Treena Orchard believes the size of the city should not matter for sex workers seeking a safer, healthier environment. And now, after wrapping her most recent study, the Health Studies professor hopes communities across southwestern Ontario will evolve how they help these marginalized groups.
Although sex work is not limited to major metro areas, most Canadian research on the subject has focused on large cities, like Toronto and Vancouver, Orchard said.
And those findings are familiar:.
Sex workers are often stigmatized and at risk of violence, poor mental and physical health. Sex workers in street-based settings, who account for the smallest percentage (10-15 per cent) of sex workers in the country, are at an even greater risk. Research shows they are most likely to struggle with poverty, addiction, traumatic events, violence, and discrimination.
But do those findings hold true for those involved with street-based sex work in smaller cities, like London? Is it easier, or more difficult, for those in smaller locales to access health and social services? What factors determine their overall health and safety?
These are questions that Orchard has sought to answer over the last several years by way of four studies involving women in sex work in the Forest City.
“I’m interested in smaller places,” Orchard said. “The research from large cities doesn’t really align with the experiences of different kinds of women, and with all the different kinds of sex work throughout the country.”
For instance, Orchard noted, there is a lot of mobility among sex workers within small- to medium-sized cities in southern Ontario – individuals who often don’t want to work in the city they’re from. In London, Orchard found a number of street-based sex workers from the Kitchener-Waterloo-Cambridge area. This finding helped develop her most recent research project, a study funded by the Canadian Institutes of Health Research, exploring the factors that contribute to the health risks and resilience among street-based women and trans women in that tri-city area that has experienced a significant economic downturn in recent years in addition to seeing a rise in the number of street-based sex workers.
“There hadn’t been much in the way of sustained research on women – and especially transwomen – in sex work in that area,” Orchard said. “I wanted to build on the work we’ve done in London, where we did both interviews and ‘social mapping.’”
Social mapping consists of asking study participants to mark on a physical map the locations where most of their sex work occurs, where they live, where they get their health-care and social services, and places they avoid or have experienced violence.
“That gives us an in-depth understanding of how space shapes health,” Orchard said. “That information is useful for service providers who might think, ‘Maybe we should shift some of our services to partner with the folks over on this part of the city because it seems that’s where a lot of people spend a lot of their time.’”
Orchard’s data spans a year and a half and just wrapped this spring.
Interviews were conducted with 35 women and seven trans women. To recruit study participants, Orchard’s team relied on word of mouth, posters, and established local agencies that see people in street-based sex work on a regular basis. Trans women, who are among the most marginalized groups in Canada and are often excluded in health research, were much more difficult to contact.
“We connected with a trans leader in that region, and that made a big difference,” Orchard said. “Most of the sex work done by transwomen is set up online. So, they don’t frequent the same kinds of services as other women who do street-based sex work.”
The 60-minute interviews covered topics such as health concerns; who they rely on for support; areas they avoid in the tri-city region; how their gender identity affects their health-related and everyday experiences; where they go for their health care and social services and how the location of those services affects how often they access them.
“If they’ve experienced stigma or barriers to care, we asked them things like, ‘Is there another place in the city that you think would work better for you?,’” Orchard said. “It’s not about them just telling us about their terrible experiences. We might say, ‘Okay, so how might things be better? How should they look?”
Beyond the usual academic avenues, the team aims to hold a town hall-style meeting to share their research results, as well as share through social media platforms like Twitter and Facebook.