Sex workers can be and often are the first-line providers of
care to the sexual health of men or who have sex with men,
especially those who don’t identify as gay. The services
provided by whores, escorts, and erotic masseurs begin with
something that is often underrated in our culture: healing
through pleasure. Inside every gay man are traces of a kid
who’s been shamed, humiliated, silenced, or terrorized for
being queer. For some people, going to a professional for sex
is one way to gain permission to experience pleasure in our
own bodies, which can be an amazingly powerful healing event.
Sex workers can also serve as
providers of information on health matters ranging from safer
sex to sexual hygiene. They can be role models of healthy male
sexuality, sexual self-acceptance, and/or gay identity. They
can be shame busters and stress-reduction engineers, and more.
In this article, I’d like to look at sex work as health care
from two different directions. What are the health-care issues
that face sex workers themselves (especially since caregivers
are notoriously lax about self-care)? And what are the
opportunities for sex workers to convey health-consciousness
to their clients?
I started working as a
massage therapist in New York City over six years ago. Since
then, I have done approximately 3000 sessions with clients. I
got my state certification training in California at the Body
Electric School, which also offers extensive training in
erotic massage as a healing practice. The vast majority of the
sessions I do combine Swedish/Esalen-style massage with
tantric massage, which incorporates erotic touch into the
massage with the intention of raising and circulating erotic
energy around the body. More often than not, the client has an
ejaculation -- or “release,” in the parlance of the trade
-- but always in the context of a full-body experience.
Most of the time I keep my
clothes on and discourage clients from interacting with me.
However, in the course of my work as a professional masseur, I
have engaged with clients in oral sex (active and receptive),
anal sex (active and receptive), fisting, foot worship, water
sports, power-and-surrender, verbal humiliation and other
kinds of role-playing, body shaving, and various forms of
intense body play, including spanking, flogging, bondage and
discipline, blindfolding, hot wax, cock & ball torture,
and experimenting with toys like titclamps, buttplugs, and
vibrators. So I consider my professional employment as a
masseur to fall within the realm of sex work. I don’t
especially relate to the term “prostitute” -- I like the
designation one client bestowed upon me, which is “pleasure
activist.”
While I have incorporated
many kinds of sexual interaction into my bodywork, I have also
coached people on breathing and meditation. I have referred
people to acupuncturists, chiropractors, medical doctors,
dentists, psychotherapists, psychic healers, colonic
hydrotherapists, nutritional counselors, and yoga studios. I
have worked with men and women who have a history of being
sexually abused and assisted them in their struggle to regain
contact with their erotic bodies, to practice consent, and to
honor their desires. I have shared what I know about using
diet, vitamins, herbal supplements, and homeopathic remedies
to treat specific ailments. I’ve given people reading lists,
xeroxed articles, and brochures on tantric sex workshops.
I’ve turned people on to some really great music. And I’ve
listened. I consider myself a holistic health practitioner,
meaning that I don’t treat bodies, I treat people, and I try
to remember that every person who arrives at my massage table
has numerous dimensions -- physical, emotional, erotic,
ethical, and spiritual.
I don’t claim to represent
or speak for sex workers as a class of people. I think my
experience and practice is not typical of sex workers. I also
think I am not alone in my attitudes toward sex work.
I notice that most of the
conversations that take place around sex workers, especially
in the context of gay men’s health, focus on them almost
exclusively as an at-risk population, a vector of
transmission, and the words “substance abuse” and
“suicide” are usually in the picture. I’m not saying
there aren’t sex workers for whom those are pressing issues.
I just don’t recognize myself in those conversations.
I came into this line of work
at the advanced age of 39 with an almost absurdly idealistic
attitude about sexual healing. That’s because I trained with
the Body Electric School in California, which was founded by a
former Jesuit named Joseph Kramer as part of a mission to heal
the split between sexuality and spirituality in Western
culture. How’s that for ambitious? His sense of mission
enflamed me. Among other things, he inspired me to investigate
the work and ideas of Wilhelm Reich, a radical psychoanalyst
and associate of Freud’s who revolutionized 20th century
thinking about sexuality as energy. As far back as 1926, Reich
was saying things like “Those who are psychically ill need
but one thing -- complete and repeated genital
gratification.”
My initial contact with Joe
Kramer involved taking his weekend workshop, “Celebrating the
Body Erotic,” which has introduced thousands of men all over
the country to some basic principles of tantric sex. The
workshop is structured as a series of rituals that give men
practice at integrating eye contact, breathing, being in heart
space, and intentional touch, including genital massage. The
climax of the workshop (so to speak) is a Taoist erotic
massage ritual in which each person is massaged for an hour
and a half, breathing consciously and being continually
pleasured erotically without the goal of ejaculation.
