Making stories matter

You know how sometimes you read something and it makes the hairs on the back of your neck stand up?

Narratives about identity and experiences are certainly powerful, necessary, therapeutic, and transformative. Yet I’m struck by their limitations. Knowing about someone’s lived experience of mental illness is important but it is a starting place, not the final outcome of advocacy and health promotion efforts. Discrimination still persists within mental health organisations and services who I’m sure have heard all the stories. Key to making stories matter is translating the stories into practices, actions and change at all levels from the individual, community and systems level. The inadequacy or unsustainability of interventions will not shift from stories alone. We must make stories matter.  (emphasis shifted)

Selfies, narcissism and stigma, Natalie Hendry, 21 Oct 2014.

Are sex researchers afraid to get our hands dirty? Sex-positivity and the policy and media discourses.

The left, [George Lakoff] argues, is losing the political argument – every year, it cedes more ground to the right, under the mistaken impression that this will bring everything closer to the centre. In fact, there is no centre: the more progressives capitulate, the more boldly the conservatives express their vision, and the further to the right the mainstream moves. The reason is that conservatives speak from an authentic moral position, and appeal to voters’ values. Liberals try to argue against them using evidence; they are embarrassed by emotionality. (Zoe Williams, The Guardian, 1 Feb 2014)

WILL MCAVOY: If liberals are so smart, why do you lose so goddamn always?  (The Newsroom.)

When I began for the Victorian AIDS Council ten years ago, I got a really thorough apprenticeship in community-based HIV work from my colleagues, Guy Hussey, Tex McKenzie and Asvin Phorugngam.  It was grounded in three main principles:

  • Sex-positivity
  • Adult learning principles
  • Close personal understanding of the gay community

There have been big shifts in how HIV prevention is understood within the sector and the public health system.  Australia’s first national HIV strategy talked extensively about education, but by the third release of the strategy, it was talking about health promotion reflecting the slow diffusion of the impact of the Ottawa Charter for Health Promotion (WHO, 1986).  In 2004, I was a project worker in a position called Health Educator in a team called Health Promotion.

There have been further changes, such as a further shift in the self-concept of prevention work from health promotion to public health. At the recent AFAO Gay Men’s HIV Education conference in Sydney, I met gay men who’d done Masters in Public Health degrees before coming to work in gay men’s health, and many of them were excited about some pretty mundane ‘technological innovations’.  (Popup ads on Grindr — high tech shit.) My concern is that, along the way, many of the good things about adult education have been lost from our collective understanding of how HIV prevention works.

In the same time period, Australian society has become markedly less progressive, particularly around sex.  No, not sexuality, if you understand that as a reference to sexual orientation rather than ways-of-being-sexual.  As gay identity has become more and more acceptable, there has been an increasing level of comfort talking about what kind of sex gay men shouldn’t be having, and dis-comfort around what kinds of sex gay men are actually having.  For example, there has been extensive mainstream news coverage ‘othering’ barebacking — unprotected anal sex — as something the ‘bad gays’ do and the ‘good gays’ (the ones who get married) apparently don’t.

Similarly, there have been media panics around the increasing uptake of heterosexual anal sex and decreasing age of first sex and increased access to porn via the Internet and apps and increased use of online and mobile dating services and sex work and surrogacy as human trafficking.  *deep breath*

One bright spot has been the emergence of feminism as a viable alternative body of thought for social criticism to fill the void left by Marxism.  I’m not wild about the literalism of ‘feminism=for women’ that informs splitting Daily Life from the Fairfax online properties, particularly since those properties have become increasingly un-feminist in their coverage.  But it has had an undeniable influence on public debate around the deaths of Jill Meagher and Traci Connelly and the need for wide-scale feminist law reform.

There have also been feminist positions taken against sex work, against pornography, against casual hookups, against stripping, against pole-dancing, against, well, sex itself.  They have gone hand in hand with social conservative and Christian positions dating back to the Howard government that went more or less unchallenged under Rudd and Gillard.

All of this makes sex-positivity an increasingly challenging position to take.

During the week, the Burnet Institute did a press release that got a heap of coverage.  It was for two conference presentations.  It summarised multiple years of surveys at the Big Day Out.  Across the different time points, the average age of first sex got younger.  The researchers speculate this is attributable to increased exposure to pornography:

One potential explanation for a historical decrease in AFS is the increasing role of the media in creating a ‘sexualised’ culture, and its use as a sexual education and empowerment tool for young people. Young people surveyed at the Big Day Out in 2012 stated that they were equally comfortable sourcing sexual health information from both a website and a doctor. Sexualised content such as pornography has become normalised in today’s society, and provides a private and easily accessible way for young people to learn about sex and sexual norms. Furthermore, in a study by Brown et al., early exposure to sexualised content predicted oral sex and sexual intercourse (Vella et al, 2014, citations omitted).

There are so many things wrong with this.

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At this point I want to take a detour for a moment and talk about research practice and policy discourse.

Previously I’ve written here about how public health as a practical discipline tends only to be informed by a couple of social scientific disciplines: epidemiology and psychology.  Social public health refers to a form of public health practice informed by a broader palette of knowledge practices, including sociology, anthropology, cultural studies, etc (Kippax & Race, 2003).

