Eleanor Maticka-Tyndale and Jacqueline Lewis|
Division of STD Prevention and Control
Laboratory Centres for Disease Control
Grant No. H1021-7-0241/001/SS
Escort Services In A Border Town
Transmission dynamics of sexually transmitted infections within and between communities
Literature & Policy Summary
Eleanor Maticka-Tyndale and Jacqueline Lewis
Division of STD Prevention and Control
Many people made this project possible. We were fortunate to have a team of excellent research associates and assistants Jocalyn Clark, Jennifer Zubick, Shelley Young, Connie Mailloux and June Oakes who set interview appointments, located documents and literature, transcribed interviews, prepared annotated bibliographies, and catalogued and stored the volumes of material needed for this project. We are particularly grateful to the escorts, agency owners and personnel, city employees, agency personnel, police representatives, and fellow researchers who so generously shared their time and expertise with us in interviews, phone calls and email communications. And finally, we are thankful to the Division of STD Prevention and Control. Laboratory Centres for Disease Control, Health Canada for funding this project and understanding that community-based research often follows its own timetable, regardless of what plans have been made.
Table of Contents
This document reports the results of an exploratory study, conducted in a border city with a recently opened casino, that examined the potential impact of the licensing of escort services on the spread of sexually transmitted infections (STIs) between the United States and Canada. Concern for the spread of STIs results from their higher prevalence in the United States than in Canada. Recommendations are made in the report with respect to research, policy and programming.
The study used Windsor, Ontario as its focus of inquiry because it borders the United States, recently opened a casino that attracts thousands of visitors from the United States, and initiated licensing of escorts and escort agencies in 1996. Information for this report came from:
This study examined the relationship between the opening of the casino, the licensing of escorts and potential transmission of STIs from American clientele to Canadian escorts.
1. Literature Review
Research conducted in a variety of geographical locations where sex work is governed by differing legislative approaches demonstrates that:
2. The Casino And The Escort Industry1 The escort industry in Windsor has increased since the opening of the casino. 2 Between 20% and 90% of customers of any particular escort come from the United States. 3 The casino, strip clubs and escort services create an attractive adult entertainment package for some business and recreational visitors to the city. (3) Licensing 1 Some Canadian municipalities have licensing bylaws that apply to escorts and escort agencies. - i - 1 Licensing creates legitimacy for escort work, it is a "business like any other business." 2 The "aura of legitimacy" attracts both workers and customers. 3 Licensing empowers escorts and agency owners and facilitates their integration into the community. 4 There is confusion among escorts, agency owners and personnel, and the public over how municipal licensing interfaces with criminal code statutes related to prostitution. 5 Criminal code statutes interfere with acknowledgement that escort work involves the delivery of sexual services. 6 This inhibits the ability of the city, its agencies, and escort agencies to address health and safety issues related to the delivery of sexual services by escorts. 7 Municipal police are responsible for enforcing both the municipal bylaws and the criminal code. 8 Enforcement of the municipal bylaw is paid from licensing fees charged to escorts and escort agencies. 9 The dual role of police: 10 Reduces the costs and complexity of enforcing the criminal code. 11 Provides the police with regular and easy access to agencies and escorts. 12 Makes it possible for police to use information obtained through licensing together with the authority of bylaw enforcement to police potential criminal code offences. 13 Police do not always respect the confidentiality promised to escorts related to information recorded as part of licensing. (4) Sexually Transmitted Infections 1 Escorts reported that: 2 Condoms were the principle method used to prevent STIs. 3 They used condoms for all consensual oral and penetrative contact with customers. 4 It was a rare customer who did not ask "how much more for no condom." 5 Escorts lacked information about other preventive practices, or about STIs that are not prevented with condom use. Conclusions The casino is a large draw for visitors from both Canada and other countries, primarily the United States. For some visitors, the casino is the main draw in an adult entertainment package that also includes strip clubs and escort services. Given the higher prevalence of all STIs in the United States as compared to Canada, and the fact that some are not prevented through condom use, the vulnerability of Canadian escorts to STIs increases with an increase in American clientele. Licensing of escorts and escort agencies has the potential to contribute to prevention of STIs through legitimating escort work, empowering escorts, and enhancing their integration in the community and potential access to community and health services. In order to achieve this end, however, the occupational health and safety needs of escorts must be addressed, particularly with respect to engaging in sex with customers The potential for violation of criminal code statutes related to prostitution (CC s.212) when agencies or licensing municipalities become involved in the sex work portion of escort work inhibits their involvement in openly addressing the health and safety needs of escorts. - ii - Introduction __________________________________________
In 1994 the City of Windsor, Ontario embarked on a new economic and social era with the opening of a large casino. With it came a weekly influx of tens of thousands of visitors from the United States, some of whom sought other forms of adult entertainment in addition to gambling. In 1996, in anticipation of growth in the escort industry resulting from the influx of visitors, Windsor's city council initiated the licensing of agencies and workers involved in the provision of certain "personal services" (Bianchi 1996; Vander Doelen& Smrke 1996; van Wageningen 1996; Windsor Star 1996a, 1996c, 1996d, 1996e, 1996f). Included under the licensing by-laws were individuals who provided, on an out-call basis: dating services, non-therapeutic massage or body rub, personal modelling, and escort services.1 This series of events created a change in the social framework within which escort work was conducted and a growth in the escort industry. It also raised the question of the potential impact of an increase in the number of American visitors, the location of escort work in an expanded adult entertainment sector, and municipal licencing on the transmission of sexually transmitted infections (STIs) within the region and between the United States and Canada (Klovdahl, et al. 1994; Leopold& Steffan 1996).
In law and policy, as well as in research, it is assumed that neither sex work nor prostitution require definition. For example, while the Criminal Code of Canada (see sections 210-213) uses the terms "prostitute" or "prostitution," neither are defined. A common definition used in research is: the exchange of sexual services for money or things of monetary value (Badgley Committee 1984; Fraser Committee 1985; Scambler& Scambler 1995). The assumption that this is an agreed upon definition, however, is a false one. For example, debates about what constitutes sex work, and therefore who qualifies for the label of sex worker or prostitute, have accompanied the application of this definition in the large scale Vanguard project in Vancouver (Sorfleet 1997). The term sex work has been used to refer to a variety of activities including: street prostitution, exotic massage, body rub, pornographic modelling and acting, telephone sex, exotic dancing, escort and call girl services.
Sex work commodifies what has been socially constructed as a personal, private, and integral part of one's identity in contemporary western cultures (Davidson 1995). Under this social construction, the exchange of sex for money is seen as deviant and immoral and subject to legislative and police control (Brock 1989; Federal-Provincial-Territorial Working Group on Prostitution 1995a, 1995b, 1998; Hepburn 1993; Holsopple 1998a). Sex workers have been pathologized as psychologically scarred, immoral, or victims (Davis 1971; Farley& Barkan 1998; James 1976; Raymond 1998). This view of sex work and sex workers permeates research, programme and policy. Research has been conducted and policy formulated with little or no consultation with sex workers themselves (Chancer 1993; Rajan 1997; Shaver 1998) and with attention focussed on street prostitution, sexually transmitted infections (STIs), and "saving" (prevention) or "rescuing" (treatment or intervention) women from sex work. This focus persists, despite evidence that: 1 street prostitution is engaged in by only a minority of sex workers (Jackson, et al. 1992; Longstaff 1993); 2 within a particular culture and region, sex workers are more likely to protect themselves against the spread of STIs than those engaging in non-commercial genital sex with multiple partners (Brock 1989; Haug& Cini 1984; Jackson& Highcrest 1996; Jackson, et al. 1992); and 3 for most sex workers, the voluntariness and conditions of sex work closely parallel those of other low paying, low skill, menial jobs (Bindman& Doezema 1997; Jenness 1990; Sangera 1997).
The Prostitutes' Rights Movement became visible in North America, Europe and Australia in the 1970s with the founding of organizations such as COYOTE. Members of this movement have challenged researchers and policy-makers to shift attention away from an individualistic, single issue approach to sex work. Specifically, they have called for a shift of focus to the level of the political, social and economic factors, such as the influence that women's relative poverty, low status, and disempowerment have, not only in drawing women into sex work, but in the way the work is conducted and dealt with by the community. As several sex worker/activists and researchers have noted: research, programmes and policies need to view sex work as work (Bindman& Doezema 1997; Jenness 1990; Sorfleet 1997). In response to the call for this paradigm shift, some recent research has begun to focus on the impact of policy and legislation on the conduct of sex work and the health and well-being of sex workers (Alexander, et al. 1996; Benson& Matthews 1995; Bindman& Doezema 1997; Elwood, et al. 1997, Lewis and Maticka-Tyndale, 1999; Maticka-Tyndale et al., 1999; 2000).
The challenge posed by sex workers' rights advocates is a challenge to modify the theoretical framework that has typically guided research on the sex trade. Specifically, it is a challenge to move away from the nearly exclusive use of a social psychological paradigm to using a paradigm of political economy. Such a shift would have implications for both research and policy. The dominant social psychological paradigm focuses attention on the individual, individual decision making, risk, and risk reduction strategies, and develops policy and programmes from a social service perspective in order to meet the perceived needs of individuals. A political economy focus, in contrast, turns our attention to social institutions, such as the family, health services, criminal justice, community, and economic institutions. Research questions from this perspective address how these social institutions create a framework that sets boundaries around the decisions and actions of individuals. Policy and programmes based on a foundation of political economy are more likely to be based on a foundation of human rights than individual needs and to target change at the level of the community or society. Paraphrasing Karl Marx: people choose their own destiny but the choice is made from within conditions or social frameworks that are not of their own choosing. As researchers have discovered, sex workers choose to engage in personal and work practices that either raise or lower their risk of exposure to health threats such as STIs. The choices that are available or necessary, however, are determined by social conditions such as laws, the economy, family circumstances, local policing practices, etc. The social psychology and political economy paradigms are neither mutually exclusive nor exhaustive. Both make important contributions to an understanding of personal and social realities. The difference between them is in the focus of research, policy and programming.
This report is set within the context of the paradigm of political economy. The research on which it is based was initiated in response to a change in the local economy of Windsor, Ontario that resulted from the opening of a casino, and a change in the municipal policies and legislation related to certain forms of sex work that accompanied this opening. While the focus of the research is on transmission of STIs, this focus is considered from within the context of the social, economic and political institutions in the local setting, the conduct of a form of sex work other than street prostitution (escort services), and the effect of conducting escort work within a particular local context on the overall health and well-being of women who work in this occupation.
Escort work is one form of "inside" sex work. In 1983, the Bureau of Municipal Research estimated that 80-90% of sex work in Canada occurred indoors rather than on the streets (Bureau of Municipal Research 1983). Based on research reported to them, the more recent Federal-Provincial-Territorial Working Group on Prostitution concluded that in smaller cities all sex work occurred indoors, involving escorts and independent advertisers (Federal-Provincial-Territorial Working Group on Prostitution 1995). Escort work is engaged in by independent advertisers or through agencies. Advertisements for the services of escorts are commonly placed in local newspapers, phone books, weekly entertainment magazines, or on the Internet. While typically there is no explicit mention of sex in these advertisements, the wording, pictures, and descriptions of the available escorts imply that sexual services are available (see for example the study by Allman 1994 of advertisements by male escorts).
