Experiences of Sex Workers with Disability in Australia

Sex work stigma and disability stigma significantly contribute to the prevalence of violence against sex workers with disabilities. Sex work stigma manifests as: 

• criminalisation, over-regulation and heavy policing of sex workers
• people with disability who do sex work being stigmatised and pathologised
• migrant sex workers being targeted, deported and detained 
• disability support services excluding and erasing sex workers with disability 
• public acts of discrimination and vilification against sex workers 
• violent perpetrators who believe they can target sex workers with impunity. 

 Addressing and reducing sex work stigma is an integral part of preventing violence against sex workers with disability. Sex work stigma is  a ‘driving force behind many policies and regulatory frameworks that govern sex work, including criminalisation, licensing and end-demand policies.’  These legal frameworks and their enforcement, coupled with the gradual extension of police powers, medical mistreatment and pathologisation of sex work by medical professionals reinforce stigma against sex workers. They promote the idea that the community must be protected from sex workers, or that we must be protected from ourselves, rather than viewing us as citizens and workers equally deserving of protection under the law. 

Stigma against sex workers has been identified as a negative health determinant that affects the mental and physical health of sex workers,  our ability to access non-judgemental health care and our access to basic needs like housing, financial security and legal support.  For sex workers with disability, this is magnified by the intersection of stigma and discrimination against people with disabilities. 

“To be both a sex worker and disabled you are doubly systemically isolated within the community and the impact of that is immeasurable and effects all parts of your life and interactions. I don’t think there is a time when it doesn’t affect us.” (Survey Respondent) 

“In a broader way, like when I’m out in the world, the recipe of being a disabled sex worker is so difficult when interacting with lawyers, doctors etc…I’m always asking myself: ‘Am I going to be treated like a human or not?’”  (Survey Respondent) 

“There is no part of my being a sex worker that isn’t impacted by my disability, as is the same for other aspects of who I am. Too disabled for [sex worker] peer health orgs, and sex [work] too stigmatised and unheard of in specialist disability health services. It is not safe to be either, let alone both. Both identities are so heavily policed and restricted…and I dont know a single person who is able to access any services being out about BOTH sex work status and disability at one time.” (Survey Respondent)

Several sex workers also spoke to personal difficulties that they have experienced in identifying and disclosing either their sex work or disability across different aspects of life:

“It took me a long time to identify as a person with a disability. I’ve been diagnosed and treated with depression for 17 years but never considered it a disability even though it affected how I lived my life. It wasn’t until I developed a chronic condition that affected my ability [to] walk and move that I started to identify that way and accept that my mental health conditions also were part of my disability.” (Survey Respondent) 

“I have to be very careful who I tell that I’m a sex worker. I have been systematically abused and I feel like outing myself has an impact on my interactions. Like there is the stereotype that we are vulnerable people who are forced to do the work.” (Roundtable Participant)

“People often dismiss my chronic pain because I am ‘too young to have pain’, also because both of my disabilities are invisible they are dismissed more easily. It makes me feel invalidated, misunderstood and not seen.” (Survey Respondent) 

“My disabilities are 99% invisible, and the torment of people not understanding and assuming you can do anything a healthy or abled person can do (and pushing you to do so) can be so depressing.” (Roundtable Participant) 

“Despite disabled sex workers being a part of our movement’s history, we are often not mentioned. Unfortunately disability gets removed from history, even sex work history.” (Roundtable Participant)

In one roundtable discussion, participants identified this imbalance as part of a ‘desirability politics’ wherein disability stigma affects perceptions of how ‘desirable’ an individual is deemed to be. This is often seen as incompatible to popular notions of sex workers as pinnacles of mainstream ‘desirability’:

“There is also not a lot of talk about sex workers choosing sex work because they are disabled. I think this is due to desirability politics, like disabled people are not viewed as sexual or desirable. Yep, the fact that sex work funds my lifestyle as someone with lots of health expenses isn’t sexy Twitter fodder.” (Roundtable Participant) 

“…This aligns with the narrative that sex workers are not disabled, it is only clients who are disabled and require accessible ways to access brothels.” (Roundtable Participant)

“…Fat people have more access needs than straight sized people. I am a person that has access needs because of my size, it’s important that that is included in disability discussions, just like people of certain stature are included in disability spaces. I get so much advice from non-physically disabled sex workers – It’s like – have you ever sat in a wheelchair as a fat worker? There are so many access needs that come from being fat and disabled that aren’t acknowledged or spoken about.” (Roundtable Participant) 

“Weight changes are often part and parcel when you become disabled or sick like I don’t know why it’s ostracised. It’s the effect of being unable to be as active as we were and it’s heartbreaking.” (Roundtable Participant)

“Having my addiction on my record forever has made life so hard for me, I’ve had to tell so many lies even when I really wanted to tell the truth and get help.” (Roundtable Participant) 

“My treatment order includes having to do regular piss tests, the GP looking for track marks, only being able to pick up my medication twice a week. Even though I have never failed a drug test since starting my medication.” (Roundtable Participant) 

•  96% of participants reported experiencing stigma or discrimination related to their sex work within the last 12 months, including 
• 34% who indicated that this ‘often’ or ‘always’ occurred. 
• In 2015, research by CSRH found that among the general public, 64% self-reported they would behave negatively toward sex workers because of their sex work.

