Cycles of Stigma: How Prohibition Makes Sex Work and Drug Use Even More Dangerous
by Maximilian Eyle
June was Pride Month in America, and this year’s theme in New York City was “Defiantly Different”. It represents a chance to push back against the stigma surrounding LGBTQ identities and lifestyles while celebrating the diversity of self-expression that exists within the LGBTQ community. When we talk about stigma in this context, it is usually regarding a lack of acceptance of the individual’s sexuality on the part of the family or by society. What is less frequently acknowledged is that the manifestation of this stigma often sets off a chain reaction as the individual struggles to cope with the trauma of their sexual identity being denied or ridiculed.
When we think about where LGBTQ culture shines brightest, big cities come to mind. Metropolitan areas like New York City act as magnets for members of the LGBTQ community nationwide due to the more progressive mentality toward sexuality and the greater availability of support resources. The stigma associated with non-heteronormative lifestyles in many areas of the U.S., particularly rural communities and small towns, often makes it unpleasant and even unsafe to live openly there.
As these stigmatized people seek a new life in a more accepting environment, they often carry heavy burdens. Some are material, like the struggle to survive financially in an expensive and foreign environment like New York City. Others are emotional, like the memories of having been spurned by friends and family where you grew up. Though there may be less anti-LGBTQ sentiment in a metropolitan area like New York, many who come to such a large city find themselves unable to survive financially.
For members of the transgender community, their ability to conceal their sexual identity can be more difficult than for gays or lesbians. When faced with this added barrier to entering the “traditional” workforce, some will inevitably turn to sex work as a means of survival. The National Transgender Discrimination Survey studied this and other issues among 6,400 transgender adults nationwide between 2008 and 2009. It found that, “An overwhelming majority (69.3%) of [transgender] sex workers reported experiencing an adverse job outcome in the traditional workforce, such as being denied a job or promotion or being fired because of their gender identity or expression.”
Because prostitution is illegal in the vast majority of the United States, legal and social repercussions face those who choose this line of work, needlessly stigmatizing them and making their lives less safe. They are forced to enter the black market, put themselves at risk for arrest, and are limited in their ability to receive access to contraception, STD testing, and other essential healthcare resources. Though heterosexual prostitution is also stigmatized, the taboo tends to be greater for gay or transgender sex workers.
If the person has been arrested for drug use, finding a traditional employment path will be particularly difficult if not impossible. Again we see the damaging influence of stigma appear – this time in the context of drug use. The War on Drugs has conditioned society to regard substance use as a moral failing, much like many anti-gay groups view LGBTQ lifestyles as morally wrong. Our justice system advances this perspective by incarcerating and punishing these individuals, adding the inescapable and institutionalized stigma of a criminal record.
Just as prohibiting sex work makes it even more dangerous, the most dysfunctional and destructive aspects of drug use are usually products of prohibition rather than of the substance itself. Consider overdoses, which almost always result from the user’s inability to know the content, purity, or strength of what they are ingesting. In the U.S., where nearly 65,000 people died from drug overdoses in 2016, users are buying their drugs on the black market. They cannot know what they are consuming, and their purchases fuel a black market worth over $100 billion annually. In Switzerland, where the government started giving opioid users access to pharmaceutical heroin and other opioid substitutes dispensed in a clinical setting, their overdose rate dropped by half and the rate of HIV infection dropped by 65%. Furthermore, the rate of new users there has declined. This harm reduction practice puts users in contact with medical staff without the pressure to change their lifestyle or usage.
The long history of stigmatizing members of the LGBTQ community increases the rate of trauma and abuse. (77% of transgender sex workers experienced harassment during childhood after expressing their transgender identity.) The continued discrimination that is present as transgender people enter the workforce forces them to find alternatives in the black market, bringing with it further stigma and legal peril. The consequences of this are dire. The attempted suicide rate of transgender sex workers is over 60%.
The legal system’s practice of legislating morality via the criminalization of drugs as well as sex work only serves to exacerbate the potential dangers of these behaviors by limiting the available resources and adding to the stigma felt by drug users and sex workers. Compassion, not punishment, should be the underlying philosophy behind our public policy. The social and legislated stigma felt by people who are drug users, sex workers, LGBTQ, or a combination thereof, is a cruel burden that must be lifted before we can truly hope to help the most at-risk members of our communities.
Maximilian Eyle is a native of Syracuse, NY and a graduate of Hobart and William Smith Colleges. He works as a media consultant and writes each month about a variety of issues for Spanish-language papers across New York State. Maximilian has a love of Hispanic culture and learned Spanish while living in Spain where he studied and worked as an English teacher. He can be contacted at firstname.lastname@example.org.