18 Chapter 18 – Sexual Marketplace

Ericka Goerling, PhD and Emerson Wolfe, MS

Learning Outcomes

  • Demonstrate an understanding of the commercialization of sex as it relates to prostitution, pornography, and adult entertainment.
  • Analyze the impact of erotic media on sexual knowledge and behavior.
  • Distinguish between porn consumption and moral distress as it relates to problematic porn use.
  • Examine the historical considerations of sex work, as well as current sex work practices in the United States.
  • Discuss the impact of stigma in the lives of sex workers and explore stigma-resistant strategies.


As a bridge between the last section on sexual disorders and treatment, we begin to make our way to the topic of the sexual marketplace and sex work by first examining the complexities of pornography. In the United States, pornography is both reviled by many (evoking legislation to shut down content) and yet is consumed with the highest frequency of anywhere throughout the world. This section seeks to provide the most recent research in terms of creation, consumption, benefits, challenges, and the impact of pornography.

Pornography History

Some may argue that for as long as people have been having sex, folks have also sought out ways to portray sex. Originally defined as art or literature that depicted the life of prostitutes, the word pornography comes from the Greek term porni (‘prostitute’) and graphein (‘to write’; Jenkins, 2020). With time, the term pornography has evolved to generally mean content (in imagery, language, sound) that is generated with the intent to elicit sexual arousal or excitement. Whereas erotica tends to be generally acceptable artistic content, pornography encompasses illicit and condemned materials (Jenkins, 2020; Lehmiller, 2018). The challenge with these differences, of course, is the subjectivity of definitions. Indeed, even cultural and religious artifacts completely acceptable by one culture, may be viewed as completely offensive by another (Jenkins, 2020). Consequently, the history of pornography can be challenging to synthesize.

In addition to ancient cave drawings of naked people, one of the most archaic artifacts ever discovered is the Venus of Willendorf, a 30,000 year old rock carving of a naked, voluptuous figure. Ancient Greeks and Romans shared literature and art portraying all sorts of heterosexual and homosexual sex, as well as orgies. Across the globe, the Moche of Peru depicted sex acts on their pottery and throughout India, images of the Kama Sutra were present (Lenz, 2020). For centuries, many cultures developed content combining art and sex. From illustrated sex manuals during the Renaissance (I Modi) to woodblock renderings of erotica in Japan, explicit content could be found throughout the world (Jenkins, 2020; Lenz, 2020).

Museum of Anatolian Civilization (c. 1600BC)
Georges Jansoone (JoJan), CC BY-SA 3.0 <http://creativecommons.org/licenses/by-sa/3.0/>, via Wikimedia Commons

With the advent of the printing press, written and visual materials became more available to the masses. Incorporating romance, humor, and/or political and religious critiques, pornographic materials became a popular medium worldwide. By the Victorian era, Britain and the United States enacted laws prohibiting the creation, publication and/or distribution of ‘obscene’ materials (remember that Comstock Act?). Interestingly, some scholars argue that these restrictions only heightened the taboo nature of sexual depictions, heralding in many ‘underground’ means in the creation and dissemination of pornographic content (Jenkins, 2020; Lenz, 2020).

With the advent of photography and moving pictures, pornography took on additional features. In 1896, French directors Eugène Pirou and Albert Kirchner, produced Le coucher de la mariée which featured a newlywed slowly undressing in front of her husband (down to her bloomers!). Although tame by today’s standards, this tittilating film popularized more projects in France and throughout the United States, heralding a vast underground marketplace for pornographic material. In 1969, Denmark was the first country to decriminalize pornographic films by removing censorship laws (Lenz, 2020). With the intersecting “Free Love” movement hitting the United States, pornographic films started to become more commonplace, including being profiled in major motion picture arts (e.g. Blue Movie, The Last Tango in Paris, Deep Throat). In 1973, the U.S. Supreme Court reduced its’ standards of obscenity (Miller v. California), although the remaining criteria were left fairly subjective, ultimately allowing community standards to influence the legality of produced material (hence the difference between what is acceptable in rural Bible belt areas versus the Vegas Strip or brothels in Nevada; Lehmiller, 2018). With the advent of VHS tapes in the 1980s and DVDs in the mid-90s, video pornography became more available.

