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  • Writer's pictureAntonia Boorman

How to change societal perceptions and eradicate stigma

Updated: Dec 20, 2020

[Sex Work Series] Paper 5a: How to change societal perceptions: Changing the influence of historical taboos on modern-day legislation through psychological and sociological techniques


New Zealand is the only country worldwide to have a national policy of decriminalisation. All other countries have systems of partial criminalisation, regulated legalisation or follow the nordic model. The reason that restriction and regulation are the most common forms of legal systems around sex work is due to the heavy stigma sex workers are subjected to. Within this paper, I will be exploring how the negative stigma and taboos surrounding sex work have arisen and how they influence modern-day legislation. Once this is established, I will use a variety of psychological and sociological theories to examine how these deeply ingrained perceptions can be influenced and adapted. This paper will act as a basis for the final policy proposal in terms of the psychological and sociological techniques that will be proposed in conjunction with the policy reform. Ever since the rise of democracy, the power of the people has been substantial. From a political campaign to social movements, the mass populous has the power to make change happen. This is why it is crucial to understand how people operate in terms of how opinions and beliefs are formed and changed, how social gathering arises and gain momentum, and how these combined influences social, cultural and political reform.

To clarify, stigma is defined as “a strong feeling of disapproval that most people in a society have about something” (Cambridge Dictionary, 2020, para. 1), while a taboo is “a subject, word, or action that is avoided for religious or social reasons” (Cambridge Dictionary, 2020, para. 1). The negative stigmas and taboos that surround sex work can have impactful consequences of sex workers such as increasing social exclusion, creating barriers to enter other job sectors, and even influencing legislative policy. In this paper, I explore why these taboos exist, what specific stigmas impact sex workers and how social contagion theory can be used both to understand the flow of these ideas as well as to change the societal ideologies that influence policy decisions. This will be further expanded upon by examining psychological theories that can be used to draft the framing of a political reform to make it more socially accepted¹. By highlighting and understanding the root of these perceptions, it can help to identify how to shift a change in ideologies.

How sex work stigma and taboos arose

Rudyard Kipling is famously quoted saying that sex work is “the most ancient profession in the world” (Kipling, 1898, p. 5). Whether it is the oldest or not is irrelevant, but his point stands that sex work has been around for centuries. One of the earliest recordings of sex work as a profession links back to 2400 BCE in Sumer (Lerner, 1989), one of the first civilisations in the world (Lerner, 1989). The sex workers there were tied to religious worship of the goddess of love, Ishtar (Lerner, 1989). Sex workers were not only religiously respected but also given legal rights, as seen on The Code of Hammurabi, one of the oldest legal documents in 1780 BCE (Luckenbill, 1917), where it is documented of sex workers’ rights to property (Law 179, Code of Hammurabi), rights to inheritance (Law 180, Code of Hammurabi), and rights to custody of their children (Law 187, Code of Hammurabi). In the translation of the Code of Hammurabi, the word used for sex workers translates to “sisters of God” and “devoted women” (Law 178 & 179, Code of Hammurabi) which have positive connotations reflecting religious and divine associations, illustrating that sex work wasn’t always considered a negative thing with an intense stigma. These positive and religious associations continued throughout ancient history, for instance, during the Aztecs period of were sex workers, ‘Ahuiani’ which translated to ‘the bringer of joy’ (Jimenez, 2004), were seen as servants of the goddess of sexual power, Xochiquetzal, and were even trained as priestesses in human sacrifices (Mejia, 2017).

The concept of sex work isn’t unique solely to human experience but can be also seen in the animal world. Various studies, such as those conducted by Keith Chen and Michael D. Gumbert, have seen monkeys, in particular, engaging in the trading of sex for their equivalent of monetary gain ie. food or grooming. In Chen’s experiment on the effects of establishing money and economic markets with Capuchin monkeys, he introduced tokens which the monkeys could trade for grapes, jelly, and apples, the prices of each varying (Chen, et al., 2006). Almost as soon as the commerce was introduced, female Capuchin monkeys began trading sex for tokens which were immediately used to purchase more fruits (Chen, et al., 2006). This can also be seen among long-tailed macaques, where the male macaques trade grooming for sex with females (Gumert, 2007). Gumbert observed that the length of grooming acted as a form of currency in an invisible market (Gumert, 2007). Furthermore, the ‘price’, ie. length of time grooming before females allowed for sex, fluctuated depending on the availability of females as well as the status of the females in the troop (Gumert, 2007). Therefore, the concept of transactional sex is not a uniquely human thing. Seeing that humans are primates too, it can even be interpreted as inherently biological.