This report is divided into five sections: 1. A review of the methodology used in this project. 2. A review of research literature addressing factors that influence the vulnerability of sex workers to STIs. The research literature is discussed in conjunction with information collected as part of this research project. 3. A description of the relationship between the escort and other adult entertainment industries in Windsor, Ontario, focussing on the social dynamics that affect this relationship. 4. A review and examination of national and local policies and legislation related to the escort industry in Canada. The review uses Windsor, Ontario as a case study. It also includes a review of policies in two other jurisdictions: the Netherlands and the state of Nevada in the United States of America for comparative purposes. 5. Preliminary research, policy and programme recommendations based on this research. Methodology ___________________________________________
This study was conducted between November 1997 and the spring of 1999. Besides the current report, a second one on the methodological challenges of conducting research on sex work was produced as a result of the project (Lewis& Maticka-Tyndale 2000). The information for the current report was collected based on: 1) A review of the literature on sex work and STIs, with a particular focus on inside sex work. Sociofile, Medline, Cinahl, and Psychlit were searched using the following terms as well as combinations of these terms: adult entertainment, call girl, commercial sex, escort, escort agency, hooker, pimp, prostitute/tion, romance tourism, sex tourism, sex trade, sex worker, sex industry, sex for money, sex for drugs, whore. The references in these articles led to a review of books and chapters in anthologies. Two listserves were subscribed to (sex-work forum and gender-aids) and information discussed that related to sex work, sex tourism, STIs, migration or travel and sex was collected. Finally, several websites were located through the homepages of SWAV (Sex Workers Alliance of Vancouver), Commercial Sex Information Service (CSIS), Maggie's, Network of Sex Work Projects, and COYOTE that led to further resources in the form of on-line papers from conferences and discussion groups. 2) Analysis of national and local policies relevant to this industry and its workers, including Canada (in particular comparing local policies in Windsor, Ontario and Calgary, Alberta), the United States (in particular Nevada), and Holland. 3) Consultation with five Canadian researchers currently working in the area of sex work (Lois Jackson, Dalhousie University; Fran Shaver, Concordia University; Pamela Downes, University of Saskatchewan; Augustine Brannigan, University of Calgary; Sharon Williams, University of British Columbia at Kelowna), an American researcher who has conducted research on sex work internationally (Wendy Chapkis, University of Southern Maine), and a Dutch researcher who has been involved in sex work research in the Netherlands (Ine Vanwesenbeeck). 4) Consultation with sex worker advocacy groups in Canada, the Netherlands and the United States. 5) Interviews with 18 escorts and 8 escort agency personnel working in Windsor, Ontario. 6) Interviews with 21 key informants in Windsor, Ontario and Calgary, Alberta. These included public health and social service workers, city councillors, municipal employees and police, who have contact with the industry or work with policies related to it. 7) Observations of local events related to the escort industry in Windsor, Ontario from 1997 through 1999. 8) Discussions with representatives of sex worker organizations using listserves, email, telephone and face-to-face meetings.
Sections of this report that were based on interviews with key informants were sent to a selection of study informants for feedback and correction of factual information prior to completion of the report. Literature Review ___________________________________________
John Lowman, who has contributed extensively to our understanding of sex work and policy in Canada, notes that prior to the Badgley (1984) and Fraser Commissions (1985) of the 1980s there was little research on sex work in Canada (Lowman 1992). The two commissions conducted and contracted studies of prostitution in cities across Canada and produced social, legal and political policy recommendations (Lowman 1991). While this research examined sex work from within a social and political context, most academic research on sex work and STIs has used a social psychological framework, identifying risk factors that increase the probability of acquiring an STI. This research has identified the primary risk factors for sex workers acquiring STIs as: intravenous drug use (IDU), multiple partners from segments of the population or geographical areas with high infection rates, lack of or erratic use of condoms, concurrent STIs, use of oral contraceptives, and gynaecological surgery (for reviews of the collective work see: Padian 1988; Pyett& Warr 1997; Scambler, et al. 1990). The bulk of research targeting transmission and prevention of STIs in sex work has focussed on condom use (Jackson, Highcrest& Coates 1992; Pyett& Warr 1997; Scambler& Scambler 1995) and the primary policies to prevent the spread of STIs have included mandatory testing (e.g., Nevada) and promotion of condom use. There has been little work related to STIs and sex work from the perspective of political economy or identifying economic, political and social conditions that relate to vulnerability--that is, that place an individual into situations where risk factors are salient. The scarce research that has examined vulnerability to STIs has focussed on a broad range of interconnected social and economic factors. Among these factors are: the social location and status of sex work (including differences between different forms of sex work); access to employment and alternative economic resources; conditions of work and workplace; delivery and uptake of health, social and related services; victimization of sex workers by clients, police, the public, and the state; laws and policies regarding sex work. Together with personal health and work practices of sex workers, these factors are the categories used to organize the literature reviewed for this project.
The research literature on escorts is sparse. We located a total of four articles (Foltz 1979; Jackson, et al. 1992; Lowman 1985-1986; Pyett& Warr 1997), one research report (Hancock 1998), and one autobiographical reflection (Highcrest 1997) that dealt with escort work.2 Only one of these articles (Foltz 1979) reported research conducted specifically on escorts. Consequently, the literature review deals with sex work in general and places escorts within this context based on these six sources and the interviews and on-line discussions conducted as part of this project.
Social Location and Status of Sex Work
Sex work has not been included as an occupational category in labour force or social stratification research, consequently, the social location and status of sex work relative to other occupations, and the number of women working in the diverse forms of sex work is unknown. Researchers, particularly those who themselves are, or have been, sex workers, compare sex work with other low paying, low skill jobs. Many have commented that though sex work carries the potential for higher income than these other jobs, the reality is that most sex workers accumulate very little money and the social status of sex work in the community is low (Brock& Thistlethwaite 1996; Hodgson 1997; Holsopple 1998a, 1998b; Lowman 1985-1986; Sangera 1997). Within sex work itself there is a status gradation of occupations ranging from street prostitution (particularly those who work on what is referred to as the "low track") at the bottom, to escorts or call girls at or near the top (Lowman 1985-1986). Brock (1998), in her recent review of contemporary sex work in Canada, echoes the conclusion of other researchers that regardless of the specific form it takes, sex work is stigmatized, considered an illegitimate occupation, and is widely viewed as "dirty" both morally and physically. Pheterson (1990, 1993) observes that while the status and stigma of sex work are bounded and temporal for men (both clients and male sex workers), women are stigmatized regardless of changes in occupation, with the stigma affecting all aspects of their lives. This makes female sex workers and former female sex workers fair game for scrutiny and attack.
The low status and social location of sex work in Canada can be seen in the efforts of local communities organizing to have sex workers removed from their streets. For example, one Toronto city councillor, Judy Sgro, recently asked police to do "sweeps" every 3-4 weeks of areas where prostitutes are known to work (Abbate 1998). Several informants in this study commented that a prime incentive for licensing policies that forbad escorts to work from their homes was that people don't want this type of business in their neighbourhoods, even though this form of sex work is invisible to local residents. Not only do communities want to eliminate sex work (whether visible or not) from their neighbourhoods, they want to exclude sex workers from even living in their neighbourhoods. In our study, for example, concern over where sex workers lived was expressed when local community members inadvertently discovered that some of their neighbours had escort licenses. From these observations, we can conclude that, regardless of the form it takes, sex work is a stigmatized occupation that is at or near the bottom of the occupational status hierarchy.
Not only is sex work stigmatized and a low status occupation, it is also treated as an illegitimate occupation. Sex workers are neither afforded the rights, nor carry the responsibilities, associated with employment in Canada. This is primarily because of the ambiguity of the legal status of their work.3 Sex workers rarely register as independent business persons, pay income tax, charge GST, pay into or receive pension, unemployment, maternity, disability, or other benefits. Few of them have any evidence of employment that can be used in applying for loans or verifying their ability to meet rental or other payments. They have generally not been eligible for compensation related to workplace injuries or victimization. Even when working for a regular employer such as a "strip club," escort agency, or massage parlour, they are typically hired as independent contractors, even though their relationship with employers rarely meets federal guidelines for independent contractors (see Bindman& Doezema 1997). Consequently, sex workers are not protected by labour codes or by health regulations regarding employer responsibility for health and safety. When combined, the stigmatization and lack of legitimization of sex work produce an outcaste status. As outcastes, sex workers are placed outside the social fabric. This status has consequences not only for the sex worker, but also for the larger community. As noted by Becker (1973) and Goffman (1963), outcastes may respond to their status by rejecting the rules and conventions of the larger community and replacing them with their own, alternate social conventions and rules, which often conflict with those of the dominant society.
A response to stigmatization, and to prevent having stigmatization and an outcaste status permeate one's life, is to hide the characteristics that produce the stigma (Goffman 1963). This approach was used by the escorts we interviewed, as well as by the exotic dancers interviewed in an earlier study (Lewis& Maticka-Tyndale 1998a). While this strategy provided some protection from stigmatization, it also contributed to vulnerability to STIs by: (1) precluding organizing or joining organizations such as unions, formal support groups, and advocacy or health promotion organizations that could work to improve work conditions, provide social supports, or information and support for reducing health risks; (2) leading to avoidance of confrontations with employers, the public, police and others (even about work and living conditions that increase risk); (3) leaving one vulnerable to exploitation via threats (spoken or understood) of public exposure; and, (4) if pursuing one's own interests requires public visibility, jeopardizing those interests rather than risking discovery4.
Although sex work in general carries a low social status, there is a hierarchy among the various forms of sex work. Escorts are located in a relatively high status occupation in this hierarchy, with their work considered to be safer (Brannigan 1998; Lowman 1985-1986), more lucrative, and their occupation easier to hide from public view (Davidson 1995; Highcrest 1997). Researchers generally find that escorts, compared to those in other sex work occupations, are a difficult population to study. This difficulty is tied to the relative invisibility nature of their work, and therefore the difficulty of accessing participants, and the reluctance on the part of many escorts to participate in research (Hancock 1998; Williams 1998).
While we did not have difficulties recruiting participants for this study,5 escorts, as well as exotic dancers in our earlier study (Lewis& Maticka-Tyndale 1998a), clearly used a hierarchy to locate themselves vis-a-vis other sex workers. Most of the exotic dancers we spoke with viewed themselves as entertainers and refused to accept the label of sex worker. Escorts tended to separate themselves from identification with "lower" levels of sex work. As one young escort commented after spending a night sharing a jail cell with several street prostitutes: I'm not like them. They're disgusting, all dirty and smelly. Several of them look like they got AIDS. I'm not anything like them, no way, I'd never be a whore. Although many escorts acknowledged that they are engaging in prostitution, they typically tried to protect themselves from the stigma associated with street prostitution by referring to themselves as escorts and the men who use their services as customers or clients, and by emphasizing that escort work was a job that did not necessarily involve sexual services. The hierarchy used by exotic dancers and escorts to separate themselves from other sex workers can serve to further isolate them from the possibility of collective action, support, and accessing services designed to help sex workers deal with occupational risks. However, it also makes it easier for them to remain part of mainstream society rather than affiliating with fellow "outcastes."
Few of the escorts or exotic dancers we spoke with were willing to risk public exposure, even if it could ultimately be for their own and other sex workers' benefit. According to Margo St. James, sex worker/activist and founder of COYOTE,6 sex workers are disempowered in the public arena. She notes that it is only a small group of exceptionally brave individuals that is prepared to take a public stand, form advocacy groups, and engage in action on behalf of themselves and their fellow sex workers. As Jenness (1990, 1993) points out, the fact that few sex workers are willing to do the work, and publicly bear the stigma, of advocacy is a contributing factor in the instability of sex worker organizations. If the conditions of sex work are to change, advocacy and action by sex workers is probably necessary since the stigmatized status of the occupation also works against other organizations in the human rights, labour, health or women's issues arena "taking up the cause" of sex worker advocacy.
Access to Employment and Alternative Economic Resources
As noted by de Zalduondo (de Zalduondo 1991:230), "economic factors play diverse roles in the supply and demand sides of commercial sex. They affect the individual's entry into sex work and their ability to stop, the types of customers acquired, sex workers' ability to tolerate the economic consequences of selectivity, and numerous other factors which mediate risk of exposure to HIV [and other STIs]." The absence of employment that provides a livable wage to women with little education has been consistently identified as the primary motivation for entering sex work (e.g., Brock& Thistlethwaite 1996; Chancer 1993; Chapkis 1997; Davis 1971; de Zalduondo 1991; Lowman 1985-1986; Maticka-Tyndale& Lewis 1997; Reynolds 1986; Sangera 1997). Women enter sex work to support themselves and their children, to repay debts, or to pay for necessities in their lives. All the women we interviewed reported that they entered escort work because the jobs they had, or that were available to them, paid lower wages (frequently insufficient to provide for their needs) and required them to work longer hours and on a fixed schedule.
Once "in the life," the need for a livable wage influences how business is conducted and the risks women will take. As Jackson, Highcrest and Coates point out (1992:282) "economic incentives for risk-taking behaviours are common." Clients are often resistant to condom use or willing to pay more money for sex without a condom (Albert, et al. 1998; Plumridge, et al. 1997a; Pyett& Warr 1997). Researchers have consistently documented that those workers in the greatest financial need are the ones who are most likely to acquiesce when they encounter resistant clients, or to agree to comply with client requests for risky sexual encounters (de Zalduondo 1991; Jackson, et al. 1992; Scambler& Scambler 1995, 1997; Vanwesenbeeck, et al. 1993). The women we interviewed reported that it was common for clients to ask "how much more for no condom?" It is the sex worker who must insist on condom use, and convince resistant clients even though they know they can earn more, or that their job will be easier, if they are willing to comply with customers' requests.
