Coming out as trans meant leaving behind life as she knew it. Living in a new city, Dr Adrienne Macartney turned to sex work to fund two degrees, but enduring prejudice continued to limit her options. She reveals why trans sex workers are no less vulnerable than their cis-gender colleagues.

I came out as gay before coming out as trans. It felt easier, more socially comprehensible, despite being a misnomer. Trans was too much, too indigestible, too terrifying. 

However, I soon realised I needed to fully come out as trans, to give honest air to a painful need to stop living a burdensome mask of masculinity – one that was tearing me apart ever more destructively. At the time I was a mountain guide, and climbing increasingly big peaks alone, simply willing death to excuse me from addressing who I was. 

The common perception that people who gender transition do so because of a sexual kink is a damaging and usually inaccurate narrative. I get no ‘thrill’ from wearing female attire. My personal sexual tastes are positively mundane compared to many. 

To this day I cannot describe with precision the boundary between man and woman, yet socially and practically most of us recognise the difference in our day-to-day interactions. I felt I was in the wrong camp and would simply perish if I stayed there. 

The social castigation of coming out was far in excess of anything I anticipated. Old friends became silent, and warm relationships cooled to frosty hostility. My family thought I was having an embarrassing ‘phase’ and were entirely unsupportive. I had been married for a year, and we tried to find a way through, but my wife understandably needed time away, and left.

It became futile to continue my job, partly through personal shame, and partly because of its social nature and the close ties my wife had to it. I left for Edinburgh, where I would be anonymous. I saw it as an escape, a place to resolve a healthier path for myself.

Finding another job proved impossible, no matter how menial or low paid. My wife was Canadian, midway through gaining a UK passport, and I could not claim benefits without jeopardising this. After a few months of unemployment, my savings had gone and I had sold everything I had of value.

"I soon realised I needed to fully come out as trans, to give honest air to a painful need to stop living a burdensome mask of masculinity."

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Being trans in the world of sex work

Transitioning using the NHS means presenting as female all day, every day. Failure to do this risks being rejected from the long waiting lists. A sensible mandate in some respects, it has subtle cruelty in early transition, when one is not physically perceived as female by most. Society exposes its sheer hatred to the transsexual who does not ‘pass’. Spat at, called “tranny”, “scum”, “chick with a dick”, jeered at; it was the steady, ubiquitous nature of this hate that destroyed my self-confidence. Every long stare, every muttered insult on every street, every day, made me turn in on myself and fill with self-hate.

Someone on a trans support forum suggested escorting, and I thought: Why not? A brutal solution to a complex financial problem. Initially I had no confidence and my rates were minuscule. I used an online platform, and men started to arrive at my damp basement flat in Leith. I remember shaking like a leaf waiting for the first client. After, I gave myself the enormous treat of a pub meal; an unaccustomed luxury and a good example of the food insecurity many sex workers face.

Months passed and my confidence rose along with my fees. I learned the trade, how to manage emotional and physical boundaries with clients and how to ensure safe sex. I discovered how to avoid client tricks, such as condom removal, and scams, such as underpayment. Safe sex is often difficult to demand, and it is only more recently that I have insisted condoms be used on oral. 

I managed to save money, moving out of the damp flat into a beautiful place overlooking Arthur’s Seat, a hilly beauty spot in Edinburgh, all the while studying a BSc in geoscience at the Open University. At the time the OU ran a scheme that allowed low-income students to study for free, a powerful tool for social mobility and opening up routes out of bad places. 

I gained a first with honours and was offered a PhD funded by the UK Space Agency. Escorting was over, I thought. I had my main transition surgery midway through the doctorate, and physically it hit me hard. I took longer to recover than I expected; I have always healed slowly. The university gave no funded time off, and my grant expired with the PhD unfinished. 

I returned to escorting, as I knew it would allow me time to study. The PhD had given me confidence, though, and I found myself expecting better treatment from my clients. I think this correlated with a rise in my feelings of self-worth, which can be a side effect of education and training programmes. 

It is important for government, law and policy makers, charities and the public to see trans sex workers in the same way as other sex workers. 