From pretty early on in the HIV response in Australia, prevention was informed by a multi-disciplinary social public health approach.

More recently though, I was at a conference in social research and saw postgrad students doing things like lumping together all Asians into one category because there were too few of them to analyse statistically in separate groups based on country of origin.  Sure, you can get results from that, but what would you do with them?  Make a campaign poster in Chinese Restaurant Menu font to signal ‘hey, Asians, we’re talking to you’?

At that research conference I really appreciated when a senior colleague, a sociologist, fired up and pointed out the problems in that classification.  It scared the living hell out of the postgrad student, but I wondered why nobody had pointed this issue out to them.  The answer was, probably, there’s a growing divide in many research centres between quant people and qual people, positivist and critical theory perspectives.  Projects in which these disciplines actually converse, rather than work side-by-side, are getting rarer than before.

As well, what the quant people recognise and the qual people often don’t is that low quality research can nonetheless (a) get published, obviously and (b) exert considerable policy influence just because it’s simple.  When it gets passed up through the hierarchy at a health department for sign-off, it all gets reduced down to a single page memo, so insisting on nuance/complexity can be a liability.

If a senior policy officer were writing up the findings of that postgrad student’s research, they might not even put “Asian” into that memo.  It might come out saying “cultural diversity”, because in policy language specific detail is dangerous.  The more specific it is, the smaller the group affected, the more it looks like special treatment, the harder it is to fund.

Policy is another discourse that has infected strategy-writing in Australia’s BBV responses.  In my contribution to a working group writing Australia’s testing strategy for hep B, a condition that overwhelmingly affects migrants from countries where infant vaccination isn’t universal, I had a massive fight on my hands to get specific detail about cultural safety, use of interpreters, and relevant cultural understandings into the final document.

The problem is partly about policy people hating specific details and partly about educated middle-class white people feeling uncomfortable with the symbolic violence inherent in producing knowledge about non-white people…. as if that discomfort ethically outweighs the imperative to prevent non-white people dying from hepatitis B related liver cancer.

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I think that squeamishness is similar to what George Lakoff is describing in the quote that opens this post, and a similar kind of squeamishness is holding smart, progressive, sex-positive people back from adding their voices in a robust manner to media discourse about sex.

During the week, I received an e-mail asking if I knew anyone who wanted to comment on the ‘early first sex’ paper, for a short news article exploring whether the same applies to same sex attracted young people.  I replied saying no thanks, but hey, maybe someone could mention ‘sensation seeking‘ as a personality trait that predicts both porn use and early first sex.

I got an e-mail back from a senior colleague, someone I trust and respect, saying ‘you should be very cautious because the concept of sensation seeking is subject to contestation’.

There is nobody I would trust more to give me a run-down on how a particular concept or theory was problematic for academic use.  But I want to spell out here why I think that concern for fidelity to the complexity and history of social scientific debates sometimes backfires when it comes to media engagement.

In a short news article, the genre conventions rule. You’ve got one sentence to meet the journo’s brief — in this case, yes/no, does the finding apply to same sex attracted kids?

And, if you phrase it really well, you can get another sentence or two, towards the end of the article, to, as they say in politics, ‘put a context around’ the initial findings.  It could go something like this:

There are personality traits that make some people more likely to attend a music festival, take drugs, use porn and have earlier sex than the rest of their cohort.  The initial findings are interesting but we would like to see the research explore those possible confounding factors.

As someone originally trained in cultural studies, one of the more challenging things for me about the social psychological literature on HIV prevention is what we could call its naturalistic epistemology – the idea that phenomena like porn exist in an external, objectively measurable reality, as things with causal influences in their own right.

Like any cultural product, the effect of porn is necessarily mediated by what we call active reception by the audience.  The mimetic or ‘monkey see monkey do’ theory of media effects has been thoroughly discredited, but how many epidemiologists — like the crew at Burnet — are reading books and papers in media and communication studies?

Even journalists — who probably do have some exposure to this research — would face an impossible task trying to render these complexities in a 600 word news piece.

So to combat sex-negative crap like ‘porn is making teens have sex earlier’, psychological concepts with their technical-sounding names and plain English definitions and above all, their naturalistic epistemology that matches that of journalism, are often the best resource to draw on.

When Dr Megan Lim from the Burnet Institute was interviewed on Radio National, she said:

“People who watched pornography more often were more likely to have sex without condoms, more likely to engage in behaviours like anal intercourse, and also to have sex at a younger age. But, I guess, from this study, we definitely can’t conclude that pornography is a causal factor, just that the two behaviours are correlated.”

The interviewer James Carlton went straight to the point:  “And if it’s not a causal factor, what might be the factors behind its correlation?”  In response Dr Lim made the point where sensation seeking is relevant:

“Yeah, well, I think probably just the fact that people who are more sexually aware, sexually developed, more interested in sex are those that are more likely to watch pornography and also the ones who are more likely to engage in sexual behaviours.”

Sensation seeking is a useful concept there because it makes the story about diversity among individuals, whereas a conservative Christian school board member listening to that interview could have easily concluded that comprehensive sex education is what leads to young people being “more sexually aware, sexually developed, more interested in sex”.

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Simplistic, sensationalist, sex-negative ‘findings’ get extensive media coverage and three years later somebody writes a smart, sensible book or discourse analysis in academic language in a peer reviewed publication and nobody in the news media, the policy or mainstream communities ever gets to hear about it.

