Prostitution is pregnant with disease, a disease infecting not only the guilty but contaminating the innocent wife and child in the home with sickening certainty almost inconceivable; a disease to be feared as a leprous plague; a disease scattering misery broadcast, and leaving in its wake sterility, insanity, paralysis, and the blinded eyes of little babes, the twisted limbs of deformed children, degradation, physical rot and mental decay. – The Social Evil in Chicago (1911)
In ancient times disease was usually viewed as a punishment from the gods; bacteria are, after all, invisible to the naked eye, and until the development of the germ theory the advent of illnesses seemed mysterious and even supernatural. The idea that disease is caused by invisibly-small organisms or “seeds” actually dates to Roman times, but because it could not be proven that such organisms existed until after the invention of the microscope in the 17th century, the theory was never universally accepted even in the medical community, much less among the general public. And even after Pasteur and others had proven the existence of pathogens, the notion of illness as a punishment for sin never wholly disappeared; rather, it merely mutated into a different form thanks to the realization that cleanliness (which, as the aphorism informs us, is next to godliness) tended to greatly reduce the risk of sickness. Those who led “clean”, well-ordered, regimented and “godly” lives became ill much less often, and gossips might even explain an exception by whispering that the sufferer had deviated from “proper” behavior in some way. Since the popularization of the germ theory was contemporary with the “Social Purity” movement, the former neatly dovetailed with the latter in the minds of a large number of Britons and Americans and helped reinforce the push to outlaw “dirty” behaviors such as drinking, extramarital sex (especially with prostitutes) and even masturbation.
Even in ancient times prostitutes recognized that certain diseases were more common among their number than in others, but these illnesses of the Classical Era seem to have been viewed as more of a nuisance than anything else; gonorrhea was completely unknown in Europe before the 11th century, and though lesions consistent with some forms of syphilis have been identified in Roman remains, the absence of any clear description of it in the medical literature supports the theory that this was a milder strain to which most people were resistant. As gonorrhea seems to have come back from the Middle East with the Crusaders, so syphilis seems to have returned to Europe with Columbus; though the “great pox” was well-established among Pre-Columbian inhabitants of the Americas, the first recorded European outbreak occurred among French troops in 1495, and they seem to have contracted it from Spanish mercenaries. This cannot be taken as evidence of rampant homosexuality in the French Army, however, because this early form of the disease was highly contagious even through casual contact and was both more virulent and far more lethal; fortunately Europeans soon developed an immunity to this “proto-syphilis”, and by 1546 it had mutated into the venereal form known today.
By the mid-17th century European whores had largely figured out the visible signs of contagion, but unfortunately both syphilis and gonorrhea can sometimes be transmitted by asymptomatic individuals and so even though the rate of infection among better-informed prostitutes was lower than among other promiscuous individuals (such as members of the upper classes), it was still higher than among the less-promiscuous middle classes, giving rise to the bourgeois notion of prostitutes as carriers of disease. By the early 19th century all but the least fortunate streetwalkers were scrupulous about examining customers; in French brothels the madam herself generally performed the check before allowing a client access to any of her staff, and in English and American establishments the whores were quite as careful as modern girls, lacking only latex condoms as the final precaution. As one customer of a Storyville brothel (quoted in Whores in History) wrote, “She approached and seized my genital organ in such a way as to determine whether or not I had the gonorrhea. She did this particular operation with more knowledge and skill than she did anything else before or after.” But despite such published accounts and the research of medical doctors like William Acton (who despite his moral opposition to prostitution pointed out that whores were consistently healthier than other working-class women due to their precautions and relative affluence), the myth of the “diseased whore” grew and in 1864 the English Parliament passed the first of several Contagious Disease Acts, which were rationalized as measures to root out venereal disease in the armed forces but were actually nothing more than anti-prostitution laws.
The Act created a police “morals squad” which was empowered to define any woman in London as a “common prostitute”, at which point she was arrested and hauled in chains before a magistrate who could order her to undergo a medical examination; if she refused (due to such minor details as, say, not actually being a prostitute) she could be confined to a “Lock Hospital” (basically a prison with a medical staff), forcibly examined and detained for up to 90 days, during which time the staff attempted to scare her out of prostitution while “treating” her with mercury, a largely-ineffective “cure” which even many Victorian doctors opposed. Many were not sick when they arrived, but contracted other diseases (which of course were always interpreted as venereal) from the unsanitary conditions in which they were confined. If she survived the “cure”, an unmarried woman so imprisoned would generally emerge to find her children had been sent to workhouses and her possessions sold to pay her rent. As if all this wasn’t bad enough, a second Act in 1866 expanded the powers of police, forced prostitutes to register and condemned them to “health inspections” every two weeks; the third Act (in 1869) expanded the system to most of the country and inspired an NGO whose members “helped” the police by reporting any promiscuous or troublesome woman (or any one who offended them) as a “prostitute”, who was dragged away and registered no matter what she said in her own defense.
