An Argument for Decriminalizing Sex Work

Abstract of a red light
Abstract at a Red Light. James Loesch. Creative Commons for Flickr.

Different human rights groups support or have called for the decriminalization of sex work. Some of which include Amnesty International, World Health Organization, UNAIDS, International Labour Organization, the Global Alliance Against Trafficking in Women, the Global Network of Sex Work Projects, the Global Commission on HIV and the Law, Human Rights Watch, the Open Society Foundations, and Anti-Slavery International.

Picking on one, the Human Rights Watch supports the full decriminalization of consensual adult sex work in support and defense of human rights relating to personal autonomy and privacy as, “A government should not be telling consenting adults whom they can have sexual relations with and on what terms.” Joining 61 other organizations, they recently advocated for a bill that would decriminalize sex work in Washington, DC. This Community Safety and Health Amendment Act intends to repeal statutes that criminalize adults who voluntarily and consensually engage in sexual exchange, while it upholds and defends the legislature which prohibits sex trafficking. The HRW affirms that adult consensual sexual activity may be covered by the concept of privacy, rejecting the idea that criminalization was a protective measure against HIV and STIs, and conveying that it was more likely to drive a vulnerable population underground.

However, the demands of these organizations and supporters of sex workers have surfaced controversy around sexuality, health, economics, and morality. Often the idea of sex work may be tied to or conflated with sex trafficking, child sex abuse, and rape. Open Society Foundation simply defines sex workers as “adults who receive money or goods in exchange for consensual sexual services or erotic performances, either regularly or occasionally.” Sex work encompasses a wide range of professions and activities which include the trade of some form of sexual activity, performance, or service for a client to a number of fans for some kind of payment (including prostitution, pornography, stripping, and other forms of commercial sex). It is clearly separated from those services that utilize “the threat or use of force, abduction, deception, or other forms of coercion for the purpose of exploitation”. Decriminalizing sex work would call for the “removal of criminal and administrative penalties that apply specifically to sex work, creating an enabling environment for sex workers’ health and safety.” Amnesty International expands on these definitions in this report.

Many members of society view sex work as immoral or degrading to women, arguing that sex work is inherently exploitative of women, even if these workers find it profitable or empowering- even simply as the power to creatively express one’s sexuality. When we think of sex workers, we tend to assume they were forced into it or assume a desperate narrative with no other options. Then, maybe, we judge their appearance while tying it to their worth or a fantasized idea of sex workers opposed to the ordinariness we associate with other professions and community members. A simple argument says that, like any profession, there are extremely different motivations to pursue these professions and, in the end, it’s a job or choice of work with its own pros and cons for each lifestyle (affording many lifestyles). Also, anyone and any personality can be a sex worker.

People enter and remain in this work for a multitude of reasons creating each individual experience of sex work; however, many face the same response and abuse in the workplace or trade. Owning to the stigma associated with the profession, not many can come out and say they are a sex worker. They must fight to be recognized beyond the stigma or continue to repress or hide their daily lives from their community or society. Sex workers report extreme violence and harassment from clients, managers, police and society and even more cannot report these violences, facing incrimination or even incarceration. Ironically, laws on sex work undermine governments’ own efforts to reduce high rates of violence against women and reduce rates of HIV infection in sex worker populations.

Repressive policing not only further marginalizes sex workers as a whole, but it also reinforces what it promises to remove as it exposes sex workers to different abuses and exploitation by police or law enforcement officials who may arrest, harass, physically or verbally abuse, extort bribes and sexual services, or deny protection to sex workers avoiding the eyes of the law. Some sex work may be illegal because it is viewed as immoral and degrading, but people governed by these laws do not share the same moral beliefs. As police fail to act on sex workers’ reports of crimes, or blame and arrest sex workers themselves, offenders may operate with impunity while sex workers are discouraged from reporting to the police in the future. Then there is the financial toll of criminalization as repeating fines or arrests push some further into poverty. People may be forced to keep selling sex as potential employers will not hire those with a criminal record. Also, if the need for money found some sex workers in the streets, how will fines deter the work?

