases all over the world in which the whole budget of families is supported not only partially but even exclusively by the occupation of one person as a sex worker.There are cases in which that is happening openly and even more where the social stigma along with the legal framework and status (criminalization), work conversely and do not allow these families to be honest about the real origins of their family income.
Income inequality is also a feature of sex work.This includes the cases of sex tourism and many more types of sex work (Pruitt & Lafont, 1995;Weitzer, 2009;O'Connell Davidson, 2014).This inequality in incomes, has a significant impact on the power relations of the two parties involved.It is profound that the financial ability of the client to afford a journey to an exotic famous for the sex tourism destination (for example The Netherlands, Thailand, The Caribbean, Brazil etc.) or just the ability to purchase one sex worker's services gives to the client an obvious upper hand, for the choice of use to be his or hers.
But to be crystal clear, extreme poverty is not the only economic push factor for sex workers.It has also been observed that middle classed people in the neo-liberal capitalist world, are pushed to get involved in the sex industry in its various aspects as sex workers (Bernstein, 2007).That is because of the economic inequalities of the post-industrialized capitalist societies.
Moreover, not only criminalized, but also legalized and decriminalized sex work, is not regulated efficiently in terms of employment regulation and labor protection (Cruz, 2013;O'Connell Davidson;Benoit et al., 2019).Thus, sex workers are being exploited in many different ways, and they are denied their own labor rights, even though they are not breaking any law, in many cases.Albeit the legitimacy of the sex workers' occupation, to avoid taxes and social stigma, many sex workers stay out of the official and registered sex industry by working without being registered, and by that they abolish any labor rights in a state which decriminalized sex work had granted them (Kavemann, 2007), and leave themselves totally unprotected against the human trafficking networks that operate all over the Globe (Benoit et al., 2019).

Racial/ethnic inequalities
Racism is a social phenomenon that exists in many places of the world.Not only it is not yet extinct but from times to times, there are major outbreaks of racism, that lead to shifts in social, political and even economic life in societies and states.Racism involves many and different expressions.Racial and ethnic inequalities are really important phenomena.
Of course, sex work is affected by these inequalities and at some points, it is sex work that generates and produce those inequalities (Bishop & Robinson, 1998;O'Connel Davidson, 2001;Koken et al., 2010).The race and the ethnic background of the sex worker plays a major role in the process of choosing whose services one client will purchase (Schols, 2018).Also, these features of the sex workers, affect the payment of them by the clients and the price of their services.All these in a deeply racist spirit and way of action.Many female, male and transgendered sex workers are being discriminated by many clients, because of their color or their ethnic origins (Koken et al., 2010) and by that, these types of inequalities are reproduced and escalated into even major social issues and problems.
Non-privileged parts of the sex industry laborers, people of color, differentiated ethnic minorities and other migrants are heavily affected by these inequalities.The phenomenon of refugees and migrants who work in the sex industry because of their disability to work elsewhere and earn in a different way their living is an important paradigm of what ethnic inequality really means for the sex workers.These refugees and migrants are often victims of human trafficking.The experiences of migrant sex workers are similarly shaped by intersecting forms of inequality.Migrant sex workers often face additional barriers to accessing health and social services, as they may fear deportation or be subjected to racist and xenophobic attitudes.For example, in a study of migrant sex workers in the Netherlands, it was found that they were more likely to face barriers to accessing health services, as they were afraid of being reported to immigration authorities (Schols et al., 2018).All the above of course export inequality to their communities and reproduces such pathogenic reflections and narratives, which marginalize in many ways these groups of sex workers.