"The PhD had given me confidence and I found myself expecting better treatment from my clients. I think this correlated with a rise in my feelings of self-worth."

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I eventually finished my PhD and straight away gained a lecturer position at the University of St Andrews and also taught robotics at Glasgow. During my doctorate I had been running a science communication project called Science Hooker, which, in addition to science, discussed sex-workers’ rights and how criminalising legal models unfairly punish sex workers. My students began following this media and I soon found my contracts cancelled. I became an escort once again, albeit with a very select clientele and unique funding arrangements. 

Being transgender initially caused social exclusion and unemployment. Later, being open about my sex-work history caused further unemployment. My engagement with sex work has always been for financial reasons, never to seek thrills or satisfy a kink. Over time my escorting skills and fees increased until it became the most logical method of earning money, despite no longer being the only option, as I ‘passed’ as a female in society and could potentially gain other work. 

However, the type of escorting I provided had changed. No longer offering high-risk quickies, instead I now offer trips to European capitals, often purely platonically, to clients I trust. The work has become safer and thus more appealing. 

It often feels as though there’s a common perception that trans sex workers are less vulnerable than other sex workers, that we are providing commercial sex more as a hobby, to fulfil sexual fantasies, somehow part of the equation of changing gender. In truth, the motivations of most trans sex workers are dominated by the same needs as other sex workers: the need to earn money for food and accommodation; to survive in a landscape that’s fiercely hostile. 

We are no more likely to be sexual predators or unstable people than anyone else. We are no more likely to engage in risky sex than other sex workers. We do not engage in sex work for more frivolous or sexually motivated reasons than other sex workers. Policy, healthcare and support-work access should reflect this, not perpetuate the stigma and assumptions society holds of trans people.

Dr Adrienne Macartney has worked as a sex worker, on and off, for approximately ten years. During this time she gained a first in her BSc in geoscience at the Open University, and a PhD in geochemistry and space engineering at the University of Glasgow, funded by the UK Space Agency. 

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Dr Adrienne Macartney

Author

Jessa Fairbrother is a visual artist using photography, performance and stitch. Her long-term investigations revolve around subjects of yearning and the porous body. Her work is held in numerous private and public collections worldwide, including Tate Britain, the V&A, the Yale Center for British Art and the Museum of Fine Art, Houston. Her work is represented by the Photographers’ Gallery, London and AnzenbergerGallery, Vienna. She is also a QEST (Queen Elizabeth Scholarship Trust) scholar.

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Jessa Fairbrother

jessafairbrother.com

Jessa on QEST

Artist

Article

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Unstable. Predatory. Risk takers. Dr Adrienne Macartney sheds stark light on the hostile and negative assumptions faced by trans sex workers.

Dr Kate Lister invited five contributors to share their diverse, profound and often heartbreaking personal experiences of sex work, with each reflecting upon how the stigma of sex work can have a significant impact on sex workers’ mental health, on their place in society and on their physical safety. The result is a series of unique perspectives that question the political and societal reluctance to legitimise sex work and how it might better protect those who are the most vulnerable. 

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Dr Kate Lister

Editor

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Sex work, stigma and whorephobia

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Dr Kate Lister invited five contributors to share their diverse, profound and often heartbreaking personal experiences of sex work.

Reframing sex work

Charmaine was sexually exploited as a child in the care system, and as a result experienced abusive relationships, addiction and the world of sex work. But the horrible things that have happened to her don’t make her a bad person, as she reveals in her honest and poignant story.

I was four when I was first taken into care. I was being sexually abused by my stepdad and my mum was an alcoholic. No one explained what was happening. Suddenly I was in a big house with lots of other kids and I didn’t know where my family had gone. I remember thinking I must have done something wrong. The staff used to say that it wasn’t my fault, but they wouldn’t tell me why I couldn’t go home. We never spoke about the sexual abuse. 

I was nine when I first sold sex.* One of the older girls at the children’s home in Leeds was already working down on Spencer Place in Chapeltown. She was 16. We wanted money to buy drink, so we got dressed up, went down on the beat, and a punter pulled up. I thought I was doing something normal. I thought sex was normal. To me, it was. I was amazed that anyone would pay me for it. I remember feeling excited about how much money I was holding.

