A lack of access to adequate and dignified healthcare is often a struggle for those in the sex trade, particularly for those who work in the streets. This is due to lack of access to transportation, availability of healthcare professionals trained in working with people who trade sex, and cost of clinics and meds. Numerous historical atrocities perpetrated upon already underserved populations by conventional medicine has led to an understandable and healthy distrust of the current system of healthcare and medicine.
If we do access clinics, navigating the environment can present further challenges. Caring for sex workers seeking health services requires knowledge, flexibility, open-mindedness, respect, confidentiality, and, above all, a non-judgmental attitude. When we disclose our occupation or what we do to survive, we often experience stigmatizing behavior from staff in the form of disapproval, shaming, and questioning about our work in a degrading manner. Healthcare providers inevitably bring their own biases into the room. When these go unchecked, moral judgments can lead them to draw their own conclusions. Stigma exists in the territory of the mind and discrimination consists of the actions that follow suit. Without nuanced and thorough training about the health needs of sex workers, treatment plans can be applied hastily and misdiagnoses are common.
Mental health is strongly influenced by environmental and social circumstances. Being part of a trade that is subjected to censorship, monitoring, harassment, criminalization, physical assault, sexual assault, and murder at an alarming rate can weigh heavily on us mentally and emotionally. Sex workers are not a homogenous group and, as reflective of larger societal oppression, we see a disproportionate amount of violence afflicted against people of color, undocumented, trans* and street-based workers. Violence and pain come in many forms and the struggle for mental and emotional wellbeing can be exacerbated when trying to find, and feel adequately served by, mental health professionals.
Another barrier to care is the narrowly considered anti-trafficking movement. With a recent uptick in the capital gains possible in this moral crusade, service providers and employees in many sectors are receiving mandatory training in an attempt to equip them to “spot trafficking.” Training materials include “red flags” as broad as anyone who experiences repeated STIs and/or pregnancies, appears fearful or anxious, pays in cash and does not have insurance, and/or shows signs of substance abuse. This body and lifestyle policing paired with blatant racial profiling turns a routine health check up into an interrogation with serious and heinous consequences. By assuming every sex worker is a victim of trafficking, the likelihood of police involvement, criminalization, and deportation is increased for those seeking care.
Not every sex worker is trafficked, coerced, pimped, devoid of choice or a victim of circumstance. Providing sexual services in exchange for resources can be a choice, however relative under capitalism. What someone does to make ends meet should not be a subject of interrogation in the health clinic. Every person, regardless of how they source money or resources, deserves to feel safe and respected while seeking medical care and should not be forced to disclose personal details or withstand unwanted and invasive attention.
When the available conventional medical options are inaccessible, cost prohibitive, dismal, or a precarious site of possible criminalization, treatment is delayed or abandoned completely. Infections gone unattended can spread to larger body systems, leading to long-term health complications. These health risks can also be passed on to sexual partners. Combined, this can spark mental health breaks, which intensify in isolation, and become risky to oneself or others. Contrary to the grotesque stereotype that sex workers don’t care about their bodies, those who trade sex are most often acutely aware of, and responsive to, bodily needs. Structural barriers prevent us from accessing care. As with most things, sex workers take healthcare matters into their own hands.
Women with a Vision (WWAV) is a longstanding local powerhouse non-profit in New Orleans that explicitly advocates on behalf of sex workers. In the winter of 2018, they received a grant from the Sex Workers Giving Circle (SWGC), a fund housed at the Third Wave Foundation. The SWGC is a cross-class, multiracial, intergenerational group of women, queer, and trans people with current or past experience in the sex trade who come together to pool resources and raise money. $100,000 was distributed amongst eleven groups speckled across the US working towards liberation for people in the sex trade. SWGC operates from an understanding that sex workers are best positioned to transform the oppressive conditions that affect our own lives, but our movements remain critically under-resourced even as political attacks continue to mount.
