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Copyright © The Author(s) 2022. There is extensive qualitative evidence of violence and enforcement impacting sex workers who are ethnically or racially minoritized, and gender or sexual minority sex workers, but there is little quantitative evidence. Baseline and follow-up data were collected among 288 sex workers of diverse genders (cis/transgender women and men and non-binary people) in London (2018–2019). Interviewer-administered and self-completed questionnaires included reports of rape, emotional violence, and (un)lawful police encounters. We used generalized estimating equation models (Stata vs 16.1) to measure associations between (i) ethnic/racial identity (Black, Asian, mixed or multiple vs White) and recent (6 months) or past police enforcement and (ii) ethnic/racial and sexual identity (lesbian, gay or bisexual (LGB) vs. heterosexual) with recent rape and emotional violence (there was insufficient data to examine the association with transgender/non-binary identities). Ethnically/racially minoritized sex workers (26.4%) reported more police encounters partly due to increased representation in street settings (51.4% vs 30.7% off-street, p = 0.002). After accounting for street setting, ethnically/racially minoritized sex workers had higher odds of recent arrest (adjusted odds ratio 2.8, 95% CI 1.3–5.8), past imprisonment (aOR 2.3, 95% CI 1.1–5.0), police extortion (aOR 3.3, 95% CI 1.4–7.8), and rape (aOR 3.6, 95% CI 1.1–11.5). LGB-identifying sex workers (55.4%) were more vulnerable to rape (aOR 2.4, 95% CI 1.1–5.2) and emotional violence. Sex workers identifying as ethnically/racially minoritized (aOR 2.1, 95% CI 1.0–4.5), LGB (aOR 2.0, 95% CI 1.0–4.0), or who use drugs (aOR 2.0, 95% CI 1.1–3.8) were more likely to have experienced emotional violence than white-identifying, heterosexual or those who did not use drugs. Experience of any recent police enforcement was associated with increased odds of rape (aOR 3.6, 95% CI 1.3–8.4) and emotional violence (aOR 4.9, 95% CI 1.8–13.0). Findings show how police enforcement disproportionately targets ethnically/racially minoritized sex workers and contributes to increased risk of rape and emotional violence, which is elevated among sexual and ethnically/racially minoritized workers. The National Institute for Health Research (NIHR) Public Health Research Programme (PHR) funded this study (PHR 15/55/58).

Background National Ugly Mugs (NUM) is a UK-wide violence prevention and victim support charity that provides a mechanism for sex workers to share safety information and obtain support for harms that they may experience during the course of their work. Over the past several years, NUM has witnessed a decline in sex workers willing to access police as part of their recovery journeys after experiencing victimisation. In 2012, 28% of those reporting to NUM chose to engage with the legal system; in 2020, this was down to 7.7% amongst off-street independent workers. Statistics for 2021 indicate a continuation of this downward trend. Furthermore, anonymous consent to share information with police also declined from 95% in 2012 to 69% in 2020. Methods NUM conducted a survey of 88 sex working members in 2020. This information combined with our data on victimisation provides insights of the factors that deter sex workers from involving police as part of their justice-seeking efforts. Results Survey results reveal that sex workers feel alienated and untrusting of police and courts. Conclusions The implications of sex workers not sharing information about dangerous individuals with police and choosing not to participate in court processes signal significant flaws in our legal system regarding safe and inequitable access and pose dangers for all of us.

This book provides readers a rare opportunity to hear from some of the most hidden off-street sex workers in the population, those living dual lives, trading sex alongside ‘square’ mainstream employment. Stereotypes about who trades sex, of ‘exiting’ and transitioning to and from sex work as being chaotic, as well as simplistic, binary framings of sex work as something one is either in or out of, trapped or survived, are challenged by these sex workers whose practices uncover a fluid Continuum of Sex Industry Work and Square Work (SIWSQ) Involvement. Sex workers (Contributors) share lived experiences of combating labour precarity and insecure work, concerns about Brexit, and the UK Whorearchy that stratifies the sex industry and influences pricing and value, along with the stress of keeping secrets while living under the constant threat of being outed. Contributors engage in skilful stigma-avoidance, selective disclosure, on-and offline audience/information segregation, and manage people and devices to conceal stigmatised work in the digital age. The phenomenon of duality is thoroughly examined and in doing so we learn about the impacts of constructing a precarious labour markets while legislating poverty, and the lies we propagate about who trades sex and how we treat them. Ultimately, those living dual lives do so in response to economic conditions that we co-create. Our focus must be on reshaping the structures, systems and social forms that circumscribe our social realities and not in the vilification of these innovators.