The work entails forming relationships with a wide range of clients at different levels of intimacy. Unfortunately, sex work offers comfort to predators, or those who mean harm, who also understand and exploit the workers paralleling relationship with police. Working in isolation, workers’ lives are threatened as they avoid the police and are denied these protections in their workplace and, off the hook, predators continue to harm more even those outside of the sex trade. Facing arrest or prosecution themselves, any client may protect themselves from blocked numbers leaving workers in the dark with no evidence of whom they are dealing with, surrendering that safety. Some laws advocate helping sex workers by removing the option of work as it criminalizes only those who buy sex. Now, to incentivize clients and income, workers may be forced to drop prices, offer more risky services, or reach out to potentially abusive third-party management.

Woman holding poster reaing "Sex Workers Demand Safe Spaces"
Sex Workers Demand Safe Spaces. Fibonacci Blue. Creative Commons for Flckr.

Decriminalizing and regulating the work of sex workers would allow them the right to choose their clients and negotiating power or power to cease the service when they feel uncomfortable or unsafe. Criminalization, or the threat of it, complicates and weakens workers’ power to negotiate terms with their clients or collaborate with others for safety. So, for example, it may increase the chance for workers to engage in sex with clients without a condom (which may be used as evidence of the crime). Although variable in different contexts, in low and middle-income countries on average, sex workers are 13 times more at risk of HIV, compared to women of reproductive age (age 15 to 49), so their ability to negotiate condom use is important.

According to a study led by the London School of Hygiene & Tropical Medicine and published by the American Association for the Advancement of Science, sex workers who had been exposed to repressive policing had a three times higher chance of experiencing sexual or physical violence by anyone, including clients and partners. They were also twice as likely to have Sexual Transmitted Infections than those who avoided repressive policing.

In order to be protected from exploitation by third party managers and dangerous clients, to be informed on sexual transmitted infection and other health concerns or vulnerabilities, to be able to unionize and self-manage, and to be able to reach out to law enforcement, sex work should be regulated by the same occupational safety and health regulations that benefit workers in other labor industries. Dedicated efforts must consider the elevated or unique risks, vulnerabilities, and intersectional stigmas surrounding different sex workers, including men, transgender, and other gender identities and portions to improve health outcomes and human rights. Wider political actions are needed to address inequalities, stigma, and exclusion or marginalization that sex workers face even past the criminal justice system to health, housing, employment, education, domestic abuses, etc.

We are faced with opposing or contradictory narratives of the sex work experience, but we have chosen some to represent the entire concept especially those tailored to our own feelings of sex and commerce without concern or consideration of those even more immediately affected. The conversation of sex work needs to open up to understand and share the message to all that the labor itself is the commodity, not the laborer and it requires workers more considerate rights and regulations. If sex work is legally accepted with due rights and respect, it can become something that benefits- even especially vulnerable or marginalized- women and humanity.

What sex workers need is not condescension and invasion into their private lives, but support in achieving decent working conditions.”

Additional Sources:

Open Society Foundations

Vox

 

 

 

The Criminalization of Mental Illness

Prison cell block
Prison cell block. Source: Bob Jagendorf, Creative Commons.

It is no secret that the United States has an issue of overcrowding prisons, which can lead to many issues regarding quality of life in prisons. Overcrowding in prisons is not just a problem in the United States; over 100 other countries also have this issue. In many countries, the criminalization of mental health is a factor that is compounding the issue. Individuals with severe mental illnesses not only need treatment that prisons don’t provide, but also can be put in dangerous situations when they are in prison. Despite this, they are more likely to end up in prison than in treatment.

