#OTalk 19th Nov 2019 Sex work and Occupational Therapy.

This week Rachel Rules ‪@_rachelOT and ‬ ‪ Rebecca Twinley‬ ‪@RebeccaTwinley‬ will be leading the chat,  here is what she had to say…

Sex work holds a ‘provocative place in the social psyche’(McCray, Wesely, & Rasche, 2011), yet sex work is a more commonplace role than society recognises. It is predicted that 40-42 million people engage in sex as work globally (Fondation Scelles, 2016), however, there are complications in making this estimate due to the covert nature of sex workand the actual amount is likely much higher. Sex workers are a diverse community from a range of socioeconomic backgrounds – this community encompasses women, men, transgender and gender-diverse individuals – and ways of engaging in sex as work are equally as varied.

In the search for Occupational Therapy literature related to this community of people, it was found that there is a dearth of research from an occupational perspective. Though, Ecklund, Arana, Henning, Lopez, Patel and Varnell’s (2018) phenomenological study explores the facilitators and barriers to occupational participation for six female exotic dancers leaving the sex industry and recognises the role of the Occupational Therapist in working with this population.

When considering the promotion of health through occupation, the stigma that sex workers face can greatly contribute to marginalisation and alienation in society (Open Society Foundations, 2019). This can affect access to health care services and if a person chooses to leave sex work, future working roles.

When considering the lives of sex workers as occupational beings, it is useful to consider the concept of the ‘dark side of occupation’ (Twinley, 2013), in exploring the unexplored and ensuring that people and their occupations are not ‘censored’ or ‘condemned’.

The aim of this #OTalk is simply to encourage thinking about Occupational Therapists’ knowledge, pre-conceptions andabilities in working holistically with sex workers.

This #Otalk differs, in that I have invited the sex workers of twitter to engage in the latter part of the talk, in the hope of capturing their experiences of accessing mainstream healthand social care services and to learn how we can improve our services and approach.

1. What is your current knowledge and understanding of sex as work?

2. Do you believe that discussing sex work is within your remit as an Occupational Therapist?

3. Are you aware of any non-mainstream or sex worker specific services in your community that you could signpost sex workers to, if they wished to access them?

4. What do you perceive the Occupational Therapy role to be in working with sex workers in your community?

5. The following two questions are directed at people who engage in sex as work – Do you have any experiences to share in accessing ‘mainstream’ health and social careservices (for both physical and mental health)? Do you disclose your work?

6. Is there anything that you think could be improved? What would you like health and social care professionals to know?

Post Chat Updates:

Online Transcript: #OTalk Transcript from www.symplur.com/healthcare-hashtags/OTalk

PDF of transcript: #OTalk 19 Nov 2019

The Numbers

1.579M Impressions
472 Tweets
76 Participants

#OTalk Participants


Eckland, E., Arana, J., Henning, L., Lopez, J., Patel., R. & Varnell, J. (2018) Exploring the role of occupational therapy with women leaving the sex industry. American Journal of Occupational Therapy, 72, 1.

Fondation Scelles (2016) Prostitution. Exploitation, persecution, repression. Retrieved from https://www.fondationscelles.org/pdf/RM4/1_Book_Prostitution_Exploitation_Persecution_Repression_Fondation_Scelles_ENG.pdf

McCray, K., Wesely, J. K., & Rasche, C. E. (2011). Rehab retrospect: Former prostitutes and the (re)construction of deviance. Deviant Behavior, 32(8), 743–768.

Open Society Foundations (2019). Understanding Sex Work in an Open Society. Retrieved from https://www.opensocietyfoundations.org/explainers/understanding-sex-work-open-society

Twinley, R. (2013) The dark side of occupation: a concept for consideration. Australian Occupational Therapy Journal, 60(4), 301-303.


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