Of course- perhaps the most profound shift in the accessibility of pornographic material arrived with the invention and ultimate ubiquity of the INTERNET. By the late 1990s, pornographic content on the internet became one of the most profitable industries (Jenkins, 2020). The private, affordable (often free), and diverse material available online has been an absolute game changer in terms of sheer consumption. By 2003 there were 1.3 million sites and 260 million pages of pornography. In 2019, the most popular mainstream pornography website, PornHub, received 42 billion visits, which means there was an average of 115 million visits per day Pornhub Insights, 2019). To be clear, that’s just one site; some scholars maintain that 10 to 20 percent of all internet activity is related to pornography (Lenz, 2020; Lehmiller, 2018).

As a consequence of the massive proliferation of pornographic material, research in the area is starting to increase. In 2014, the first international peer-reviewed scholarly journal, Porn Studies, was launched. This is certainly understandable since the potential saturation of explicit sexual content is new and distinctive to this era of humankind. Indeed, many questions and considerations abound and, as history has certainly illuminated before, the issues are not as black and white as one might initially predict.

What are the impacts of porn? (Or…everything you wanted to know about pornography but were afraid to ask.)

Pornography is one of those topics that have catalyzed public, political, faith-based, legal, and personal interest. On the one  hand, the growing engagement in topics around porn use can be instructive and helpful. On the other hand, assumptions about porn use and/or ongoing misinformation can be reductionistic and harmful. Unfortunately, this section isn’t exhaustive on all the issues, however our intent is to balance the emerging data with folks’ unique experiences in ways that will be educational and empowering, especially in terms of one’s own decision making.

(Spoiler: For almost all of these questions, the answer typically involves the concept of… it depends.)

Is pornography a public health concern?

In 2016, pornography became a campaign issue among Republicans and the state of Utah officially declared pornography a “public health crisis” (Lehmiller, 2018). In the next three years, 16 more U.S. states introduced resolutions stating that pornography is deemed a crisis of public health (Nelson & Rothman, 2020). So…is it? Well- it depends on how you define a public health crisis. If one defines a public health crisis as something in which there is an acute event needing immediate response, direct or imminent contagion leading to death (e.g. Covid), an event with property destruction, population displacement, and/or an event that overwhelms local response to community health, then pornography consumption likely does not meet that criteria (Nelson & Rothman, 2020). Importantly, that doesn’t preclude engagement from public health processes, especially in terms of education, awareness, and harm reduction.

In the U.S. an estimated 36-75% of men and 16-41% of women report pornography usage (Berger, Kehoe, Doan, Crain, Klam, Marshall, & Christman, 2019). Between twenty to thirty percent of kids between 10-12 years old have reported some exposure to pornographic in the United States (Efrati, 2019). With exposure to pornography occurring in early adolescence, concerns have risen regarding kids’ and teens’ developmental impact of viewing such explicit materials. Interestingly, the evidence that porn exposure (particularly intentional, repeated engagement) has entirely negative consequences isn’t corroborated. In Peter and Valkenburg’s (2016) review of 20 years of research on adolescents and pornography, only a few, consistent findings emerged. Pornography use was associated with more permissive sexual attitudes (e.g. acceptance of casual sex, early sexual activity, which was stronger for girls), as well as linked with stronger gender-stereotypical sexual attitudes. They also noted a higher likelihood to engage in sexual aggression (male) as well as to experience it (female). Finally, there were mixed data regarding pornography consumption and the use of condoms. Importantly, this massive review covered studies from all over the world with multiple perspectives, laws and norms informing their respective outcomes. Still- there’s some critical information yielded, which may certainly have public health and education implications. Ultimately- this leads to another question:

Is pornography a sex educator?

In a review of qualitative studies, some consistencies emerged regarding an association between exposure to porn and acquisition of sexual education (both positive and negative; Peter & Valkenburg, 2016). There were some initial indicators that showed some adolescents learn sexual scripts from pornography, with some teens imitating what they see. On average, adolescents reported pornographic scripts as “unrealistic,” however with frequent consumption, that perception shifted, as did more permissive sexual attitudes. Ultimately, more research will want to examine the role of pornography as a sex educator (especially in areas where comprehensive sexuality education is not occurring).

Although the evidence regarding the impact of pornography on adolescents is mixed, public health officials argue that media literacy skills help adolescents think critically about sexualized and non-sexualized media to which they are exposed (Rothman, Daley, & Alder, 2020). Consequently, a rising number of porn literacy programs are emerging as an adjunct to CSE or as stand-alone training. Certainly expanding notions of healthy sexuality, consent, and media engagement may be quite essential in equipping teens with more information (initial results of program efficacy are promising; Rothman, Daley, & Alder, 2020).

