Experiences of U.S. Transgender/Nonbinary Young Adults Doing Online Sex Work: An Occupational Health Perspective

Background: Evidence shows that online solicitation facilitates sex workers’ ability to mitigate the risk of workplace violence. However, little is known about how end-demand sex work criminalization and the regulation of online sex work sites shape men and non-binary sex workers’ ability to maintain their own safety while soliciting services online. Methods: We conducted 21 semi-structured interviews with men and non-binary sex workers in British Columbia between 2020–2021 and examined their ability to enact safety strategies online in the context of end-demand criminalization. Analysis drew on a structural determinants of health framework. Results: Most participants emphasized that sex work is not inherently dangerous and described how soliciting services online facilitated their ability to enact personal safety strategies and remain in control of client interactions. However, participants also described how end-demand criminalization, sex work stigma, and restrictive website policies compromise their ability to solicit services online and to enact safety strategies. Conclusions: Alongside calls to decriminalize sex work, these findings emphasize the need to normalize sex work as a form of labour, promote access to online solicitation among men and non-binary sex workers, and develop standards for online sex work platforms in partnership with sex workers that prioritize sex worker safety.

Online sex work refers to sexual services that are provided via the internet for compensation. Views of sex work range from empowering to oppressive. Various frameworks examine the balance between these extremes, but how these viewpoints operate in online sex work is underexplored. We examined the experiences of female and nonbinary online sex workers, using a feminist lens. Zoom interviews were conducted with 15 participants ranging from 18 to 33 years old. We describe results identified through thematic analysis within two groups—participants’ experiences with misogyny and with managing misogyny. We further identified major themes and subthemes within each. Findings were framed using a micro/macro theoretical framework in which experiences with misogyny were complex and involved both individual and structural consideration. Micro or individual factors such as empowerment, validation, and agency operate under larger macro systems such as misogyny, patriarchy, and capitalism. This study expands on current literature, illuminating how empowerment and oppression operate simultaneously in online sex work.

The rise of the online sex work industry is reshaping how people conceptualise and negotiate sexual encounters across digital and offline spaces. This article analyses content from an online sex work forum (AmberCutie Forum (ACF)) to examine how online sex workers establish boundaries between their online and offline lives to manage competing expectations from their partners and viewers. Our analysis reveals a misogynistic double standard whereby workers are seen to threaten monogamous values, while viewers escape the same level of moral culpability. We argue that the cultural logics of monogamy function to delegitimise the labour involved with online sex work and increase the risk posed to online sex workers through retributive misogyny, including cyber-harassment toward sex workers. This impacts sex workers’ emotional and financial wellbeing and reinforces gendered power relations by prioritising stereotypically masculine pleasure over workers’ economic interests.

The erotic camming industry has been around for almost three decades, exponentially growing as technology continues to push the bounds of how sex work is constituted online. The advent of the COVID-19 pandemic ushered in unexpected technological and cultural revolutions, with increased innovations, humans becoming more dependent on technology more than ever, and disrupted online and offline operations (Anikin, 2021). The sex industry has irrevocably changed as well, especially online sex workers and adult performers as they experience an economic boom in the midst of the pandemic. This gave grounds to increased online sex work engagement, ranging from the creation of new online sex service sites and digital creators to camming veterans who had been active pre-COVID (Rubattu et al., 2023). Sites like OnlyFans can offer as a curious case study of ushering in exponential economic growth and social change and is worth exploring through critical lenses to complicate and challenge the hegemonic structures that is positioned in and must navigate through. In this piece, I will explore OnlyFans through the lens of neoliberalism, complicating the empowering language of self-made and empowered sex workers while they navigate capitalistic structures and at their expense, exploited for capital gain. Different case studies will be explored showing sex workers being affected by the “Girl Boss” neoliberal and choice feminist rhetoric, critiquing the language that presumably was in place to uplift and empower sex workers to destigmatize sex work (but inversely feed into capitalistic structures). I attempt to pull back the rose-colored glasses that so many sex workers on OnlyFans went in with (the promise of quick, easy, earn-while-you-sleep money along with being your own boss) and critically think about why this language has been prominent in the first place. The language of empowerment within neoliberal feminism, as reflected in this piece, is a quite potent tool for capitalism to be perpetuated, especially within the world of online sex work. No matter how much one is aware of the tendrils of capitalism reaching out in almost every aspect of their lives, they must play the game if they want to operate within the world of online sex work. Capitalism has shown to push workers, especially in marginalized communities, to different lengths to garner income: whether that may be enduring racism and discrimination to retain subscribers, to going through almost harmful lengths in order to stay above the competition, to almost losing oneself because of feeling personal responsibility to respond to the inequalities manifested by capitalism. Neoliberalism thrives hand in hand with capitalism and is part of a symbiotic relationship at the expense of our sex workers. Perhaps our gaslighting, gatekeeping, and girlbossing isn’t as productive as we thought.