Sex-negativity wins in a default because the sex-positive advocates are too afraid to show up.  Or worse, we get represented by counsellors who do most of their work with people having problems and that becomes the narrative. Rather than sensation seeking — a curious, exploratory, energetic drive — we get stories about sexual compulsivity and porn addiction.

I wrote the paragraph above on Friday, and on Saturday I found this article about porn addiction by Julia Medew (of course) in The Age (of course).  Some experts estimate… some doctors believe… a growing number of sexologists have reported…  This is a Fox News version of health reporting.  All the ingredients you need to write that story are there:

  • A factoid: one in ten people who use porn becomes addicted, apparently.
  • Some human colour: “Like most men, Hugh Martin’s first encounter with porn was accidental.”
  • An expert opinion: “A leading sex therapist” says “I believe the brain is plastic”.

For all we know, Medew shopped around any number of academics looking for a quote to fit her hackneyed angle, and all of them, perhaps wisely, refused to provide one, or gave one that didn’t fit the narrative and so didn’t get a mention.

For academics, engaging with the media around sex and sexuality must be incredibly frustrating.  There is no shortage of really shitty reporting about sex.  The challenge calls to mind a distinction made by de Certeau: elites have strategy, the rest of us have only tactics.  There is no ‘media strategy’ that will, once and for all, ‘address the problem’ of sex-negative media coverage.  That’s wishful thinking.

Instead, it’s like one big game of whack-a-mole, slapping down crappy articles with whatever works in the moment.  Thank goodness there’s nothing really serious at stake — just the future of comprehensive sex education in schools and policy support for frank, sexy HIV prevention campaigns.  It’s a game we need to get good at, and that will only happen when we get out on the field.

Are you a sexual racist? Article from 2003.

An article in the Daily LifeI only date hot white girls” prompted me to dig out this post from way back.  I wrote this back in 2003 as a volunteer for the Victorian AIDS Council for its regular column “ComMENts” in the gay paper MCV.  The following year I went to work for the AIDS Council in an HIV prevention role.  I recently celebrated my tenth year in HIV work, but it was actually a concern for sexual racism that led me into gay men’s health promotion.  This is one of a series of pieces I refer to in a recent post on Croakey, co-authored with Suzanne Nguyen, about defining everyday racism.


Sexual Racism. Is it a real problem or just activism’s latest buzzword? Are you a sexual racist?

Sexual racism is hard to see at first, because it looks just like personal sexual preference, and we’ve been fighting for freedom there for decades. So when someone says ‘I’m just not attracted to Asians’, is that privileged speech that is immune to criticism? Maybe not.

The rumblings started online with the ‘Sexual Racism Sux’ (SRS) campaign launched last year [2002] by three Sydney activists, targeting chatrooms and personals and the exclusionary language you can find there. ‘No GAMs’, or ‘No GAMs, Fats or Femmes.’ Online it’s easy to say stuff you’d never dare say in ‘real life,’ but the effect it has is real.

The SRS Campaign doesn’t argue that guys who ‘prefer’ only GWM’s are racist. Instead it criticises exclusionary expressions of sexual preference: ‘We’re not saying you’re supposed to change your preference,’ says Peretta Anggerek, ‘We’re just asking for people to be decent.’ That sounds fair enough, when ‘I prefer Caucasians’ will do the trick.

Already a ‘Freedom 4 Gays’ counter site has been set up to attack the SRS-ers as ‘sexual nazis’, ridiculing the idea that net users should say what they’re looking for instead of who they refuse to consider. ‘Freedom 4 Gays’ writes, anonymously, that he’d have to list every single nationality except the Asian ones. But if he’ll consider anyone but an Asian person, it’s not hard to call him a sexual racist.

The real question is difficult: is the problem the expression or the exclusive preference itself? The exclusive preference has all sorts of nasty power effects. It isolates non-white people as the objects of a racial fetish. It creates small racial ghettoes where the scarcity of the few white guys who’ll date non-white guys inflates their market value, and the dating power that goes with it. It reduces the pool of potential friends and playmates: if you’ve ever felt the scene was too small, this is one reason why.

Expression matters, too. Culture is the collective sum of our attitudes and interactions, so tact and positive expression make for a kinder culture. We live everyday with the alternative: men insisting on their rights, especially their right to denigrate others, and it has a real effect on community health. Depressed individuals are more likely to engage in risk-taking and self-harming behaviours, like unsafe sex.

In a broader sense it creates a divided and stratified community obsessed with policing the borders of each little social niche. Sexual racism re-marginalises people who have already been marginalised by their ethnic communities because of their sexuality. It’s pure hypocrisy to call for acceptance and understanding of sexual difference, then to deny the same to people of different cultures.

Many guys do already advertise their preference in positive terms, saying ‘I prefer’ instead of ‘not into.’ Racially exclusive sexual preference may be something that only diminishes over time, in a generation or two. The first step, a step we can take now, is to recognise the exclusive attitudes that deter and discourage baby queers from considering anyone except white guys as attractive and as full sexual citizens. In the meantime, you don’t need to want to fuck someone to treat them with respect.

