Gender, violence and health: Contexts of vulnerabilities, resiliencies and care among people in the sex industry

Sex workers are commonly described as being different from other workers because of their drug use and the presumed causal link between drug use and  being a sex worker. But how true is this stereotype of sex workers as drug addicts? On this CIHR team grant, we recently asked a diverse sample of 218 sex workers from across Canada about their drug use at work and in their personal lives, their experience of discrimination, and the impact of prostitution stigma on their self-esteem and feelings of self-worth. Results show that the vast majority never or rarely use alcohol or drugs just prior to serving a client. While weekly consumption of alcohol, marijuana and club drugs is common in sex workers’ personal lives (as is the case for many working-age people in our society), 90% do not consume cocaine/crack, crystal meth/speed or heroin on a weekly basis.

These data show that the substance use behaviour of this group of sex workers is not very different from some other groups of Canadian workers. So why do people in our society have this false impression of sex workers? Although drug use likely contributes to involvement in the sex industry in some cases, the societal disapproval of selling sexual services likely influences our impression of another stigmatized behaviour: use of drugs. People who work in the sex industry are commonly constructed as “others” who exist in a distant criminal world where the provisions and social rights expected in the “normal” world do not apply. Derogatory labels (e.g., addicted hooker, crack whore) are routinely used to describe them, and data from workers, customers and the general public demonstrate the frequency, intensity, and saliency of these labels, and stigma “colours all sex work”.

At least half of participants reported lifetime experiences of discrimination at school, work, on the street or in a public setting and from the police or in the courts. The perception of prostitution stigma is omnipresent among these sex workers.

This group who are vulnerable to moral condemnation are also least able to buffer themselves against the damaging impact of how people treat them. People in the sex industry are more likely to grow up in poverty and unstable circumstances, to be victims of neglect or abuse, to have limited education and poor economic prospects, and to have few resources to protect themselves against the damaging impact of how people treat them.

Funding body: Canadian Institutes of Health Research, Research Team Grant: Violence, Gender and Health

Progress to date: Data collection is completed, with a final sample of 218 sex workers, 35 spouses/intimate partners of sex workers, 258 clients, 55 sex industry managers, and 106 regulators and service providers. A national report was released in the fall of 2014 coinciding with an international symposium and workshop.  Twelve peer-reviewed articles and one book chapter have been published from the project and five other papers are under review, including a paper examining the social determinants of substance use among sex workers. A large number of papers have been presented at academic conferences, community meetings and other forums and six reports written up and distributed to interested parties. 

Key findings from this project can be found in facts & stats/sex industry in Canada.

Project website:

Related publications

Building on the evidence: A working paper on the sex industry in Canada

Science fact or science fiction: Are all sex workers victimized?