For many gay men, this is a
new experience and one that is ultimately as much a spiritual
experience as an erotic experience. That was certainly true of
me. My first Taoist erotic massage broke through a logjam of
unprocessed AIDS grief. I discovered, quite unexpectedly, that
by trying to cultivate only positive emotions I had blocked
myself from feeling almost anything, including sexual arousal.
Once I let myself feel the flood of sensations, which included
weeping and sobbing for quite a long time, I felt clearer and
lighter and able to feel all my feelings. That was my first
glimpse of sexual healing.
Joe Kramer also introduced me
to the ancient concept of the sacred prostitute -- or
“sacred intimate,” as he translated it -- who held the
space for sex to be an experience about connection to spirit
or communion with God, if you needed that in your life. Since
we don’t have temples that provide that kind of worship
ceremony in the United States, Joe Kramer devised an elaborate
training for sacred intimates, envisioning it as a
contemporary occupation. I was perhaps foolish enough to take
it seriously as something to undertake professionally. In any
case, I got a lot out of that training. Among other things,
the Body Electric School is very scrupulous in its training
programs about hygiene and protocol. So in addition to
excellent instruction in skillful touch and breathwork, I got
instilled with basic hygienic practices that are important in
maintaining a bodywork practice.
The cardinal rule of medical
ethics is “First, do no harm.” That means to yourself as
well as to anybody else. A lot of the basic concepts of
hygiene have to do with being mindful about preventing myself
from being exposed to health hazards. Protecting myself means
protecting my client. Both of us benefit.
So, for instance, I use clean
sheets and towels for each client. I wash my hands, with soap
and hot water, before and after a session. I try to be mindful
about butt hygiene and scat germs, since probably at least
half of the people I see for erotic massage enjoy some version
of butt-pleasuring. I always have a supply of disposable latex
gloves available for buttplay or use with toys, and dispose of
them properly afterwards. Finger cots are also useful to have
around, little rubbers that slide over a single finger -- I
get them at hospital supply stores. If I’m inside
someone’s butt with an unrubbered finger or anything else, I
try to be really mindful of where that hand goes next. If I do
a session where I’m playing with someone’s butt, and then
I answer the phone, and then I pour a glass of water out of a
pitcher in the refrigerator, I’ve left a possible trail of
microbes that could expose me and any houseguests to parasites
or hepatitis. Also I pay attention to lube containers and oil
bottles -- am I touching them with clean hands? I often use
disposable gloves to slip over a tube of KY, for example. One
last word to the wise about butt stuff: Clip your fingernails.
These are really basic safer-sex education things that I
picked up from Body Electric trainings, and they’re worth
mentioning particularly to professionals who presumably have
more sexual contacts than the average person.
One of the things I like most
about being a professional bodyworker is the invitation to pay
attention to my own body. Am I eating right? Am I exercising?
Am I keeping my body clean and well-groomed? Am I getting
enough sleep? If I don’t get to a yoga class once a week, I
feel tight and cranky in my body. If I don’t get a massage
myself every couple of weeks, I start feeling really draggy.
And I constantly have to be attentive to overworking. Bodyworkers suffer all the emotional strains of people who are
self-employed. I never know when the next chunk of change is
going to come along, so I’m reluctant to turn down any work.
But I have to be careful about burning out. Some signs of that
are when I have trouble staying in my body. Do I find that
I’m numbing myself out with food, or booze, or Net-surfing?
Maybe it’s time to take a break.
Some of the most important
issues of self-care for sex workers have to do with
groundedness. Touching a lot of different people, especially
on an intimate basis, can be really really fun and exciting
and satisfying at times. It also means taking on a lot of
extra energy from other people, emotional and spiritual
energy, and you have to find ways to clear that stuff out. I
remember when I started out, I thought it was my job to have
sex with absolutely anybody who walked in the door, just
because they wanted it. The third day, a guy came for a
massage who was really depressed and angry and a complete
black cloud of negative energy. Visions of sexual healing
dancing in my head, I got naked and gave him a very erotic
session and was wide open with him -- and promptly got sick
and wasn’t able to work at all for several days. It was like
I’d drunk a couple of gallons of toxic waste.