[*This is rightly recognised as child sexual exploitation today. The author wished to fully communicate how she understood what was happening to her at the time, but it is equally as important to state that no child can ‘sell sex’.] 

I was 11 when first took crack and heroin. I used to lie about my age all the time, but people must have known. I fell in with drug dealers pretty quickly, but to me they were my friends. I didn’t know I was being coerced. By 12, I had a dealer boyfriend. He took me off the streets for a while, but he also got me hooked on drugs. He used to beat me up and tell me it was to make me stronger. I’ve had beatings all my life. 

I was 16 when I was first arrested for soliciting for sex. Today there are support groups and outreach programmes to help working girls, but there was none of that when I was on the street. The police would arrest you, slap an anti-social behaviour order on you, and issue a fine. Then you’d have to go back on the streets to earn the money to pay the fine. 

Once you’ve got a police record for soliciting, you can’t get a regular job. Once you’ve got a smack habit, people just look away. 

"It sounds bizarre, but I loved being in jail. It helped me. I got counselling there and was detoxed. I’ve never been to school and there were education programmes in prison."

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Surviving sex work on the streets

I was 17 when I first went to jail. I got eight years for kidnapping and firearms offences. During admission, I found out I was six and a half months pregnant. I gave birth to my daughter while I was serving time at New Hall Young Offender Institute in Wakefield. 

I know people looked down on me when I was on the street. But they didn’t know anything about me.

It sounds bizarre, but I loved being in jail. It helped me. I got counselling there and was detoxed. I’ve never been to school and there were education programmes in prison. There was a structure that I’d never had before. They showed me how to do really simple things like filling out forms, opening a bank account, and doing laundry. I was like a baby learning to walk for the first time. 

I was in and out of prison for ten years. At one point it was my second home. But it was better than being out on the streets. It was better than being on drugs. 

I first got properly clean at 28. My mum had got in contact with me while I was in jail and I went to stay with her when I was released. Being with my family again centred me. After years of not knowing where I was going to sleep or eat next, I had a proper home. I was put on a methadone script and got off smack. Local support groups helped me exit sex work as well. 

I got my first job at 34. I was put in touch with a charity that helps people with a criminal record find work. They all knew I’d been in jail, but I didn’t dare tell anyone why. I thought if they knew I’d been a drug addict and worked on the streets as a prostitute, they would judge me and look down on me. I got a job in a department store and I was good at it, but then someone I’d been in jail with recognised me and all my past came out. When they fired me, they said it was because I hadn’t disclosed my full record during interview. 

"One of the hardest things about getting clean is cutting ties with your past life."

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I relapsed shortly after that. One of the hardest things about getting clean is cutting ties with your past life. Giving up drugs is easy compared to trying to get someone to give you a job when you’ve got a criminal record. I’d been a junkie and a working girl for twenty years. That was all I knew. I was so upset I’d lost that job that I started using again. Just a bit, I thought. Just to help me through this. But it doesn’t work like that. 

I started dating a drug dealer and everything spiralled very quickly. I was soon back on heroin and working on the street to feed my habit. I was so ashamed I left my mum’s and cut all contact with my family. I can’t be around them when I’m using. 

I worked in the Leeds managed area then and things were very different. The police don’t arrest punters or the girls there. They try to help you instead of sticking you in a cell. There are also charities like Basis to support women like me. They helped me get off drugs again, move back with my mum, and to make better choices. They’re still supporting me now. 

I was 36 when I became a grandma for the first time. My little girl has a family of her own and I want to be there for them. I’m 38 now and am clean, sober and no longer do sex work. But it’s not easy. My record makes it difficult to get a job, I am a full-time carer for my mum, and I’m on Universal Credit. I’ve had my benefits sanctioned several times because of administration issues, and I know I could go down on the beat anytime and earn several hundred pounds. 

Sometimes I can’t believe I survived what I have been through. I should have died so many times, but here I am. Society writes us off as ‘prostitutes’ and I know people looked down on me when I was on the street. But they didn’t know anything about me. What people don’t seem to understand is that this is our lives. People live this. I know horrible things have happened to me, but I’m not a horrible person. Working girls are not horrible people. We’re all just trying to get by.