Cultural and environmental factors are difficult to change, but cultures change when enough individuals do. The bitchiness, emptiness and hell, the boringness of the scene – and we’ve all felt it – have a lot to do with the people it excludes, and our fear that one day we’ll be excluded, too. (Anyone here afraid of ageing?)

The SRS campaign doesn’t ask people to take personal responsibility for the racism of our whole culture – only for the part their expressions of sexual preference can play in it. Even if you disagree with the concept, giving thought to it is a good start.


Author note: Since writing this my position has actually shifted; I’m now a lot more inclined to argue that we should take personal responsibility for the racism of ‘our’ (by which at the time I meant ‘white Australian’) whole culture.  As I’ve moved from activism into health promotion practice and now social research, I’ve become a lot more interested in arguing that the system of preferences itself is racist, not just the way those preferences are expressed.  Also, this was clearly written before I worked in HIV prevention — people who live with depression are sometimes more likely to take risks and other times less likely; it’s not the slam-dunk predictor of HIV infection that my statement here suggests it is.

What do you think?  I welcome constructive responses in the comments section below.  You can also reply to me directly at twitter.com/onekind.

Sunday Snippets

I’m up at the orsm Jonas family’s farm with an incredible bunch of likeminded foodie lefty people.

I’m up here with the fabulous Linda Kirkman — researcher of friends with benefits relationships among rural heterosexuals over 50, and earlier in her life, Australia’s first surrogate mother.

Here she is in yesterday’s Good Weekend:

Here’s a video interview I did at the AIDS2014 conference with Rex Pilgrim from ACT UP Queensland.  We talk about the three main responses to the media panic about deliberate HIV infection — the criminal law, public health management, and a supportive community response.

Lastly, I got to co-author an article with the incredibly talented Suzanne Nguyen — artist, designer, story collector and provoker of thoughtful conversations about the modern reality of race in Australia.  For Croakey, the Crikey health blog.

Click to visit:  Defining and responding to everyday racism

Word choice matters: ‘prostitution’ and ‘sex work’ in The Hoopla

Introduction

The Hoopla is an online news and commentary magazine for an audience of politically engaged and ‘predominantly older’ women (Bodey, 2013).  Recently it has published a couple of pieces on sex work that troubled me and I challenged its editor, political journalist and comedian Wendy Harmer, to reconsider its implicit stance against sex work as a profession.  ‘That’s bullshit, Daniel’, she wrote in reply, ‘the Hoopla canvasses all opinions, do a cursory search, you’ll find them.’

The site is notable in the Australian publishing sector for paying its writers, and it has the best paywall in the business — really low friction and a reasonably priced day pass at 99c per day.  The Age and Black Inc, if you’re reading this, nota bene!  So I took Wendy up on her invitation and used the search tool to undertake a quick and dirty content analysis of its articles.

Content analysis is a methodology “by which the researcher seeks to determine the manifest content of written, spoken or published communications by systematic, objective and quantitative analysis” (Zito 1975, p73).  It assumes that patterns in the subject matter reflect the attitudes of the people who create it (Berger, 1998, p23).

These days, the language around “systematic, objective and quantitative” sounds a bit quaint — most researchers are more likely to acknowledge that we bring perspectives and commitments of our own to the analysis, and that textual material is capable of being read in multiple ways, although these readings are themselves patterned by power relations and ideology.

As a writer and researcher around stigma and sexual health I have a particular concern for the way stigma operates to normalise discrimination and inequity in legislation regarding members of marginalised groups (Parker & Aggleton, 2003).

The Lancet shares that concern: in a special edition launched at the AIDS2014 conference in Melbourne, it published a series of studies supporting full decriminalisation of sex work as the best approach to promote the health and wellbeing of both sex workers and their clients.

As then-Prof (now Justice) Marcia Neave found in her inquiry into Victorian laws against sex work in the 1990s, criminalising sex work makes sex workers vulnerable to violence and extortion by both clients and police.

The same dynamic is found in laws criminalising sex between men: if consensual sex is illegal, and you are beaten up or blackmailed in connection with it, you can’t seek help from the police without making an admission of criminal wrongdoing.

In places where the law prohibits purchasing sexual services, as it does in many American states and Nordic countries, it creates an incentive for clients to drive with sex workers to places where police are few and far — an unsafe environment for workers if the client turns violent.

Laws that prohibit making any kind of a profit from another person selling sexual services also tend to apply to managers, cleaners and security staff.  The presence of ‘pimps’ and protection rackets is more likely when it is not possible to treat sex work as a legitimate business with all the administrative, security and occupational health and safety overhead support.

Finally, criminalising sex work creates a bigger ‘haystack’ in which to find the needle of people being trafficked.  This is one reason why Denmark, which decriminalised sex work in 1999, apparently finds four times as many trafficked people than Sweden, which has a much larger population and criminalises the purchase of sex.

I got that last factoid from an article by Gabrielle Jackson in The Hoopla (2/9/14) titled “The real cost of selling sex”, but I used my training in epidemiology to flip it around: more reported cases doesn’t mean Denmark has a worse trafficking problem; it could actually mean they’re better at finding trafficking cases.  (For the same reason, you can’t look at an increase in HIV diagnoses and ‘read off from the numbers’ what it means for rates of new infections.)