Women with a Vision is using this grant to expand their healing justice work. Healing justice is a framework to lift up and politicize the critical role of health and healing in our communities and movements. It is the work of responding to, and intervening on, generational trauma and bringing collective practices that can impact and transform the consequences of oppression on our bodies, hearts and minds. As part of their healing justice initiatives, WWAV offered funding for an herbal medicine kit for sex workers and those who trade sex, prioritizing POC and trans* street-based workers. Through long-term bonds forged between autonomous organizers and WWAV staff members in the intimate local sex work political organizing circle, Health Within the Hustle was born.
Health Within the Hustle is a mutual aid solidarity project centered around botanical medicine, health sovereignty, and community interdependence. It is entirely dreamt, funded, directed, and created by current and former sex workers. The project was envisaged in an herb school funded through money made in the hustle and inspired by the wisdom of an educator who financed their own herbal education through working in the industry. Health Within the Hustle is part of a long lineage of funding and sharing autonomous education through erotic labor.
Over the course of the spring, workshops were held for current and former sex workers to be part of the medicine-making process. In a livelihood so often done in isolation and necessary secrecy, we came together to foster in-person connections— to concoct, console, and co-conspire. Each medicinal formula contains the magic of being touched by several sex workers’ hands with a collective experience of over 35 years of hustling in each bottle and tin. We talked of the pervasive fear mounting as the year anniversary of traumatic raids of local strip clubs approached, mama’s tips for sewing pockets into bras to keep money safe in the streets, how to find a semblance of stability while having to leave town regularly to pay rent, and we questioned what the fuck a blockchain actually is.
Fisting jars of plants and packing boric acid pills, the room filled with the scent of floral oils and the sense that actions of solidarity are vital for healing. Healing is laughing together: it is building and maintaining a relationship with the land and the more-than-human world, it is participation in the fight against the systems hell-bent on swallowing us whole, it is sharing food and recipes for emotional resilience. Healing is fierce and it is tender, it is saying we deserve better and we will be better together. Healing is strategic. Without healing we are at risk to keep reiterating the same structures we are trying to move away from, the exact structures that seek to alienate and divide us. When we find each other, we find health within the hustle.
At present, over 100 shimmering metallic fannypacks are filled with herbal medicine preparations that will be distributed via local street outreach with the remaining medicine available in a sex worker’s community apothecary. Each medicinal formula was created based off of observations and conversations by folks doing direct street outreach with Trystereo Harm Reduction Collective and WWAV, and through directly asking folks in the hustle about their healthcare needs. The trap many mutual aid projects can fall into is a lack of critical consideration for how useful the resources being offered are for the folks they are intended for and how concepts might translate when materialized. How feasible is carrying a hefty weight of glass tincture bottles for those with no reliable place to store them? While herbal teas may do wonders for UTI support, how helpful are tea bags given to folks who don’t have readily available hot water? A sitz bath is a great solution for some and a high-barrier remedy for others. As one person involved with the project is fond of saying, “If your medicine isn’t accessible, what good is it?”
Health and healing projects must be rooted in self-determination and intended towards collective liberation. An accessible project can be measured by its ability to reach smaller, often unconsidered groups of people and those most marginalized. At its root herbalism has always been a tool of resistance. Being in direct relationship with the plant world is a way to understand the broader patterns and interdependencies of all life. This powerful connection is threatened by herbalism’s recent rebranding by the marketers of conscious capitalism as luxury medicine, increasingly available only to the affluent who can afford it. By reconnecting with ancient models of restoration, educating ourselves about our herbal allies, and sharing folk medicine directly outside of capitalist modes of consumption, we build a network of healing that can support our movement away from the stigmatizing and costly corporate power structure that healthcare has become. We must push back against the State which criminalizes our survival and build long-term community health resilience for sex workers and those in the sex trade.
Kits are available to literally meet people where they’re at via WWAV & Trystereo. They will be available for current sex workers at an event in honor of International Whores Day June 2nd. Check @WWAVinc on Twitter and @wwavnola on IG for details.