The Acts were so broad that they caught up huge numbers of unmarried working-class women in their dragnet, and so tyrannical that they even offended the sensibilities of many middle-class people. One of these, Josephine Butler, campaigned tirelessly against the Acts for 16 years, collecting a large following and eventually winning their repeal in 1886. Unfortunately, like so many “rescuers” Butler blamed prostitution itself (rather than society’s attempts to suppress it) for the misfortunes of whores, and after her victory turned her efforts to the abolition of the profession. Her activism, and more importantly that of the sexually-repressed middle-class Christian female “purity crusaders” she inspired, resulted in the wave of prohibitionist laws which inundated Europe and North America for the next three decades; by 1918 prostitution was illegal virtually everywhere in the Western world.
And though the tide of busybody regulation of individual sexual activity has largely receded in most of the civilized world, the United States remains submerged in it and some things are the same now as they were in the 19th century. Busybody moralists still profess that their efforts to infantilize whores, rob us of agency, hunt us down and destroy our livelihoods are “for our own good”; amateur women are still victimized by laws designed to “get” prostitutes, sex workers still face the prospect of our children being abducted and our goods pillaged by the State, crypto-moralists still believe that puritanical eating regimens and disinfection of everything are the keys to health, and the “dirty whore” stereotype is as popular as ever. Though the incidence of venereal disease is twice as high in the promiscuous segment of the general population as among streetwalkers and only 3 to 5% of venereal disease in the United States is related to prostitution (compared to 35% from adolescents), the myth doggedly persists that whores spread disease. When one further considers that some studies have shown STD rates up to 80x higher in streetwalkers than in other types of prostitutes, this means that the incidence of STDs in promiscuous non-prostitutes is up to 160x that in escorts, and that escorts and brothel workers together account for only about 0.4% of the sexually transmitted disease in the United States. Yet every legalization regime includes mandatory (and often invasive) “health checks”, while 95-97% of STDs are spread by the good, “clean” members of the general population who can legally screw anybody they like without even the most cursory or sporadic health checks and face neither stigma nor revocation of their professional credentials should they turn up infected.
What about sluts?
There should totally be a slut test ‘specially in bars.
I think the objections by all the men that would round up would get that idea nixed pretty quickly.
I think it is because hookers don’t get wrapped up in the heat of the moment like someone that is intoxicated by hormones. It is easier for us to say, “Are you kidding me?”
I think they should do more to educate young girls how to check… and what it is that they are looking for.
Especially with warts, it can be difficult to notice, or to know the difference between a normal skin tag, and a contagious wart. Condoms won’t completely prevent their transmission.
I had some older guy get so pissed at me that I canceled his session after seeing a huge, no question about it wart. He said it was there his whole life. I said “well then, you have had genital warts your whole life.”
Over a third of venereal disease is spread among young people who are more subject to being overcome by hormones, less resistant to “if you loved me you’d let me” pressure and (in the United States) much less likely to know beans about sex due to lack of sex education. How much of the 60% spread by noncommercial adult promiscuity is also spread under the influence of alcohol? Professionals know better and can’t be convinced to ignore obvious problems or go bareback by stupid lines.
Well of course it is. In the minds of these young people what they’re doing is not sex. I mean, don’t we all know that having oral activities isn’t really sex. I’m not sure what it is but I like it and try to have some as often as I can. I mean since it’s not really sex, there’s nothing to worry about, is there?
All people of course have a motivation to avoid STDs. Sex workers have even more of a motivation because of the obvious potential impact on their primary source of income. Naturally society wants to scapegoat those with the strongest incentive to avoid spreading contagions. Ggggrrrr…
I’m reminded of what happened when Semmelweis tried to convince doctors that washing their hand between patients might save women from dying of post-childbirth infections. The community responded with outrage, insisting famously that “a gentleman’s hands are always clean” and that women who died of infections were just weak. The need to tie disease to social or political status is powerful and really dates back to biblical times.