In her book Sex and the Margins (2007) Laura Agustin points out the many reasons why it’s tricky to nail down hard facts about so-called ‘trafficking’.  So hard, in fact, that the main index on trafficking actually measures worldwide media reports on the issue, rather than any primary data source on persons found to have been trafficked.  In due course, Jackson’s article and the many, many others like it — articles reporting on other articles — will be taken as proof that trafficking is on the increase.

Methods

Every time a journalist and her editor write about sex work on The Hoopla, they make word choices that reveal underlying attitudes and value judgments towards that topic.

I’m using a tactic I developed in my work around ‘sexual racism’ in the gay community, where many people argued that saying “No Asians” in their profile simply reflected a diversity of opinion their preferences for a particular body type.

Since it costs literally nothing to choose a more neutral phrase (“Prefer white men”) over the other (“No Asians”), I conclude they must have intended the negative judgment implicit in the latter, even if they don’t admit it to themselves.

I use market theory a lot in my work on sexual racism and in technical terms this is the linguistic equivalent of “revealed preferences” in the economic analysis of purchasing behaviour.  Yep, word choices are purchases: they buy different amounts of grief from different audiences with different material and symbolic interests in the subject.

In the analysis that follows I’m looking at patterns in the word choices made by The Hoopla in its coverage of sex work.  Given that it has multiple writers, I want to know what its average way of describing sex work is, as well as the range of different stances it takes on sex work, as signalled by those word choices.

I do this by counting the word choices: sex work or worker vs. prostitute (noun or verb) or prostitution, taking care to differentiate between authors using a term themselves vs. quoting an interviewee or secondary text using the term.  I created a spreadsheet where you can view how I coded the articles and the key quotes from each one.  I used the search tool available on TheHoopla.com.au with a 99c day pass and I coded every article it returned.

In particular, from a semantic perspective I’m interested in what differences do their writers observe between sex work and other practices like trafficking, child abuse, and rape? — given that many anti-sex work advocates like Kajsa Ekis Ekman argue there is an essential continuity between paid sex work and human trafficking since, in their view, humans are ‘bought and sold’ in both.  This analysis is inherently more open ended than the quantitative analysis of word choices; reasonable people could disagree on the interpretation so I spell it out here and I welcome constructive responses in the comments below.

Findings

Word choices

I found 45 articles making a word choice between ‘sex work’ or ‘prostitution’.

  • In three articles (7%) the author used ‘sex work’ or ‘sex worker’ exclusively.
  • In one article (2%) the author quoted someone using ‘sex work’ or ‘sex worker’ exclusively.
  • In nine articles (20%) the author used both ‘sex work/er’ and ‘prostitute’ or ‘prostitution’.
  • In six articles (13%) the author quoted someone using ‘prostitute’ or ‘prostitution’ exclusively.
  • In 26 articles (58%) the author used ‘prostitute’ or ‘prostitution’ exclusively.

Takehome: these numbers do not support Wendy Harmer’s view that The Hoopla canvasses diverse opinions on sex work.  By an overwhelming majority, the articles on The Hoopla represent sex work as prostitution.  This is discussed further below.

Two articles either by or featuring Gabrielle Jackson went full flush: the author used and quoted people using both forms.

Themes and differences

1) Dead prostitutes as entertainment for The Hoopla‘s readership

In my tweet about ‘rough cut results’ last night I drastically undercounted the number of times the site mentions ‘prostitutes’.  I thought there was something hinky about the search function; it was returning a whole bunch of book reviews in error.

Turns out… not an error.  Eleven results for ‘prostitute’ were for synopses of novels reviewed by Meredith Jaffe, who might just need PTSD counselling by now.  Have a read and see if you can spot the theme.

“In the Newgate prison, four young women are allied by their need for friendship and protection in a world where life is fragile and, if no one is there to watch you back, it’s short as well. Loud, brave prostitute Friday Woolfe is their protector.”
“Bestselling, award-winning mother/daughter writing team P.J. and Traci Lambrecht aka P.J. Tracy are back with another nail-biting thriller, Two Evils. A group of young Native American girls are abducted from their reservation, fresh fodder for under-aged prostitution.”
“A suburban madam is found dead in her car supposedly having committed suicide and a few suburbs away, Heloise Lewis has more than a passing interest in the woman’s death. Heloise is very careful about blending in. As far as her neighbours are concerned, Heloise is just another suburban mum, a young widow who works as a lobbyist for pay equity for women. No one knows that Heloise is also a suburban madam, she’s just a lot more careful about how she runs her business than the dead prostitute.”
“In the late 18th century in the south of India, a daughter Maya is born into a family of devadasi, the temple dancers who are married to Shiva and thus regarded as a higher caste even as the priests and brokers prostitute them to wealthy patrons.”
“Because she is the daughter of the town prostitute, she does not seem to be an especially valued resident, and many of the locals are dismissive of what has happened.”
“Into their circle enters a stranger, the Scottish lawyer Walter Moody, himself travelling under a false name and escaping a past that has transpired to follow him. At question is a murder, a prostitute found half dead on the road to Arahura, a missing trunk, a stolen identity and the whereabouts of one Emery Staines, a wealthy gold digger cum business man.”
“At question is a murder, a prostitute found half dead on the road to Arahura, a missing trunk, a stolen identity and the whereabouts of one Emery Staines, a wealthy gold digger cum business man.” / “On the Gulf Coast of Texas after the American Civil War, a prostitute called Lucinda steals out of the bordello in which she has been a virtual prisoner, and sets course for Middle Bayou.”
“Some weeks after Angie’s death, a girl was found dead in Kings Cross, killed in the same manner. Kelly was a homeless teenage prostitute, a heroin addict and there was nothing to link the two murders except the killer’s use of a scarf tied in a distinctive manner. But Erin knows the murders are connected and she is determined to find out which member of Jane’s family holds the secret.”
“Jade’s mother is a drug addicted prostitute and when she dies of an overdose, it is Banjo’s family that takes the wild teenage orphan in.”
“The wealthy and powerful Cavanagh family has put a price on Mak’s head. She asked too many questions about the dead Thai girl found in a dumpster and the Cavanagh heir Damien’s involvement in the illegal, under aged prostitute’s death. “
“But when prostitute Jane Delaney turns up in the morgue murdered and detectives Butch Bonnie and Rick Landry identify her as Lucy Bennett, Amanda and Evelyn decide to risk their almost non-existent careers and investigate the crime.”