Not only is access to jobs outside sex work restricted for some individuals, but access to higher status, safer, and higher paying forms of sex work, such as escort work, may also be restricted. While it is common for women involved in sex work to move between a variety of sex work occupations, municipalities that license some of these occupations impose restrictions on who is eligible. A common restriction is to refuse to license anyone with a history of prostitution or drug offenses, making it impossible to move from the more dangerous street prostitution to safer forms of sex work. Licensed sex workers may also lose their license should police discover they have been involved in drug use or prostitution, pushing them back onto the streets (Vazquez& Martin 1996).
McLeod (1982) describes entry into prostitution as "resistance in the face of poverty." As Sangera (1997: 5-6) notes: ...prostitution is among the oldest professions. This is due to the fact that the social and economic vulnerability of women and their attendant powerlessness in society has left only a small range of options open to them to eke out a livelihood. So prostitution is indeed the twin sibling of poverty, and as old as indigence, destitution, and compulsion. Women with no assets and few options have relied directly on their bodies to maintain themselves and their dependents through the ages. Prior to licensing, some women used escort work to supplement their mother's allowance or social assistance payments. One escort was quoted in the Windsor Star as estimating that 99% of escorts, before licensing was instituted, were on mother's allowance. Police sources estimate that 40-60% of prostitutes in the city were receiving welfare (Windsor Star 1996c). Since licensing requires agencies to keep records of the work of escorts and to file tax returns that include information about the escorts with whom they have contracted, women must now choose between escort work and government support. This situation places additional pressure on sex workers to maximize their earnings as escorts. They must, "make it on their own" without the safety net of social assistance and mother's allowance.
The universal limitation of occupational options for women, the high rate of poverty among women as compared to men, and the disproportionate number of women who have sole responsibility for their children provide the impetus for some women to enter sex work. For some, it also provides the impetus to do whatever it takes to maximize their income, regardless of its implications for their own health or well-being.
Conditions of Work and Workplace
Good working conditions allow sex workers to refuse any particular sexual practice or partner and to be free of threats of exploitation or victimization by employers, co-workers, clients, or police (Bindman& Doezema 1997; Pheterson 1993). Bad working conditions make sex workers vulnerable to a wide array of health threats and injuries, including increased vulnerability to STIs. Some examples of bad work conditions include: 1
For all sex workers: the lack of adequate protection from sexual assaults (e.g., Maticka-Tyndale, et al. 1999). (1) For exotic dancers: costuming requirements that leave no way to carry condoms while dancing (Hancock 1998; Holsopple 1998; Maticka-Tyndale, et al. 1999; 2000). (1) For escorts, exotic dancers and masseuses: policies and legislation forbidding physical contact. The consequent denial that such contact occurs means condoms and even information about transmission risk are not provided as part of employment and may not be permitted in the place of employment (Maticka-Tyndale, et al. 1999). (1) For escorts, and potentially other sex workers: meeting a client alone in the privacy of a hotel/motel room or a home. In such environments the sex worker must assess the potential dangerousness of a client both in terms of the potential for assault and resistance to condom use, and they must deal with these issues on their own. (1) For street prostitutes and escorts: municipal traffic regulations that forbid vehicles to stop on downtown streets, forcing street prostitutes to make rapid assessments of the safety or danger posed by a potential client as they quickly enter his vehicle and making it difficult for escort drivers to be "on call" and available to come to an escort's aid.
When employers, managers, agents, drivers, and others associated with sex work ignore or deny that genital sexual contact occurs as part of a particular form of sex work (e.g., exotic dancing, escort services, exotic massage), information and support for self-protective practices (e.g., condom supplies, information or training on how to properly use a condom or how to use it with a reluctant customer, information on relative risk of different sexual practices and how to reduce risk, information on STIs that are not prevented through condom use) will not be provided. Even if condoms are used, they may not be used properly. For example, in a study of sex workers in Nevada brothels, it was found that not all sex workers used condoms effectively (Albert, et al. 1995), highlighting the importance of appropriate training to develop condom use skills.
Several researchers have pointed out that many of the hazards associated with the conditions in which sex workers conduct their job parallel those of women in other service occupations (Bindman& Doezema 1997; Ford 1998; Gotell 1997; Shaver 1996, 1997). These researchers recommend that such hazards be addressed through existing, or modified, by-laws and work place policies. For example, Bindman and Doezema, in a 1997 report produced for the International Labour Organization, detailed working conditions and international agreements that could be applied to sex work (Bindman& Doezema 1997). As Cheryl Overs, an Australian sex worker/activist notes: Every industry has the potential to...exploit workers, to be a health hazard.... But elsewhere the mechanisms to control these are in place. There are no taken-for-granted rules which prevent people from going bareheaded on a construction site or coal miners from working in the pits for 18 hours. Just extend safeguards to the sex industry, and all the cliched charges against it will disappear (Overs as quoted in Rajan 1997: 12).
Sex workers, even when working with an agency or for an employer, have no protection from threats to health and safety related to their job. Though their work does not fit legislative guidelines for contract labour, agencies and employers often treat them as such, eliminating their responsibility for minimizing risks associated with the job (Holsopple 1998). In Canada, none of the sex work occupations are unionized or regulated by workplace health and safety policies. Sex worker unions have, however, been established in Thailand, Cambodia and Vietnam (sex-work forum: entry#s 127, 128) and exotic dancers working in at least one San Francisco club have unionized, though under considerable duress and harassment from management.
Delivery and Uptake of Health, Social and Related Services
Lowman (1985-1986: 37), in his review of five regional studies of sex work in Canada (including street prostitutes, escorts and male hustlers), observed that sex workers use few social services other than financial assistance and medical care. Sex workers access health care in a diversity of settings, including the offices of physicians and in general and specialty clinics. Research has identified a variety of barriers to the development and delivery of appropriate health programmes to sex workers (Alexander, et al. 1996; Dorfman, et al.1993; Weiner 1996). Prevention of health problems related to sex work is facilitated when health care providers are aware that patients are sex workers, are knowledgeable about the potential health concerns related to their work, and are able to provide non-judgmental counsel and treatment in an environment in which sex workers can feel safe and comfortable (Alexander, et al.1996; Cornmann& Hirschsmann, 1996; Scambler& Scambler 1995). The way in which diagnostic and health care facilities are used is related to both early detection and treatment of STIs and other potential health problems, including those associated with substance use and abuse (Maticka-Tyndale 1997). For example, several STIs (e.g., chlamydia, gonorrhea) may remain relatively asymptomatic in women (Patrick 1997) making regular testing imperative for early detection and treatment (Macdonald& Brunham 1997). Without such treatment, STIs such as chlamydia and gonorrhea can progress to more damaging sequelae such as PID and impaired fertility (MacDonald& Brunham 1997). If a health care provider is unaware of a woman's vulnerability to STIs, such tests are not likely to be performed.
In our research, we found that escorts typically used health clinics for regular testing of STIs and few had regular health care providers. The result is little continuity in care, diagnosis, or treatment relevant to their specific health needs. We found, however, as did Scambler and Scambler (1995), that even when escorts (or exotic dancers in our earlier research) did have their own physicians, most did not disclose their occupation, precluding open communication and effective health promotion and care.
There are several Canadian projects designed to deliver health and social services to sex workers. Most, like Cactus Montreal and Calgary's street vans, are geared to those who work the streets. Others, like Stella's in Montreal and Maggie's in Toronto, have drop-in centres and are involved in advocacy, support, and some health-referral services. They do not offer actual health services to clients. Some clinics, such as those near prostitute strolls in Vancouver, Calgary, Toronto and Montreal, or STD Clinics, such as that in Windsor, have a sizable sex worker clientele, and staff make an effort to provide appropriate services. Most of these clinics, however, have designed their services for outside sex workers. To date, we have located only two programmes that are designed for inside sex workers--both for exotic dancers. The Exotic Dancers' Alliance (EDA), originally formed under the sponsorship of the Peel Health Unit, and the outreach programme operated by the North York health unit's Talk Shop work with exotic dancers. Both have initiated active health outreach and hepatitis B vaccination programmes for exotic dancers in the strip clubs where they work. The resistance of escorts to associating with other sex workers creates the need for a special form of outreach to this group as has been established for exotic dancers.
Victimization by Clients, Police, the Public and the State
Sex workers are regularly subject to various forms of victimization, including robbery, fraud, physical and sexual assault, police entrapment and harassment, stalking, denial of living accommodation, denial of protection and/or redress in situations of abuse, assault and fraud, and loss of custody of children (Barnard 1993; Farley& Barkan 1998; Hatty 1989; Hodgson 1997; James& Meyerding 1997; Lewis& Maticka-Tyndale 1998a, 1998b; Pyett& Warr 1997; van Wageningen 1996; Vanwesenbeeck, et al. 1995). A review of research by Hatty (1989), and Pyett and Warr's (1997) more recent review, leads to the conclusion that over 75% of street prostitutes are assaulted by pimps, clients, or police while working. Several researchers, including those interviewed as part of this study, have observed that street prostitution is the most dangerous form of sex work (Barnard 1993; Brannigan 1998; Miller 1993; Miller& Swartz 1995; Shaver 1998). As Brannigan commented in an interview for this study, "You don't hear about escorts getting murdered. But every year prostitutes are killed." This observation is supported by the data presented by Duchesne (1995) in her report for the Canadian Centre for Justice Statistics and by data highlighted in a recent Vancouver Sun article (Hogben& Kines 1999). Though it is rare to hear of the murder of an escort in conjunction with her work, our study of escorts, as well as that of exotic dancers, produced results that parallelled those of research on other sex work occupations with respect to sexual and physical assault in domestic lives (including during childhood) and on the job. Exotic dancers participating in an earlier study reported sexual assault by employers, landlords and neighbours. Several participants in the escort study reported requiring hospitalization because of assaults.
When a woman is employed in sex work the general assumption is that she is available for any form of sex with anyone. She is perceived to have lost her right to say "no" to sexual encounters (Bindman& Doezema 1997; Lewis& Maticka-Tyndale 1998; Pheterson 1990, 1993). Most sex workers do not file complaints with the police in response to assault or attempted assault, and when they do, they cannot be sure that their complaints will be taken seriously (Lewis& Maticka-Tyndale 1998b; Maticka-Tyndale, et al. 1999; Pheterson 1993). As one escort commented: If you ever get raped or something like that, what can you do...the police don't like escorts, first of all. You can't go to a police station and say "I've been raped, I'm an escort...by one of my clients, I've been raped." They just laugh at you and like, "That's your job honey!" Victimization (child and adult) has both immediate and long-term consequences for physical and emotional health (DeLongis, et al. 1982; Farley& Barkan 1998; Felitti 1991; Golding 1994; Goodman, et al. 1993; Vanwesenbeeck, et al. 1995; Waigandt, et al. 1990). As Vanwesenbeeck, et al. (1995) found, a history of victimization experiences (either in childhood or adult life) can impact on a woman's ability to: (1)
negotiate condom use; (2) refuse risky activity; or (3) engage in self-protective behaviour in sexual transactions with men. Clearly, the victimization experiences commonly reported by sex workers put them at increased risk of transmission of STIs.
Violence and the potential of violence and assault are viewed by sex workers as an ever-present part of their job (Miller 1993; Miller& Swartz 1995). In our research with exotic dancers we also found that experiences of and anticipated probable violence and victimization caused a high degree of stress (Lewis 1998a; Maticka-Tyndale et al. 2000). Such work-related stress was exacerbated by women's efforts to remain secretive about their occupation. Both the exotic dancers and escorts we interviewed reported engaging in concealment strategies to avoid discovery, stigmatization and possible victimization that could result if others knew (e.g., loss of child custody, loss of family, denial of living accommodation, stalking, etc.). Such efforts led to coping strategies that resulted in intended or unintended isolation from similar and supportive others, substance use, and to concealment of their occupation, even from health care providers, all of which jeopardize health and well-being and increase vulnerability to STIs.
Personal Health Practices and Coping Strategies
The sexual services provided by sex workers differ depending on the location and type of sex work. Jackson, Highcrest and Coates (1992), in their discussion of the relative risk of exposure to HIV associated with different forms of sex work, observed that the relatively low risk activities of oral sex and masturbation were the most common services provided on the streets, in body rub and massage parlours and by exotic dancers in adult entertainment lounges. The high risk activities of vaginal and anal intercourse were more common in the work of escorts and call-girls. The sexual services provided by the escorts we interviewed covered a wide range including masturbation, oral sex, vaginal and anal intercourse, urination and defecation to produce sexual arousal, use of a variety of props and sex toys, role playing, and sado-masochistic practices. While the most commonly requested sexual service was vaginal intercourse, since this carries a high fee (approximately $200 in addition to the $130 introduction fee paid in order to make contact with an escort), most clients actually contracts for oral sex was instead (approximately $100 in addition to the introduction fee).