Regarding streetwalkers — I read at some point, I think on the Freakonomics blog, that when cops take bribes in custom from streetwalkers for not running them in, one of the things they most want is unprotected sex. If true, this is just another example of how criminalization makes the problem worse, not better.
Cops have a weird aversion to condoms, even more than most men; I wrote about it in my column of August 6th. I’m sure it has something to do with power and control, and their belief that ordinary citizens (especially women) are just animals to be used in any way the ruling class sees fit.
Very well said, Maggie. This is one more example of purblind (deliberately ignorant) lawmakers and hysterical Christians screaming from their high horse about how superior their morals are.
Let’s secede.
The problem with morals is their subjectivity and how quickly they can shift under the right circumstances
The real problem is that nearly everyone uses the word “morals” to mean “mores”, which aren’t at all the same thing. “Morals” are basically the same thing as ethics, and have nothing to do with sexual behavior except insofar as they apply to the way one treats people with whom one interacts sexually. Rules of sexual conduct change from place to place and year to year, therefore they are mores; religious fanatics apply the wrong label to imply that these customs are based in some universal code of ethics, which they aren’t.
I’m an extremely moral person, but my personal mores are not those of the majority of either Christians or Americans.
Hey, restaurants have to pass inspections, whereas some random fool who brings brownies to work may be cultivating Bubonic Plague in his kitchen for all the Authorities care. I’m not saying that the inspections are necessarily JUSTIFIED, just that whores aren’t exactly being singled out where they are concerned.
Restaurants have to pass inspections, yet people who work as individual cooks do not. I actually have nothing against licensed brothels or escort services requiring employees/contractors to produce health reports from their own doctors every so often (say, quarterly or monthly); what I have a problem with is heavy-handed and invasive examinations by government officials and Draconian “preventative measures” such as keeping girls imprisoned for weeks at a time so as to keep the “dirty whores” from contaminating “real people” while working.
Now I know for sure that you wouldn’t mind working under the regs I’d impose, if I could impose regs.
Chalk and cheese.
When there’s a nationwide epidemic of bubonic plague the CDC confirms is being predominantly spread by indiscriminate eating of homemade brownies in bars, nightclubs and schools and the government responds by shrieking all restaurants are dirty filthy scum which must be regularly inspected to stop the crisis, then you can tell us it’s nothing personal.
In my home state, food preparers get tests for food-borne illnesses from the local clinics at no charge once every year or two. I’m not sure about other states, however.
Americans are very ignorant about sexual health. I noticed a big difference in Canada where people are in general much more knowledgeable about sexual health and open about it. I guess it is the sex ed in schools.
Said it before. If the big concern is the spread of disease then SEX needs to be made illegal. You want a guarantee against STDs? Don’t have sex. With anybody. Money does not cause or spread STDs. The persecution of whores is not about public health and safety, we are just the scapegoat. I know many men and many amateurs who have had TO THIS DAY more sexual partners than I have in either my personal or professional life.
I remember reading a fairly interesting book on the subject of prostitution and disease control in nineteenth-century Britain. It was called City of Dreadful Delight.
[…] livelihood depends on your pussy, you will ensure that it stays in tip-top, pristine condition. The Honest Courtesan has pointed this out more than once. Prostitutes, even the street girls, know they're a high risk […]
I think a lot of talk about protecting women comes from an inherent hatred of heterosexuality in some camps, a dislike of sex in others (and a severely judgmental view of what constitutes “acceptable sex”) and a wish to exert severe social control.
This last – severe social control – is an instinct hard-wired into the paternalistic social utopianism of the cultural-marxist left.
Arguments are all served by crass identity politics.
In all cases, this kind of paternalism does nothing but isolate and separate women.
they are usually at the bars.
You mention several studies here and in other posts on your blog – do you have any links to similar epidemiological/public health studies done in the US and in the last 10 years? I’ve been looking at the British journal titled Sexually Transmitted Infections but striking out.
Thank you for this blog. I used to work in the Tenderloin district of San Francisco with women who had gotten out of street prostitution or were trying to leave the business. You have really opened my eyes to the other side of sex work. I am particularly fascinated by the health issue, since the connection between disease and prostitution was a basic assumption at my former workplace. In fairness, our clients had experienced the stuff of nightmares – long term IV drug use, unprotected sex, frequent rape – but I realize now that they were just one segment of the overall sex worker population. And while I’ve always personally believed one is more likely to get an STI in a frat house than a cat house, I’d love to have a scientist to back me up!