Prostitute. Dead prostitute. Half dead prostitute. Underaged prostitute. Prostitute on the run. Missing daughter of town prostitute. Homeless teenage heroin addicted dead prostitute.

Seems The Hoopla are plenty happy to recommend as light entertainment a book in which a dead prostitute is a plot device.

More seriously, all of these hackneyed plots reinforce a single Judeo-Christian moral: the wages of sin is death.

2) Blurred lines

Articles in The Hoopla repeatedly fail to distinguish between sex work — sex between consenting adults for money — and rape of children or adults.  There’s something particularly obscene in referring to ‘underaged sex work’.  That’s child rape.  Likewise, ‘forced sex work’ is multiple rape.  Examples include:

“They talk candidly – *intimately* – to camera about their issues of the moment: getting married, having a baby, graduating from school, being forced into prostitution, living with violent oppression.” and “In Cambodia, child prostitution, in the projects of New York, drugs and gang violence, in Sydney, the lure of suicide.” (The Hoopla, 30 Aug 13, “I am a girl. I need to be seen.”).

“Bestselling, award-winning mother/daughter writing team P.J. and Traci Lambrecht aka P.J. Tracy are back with another nail-biting thriller, Two Evils. A group of young Native American girls are abducted from their reservation, fresh fodder for under-aged prostitution.” (Meredith Jaffe, 1 Feb 13, “January’s top 5 Aussie books”).

“In the late 18th century in the south of India, a daughter Maya is born into a family of devadasi, the temple dancers who are married to Shiva and thus regarded as a higher caste even as the priests and brokers prostitute them to wealthy patrons.” (Meredith Jaffe, 28 Jun 13, “The silent book club”).

‘Just like the Australian man who married a woman from Iraq and brought her back with the promise a “new life”. “When she came to Australia she was locked up in a hotel room and the husband then started bringing his friends and acquaintances and forcing his newly acquired wife into sexual servitude, into prostitution.”’ (Antoinette Lattouf, 25 Oct 13, “No say in her future”).

One quote in particular demonstrates the conceptual slippage that occurs when anti-sex work advocates paint consensual sex work and sexual slavery with the same brush:

“Would women choose sex work if they had well-paying options with real work flexibility? It is difficult to think about sex workers in the west without thinking about sex work in developing countries, and how many girls and women are traded/forced/raped/abused sexually. Often, for them, being in the sex industry isn’t a choice.” (Catherine Walsh, 18 April 2014, “Should we turn off the red light?”)

In fact, at the recent International AIDS Conference in Melbourne, a sex worker from Africa said in a plenary, “please stop buying me sewing machines. I could afford to buy ten sewing machines — if I cared to get paid $3/hour.”  For many women, sex work is the well-paying option with real work flexibility.  

But the author quickly skates away from her own question to raise the more emotive issue of “girls and women (who) are traded/forced/raped/abused sexually”.  When emotions are raised, our guard goes down, and perhaps we don’t notice that a paragraph that begins talking about “sex work” ends with “being in the sex industry isn’t a choice” for some women.

It matters to use terminology that recognises a difference between sex work and rape or trafficking. For many people who support decriminalising sex work, a key reason is that it makes it easier to spot illegal practices. Research shows that when sex work is not illegal in its own right, male clients of sex workers actively participate in reporting suspected coercive practices.

Lastly, I’d note that all five quotes above concern non-white women being forced into sexual slavery.  There is absolutely zero demand for narratives about a highschool teacher in California who has been sacked and now lives on minimum wage because she has a rap sheet for an arrest for soliciting, even though she was never tried or convicted.  

On the other hand, there is so much demand for narratives that tug at the heart strings and feed into White Saviour Complex, they have led to moral entrepreneurs like Somaly Mam creating the narratives and coaching people to recite them for Oprah.  This is an example of what Chimamanda Ngozi Adichie calls “the danger of a single story” about the developing world.

3) Prostitution as pejorative

Another article by Meredith Jaffe (12/10/12, “The Hoopla Literary Society”) talks about how a publisher loses its $500K advance when Julian Assange decides not to go ahead with a book deal, announcing “All memoir is prostitution”.