Gender inequalities
Gender inequality is a worldwide social problem.The intense and depth of gender inequality differ from country to country, and from society to society.But it is undisputable, even though some more conservative commentators often struggle to argue for the opposite, that gender inequality is not absent from any society in the post-modern world of the 21st century.This inequality affects so many aspects of human social, economic and political activity.Naturally it heavily affects sex work and sex workers.Women are mostly presented as natural servants of men's desires and wishes (Satz, 2010;Benoit et al., 2019).Women are objectified and become mere objects of trade (Koken et al., 2010).Pateman (1988) gets to the conclusion that female sex workers in particular are selling their own selves in a quite real sense.The sex worker's relation with the client is an essential relation of domination and subordination of the first's self, arising only under conditions of gender inequality (Anderson, 2002;Satz, 2010;Farley, 2018).This type of gender inequalities is found to be just a mere possible aspect of sex work, but also an inherent characteristic of sex industry worldwide (Phillips, 2011).Gender, race, sexuality, and migration status intersect to shape the experiences of sex workers in complex and nuanced ways.
Women, transgender people, and gender non-conforming individuals are disproportionately represented in the sex industry, and are more likely to experience violence, exploitation, and poverty in their work.For example, in a study of transgender sex workers in India, it was found that they were more likely to face violence and discrimination in their work compared to other sex workers (Rao et al., 2016).
Sex work may many times be a darkest expression, reinforcement and reproduction of patriarchal power relations, that deeply undermine women's and LGBTQ+ people's rights and dignity (Hughes, 2000;Raymond, 2004;Jeffreys, 2009;) as many sex workers are members of the LGBTQ+ community.It is them, who many times are being heavily exploited, abused and of course underpaid for their services.All these phenomena of mistreatment are heavily boosted by the extensive human trafficking that takes place in many regions of the world (Anderson & O'Connell Davidson, 2002;MacKinnon, 2011).
The experiences of LGBTQ+ sex workers are similarly shaped by multiple forms of discrimination, including homophobia, transphobia, and biphobia.This can result in higher levels of stigma, violence, and poverty for LGBTQ+ sex workers, who may face additional barriers to accessing support and services.For example, in a study of LGBTQ+ sex workers in the United States, it was found that they were more likely to experience homelessness, poverty, and violence compared to non-LGBTQ+ sex workers, and also faced discrimination in accessing healthcare and social services (Bickham et al., 2018).

Age and "beauty" inequalities
It has been found that age is a factor of great significance for clients' choice, when scouting for a sex worker to service them (Anderson & O'Connell Davidson, 2002).It is a feature that convinces to a large scale a client if the sex worker is attractive or not, if one deserves the cost and the trouble.
Many sex workers are being discriminated because of their age.They are being set aside mostly by male clients who choose younger sex workers, to purchase their services, and undermine the worth of older sex workers.They are being reviewed by the status of their body and their physical characteristics (O'Connell Davidson, 2014).Either they get the job or not.
Sex work then, reproduces a pathogenic which is related to human age, to woman's age, to man's age, to transgender's age.Beauty in general can be a cardinal factor as to how a person is going to be treated in many social engagements, for example even in social and health care (Polyzoidis, 2019).
In that context, beauty, charming and worth, is being quantified in terms of years and features of body that are strongly connected with ageing.To be straight clear, they are being reviewed and assessed like meat, like objects (Monto, 2004;Satz, 2010;MacKinnon, 2011).That dehumanization is a great question for theorists, sociologists, and other social scientists in general.

Health inequalities
The legal framework around sex work affects many of its aspects; one of them is health.Not only health of the sex workers but of their clients too.In countries such as the United States of America, health inequalities are gigantic due to the structure and the form of the health system.In countries like this, due to the criminalization of the main forms of sex work (not in all States, but in their vast majority), in many cases there is no access to health and medical care by sex workers.This situation, along with other social inequalities and imbalances of power with clients, leave them vulnerable to many Sexually Transmitted Diseases, including a dangerously high risk of possible exposure to HIV (Overs, 2002;Corrêa & Parker, 2004;Decker et al., 2015;Schols et al., 2018).
Not only in that kind of countries but also in countries with different kinds of healthcare systems, sex workers are putting themselves and their clients into great risks because of the implicated criminalization against sex work.When criminalization is implicated by the state authorities, the state cannot have any effective monitoring or control over the health of the women, men and transgendered people who work illegally as sex workers (Cusick & Berney, 2005;Padilla et al., 2008;Rao et al., 2016).In a study of sex workers in South Africa, it was found that stigma and discrimination made it more difficult for sex workers to access health services, leading to increased risks of HIV and other sexually transmitted infections (Shisana et al., 2014).In their struggle to survive, they might become dangerous for their own health and lives as well as for their clients', and of course they find severe difficulties in seeking help from any official authority.In that way, health inequalities are dangerously deepened in a society.