The primary personal health practice considered to have an effect on STIs is condom use (Maticka-Tyndale 1997). However, what must be remembered is that condoms do not provide complete protection from STIs. For example, the human papilloma (HPV) and herpes viruses, may be transmitted despite condom use (Steben& Sacks 1997). HPV has been implicated in cervical cancer, rates of which are higher among prostitutes (Messing, et al. 1993; Network of Sex Work Projects 1997). Research on condom use by sex workers has repeatedly shown that when condoms are available, there is a high degree of regularity in condom use with clients, not only for vaginal and anal intercourse but also for oral sex and masturbation (e.g., Chapkis 1997; Cohen& Alexander 1995; Day, et al. 1988; Day& Ward 1997; Jesson 1993; Jesson, et al. 1994; Maticka-Tyndale, et al. 1999; Scambler& Scambler 1995, 1997; Shaver 1996; Shaver& Newmeyer 1997; Vanwesenbeeck, et al. 1993; Venema& Visser 1990). It is common, however, for customers to pressure sex workers to provide fellatio or genital sexual services without condoms, often offering higher pay for condom-less sex (Albert, et al. 1998; Barnard 1993; Plumridge, et al. 1997a; McKeganey& Barnard 1996; Pyett& Warr 1997; Vanwesenbeeck, et al. 1994). This leaves the responsibility for managing condom use with the sex worker. Our interviews with escorts supported these conclusions. All claimed that condoms were consistently used for oral sex, vaginal and anal intercourse, as well as, in some cases, for masturbation; and that the pressure for condom-less sex came from clients.
Despite a high degree of regularity of condom use in sex work, researchers in all countries find four situations in which condoms were less likely to be used: (1)
with regular customers (Jackson, et al. 1992; Scambler& Scambler 1995; Vanwesenbeeck, et al. 1993; Venema& Visser 1990); (2) when financial need (for whatever reason) was acute (de Zalduondo 1991; Jackson, et al. 1992; Pheterson 1990; Scambler& Scambler 1995); (3) with lovers and relationship partners (Chapkis 1997; Day& Ward 1990; Dorfman, et al. 1992; El-Bassel, et al. 1997; Jesson, et al. 1994; Maticka-Tyndale, et al. 1999; Pyett& Warr 1997; Scambler& Scambler 1995, 1997; Shaver& Newmeyer 1997; Vanwesenbeeck, et al. 1993; Venema& Visser 1990); and (4) in situations of third party abuse (Maticka-Tyndale, et al. 1999; 2000; Pheterson,1993). In addition, in studies in the Netherlands, de Graaf et al. (1993, 1995) and Vanwesenbeeck, et al. (1993) found that specific subgroups of sex workers, including those who were IDUs and those who were financially dependent on sex work to sustain an addiction, were more likely to engage in risky sexual encounters. Based on a review of the literature and her own research findings, Pheterson (1993) concluded that third party abuse and financial need were the greatest pressures to be indiscriminate with selecting customers or using condoms. According to Pheterson (1993: 40), risk taking is not part of the sex work but part of the abuse, poverty, and poor work conditions. The interviews we conducted for this research parallel these findings with only one exception, condom-less sex with regular customers. The escorts interviewed claimed consistent condom use, regardless of how well they knew a customer.
Substance use and abuse is reported to be commonplace among some groups of sex workers (El-Bassel, et al. 1997; Maticka-Tyndale& Lewis 1997; Plant, et al. 1990; Prus& Irini 1980; Pyett& Warr 1997). While some women enter sex work in order to finance a previously established drug habit (Harcourt& Philpot 1990), others use alcohol and other drugs to deal with personal life or job stresses (Alexander, et al. 1996; Maticka-Tyndale& Lewis 1997); Maticka-Tyndale et al. 2000. Substance use and abuse not only have a direct impact on health, but make sex workers more vulnerable to coercion (physical and financial) and assault, and to influence the likelihood of condom use (Lewis& Maticka-Tyndale 1998a; Maticka-Tyndale et al. 1999; Plant, et al. 1990; Vanwesenbeeck, et al. 1993). In addition, as Pyett and Ware (1997) observed, drug and alcohol use may be accompanied by other health problems that increase sex workers' vulnerability to STIs.
In our studies with both exotic dancers and escorts, alcohol and tobacco were the most commonly used substances, followed by marijuana, cocaine, heroin, and other illicit drugs. However, studies from the United States and Europe suggest that street prostitutes are more likely to be IDUs (McKeganey& Barnard 1996; Plant, et al. 1990) than are escorts or exotic dancers. Kail, Watson and Ray, (1995) in their study of over 9000 IDUs, found that those who traded sex for money or drugs were not only more likely to engage in risky sex, but also more likely to engage in risky drug-related behaviours such as sharing needles, producing another form of exposure to infections. Concluding Comments Related to Escort Work
There is increasing awareness that prevention of STIs is not simply a matter of using condoms, but relates to factors of personal and social health and well-being that heighten or reduce vulnerability. Sex work is a stigmatized occupation in which women with limited marketable skills and economic resources work. Though escort work is at the high end of the status hierarchy of sex work, and though women working as escorts work in a safer environment than those walking the streets, they are not free from assault, coercion, stigmatization and other forms of victimization. Many of the women we interviewed had experienced at least some form of victimization, and some had been forced to have sex without a condom.
The sexual services that escorts provide may include: masturbation, oral sex, vaginal intercourse, anal intercourse, urinating or defecating on the client, role playing, and sado-masochistic practices. The escorts who participated in this study reported consistent condom use for penetrative sex of any kind and often also for masturbation. They were generally unaware that some STIs were not prevented by using condoms or could be transmitted through non-penetrative activity. While most were regularly tested for STIs, few had regular physicians or disclosed their occupation to their health care provider, preventing them from openly discussing risks and prevention. Escorts and Adult Entertainment The Local Scene ___________________________________________
Windsor, Ontario, a city of 200,000 inhabitants is located at the southern tip of Canada, directly across the river from Detroit, Michigan, a city of over 6 million. Although most Canadians probably look to the United States as a more urbane environment than Canada, and most Americans consider Canadian cities as safer and considerably "tamer" than American cities, Windsor has been dubbed "sin city" by its American neighbours. The label appears to come from the activities that attract American visitors to Windsor. During the American prohibition, for example, Windsor figured prominently in the "rum running" of alcohol to various American ports and was a place where Americans could legally imbibe. Ontario's lower minimum age for alcohol consumption compared to the surrounding American states, continues to attract American youth to the growing number of bars and clubs in downtown Windsor. Canada and Ontario's legislation regulating strip tease, and the sex industry in general, are more lenient than that in neighbouring states (referred to as more "enlightened" in a report on the American television show, 20/20 first aired in May, 1998). Total nudity is permitted in strip clubs, as was lap dancing for a period of time. In addition, selling sex is not legally prohibited in Canada. During the 1990s there have been additional events that have helped maintain Windsor's reputation: the opening of a casino (where, unlike American casinos, winnings are free from taxation), an Ontario court ruling permitting female public "toplessness" (though few women are seen topless in public), and the licensing of escort services by the city of Windsor. These events, together with the favourable exchange rate on the American dollar, are some of the attractions for American visitors.
Windsor's adult entertainment sector, including its race track, casino, bars, strip clubs, and escort services, has experienced a phase of growth that was ushered in by the opening of a temporary casino in 1994, a second temporary casino in 1996, and the permanent river-front casino and hotel in 1998. Between 1994 and 1996 the number of classified ads for escort services increased ten-fold in local newspapers and telephone books (Vander Doelen& Smrke 1996), and, according to a report in the Windsor Star, the number of escort services tripled (Windsor Star 1996a), suggesting an increase in the industry, or at least an increase in its public visibility.7
Shortly after the casino opened, Windsor's police services pursued passage of an escort licensing by-law. For the police, licencing was seen as a tool to increase their knowledge of and control over an industry which was perceived to be growing quickly and prone to a range of crimes (e.g., fraud, robbery, assault, underage sex workers, organized crime).8 As a Windsor police service representative interviewed for this study explained: Escort work is particularly difficult to police. You can't find it. In most cases you'd have to have a guy in a hotel room who actually does it [has sex with an escort].9 We don't have any cops ready to do that. When it's licenced we know who they are and where they are. We can keep tabs on it. Since escort work is relatively invisible, without licensing, it is difficult for police to gain information about the industry. Licensing of escorts and escort agencies was therefore seen by police as a mechanism to control the industry by regulating who could work as an escort or open an agency (e.g., minimum age, requirements for background clearance, etc.), and by supplying information about who was working in it.
The first attempt at licensing escorts did not receive city council support. A task force was struck to make recommendations for a by-law to city council. The task force consisted of representatives from various municipal groups which, over the time period it met, included representatives of: the Women's Incentive Centre, the AIDS Committee of Windsor, The Sexual Assault Crisis Centre, The Windsor and District Health Unit, Windsor Police Services, the City Clerk's Office, a municipal councillor, and an interested citizen. Not all of these individuals were official members of the task force or participated in all of its activities and meetings, but all had input either into the licensing recommendations or to the programmes developed by the task force and recommended to city council. Attempts to find an escort to sit on the task force were unsuccessful. The task force examined by-laws from other cities, considered whether Windsor needed a by-law, and presented a report and revised by-law to city council in the spring of 1996. In addition to proposing that escort work be licensed, the task force recommended that a portion of the funds collected from licensing be allocated to providing educational, support and counselling services to assist escorts who wished to leave the occupation. The City of Windsor passed the by-law requiring escorts and escort agency owners, as well as those working on an out-call basis providing body rubs, non-medical massage, and private modelling, and the agencies running these services, to obtain a municipal license and abide by several licensing regulations. In addition, Council voted that: up to 50% of the revenues from licensing of Escorts and Personal Service Agents be directed to a fund to be "earmarked" for use for special investigations necessary to monitor the successful implementation of the provisions and to be used for transitional assistance to persons wishing to leave the business. (Bill No. 104 as amended on May 6, 1996) By July 1996, one month after the deadline for obtaining a license, 5 agencies and 41 escorts had been licensed. By the end of 1996, 12 agencies were licensed and police report that there were 20 licensed agencies in mid-1999.
The escorts we interviewed reported that, prior to licensing, most escorts served a primarily local clientele. The local business continued after licensing, with visitors to Windsor added as customers. All the escorts we interviewed served American clientele. While local clients formed the bulk of business for some women, Americans accounted for as much as 90% of the business of others. The difference depended to a large degree on where an agency or an escort advertised, whether an escort prefers hotel or home calls, as well as whether the escort or agency was in business prior to licensing. For example, advertisements on the Internet, including pictures and brief profiles of some of the available escorts, and ads in the Detroit area Yellow Pages brought in more non-local clientele; whereas, escorts and agencies that were only listed in the local media (e.g., newspapers) were more likely to attract local clientele. One agency owner, who had joined the Convention and Visitors Bureau of Windsor, Essex County and Pelee Island, placed advertisements in the publications of the Bureau and at the casino alongside other members' ads for the first six months the casino was open. When members of the Bureau and the Casino Corporation realized the nature of the business being advertised, they insisted that the agency advertisements be removed. However, several hotels in the city provide information to their guests on local attractions, including information about escort services.
For at least some visitors, the licensing of escort services appears to have produced a sense that "everything is legal"( i.e. that there are no legal prohibitions related to sex work in Canada), providing an incentive to engage a sex worker. Our research findings suggest that escort services are part of an adult entertainment package that includes the casino and strip clubs. The casino is the "main draw" in this package and is responsible for increasing business to escort services. Without the casino, the increase of recent years would be unlikely. For some tourists and business travellers, the casino-strip club-escort combination provides an enticing package. Escorts reported that the bulk of their non-local clientele come to Windsor to visit the casino and afterwards hire an escort. Escorts also reported that a typical "coming of age" ritual among American men was to come to Windsor with a group of friends, rent a suite of rooms, go to the casino and strip clubs and then hire an escort. Agency owners reported it was also common to get mid-day phone calls from visiting businessmen inquiring about escorts for after-work companionship and that one form of post-work relaxation for visiting businessmen included visiting the casino and a strip club and/or hiring an escort. In addition, for some weekend visitors, a trip to Windsor for entertainment included the casino and an escort.