This illustrates the pejorative moral connotations of the word “prostitute”, which have their roots in Judeo-Christian morality, and underpin the argument of neo-conservative feminists like Kajsa Ekman and Gail Dines.  They express the idea that sex work is “selling the self”, rather than being paid for a skilled service for a particular period of time on terms and conditions. 

This is apparently a problem exclusive to sex work and not, say, working for a major law firm, or in immigration detention.

Further, in one of the quotes under (2) above, priests and brokers prostitute the temple dancers to wealthy patrons.  This points to the inherent ambiguity of saying ‘prostitution’ as opposed to ‘sex work’.  You can prostitute someone else to a third party; the term is inherently transitive. 

Sex work is by definition paid and consensual.  If the sex is not consensual, it isn’t work, it’s rape.  The concept of work comes with expectations around free agreement to a contract, a fair wage and safe working conditions, all of which can and are currently protected for sex workers by the institutions of workplace relations and occupational health and safety.

That’s why it’s so disappointing to read this by Caroline Baum:

“Whether you call that semantics or simply rebranding it’s a bit like prostitutes calling themselves sex workers. It’s true, but it’s not the whole story.” (17 July 2012, “Don’t dance at my funeral”).

Also, frankly, I call it a bit weird, in an article about funeral arrangements.  

Conclusion

The results and discussion here suggest The Hoopla needs to have a think about how it talks about sex workers.

Calling sex work prostitution is at best hopelessly loaded and ambiguous.  At worst, proposals to criminalise it smoosh together sex work and rape/slavery — as if sexual consent didn’t make a difference between them.  That might make sense in some neo-conservative feminism informed by Judeo-Christian values that see a sex worker as a ruined woman, but it doesn’t make any kind of sense within progressive, sex-positive feminism — the kind I was brought up to practice and believe in.

I’ll leave it there.  Please feel free to leave constructive responses in the comments section below.  

Telling tales and talking-through

It seems like mainstream society has finally caught on to the way HIV treatments brought an end to the AIDS era and ushered in the age of living with HIV.  Eighteen years late to the party, but to borrow a great line from the The West Wing, let’s just celebrate the fact they showed up at all.  

As I noted in my last post about the “Bareback Backlash”, it has been hard, in the meantime, to do prevention messages about sex without condoms when our funders can open The Age and find Karen Kissane talking about unprotected sex as “Dancing with Death”.  

As Dion Kagan notes in Kill Your Darlings there has been a recent wave of films and television events, for a combined gay and heterosexual audience, in an emerging genre of “AIDS nostalgia”.  I’m thinking of films like Dallas Buyers’ Club and television series like Angels in America and The Normal Heart.  

I’m not sure these are unprecedented; there was The Hours before them and Rent and Philadelphia, etc, but I agree there’s a sense of a moment around the recent crop — a recognition that the AIDS narrative is out of date and something new needs working through.

In a panel discussion talk at the Emerging Writers Festival, Dion described the way these televisual events function as cultural handles on the phenomenon of AIDS for those who live at some considerable remove from it.  He’d mention at a barbecue writing his PhD on AIDS and barebacking and people would ask “Oh, have you seen ______?”  

This made Dion the perfect person to host another discussion, provocatively titled “AIDS is Dead; Long Live HIV!” at the Melbourne Writers’ Festival, featuring Elizabeth Pisani, author of The Wisdom of Whores and Indonesia Etc and Colin Batrouney, Director of Health Promotion, Policy and Communications at the Victorian AIDS Council.

Dion asked Colin Batrouney what people ask him at barbecues; Batrouney got a good laugh by saying “People put on their compassion face” (he mimics this) “and say, Oh, that must be very hard.”  

Elizabeth Pisani said she proposed the session title out of the desire for people to recognise how the reality of HIV has changed.  She tells of asking a friend of hers, a Frenchman, on third-line treatments that occasionally interfere with his life, what was the greatest hardship he suffered last year.  He thought for a while and said, “Some friends of mine were going skiing and it was the day of my appointment with a doctor, so I had to miss a day of skiing.”

Pisani snarkily imagined an HIV prevention campaign message: “Don’t get HIV or you’ll miss a day of skiing.”

Dion asked Batrouney if he was nostalgic for a time when the prevention message was simpler: “Use a condom every time”. Colin recalled an answer he gave at the Understanding What Works and Why workshop at AIDS2014, noting there has never been some Arcadian moment of the AIDS epidemic when everything was simple; every moment has always been the most complex moment ever.

This remark is right on the money: it nails what’s most pernicious about that heterosexual AIDS nostalgia — the symbolic violence of the wistful imagination of a time when those naughty gay boys were scared straight, frightened by the threat of death into using condoms and forgoing their perversions.

This desire is visible in the support of many conservatives for marriage equality: AIDS as stick, gay marriage as carrot.

As the Social Aspects of the Prevention of AIDS study showed, way back in the early 90s when deaths from AIDS were at their peak, gay men were still having sex without condoms — in the name of intimacy, resistance, survival.

So it was frustrating that the only prevention message that Elizabeth Pisani can imagine is one based on fear.  

