1 Sex workers who provide services to clients with disability in New South Wales, Australia by Rachel Wotton Thesis Submitted in Fulfillment of the Requirements for the Degree of Master of Philosophy (Medicine) By Research University of Sydney September 2016 2 Candidate’s Statement 3 Acknowledgments I would like to acknowledge a number of people who have given me their ongoing support, guidance and faith in my ability to deliver this final dissertation. My former supervisors, Dr. Russell Shuttleworth and Ms. Alison Arnot-Bradshaw. My ongoing supervisor Dr. Patricia Weerakoon who has supported me throughout this journey. Prof. Emeritus Trevor Parmenter who so graciously agreed to become my primary supervisor in my last year, going above and beyond to assist with the transfer to the Medical Faculty. Julie Cameron, at the Faculty of Health Sciences, who patiently jumped through all privacy and administrative hoops Survey Monkey created so that I could regain access to my raw data. John Paul Cenzato, for excelling in your role as librarian Amanda Reid who has been such a calming and supportive influence. Your guidance throughout the whole writing process with editing, suggestions and encouragement has been incalculable. Saul Isbister who, along with your amazing editing skills, has always believed in my ability to complete this. Your support and friendship is invaluable to me. Julie Bates, Liz Emrys and Kylie Maxwell for your encouragement, friendship and support. Natalie Hamam for giving me renewed inspiration. See you at the next graduation! Z.H. who has given me love and support throughout. I’d also like to thank all of my fantastic clients, who continue to choose to spend time with me. It certainly has contributed to my ability to self-fund my studies. Finally I would like to thank all of the sex workers who took time out of their busy lives to complete this survey. Without you this could never have been done. 4 Abstract SEX WORKERS WHO PROVIDE SERVICES TO CLIENTS WITH DISABILITY IN NEW SOUTH WALES, AUSTRALIA Aims: Sexuality and sexual needs/desires of people with disability have historically been overlooked amongst the general public. Long standing social attitudes and stereotypes have fundamentally dictated that people with disabilities cannot and should not express their sexual agency. In particular, when people with disability have sought to express their sexual needs via the services of a sex worker, this has tended to provoke much social and political ire. This research is an exploratory study about sex workers who provide services to clients with disability. The aim of this research is to identify the nature and extent of such activities to produce empirical data to support anecdotal evidence and recent emerging research in this field. Method: This exploratory online survey asked sex workers who worked in New South Wales (NSW) to share their experiences of providing services to clients with disability. This included the frequency, type and range of services provided, location of service delivery and how clients made contact. Questions were asked regarding third party assistance and the identification of any barriers or challenges faced by sex workers. The survey also encouraged sex workers to share personal reflections on what they thought were the most positive aspects of their work. 5 Results: The findings, from 65 respondents, indicate that sex workers in NSW have provided a wide range of sexual services to clients with disability across the state. The sex workers’ ages ranged from 21 to 61 years, identifying as either female, male or transgender. Services were provided in varied locations including brothels, massage parlours, private homes, hotels, nursing homes, the client’s hospital room or their client’s group home/ supported accommodation. Their clients’ disabilities were quite expansive, spanned both physical and cognitive disabilities and acquired and congenital disabilities. A number of issues and barriers were identified that concerned the client, carers, support staff and / or family and friends of the client. Forty seven sex workers shared their personal perspectives of what they considered the most positive aspects in providing services to clients with disability. Conclusions: The respondents’ narratives revealed their professional enthusiasm with interacting with clients with disability. This includes a desire to have further training and support to alleviate barriers and challenging situations that impede clear communication and supportive pathways between themselves and their clients. These results also contribute to an awareness of how decriminalisation can provide a supportive environment for this to occur. This study builds upon an expanding body of work that can be used to educate and influence the future development of training and awareness workshops for sex workers, disability services provider, clients with a disability, academics, policy makers and the general public. 6 Table of Contents Candidate’s Statement .........................................................................................................2 Acknowledgments................................................................................................................3 Abstract ................................................................................................................................4 Table of Contents .................................................................................................................6 List of Tables .......................................................................................................................9 List of Figures ....................................................................................................................10 Chapter 1. Introduction ......................................................................................................11 Chapter 2: Sexuality ...........................................................................................................20 Well known research scales for sexuality and sexual orientation ................................23 Sexuality within Australia............................................................................................28 Chapter 3: Sexuality and Disability ...................................................................................30 Definitions within Australia .........................................................................................33 Prevalence within Australia .........................................................................................37 Disability rights within Australia .................................................................................38 Sexual rights and disability ..........................................................................................40 Representation in film, TV and multi-media platforms ...............................................42 Disability and Ageing ..................................................................................................48 Chapter 4: Sex Work ..........................................................................................................53 Definitions and terminology ........................................................................................55 Workplace locations and advertising ...........................................................................56 Demographics ..............................................................................................................58 7 The modern Sex Workers’ Rights Movement .............................................................66 Legislation....................................................................................................................70 Chapter 5: Clients of sex workers ......................................................................................77 Clients in general .........................................................................................................77 Motivation ......................................................................................................................... 79 Prevalence ......................................................................................................................... 81 Demographics ................................................................................................................... 85 Locations where clients visit ............................................................................................. 86 Female clients ................................................................................................................... 88 Clients with disability ..................................................................................................89 Motivation ......................................................................................................................... 92 Female clients ................................................................................................................... 93 Media……………………………………………………….……………………94 Prevalence ......................................................................................................................... 97 Organisations and access to the sex industry .................................................................... 99 Other forms of assisted sexual services .......................................................................... 102 Guidelines and policies