Up until the 1960s in the United States, when someone had a severe mental illness, they were typically placed in a mental institution or asylum. In an effort to provide patients in mental institutions better community-based care and reduce government spending, the process of deinstitutionalization began. However, that is not how it played out. While the movement gave those with mental illness more rights and turned society away from locking them up, it released some that would have benefitted from long-term care that community centers could not provide. However, with many patients moving out of long-term treatment facilities, many of these facilities were shutting down. This left community mental health centers to try to treat illnesses they were not originally intended to. Another issue arose when insufficient funding was allocated for the community mental health centers, further overwhelming the new system. Because the difficulty of the transition from institutionalization to community care was underestimated, many—then and today—have gone without treatment. The lack of treatment for serious mental illness, like Schizophrenia, has led to the incarceration of many people with mental illness who should instead be treated.

Not Guilty by Reason of Insanity

Another issue that has contributed to the criminalization of mental illness is the difference between the clinical definition of mental illness and the legal definition. The diagnosis of mental illness is dictated by the Diagnostic and Statistical Manual of Mental Disorders (DSM). The law, however, sees mental illness as symptoms that impair mental functioning. The main diagnoses that fits into the legal definition are psychotic disorders, such as Schizophrenia. Even if someone has been diagnosed with a psychotic disorder, when pleading not guilty by reasoning of insanity, their lawyer must show that they were having symptoms at the time of the crime that contributed to said crime. This can be a difficult task as some states require that the symptoms are so severe that the defendant didn’t know that the crime was illegal. Even in cases where the defendant has shown this to be true, some juries will give a verdict of guilty to ensure that someone is held accountable for the offense.

Some states have gotten rid of the insanity plea altogether, while others have changed it to “guilty because of mental illness” meaning after treatment, they must serve their sentence in prison. This can sometimes put the progress a patient has made in jeopardy, as prisons are not a suitable environment for maintaining a newly achieved healthy mental state. In states where not guilty by reason of insanity is still in effect, those found not guilty by reason of insanity are supposed to be released after sanity has been restored. Yet, this is rarely the case; due to fear they will go off their medicine and commit the same violent crimes, many are held in treatment facilities indefinitely. With the threat of this outcome overhead, many opt out of the not guilty by reason of insanity plea and are instead place into a prison where they will not receive the appropriate care.

Because of the law’s strict definition of mental illness, many are being placed in already crowded, underfunded prisons. Because of the lack of mental health professionals, prisoners in some states, including Nebraska, may not receive medications for mental illnesses or have access to talk to counselors. This can cause the reemergence of once-controlled symptoms, making the prisoner with a mental illness a danger not only to himself, but also to others. Additionally, many with severe mental illness are put in solitary confinement for long periods of time. Psychologists who have studied the effects of solitary confinement have seen a pattern of increased mental health problems in people who were originally neurotypical. If this is true, the effects on prisoners with mental illness could be devastating. Not only are people being sent to prison when they should receive treatment, they are also being put in situations that make their symptoms worse and make it harder to reenter into society if their sentence allows.

Substance Use Criminalization

In addition to violent crimes committed because of mental illness, many nonviolent acts associated with mental illness are criminalized; Substance Use Disorders are recognized by the DSM V and are therefore diagnosable and treatable, but the law instead criminalizes it. While at any given time there are more convictions for violent crimes, more people are sent to prison a year for drug-related crimes than violent crimes. Studies have shown that those imprisoned for drug-use are unlikely to receive treatment and often return to using drugs once released because they lack the resources that treatment would have given them. Sending people with Substance Abuse Disorders to jail does not improve their illness.

Not only those with Substance abuse disorder are affected by this criminalization; those diagnosed with another mental illness are five to eighteen times more likely to have a comorbid Substance Use Disorder. This can further prevent someone who needs treatment from receiving it. Most prisons don’t have adequate resources to treat prisoners with mental illness, so imprisoning people for crimes that are directly tied to mental illness can be detrimental to their treatment and future.