One area for consideration, of course, is when pornography consumption becomes compulsive in nature. Indeed, in one study, 10-18% of adolescent porn users met the criteria for compulsive sexual behavior disorder (Efrait, 2019). This leads to our next question:

Is pornography addictive?

Perhaps one of the most recurrent questions in terms of porn consumption is “Can watching porn become addictive?” This question often stems from fear; fear of out-of-control behavior, fear that one’s partner will only want to watch porn versus engage in physical intimacy with them, and/or fear of moral/religious recriminations. Indeed, there’s been little public discourse about what it means to engage with porn, nor any widespread porn literacy available yet to emerging adolescents and young adults. Just like the other questions, our answer: It depends. Let’s break it down.

There are two major domains that need to be considered. The first is how we define addiction, along with the social/moral standards of the acceptance of porn use, including relationships with frequency of porn use. What the literature consistently shows is that perceptions of morality impact distress, which lends to self-identified problematic pornography use. The second area we will examine is the recent inclusion of Compulsive Sexual Behavior Disorder (CSBD) in the International Classification of Disease and both practical and neurological underpinnings of the CSBD.

Frequency of Porn Usage and Moral Incongruity as Factors of Distress

Pornography use is controversial, despite its’ perceived ubiquitous nature (one 2016 study found 70% of men and 40% women reported consuming porn in the previous year; Grubbs, Kraus, & Perry, 2019). There are many notable and public cases of porn use being depicted as an indicator of sexual deviancy, moral failing, a relationship killer, a ‘new drug’ and much more. While there has been a massive amount of public sentiment about pornography, empirical evidence about porn use has emerged with more clarity in the past decade. One of the most important and consistent findings is that distress linked to porn use is certainly real; in one national sample over 10% of men and 7% of women perceived themselves as having difficulty controlling their sexual feelings, urges, and behaviors in a way that causes them distress (Dickenson, Gleason, Coleman, Minder, 2018).

The challenge of determining if this distress is clinically significant has also been explored. How does one know if their porn usage is too much? In some instances, just viewing an image or watching a video once is deemed as something immoral and problematic. In other cases, daily intake of pornography may seem completely normative and non-problematic. In other words- frequency of usage is quite subjective and, taken alone, not a useful indicator of problematic porn use. Indeed, frequency of pornography use is not considered to be a reliable indicator of problematic pornography use. Research finds that the number of people with high frequency of porn use with no reported problems were 3 to 6 times higher than those with problematic high rates of porn use (Bőthe, Tóth-Király, Potenza, Orosz, & Demetrovics, 2020). In other words, how often someone consumes pornography is not, by itself, a clinical indicator of problematic use.

Research has generated a considerable amount of evidence finding that many people have strong moral, often religiously based, restrictions on the use of pornography and/or masturbation (Grubbs, Kraus, & Perry, 2019; Grubbs, Perry, Wilt, & Reid, 2018; Grubbs, Kraus, Perry, Lewczuk, & Gola, 2020). Although a belief system may exist that condemns pornography usage, people might still engage in porn consumption. Scholars have termed this experience moral incongruence, feelings or thoughts related to a behavior (using pornography) that are in opposition to one’s core values or beliefs (Brand, Blycker, & Potenza, 2019; Grubbs, et al 2020). This moral incongruence is a distinctive consideration when considering problematic porn usage and, accompanying that, religiousness emerges as a frequent correlate in people’s perception of problematic use (Grubbs, et al, 2018). As Grubbs and his team write (2020),

“People may report feeling addicted to pornography or sexual behavior for various reasons, but morality and moral distress seem to be key parts of why individuals might they they are addicted to pornography or sexual behavior” (italics mine; 2020, p. 266).


Even in a cursory review of religion and pornography on YouTube, there were dozens upon dozens of videos condemning porn use from a variety of faiths (Christianity, Latter Day Saints, Catholicism, Judaism, Islam, even a Yogic admonishment). In sum, if one is aligned with faith practices that condemn pornography, but they’re still consuming porn – they are more likely to experience moral incongruence and, consequently, are more likely to self-diagnose that their behavior is problematic.

Importantly, whether someone is actually experiencing problematic, excessive pornography use or if they are distinctively undergoing distress because of any/all use are important factors in clinical response. Certainly, if someone is experiencing emotional pain, psychological consequences, and/or significant interpersonal consequences, intervention may be critical (Grubbs, et al, 2018). With that in mind, more guidance has recently emerged for diagnostic purposes.