I’m a public health researcher who doesn’t specialize in sex work or sexually-transmitted infections, but has some familiarity with the field. I’m not aware of any studies comparing STI prevalence between sex workers and women in the general population with multiple sexual partners. Most current research in this area is conducted in less-developed countries, where the problem is truly frightening (especially for the sex workers), but at bottom are references and abstracts for two San Francisco studies. The first includes incall and outcall workers and escorts, so it’s is freely accessible via http://www.pubmed.gov; the other may be available for download through a local library.
Presumably sex workers who don’t abuse drugs or alcohol, work in secure locations, are consistently protected from forced sex, and are empowered to enforce universal condom use, would be at relatively low risk for STIs. The challenge for the sex worker is finding and maintaining such a situation early in her career. For the client, of course, it’s locating and correctly identifying such a sex worker.
Sex Transm Infect. 2006 October; 82(5): 418–422.
Sex worker health: San Francisco style
D Cohan, A Lutnick, P Davidson, C Cloniger, A Herlyn, J Breyer, C Cobaugh, D Wilson, and J Klausner
OBJECTIVES:
To describe the characteristics of sex workers accessing care at a peer based clinic in San Francisco and to evaluate predictors of sexually transmitted infections (STI).
METHODS:
We conducted an observational study of sex workers at St James Infirmary. Individuals underwent an initial questionnaire, and we offered screening for STI at each clinic visit. We performed univariate, bivariate, and multivariable analyses to assess for predictors of STI in this population.
RESULTS:
We saw 783 sex workers identifying as female (53.6%), male (23.9%), male to female transgender (16.1%), and other (6.5%). 70% had never disclosed their sex work to a medical provider. Participants represented a wide range of ethnicities, educational backgrounds, and types of sex work. The most common substance used was tobacco (45.8%). Nearly 40% reported current illicit drug use. Over half reported domestic violence, and 36.0% reported sex work related violence. Those screened had gonorrhoea (12.4%), chlamydia (6.8%), syphilis (1.8%), or herpes simplex virus 2 (34.3%). Predictors of STI included African-American race (odds ratio (OR) 3.3), male gender (OR 1.9), and sex work related violence (OR 1.9). In contrast, participants who had only ever engaged in collective sex work were less likely to have an STI (OR 0.4).
CONCLUSIONS:
The majority of sex workers have never discussed their work with a medical provider. Domestic violence is extremely prevalent as is work related violence. Working with other sex workers appears to be protective of STIs. STI prevention interventions should target African-American and male sex workers. Addressing violence in the workplace and encouraging sex workers to work collectively may be effective prevention strategies.
AIDS Behav. 2004 Dec;8(4):475-83.
Social factors related to risk for violence and sexually transmitted infections/HIV among Asian massage parlor workers in San Francisco.
Nemoto T, Iwamoto M, Wong S, Le MN, Operario D.
Asian women who work at massage parlors in San Francisco have high levels of risk for sexually transmitted infections (STIs), including HIV, and being victims of violence, which jeopardizes their health and wellbeing. On the basis of mapping, the targeted districts in San Francisco where massage parlors were located, 23 massage parlors were identified where commercial sex activity took place. Using snowball-sampling methods, 43 Asian female massage parlor workers were recruited for focus groups; 21 participants were Vietnamese and 22 were Thai. Qualitative analyses revealed frequent exposure to violence including verbal or physical abuse from customers and gang members, as well as persistent HIV risk behaviors associated with multiple daily sex partners, inconsistent condom use with customers, and forced sex. Social factors related to gender, immigration status, and socioeconomic status appeared to be closely tied to the health and wellbeing of Asian masseuses. Study findings suggest that individualized as well as community-level interventions are necessary to improve these women’s health and decrease their prolonged exposure to risks for STIs and violence.
I meant to say that the inclusion of incall and outcall workers indicates that the study wasn’t limited to obviously high-risk populations like street workers. It has nothing to do with why the article is available via pubmed!
[…] The Daily Mail’s coverage also included the false claim that sex workers spread disease. […]
[…] In fact, in countries where prostitution is legal or quais-legal, non-street walkers often have lower STI rates than the general […]
[…] http://maggiemcneill.wordpress.com/2011/06/24/dirty-whores/ […]
[…] http://maggiemcneill.wordpress.com/2011/06/24/dirty-whores/ […]
[…] The Daily Mail’s coverage also included the false claim that sex workers spread disease. […]
[…] — Ignoring the fact that sex workers have fewer STDs than amateurs (in reality, “only about 3-5% of all STIs can be attributed to either side of a sex work transaction, and …) […]