Sex worker stigma compounds differently for sex workers from other marginalised communities who are routinely targeted by police and for sex workers who are parents, use drugs, are young or work as street based sex workers.  For Aboriginal and Torres Strait Islander sex workers, racism further exacerbates sex work stigma as they already ‘face targeted police interaction and disproportionate rates of incarceration.’  Migrant sex workers experience racialised sex work stigma often based on racist assumptions that they cannot work independently and thus must be involved in organised crime as victims of trafficking or exploitation. 

Sex work stigma can also compound depending on what type of sex work we do. Sex workers often refer to this as ‘whorearchy’, in which different aspects of sex work are viewed as more or less valued or ‘respectable’ than others. Sex work stigma impacts on attitudes towards violent crimes committed against sex workers, including how they are approached by investigatory teams of law enforcement, the judiciary or by the media. It also plays out in how families and communities respond to violence where the victim/survivor is known to be a sex worker, regardless of the context in which the violence takes place. We see this when a victim of violence’s sex work status is emphasized by the media, or when a sex worker victim is ‘outed’ in the private or public spheres following their death.

The illustrative contributions of sex workers with disabilities in this report, show that disability is also a compounding factor for sex worker experiences of discrimination and stigma. In this way, sex work stigma can be understood as both an origin point of stigma and an amplifier of existing stigma. 

When we say ‘sex work is work’, we acknowledge that sex work is a legitimate and skilled occupation. Sex workers, like all workers deserve access to rights and redress. The fight to end violence against sex workers involves the direct recognition of our status as workers, and as individuals deserving of the full suite of human and industrial rights afforded to others. 

Sex work offers flexible working conditions that are less available in other industries 

A NSW independent and brothel worker provided the following statements: 

“My mental health has severely impacted my ability to maintain or pursue any job outside of sex work. When I started over a decade ago, it felt like my only choice. I was broke and struggled to maintain any other job. The flexibility sex work afforded and being able to earn money on my own terms gave me back some autonomy. Now I am quietly quite proud of my work. My clients are all types of people of course, but the ones that seek me out and become regulars often also struggle with mental health. I think we recognise each other. Because I have these experiences myself I think I’m better equipped to understand and cater to what these people may be looking for.”

A NSW & ACT based independent sex worker stated: 

“I started doing sex work because of my disability. I am an Auslan interpreter and that can be quite a physically demanding job. When I developed a chronic condition I found I could no longer do the hours I was before and needed to supplement my income somehow as I was also a single mother of two at the time. Sex work allowed me to work around my flare ups and child care options while making enough to be able to pay rent and buy groceries.”

An anonymous survey respondent stated: 

“My disabilities affect me in different ways at work. I suffer from chronic pain and pain has at times stopped me from working for periods of time. Sometimes it is a day off here and there, other times it has been whole months. My disabilities greatly influenced my choice to start sex work. I’ve dealt with chronic pain for a decade, along with various mental health issues. I feel at this point in time I am physically unable to uphold a ‘normal’ job because of these reasons. Sex work allows me to have more flexibility with the hours I work.”

A VIC based sex worker stated: 

“Over the years I’ve specialised in working with clients with disabilities themselves. Being able to understand and identify with them helps them relax and not feel so self conscious. I can sustain [working as a sex worker]. It is more flexible and I can do it when I’m feeling well enough and won’t lose my job when I can’t work cos I’m not well. [I can a]dapt the work to my physical and mental needs.”

Experience of disability provides transferrable skills for sex work 

“The sensitivities I have as a disabled sex worker translate well into skills needed throughout sex work. I do well de-escalating potentially tricky situations. I can support other workers and point them toward resources I’ve used myself. I am proud that my experience as a neurodivergent person has helped me to be a better provider, and to bring comfort to other people like me. This brings me confidence that supports my own mental health journey.” (Survey Respondent) 

Another sex worker who identifies as queer, Aboriginal and/or Torres Strait Islander and a person of colour stated: 

“ASD meant I was good at being able to ‘break up’ with a client due to my black and white thinking. It also was good when I needed to lie and make up a convincing story about myself [to protect my privacy when dealing with clients]. [ADHD] meant I had lots of energy for night shifts.”