Sangera (1997: 6), in her examination of the changes in sex work related to globalization, suggests that a new dimension to sex work is emerging. Historically, prostitutes concentrated near colonies of single men (e.g., military camps, port cities, colonies of migrant workers) In addition, during times of natural disasters or social and political upheavals, there have always been increases in the masses of women offering sexual services in the market. Sangera refers to this as the first, or traditional, tier of sex work, a tier that has marked sex work throughout history. The numbers of men and women involved in this tier of sex work remains relatively stable and its presence relatively predictable. Globalization has produced a second tier. This tier is attached to the tourism industry, catering primarily to domestic and international tourists and business travellers. It grows and flourishes around major tourist and business centres (Sangera 1997:7). Unlike the first tier, this tier is a growing industry, drawing an increasing number of women from more disadvantaged regions and with fewer personal resources into an industry designed to provide "R and R for the corporate world workforce" (Sangera 1997:11).
The growth in the escort industry in Windsor reflects this second tier of sex work. It exists within the context of an adult entertainment industry that is used to attract tourists, conventions, and business people to Windsor, and, for some, has become part of the "R and R" package that is available in this locale. The second tier characteristics are present not only in Windsor's draw for clientele but also in its draw for workers. A number of the women we interviewed came to Windsor from other regions in Canada specifically because they heard that escort work was licensed, and therefore "legitimate." They also came because they expected an influx of clientele tied to the increase in tourists coming to the city to visit the casino. Although the casino brought an influx of business for escorts, almost all the women also spoke of seasonal fluctuations in the types of tourists drawn to the region. Some women reported leaving Windsor to work in other locations during "slow times." Such movement parallels what Sangera (1997) described for tourist centres in the developing world and fits the profile of the second tier of sex work.
Movement of clients and sex workers across geographical areas carries the potential of spreading STIs through networks of partners across regions (Klovdahl, et al. 1994). The association of cross-border travel with sex work (e.g., sex tourism, trafficking) has become an area of major concern in other parts of the world, including Europe and Asia (Leopold& Steffan 1996; Lyons 1997; Rajan 1997; Sangera 1997). What we are beginning to see in Windsor reflects the trend seen in this global picture and should be considered from within this context. National and Local Policies and Legislation ___________________________________________
As countless researchers and policy makers have observed, law and policy have been unsuccessful in eliminating sex work (Decker 1979; McLaren& Lowman 1990; Reynolds 1986: 35). However, as Reynolds (1986) demonstrates using a diversity of jurisdictions in the United States, law and policy do influence the form and prevalence of sex work in a particular region, with local laws and policies creating an "ambience conducive to different kinds of prostitution" (Reynolds 1986: 35). The work of researchers such as Bindman and Doezema (1997), Brock and Thistlethwaite (1996), and Decker (1979), who have examined law, policy, culture and sex work internationally, supports three conclusions: (1) the form and prevalence of sex work are influenced by local law and policy; (2) the health, safety and well-being of sex workers are influenced by local law and policy; and (3) law and policy grow out of local history and culture. All three conclusions point to law and policy as important areas of inquiry.
Legal responses to sex work take one or a combination of four approaches: prohibition, tolerance, regulation and decriminalization. The goal of a prohibitionist approach is to eliminate sex work through direct criminalization. Thus, the exchange of sexual services for money is illegal for both seller and buyer. This approach is seen in all regions in the United States with the exception of a few counties in the state of Nevada. The goal of the toleration approach is also the abolition of sex work; however, legislators recognize the difficulty in producing a definition of sex work or prostitution that will withstand the test of court proceedings (Decker 1979: 124-125) and sex workers are generally seen as victims of the commercial sex industry and the circumstances that brought them into sex work (Coalition against Trafficking in Women 1998; Holsopple 1998a; Raymond 1998). Consequently, the actual exchange of sex for money itself is not criminalized, however, actions related to sex work, such as loitering, public soliciting or communication, kerb-crawling, living off the avails, transporting for the purpose of prostitution, etc., are against the law. Canadian laws fit the tolerance approach. Both prohibition and toleration have the effect of driving much of sex work underground and out of sight, since sex workers and/or their associates may be subject to arrest and prosecution if they are discovered. In the regulation approach, the practice of sex work is controlled through zoning, licensing, restriction of place of work (e.g., only in licensed brothels), requirements for health examinations, etc. In this approach the goal is control of sex work for any one or combination of reasons, such as: limiting the spread of STIs, combatting "moral decay," preserving "public decency," and protecting sex workers (Brock 1989; Hatty 1989; McLaren& Lowman 1990). This is the approach taken in Germany, Austria, Switzerland, Australia and several counties in Nevada. The final approach is that of decriminalization (also referred to as abolition, i.e. abolition of laws: Hatty 1989). Under this approach neither sex work nor activities peripheral to it are subject to criminal law nor to any form of unique regulation or control. Sex work is treated as an occupation and is subject to the same types of occupational control as similar occupations. Policies regarding sex work in the Netherlands come closest to a decriminalization model. However, Dutch policies include local regulation of sex work, primarily through zoning, and include characteristics of a toleration model.
Decriminalization is advocated by the International Committee on Prostitutes' Rights. Bindman and Doezema (1997), in their cross-national report on sex work, argue that this approach is consistent with conventions passed by the International Labour Organization (ILO) and by several human rights groups and is the approach which best meets international human rights standards and labour code conventions agreed to by members of the United Nations and ILO. Bindman and Doezema provide documentation of human rights abuses and poor labour standards associated with sex work. From their analysis they conclude that decriminalization, together with the application of standard human rights and labour code conventions, is the only way the human rights, health, and well-being of sex workers can be protected. This conclusion parallels that reached by several researchers who suggest that the conditions under which sex work is performed and the health and well-being of sex workers are best served by de-marginalizing sex workers from mainstream society, which requires as a first move, decriminalization (Pheterson 1990, 1993; Scambler& Scambler 1995). What must be recognized, however, is that there are also organizations such as the Coalition against Trafficking in Women and WHISPER that firmly oppose decriminalization. They believe that such policies lead to further exploitation of women and women's sexuality, and exacerbate human rights violations perpetrated on sex workers (see for example: Coalition against Trafficking in Women 1998; Holsopple 1998a; Raymond 1998). Examples of Legislative Approaches:
Various social hygiene movements and "purity" campaigns of the early 1900s resulted in the criminalization of sex work in all states in the United States of America except Nevada. In the United States, legal prohibitions related to sex work exist at the level of federal and state statutes and local ordinances. They may be directed toward the worker, the client or those who promote and benefit from sex work and, depending on the jurisdiction, may be either criminal or civil in nature (Decker 1979: 81). The state of Nevada is the exception to this rule. While Nevada's penal code addresses prostitution-related activities that might disrupt the peace of the community (e.g., soliciting, keeping a house which habitually disturbs the community) or exploit prostitutes (e.g., living off the earnings of a prostitute, pandering, and placing a person in a house of prostitution), neither sex work itself nor maintaining a brothel are prohibited in the state's penal code (Decker 1979:89). Specific provisions of the state's penal code allow counties with populations of less than 200,000 to license, regulate or prohibit houses of prostitution. Prostitution is prohibited, however, in Nevada's three largest cities (Las Vegas, Reno and Carson City), two of which are major tourist centres. In addition, within counties that permit brothels, incorporated municipalities may choose to prohibit or further regulate brothels within their boundaries. Control of brothels and brothel workers varies across counties. Some permit brothels to exist without regulation, others license and regulate brothels and workers. Registration with police, proof of regular testing for specific STIs, specific consequences for a positive test for certain STIs, and restriction of movement and residence outside the brothel are in force in some jurisdictions. In all jurisdictions, brothels exist only so long as they are not deemed to be a public nuisance (Bindman& Doezema 1997; Decker 1979:89-92; Reynolds 1986: 88). Thus, while brothels may be tolerated, they can be forced to close if an offended citizen can successfully prove they are a public nuisance.
Debates surrounding provision of county-option with respect to sex work have focussed not on whether brothels should be permitted in Nevada, but on the impact that approval of brothels in the two large tourist centres of Las Vegas and Reno might have: You can't be so vulgar that you offend McAmerica which fills your hotels. It must not become so open, so raw that it hurts the real business, which is gambling (Vogliotti 1975:235-6 as quoted in Reynolds 1986: 99). If Las Vegas should do something so stupid as to have open whorehouses, America's wives would scream like banshees. Nothing would hurt conventions more than if women learned that their men were off to a town that had open twenty-dollar parlors (Vogliotti 1975:29 as quoted in Reynolds 1986: 99).
Reynolds suggests that the more accepting approach to brothels in Nevada, compared to the remainder of the United States, can best be understood in relation to their place in the history of the state and the social structure of Nevada today. Brothels, or "cathouses," have been part of the Nevada landscape since the region was settled and have been tolerated throughout the state's history, with madams and workers integrated into the culture and structure of local communities (Reynolds 1986: 98). Current residents refer to the presence of brothels as "just part of the way of life" in Nevada and tell stories of how madams and "girls" support local causes and are good neighbours. Some even claim that brothels result in a lower incidence of rape in the state, though comparative crime statistics do not support this conclusion (Reynolds 1986: 101). Some newer residents of the state do not share this attitude and have successfully lobbied for prohibition in some locations.
With the exception of Las Vegas, Reno and Carson City, Nevada is sparsely populated, with residents living on ranches, farms, at mining sites, military bases and in small towns. The location of brothels is influenced by four factors: highways, railroads, nearness to a big city and proximity of military bases. Highways and railroads facilitate access to brothels and military bases and large cities insure a clientele. Nevada's three largest brothels, the Chicken Ranch (which has a landing strip) and Mustang Ranches I and II, are located at the closest proximity possible to Las Vegas and Reno respectively. Most of the remainder of the brothels are small and rely on attracting customers by word of mouth and repeat business (Reynolds 1986).
While brothels, compared to other forms of sex work, provide some protection for sex workers from the dangers of street work, and the legalization of brothel work eliminates the possibility of criminal charges for such work, prostitute advocates do not support this model of legalization and have identified several problems with it: (1)
The licensing requirement creates a permanent record that someone has engaged in sex work, and may have repercussions for other employment, child custody, housing, and in a variety of other situations. 2 There are neither legislated restrictions on the activities (e.g., they must comply with condom use), nor health requirements for clients. While customers are assured that licensed prostitutes have passed police and health screening (where these are required), prostitutes have no such assurances about customers. 3 Most counties and municipalities impose an array of restrictions on the movement and residence of brothel workers, forbidding them to live outside brothels even when they are no longer working as sex workers, forbidding them to be in the company of men outside of the brothel, and, in some cases, forbidding brothel workers from being outside the brothel except on specific days and under specific conditions (Bindman& Doezema 1997; Decker 1979; Reynolds 1986). This effectively isolates brothel workers from society. As Carol Leigh of COYOTE has stated, "the only legalized prostitution model in this country [the United States] is an abusive state regulatory system designed to protect clients, not the actual sex workers" (Leigh 1999).
Decriminalization with Local Regulation: The Netherlands
The Netherlands is known for its acceptance of sex work. Sex work takes place in clubs, brothels, from windows, in escort services and on the streets. The Welfare Directorate subsidizes an ongoing research programme on sex work conducted by the Mr. A. de Graaf Foundation, and the Ministry of Social Affairs and Employment finances The Red Thread, a national advocacy organization of current and former sex workers (Mak 1997a). Both organizations have encouraged a labour and human rights approach to sex work in Holland.
Article 250 bis, originally passed in 1897 as a statute that outlawed brothels in Amsterdam, and adopted nationally in 1911, codifies Holland's legislation regarding sex work. While sex work is legal, organizing and making a profit from the work of others (e.g., brothels, sex clubs, renting windows), is not. Modifications to article 250 bis made during the 1990s clarified the distinction between forced and voluntary prostitution (making the former illegal) and established minimum ages for employment in various forms of sex work (18 years of age for work as a prostitute or to act in hard core pornography; 16 years of age to visit a prostitute or act in soft core pornography). Sex workers are not required to register or to have regular health checks. Public attitudes and local approaches to sex work do not, however, conform directly to the official legislation. While brothels and sex clubs were officially forbidden until 1999, they were generally tolerated as long as they followed health and fire codes (Chao 1997). While sex work is legal, municipal by-laws commonly set restrictions on where it may be conducted. As Mak (1997), in his review of Dutch policies and practices for a EUROPAP study of sex work in Europe, notes: Organized prostitution is forbidden, while, in practice, commercial brothels are allowed to operate with varying amounts of freedom. Likewise, while the individual exchange of sex for money is not considered to be a criminal offence, streetwalking is usually deemed a public nuisance and forbidden by local by-laws. (Make 1997:1)
Most cities in the Netherlands confine street prostitution, brothels, windows and clubs to what are referred to as "zones of tolerance" or "red light districts." Escort work, however, is not controlled. In a telephone interview, Ine Vanwesenbeeck (1998), a leading researcher on sex work in the Netherlands, pointed out that because escort work is "invisible and can be going on anywhere without people knowing it,...it isn't a concern." Though its invisibility prevents public protest about nuisance, The Red Thread has raised several other concerns about escort work. It [escort work] is a big problem here. It's a kind of a hide-out for all sorts of brothel operators who don't want to meet standards. They do escorts instead because it is very difficult to catch an escort service.. you can employ all sorts of women without taking care of any conditions and they can be terribly exploited (The Red Thread 1998).
