by Audacia Ray. Originally published on January 10, 2010 at RH Reality Check.

It was inspiring to meet the HIV-positive rural women, illiterate sex workers, and community health advocates who are working together to facilitate change in their communities. Many told me how for years, doctors in the local primary health centers refused to provide health services to sex workers or avoided touching them by giving them inoculations with extra long needles. With SANGRAM’s assistance, sex workers have been able to form alliances with some of the doctors and achieve a higher standard of care and respect. Their efforts have resulted in health system improvements that benefit the entire community: advocates have been successful in demanding that the primary health centers be functional, with trained staff, adequate supplies, and medicine. 

Since becoming a part of the U.S. sex worker rights movement five years ago, talking about contentious issues concerning bodies, labor, money, and rights has very much become my calling. In the past year alone, I’ve been quoted on CNN about the value of virginity, talked about South Carolina’s Governor Mark Sanford on WNYC’s The Takeaway, and admonished the Boston Herald for its slurs toward sex workers. Suffice to say, I give my opinion freely and often loudly.

I thought I knew a lot about sex work, rights, and organizing when, in September, I set off for two weeks in India with my colleague Khushbu Srivastava, Program Officer for Asia at the International Women’s Health Coalition. But as much as I am accustomed to being an "expert," I quickly realized that I knew next to nothing about the nuances of Indian culture and the dynamics of the local struggle for sexual rights and reproductive health. While there are many things that I learned during the two weeks I spent time with our partners at CREA, The YP Foundation, Commonhealth, and SANGRAM, perhaps the biggest lesson I learned--as a leader, as an advocate, and as privileged white lady from the United States who was way out of my element--was to shut up and listen.

I spent almost a week in Sangli, a rural district that’s six to nine hours (depending on who’s driving!) southeast of Mumbai. Maharashtra state, where Sangli is located, has progressive laws that afford many rights to its citizens, particularly in respect to accessing healthcare. However, populations that are already marginalized in their communities and in local institutions—like sex workers, HIV-positive women, and people who are not literate—do not know their rights or how to navigate the legal structures and institutions that facilitate access to these rights and services.

In Sangli, I spent time with the staff and organizers of SANGRAM, whichempowers individuals with the knowledge and tools they need to understand and claim their rights. SANGRAM was founded in 1992 to address the growing HIV infection rate in Sangli district, and they soon realized the value of mobilizing sex workers to become agents of change in fostering a sustainable and effective response to the epidemic. Today, one of the organization’s largest projects is a collective of 5,000 sex workers that manages a peer HIV prevention education and condom distribution program in Sangli. This collective also advocates to ensure equal access to health services and end violence and discrimination against sex workers. While many organizations train and bring in people from outside the community to help and support people in need (the social work model), SANGRAM operates under the principle that the only way to empower people is to provide them with the tools they need to claim their rights and facilitate change.

It was inspiring to meet the HIV-positive rural women, illiterate sex workers, and community health advocates who are working together to facilitate change in their communities. Many told me how for years, doctors in the local primary health centers refused to provide health services to sex workers or avoided touching them by giving them inoculations with extra long needles. With SANGRAM’s assistance, sex workers have been able to form alliances with some of the doctors and achieve a higher standard of care and respect. Their efforts have resulted in health system improvements that benefit the entire community: advocates have been successful in demanding that the primary health centers be functional, with trained staff, adequate supplies, and medicine.

In Sangli, I worked with SANGRAM to document their work and successes. On International Human Rights Day, we released a five minute video about sex worker organizing, the first collaborative media project of the International Women’s Health Coalition & SANGRAM.

Since we posted the short documentary about SANGRAM and the mobilization of sex workers in Sangli, it’s been interesting to read the posted comments and reactions. One of the most frequent responses is a well-meaning but slightly problematic one. To paraphrase: "It’s so great to see these women getting the protection and help they need!" Obviously, the respondents want what’s best for women, but this response doesn’t instill much trust in the agency of sex workers to realize what’s best for them on their own. Furthermore, it casts sex workers as damaged goods: victims in need of saving, delicate flowers in need of protection.

Why is it that there has been a shift in how advocates describe those who experience gender-based violence from "victim" to "survivor," but when speaking of people in the sex industry, the word "victim" has persisted? Why is it that US-funded HIV prevention programs require a denunciation of sex work by organizations best poised to reach sex workers with life-saving information and services? Why is it that while in other social justice movements, the voices of the people most affected are at the forefront, yet some feminists are quick to leap into conversations about sex work and trafficking to speak for the affected communities?

The basic answer to these questions is that many people regard the sex industry as something that must be halted, one that at its core perpetuates violence against the people who work in it, a business from which no good can come. I won’t argue that the sex industry is a well-functioning industry that respects the rights of all its workers, or that most sex workers feel safe and fulfilled in their jobs. However, there are a variety of contributing factors that might keep a sex worker in the business, even if the worker has the choice to leave it for other work.

SANGRAM works to prioritize the voices of sex workers themselves, so that sex workers can articulate what they need to be safe, healthy, and able to provide for themselves and their families. Sometimes this includes an exit strategy, but often the sex workers’ circumstances and the economic and social climate in which they live make exit from the sex industry unrealistic.

Programs that are designed to rescue and protect sex workers from the industry usually don’t comprehensively consider the well-being and economic stability of the people they are supposed to serve. One of the tactics these programs often employ is abstinence education – and we all know how well that’s worked for sexuality education. Another recent example of an attempt to rehabilitate sex workers is an initiative launched in India in which men volunteered to marry sex workers to get them out of the sexually exploitative situation of the sex industry. As any survivor of intimate partner violence knows, marriage isn’t exactly a safe haven from violence or HIV infection for women.

As a major Open Society Institute report titled "Rights, Not Rescue" indicates, programs that aim to get sex workers out of the industry do little to reduce violence or improve health and working conditions within the industry. According to the report, which analyzes rehabilitation programs in

Botswana, Namibia, and South Africa, "None of the interviewed sex workers who had completed rehabilitation programs had managed to obtain gainful employment from their training." Domestically, in a recent program launched by the Dallas, Texas police to rehabilitate sex workers, half of 375 arrested sex workers chose rehabilitation over being charged with prostitution, but only 21 of those who went through the rehabilitation program had left the business upon follow up.

Despite these numbers and testimonies by sex workers about the problems with rescue and rehabilitation programs, getting sex workers out of sex work is widely posited as the way to end exploitation.

The exercise of human rights should not be contingent on whether or not you think a person’s choices or circumstances are a good way to live or be. Entangling morality with a conversation about rights and painting a portrait of people in the sex industry as victims without voices only perpetuates their disempowerment.

The feminist movement is built on the principle that women should have opportunities that are equal to those granted to men, a lot of which is about economic opportunity – things like pay equity and the ability to own property. It is also built on the struggle for women’s rights to control their own bodies and make choices about their sexual rights and reproductive health that are unfettered by cultural and familial demands. The struggle for sex workers’ rights is at the intersection of the struggle for economic justice and bodily rights, and it is perhaps that combination that can often make discussing sex work uncomfortable.