Sex work as a way to financially and temporally accommodate disability 

“We are constantly making money to cater for our disability. I have to spend so much money on medical appointments and specialists. It’s bittersweet. I am so glad that I can get to those appointments and pay for treatment but it can feel like going paycheck to paycheck, where a lot of our profits go to managing and maintaining our health. So yeah, it’s bittersweet.”(Roundtable Participant) 

“In sex work you get relatively higher pay for shorter bursts of energy. This makes it more feasible than traditional employment. The higher pay off makes it worth the consequences of exerting myself.” (Roundtable Participant) 

“The flexibility of my work schedule is great. I can switch on and off when I want to. I also have learnt a lot about boundaries and autonomy which I didn’t get in other industries. But it is exhausting, having to advocate for yourself all the time without much support. It can be a lonely career choice before you find community. I’m grateful for the choice, flexibility and autonomy – even if its been hard.” (Roundtable Participant) 

Whatever the reason we undertake sex work, and whether or not we enjoy the work, we must have access to rights and support 

Sex workers may be understood in mainstream culture and within government social support structures as ‘victims’ with no autonomy who are in need of ‘rescue’. This stereotype may compound significantly for sex workers with disabilities, who may already experience infantilisation and pathologisation from members of the public, loved ones, support service workers and health professionals. It is essential to actively combat this perception, particularly among those involved in mainstream disability support structures, from policymakers to frontline workers. 

Sex workers push-back demands that we prove we are ‘empowered’ in our work or that we love our work in order to be seen as legitimate workers. Workers in other industries are not conditionally provided with rights, support or understanding depending on their attitudes towards their jobs. The right to safe work should be available to all, including sex workers with disabilities. 

“[As a] power wheelchair user with substantial limitations, I wasn’t able to get work in brothels. All nearby brothels had stairs, and as a fat person [I] have limitations also. [I could not] visit client homes [and few] clients were willing to book a hotel. I required access taxis which are more expensive than regular taxis. Doing sex work online was exhausting, but I pushed through to try and establish myself and get the first pay out after 2 months. After expenses to set up camming (equipment and tip activated toys, accessibility assistive devices) I didn’t break even. I cannot do in person work from my apartment as it’s social housing with case workers and cameras. I’ve been homeless too many times with the inability to access accessible enough housing to risk any trouble from this work from home.”

“I’ve thought before that brothels treat workers like employees when they need to and sub contractors when it suits them. I’m at a great establishment now, but in the past there have been places that don’t allow for breaks or require medical certificates for all absences. Allowing disabled workers to work how they need to, without fear of repercussions, would be the best thing I could think of.”

“I got bullied a lot by workers for being autistic. Managers tried to take advantage of me because of it.”

“There are physical barriers for sure. For example a lot of establishments are inaccessible, with minimal areas to rest. This is paired with the requirement to do long shifts. Where management often wants me to commit to shifts without consideration for what my pain/energy/capacity levels will be. These things could be easier if I wasn’t required to do very long shifts. The lack of flexibility is an issue.”

“The shift length is definitely an issue. Because it isn’t feasible for me to do long shifts at full capacity, I feel like I have to do a lot of shifts, including graveyard shifts, in order to make enough money. This has led to a lot of comparison with other workers, we are often pitted against each other by management.” 

“Physical pain and fatigue can be very hard to manage when doing sex work. When I have to do a lot of physical labour during a shift, without the necessary support, it leads to an exacerbation of my pain and other physical symptoms.” 

“If you want to work at a brothel – can you get inside? Are you a wheelchair user (ambulatory or otherwise) and is the brothel able to accommodate your chair? Are there steps inside? Strobes, flashing lights, bright lights and loud noises can be very bad for epilepsy and sensory disabilities.”

“There is not much understanding about the high risk of doing certain things at work. Lots of management hound you to wear heels etc., which is high risk anyway if you have things like tendon issues. This is compounded by having to walk on slippery surfaces and up stairs. There is not care from management nor is there space for sex workers to take care of themselves or each other in between bookings or shifts.” 

“It’s better being able to make accommodations for myself, rather than having to argue with a boss or advocate for myself when there is pushback.”

“I always found it really odd that there are establishments that ‘seem’ to hold value in/ consideration for disabled clients and try to adhere to those needs in some ways but there’s no support or infrastructure in place for workers/disabled workers.”

“I have lost a lot of jobs because of not having proper adjustments made for my disabilities, and being seen as a risk.” (Roundtable Participant) 

“I struggle to access other work because I’m not well enough mentally to deal with the pressures of a full-time job. I can’t consistently show up for work every day, I have terrible insomnia from PTSD so I often can’t fall asleep until 4/5am, which makes it impossible to then work an office job that is 9-5. Sex work’s nature of being sporadic, flexible and needing less hours of work to provide maximum income per hour of work, is an option that other jobs in the labour market simply don’t afford. I’m well educated, with a bachelor’s and a master’s degree, so it’s not a lack of intellect in terms of accessing other jobs, but a lack of flexible working conditions in other industries.” (Roundtable Participant) 

“Unworkable hours, no understanding of limitations, pressure to push yourself past your limitations, lack of accommodations, refusal of accommodations, constantly having to advocate for your rights in a way that nondisabled people don’t have to.” (Roundtable Participant) 

“What jobs even exist outside of sex work that are for me? There are not many options that are realistically out there?… I don’t think there is any real benefit in non sex work jobs for me.” (Roundtable Participant) 

“There are no straight [non sex work] jobs I can physically do, a minimum shift of 3 hrs is too much, I can’t commit to scheduled shifts due to the variability of my capacity.” (Roundtable Participant)

We know that when any aspect of our sex work is criminalised, there are opportunities for perpetrators to commit violence against us with impunity. This relates not just to clients, but to police, immigration officials, family, friends or partners, and the general public. 

