Book review: Male Sex Work and Society

Male Sex Work and Society is 500 pages with 17 essays and research pieces presented in four sections: historical, marketing of male sex work, current social and cultural issues and seven case studies of social and cultural variations between different countries.

The editors state their intention to examine ‘how male sex work has been understood, both historically and cross-culturally’ and in doing so attempt ‘to move away from “scientific” understandings of male sex work that have painted sex workers and their clients as at-risk and/or pathological populations’

The collection is prefaced by a swathe of glowing reviews, nearly all of these by academics. But as a sex worker, I cannot agree that the collection completely moves away from pathologising us. Much of the work included in the collection is problematic in many ways and on many levels.

While recognising there is a huge range and diversity of male sex work, most of the works in the collection fail to capture the dynamics of this range or understand it in full. Male sex workers are presented through a series of static studies of segments of our work, many of which include broad and often sweeping statements that imply conclusions well beyond what was studied.

The editors specifically recognise that male sex work changes quickly and has done so recently, especially with the uptake of the internet by male sex workers and their clients. However, many of the studies included in the collection are already dated and no longer relevant.

The editors and contributors appear to be travellers in a foreign land whose language they do not speak and customs they only partially understand. They are all certainly experienced sexual health and public health researchers who have published a range of work on sex work and the sex industry. However, flaws attributable to the lack of consultation with male sex workers themselves in the research projects and the editing of the collection are glaringly obvious if you are yourself a sex worker.

As I read this work and evaluated the research, its interpretation, and conclusions, my reaction on almost each page was: ‘Maybe yes, but’. In almost every case I could see something that had been overlooked or to an extent misread. Sometimes it was just one or two minor things, but often a fairly major factor.

This was also the leading reaction of many of my colleagues who read various parts of the work. Few ended up reading it in full, even though its publication had been eagerly awaited. Maybe that in itself forms a sort of peer review.

Most importantly, from both a rights and health perspective, the editors and the authors do not seem to understand the concept of decriminalisation in a sex work context. The terms ‘decriminalisation’ and ‘legalisation’ are often used interchangeably, despite their distinct meanings. In one place there is even a reference to the need to regulate sex work in decriminalised settings.

The editors seem more interested in male sex work research than they do in male sex workers. They repeatedly stress the need for more research and in their conclusion they fall back on the vector of disease argument that they explicitly rejected earlier in the work.

Statements such as: ‘Existing HIV prevention programs succeed in changing behavior only in highly motivated individuals. The AIDS epidemic is moving relentlessly into its next phase (Parsons & Bimbi, 2007) and intervention approaches are now urgently needed for men who intentionally engage in unsafe commercial sex’ (p. 466) are dated, and not supported by evidence.

Linking sex workers with deliberate HIV seroconversion, ‘a growth of subcultural sexual behaviors, such as HIV-negative individuals seeking out HIV-positive partners;’ (p. 466) is also not supported by evidence, and nor is the ‘urgent need for studies that explore and explain individual MSWs’ motivations for offering and/ or practicing unsafe sex or being ambiguous about their intentions.’ (p.467).

The editors conclude with a call for more research in order that sex work might be better regulated for the benefit of the sex worker, their clients and public health. This is not a surprising conclusion for a book that misinterprets decriminalisation and its impacts, and ignores almost completely the sex worker rights movement and sex worker organisations – not to mention the perspective of male sex workers in these groups and movements.

One can only hope that the editors and a majority of the authors, like us, received free copies of The Lancet’s series on Sex Work and HIV when it was released at AIDS 2014 in July last year, and have now updated their thinking on sex work, male sex work and how sex work research might be better conducted.

Cameron Cox is Male Sex Worker Representative, Scarlet Alliance, Australian Sex Workers Association.