Introduction Part One: ‘You might as well just hang up your bra and go home’ contains the research study design, interpretive phenomenology as the theoretical approach and methodology, and shares the central research question and the challenges of enumerating sex industry workers. It discusses ethical considerations and explains why ethnographic and biological information is presented in aggregate and anonymous forms that prevents the reverse engineering of Contributor profiles. Introduction Part Two: The Contributors presents ethnographic and aggregate statistical information about Contributor’s biographies in terms of work experience, gender and age for example. Contributors discuss their high educational attainment, skills and the status frustration that comes about as a result of the lack of opportunities for full-time, meaningful, liveable waged jobs commensurate with education.

In this chapter, extent literature on ‘exiting’ sex work is presented and then problematise due the limitations of role transition theories that underpin this scholarship, the overreliance on the experiences of the most visible sex workers, who are street-based, and ideological standpoints that view sex work as wholly exploitation, all contributes to simplistic dichotomy conceptualisations of as something people are either trapped in or have survived. Drawing on the lived experiences and practices of Contributors who operate at the intersection of sex work and square work, and research that offers a nuanced understanding of the factors that influence decisions about involvement in sex work. The Continuum of Sex Industry Work and Square Work (SIWSQ) is introduced as an alternative framework to understand this complex issue. The chapter ends with a detailed accounting by participants of their diversified earnings derived from duality compared to the general population, time investments in work in both industries, and how participating in concurrent sex work and square work provides ‘flexicurity’. Contributors discuss how duality staves off poverty, provides money for emergencies, seed money and funding for interim projects such as tuition, and facilitates social mobility if engaged in as a longer-term financial strategy to pay for life.

This chapter opens with literature around stigma and presents Contributors’ insights and challenges with concealing discrediting information, as well as their fears and lived experiences of being outed as sex workers. Unfortunately, we do not treat active or former sex workers with compassion for the contexts in which they (and the rest of us) make decisions about their livelihoods. They experience status loss and social death as a result of the deleterious effects of ‘whore’ stigma. Blending literature on deception and secret-keeping, Contributors express the costs associated with hiding in plain sight and concealing work to protect themselves and their loved ones from us.

Goffman’s works on strategies about concealing stigmatised identities that relate to double, double biographies, line and face and appearance management are brought to life through the experiences of Contributors. Some of these sex workers create psychological and geographical distance between work sites and personal lives, transition roles, personas and attire in the liminal spaces and manage audiences and information across employment settings in sex work and square work. The Dual-life Relational Paradigm Venn diagram illustrates seven relational fields in which information and relationships from sex work, square work and personal lives may collide. Contributors safeguard against accidental revelation and the intermingling of people who ‘know’ them differently or being caught in the wrong place with the wrong face. Contributors discuss their experiences of managing information communication technologies (ICTs), devices, and the risks and experiences of being ‘outed’ through technology and ends with their commentary on digital surveillance when living a dual life.

This chapter shares critical reflections of duality in light of precarious work in sex industries and mainstream markets. Marxist concepts of alienation, estrangement and species-being along with contemporary labour arrangements such as zero-hours contracts, provide theoretical and practical contexts for feelings of disillusionment among Contributors who, after investing time and money in educational attainment, landed shitty, temporary, low paying square jobs. Contributors who hold roles in public trust, and those who have been on (sick) benefits, share how trapped they feel in gig economies across markets. As sex workers, they suffer the violence of being excluded from civil participation in policy discussions about the labour market and how sex industries ought to be regulated. Although duality provides flexicurity, many would rather have secure employment in the disciplines and fields that they trained in. The penalties associated with being out to the state as a known sex worker means that privileged lobbyists inform policy instead of the diverse populations of people active in UK sex industries, who can provide insights into who trades sex and how to reduce harm and exploitation relative to the changing design of sex industries for diverse on/off-street and online sex industry workers.

This chapter opens with the diverse perspectives of Contributors about Brexit and how they anticipated leaving the EU would affect their (sex) work and identities. Their insights were collected beginning just before the June 23rd 2016 EU referendum and Contributors were particularly concerned with the anticipated economic outcomes of leaving the single market but doubly so, as this geo-political decision had already begun to affect both their sex industry work and mainstream jobs. The sex industry is shaped by a range of sentiments heard in the public domain among Brexiteers and Remainers and this discourse ‘visibilised’ a UK Whorearchy, a hierarchy that ranks desirable race and gender qualities and other factors for example, and in this case, cultural origin to organise sex workers from most valuable and high priced to less so. This Brexit-inspired UK whorearchy highly valued ‘white Britishness’ such that white migrant Eastern Europeans were virtually constructed out of whiteness, slipping down the rungs of the UK Whorearchy. Literature on Balkanism and colourism help make the argument that the UK Whorearchy is reflective of mainstream societal values and must be viewed in relation to similar stratifications in the dual labour market.

Contributors’ choices about identification with sex work and square work are related to post-structural theories of identities and inform elements of macro and micro role transitioning necessary for duality. Insights from Stuart hall, as well as Goffmanian, Du Boisian approaches to understanding social identities, double consciousness, and the differing presentations of self, necessary for managing identity and information, aid in deepening understanding of role transition as it relates to stigmatised workers. Literature on macro and micro role transition and rites of passage supplement descriptions of Contributors’ rituals of movement and the mental shifts made between roles and how they construct their work environments and social life-worlds in ways that promote seamless role transitions and separation for those who work from home.