So why is there a stigma associated with transactional sex?

Sex work began to be stigmatised once economic markets and political regulations became involved. In Ancient Greece, many sex workers were slaves employed by state-regulated brothels that brought in most of the income into different cities (Kurke, 1997). Free sex workers had to register with the state and pay hefty taxation (Kurke, 1997). Sex workers, unlike married women at the time, were able to make their own money so were financially independent (Kurke, 1997). Women were marginalised in society and considering that sex workers were the only women to be a financially independent increased stigma towards them (Kurke, 1997). Similarly, in Ancient Rome, though the act of selling sex was socially accepted, legal and licensed by the state, sex workers themselves had no citizenship rights (Dillion et al., 2005). Sex work as regulated, not for a moral reason but to maximise profit from the trade (McGinn, 2004). Sex workers were marginalised but only because they were usually slaves or other non-citizens (Dillion et al., 2005).

The rise of Christianity in the 4th century influenced the change in the root of the stigma from citizenship-based to moral-based (Knauer, 2002). The social acceptance of Christianity, coupled with its power on governance and legislation, became a dominant force in shaping societal opinions. Sex outside marriage was considered sinful, meaning that selling sex was completely morally impermissible (Knauer, 2002). Throughout Western Europe, this influence gained momentum through the Middle Ages to present day and became a driving force in the current moral attitudes towards sex work (Geremek, 2006). Sex work was permitted in the Middle Ages as sex work was considered to protect the ‘respectable marriageable women’ from rape (Geremek, 2006). This was even the view of the church at the time, as exemplified by St. Augustine who suggested that sex work would encourage lust and sinful behaviour (Karras, 1989). However, sex workers were explicitly distinguished from the ‘respectable women’ through clothing, such as in 14th century England where sex workers had to wear yellow hoods as yellow symbolised shame (Karras, 1989), and only permitted to work in brothels, owned by the church, in specific red-light districts (Bennett, 1989). Alongside the stigma of being immoral and sinful, and the social exclusion that came with the segregation of sex workers, sex workers also lacked legal rights as they did in Ancient Rome. Sex workers could not own or inherit property, report crimes or be defended for crimes legally (Bullough, 1994).

Moving forward to the 14th to 19th century, the negative attitudes towards sex work solidified through the outbreak of major sexually transmitted diseases ie. Europe’s syphilis epidemic in the 1490s (Silay, 1994). Sex workers became directly associated with disease (Silay, 1994). The Catholic church's stance became very clear, very quickly. Pope Sixtus V enacting a death penalty for “sins against nature” (Freiburger & Marcum, 2015, p. 169), ie. sex work, which was to be obeyed by all Catholic countries (Freiburger & Marcum, 2015). Throughout the following century, many countries across Europe began to legally abolish sex work including England, France, and many other Catholic countries. Mutilations and public humiliation of sex workers became regular (Freiburger & Marcum, 2015). All of which forced sex work from the 16th century to become underground and out of sight (Freiburger & Marcum, 2015), and remain like this to today.

This perception of sex workers as immoral and diseased remained through to the 19th century when it was strengthened by law. The Contagious Diseases Act 1864 enacted by the UK, followed by France adopting similar legislation, subjected sex workers to arrest and forced, invasive medical examinations to identify them to soldiers as diseased and contagious (Walkowitz, 1980). Josephine Butler, a predominant feminist and core activist within the British suffragette movement, described this legislation as medical rape (Vicinus, 1994). This legislation, coupled with the stigmatised media portraying it, lasted to the second world war and still somewhat remains today in the negative sentiments and hostility towards sex workers.

Figure 2: Three World War II posters portraying sex workers as diseased (Peppers, 2013).

Butler’s involvement was a core part of achieving of women’s suffrage, yet her efforts also ended up harming women through her advocacy for and achievement of the criminalisation of sex workers in the UK (Criminal Law Amendment Act, 1885).

Sex workers had control over their sexuality and were seen as a threat to the role of a woman (Agustín, 2013). Criminalisation of sex work was a patriarchal way of controlling and oppressing a women’s ability to chose to do what she wanted with her sexuality. As highlighted by Laura Agustín, an anthropologist specialising in studying the sex industry, “all prostitution laws are conceived as methods to control women who, before ideas of victimhood took hold, were understood to be powerful, dangerous figures associated with rebellion, revolt, carnival, the world upside down, spiritual power and calculated wrongdoing” (Agustín, 2013, para. 15). This stigma was especially prominent due to the control of the patriarchy in Victorian times.