Violence within the sex industry is often blamed on the ‘nature’ of sex work, which leads to reforms that seek to over regulate or criminalise our work, clients and workplaces in an effort to impact ‘demand’ for sexual services or to abolish the sex industry. This is especially so for sex workers with disability, whose experience of work-based violence can trigger a ‘rescue’ response rather than one that understands and addresses our experiences as preventable workplace violence, for which we are entitled to redress. 

Sex workers with disability reflected on experiences of workplace violence in our research. When asked whether they had experienced ‘barriers, discrimination or harm within an employment setting’, survey respondents were able to identify whether this occurred because of sex work, disability, or the intersection of the two. Incidents related to disability were the most common. 

The comments made by participants acknowledge the importance of equitable access to redress when this occurs: 

“Sex workers can’t access work cover, so if you’re sexually assaulted on the job and need time off because your mental health is impacted, there’s no way to get support. So you’re forced to work sick, or not have an income. I found that workplaces don’t provide any support to sex workers experiencing mental health issues/trauma/sexual assault, whilst if you were sexually assaulted on another job and as a result were diagnosed with eg PTSD, you’d be able to be off on work cover until you’re well again.” (Survey Respondent) 

Participants in our roundtable session on employment and income conversed together about these experiences, and the difficulties in challenging or getting support for them. 

“I think I’ve experienced more harm from managers than clients, and that’s definitely because if you get known as the “problem” worker then there are consequences that affect your income. This happens in civ workplaces as well, when you have health issues then you are labelled a ‘problem’”

“When I have experienced harm doing sex work I don’t always feel fully equipped to protect myself. I think a part of this is the lack of recognition of disability within establishments which leads to both management and other workers seeing you as a problem, attention seeker, dramatic and delusional – I get the overall impression that they view me as a burden because my health issues are beyond my control.”

“Yes, so many sex workers live with invisible illness and there is such a lack of understanding about those issues…being made to feel like a burden really resonates with me.”

Where criminalisation or licensing frameworks are in place, police become the primary regulators of the industry. It is clear that police cannot effectively occupy both roles of (alleged) protector and prosecutor in a way that provides appropriate support or services to sex worker survivors of violent crime. This conflicting role has long been criticised by sex workers as the cause of various barriers that sex workers face when considering reporting violence.  

Sex workers assert that criminalising and punitive laws that target sex workers, our clients, or our families and associates are forms of state violence, as these laws directly aid and abet ongoing violence against sex workers by state actors and the public. This is very much at play in the way sex workers with disabilities experience aspects of their lives, including access to justice and experiences of harm, exploitation and violence. 

State violence is particularly insidious as it positions violence against sex workers as ‘lawful’ or otherwise excusable and thus ‘socially acceptable’ violence. Understanding and challenging the manifestations of state violence is essential to ending violence against sex workers. This is an important structural factor in the experiences of sex workers with disabilities. 

When asked about experiences of barriers, discrimination or harm within a justice setting (e.g., courts, police, detention), 

• 10 respondents reflected mixed experiences with this space, 
• 40% indicated that this was not an issue for them, 
• 40% reported negative experiences relating to disability, 
• 30% had experienced harm in justice settings related to their sex work. 

One respondent elaborated on the intersection between the two experiences:

“[…]I experienced discrimination by police and sexual assault services when reporting sexual assault as a sex worker. If you have a mental health condition and you’re a woman and also a sex worker, you’re quickly dismissed as ‘hysterical’ and ‘unreliable’ by police. Also police asked me when I reported sexual assault as a sex worker if I pay tax. I don’t think any other professional would be asked that when reporting workplace sexual assault.”

The risk of mistreatment by police increases for sex workers with disabilities. The research report ‘Police responses to people with disability,’ written by a UNSW research team for the ADRC, explains that the nature of police responses to people with disabilities is characterised by: 

• negative assumptions and discriminatory attitudes, 
• failure to identify or accept disability and resistance to engaging mandated supports and 
• police violence. 

A study conducted with Queensland sex workers in 2017 asked participants if they would make a complaint to police if they were assaulted at work:

• Only 46% said that they would, and
• 50% said they would not. 

Of those who said they would not report an assault:

• 66% of respondents cited stigma and privacy concerns as key barriers to reporting 
• 38% indicated that they ‘mistrusted police, their competence, the legal system and / or anticipated discrimination.’ 

Other sex work literature and research echoes this mistrust of police. This includes fears that police will charge workers with prostitution offences if they are sexually assaulted while working outside of the law. As one sex worker writes:

‘Historically and globally, police have been the source of continued abuse, rape, violence and harassment of sex workers. They are not our protectors.’