Charmaine (not her real name) is a recovering drug addict and sold sex on the streets of Leeds for 25 years. She has now exited sex work and volunteers with Basis, a sex work project in Leeds to support other women. 

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Charmaine

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In care at four, on the streets at nine, Charmaine has had a traumatic journey to reach life as it is now: no drugs, no sex work, looking after her mum, and enjoying her grandchildren. Here she writes honestly about her past.

Exotic dancer Ella Smith was in a job she loved. It gave her confidence and allowed her to work flexibly to fit in with her studies. Then a campaign to close the club she worked in made secret films of her colleagues. But she and fellow dancers stood up for their right to work.

In March 2019 my life was turned upside down, as were those of my friends and colleagues. The job I loved turned into a job I dreaded, where I feared what was coming next. If I told you I’m a sex worker, you might think this abuse was caused by my clients, but it wasn’t; it was caused by feminist groups who said I needed saving. They wanted to support women – yet all they did was manage to bully, belittle and stigmatise exotic dancers like me. 

Becoming a dancer at Sheffield’s Spearmint Rhino was the best thing I’d ever done. It gave me the confidence I desperately lacked throughout life. As someone who has struggled with an eating disorder, I would never have imagined finding the self-love that I have right now through sex work. 

I was paranoid that every person who came into the club was another undercover investigator trying to take my job away. 

I am a university student and well educated. Dancing wasn’t my only option. I wasn’t forced into this. I made this choice myself because it suits my lifestyle. I can work whenever I want, wherever I want. Dancing has given me the opportunity to pursue things I could never have imagined before.

In February 2019 the feminist group Not Buying It sent private investigators into our club to buy lap dances and secretly film the women dancing. They did this to ‘prove’ to Sheffield Council that Spearmint Rhino was in breach of its own code of conduct and should have its licence revoked. They filmed women naked and without their consent, and this was only the beginning. 

Not Buying It have no idea of the hurt they caused to the women they filmed. Not only has it traumatised the women themselves, but it has also hurt their families, their friends and their children. I wasn’t one of those filmed, but the investigators’ actions and the ensuing campaign to close our club left me extremely anxious and scared to go to work. It took all the joy out of a job I love. 

"Becoming a dancer at Sheffield’s Spearmint Rhino was the best thing I’d ever done. It gave me the confidence I desperately lacked throughout life."

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Sex work and feminism

I was paranoid that every person who came into the club was another undercover investigator trying to take my job away. I was always on edge, watching people, checking buttons for cameras, looking in people’s ears to see if they were wearing earpieces. I was hyper-aware of customers who used their mobile phones and frightened that they were secretly recording me.

It was torture. Work went from being the place I felt safest to a place I felt judged and under attack. 

Then there was the feminist campaign against us online. I would wake up in the morning wondering what else was being said about me and my peers by people who had never met us. On their website they claimed that “every woman who has left the industry has told us that the overwhelming majority of dancers had come from abusive backgrounds”. 

They claimed that “drugs, drug dealing, serious physical and sexual assault” are all common in lap-dancing clubs, and that “pimps source dancers inside clubs – after all, they are little more than a grooming ground for vulnerable young women into prostitution”. 

They wrote that some women have had to give up their jobs when a strip club opened nearby and that “clubs can quite literally create ‘No-Go Zones’”. They claimed to know so much, yet had never spoken to any of us. If they had, they would have met very different people from those described on their website. 

On social media, feminist groups said that the best thing for the dancers would be to close our workplace immediately. How could this be so? We want to work here; we love our jobs.

I reached out personally to Not Buying It, to speak with them so they could actually talk to us about our jobs. They ignored me and told me I was unprofessional in my approach and shouldn’t use a social media like that. It seems bizarre that they refused to meet with the very people they were campaigning to ‘save’. 

How can you support or help anyone if you refuse to speak to them? How do these groups get away with such public online hate towards people like me, simply because of the line of work we choose to do? 

"Then there was the feminist campaign against us online. I would wake up in the morning wondering what else was being said about me and my peers by people who had never met us."