Compulsive Sexual Behavior Disorder (CSBD)

In 2020, the World Health Organization’s International Classification of Disease (ICD-11) adopted a new disorder (categorized under Impulse Control Disorders), known as Compulsive Sexual Behavior Disorder. It’s important to note that this is different than the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-V; 2013), which currently does not have a correlating disorder (although hypersexual disorder was considered it was, ultimately, not included in the DSM-V). The criteria are below:

CSBD Defined Symptoms Include Duration/Intensity Considerations
Compulsive sexual behavior disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior. Repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities Numerous unsuccessful efforts to significantly reduce repetitive sexual behavior; Continued repetitive sexual behavior despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behavior is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviors is not sufficient to meet this requirement.

(WHO, 2020)

Please note that this definition/diagnosis isn’t exclusively about excessive or problematic pornography use. However, in the field trials for this disorder, the most common application (81% of the cases) was for compulsive porn use (Grubbs, et al, 2020) and some researchers advocate for problematic pornography usage to emerge as a subtype of CSBD (Gola, et al, 2020). Also note that there is a rule-out in terms of moral incongruence. That is- just because someone’s cultural/religious underpinnings disapprove of their sexual engagement does not, inherently, make their behavior diagnosable.

With the advent of CSBD, additional research continues to emerge. Neurological imaging notes brain activity among those diagnosed with CSBD as being similar to other impulse control disorders, including Obsessive-Compulsive Disorder and other addictions (Draps, et al, 2020; Gola, et al, 2017). Ultimately, these findings inform efficacious practices for clinical interventions for folks with this diagnosis.

Modernized Sex Work

In addition to cultural and religious norms often denouncing consumption of pornography, the creation of pornography can be reviled. Consequently, a full understanding of the psychological make-up of those who create and act in pornography is only recently coming to light. Despite assumptions that porn stars are flawed in some way, numerous psychological studies find evidence to the contrary. The characteristics of people acting in pornography show them to be just as psychologically healthy as anyone else in most regards and, overall, they tend to have a very positive self-image (Lehmiller, 2018).

Some scholars argue that shifts in the well-being of actors in pornography has been, in part, based on the high levels of commercial consumption of pornographic materials. Certainly, there is a long legacy of very little rights and protections (to include stories of rampant abuse and coercion) among porn actors. This is, fortunately, shifting (albeit slowly). California leads the way in policy making (it’s also the world capital of porn production). Porn workers looking to unionize are incredibly active. In 2012 California passed a provision requiring that all pornography actors are over the age of 18. This is currently being revisited to increase that age to 21. There is also more pressure for the industry to employ the display of condom use in pornography. This has been hotly contested by the industry, who alleges that it will reduce profitability, even though second highest porn producer, Brazil, sees no reduction in consumption or profitability with that policy in place (Mellish, 2018).

Other advancements in the field include the proliferation of numerous platforms that allow people to create and generate content in distinctive ways. On one hand, this flexibility has empowered many folks to enter the field of pornography/sex work in independent, manageable, and entrepreneurial ways. On the other hand, because of the lack of public policy, employment laws, as well as public support, there still remains a tenuousness in job security. To be sure, however, the Internet has shifted the ways in which sex work gets performed; webcam performers, amateur porn production, escort and companion services with no Johns, have all seen a significant uptick in activity, with no indication of ebbing anytime soon.

There are, of course, challenges that technology brings to the world of pornography, as well as to folks’ personal safety. Child pornography, which is unlawful and unacceptable in most cultures throughout the globe, still occurs at alarming rates. Additionally, issues of revenge porn, or nonconsensual pornography (NCP), which is defined as the distribution of sexually graphic images of individuals without their consent have become increasingly problematic (Cyber Civil Rights Initiative, 2021). Currently, 46 states, the District of Columbia and Guam all have revenge porn statutes in place (CCRI, 2021). There’s also the challenge of technology and the ease of creating Deep Fakes, AI generated fake videos. According to Guardian writer, Ian Sample (2020), “The AI firm Deeptrace found 15,000 deepfake videos online in September 2019, a near doubling over nine months. A staggering 96% were pornographic and 99% of those mapped faces from female celebrities on to porn stars.” We are definitely on the cusp of emerging technologies that can be both exploratory and exciting, but which also compel aspects of oversight that are essential for safety and well-being for all.