Both the de Graaf Foundation and The Red Thread are strong advocates for the rights of sex workers with respect to employers in clubs, brothels and escort services. At the time this research was conducted the Dutch parliament was considering passage of a new bill, which was eventually passed in 1999. According to Vanwesenbeeck the bill is: a tool and the means to get hold of the organization of prostitution, because the condoning doesn't [create] any legal apparatus to intervene and to control and direct how it should be done...one wants to legitimize the acceptable forms of prostitution and one wants to fight the more exploited ones.(Vanwesenbeeck 1998) Vanwesenbeeck and The Red Threat saw the bill as necessary because sex workers had no legal basis for making demands, as workers, on their employers. The proposed bill included requirements for hygiene, fire and safety precautions in sex clubs, brothels, or window prostitution and also limited employment to legal residents of the Netherlands. This latter provision addressed a second area of concern--the large number of foreigners working in the sex industry in the Netherlands. Migrants are drawn to the Netherlands primarily from Latin America, Asia and the former countries of the eastern bloc. The Red Thread estimates that there are 200 window prostitution businesses, 70 closed brothels and over 5,000 prostitutes working in Amsterdam. They also estimate that between 50% and 70% of the women working as window prostitutes in the red light district of Amsterdam are illegal migrants to the Netherlands. It is migrant sex workers who are most often found in brothels and windows. They are also the ones who are particularly prone to exploitation, since they are in the country illegally.
In their interviews, Vanwesenbeeck and The Red Thread representative both stressed that the legal status of sex work in the Netherlands should not be taken as an indication of its acceptance by the general population. Similar to other countries with less liberal laws, sex workers in the Netherlands are stigmatized and marginalized, and their human rights persistently threatened. While zones of tolerance provide sex workers with a place to conduct their work free of official police harassment, these zones are typically far from basic amenities such as coffee shops or restaurants. It is left to social service agencies and outreach workers to provide locations for sex workers to buy food and drink and a safe place to rest (Bindman& Doezema 1997; Mak 1997a).
When asked about health concerns in general and STIs in particular, especially given the popularity of Amsterdam's red light districts with foreign travellers, and the growth in sex work on the country's borders, both Vanwesenbeeck and The Red Thread representative stressed that there were no concerns with health problems. Studies of HIV prevalence in the Netherlands conducted in 1986 and 1990 showed low rates of infection among sex workers who were not intravenous drug users (van Haastrecht, et al. 1993; Mak 1997a). Condom use and safer sex practices are considered to be standard in the sex work industry in the Netherlands. In her research, Vanwesenbeeck found that, unlike the situation in other countries, both Dutch customers and sex workers are likely to be concerned with condom use (de Graaf, et al. 1993; Plumridge, et al. 1997; Vanwesenbeeck, et al. 1993; Vanwesenbeeck, et al. 1994).
Although condom use and safer sex practices are considered to be standard among Dutch sex workers and customers, condom use is not universal in sex work in the Netherlands (Vanwesenbeeck, et al. 1995). Particular concern has been expressed about migrant customers (Mak, 1997a) and sex workers from Latin America (van Haastrecht, et al. 1993) or from neighbouring countries in Eastern Europe (e.g., Poland and the Czech Republic), where condom use is less common. Condom use has also been reported as lower among sex workers who work at home or via escort agencies (Hooykas, et al. 1989). According to Vanwesenbeeck (1998), there are many different kinds of people engaged in sex work. Some "function very well," while others "have a great deal of difficulty." Individuals in this latter group are "the most vulnerable .. and often get caught up in the black market and are badly exploited." They are also the group most vulnerable to STIs.
Toleration: Canadian Federal Law
The status of sex work in Canada presents a confusing picture for most people. Although it is commonly believed that sex work is illegal, the exchange of sex for money is not prohibited by the Criminal Code of Canada (1985). Instead, the relevant sections of the Criminal Code (sections 210 through 213) target only activities associated with sex work, including: keeping or being found in a common bawdy-house (s. 210), providing directions to or transporting someone to a bawdy house (s. 211), procuring or living off the avails of prostitution (s. 212), communication in a public place for the purpose of prostitution (s. 213), and purchasing sexual services from someone under 18 years of age (s. 212(4)). In addition, some forms of sex work leave workers open to charges under other sections of the Criminal Code such as: obscenity (s. 163), engaging in an immoral theatrical performance (s. 167), performing an indecent act in a public place (s. 173), and public nudity (s. 174). Thus, while sex work is not illegal, a number of activities associated with it are.
While Canadian criminal laws make it difficult for street prostitutes (s. 213) and in-call prostitutes (s. 210) to practice their profession, or for exotic dancers to perform certain types of dances (s. 163, s. 167, s. 173 and s. 174), or to engage in consensual acts of sexual contact on the premises of the strip club (s. 210), without violating federal statutes, it does not necessarily impede the work of escorts, who work on an out-call basis. However, there are Criminal Code restrictions on escort work. For example, according to s. 212, any individual who arranges for someone to engage in prostitution (e.g., an escort who "brings a friend along," an agency owner who arranges for an escort to meet a client explicitly for the purpose of the exchange of sex for money) is in violation of Canadian criminal law. In addition, s. 212 makes it illegal for anyone to live off the money earned by a sex worker, which can technically be extended beyond "pimps" and employers or agents to include children, spouses, lovers, parents, siblings, friends, babysitters and drivers.
Federal criminal statutes may be enforced by the Royal Canadian Mounted Police, provincial police or municipal police forces. These statutes supersede any laws, by-laws, legislation, codes or statutes passed by lower levels of government such as provincial parliaments or city councils, the legality of which are determined by whether they conform to federal statutes. Police, however, often take local policies and situations into consideration when deciding upon their course of action. A common approach to enforcement is to wait for complaints to be made by local citizens, agencies and organizations, or city councillors, or for violations of other sections of the Criminal Code to be evident before applying the prostitution-related sections of the Criminal Code. Police in many jurisdictions see their role as protecting the safety of sex workers or working toward getting them out of sex work rather than strictly enforcing federal statutes (Federal-Provincial-Territorial Working Group on Prostitution 1995a, 1995b, 1998). As a sergeant from the Windsor Street Crimes Branch commented when explaining his own enforcement policy: My feeling about this whole thing is that the women and men involved in the sex trade industry as prostitutes are victims.... My primary focus is on the pimps, the escort agents or the drug dealers. Based on their own investigations, members of the recent Federal-Provincial-Territorial Working Group on Prostitution (1998) concluded that, in general, police enforcement efforts focus on the visible forms of sex work, or on the procurement of youth (see also, Larsen 1992b). Charges, however, have been laid against escorts as well as agency owners as evidenced in recent cases in Toronto and Windsor (Mandel 1998b).
Municipal Policies and By-Laws
Police are more likely to use municipal by-laws and regulations to control sex work than to lay charges under the Criminal Code. This is for two reasons. First, it is easier to issue tickets and summonses for infractions of municipal by-laws than to amass sufficient evidence to lay charges under the Criminal Code. Second, municipal regulations and by-laws can more easily be moulded to fit local situations. Some examples of regulation and control tactics that have been used recently in Canadian municipalities include: 1
Creating a series of one-way streets to change traffic patterns and make it difficult for potential customers to circle or cruise a prostitute stroll. 2 Restricting the operation of escort services and body-rub or massage parlors to non-residential and, at times, industrial zones. 3 Issuing a large number of tickets for loitering or jaywalking to street prostitutes when they work in certain areas of the city. 4 Maintaining a highly visible police presence in areas where sex workers are conducting business. 5 Prohibiting vehicles from parking or stopping in certain areas of the city. The application and strict enforcement of regulations such as these is designed to discourage sex work, or at least to encourage sex workers to move to areas where they are less visible. Research demonstrates that while these tactics have not decreased the number of sex workers, they have made sex work more dangerous (Brock 1998; Downes 1999; Shaver 1999; and comments on the sex-forum listserve). For example: (1)
It is difficult for street prostitutes to assess the safety of a potential client before getting into his car if parking and stopping are prohibited. 2 Drivers cannot perform their body guard function for escorts if they cannot park or stop near where an escort is working. 3 Tactics that move sex work into the least populated sections of a city eliminate the safety afforded by public visibility and sex workers often do not have access to coffee shops, restaurants or other places where they can "take a break" or escape rain, snow or cold temperatures.
Several Canadian municipalities also regulate some forms of sex work through licensing provisions. We compared the by-laws, and interviewed city employees and police representatives in two Canadian municipalities that license escorts, Calgary and Windsor. In both cities, the motives behind establishing licensing were to increase regulation and control of an industry which was seen as prone to fraud, violence and infiltration by organized crime and to make it easier for police to keep minors out of the industry. The licensing of escorts and agencies produces a file which is maintained by the licensing office and the police that includes names, addresses, phone numbers, and photographs of escorts and agency owners. Background checks, conducted by police as part of licensing requirements, allow municipalities to assure agencies and potential customers that licensed escorts have no recent history of involvement in prostitution (a 2 year cutoff is used in Windsor), or a history of involvement in drugs, fraud or crimes of violence. Such checks also assure escorts and clients that agency owners are not associated with organized crime.
The requirement that agencies maintain a record of the times and locations where escorts are sent is designed to facilitate police protection of escorts and the potential apprehension of clients should they perpetrate a crime against an escort. In Calgary, the rationale provided for a licensing policy that prohibits escorts from working independent of an agency is the maximization of protection for escorts and ease of police work. Such a policy also provides agencies with a captive labour force and ensures local citizens that escort services will not be operating in residential neighbourhoods. In Windsor there is no such requirement. Escort businesses (either solo operations or agencies) fit the criteria set for "home occupancy" businesses of The City of Windsor Zoning By-laws. As a result, escorts can work independent of agencies if they choose and can use their homes as their offices. However, since "in-call" services are prohibited by the federal bawdy house laws (s.210), they cannot entertain customers in their homes. In both cities, escorts pay an annual fee for their license, as do agency owners. In Windsor, 50% of the fee is "earmarked" for payment of the costs of policing the by-law and for use in "exit services" for escorts who wish to leave the sex work industry.
Although escorts in both municipalities are subject to police checks, they are not required to submit to regular health checks or screening for STIs, such as those required of brothel sex workers in Nevada. Several of the escorts and agency owners who were interviewed found the requirement for police clearance and the absence of any requirement for medical clearance to be a strange combination. For example, one woman said: I think for a girl to get a license, she should also have to go to a doctor and get herself checked out. I mean they had to do the police clearance to make sure you know, we're not wanted, or we're not murders or anything like that. The least they can do is show the same concern health wise. This woman, and others we interviewed, saw medical checks as an occupational protection for escorts in order to "find out if anything is wrong and get it tended to." They also saw it as protection for the reputation of escorts: Women who have something shouldn't be doing this work. It gives us all a bad name. Agency owners also felt there was a need for medical clearance of escorts. For at least one agency owner, the concern was less with the escorts' health and well-being and more with minimizing liability: So a guy gets AIDS from one of my girls, he's gonna come back on me saying I have to send clean girls. What am I supposed to do, I've got no protection.
These comments about medical screening fail to recognize its limitations and implications. Historically, health screening has been seen as a protection for clients rather than sex workers, with punitive consequences inflicted on escorts if they refused to be tested for STIs or if they tested positive (Brock& Thistlethwaite 1996; Reynolds 1986). Testing, however, is of little use as an indication of freedom from infection since test results deal only with infections that are detectable at the time of testing and results are out-of-date for sexually active individuals before they are obtained. Testing can provides a false sense of security to both escorts and clients who are unaware of this limitation. In addition, if testing were required, this would raise the question of liability if a client became infected by an escort. Besides being of questionable usefulness, requiring STI testing further stigmatizes escorts and serves merely to identify those who have been victimized and infected by clients. More effective protection for escorts and clients is provided when information and resources to prevent transmission are available.