In one of our roundtable sessions, sex workers with disability shared their experiences of interacting with police. The focus was primarily on sex work experiences and illustrates a thematic ‘baseline’ of disbelief and victim-blaming from police. 

“I have experienced physical and sexual violence from clients when I was working in a share house of sex workers. I was [told by police] there wasn’t anything they could do because I had consented to becoming a sex worker and it comes with the territory.”

“I’ve had a fair bit of experience with [Queensland Police Service]. I reported instances of domestic violence and stalking and the response times were so slow and I was made to repeat my story several times. Once, when I visited their HQ a man made me recall the entire story in the foyer before letting me talk to another officer. When I had spoken to someone on the phone before coming in I was told I wouldn’t have to repeat my story. The cops then refused to report it. I think it’s because I was being stalked by another sex worker who I had been in a relationship with. I think the intersection of queerness, polyamory and sex work made them think I was a time waster and that this person was just a ‘crazy ex bestie’.” 

“There is some work happening with ‘sex work friendly officers’ in QLD, I have had some success in reporting since that has started.”

“In [South Australia] I have never reported – I know people that have tried to and it goes fucking horribly. For example I know about a worker who had been assaulted while at work and had called the cops. Then two male cops showed up and started taking the workers report. One cop said, ‘well you shouldn’t have been out here prostituting yourself’. The worker obviously didn’t continue with the report.”

Have you experienced any barriers to reporting or seeking support in relation to violence or harm you have experienced? (10 respondents) 

If you told anyone about the harm, who did you tell? (9 respondents) 

Where individuals did seek support, they had the following to say about their experiences: 

“No support offered, didn’t know what to do, seemingly hadn’t encountered this ever before/were not educated enough to put down their own stigma and bias.”

“I was fired.”

“[It went] badly, I was ostracised doctors and counsellors kind but no power to change outcome to report”

“I was told there wasn’t anything they could do because I had consented to becoming a sex worker and it comes with the territory.”

“I told a manager once. I was fired. I learnt not to bother after that.”

• are parents, 
• use drugs,
• are young or 
• work as street based sex workers, who are routinely targeted by police 

 For Aboriginal and Torres Strait Islander sex workers, racism further exacerbates sex work stigma as they already ‘face targeted police interaction and disproportionate rates of incarceration.’ 

People with disabilities are overrepresented in the criminal justice system, indicating they also experience discrimination and police targeting.

In a recent study conducted about the interaction between sex worker stigma and the criminal justice system, participants highlighted various intersectional factors that are ‘protective’ for sex workers when dealing with police:

• whiteness, 
• class, 
• heterosexuality, 
• being cisgender, 
• being employed outside the sex industry, 
• English-speaking and 
• working in a decriminalised jurisdiction.’ 

The study further notes that for ‘sex workers with multiple stigmatised identities, police engagement remain[s] a severe risk’.  Sex worker participants further described ‘varying degrees of dissatisfaction, disappointment and frustration’ about their interactions with police as victims of crime, with only a few reporting positive outcomes. 

This study highlights that as sex workers we anticipate proactive police action ‘in charging, arresting or reporting’  us, whilst also expecting complete police inaction when addressing crimes against us.

“The police don’t believe that we have the ability to work independently. They believe we are being controlled and try to get us to admit that someone put in our advertising, or helped us write it, or that someone is answering our phones. They try to get us to tell them who this is. Even when there is no-one.” 

‘The police have the power–we don’t have any. It would be very difficult for an Asian sex worker to explain or convince the police they were not doing anything wrong. The attitude of the police is that they don’t trust us, they don’t like us. When police say to sex workers ‘I’m going to send you home’ it shows their racism, their lack of professionalism and their hatred towards us.’

Some survey respondents spoke to their experiences as sex workers with disability  who are in Australia on a visa. They do not have access to same rights of Australian citizens, noting that working visas do not recognise sex work as skilled work. 

“A lot of migrant workers are targeted by police, experiencing deportation threats, coerced through minimal options being given, not bringing interpreters to meetings, issuing plea deals without proper explanation.”

Sex workers may also fear self-incrimination within criminalised and licensed jurisdictions if we disclose our sex work to a healthcare provider. These barriers are compounded for sex workers living with HIV, who can experience intersectional stigma and marginalisation as well as dual criminalisation. This is one of the reasons sex workers advocate for the full decriminalisation of sex work; fear of criminalisation is a key barrier to sex worker health. 

When asked whether they faced barriers to care or discrimination or harm within a healthcare setting, 67% (n=8) of survey question respondents associated their experiences with disability, 22% (n=5) identified the combination of sex work and disability, and 25% (n=3) identified sex work alone as the reason for their negative experience. 