Sex Work

Individuals may engage in sex work for a variety of complex reasons. Some may enjoy performing for others, having sex, or being sexual alone for others to watch. Others may see sex work as providing them with access to resources for themselves or their families and feel like this is their only or best option due to being disenfranchised by society. Some may be coerced or forced into sex work against their will. Any combinations of these reasons and more may exist, creating unique experiences in the lives of sex workers. “The term ‘sex work’ is an umbrella term for the provision of sexual services or performances by one person for which a second person, the client or customer, provides money or other markers of economic value (i.e., goods, services). Sex work refers to prostitutes, escorts, strippers, porn actors, sex phone operators, or dominatrixes” (Sawicki et al., 2019, p. 355). Anyone working within the industry, managers, camera operators, video editors, marketing agents, etc. are also part of the sex industry and can exert varying degrees of power and influence over the individuals providing direct sexual services (Overs, 2002). Sex workers are defined as adults who receive money, housing, food, etc. as compensation for sexual acts (Overs, 2002). Taking a look at sex work in the past can provide us with insights into the present. While a majority of sex workers are cisgender women, transgender individuals, cisgender men, and intersex individuals can also be sex workers as well. The health and safety concerns will be different based on the types of sexual services being offered, access to health and mental healthcare, the stigma in the community, and the intersecting identities of the sex workers.

From Pompeii to Western Expansion

While examples of sex work can be found from around the world, time periods, and contain specifics related to the social fabric of the community in which it took place, two examples from different times and geographic locations will be explored to analyze the way that resources, social power, and the commercialization of sex connect to influence the lives of sex workers.

Sexual Art and Graffiti of Pompeii

The complexities of sex work cannot be stressed enough, and sexual services as part of slavery and victimization as well as leverage to gain access to resources and social status are not dichotomous and may share many overlapping features. For instance, in Pompeii, archaeologists have long been studying the ancient Roman community buried in ash from an explosion at Mount Vesuvius in current-day Italy. While most people have seen images of the inhabitants of Pompeii who tried to shelter and cover themselves, what is less known is the extensive erotic graffiti and art that has been uncovered and preserved. Slavery was commonly practiced within the society and this included sexual slavery (Baird, 2015; Levin-Richardson, 2011; Severy-Hoven, 2013). Female, male and intersex bodies are present in sexual imagery within homes in varying degrees of what appears to be consensual to sadistic and violent (Severy-Hoven, 2013).

“Pompeii, Brothel,menu 1” by michael clarke stuff is licensed under CC BY-SA 2.0

Themes of power, femininity, and masculinity can only be analyzed with the biases present from the gaze of today which make it difficult to know the full extent of what was truly happening in the society at the time (Severy-Hoven, 2013). Material remnants in addition to the graffiti and art have been uncovered, such as a gold bracelet with the translated words of ‘The master to his very own slave-girl’ inscribed on the inside (Baird, 2015, p. 164). While most of the images show women’s bodies at the whim of the males (Levin-Richardson, 2011; Severy-Hoven, 2013), images of men having sex with men were also depicted within the prominent brothel known as the Lupanare (Levin-Richardson, 2011). While many wealthy free individuals could afford to have their own slaves at home, others who were soldiers, slaves themselves, free but poor, etc. would go to the brothel to seek sexual services as noted by the professions and names inscribed on the walls of the brothel which represented the names of clients as well as the prostitutes (Levin-Richardson, 2011).

While scholars can only try to piece together the material and artistic remains of the past, themes of slavery, sexual service as normative, and power dynamics between wealthy, free men and others in the society remain consistent, recurring themes to explore and analyze (Baird, 2015; Levin-Richardson, 2011; Severy-Hoven, 2013). In the context of slavery, consent is questioned (Baird, 2015). Arguably, the experiences of sex workers in Pompeii were likely varied with some effectively navigating how to gain social and economic status through the use of their sexual desirability whereas others were more victimized and abused by those in power (Baird, 2015). Since we will never know the full details or complexities of this society, perhaps the greatest lesson comes from our own perceptions of the graffiti and artwork and the way that we use our current-day experiences to analyze the past.