In discussing licensing, escorts and agency owners also expressed the view that licensing should be accompanied by a set of standards which police would be expected to enforce on behalf of the escorts. An agency owner provided an example: I called the police when they said they [the escorts] hadn't been paid. And the police, there were five of them, and they were horrendous. J left crying, M was crying her head off. They treated the girls like garbage. And I said look, I booked them here, I know, I'm the owner of the agency, I know they've been in there forty minutes, they should get paid. And a couple of the cops who were there, we know are the biggest rip-off artists in the city. They said, "you should expect to get ripped off and beaten up. We're not your collection agency." Some escorts also thought that there should be licensing standards enforced on behalf of the agency owner and client: This one girl ripped a guy off took his money and left. He's gonna call me and complain you know yelling at me about how he didn't get what he paid for. I called the police to ask what they were going to do about her they said nothing, all you can do is just not send her out anymore.
The response of Windsor officers reflected in these examples is consistent with the views of a Calgary police representative who stated: Until these women hit rock bottom and experience hard times first hand they won't get out. Making it easy for them isn't helping. It just keeps them in the business. Clearly, some police officers decide how they will enforce laws based on their own personal values even when this denies individuals the right to police protection or legal redress. One representative of Windsor police services was disturbed by these reports of police disinterest and disrespect. He insisted that escorts and agency owners must be treated with the respect and consideration afforded all citizens and business people and stressed that any situation where police officers were disrespectful, "talked down to," or harassed an escort or agency owner that came to his attention was fully investigated. As he observed: We are police officers and for those officers who think they are holier than thou, that is not our business. Private feelings should not come into policing.
Though escort work does not violate any Criminal Code statutes, because they are sex workers, escorts may be subject to the same marginalization and stigmatization as other sex workers. From our interviews, it is clear that many escorts and private citizens believe that escort work is illegal and that municipal licencing has made it legal. Even though such beliefs are false, by officially recognizing escort work as an occupation, municipal licensing empowers escorts and reduces their sense of stigmatization. Several Windsor escorts commented that they were drawn to the city because of licensing, or that they only entered escort work once it was licensed and "made legal." The legitimation of escort work through licensing was seen by the escorts we interviewed as providing several advantages: The bottom line is, it's licensed, it's legal, it's a business that people have to treat as such. So, before we were licensed anybody that was working got ripped off all the time--customers stole everything, customers got ripped off, the girls got beat up, there was nothing you could do about it because they're doing something illegal anyways. A lot of guys are assholes, but they're a little bit scared now because we are licensed. They're a little bit leery of doing anything they might have, you know, normally done. ...you'd be able to do your taxes. I think that's right.... A lot of people are still going to be prejudice against us, but now that we have our license, we're self employed. It shows we are legally working.... So, if I want to lease a car, I can say I'm an escort, here's my license. It's easier that way because before... there was no proof you were doing it.
Municipal licencing provides a mechanism to control the employment practices of escort agencies. Since municipal regulations must not conflict with Criminal Code statutes, they function as a local method for setting easily enforceable standards for employment and business practices. For example, agencies cannot require an escort to provide sexual services to a client. If it does, this constitutes procurement and violates s. 212. In addition, an agency cannot promise a client that particular sexual services (or any sexual services) will be provided. Thus, the exchange of sex for money is completely under the control and discretion of the escort. This was demonstrated in a recent police raid on escort agencies when agencies that violated these procedures were charged with by-law infractions.
The downside of licensing is that it creates a record of who works in the escort industry. Though this record is not available to the general public, it is available to government organizations (e.g., taxation, social services) and may be subpoenaed in legal proceedings such as child custody and criminal cases. In Windsor, though the city licensing office has successfully maintained the confidentiality of its records, this has not been the case for police services. On occasion, police officers have used these records and the information in them in a manner that has exposed escorts to public visibility. One escort summarizes the situation for escorts in Windsor: The police have a lot more access to what we're doing than they did before. That worries me, I don't want them, or the fact that I'm an escort popping up at any time.
Although municipalities can license personal services such as escort work, they must walk a fine line when formulating and implementing local licensing policies in order to avoid coming into conflict with the Criminal Code. This potential conflict is one of the factors that detracts from the potential benefits of municipal licensing. For example, while municipalities can license particular "personal services" such as escorting, dating, massage and exotic dancing, they must avoid any inference that the service they are licensing involves the exchange of sex for money. The actions of municipal officers who provide information or services to escorts related to engaging in sex with clients (e.g., explanations of how to minimize certain health and safety risks or how to conduct work without violating federal statutes), could be used as an indication that they are aware that sex is being exchanged for money, making them vulnerable to prosecution under criminal statutes regarding procurement (s. 212). For example, police representatives interviewed for this study explained that imposing requirements for STI screening not only raised issues of potential liability if a customer became infected, but could also be seen as implying that the municipality knew that sex occurs as part of escort work, placing the municipality in violation of federal statutes.10
These same restrictions exist for escort agencies and their personnel. If an agency were to require STI screening, or if an agency owner or employee were to provide information or services to an escort or a client that could be construed as indicating that they were aware of the sale of sexual services, that agency and/or employee could be subject to charges under federal statutes. In fact, agency owners have been charged under the procuring statute for discussing expected and optional sexual practices with potential employees (Claridge 1999). After the recent police raid of local agencies, agency owners met with representatives of the local licensing commission to request clarification of the by-laws and the legal restrictions on their businesses. In response, the local licensing commission provided the owners with some broad guidelines. Among them was the recommendation that agency personnel not become involved "in the actual delivery [emphasis added] of personal services." Owners were instructed that they must restrict their services to "telephone answering, paging, referral and introduction services, [and] telephone follow-up for security purposes" (Bertolin June 25, 1998). While charges against agencies are possible regardless of whether escort licensing exists in a municipality, licensing increases police control over the industry in several ways. For example, it provides detailed personal information on everyone involved in the industry; the business address of agencies; a reason to conduct checks on the industry and its personnel (license and record keeping verification); and a vehicle other than the Criminal code through which to charge escorts, agency owners and their personnel.
The fine line that municipalities and escort agencies must walk to avoid coming into direct conflict with federal laws impedes the provision of information about, or services to facilitate, conducting the sex work part of escort work in a safe manner. One city employee observed that this approach is based on the assumption that provision of services and information is a form of encouragement for individuals to participate in the exchange of sex for money. She observed that this approach fails to recognize that provision of information and services may have exactly the opposite effect, i.e., it may discourage individuals from becoming escorts once they fully realize what is involved, and, if they do become escorts, they do so more fully aware of the nature of the occupation and how to protect their health and well-being. Under the current situation, escorts are left on their own to figure out what the job involves and how to conduct their work in a manner that minimizes risk to health and well-being and the possibility of being charged with Criminal Code or municipal by-law violations. Neither the licensing offices nor escort agency owners are responsible for health and safety risks associated with the sex work part of the job, and occupational health and safety guidelines or legislation cannot be applied to this (see discussions in Bindman& Doezema 1997) industry.
Policing and Escort Work
Escorts come in contact with police not only in relation to the policing of federal criminal statutes and municipal licensing policies, but also when they are the victims of crime. Police are mandated to protect citizens from or provide mechanisms for redress in cases of robbery and physical and sexual assault. As has already been discussed, these are common experiences of sex workers, including escorts (Duchesne 1995; Farley& Barkan 1998; Hatty 1989; James& Meyerding 1997; Lewis& Maticka-Tyndale 1998a, 1998b; Miller 1993; Pyett& Warr 1997; van Wageningen 1996; Vanwesenbeeck, et al. 1995). Although some officers have acted in a nondiscriminatory manner in their response to escorts and other sex workers who have been victimized while working, there are also numerous accounts of police responding in a discriminatory manner (Hatty 1989; Maticka-Tyndale, et al. 1999; Miller 1993; Pheterson 1990). When their complaints are not taken seriously, sex workers are denied their rights as citizens to police protection, further marginalizing and stigmatizing them and increasing their vulnerability to STIs. The police, however, may not see it this way, as reflected in the response of the Calgary police representative who was interviewed for this project who explained that the policing practice of non-response to sex worker complaints was ultimately beneficial to women, since the experience of victimization and lack of police assistance provided incentive to leave sex work.
Research consistently demonstrates that sex workers cannot rely on police for protection (Barnard 1993; Pheterson 1990, 1993; Lewis& Maticka-Tyndale 1998a). In addition, victimization may actually be perpetrated by the police on sex workers through entrapment and harassment. The escorts interviewed for this study told of attempts by police to manipulate them into violating criminal statutes, exposing them to potential arrest and license revocation. Two entrapment techniques were commonly used. In one, a call was made to an agency to request an escort. When the escort arrived, attempts were made to entice her into negotiating a fee for sexual services in what is technically a public place, such as a private hotel room with the door, window or curtains open, thereby violating the statute pertaining to public solicitation (s. 212). Another technique was to call an escort who works privately and ask her to bring a friend on the "date." If she did, she violated the federal statute regarding procurement (s. 213), as well as licensing regulations which required an agency license in order to arrange a "date" for another escort. One factor that contributes to the vulnerability of escorts to this type of police action is that municipal licensing bureaus, in an effort to maintain a separation between escort work and the exchange of sex for money, do not provide information to escorts about the federal and municipal laws related to their work. Police representatives insisted that it was the responsibility of escorts to ensure they knew and abided by municipal, provincial and federal laws, ordinances and by-laws. We were reminded that section 19 of the Criminal Code clearly states that ignorance of a law cannot be used as a defence for violation of that law. However, escorts and agency owners asked, "Who is responsible for telling us what the laws are that apply to our business? How are we supposed to find out what the laws are?"
In our study of exotic dancers, as well as in this study of escorts, we found that women were poorly informed about federal statutes and legal precedents that related to their work. We also found that city councillors, some workers in agencies, and the general population were similarly ill informed about such matters. Many expressed disbelief when they learned of the different regulations and statutes and were confused about how a city could license sex work and simultaneously deny that it was sex work. Following the police raid of several escort agencies in Windsor, there was considerable confusion and shock expressed by owners and escorts (Mandel 1998a). The comments of one escort summarized the feelings of the women we interviewed: This is ridiculous. How can anyone imagine that escort work is about anything but sex? How are we supposed to work? As a police representative said in an interview, "Escort isn't about prostitution .... it is prostitution. But we can't say that."
The legitimation of their work, attained through licensing, is jeopardized by police raids and crackdowns on the escort industry. In addition, police raids make escorts and agencies reluctant to trust the police. As one escort commented: Before we got raided I felt that we could call the police if we had to, if there was a problem we could confront the police. Not any more. When we asked what they felt they needed to conduct their work safely (including protection from STIs), escorts' responses typically made reference to the law and police responses: I'd like to know what the laws are and stuff, 'cuz I'm not going to jail for this, I don't want no type of a charge, just protection.
In municipalities where escort work is licensed, police are responsible for ensuring that licensing regulations are being followed and that no unlicensed escorts are working in the municipality. This requires license inspections. At times, the license inspections conducted by police were experienced by escorts as harassment and an undue disruption of their work. To carry out license checks, police acted as clients and arranged to have an escort come to their hotel room. Upon arrival, she was asked to produce her license. Although escorts are not responsible for the agency's portion of the introduction fee when a call turns out to be a license check, they are, however, responsible for a $20 driver's fee. Though license checks require little time, police periodically detained escorts unnecessarily and coerced them to be photographed or interviewed about the work they did and their relationship with the agency they worked for. In our interview with police representatives it was confirmed that as long as everything with their license "was in order," escorts could decline being photographed or interviewed. However, escorts reported that they were reluctant to decline any requests from police, particularly since they were not sure what the restrictions were on their occupation, nor what their rights were. In general, the women we interviewed did not object to license inspections per se. Instead, they objected to the loss of the $20 driver's fee, the manner in which the inspection was carried out, including unnecessary detention and photographing, and being "kept in the dark" about their rights and the specific conditions of local by-laws and federal statutes.
The information provided to police as a result of licensing can also facilitate police actions that are damaging to the emotional and social well-being of escorts. For example, during a police investigation of local escort agencies, the licensing information on file was used by police to contact current and former escorts to inquire about agency practices. Escorts reported that police arrived at private homes at all hours of the night and without warning, wanting to speak to them about the agency they worked for. Escorts who were unaware of the specifics of the laws related to their occupation were bullied with threats of loss of licence if they didn't provide information about agency practices. Several women unknowingly provided incriminating information to police about the very agencies that had provided them with information and services appropriate to conducting their work in a manner that minimized health and safety risks. The invasion of privacy and the disrespect for individual escort workers' private lives were exacerbated for some escorts who spoke of feeling forced to comply with police requests to allow them to enter their homes and to answer questions without counsel or time to reflect. One woman reported that the police told her "either you answer our questions now or we'll take you down to the station." Others recounted stories of the police acting without discretion and "outing" escorts to their family members. In one case, a woman who had left the industry and had since married had her former occupation disclosed to her husband by police. A similar situation occurred when the police arrived at the door of a young woman who lived with her grandmother.