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The most damaging part of being a sex worker is not the work itself but the stigma around it. It is stigma that damages sex workers’ mental health, prevents us from speaking out, and that enables abuse against us. This becomes more pronounced when groups like Not Buying It claim they want to help us, yet continually degrade us by filming without consent and casting us as tragic victims to be rescued. 

But we do not need saving. We want to work in safety and for our choices to be respected. We are already seen as vulnerable in society because of people’s opinions and attitudes towards our work; surely women’s groups should be fighting to ensure a safe working environment for us, not to take away our livelihoods?

In September 2019, I and other dancers sat through an eight-hour hearing in front of Sheffield’s licensing committee to determine if our club would be allowed to keep its licence. I heard anti-sex-work campaigners talk about the location of our club, the job I do, about our customers, and what kind of women we were, but I didn’t know any of these people. They had never set foot in my workplace or made any kind of effort to get to know me. 

In eight hours of objections, there was barely any recognition of how degrading it was for Not Buying It to film naked women without their consent and then share this footage with others. They had violated a workspace where women felt safe and yet this didn’t seem to be of concern to anyone but the women who had been subjected to that violation.

Our club was allowed to keep its licence, but Not Buying It have publicly stated they will stop at nothing to close us down. We have been left anxious, paranoid, degraded and stigmatised by feminists who are trying to snatch our livelihoods away.

I’ll never understand what we’ve done to cause so much hatred from people who have never met us. We are strong, independent women doing jobs we love and earning a living. It’s awful to be so publicly ridiculed for a choice that some do not agree with. 

To those who disagree with our choices, I would say: Please stop trying to save us. Work with us, listen to us, and find out what we want rather than campaigning against us. 

Ella Smith (not her real name) has worked as a dancer at Spearmint Rhino in Sheffield for two years and is also a qualified personal trainer. She has been an outspoken critic of the feminist campaigns against Spearmint Rhino and is currently studying for her degree in psychology at Sheffield University.

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Ella Smith

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When campaigners filmed secretly in the club where she worked, exotic dancer Ella Smith felt frightened and degraded. Here she speaks out about the attack on her livelihood.

Sex work and critical campaigners

Many of us trust the police to protect us from crime and find and punish those who commit it. But sex workers don’t have that luxury. If they report clients’ offences, they are often faced with indifference and an assumption that violence is simply part of the job. One organisation is trying to turn the tide, as sex worker Abigail explains.

In 2017 I experienced a burglary at my home late at night. I immediately phoned the police, who arrived within a couple of hours, made sure I was okay, cleared up the glass from the window that had been smashed, took my details and sent a forensics officer over the next day. I was shaken, but I never had any doubt that contacting the police was the right thing to do – the safe thing to do. 

Like most other people, I used to look to the police as pillars of the community who safeguarded society. I believed those children’s TV shows where the friendly man in the blue helmet would help people cross the road or give someone directions. Even as I grew into adulthood, the police were the people who’d chase down the thief, stop the dangerous driver or solve the murder.

It was only when I became a sex worker, in April 2018, that this veneer started to slip. Suddenly the police became the people who might arrest me or my fellow sex workers for trying to support our partners and families. They became the people who’d dismiss our experiences of violence, or worse, be the perpetrators of that violence. 

In a society that sees sex workers as disposable, easy targets or criminals, I cannot ever feel truly safe. 

As a sex worker, the idea of reporting to the police feels like playing roulette. You have no idea what is going to happen to you – whether you're going to be sat down with an officer who understands what it is that you do, gives you a cup of tea and listens to what you have to say (and then does something about it), or whether you’re going to be greeted by someone who dismisses your trauma as an occupational hazard and sends you on your way.

I’m very lucky – I have not yet had to report anything that has happened to me in sex work. But across the country, I see my friends and colleagues take a huge risk every time they choose to report directly to the police, and that risk does not always pay off. 

"Each and every one of these stories erodes your trust in the people you’ve been taught since childhood will keep you safe."

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Selling sex and sacrificing safety

When a client contacted a friend of mine and asked her to perform sexual acts with a minor, her report to the police was disregarded. Instead the officer said, “Why are you so upset? You should expect this with what you do.” Another worker was one of several women filmed by undercover police when they infiltrated the strip club where she worked and took covert footage without permission. In 2017 a cleaner in a Bournemouth brothel was convicted under brothel-keeping laws after calling 999 for a client who had had a heart attack while on the premises.