Current solutions

Some states are trying to combat the increasing proportion of prisoners with mental illness not receiving treatment. With our corrections system slowly catching up with our understanding of mental illness, states—like California—are beginning to consider replacing their old jails, not with new ones exactly like them, but instead with centers focused on rehabilitation. They are not calling for moving all criminals with mental illness out of prisons, but instead treating those with mental illness while they serve their sentence. Additionally, they do want to increase the diversion from jails, but that will be done on a case-by-case basis and only for those who have committed a crime because of mental illness.

Stigma

Ultimately, the criminalization of mental illness has a lot to do with the stigma surrounding it. The general population connects mental illness with violence, which leads to harsher punishments. As a society, we need to reduce stigma before any change can happen. If we continue to see those with mental health problems as inherently violent, they will continue to be prosecuted and sentenced unjustly.

HIV and Human Rights

People and Places. Source: Ted Eytan, Creative Commons

The history of the HIV and AIDS epidemic started in illness, anxiety and mortality as the world encountered and handled a new and unidentified virus. It is commonly believed that HIV begun in Kinshasa, in the Democratic Republic of Congo around 1920 transmitted from chimpanzees to humans. The original earliest case where a blood sample could confirm the infection of HIV was from a blood sample taken in 1959 from a man living in the Kinshasa region.  Available records suggests that the rampant spread of HIV and contemporary epidemic started in the mid- to late 1970s. During the 1980s, the HIV pandemic spread across South America, North America, Australia, Africa and Europe. The progress and efforts made in the last 30 years to prevent the disability and mortality due to HIV have been enormous. Despite the tremendous improvements regarding HIV research and support, progress remains hindered by numerous challenges. Originally, HIV was identified and diagnosed in men who have sex with men, people who inject drugs, and sexually active people such as sex workers. HIV was perceived and declared a disease only deviant people get because they engage in inappropriate behavior; therefore, HIV and people infected with HIV have been subjected to a corresponding negative social image. Research and education has aided in countering the negative association of HIV transmittance. The CDC explains HIV transmittance takes place via “only certain body fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk—from a person who has HIV can transmit HIV.” People impacted by HIV, regardless of how it was transmitted, withstand constant stigmatization, discrimination and violations of their basic human rights. There is an inseparable link between human rights and HIV is now extensively acknowledged and accepted.

“Protecting, promoting, respecting and fulfilling people’s human rights is essential to ensure that they are able to access these services and enable an effective response to HIV and AIDS.”

-Avert Society

Human rights treaties and laws play an essential role in protecting the rights of HIV positive populations. The Universal Declaration of Human Rights (UDHR), Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), and the International Covenant on Economic, Social and Cultural Rights (ICESCR) are all important documents that thoroughly elaborate the rights of all people, which include HIV positive individuals.  Article 25 of the UDHR, Articles 10 – 12, and 14 of the CEDAW, and lastly Article 12 of the ICESCR all secure the human right of healthcare and the prevention, treatment and control of diseases. Finally, the ICESCR and the UDHR secures employment, cultural and community participation rights for individuals regardless of age, disabilities, illness, or any form of discrimination.

Human rights violations in the context of HIV

Access to health care services

In 2015, 36.7 million people are currently living with HIV/AIDS, with the majority of HIV/AIDS positive individuals– 25.5 million – living in sub-Saharan Africa. Today, in 2017, only 46% of HIV positive adults and 49% of HIV positive children worldwide are receiving treatment, with large gaps in access to HIV testing and treatment in Africa and the Middle East. Individuals living in low-middle income locations face constant financial, social and logistical barriers to accessing diagnostic services and treatment. Some of the main obstacles individuals of lower income families’ face include the high costs of medical services, the lack of local and nearby health care facilities, and the inability to leave work to visit the doctor. vert Society asserts that stigma and discrimination from community and family influences the utilization of HIV healthcare services by HIV positive individuals. Additionally, the criminalization of HIV is also significantly affecting the access to HIV health care services. In 2014, 72 countries have implemented laws that allow HIV criminalization. Criminalization laws are usually either HIV specific, or either HIV is just one of the diseases covered by the law. HIV criminalization laws normalize, instigate and allow discrimination and stigma towards HIV positive individuals. HIV criminalization laws and socio-ecological barriers undermine HIV prevention efforts and do not decrease the rates of HIV.