The policing practices described above affect the emotional and social well-being of escorts through disempowerment, economic costs, stigmatization, invasion of privacy, and disruption of family and personal life. Economic costs come in the form of income lost during time spent with police, drivers' fees that escorts must pay, and expenses associated with being arrested and charged (e.g., lawyers' fees, fines) and with having licenses revoked. Social, emotional and physical health are affected when escorts take risks in order to maximize their incomes to compensate for losses associated with entrapment and harassment, or when they are forced to turn from the relative safety of escort work to the greater danger of street prostitution because they have lost their license. The women we interviewed typically had minimal education and marketable skills. They became escorts because of the absence of employment that could provide a livable wage. The police practices described here contributed to their vulnerability to STIs by disempowering, marginalizing and stigmatizing them and denying them information and services related to conducting their work safely. Licencing and Health and Well-being
Municipal licensing of escorts provides a semblance of legitimacy for the occupation, potentially combatting the negative emotional and social effects of stigmatization. In Windsor, escorts were promised that licensing would provide increased police protection and freedom from police harassment (a common problem for street prostitutes). In addition, a portion of the escort licensing revenues were expected to be used in programmes that benefited escorts. The experiences of the escorts we studied did not match these expectations and promises. At the moment, assistance to escorts is provided on a discretionary basis by the Supervisor of the Licence Division. Between seven and eight escorts have received funding for educational courses, personal counselling and similar assistance. However, none of the escorts we interviewed were aware that such assistance was available. In fact, there was no consistent way in which the funds designated to "benefit escorts" had been used, despite efforts by municipal employees and community-based organizations to actualize the promise of programmes for escorts.
From the women's perspective, licensing is primarily a way to increase the money in police and municipal coffers. It increases police presence in the lives of escorts, makes policing easier and less costly, and disempowers escorts, and their employers, from taking action to enhance health and safety. Disempowerment, together with the social stigma typically associated with sex work, even when it is licensed, make it difficult for escorts to act assertively on their own behalf. They fear further increasing police presence in their lives and being forced into a public arena. Consequently, escorts rarely ask questions or protest discriminatory treatment, and are reluctant to organize, all of which are strategies that could potentially improve their work conditions and their physical, emotional and social health. While licencing has provided some benefits to escorts and has the potential of providing far more, in Windsor it carries far greater benefits for the police.
Each week Windsor's casino is the destination of thousands of visitors from the United States each week. The casino, together with strip clubs and escort services, has created an adult entertainment sector that appeals to a certain portion of visitors to the city. Based on this study we estimate that well over half of the clients of escorts are men from the United States. The American clientele come from a country with a higher prevalence of STIs and inevitably bring STIs to Canada. Even with 100% condom use, the vulnerability of escorts to STIs in this municipality has increased with the growth in the local industry and change in the clientele.
One of the advantages to escort work compared to other forms of sex work is that it remains relatively invisible to the general population and can be conducted without violating Criminal Code statutes. Escorts can arrange their work from their homes rather than in a location identified with sex work. Escorts are rarely identified as sex workers by others in their community, and consequently are not subject to the same stigmatization, marginalization and victimization experienced by some other sex workers. The available sex work research indicates that all of these factors contribute to minimizing vulnerability to STIs. The one aspect of their job that increases vulnerability is the secrecy which escorts often maintain about their work. Secrecy may impede them from gathering and acting on information that will reduce their risk for STIs and from obtaining medical care appropriate to their occupational needs. The licensing of escorts can either further decrease vulnerability, by conferring legitimacy on the occupation and reducing the need for secrecy, or can increase vulnerability by counteracting the very characteristics of this form of sex work that are beneficial to the health, safety and well-being of workers.
The recent events in Windsor reflect the development of a licensing policy that could have further decreased vulnerability. Initially it produced a sense of legitimacy and empowerment among escorts. Women were drawn to work as escorts in Windsor specifically because of licensing and the legitimation it conferred on their occupation. Local agencies, the city, and the police worked together to frame a by-law that provided greater autonomy and respect for the human rights of escorts, compared to by-laws developed elsewhere in Canada. Escorts in Windsor were able to choose whether to work for an agency or independent of one, to work for several agencies if they wished, and to change agencies at will. They were able to arrange their work from their homes, remaining in their community and with their families while they awaited calls from clients. Agency owners and receptionists were also able to work from home. Residency restrictions were no different than those for other municipally licensed occupations (e.g., taxi drivers). The city clerk made it clear to city council, the police and the community that escorts were to be treated as were any other business persons. When escorts and agency owners contacted the city clerk's office, they were treated with respect, "just like other business people." These provisions are unlike those in most other Canadian municipalities. They contribute to escorts, agency owners, receptionists and drivers remaining integrated in their local communities rather than segregated in "red light" districts and thus, keep them part of the mainstream, "above ground" community rather than pushing them into the "under ground" sector of society. They also allow escorts to make decisions about how and for whom they will work in the same way that workers in other occupations do. As a result, escorts and agency owners felt they could call on the city and police services as any legitimate business people could.
Windsor's licensing by-law also differed from that of other municipalities in its allocation of a portion of the licensing fees for programming to benefit escorts. Such programmes were developed by a coalition of community agencies. The plan was for license applicants to be provided with a series of workshops dealing with topics such as money management, health, community resources, safer sex, and laws related to the occupation of escorting. These were envisioned as similar to workshops required of other municipally licensed occupations such as taxi drivers. The plan, however, did not receive city council approval. Councillors were not prepared to allocate funds to "training sex workers," even though the funds came from the sex workers themselves (Mandel 1998a). To date, community agencies have not moved forward with the planned workshops because they have insufficient funds or authority within their own organizations move forward with these workshops. A portion of the licensing fees are still allocated for programmes to benefit escorts, specifically to assist them to leave the profession, however, city council has not approved any programmes. The funds are currently provided, on a discretionary basis, to individual escorts who request assistance from the city clerk's office for education or training in order to leave escort work. None of the escorts we interviewed were aware of the presence of the funds or how to access them. In the absence of workshops, attempts have been made by the city clerk's office to put together an information package for escorts that would be distributed with licenses and would include information on issues pertaining to health, law, and services available in the city. The package has not yet been prepared.
A primary benefit to licensing escorts is the potential of providing greater protection and redress to escorts, agency owners, and clientele. Based on the interviews and observations conducted for this study, cannot conclude that this potential has not been realized for escorts and agency owners. This is particularly the case since the police raid that occurred in the spring of 1998. Some escorts felt the police raid was necessary because some agencies were engaging in practices that bordered on forcing escorts to engage in sex with clients and inhibited their ability to negotiate services and fees directly with clients. However, for other escorts and agency owners, the raids shattered trust in the police and much of the sense of empowerment that escorts had developed (Mandel 1998b). This is, in large part, due to the confusion over what is and is not legal and the inability or unwillingness of anyone to clarify legal issues for those working in the escort industry.
Escorts, the casino and strip clubs are all part of the adult entertainment industry. As more municipalities open casinos in order to "cash in" on the economic benefits that they bring, they face the possibility of increases in other areas of adult entertainment such as escort services, similar to that experienced in Windsor. The question becomes whether escort work will be treated as an occupation or as a pariah. If our concerns are with health, safety and well-being, the approach taken in the Netherlands, described by Venema and Visser (1990) as a "safer prostitution" approach holds the most promise. Recommendations ___________________________________________ Research
To our knowledge, this is the only research since the 1970s that has focussed specifically on escort work. From estimates made by the local police department and the experience of Windsor, it is this form of sex work which increases when a city opens a large casino with tourist appeal. From our own research it is clear to us that, as in any occupation, including any sex work occupation, escorts and agencies reflect a wide diversity of individuals with different strengths, needs and vulnerabilities. We know little of these differences. In addition, this research has demonstrated the importance of understanding how laws and policies in different sectors and jurisdictions interface with each other and impact on the lives and livelihoods of different groups of citizens. This work has begun to operationalize the concept healthy public policy described by Hamilton and Bhatti (1996) as an important strategy for influencing health and well-being. Based on the research we have conducted for this report we recommend that research is needed to answer the following questions: (1) What is the economic and political relationship between escort work and other forms of adult entertainment, particularly casinos? (1) Casinos are being opened in locations with different local histories and profiles. For example, the Niagara region is considered a location that appeals to tourists with families and children, whereas Windsor's profile seems to appeal more to adults. Will these profiles reflect differently on the visitors attracted to casinos and how will this affect the local sex work industry? Are different approaches and models more appropriate to different regions? (1) What role do local policies and programmes play in minimizing the vulnerability of escorts to undesirable effects on health, safety and well-being, including vulnerability to STIs? (1) Is there evidence from areas that attract business and tourist travel that we are experiencing a growth in the second tier of sex work as described by Sangera (1997)? Are different forms of policy and programme required for this tier than for the first tier? (1) What is the profile of clients using the services of escorts as compared to those using other sex workers? (1) How does the Criminal Code interface with local policies to influence the health, well-being and safety of sex workers on the job, their mobility out of sex work and specifically the transmission and prevention of STIs? (1) What aspects of public policy contribute to the health and well-being of sex workers and what aspects are harmful?
From the specific perspective of reducing transmission of STIs from the United States to Canada and within the Canadian population of escorts and clients of escorts, and from the more general perspective of enhancing the overall health, safety and well-being of escorts, the municipal licensing of escorts is not an example of a beneficial, or healthy public policy. While the potential of a healthy public policy is evident, this has not been realized in the local example. Two factors have acted as deterrents: (1) the lack of courage on the part of Windsor's city council to endorse programming that would provide escorts with the information they have requested and with information and resources that would reduce vulnerability; and (2) the dual responsibility of local police to monitor local by-laws and to enforce federal statutes. Prior to licensing, there were few ways in which police could locate escorts and escort agencies. As police service representatives said, "stings" were costly and unproductive. As a result, charging escorts or agencies with violation of criminal statutes was difficult (since there was little in their work that violated such statutes), and took a great deal of time to amass sufficient evidence. Police work, however, is much easier with licensing. In addition, as part of their role in policing municipal by-laws, police have ready access to agency premises and files and regularly perform license checks on escorts (paid for from fees collected for licenses) during which they also engage in entrapment. Police raids and arrests of escorts and agency owners counteract the positive effects of municipal licencing. While licencing produces a sense of empowerment among escorts and an increased willingness to take action and access local services on their own behalf, raids and arrests create confusion, mistrust, disempowerment, and make escorts unwilling to act in any way that might bring public attention.
Municipal licensing could realize the potential benefits if: (1)
Programmes such as those proposed by the coalition of community agencies were available, particularly if escorts participated in their design and delivery. (1) Escorts and agencies were provided with guidelines that clearly outlined the parameters of the municipal by-law and how it interfaces with any provincial or federal statutes that might affect what goes on as part of escort work. Since the exchange of sex for money is not illegal in Canada, it should be possible to provide any individual who wishes information about what, in relation to the exchange of sex for money, is illegal. (1) Clients were provided with information about the legal parameters that apply to escort work, including municipal by-laws, and federal statutes related to prostitution, sexual assault and age of consent. (1) Occupational health and safety standards were developed and agents were responsible for maintaining safety in relation to the work of escorts in the same way these expectations are placed on employers in other occupations. (1) Municipal by-law enforcement were removed from the responsibility of the local police services.
Based on this research we recommend that programming that addresses STI transmission in the escort industry: (1) Involve sex workers in setting directions, designing and implementing programmes. As illustrated in the presentations at the 1996 International Conference on AIDS (Kywe, et al. 1996; Moreno, et al. 1996; Serre, et al. 1996; Van Nhieu, et al. 1996) and in research conducted on sex work in Europe (Mak 1997b), this approach produces the most effective programming (1) Should be multifaceted, addressing legal, economic and social concerns as well as those in the area of STIs and health. The escorts (and exotic dancers) who have participated in our research have been more concerned with legal, social and economic issues than with health issues, and when health is considered holistically, these areas are, in fact, interconnected.
Sex work is subject to legal regulation and censure in virtually all countries, yet, as McLaren and Lowman observe (1990), it remains. According to Sangera (1997), sex work in conjunction with adult entertainment and tourism not only remains, but is increasing. As Brock and Thistlethwaite (1996) note: Laws against prostitution isolate sex workers, giving them a permanent record as offenders of moral and civil statutes, which separates them from the rest of society. (Brock& Thistlethwaite 1996). It is time we treated sex work as work and established and enforced appropriate occupational health and safety policies. We can perhaps look to the Netherlands for an example of an approach to sex work that takes, as its priority, the occupational health and safety and human rights of all workers, including sex workers (Venema& Visser 1990). References ___________________________________
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