While online sex work in the form of the creation and sale of pornographic content is not a new phenomenon, the recent prominence of the platform OnlyFans drew additional attention to this sector. This article argues that OnlyFans, and other similar erotic-content platforms, can be understood as forms of platform-mediated gig-economy work, reflecting increased freedoms in some ways, but tempered with heightened financial precarity. Gig-economy work, with its linkages to discourses of entrepreneurialism, is intrinsically linked to neoliberalism, and in the context of online sex work, the division of labour is gendered. Conventional models of pornography production have been critiqued for the way they limit performers’ control over their working conditions, and direct-to-consumer marketing of self-shot footage has been offered as a remedy to this. However, creators are still reliant on third parties in the form of platforms and payment processors. The recent threat that OnlyFans might ban explicit content, displacing the online sex workers who depend on the platform for a living, as well as the demonetization of Pornhub and AVN Stars, highlights the way that online sex work is made vulnerable by existing at the nexus of sex work stigma, and the precarity inherent in platform-mediated gig-economy work.

It has been well established that those working in the sex industry are at various risks of violence and crime depending on where they sell sex and the environments in which they work. What sociological research has failed to address is how crime and safety have been affected by the dynamic changing nature of sex work given the dominance of the internet and digital technologies, including the development of new markets such as webcamming. This paper reports the most comprehensive findings on the internet-based sex market in the UK demonstrating types of crimes experienced by internet-based sex workers and the strategies of risk management that sex workers adopt, building on our article in the British Journal of Sociology in 2007. We present the concept of 'blended safety repertoires' to explain how sex workers, particularly independent escorts, are using a range of traditional techniques alongside digitally enabled strategies to keep themselves safe. We contribute a deeper understanding of why sex workers who work indoors rarely report crimes to the police, reflecting the dilemmas experienced. Our findings highlight how legal and policy changes which seek to ban online adult services advertising and sex work related content within online spaces would have direct impact on the safety strategies online sex workers employ and would further undermine their safety. These findings occur in a context where aspects of sex work are quasi-criminalized through the brothel keeping legislation. We conclude that the legal and policy failure to recognize sex work as a form of employment, contributes to the stigmatization of sex work and prevents individuals working together. Current UK policy disallows a framework for employment laws and health and safety standards to regulate sex work, leaving sex workers in the shadow economy, their safety at risk in a quasi-legal system. In light of the strong evidence that the internet makes sex work safer, we argue that decriminalisation as a rights based model of regulation is most appropriate.

From 2008 to 2018 research across the social sciences has burgeoned concerning sex work and social stigma. This paper employs a scoping review methodology to map scholarship produced during this period and develop a more coherent body of knowledge concerning the relationship between social stigma and female-identified sex workers. Twenty-six pieces of research related to sex work stigma are identified and reviewed from across the disciplines of sociology (n = 8), public health (n = 6), social work (n = 4), criminology (n = 2), psychology (n = 2), communications (n = 2), nursing (n = 1), and political science (n = 1). This scoping review identifies the main sources of sex-work stigma, the ways in which sex-work stigma manifests for sex workers, and stigma resistance strategies, as discussed in this body of literature. If, as theorists and researchers suggest, social stigma is at the foundation of the pernicious violence against sex workers, understanding the sources, manifestations, and resistance strategies of sex-work stigma is critical to countering and shifting this stigma. Findings include potential areas of research, policy, and practice to address and challenge sex-work stigma, recognizing that successful social transformation occurs in a dialectic between society’s socio-structural, community, and intrapersonal levels.