Pisani spoke favourably of the New York Department of Public Health campaign “It’s never just HIV”, which threatens an audience imagined to be unafraid of HIV with side effects and co-infections.  Watch for yourself:

Every time Pisani talked about “a prevention message”, it was about motivating people through fear of negative consequences.  If you share that view, it seems a huge problem that the consequences of HIV are now much less serious than they were.  

Indeed, Pisani described the role of AIDS service organisations in developing prevention campaigns and promoting awareness of the modern lived experience of HIV as “diametrically opposed”.  And she thought the NYDPH campaign was pulled because “poz orgs objected it was stigmatising”.  

I can assure you many HIV-negative people voiced strong objections to the New York ad; I was one of them.

It’s pretty fucking fluffy logic to imply, as I heard Pisani doing, that people living with HIV have some conflict of interest when they object to a message targeting HIV-negative people as stigmatising.  

HIV-negative people are affected by stigma too.

When a campaign depicts us all as party boys who don’t think about our health — reproducing that ‘naughty boy’ stigma I describe above — there are two options:

  1. react against the ad and reject the message as well;
  2. or — believe it.

There’s hard research evidence of people doing option (1) when fear campaigns are too graphic.  I’ve argued this effect is likely to apply to messages that provoke shame or reproduce stigma too obviously.

But option (2) is the real worry.  It acts against the most crucial variable in health psychology: self-efficacy.  It also challenges the idea that gay people might work together — in the bedroom or sauna cubicle, or in organisations and online, to prevent HIV because we care about ourselves and others.

If you’re hosting a writer’s festival, you should definitely try to book Elizabeth Pisani.  She is a dream guest.  She is funny, gorgeous, she tells a cracking yarn, and yet she is simultaneously infuriating.  The ingredients of the perfect twitterstorm.

Her book The Wisdom of Whores displays her ability, as a journalist turned epidemiologist, to tell a yarn that conveys an understanding of some pretty complex concepts.  I just loved her description of a night out in a red light district in Indonesia, the chicanery needed to keep fat, corrupt policemen from impounding her blood tests, her canny knowledge of her research assistants and the role a tight pair of jeans can play in recruiting participants.  And I especially love and admire how, by the end of the chapter, the reader knows more than they realise about sampling bias in research.

This ability was on display at the forum.  And so was its dark side: the way a yarn, a canned tale developed in advance and trotted out on cue, is the opposite of ‘thinking-through’.  At the end of a good yarn, all the loose ends are neatly tied up.  But that’s not what we needed.  At this particular ‘moment’, we need talking through.

In the lovely words of a friend from Zim, with some issues you can tug on a loose thread and the sewing machine falls out.  One such issue is Pre-Exposure Prophylaxis — taking HIV meds when you are negative, so that if you’re exposed to the virus, it can’t get a foothold and you’re protected from infection.  

Evidence shows it works if you take it everyday.  (File under ‘obvious’?)  It changes everything, though, to have something to offer gay men who gave up “use a condom everytime” as personally and relationally unsustainable.

When the topic of PrEP came up, Pisani nodded, smiled wrily and told a self-deprecating tale about her own inability to remember to take the pill on time everyday to prevent the life changing consequences of having a baby.  She noted that PrEP uses Truvada, which she called a three drug combination that’s commonly used in first-line treatment in the developing world.

Except that’s not Truvada, that’s Atripla.

If gay men were as ‘sloppy’ in her words as she is about the pill, she worried, this could lead to resistant ‘strains’ of HIV developing and circulating in the developed world, putting the global response to HIV at risk.

Except that’s not how HIV resistance works; that’s a bacterial resistance model.  (More in a future post on this.)

The problem with a yarn is the way it crystallises the time when first you tell it.  Everytime you repeat it — and for an author on a book tour, I’m guessing that happens a lot — you’re taking the audience back in time.

A tale is a TARDIS.  Telling tales is time travel.

Quite frankly, Pisani told an audience a bunch of tales that were easy to understand but more or less out of date.  

This happens easily when you’re on the fringes of the HIV response: you miss out on the fast-moving central current of prevention science and policy development sweeping away old understandings of treatment and prevention.  

Thus the challenge for people working in prevention is to engage with journalists and policy-makers to ‘spin out’ new understandings in formats that non-experts can get their teeth into.  My money is on personal narratives and feature journalism for the job; 500 words with a news angle isn’t space enough to challenge anyone’s assumptions.

Personal narratives work too because, as research into mental health stigma shows, it only takes a small amount of personal contact to enable people who consume stigmatising media narratives to ‘triangulate’ them with reality.

A trickier challenge is getting people who see themselves as ‘hard’ scientists (or hard-nosed ex-journalists) to appreciate the ‘soft’ science of community-based health promotion.  

For example, to convince them why fear isn’t a useful messaging strategy, or why targeting HIV-negative people’s self-interest and identity might not work as well as more relationally premised messages.  

Or, hell, just to understand that ‘stigma’ and ‘community’ are both concepts about emergent causes and the inability to provide a pat one-sentence definition doesn’t make them fluffy and useless.

“We need to talk about fucking and getting high” is a great line, but prevention was never that simple.


 

Edit:  if you’d like to read more about stigma, I have an article about the technical challenges of defining and measuring HIV stigma in this week’s Eureka Street, the Jesuit Publications e-journal of current affairs, social justice and social policy.

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