As part of a larger study examining the effects of the design of the off-street sex industry on sex worker's health and safety practices, eight sex work experts who had experience as sex workers and as advocates and service providers were interviewed to garner their community engagement expertise in shaping the research. During narrative interviews, these experts discussed how stigma influenced their personal lives and their social justice work among sex workers. Their insights into stigma are unique to the literature because our experts simultaneously confronted direct instances of stigma that were a part of their personal and professional lives, sometimes concealing their sex work histories during the course of their professional support and advocacy work. As a result of this concealment, and because of how sex workers are sometimes mistreated, experts experienced stigma vicariously (indirectly) when their own sex work histories were not apparent. As a result of these experiences, participants became proficient at managing discrediting information about themselves when in the presence of those they mistrusted. They supported sex workers through stigmatising ordeals by using knowledge gained from these intersecting direct and vicarious experiences stigma, continuously building capacity within themselves and among other sex workers to resist stigma.

Women in the sex trade whose economic and social base are urban streets face multiple dangers of predation, isolation, and illness. A Mobile Access Project (MAP) to provide emergency medical help, peer counseling, condoms and clean needles, resource information and referral, and a place of respite and safety was initiated for sex trade workers in Vancouver, British Columbia, Canada. We conducted surveys with 100 women sex workers who accessed MAP services and reviewed MAP logbooks to document use of services. We assessed the impact of MAP through review of data from a concurrent cohort study of injection drug users and a survey of 97 women at a drop-in center in the Downtown Eastside. Over 90% of MAP clients reported that the van made them feel safer on the street. Sixteen percent of surveyed MAP clients recalled a specific incident in which the van's presence protected them from a physical assault and 10% recalled an incident when its presence had prevented a sexual assault. Distribution of needles and condoms has increased steadily since the implementation of MAP. Eighty percent of women surveyed at a drop-in center in the Downtown Eastside had received services from MAP. The peer-led Mobile Access Project has emerged as a viable harm reduction strategy for serving the immediate health and trauma-related needs of women engaged in street-level sex work.

Objective: To determine if an anxiety dimension in the Edinburgh Postnatal Depression Scale (EPDS) could be identified in a sample of pregnant women with high social risk factors. Method: Four hundred women attending prenatal outreach programs, most of whom were single, low-income, and Aboriginal, participated in a study of feelings in pregnancy. The primary outcome measure was the EPDS. Data were also collected on sociodemographic, obstetrical–biological, psychological, and behavioural variables. Results: Factor analysis of the EPDS revealed 3 factors: anxiety, depression, and self-harm. The anxiety factor accounted for the greatest variance in the overall EPDS score. Comparisons of different groups of women revealed significantly more anxiety in the women aged under 19 years, compared with those over 25 years ( P < 0.01). Linear regression analysis showed anxiety was associated with age, stressors (that is, pregnancy, health of the baby, birth of the baby, money, and other), history of depression, and fluctuating moods. Conclusions: Anxiety symptoms were predominant in the emotional distress identified by the EPDS in this sample of socially high-risk pregnant women. Younger women appear to experience the highest levels of anxiety. Anxiety in pregnancy in socially high-risk women should not be normalized. Objectif: Déterminer si la dimension de l'anxiété à l'échelle de dépression postnatale d'Édimbourg (EPDS) pouvait être identifiée dans un échantillon de femmes enceintes ayant des facteurs de risque sociaux très élevés. Méthode: Quatre cents femmes assistant à des programmes prénataux de service d'approche, dont la plupart étaient célibataires, à faible revenu, et autochtones ont participé à une étude de sentiments durant la grossesse. La principale mesure des résultats était l'EPDS. Les données ont été recueillies sur des variables sociodémographiques, obstétrico–biologiques, psychologiques, et comportementales. Résultats: L'analyse factorielle de l'EPDS a révélé 3 facteurs: l'anxiété, la dépression, et l'automutilation. Le facteur anxiété représentait la plus grande variance dans le score global à l'EPDS. Les comparaisons de différents groupes de femmes ont révélé significativement plus d'anxiété chez les femmes de moins de 19 ans, comparativement à celles de plus de 25 ans ( P < 0,01). L'analyse de régression linéaire indiquait que l'anxiété était associée à l'âge, aux stresseurs (c'est-à-dire, la grossesse, la santé du bébé, la naissance du bébé, l'argent, et d'autres), aux antécédents de dépression, et aux humeurs changeantes. Conclusions: Les symptômes d'anxiété étaient prédominants dans la détresse émotionnelle identifiée par l'EPDS dans cet échantillon de femmes enceintes socialement à risque élevé. L'anxiété durant la grossesse chez les femmes socialement à risque élevé ne devrait pas être normalisée.