(Online) Sex work is a hot topic in feminist literature which is mainly studied with respect to two perspectives towards sex work: oppression and empowerment. This study aims to understand “How online sex work of women on OnlyFans can be interpreted and try to understand if OnlyFans can be explained through the perspectives of victimization and empowerment. For this purpose, this paper will provide a theoretical discussion about two main debates (oppression and empowerment) in the literature; be analyzed by taking OnlyFans as a case. Study results show that women's online sex work experience cannot be explained purely by oppression or empowerment paradigms, instead coexistence of oppression or empowerment should be taken into account. Secondly, emphasizing only the oppression or empowerment paradigm underestimates women’s differences that directly affect women’s online sex work experiences. Thus, intersectional analyses that are taken into women’s age, race, and gender considerations are necessary in order to understand women’s OnlyFans experiences. Last but not least, women’s experiences of online sex work can change according to the motivation behind being a sex worker in OnlyFans.

ABSTRACTThe barrier HIV-stigma presents to the HIV treatment cascade is increasingly documented; however less is known about female and male sex worker engagement in and the influence of sex-work stigma on the HIV care continuum. While stigma occurs in all spheres of life, stigma within health services may be particularly detrimental to health seeking behaviors. Therefore, we present levels of sex-work stigma from healthcare workers (HCW) among male and female sex workers in Kenya, and explore the relationship between sex-work stigma and HIV counseling and testing. We also examine the relationship between sex-work stigma and utilization of non-HIV health services. A snowball sample of 497 female sex workers (FSW) and 232 male sex workers (MSW) across four sites was recruited through a modified respondent-driven sampling process. About 50% of both male and female sex workers reported anticipating verbal stigma from HCW while 72% of FSW and 54% of MSW reported experiencing at least one of seven measured forms of stigma from HCW. In general, stigma led to higher odds of reporting delay or avoidance of counseling and testing, as well as non-HIV specific services. Statistical significance of relationships varied across type of health service, type of stigma and gender. For example, anticipated stigma was not a significant predictor of delay or avoidance of health services for MSW; however, FSW who anticipated HCW stigma had significantly higher odds of avoiding (OR = 2.11) non-HIV services, compared to FSW who did not. This paper adds to the growing evidence of stigma as a roadblock in the HIV treatment cascade, as well as its undermining of the human right to health. While more attention is being paid to addressing HIV-stigma, it is equally important to address the key population stigma that often intersects with HIV-stigma.

Although online sex work has become more accessible to people of all socio-economic statuses, labor practices and work safety have not improved since the widespread use of the internet. One way that we can help empower sex workers is to understand their motivations and experiences when using the internet. In a survey conducted by Sanders et al. (2017), the highest crime that 56.2% sex workers experienced was being threatened or harassed through texts, calls, and emails. Because there is no theory application to date on this marginalized group, three theories were proposed. This literature review highlights the need to explore why sex workers, as end-users, should be included in the user cybersecurity defense conversation, such as the cybercrimes that they face, their relationship with law enforcement, and what other factors affect their safety.

The objective of this study is to explore the impacts of COVID-19 and changes taking place among the Indonesian female sex worker (FSW) community during the COVID-19 pandemic and the predictors of these changes. We conducted a cross-sectional online survey and selected the participants using a purposive snowball sampling technique. Incentives were provided to participants in the form of a 5 USD e-wallet balance. Variables of interest included adaptation to online sex work, adherence to COVID-19 prevention measures during sex work, number of clients, income reduction, social support, condom access, and condom use frequency. Sociodemographic data and COVID-19 fear index values were also collected. Final analysis included 951 FSWs, of whom 36.4% of had adapted to online sex work and 48.6% had practiced COVID-19 prevention measures. Major reductions in client frequency and income were reported by 67.8% and 71.1% of respondents, respectively. However, only 36.3% of FSWs reported they had ever received any form of social support from any parties, public or private. Meanwhile, 16.7% encountered difficulties in accessing condoms and 12.5% reported less frequent condom use during the pandemic. Easy access to condoms was the main factor influencing the frequency of condom use. As expected, staying in employment protected FSWs from major income loss, while education and younger age predicted adaptive behavioral changes, such as taking up online sex work. The COVID-19 pandemic has disrupted access to socioeconomic support systems and HIV prevention services among FSWs and has further exposed them to the dual jeopardy of HIV and COVID-19 infections.

