Demanding Harm Reduction

At the Harm Reduction Conference this year, there was a lot of conversation which highlighted just how far harm reduction organizations are from sex worker rights’ organizations, with SESTA sitting firmly in that chasm. As harm reduction spaces begin to incorporate an understanding of sex worker health and rights into their advocacy, an understanding of the narratives and approaches to the demand side of the sex trade is vitally important.

Demand-side approaches are a form of criminalization which criminalize the purchasers of sexual services and often include increased policing of the sex trade through costly “john stings”, public shaming of people buying sex, and increased fines, fees and penalties for those arrested. Depending on the jurisdiction, they may or may not impact the way those selling sex are treated by law enforcement or the courts. While they have never shown to decrease the size of the sex trade, exploitation, or recidivism, in areas where these tactics have been implemented, they have shown increased violence against sex workers, increased shaming and stigma for everyone in the sex trade and been a drain on local budgets. Some anti-trafficking advocates have tried to expand the “demand tactics” to include demand for cheap labor and goods in order to re-focus on labor, but this tactics has not manifested in policy or narrative change.

“Harm reduction” is a broad philosophy and set of interventions that covers everything from drug use to sex work to the importance of wearing seat belts while driving, but formalization and policy have narrowed to focus on public health approaches to active drug users. It is no surprise, then, that policy which further criminalizes, marginalizes and polices people who trade sex, often under the title of “anti-trafficking” has not been an area undertaken by the harm reduction community. After seeing how the closure of Backpage and passage of SESTA/FOSTA has devastated the sex worker community, including and especially many of those already accessing services in harm reduction spaces, the lack of attention has become painfully clear.

In a turn which feels new but echoes many past pushes to criminalize the sex trade, there has been a strong narrative with the story of sex work not being one of resilience or survival, but victimization. And while there if plenty of harms that contribute to the decision to trade sex and the conditions under which it happens, the ones creating that harm are clients. The most widespread policy pushes these days increasing criminalization of the sex industry are the ones which push for increased policing of clients under the label of “end demand.”

So here is my request to the harm reduction community, and especially those looking at policy: think of demand for consumption tools — think of syringes.

Much like the reasons why people use drugs, the reasons why people trade sex are diverse and ultimately, personal. Similarly, when people identify what is causing harm in their life, if they don’t identify cessation of drug use or sex work, offering only options which force people to quit that behavior, especially while not addressing any of the needs it meets, means offering nothing and probably shaming them in the process.

When laws criminalize the ways we engage in those behaviors, they don’t end the need to get high or trade sex, and they certainly don’t meet our needs to cope or pay rent, people still engage in those behaviors — just with fewer resources to do it safely. When we police syringes but not drug possession, we still criminalize drug users. When we criminalize buyers but not those selling sex, we still police sex workers. When we police communities, we see higher rates of isolation, violence, victimization and stigma.

Many laws these days focus efforts on increasing policing, penalties, fine and fees for “end demand,” and the language is couched in a victim-centered approach. In the four proposed bills reauthorizing the Trafficking Victims’ Protection Act right now (there are many more focused on trafficking, but four specifically to re-authorize the Trafficking Victims Protection Act), 14 different sections include notes about ending demand or focusing on those arrested for patronizing the sex trade. When harm reductionists hear these statements on criminalizing clients, think “what if a bill said we aren’t criminalizing injection drug users, we’re only criminalizing the syringes they use.”

There are many next steps that the harm reduction community can take when beginning to incorporate the issues sex workers face into their work and advocacy, especially bringing in those trading sex who they already serve and learning more about those already walking through their doors. In policy rooms, harm reduction advocates talking to their allies on the other side of the table are best primed to explain why sex workers need to be there talking about what harm reduction means, and the way it can save lives. Those inroads are valuable. Taking away access to online platforms compromised some of the most important harm reduction tools people utilized. The impact has been economic instability, increases in exploitation and violence — all of which sex workers saw coming. Sex workers know what happens when you increase policing of demand, and we have already seen what happens when no one listens to the experts.