Brothels as Foundations to America’s Western Cities

Western expansion of the United States in the 19th century provided numerous labor opportunities (mining, timber, construction, cattle, and freight) for men based on the way that labor and gender were viewed in the early colonies (Marek, 2018). Women’s work, such as being maids, teachers, waitresses, and seamstresses, were low status and poorly paid opportunities (Marek, 2018). With the desire for better economic situations and adventure, many women began migrating out West and some found prostitution to be their sole or supplemental source of income (Marek, 2018). Many of the women engaged in this work would refer to it as ‘sporting’ (Marek, 2018, p. 3). Prostitutes ranged in ages from early teens to older adulthood and races and ethnicities based on the impact of colonization, slavery and immigration patterns (Marek, 2018). Race was a large factor in how successful a prostitute was with Native American and red-headed women’s services costing more due to being labeled as “exotic” (Marek, 2018, p. 3).

Men outnumbered women 1 to 9 in California by the mid-1800s, and some women became madams in which they opened their own brothels and inns whereas the sex workers gained differences in status based on the services they provided with direct sexual services being seen as lower status and those who were dancers, brought men drinks in saloons, and provided entertainment for male customers as having higher status (Marek, 2018). The urban areas became to be known as ‘red light districts’ because of the relaxation and entertainment they offered to those passing through and specifically because of the brothels (Marek, 2018, p. 4). Small mining towns often developed into large urban cities following the presence of brothels which provided a huge economic source for the developing region (Marek, 2018).

The women who worked and lived in more wealthy areas had access to increases in amenities provided to them by the madams they worked for, but this came in the exchange of following the directives of the madam which may have included dictations on how to dress and requirements to walk at local parks to attract the gaze, and possible services, of onlookers (Marek, 2018). Dancers and prostitutes received lavish and expensive gifts from returning clients, their mistreatment was viewed negatively by the society at the time with repercussions at the very least of the perpetrator being outcast from the community, and it was socially acceptable and commonplace that wealthy men would sometimes marry dancers or prostitutes (Marek, 2018). Violence, abuse, and murder did occur, however, sometimes at the hands of ex-clients, madams, other sex workers seeking to reduce competition, and by suicide or drug overdose (Marek, 2018). Additionally, sexually transmitted infections began to rise, resulting in serious illness and death, and dangerous attempts at abortions caused many women to die (Marek, 2018).

By the end of the 1800s, seeing the brothels as a taxable income for cities, city councils began to pass lays criminalizing prostitution as a means of imposing fines, which resulted in madams being arrested at frequent intervals and fined for the number of women working for them (Marek, 2018). Indecent exposure laws and further ordinances began to allow police to arrest and impose fines on more and more activities related to sex work, and sex workers were thereby relegated to an inferior social status with their incomes taken away by the legal system in order for that legal system to inflate itself through often corrupt means (Marek, 2018).

As Western expansion began to continue in the late 1800s and military personnel increased in numbers at the urban centers, they engaged in gambling, drinking, and hiring prostitutes at incredibly high rates so much so that the military began to employ many women in various positions with the expectation that they would also provide sexual services to the military personnel to keep them from leaving the bases despite having their own rules on the books denouncing prostitution and sex workers (Marek, 2018). The stigmatization, shaming, policing, and criminalization began while the greater society (often even the same politicians passing laws and ordinances against the practice) continued to pay for services in a more and more underground and hidden fashion, and, at the same time, some wealthy madams who owned many properties and invested in the stock market gave back to their communities by funding a public school system in Seattle and a hospital in Omaha (Marek, 2018). Thus, urban development owes itself to the sex workers who are credited with building the wealth of communities, and the morality and illegality placed upon such actions could be viewed as economic business opportunity on the part of local city councils and the larger government as a whole moving forward.

Intersectional Feminist and Queer Perspectives

While today in the United States prostitution is illegal in all states except for Nevada, feminist and queer theory seek to question the status quo and analyze the impacts of socially constructed aspects related to women’s sexuality and the commodification of sex. In 2008, Natalie Dylan decided to auction off her virginity through a legal Nevada brothel, Moonlite Bunny Ranch, in which she received over 10,000 bids with the highest amounting to 3.8 million dollars (Dunn & Vik, 2014). When asked why she was auctioning off her virginity, Dylan “claimed a third wave feminist perspective that emphasized her right to choose what to do with her own body as well as a right to profit from it” (Dunn & Vik, 2018, p. 1432). “Dylan’s statements draw from cultural norms regarding women’s agency and virginity, both challenging them and allowing them to materialize as a site for interrogation via her actions, while simultaneously extending discourse about those actions” (Dunn & Vik, 2014, p. 489).