Ask any sex worker and we’ll have a handful of such stories to tell: our own experiences, our friends’ experiences, and the experiences of sex workers all across the UK. Each and every one of these stories erodes your trust in the people you’ve been taught since childhood will keep you safe. 

I’d heard of National Ugly Mugs (NUM – an organisation that provides greater access to justice and protection for sex workers) before I started sex working myself. I had friends all across the sex industry: the non-binary domme (who takes the dominant role in BDSM) whose disabilities made it hard for them to maintain a job in the formal labour market; the pornography performer working three jobs to support her partner on Universal Credit; the escort who made enough money from sex work to survive each month so that she could dedicate the rest of her time to volunteering and community projects. As soon as I started engaging in sex work too, I knew to sign up with NUM immediately. 

Sex workers keep each other safe. We rely on our colleagues’ generosity, kindness and community to share knowledge, information and resources. Sometimes it’s just a case of having had a bad day and needing to vent to someone who won’t make you feel like it’s your fault for choosing this line of work. Sometimes it’s needing to know which clients are thought to be safe and which ones might turn out to be stalkers, harassers, thieves, rapists – or worse. 

"Sex workers keep each other safe. We rely on our colleagues’ generosity, kindness and community to share knowledge, information and resources."

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NUM means we can share this information not just with our friends, but with a whole network of sex workers with whom we stand in solidarity. Every time I receive a NUM alert – which is sent to us if a worker has reported a dangerous person in our area – I feel mixed emotions. Sad that this has happened; anger towards a society where this has been allowed to happen, or accepted, or hidden, or, at worst, justified; but most importantly, I feel warmth and compassion towards the person brave enough to come forward and share their experiences in the hope that none of the rest of us will have to then face them. 

To share this information with NUM is to help every sex worker across the UK, and I cannot thank them enough for it.

With NUM, I know that I have the tools to protect myself as much as possible. I can use email- and number-checkers to screen clients. I can find out about anything happening in my local area that I need to avoid. I know that if I ever needed to, I could report a crime to NUM and help keep other sex workers safe, while also being able to choose whether I want to report to the police or not. 

I feel safer in the knowledge that sex workers can report incidents to NUM, which then passes on anonymised warnings, although I hope most of us never have to use this service. And yet I cannot help but feel that if every sex worker knew that the police would not dismiss, belittle or criminalise their experiences, NUM wouldn’t be needed. We should not have to fear seeking the help we so desperately need.

In a society that sees sex workers as disposable, easy targets or criminals, I cannot ever feel truly safe. The police perpetuate, recreate and reinforce that stigma that sees us either as abused victims who lack autonomy, or as criminals who deserve what we get. We demand to be seen as human, with the same rights and the same ability to access justice as everyone else.

Abigail (not her real name) is a pornography performer, webcam performer and professional submissive. In her other life, she is an academic who enjoys baking, vintage fashion and the Eurovision Song Contest.

Abigail

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Sex workers who report crimes against them can face a “what do you expect?” attitude. But one organisation is working to protect vulnerable people in the sex industry.

Therapist and sex coach Matt Valentine-Chase explores how shame and stigma negatively affect sex workers’ access to medical and mental health help. The time has come, he argues, for understanding, compassion and openness.

Some years ago, following a bereavement and some housing issues, I sought mental health support. I noticed that during the initial assessment the therapist increased my risk score when I told him what I did for a living. I am a trained therapist, so I understood the risk-assessment form he was filling in. 

When I asked him why he had increased my risk factor, he said, “Because you’re an escort.” I said, “But you haven’t asked me how I work, where I work, with whom I work. That doesn’t make sense.” I explained to him that I used flavoured condoms for oral sex, that I worked from premises (generally safer than the streets) and that I had been in the business, at that point, 20 years. He looked at me with a vacant glaze. I was already mentally unwell at this time, but I remember feeling invisible as he said, “Okay, well, it’s sex work, so I still have to increase the risk score.” 