“Existing at the intersection of experiencing chronic illness and being a sex worker has made it incredibly difficult to get appropriate care. I am yet to get a formal diagnosis or any form of treatment. Medical professionals often separate ‘sex work’ and ‘disability’ into two distinct areas of health care.” (Survey Respondent) 

The findings in this section align with Research conducted by the Centre for Social Research in Health (CSRH) indicates that 31% of the health professionals involved in the study reported that they would behave negatively toward other people because of their sex work. This is contrasted to research conducted with sex workers in 2020, which found that 91% of 647 participants reported experiencing negative treatment from health workers within the last 12 months, including 24% who indicated this ‘often’ or ‘always’ happened.

“I often don’t reach out to health services anymore or I don’t disclose that I’m a sex worker out of fear of discrimination. That is hard because sometimes sex work is the cause of the health issues I experience…and I feel like I can’t discuss those work stressors with a professional out of fear of them not getting it.” (Survey Respondent)

“Medical professionals often assume that we don’t know enough about safer sex and contraceptive options. They don’t trust you, even though as sex workers we are the experts in this.” (Survey Respondent) 

“I feel like practitioners often blame sex workers for causing their own ailments… because of our sex work.” (Survey Respondent)

“It took four years for me to get a proper diagnosis for my disability. It was four years of being told my pain wasn’t that bad and to just take anti inflammatory medication. By the end I was in a wheelchair, unable to walk, unable to look after my own self care and hygiene. But was still being dismissed by every doctor I saw so was unable to access any treatment because I couldn’t get referrals, medications, scans or tests. Without those I couldn’t have any hope of accessing financial aid such as DSP or the NDIS. Both of which I was denied anyway after a proper diagnosis. Sex work is the only reason I could afford the treatments I needed to improve. Without it I would still be severely disabled and in constant, severe pain. I still can’t afford to access the mental health treatment I need, so rely on medication alone to manage my condition. This also affects my children and my ability to access services for their mental and physical health…we can’t afford the testing to diagnose [my child] with ASD or ADHD, it’s prohibitive. And without those diagnosis, we can’t apply for the NDIS. Not being able to help my children properly has then affected my mental health, the hits just don’t stop coming.” (Survey Respondent) 

Sex work and drug use can be additional barriers to a diagnostic process, depsite being a significant part of a person’s ability to either cope with undiagnosed or untreated disability, or to afford diagnosis or treatment. 

“I don’t feel safe to disclose my sex work status to most of the medical professionals that I speak to. I am going through an autism diagnosis and haven’t mentioned sex work, despite it being a lengthy diagnostic process. It’s depressing because sex work is a huge part of my story, but I just don’t feel safe.”(Survey Respondent) 

“Because getting a diagnosis was inaccessible for me, I had to self-medicate with amphetamines. When I was able to go through a diagnostic process, it was a year long waiting process because it’s a ‘drug of dependence’ and I have a recorded medical history of using drugs.” (Survey Respondent) 

Other barriers described included fatphobia, which for one respondent caused significant delays obtaining a diagnosis for a degenerative condition: 

“I experienced severe back pain for years. Because of my body type I was told that ‘nothing is wrong with you, you just have to lose weight’. When it was finally properly investigated they found that I have spinal arthritis which is a degenerative disability. I spent all of those years suffering with no one believing me because of how I look.” (Roundtable participant) 

This causes many sex workers to seek anonymous and/or sex worker-friendly sexual and reproductive health care. This may not be an accessible option for sex workers with disability, particularly where they have access constraints or prefer to have all aspects of their health centrally supported by their GP. 

“My regular GP is very conservative so [I] couldn’t bring up sex work with her. My GP [was] uncomfortable when I asked for [STI] tests in [addition to] my regular blood [tests]. It was hard to plan how I would get regular STI testing as I get most of my blood tests from home through RDNS and I [didn’t] know how I could manage to get my regular GP to order testing. The walk-in clinics have been affected by COVID-19 and changed to appointment only.” 

“My doctor was very resistant to me wanting to get off the contraceptive pill because it was affecting my body – I think that this resistance was because I am a sex worker.” 

“People who don’t have lived experiences with sex workers WHS practices often try and lecture us on [safer sex].”

“I’ve had several doctors in the last month pushing me to get a HIV test, and I ended up telling the last one that I haven’t done penetrative sex in years so unless it’s the immaculate infection – I know my HIV status.”

“As a sex worker experiencing mental health issues as a result of trauma impacts and sexual assault in the work place, I experience discrimination accessing mental health and sexual assault services. In NSW health sexual assault services, my treatment was negatively impacted by the clinician’s perception around sex work being a reenactment of trauma, rather than seeing sex work as meeting the material need for flexible working conditions and income when you’re too ill to hold down a regular full-time job.”

“A psychologist of mine once blamed all of my issues on my sex work…despite the fact that sex work is what allowed me to afford those sessions. They can be so out of touch.”

“I have also had psychologists say that ‘sex work is the root of all your problems’. It has also felt the same with my GP, even though they don’t explicitly say that…when medical professionals are silent about it, it also feels unsafe. This can be a real barrier to medications, especially with access to prescriptions.” 

• it can be difficult, if not impossible, for sex workers to access things like income support payments (e.g. Jobseeker or other Centrelink payments) when we are out of work
• agencies that are responsible for assessing eligibility or compliance requirements, usually dont see sex work as legitimate work
• Sex workers are often left with no safety net when we are  unable to work, whether for health or other reasons. 