Within the heterosexual economy of a patriarchal society, a woman’s virginity is tied to the validity of a man’s children being his own to ensure he is not financially responsible for the children of another man (Dunn & Vik, 2014). This Victorian ideal that the purity of women is tied to the value of the state through women being the property of their husbands lies within the discourse around virginity and women’s sexual freedoms today (Dunn & Vik, 2014). Purity laws in the Bible pay special attention to women’s virginity and divide men and women from one in another in a way that imposes more regulations upon women’s sexuality than that of men’s, especially around the ideas of chastity and saving one’s self for marriage and procreation purposes (Dunn & Vik, 2014).

Some feminists argue that sex workers do not sell their bodies any more than any other worker does under a capitalistic system in which corporations use and abuse those with less access to resources (Dunn & Vik, 2014). Yet, bodies and sexualities become socially constructed and altered within capitalistic and hierarchical power structures and within the backdrop of traditional religious beliefs. While Dylan did not go on to sell her virginity in the auction, she did make at least $125,000 from a deposit paid by an Australian businessman who won but whose wife would not let him participate (Dunn & Vik, 2018). Katherine Stone in 2015 decided to participate in ‘America’s Next Top Bunny Ranch Virgin’ auction (Dunn & Vik, 2018, p. 1432). Unlike with Dylan, Stone was labeled by the original Moonlite Bunny Ranch announcement as a ‘bi-lingual Latina (born in Chile)’ (as cited in Dunn & Vik, 2018, p. 1434). From an intersectional feminist approach, discourses around her virginity and actions to auction it off occurred at the intersection of gender and ethnicity (Dunn & Vik, 2018). Spanish colonization of Latin America and the influence of the Catholic Church thereby impose specific constructions that influenced Stone’s experiences as compared to those of Dylan (Dunn & Vik, 2018). “Latina women are held to higher standards than their white peers particularly in respect to relationships between self and family and child and family” (Dunn & Vik, 2018, p. 1437).

Feminist and queer theory call out and name these factors that are present in a heterosexual and patriarchal dynamic and the intersectional perspective draws attention to the way that a multitude of power dynamics related to marginalized and privileged social identities influence social discourse regarding women and their bodies and sexuality. The experiences of Dylan and Stone exemplify the complicated nature of agency in which they both were actively participating in the auction while also at the whim of third parties (the brothel owner, the individuals making auction bids, and the media) (Dunn & Vik, 2018). Thus, the discourse present in the online conversations around Dylan’s and Stone’s experiences in auctioning off their virginities speaks volumes about the way that religion, gender, sexuality, class, and ethnicity intersect in American society (Dunn & Vik, 2018).

Stigma and the Social Determinants of Health

In recent years, social determinants of health have gained greater attention in relation to public health, physical and mental healthcare, and education in order to provide better access to services and resources. According to the Centers for Disease Control and Prevention (2021), social determinants of health are defined as “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.”

Stigma is defined as “socially constructed, context-specific experience of Othering that devalues one’s identity, social contributions and potentiality in ways that limit how one can interact within one’s world of socio-structural relationships” (Bowen & Bungay, p. 187). Stigma then acts as a harmful social determinant of health. While sex workers engage in various types of labor, such as stripping, pole dancing, having sex with clients, dominating, engaging in sexually explicit phone calls, acting in pornography, and more, certain forms of sex work will come with greater levels of risk to safety. The type of sex work that will pose the greatest risk depends on many external factors and the role and influence of third parties (such as clients or consumers, pimps or managers, and police and judges). Online sex work in which an individual can post a video of themselves masturbating without consumers being able to find out where they live is on the low end of the risk spectrum with street walking and engaging in sexual behaviors with clients existing on the more risky end due to possible contact with STIs, potential for abuse, and the fact that prostitution (unless being sexually trafficked) is a crime.

Manifestations of Stigma

“Symbolic stigma,” in particular, impacts the lives of sex workers by placing them at greater risk for mental and physical health concerns because of the way that society associates their existence with crime, disease, and immorality (Bowen & Bungay, 2016, p. 186). The stigma leaves them disenfranchised as they live and work within systems that seek to penalize them for their means of income, which is also reinforced by discrimination when they seek education opportunities, medical and mental health services, and forms of public assistance. “Whore stigma” is a particular threat to women’s lives as sex workers because society seeks to devalue their humanity based on the concept that they are less honorable or pure (Bowen & Bungay, 2016, p. 186). Bowen and Bungay (2016) discuss that sex workers often have higher health literacy than the general population but are still stereotyped and thought of as “careless” (p. 187).