Conclusions and Recommendations
Sex work and inequality are deeply correlated and interwoven.That is a reality in various ways and expressions.Inequality and its different forms can clearly be the root causes or origins of sex work.
They can as well be the outcome of sex work, as it clearly produces and reinforces inequality in its various expressions.This reproduction either of patriarchal or other systematic hierarchies, social and structural inequalities of many forms through sex work is reasonably considered by many scholars to be deeply problematic.
Sex workers are not always vulnerable and weak, but when they are, their social, economic, health and physical conditions are exposed to many perils and dangers.Even their life is being risked during their struggle and effort to earn their living through the various sex work that they are occupied with.
Many theorists, scientists, politicians and of course activists, have worked and are still working towards the degrading of inequalities that are reinforced or even produced by sex work.Many more are necessary to be made and accomplished it that direction though.

The problems
Scholarship on sex work strongly indicates that, worldwide, sex workers face various inequalities.
These inequalities negatively affect people working in the sex industry in many ways.Their dignity, self-respect, self-esteem, health, welfare and even life are systematically endangered.Social scientists have extracted safe conclusions concerning the severe dangers sex workers face during their efforts to earn their living.Criminalization of sex work, according to literature, is a core factor in marginalizing sex workers and placing them to obscurity as workers and citizens.Criminalization of sex work exacerbates inequalities faced by sex workers.Laws that criminalize sex work force it into the shadows, making it difficult for sex workers to seek protection, report violence, or access justice.Criminalization also hampers efforts to regulate and improve working conditions, leading to increased vulnerability to exploitation, violence, and health risks.As criminalization accounts for perpetuating many social, economic and health inequalities, decriminalization is something that legislators in even more countries should examine.
Not working legally block sex workers off from having regular access to regular medical examinations and testing for example for STDs and other infectious diseases.In tandem, deprives them from social security and insurance.
Economic disparities contribute to the inequalities experienced by sex workers.Many enter the sex industry due to limited economic opportunities, poverty, or lack of social support systems.Unequal power dynamics in the industry, such as exploitative practices by intermediaries or pimps, further compound economic inequalities.Limited alternative employment options and income-generating opportunities can trap sex workers in cycles of poverty and reliance on the sex industry.

Some possible solutions
Legally recognizing sex work as a form of work, grants rights to the workers and makes them visible for the welfare state and state in general.In that way they can have more security provided by law enforcement and social security.Social security, and access to health services not only can bate, but they also prevent many inequalities, by stopping social and economic marginalization.
Societies need to address all kinds of inequality that challenge and pose vital threats to sex workers.
It is a matter of social equity and human rights.That said, all social institutions have a part to play towards weeding out inequalities that challenge the core of sex workers' rights as workers, citizens and humans.
Educating and informing communities at local, national, and international scale for the serious issues that rise due to inequalities sex workers face, could cultivate more inclusive attitudes towards them.
School, Media and the Third Sector (non-governmental and non-profit organizations) can have major impact on peoples' awareness, by curing misinformation, prejudice and stereotypes.
Implementing social support programs that address the unique needs of sex workers, including safe housing, education, vocational training, and alternative employment opportunities, can help alleviate economic disparities and reduce reliance on sex work.
Emphasizing on making healthcare and social services more accessible to sex workers can enhance the chances of preventing inequalities to plague sex workers and reproduce inequity.Ensuring equitable access to comprehensive healthcare services, including sexual and reproductive health, educating healthcare and social care workers even better for the needs and special challenges sex workers face, can be impactful in confronting health, age, beauty and social inequalities in general.
Sex work inequalities are often gendered, with women, transgender individuals, and gender nonconforming people disproportionately represented in the industry.Patriarchal structures, misogyny, and gender-based violence contribute to the vulnerability of women in sex work.Intersectionality, which considers how multiple social identities (e.g., race, sexuality, disability) intersect, further shapes inequalities.For instance, women of color and LGBTQ+ sex workers may face compounded forms of discrimination and violence due to intersecting oppressions.Migration plays a significant role in shaping sex work and inequalities experienced by migrant sex workers.Migrant sex workers may face additional vulnerabilities due to language barriers, limited social networks, precarious legal status, and exploitation by traffickers or employers.The conflation of sex work and human trafficking in public discourse and policies often fails to differentiate consensual sex work from instances of coercion, further exacerbating inequalities faced by sex workers.