These payments are also unavailable to migrant sex workers, who comprise a significant proportion of sex workers in Australia. 

The sex industry workforce is a mixture of precarious workers, subcontractors and sole traders. We are only paid when we are able to work and do not have access to sick leave, annual leave or employer contributions to superannuation. Many do not have a safety net or savings to fall back on in a crisis. This is significant in understanding the experiences of sex workers with disability and their access to government support for disability.

• 5 of the 9 survey responses had had negative experiences related to their disability
• 2 had had negative experiences that related to the combination of sex work and disability,
•  2 identified sex work alone as the reason for their negative experience. 
• 3 respondents did not experience any barriers to accessing support services. 

During our roundtable discussions, sex workers engaged in peer knowledge-sharing about navigating the system to access support.  Participants found this helpful. This indicates the difficulty many SWWD experienced when applying for such support. It is important to reform these systems and provide appropriate support for navigating them.

• they had been refused or were ineligible for disability support pensions, NDIS and/or JobSeeker; 
• they experienced difficulty and ableism at distressing levels in the application process and 
• had experienced gaslighting and trauma because of  the medico-legal, administrative and invalidating process  of applying for schemes that are intended to assist.

Sex workers with disability also reported on serious harm and neglect that they have experienced when forced to rely on their own ability to earn income. For sex workers who have varying levels of capacity from day to day and who rely on sex work to afford disability supports, healthcare, food and rent, the denial of a safety net in the form of Centrelink or NDIS assistance is experienced as harm. 

Sex workers with disability also reported on the direct impact of disclosing sex work to Centrelink, ATO, or NDIS. There is real fear of disclosing sex worker status within disability support spaces, especially when the legitimacy of an individual is constantly under government interrogation (are you disabled enough? Is your disability real? Are you really unable to work? Are you lying? How can you be disabled and a sex worker? Why could you work last week but not this week?). 

The constant interrogation of the legitimacy of sex workers with disability was identified as itself a form of harm that can lead to low self-regard and poor mental health outcomes. It also directly leads to a fear of disclosing sex work to Centrelink and other support agencies. This compounds existing barriers to accessing support and eliminates the possibility of holistic support. This was particularly noted in regards to occupational therapists, who are instrumental in supporting people with disabilities to work accessible. 

Visa status 

“I am also a migrant, so I’m not eligible for NDIS or any other disability payments, hence sex work is the only job that currently caters to my needs in terms of flexible work/high pay and being able to be inconsistent e.g. taking weeks off when unwell and then working hard when feeling better.”

Experiences of or concern about lack of validation of disability 

“I’ve been rejected 5 times – I desperately need it.” 

“I have a lot of fear about even applying for government support. I have a lot of trauma from the medical and ‘support’ industries and don’t trust that I will be heard or validated when I talk to the government. I am constantly anxious that I’m going to be viewed as ‘outside their criteria’ or ‘not disabled enough’ because I am not ‘visibly’ disabled.”

“I’m about to start the process of applying to NDIS and I’m terrified. I feel so disenfranchised already. I honestly don’t know if I want to even try. I also know that it’s unlikely that I’ll be able to get NDIS accommodations for my physical disabilities.” 

Consequences of being unable to access government support 

“I work, technically, five jobs to make ends meet. The barriers are endless.” 

“I can only work so much, I exhaust myself and burn out trying to support myself and to keep surviving. When I burn out, I can’t work anymore and so lose all of that financial support. So it’s a constant battle of trying to make ends meet and then exhausting myself. I don’t trust myself to maintain my capacity therefore I don’t trust myself to stay safe all of the time.” 

“Even now that I’m working from home (online) I find that my capacity doesn’t allow me to work enough to be ‘comfortable’, it’s a constant struggle.” 

“Sex work meets more needs only sporadically – sometimes I can’t find work when I really need it. I exhaust myself trying to supplement with other jobs.” 

“The cost of living is so high, and when you have particular needs depending on your disability, it can feel like insurmountable costs just continue to pile up.” 

“I don’t disclose so I don’t know what it’s like telling NDIS about my work. There is little to no chance that I will tell NDIS because I am scared that they will use sex work as a reason to say that you are not entitled.” 

“I tried to disclose but was told not to until the NDIS plan is approved. If I could tell OTs now, it would change things. I do online work and it was so hard to find the right attachments to my toys and other things I need to work, without help. It upsets me so much that I can’t support my own needs. I cry about it alot. I’m forced to crowdfund to meet my own basic needs, it is so dystopian. I would really benefit from OT input that knows about sexually assistive tech. This is not just for my work you know cause what happens if I have a partner that is also physically disabled. I think about it for sex work but also for my other sexual needs. I am planning on doing in person work, but I would have limitations that I would need to talk about with an OT and talk about my physical needs so that I don’t over-exert myself. And I just feel like I can’t talk about it.”