This is stigma against sex work, or “whorephobia” in action, and it is the opposite of what is needed to support sex workers effectively. Sex-work stigma is often discussed in research and by practitioners, both within and outside the sex-work community, and has been identified as the leading cause of mental health problems for sex workers. 

Add to this a reluctance to access front-line mental and physical health services, often due to sex workers’ previous negative experiences, it is no wonder sex workers are more likely than the general population to experience mental health challenges. 

But something that I feel is often left out of this discussion is how this stigma is internalised by sex workers. Through my own experience, both as a sex worker and a therapist, I have seen how damaging internalised whorephobia can be. When mental health professionals automatically assume sex work is damaging, they reinforce the stigma and bring layers of judgement to the therapist–client dynamic.

As sociologist Teela Sanders and her colleagues at the University of Leicester found, “the preconceptions about sex work may lead practitioners to further stigmatise sex workers and do more damage rather than help”.

"Something I feel is often left out of the discussion is how this stigma is internalised by sex workers."

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“Internalised whorephobia” is a term I use to describe the feelings of shame and self-hatred that are often experienced by sex workers. To help others understand what I mean by this, I use a personal example of internalised homophobia. When I was 18, I had gay sex for the first time. Afterwards I scrubbed myself in the shower with a scouring pad, sobbing uncontrollably, thinking about how “dirty” I was. 

Through my own experience, both as a sex worker and a therapist, I have seen how damaging internalised whorephobia can be.

Two years later I started work as an escort. Following my first client, I got into the shower and did exactly the same thing. I remember crying, rubbing my skin raw and thinking, “How did things come to this?” At the time I thought I had hit “rock bottom” and must be “desperate” to work in the sex industry to pay my bills. 

It is important to note here that no one suggested I work in “the business”. It was I alone who sent my pictures to the escort agency. It was I who went to the interview and it was I who said “yes” to the first booking.  So, who do the words “rock bottom” and “desperate” belong to? I would argue that this view – that workers are somehow so desperate they have to sell sex – belong to the general consensus of society and that we are all victims of this societal conditioning. 

I did not make the connection between internalised homophobia and internalised whorephobia until many years after these experiences. It took another ten years after beginning to train as a therapist that the penny finally dropped. My reaction to gay sex for the first time was the same as my first experience of sex work because I had internalised stigma and shame. I was not dirty. I was not desperate. I had been subjected to powerful social scripts that told me I was. 

"The impact of keeping such a big and important part of myself hidden was significant."

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During my therapy training, I remained in the sex industry and did not retire until 2017. It was a career – and to me it was a career – of 25 years. Yet I kept it a secret. It’s difficult to describe the toll this takes. The impact of keeping such a big and important part of myself hidden was significant. But I kept quiet because I was scared of being judged and of losing my job as an NHS therapist. 

In my current therapy practice and during my three years working for the Beyond the Gaze research project, I have met and worked with hundreds of sex workers. When they realise that I have also worked in the business, they are visibly relieved. That dark shadow of secrecy is suddenly lifted from them (and from me). Then our working relationship can continue untainted by the stigma they are so sadly used to. This is a step forward in supporting sex workers to rebuild their mental health following years of dragging around the weight of stigma. 

However, sex workers should not have to seek ex-workers in order to receive the non-judgmental support they deserve. Practitioners, such as therapists, mental health workers and project workers, have some way to go before the sex-work community is supported in the way that they need. The wider research into the industry, especially research that addresses the macro view of the sex business, is for me encouraging.

Practitioners within mental health and the wider medical and therapeutic disciplines need to step up and actively seek out training in order for them to step back from stereotypes and to genuinely help the human being sitting in front of them.

For that is what we all have in common: to be human, to be vulnerable – with a need to be seen. 

Matt Valentine-Chase is a sex coach and therapist. A former researcher for the Beyond the Gaze research project at the University of Leicester, Matt trains practitioners to work with sex workers in a way that combines a respect for their contribution to society with an awareness of how stigma can affect their mental health and sense of self.

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Matt Valentine-Chase

Like everyone, sex workers sometimes need medical or mental health support. But shame and stigma seriously affect attitudes and access.

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