The stigma of sex work and sex workers has adapted through history. Sex work was once considered divine, where sex workers were respected and associated with religious gods. This positive perception turned bitter once economic and political markets were introduced where sex workers were synonymous with slaves due to their lack of citizenship rights. This stigma grew by the influence of Christianity and the increase of sexually transmitted diseases, which lead sex workers to be considered immoral and disease-ridden. Through the introduction of criminalisation laws in the 20th century across Western Europe, sex workers are now also seen as criminals. All of this has influenced the perception of sex workers today, who are seen as dangerous criminals and diseased people out to tempt and corrupt the morality of men (Mac & Smith, 2018).

How sex work stigma and taboos exist today

Today, the stigma surrounding sex work has been predominantly focused on demonising or victimising the sex worker. The word “prostitute” itself has been used to demonise sex workers² with the first recorded use by Palsgrave in the 1530s as a verb meaning “to sexually dishonour yourself” (Lister, 2017). Throughout the following centuries, the meaning of this word has altered, settling into the definition of “a person who sells sex” by the seventeenth century (Lister, 2017), but the associations with immorality and dishonour have withheld. Today the words ‘prostitute’ and ‘whore’ are used as derogatory insults used to “pejoratively used to attack and degrade women’s sexuality” (Lister, 2017, para. 19). This framing can be problematic at it can be used to demonise victims, for example, after the murders of two sex workers in Australia, the headlines read “prostitutes murdered” rather than “women murdered” (Wolf, 2018) which dehumanises the victims and focuses the blame on them rather than the perpetrator, minimising the violence on the premise that “prostitutes” are less than humans.

The word “prostitute” is solely applicable to females only (Wolf, 2018)³. If a man is a prostitute he is deemed as a ‘male prostitute’ which contrasts with the previous default norm of having the occupation being male-associated and adding ‘female’ to change the gender ie. ‘fireman, policeman, etc’ (Wolf, 2018). The fact that a default female occupation of “prostitution” has such negative connotations reflects the historical stance of women as second class citizens in society, and continuously reinforces this through the stigmatising, subordinating, demeaning, and dehumanising use today (Wolf, 2018).

The label of “prostitute’, in various languages throughout history, was used to segregate sex workers from respectable women. This follows as a direct result of patriarchy when men have created this segregation of marriageable women and promiscuous women whose only purpose is for pleasuring men (Agustin, 2013). Both of these categories are demeaning to women as they reduce women down to a wife or a whore, nothing more. Abolitionists, those who favour criminalisation and eradication of sex work, claim that the ‘whore stigma’ would be abolished if sex work was eradicated (Agustin, 2013). Yet, as seen through the criminalisation, aka ‘abolitionist’ models that exist today this is not the case. Furthermore, as argued by Agustin, the existence of “slut-shaming, victim-blaming, and rape culture” (Agustin, 2013, para. 12) today illustrate how ‘whore stigma’ exists regardless of who the women performing sex are, as it’s applied to sex workers and non-sex workers alike.

This segregation and marginalisation have stuck with the term as reflected by the lack of legal and labor rights available to sex workers across the world. The historical taboo that sex work is wrong or immoral is further reinforced today through the criminalisation of sex work which attempts to eradicate sex work completely. By officially criminalising something this portrays it to society that it is wrong. In the US, law enforcement would often arrest sex workers and shame them in court as “common prostitutes” (Healey et al., 2020) and the criminal records that came with the arrests would shut the doors on other employment opportunities, the ability to rent housing and affect child custody arrangements, all due to the negative stigma associated with sex work (Harverson, 2018). Criminalisation and prohibition laws, therefore, reinforce the historical taboo of sex work that it is immoral, indecent and criminal.