Stigma has the impact of causing people to hide their experiences as sex workers and distance themselves from people and systems that they perceive to be discriminatory or judgmental of them, which at times serves as a protective factor and at other times may prevent them from attaining needed help (Bowen & Bungay, 2016; Grittner & Walsh, 2020). Being talked down to and treated as if they cannot make decisions for themselves was a common experience reported because the assumption by members of out-groups is that they must lack personal agency to engage in sex work (Bowen & Bungay, 2016; Grittner & Walsh, 2020). Stigma can also work within the sex worker industry by shaming certain professions more than others, with streetwalking prostitutes viewed with the most stigma (Bowen & Bungay, 2016). “Systems of power, such as race, socioeconomic status, and the local sex work status hierarchy, influence” the way sex workers are perceived (Vaughn, 2019, p. 826). Due to the social structures and hierarchies of power present within society, sex workers with a greater number of marginalized intersecting identities will be further stigmatized, silenced, and criminalized. Isolation is the manifestation of stigma that is the most detrimental to physical and mental health by maintaining unsafe work environments (Bowen & Bungay, 2016; Grittner & Walsh, 2020). The social system that sex workers live, work, etc. within is what removes their agency and not the sex work itself.

Stigma-Resistant Strategies

Creating stigma-resistant strategies to improve the lives of sex workers exist at the individual level to heal from internalized discrimination and shame, community level to provide consciousness-raising education, peer support, and non-judgmental social and legal services, and institutional level to foster safe working environments.

Individual Level

Sex workers can work to dismantle internalized stigma and shame by creating boundaries around their work and personal lives, developing a support network and disclosing information about their job to mental and physical healthcare providers who are trusted, reframing sex work by highlighting the positives and rejecting generalized stigma around sexuality, resisting dominant discourses of power by reclaiming their agency and personal power, and challenging social values and beliefs (Grittner & Walsh, 2020).

Community Level

Community education that frames sex work as legitimate forms of labor through the use of consciousness-raising media campaigns can be utilized (Grittner & Walsh, 2020). Peer support groups where sex workers can support each other and provide resources, social service agencies providing non-judgmental services, and legal free of charge and financial services actively dismantle stigma across multiple fronts within communities (Grittner & Walsh, 2020).

Local activists in places around the country are working to promote community health by reducing stigma and providing education and resources. One such activist is Ashunte Coleman, a black transgender woman and former sex worker, who is working to provide support to other transgender women who are sex workers in the Tampa Bay, Florida area and started the organization Ladies Intervention Project For Success (LIPS). Check out this interview and information about Coleman’s organization from WSUF Public Radio (2021): ‘Consider Me An Essential Worker.’ How One Woman Supports Black Trans Sex Workers In The Tampa Bay Area.

Institutional Level

Here is the current law related to prostitution in Oregon (Legislative Counsel Committee, 2019):

  1. A person commits the crime of prostitution if the person engages in, or offers or agrees to engage in, sexual conduct or sexual contact in return for a fee.
  2. Prostitution is a Class A misdemeanor.
  3. It is an affirmative defense to prosecution under this section that the defendant, at the time of the alleged offense, was a victim of the crime of trafficking in persons as described in ORS 163.266 (Trafficking in persons) (1)(b) or (c). [1971 c.743 §250; 1973 c.52 §1; 1973 c.699 §6; 2011 c.151 §1; 2017 c.246 §1]

Multnomah County, the county in which Portland, OR is located, has been working since 2009 to focus police resources on preventing human sex trafficking rather than criminalizing prostitutes and has created the Multnomah County Sex Trafficking Collaborative.

Sex workers and their allies create stigma-resistant strategies that seek avenues to decriminalize sex work and to label violence against sex workers as hate crimes (Grittner & Walsh, 2020).


Like so many things that are discussed in this class, we are only touching the surface of the complexities of issues around pornography and sex work. And- like so many of our topics, what has been illuminated shows both the normative aspects of human sexuality, as well as the challenges of complex responses to sexual stimuli. Certainly we are compelled to effortfully consider culture, norms and attitudes, physiology, technology and our own personal preferences as we navigate through the emerging issues of pornography and sex work.

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Vox (2020, June 8). The most urgent threat of deepfakes isn’t politics [Video]. https://www.youtube.com/watch?v=hHHCrf2-x6w. License: All Rights Reserved. License Terms: Standard YouTube license.


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Introduction to Human Sexuality by Ericka Goerling, PhD and Emerson Wolfe, MS is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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