Stigma and Safety: Navigating Healthcare as a Sex Worker

Going to the doctor shouldn’t feel like a risk. But for many sex workers, stepping into a clinic means walking into a room where judgment is louder than the nurse’s greeting. You’re not just there for a checkup-you’re there hoping not to be shamed, ignored, or refused care because of what you do for a living. This isn’t rare. It’s everyday.

What Happens When You Walk Into a Clinic

Imagine you’re dealing with a persistent sore throat, a strange rash, or unexplained bleeding. You’ve tried home remedies. You’ve waited too long. You finally make the appointment. You tell the receptionist you’re here for a general checkup. When the doctor walks in, you hesitate. Do you say it? Do you say, I’m a sex worker?

If you do, the response might be silence. Or worse-a shift in tone. A raised eyebrow. A quick change in the script: “Let’s test for STIs,” as if that’s the only thing you could possibly need. Or worse: “You should really consider a different line of work.”

A 2024 study by the Global Network of Sex Work Projects found that 68% of sex workers in high-income countries reported being refused care or treated disrespectfully by healthcare providers in the past year. In Australia, where sex work is decriminalized in some states but still heavily stigmatized, the problem is just as real. Nurses have walked out of rooms. Doctors have refused to perform Pap smears. Clinics have asked sex workers to reschedule “because of the nature of your work.”

This isn’t about health. It’s about bias. And bias kills.

Why Stigma Is a Public Health Crisis

When people avoid care because they fear being judged, the consequences aren’t just personal-they ripple outward. Sex workers are more likely to delay testing for HIV, hepatitis, or chlamydia. They skip vaccinations. They don’t get regular cervical screenings. They avoid mental health support because therapy feels like another place they’ll be labeled “high-risk” instead of “in need of help.”

The World Health Organization says stigma is one of the top barriers to effective HIV prevention. And yet, most health systems still treat sex workers as a problem to manage-not people to serve. The result? Higher rates of preventable infections. Longer hospital stays. More deaths.

In Perth, where decriminalization has been in place since 1994, sex workers still report being turned away from public hospitals during emergencies. One woman, who asked to remain anonymous, went to the ER after a violent assault. The triage nurse asked if she was “working that night.” When she said yes, the nurse said, “We’ll call the police.” She left without treatment.

This isn’t healthcare. It’s punishment by proxy.

What Safe Healthcare Actually Looks Like

Safe healthcare for sex workers doesn’t require fancy equipment or expensive drugs. It requires three things: respect, training, and choice.

First, respect. That means not assuming your health needs are only sexual. A sex worker can have a broken wrist, diabetes, depression, or a migraine. Your job doesn’t define your body.

Second, training. Medical staff need to understand the realities of sex work-not from moral panic, but from evidence. They need to know that decriminalization improves health outcomes. That peer-led outreach works. That trauma-informed care isn’t a buzzword-it’s a necessity.

Third, choice. You should be able to choose who you see. Some sex workers prefer clinics that specialize in sex worker health. Others want to go to their local GP. Both should be options. No one should be funneled into a “sex worker clinic” like it’s a separate caste system.

In Melbourne, the Sex Workers Outreach Project runs a free clinic staffed by nurses who’ve worked with sex workers for over a decade. No forms asking for your “occupation.” No judgment. Just blood tests, condoms, PrEP, and a cup of tea. That’s what healthcare should be.

How to Find a Safe Provider

You don’t have to suffer in silence. Here’s how to find care that doesn’t make you feel like a criminal:

• Look for clinics affiliated with sex worker-led organizations. In Australia, groups like SWOP WA (Perth), SWOP NSW, and Scarlet Alliance have partnerships with doctors who understand your needs.
• Call ahead. Ask: “Do you have experience working with sex workers? Do you offer confidential STI testing without reporting?” If they hesitate, move on.
• Use peer networks. Many sex workers share lists of safe providers through encrypted apps or community groups. Ask someone you trust.
• Bring a friend. Having someone with you can reduce pressure and help you remember questions.
• Know your rights. In Western Australia, you have the right to refuse to disclose your occupation. No provider can legally force you to say what you do.

What to Say (and Not Say) at Your Appointment

You don’t owe anyone your life story. But if you want to get the care you need, here’s how to navigate the conversation:

• Start simple: “I’m here for a checkup. I’m concerned about [symptom].”
• If they ask about your job, you can say: “I’d prefer not to discuss my occupation. Can we focus on my health?”
• If they press: “I’m not comfortable answering that. I’m here for medical care, not a moral evaluation.”
• If they refuse care: “I’m filing a complaint with the health ombudsman. Is there another provider I can see today?”

You don’t need to justify your life to get treatment. Your body deserves care, no matter how you earn your income.

When the System Fails You

Sometimes, even after you’ve done everything right, the system still lets you down. You get turned away. You’re gaslit. You’re told your symptoms are “all in your head.”

Here’s what to do:

• Document everything. Write down the date, time, name of the provider, and what was said. Even if you’re upset, write it down. Later, you can file a formal complaint.
• Report to the Health and Disability Commissioner (in WA) or your state’s equivalent. They can investigate discrimination.
• Reach out to advocacy groups. Scarlet Alliance and SWOP WA can help you file complaints, connect you with legal aid, or even arrange a new appointment.
• Don’t blame yourself. This isn’t your fault. The system failed you-not you failing the system.

Change Is Possible-And It’s Already Happening

In 2023, the Royal Australian College of General Practitioners updated its guidelines to include mandatory training on stigma reduction for all registered GPs. That’s a big step. It doesn’t fix everything, but it’s a start.

In Sydney, a pilot program trained 80 doctors in trauma-informed care for sex workers. Within a year, clinic attendance among sex workers rose by 42%. STI detection rates went up-not because people were riskier, but because they felt safe enough to show up.

This isn’t about special treatment. It’s about equal treatment.

You Deserve Care

You are not your job. You are not a statistic. You are not a risk factor. You are a person with a body that needs care-just like everyone else.

The healthcare system should meet you where you are. Not where they think you should be.

If you’ve been turned away, you’re not alone. If you’re scared to go back, that’s understandable. But you don’t have to keep suffering in silence. There are people who will listen. There are clinics that will help. And there’s a growing movement that says: your health matters.

Your life isn’t a crime. Your body isn’t a violation. And your right to care? That’s not up for debate.