Not only have sex workers been framed as criminals within the legal system and wider society, but simultaneously sex workers have been portrayed as victims (Bruckert et al., 2013). For example, in the Netflix documentary “Tricked” (Wasson & Wells, 2013), the framing of the documentary was focused on the portrayal of the sex workers as victims who have been brainwashed in a cult of prostitution under the influence of the pimps conducting the manipulation and emotional and/or physical abuse. It refers to the sex workers as ‘sex slaves’ (Wasson & Wells, 2013) and exclusively shares the narratives of sex workers who have been coerced or even kidnapped. It shares different women’s stories of their experience working in the sex industry as prostitutes under control of different pimps, as well as the perspectives of police workers, legislators, and the pimps themselves ie. the police workers describe their struggles to bring pimps down, the pimps talk about how women are their commodity and its easier for them to sell women then sell drugs, and the sex workers describe their experiences of violence, coercion, manipulation, and abuse from the pimps. If a sex worker has been coerced, kidnapped or forced into sex that is trafficking, as defined by the OHCHR (2014). Conflating sex trafficking and sex work is problematic as it portrays sex workers as helpless. Victimising sex workers removes their agency and autonomy in choosing to become a sex worker. Here it is again important to distinguish sex work from sex trafficking. People who are trafficked are victims. Sex workers who consensually become sex workers are not. Furthermore, by portraying sex workers as victims and pimps as the criminals, this completely distracts the conversation away from the real issues which are more to do with the legal system of criminalisation and lack of labor rights.

As stated by Maginn & Cooper (2017), “mention the word “prostitution” and there’s more than a fair chance that most people will automatically think of a drug-dependent female in high heels and a mini-skirt shivering on a cold and darkened street in a dodgy part of the city” (Maginn & Cooper, 2017, para. 1). This description depicted is a common stereotyping of sex workers which is harmful as again it propagates sex workers as helpless ie. ‘cold’ ‘drug-dependent’, yet also dangerous as they are associated with illegal activity and crimes ‘in a dodgy part of the city’. These connotations of sex work have been influenced by the societal stigma, yet also by representations in the media ie. ‘Tricked’ on Netflix (Wasson & Wells, 2013). Even though this perception of sex workers is widely shared, it is inaccurate. For example, in the UK only 5% of sex work is street-based (Home Affairs Committee, 2016).

Abolitionists, see the very act of sex work as a form of violence against women (Agustin, 2013). This again portrays sex workers as victims rather than workers. Police raids deemed ‘rescue missions’ are used to stop sex work and thus help the sex workers rescuing them from having to perform sex work (Mac & Smith, 2018). Yet under a system of criminalisation, sex workers, once ‘rescued’, are arrested, fined and incarcerated (Mac & Smith, 2018). After release, the criminal records and fines make it almost impossible to find work leading them to poverty or forcing them to pursue more informal and illegal forms of employment. The stigma of sex work further propagates this. Meaning that ‘rescuing’ of sex workers is more harmful to them.

Victimising, criminalising and stigmatising sex workers has extreme consequences. The extent of stigma surrounding sex work can be psychologically taxing, creating social exclusion and restricting access to other forms of employment, housing and community involvement. To quote Riley Reyes, a member of the Adult Performer Advocacy Committee and current sex worker, “the worst thing about sex work is the stigma and a lot of them are shocked: people think I’m going to tell them things about sleazy agents or terrible producers or bad clients, but the worst thing about sex work is the stigma that is heaped upon you from the outside world. Stigma loses people their loved ones, it loses people their families, they get harassed and trolled, and stigma also strips people of resources that they need” (Philosophy Tube, 2019, 36:39).

Psychologically stigma can have damaging effects. According to a study conducted by Begum (2013), where he interviewed sex workers in Australia on the effects of sex work on mental health, he discovered that the emotional risks, social stigma, and exclusion associated with the industry have led to significant evidence to the damaging of mental health for workers (Begum, 2013). The contradictory elements of sex work being: financially rewarding yet entrapping; empowering yet demeaning; increasing some opportunities while reducing others; flexible and demanding; and offering both intimacy and competition (Begum, 2013). This led to workers to feel forced to have to lead a “double life” or disassociate themselves from the work (Begum, 2013). The legislation of sex work in Australia has improved the medical health and physical safety of the workers, yet the social stigma associated with the work maintains the discrimination that leads to mental health issues such as disassociation.

Research by Benoit et al (2017), examining how self-esteem is linked to profession and others’ view of our professions found that people with customer-facing jobs with high levels of human interaction in the service sectors “often experience poor treatment by bosses and customers who expect subservience” (Benoit et al., 2017, p.1) which is then internalised into diminished self-esteem. When they decided to examine this further, they found that their results highlighted that the perception of self-esteem levels is more complex and heterogeneous than expected. The sex workers reported that they felt conflicted, which supports the Begum findings, yet claimed that it was more than the social stigma influencing their levels of self-esteem such as social background factors, work location and life events and experiences (Benoit et al., 2017). This shows that sex work stigma can have direct impacts on the mental health of sex workers. In a similar study, Vanwesenbeeck (2005) conducted a study of sex workers’ mental health in conjunction with working conditions specifically. She specifically focused on how sex work stigma effects burnout and psychological stress (Vanwesenbeeck, 2005), discovering that the negative societal perceptions of sex workers caused more burnout than “concrete job characteristics” (Vanwesenbeeck, 2005, p. 637). A literature review conducted by Platt and Grenfell (2016) concluded similarly that sex workers’ emotional health was tied directly to stigma, specifically discrimination and social exclusion (Grenfell et al., 2016).