“Had an OT and NDIS planner come visit recently, I know that I can’t say whatever I want to about sex work. I just say ‘I do online work’. But it’s hard because I’ve had to fund really expensive machines for my sex work in order to meet my needs. There are a lot of limitations and it feels like I just can’t tell my care providers about that at all. I can’t talk about something that is a big part of my life.” 

“I avoid [Centrelink, DSP and NDIS] … now because of previous bad experiences. I will need to pursue NDIS in the near future and am concerned. For example, when I was on Job Seeker in WA maybe 13 years ago, I couldn’t attend an appointment with Centrelink because [I was working as a sex worker at that time]. I called to let them know and was honest about it, and was told that SW wasn’t considered work so I would be penalised for missing the appointment, but was reminded that I needed to report any income made from it.” 

Sex work, includes but is not limited to: full service sex work, social and companionship services, BDSM and fetish services, pornography performance, webcam work, phone sex work, stripping and peep show work, nude or erotic waiter or waitress work, sugaring work, sex for favours, opportunistic sex work and erotic massage work.

Not all people who do sex work identify as sex workers, and many people who trade sex for goods, housing, food, or anything other than money, may see this more as a form of trade than as formal labour. 

Sex workers with disability:
Sex workers with disabilities use a wide range of terminology to self-identify and to describe their experiences. We understand sex worker with disability to mean any sex worker who self-identifies as having disability, including sex workers who have chronic pain conditions, experience mental health conditions and/or identify as neurodiverse.

Survey:
The sex workers with disability who attended the planning meeting were sent a draft version of the survey to review and edit before it was distributed to sex workers with disability in the community.  The online survey consisted of 22 questions addressing demographic information, sex work experience, and experiences relating to employment, income, health, justice, and access to services. The survey was open for 4 weeks and only available to individuals who identified as sex workers with disability. We recruited for the survey through our social media platforms and website. Some survey respondents may have found the survey through word of mouth.

Most questions were optional, improving access for those who had low capacity to complete the whole survey. Of the 22 responses, 10 provided partial responses, and 12 answered all questions. 

Roundtable sessions:
Following the advice of the sex workers with disability who attended the planning meeting, three online round table sessions focussing on different topics were facilitated. This provided an interactive/ real time option of participation.  These sessions were only open to sex workers with disability  and were spread across three weeks, conducted at different times to accommodate different schedule constraints. 

The three sessions covered 

1. Medical and health issues,
2. Income and employment issues, and 
3. Other aspects of the holistic lived experiences of sex workers with disability  as raised by the participants. 

15 sex workers attended the online consultations, with some attending more than one session. Participants were not asked any demographic questions, as these sessions were more conversational and focussed on peer information-sharing. 

These sessions provided valuable connection points for participants. Many participants noted that peer-only spaces for sex workers with disability were uncommon and supportive. There was a call for sex worker peer organisations to facilitate these spaces more frequently.

Location:
We asked respondents to speak to where they had sex worked to account for the impact of different sex work laws and availability of disability supports and services in different jurisdictions. 

Survey respondents reported having worked in the following jurisdictions 

• New South Wales (41% n=7)
• Australian Capital Territory (29% n=5) 
• Victoria (24% n=4) 
• Queensland (18% n=3) 
• Western Australia (18% n=3)
• South Australia (12% n=2) 
• There were no survey responses for Tasmania or Northern Territory. 

The vast majority of sex workers reported living and/ or working in urban centres:

• Urban centres (94% n=16), 
• regional (12% n=2), 
• rural (12% n=2) 
• remote (6% n=1). 

Age:

• The average age of participants is 30 (16 responses, 6 skipped). 
• The youngest participant was 20
• The oldest was older than 50.

Type of sex work:
Participants reported that they currently do or have done:

• Independent work/escorting (63% n=10), 
• Brothel work (56% n=9)
• Online work/camming (44% n=7). 
• Opportunistic work (31% n=5)
• Sex for favours (31% n=5)
• Massage Parlour (19% n=3)
• Strip club or peep show (19% n=3)
• Sugaring (19% n=3)
• Porn performance (19% n=3)
• Agency (6% n=1)

The barriers to different types of sex work are described later in Section two “Experiences of sex workers with disability”, and form helpful context to these results.

Intersecting identities:
Both sex work experience and disability experience are impacted by overlaps and intersections with other identities and/or experiences of marginalisation. We asked survey participants about other aspects of their identities and received the following responses:

• LGBTIQA+ identity (80% n=12)
• working class or poor (53% n=8)
• experience of houselessness or housing precarity (47% n=7)
• Person who uses drugs (33% n=5)
• Trans/ Gender diverse (27% n=4)
• Parent or carer (13% n=2)
• Aboriginal / Torres Strait Islander (7% n=1)
• Person of Colour (7% n=1)
• Migrant / Visa holder (7% n=1)

There were a range of other experiences discussed, including fatness (with the respondent noting the impact of being fat on their access needs), sexual assault survivorship, and surviving  lateral violence.