Our Lives Matter !! Anti-LGBTI Laws Stall HIV Prevention. Source: Alsidare Hickson, Creative Commons

Criminalization of men who have sex with men (MSM)

Currently, 76 countries around the world continue to criminalize same-sex conduct. Having these laws set up really discourages MSM and the public to get tested for HIV, transition into treatment, and disclose their information due to possible discrimination and arrest. A comparison between nations with anti-homosexuality laws and nations without such law shows considerably higher HIV prevalence rates among MSM in countries with anti-homosexuality laws compared to nations without such legislation. For example, Jamaica has strict anti-buggery laws but has a prevalence of HIV in over 30% of MSM, compared to Cuba that lacks anti-buggery and has a prevalence of HIV in less than 5% of MSM. These laws also make it particularly problematic for organizations providing sexual health and HIV services to reach men who have sex with men. Further research is needed to clarify the correlation between the criminalization of same-sex conduct and rates of HIV.  The criminalization of MSM ultimately ignores the fact that HIV can be transmitted through various ways such as unintentional exposure, mother-to-child, and non-disclosure of HIV status which results in individuals not seeking health care services due to the fear of people assuming HIV was transmitted through a different route than how it was actually transmitted.

Gender Inequality

HIV disproportionately affects women and young girls because of unequal cultural, social, and economic standing in society. Gender based violence (GBV) is normalized in many societies. GBV such as rape, trafficking and early marriage makes it more difficult for women and adolescent girls to protect themselves against HIV. Women do not have power over sexual intercourse encounters. Women, in many cultures, are economically dependent on their male counterparts, making it increasingly difficult to choose their lifestyle choices. Additionally, due to the imbalanced gender power dynamic, women do not have control over family planning services, sex-based community rituals, or the choice to participate in safe sex. Studies reveal the impact of gender-based discrimination and HIV. According to one study, women living in Sub-Saharan Africa, on average have a 60% higher risk of HIV infection than their male counterparts. Another study analyzed the role of gender power imbalance on women’s ability to discuss self-protection against HIV/AIDS in Botswana and South Africa. Results concluded that “women with partners 10 or more years older than them, abused women, and those economically dependent on their partners who are less likely to suggest condom use to their partners. Gender power imbalance also influences men’s inclination towards refusing to use the suggested condom.” There is a great need to focus on women education, empowerment and self-confidence to suggest condoms, and lastly to educate and encourage men about safe sex. Gender inequalities towards women are addressed in the CEDAW; therefore, publicly and legislatively addressing the issues could significantly reduce HIV.

Millions of people have lost their lives fighting to make sure HIV positive people are able to live a long, healthy and quality filled lives. Even though we live in a country that does provide HIV healthcare services, the prevalence of HIV in the USA is still relatively high. The Human Rights Campaign reported in 2014 that Birmingham, Alabama had one of the highest rate of infection in the nation; however, the latest CDC report Birmingham is presently 12th, citing a myriad of reasons including a lack of sex education. We have and opportunity and need to stand up for each other, advocating for education and equality. There are various ways to get involved in advocating for human rights and HIV in our Birmingham community, including volunteering at local clinics: 1917 Clinic or Birmingham Aids Outreach.  If you’re sexually active, you can help prevent the spread of HIV by knowing your status, getting tested, and talking openly about HIV. Constructive conversations aid in removing the stigma and fear attached to HIV because it becomes a part of the social discourse. An HIV/AIDS prognosis is a life changing event, not a life ending moment.