Sex work stigma also has health consequences as exemplified by the “Anti-Prostitution Loyalty Oath” (APLO) and the “National Security Presidential Directive 22” (NSPD-22), US policies that require organisations to have policies in place that explicitly oppose sex work to access the US HIV and AIDS funding (Sippel, 2016) even though evidence suggests that the criminalisation of sex work actively increases HIV and AIDS. The same year that the APLO and NSPD-22 were passed, 2003, President Bush “committed $15 billion to the international fight against AIDS but required all recipients of the funding to sign an anti-prostitution pledge” (Bazelon, 2016, para. 24). This is immensely counterproductive as by condemning the practice of sex work to the extent that health and advocacy organisations fighting HIV and AIDS are unable to access the funding that is supposedly dedicated to them no change can happen. This not only harms sex workers by restricting their access to HIV and AIDS treatments and services but also harms the overall reduction of the HIV and AIDS epidemic which was the purpose of the funding. For example, organisations in Brazil collectively turned down $40 million in US HIV and AIDS funds by refusing to sign the anti-prostitution pledge (Bazelon, 2016) and as did NGOs in India who were distributing over 350,000 condoms a month which was seen as supporting sex work (Bazelon, 2016). Fighting the HIV and AIDS epidemic with morality and ideology, rather than funding protective and preventative measures to reduce transmission is ineffective.

Sex work stigma increases violence against sex workers by reducing the safety of sex workers through criminalisation and through the devaluation of sex workers (Living in Community, 2018). The demonetisation and social exclusion of sex workers, coupled with the lack of repercussions under a system of criminalisation, make them easy targets for attackers. For example, in Washington serial killer Gary Ridgeway murdered 49 sex workers (Augustin, 2013) and “picked prostitutes because I thought I could kill as many of them as I wanted without getting caught” (Younge, 2003, para. 1). Furthermore, unless a murdered attacks many women, it rarely makes news coverage as the stigmatisation of sex workers acts in the same ways as victim-blaming where they are seen to have deserved it (Augustin, 2013). As quoted from Jean Kilbourne, an activist on the portrayal of women in the media, “turning a human being into a thing, an object, is almost always the first step in justifying violence against them” (Fraley, 2017, para. 10).

Figure 3: Image showing the reinforcing feedback loop connecting sex work stigma and violence.

Note: Retrieved from

To Conclude

Within this paper I have explored: the rise of sex work stigma throughout Western Europe’s history, focusing specifically on the influence of religion, disease, and the patriarchy; how sex work stigma manifests today; and the psychological, sociological and systems-thinking theories that can explain its ingraining into society. The stigma of sex work creates prejudice which can lead to active discrimination through the form of denial of housing, social exclusion, and laws that prioritise prosecution over protection. This is why stigma must be addressed to reform the social and legislative systems around sex work to better protect the human rights of sex workers.



¹ Explained fully in Paper 6: Policy Proposal using Systems Thinking.

² Hence why I have chosen not to use it in this paper, and instead use “sex worker” which refers more to a person who works in the sex industry and illustrates connotations of choice and professionalism, acknowledging sex work as work (Lister, 2017).

³ This has been changed recently to be gender inclusive ie. firefighter, police officer, etc. Yet, the point still stands in terms of the origin of the names of the professions.

The details of which are explained in Paper 4: Sex Work Legislation in Western Europe.

Explained fully in Paper 2: Human Trafficking: Common Misconceptions and Actual Realities.

The Adult Performer Advocacy Committee (APAC) is a labour group by and for adult film performers and sex workers. The APAC works in conjunction with other sex work organisations to advocate for safer working conditions. Source:

Defined by Vanwesenbeeck (2005) as “emotional exhaustion, de-personalisation, and reduced personal competence” (Vanwesenbeeck, 2005, p. 1).

Defined by Vanwesenbeeck (2005) as “financial rewards, number of working hours, number of clients” (Vanwesenbeeck, 2005, p. 637).

Explained fully in Paper 4: Sex Work Legislation in Western Europe.



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