The COVID-19 pandemic profoundly affected physical, mental, and economic well-being across the globe and has disproportionately affected certain vulnerable groups. This paper provides a scoping review of literature on the impact of the COVID-19 pandemic on sex workers, published between December 2019 and December 2022. Six databases were systematically searched, identifying 1009 citations; 63 studies were included in the review. Thematic analysis revealed eight main themes: financial issues; exposure to harm; alternate ways of working; COVID-19 knowledge, protective behaviors, fear, and risk; well-being, mental health, and coping; access to support; access to health care; and the impact of COVID-19 on research with sex workers. COVID-associated restrictions led to reduced work and income, leaving many sex workers struggling to cover basic needs; additionally, government protections excluded those working in the informal economy. Fearing the loss of their already reduced number of clients, many felt compelled to compromise both prices and protective measures. Although some engaged in online sex work, this raised concerns about visibility and was impossible for those without technological access or skills. Many feared COVID-19, but felt pressure to continue working, often with clients who refused to wear masks or share exposure history. Other negative impacts on well-being related to the pandemic included reduced access to financial support or health care. Marginalized populations (and especially those in professions which require close contact like sex workers) need further support and capacity-building within the community to recover from the impact of COVID-19.

Sex work, or the exchange of sexual services for money or goods, is ubiquitous across eras and cultures. However, the practice of selling sex is often hidden due to stigma and the varying legal status of sex work. Online platforms that sex workers use to advertise services have become an increasingly important tool in studying a market that is largely hidden. Although prior literature has primarily shed light on sex work from a public health or policy perspective (focusing largely on female sex workers), there are few studies that empirically research patterns of service provision in online sex work. Little research has been done on understanding pricing and popularity in the market for commercial sex work. This study investigates the determinants of pricing and popularity in the market for commercial sexual services online by using data from the largest UK network of online sexual services, a platform that is the industry-standard for sex workers. While the size of these influences vary across genders, nationality, age, and services provided are shown to be primary drivers of rates and popularity in sex work.

Globally, transgender (trans) women experience pervasive stigma, which contributes to health inequities across multiple mental health outcomes. While trans stigma has been associated with increased mental health challenges, less is known about how stigma related to sex work and HIV affect mental health. Social cohesion may ameliorate the negative health consequences of stigma, but little is known about how social cohesion is associated with mental health among trans women. Using cross-sectional survey data collected in 2019 among 100 trans women sex workers living with HIV in Santo Domingo, Dominican Republic, we examined associations between stigma (related to HIV, sex work, and trans identity), social cohesion, and depression and anxiety symptoms. In unadjusted models, enacted and internalized sex work stigma were associated with greater odds of depression and anxiety symptoms and social cohesion was associated with less depression and anxiety. Resisted sex work stigma, which captured acceptance of self and work, was associated with lower odds of depression and trans stigma was associated with increased anxiety. In adjusted models, internalized sex work stigma was associated with increased depression (aOR=1.19, p=0.018) and anxiety symptoms (aOR=1.12, p=0.021), while social cohesion was associated with reduced depression (OR=0.81, p=0.002) and anxiety symptoms (aOR=0.086, p=0.023). Findings indicate the need for interventions to focus on reducing internalized sex work stigma and promoting social cohesion to improve mental health among trans women. Additional research is needed to determine how to best measure the intersections between HIV, sex work, and trans stigma and their impact on mental health.

ABSTRACTHIV stigma can inhibit uptake of HIV testing and antiretroviral therapy as well as negatively affect mental health. Efforts to reduce discrimination against people living with HIV (LWH) have contributed to greater acceptance of the infection. Female sex workers (FSW) LWH may experience overlapping stigma due to both their work and HIV status, although this is poorly understood. We examined HIV and sex-work stigma experienced by FSW LWH in Zimbabwe. Using the SAPPH-IRe cluster-randomised trial baseline survey, we analysed the data from 1039 FSW self-reporting HIV. The women were recruited in 14 sites using respondent-driven sampling. We asked five questions to assess internalised and experienced stigma related to working as a sex worker, and the same questions were asked in reference to HIV. Among all FSW, 91% reported some form of sex-work stigma. This was not associated with sociodemographic or sex-work characteristics. Rates of sex-work stigma were higher than those of HIV-related stigma. For example, 38% reported being “talked badly about” for LWH compared with 77% for their involvement in sex work. Those who reported any sex-work stigma also reported experiencing more HIV stigma compared to those who did not report sex-work stigma, suggesting a layering effect. FSW in Zimbabwe experience stigma for their role as “immoral” women and this appears more prevalent than HIV stigma. As HIV stigma attenuates, other forms of social stigma associated with the disease may persist and continue to pose barriers to effective care.