So I had to learn very
quickly how to assess people’s energy, how to control how
much of it to take on, how to maintain my own balance and my
own values and my own mood. Taking showers is one way of
clearing. Drinking a lot of water is important. I also got
into the habit of burning sage, especially after an
emotionally intense session, which is Native American medicine
for clearing and purifying sacred space for doing ritual.
Another issue for sex workers
is emotional support. Unlike office work, you don’t
necessarily have a crew of people around you who do the same
thing, whom you can talk to about your work. Unlike social work
or psychotherapy, there’s no tradition of supervision for
sex workers. You walk around with this gigantic secret in your
head that you feel like you can’t share with just anybody.
What happens when you feel overwhelmed, or troubled, or
ashamed, or anxious, or conflicted, or you find your
boundaries getting slippery, or your safe-sex standards flying
out the window? What are your own emotional needs? What are
your own sexual wounds that you might be acting out in your
work? It helps to know these things about yourself, and if you
don’t have a friend you trust to discuss these things with,
it helps to find a psychotherapist to explore these questions
with. I know I have a tremendous amount of fear and
trepidation about being judged or shamed by other people if I
talk about my erotic bodywork practice, especially when I have
conflicts or troublesome questions. I had an assumption that
any therapist would fixate on this work as being illegal or
pathological or compulsive or dangerous. Luckily, that’s not
turned out to be the case.
In dealing with clients,
I’ve come to realize that almost everything I do becomes a
model of behavior. If I’m direct and honest and upfront with
them, it’s a signal that they are free to be direct and
honest and upfront with me. Likewise, if I’m erratic about
returning phone calls or slippery with them about the fee or
manipulative about the transaction in any way, I’m issuing
them a license to be erratic or slippery or manipulative with
me. How I dress, how clean my bathroom is, how mindful I am
about sexual hygiene -- all of those things send a message.
I started my practice with a
very idealistic attitude about my ability to provide a sense
of erotic abundance and sexual generosity. I was willing to
get naked and interact with many of my clients. That period
lasted about two years. In my experience and observation, many
guys who go into sex work do it for a couple of years at most.
What happens is usually one of three things: they find a
boyfriend (which may have been the goal in the first place);
they disappear into a self-destructive spiral with drugs; or
they become completely drained of energy and move on to some
less taxing occupation. Some version of the last category
happened to me. Yet I was very committed to offering loving
touch and healing through pleasure, so I redefined my
boundaries to make it clear to my clients that what I was
offering was massage, not sex.
I want to put in a word about
the value of massage, and specifically erotic bodywork. These
days we have a lot of language to talk about sexual addiction
and sexual compulsion. But we don’t talk very much about
sexual starvation, erotic malnutrition, and touch deprivation.
Being touched is a primary human need. Very few of us get
touched as much as we’d like. I know there’s a lot of
value to getting touched or massaged in an atmosphere that is
strictly non-sexual; sometimes that’s a welcome relief and
profoundly healing in itself. At the same time, for me
personally, I find it kind of strange for a massage therapist
to touch every part of my body but steer around my genitals,
as if they don’t deserved to be touched and nurtured along
with the rest of me. My sexuality then gets split off from the
rest of my body. As gay men, most of us grew up having to
compartmentalize our sexuality and keep it hidden, creating an
unhealthy split inside us. In the work that I do, I’m
specifically giving my clients a place to integrate their
erotic energy with the rest of who they are. When you get a
good massage, every part of you is touched and honored, often
more completely and intimately than with sex partners.
A lot of the sex we have with
each other is driven by a sense of lack: “I have to go
outside myself to get something to make me whole or make up
for some deficit.” Or we think of orgasm as something that someone else
gives you. Tantra is about cultivating your own erotic energy
and orgasmic capacity, which is the same pool of energy that
supplies your ability to love and to pray. With tantric
massage, I’m empowering the person on the table to breathe
and expand and experience his own erotic self, not mine. I’m
the guide, not the ride. Modelling boundaries is one of the
most important things I can convey to my clients.
For sex workers, one of the
most important though trickiest aspects of interacting with
clients is the area of sexual ethics. Negotiating what we’re
going to do together has several layers to it. Although on one
level it can be a simple professional fee for service, there
are always health issues in the picture. It is theoretically
possible to have an erotic massage or a paid sexual encounter
that is entirely free of risk of exposure to HIV or sexually
transmitted diseases, and certainly many sessions are
conducted with scrupulous adherence to safer-sex principles.
But we all know that in the real world, there are many gray
areas, and what one person considers acceptable sexual
practice may be a red flag for someone else. This raises all
the tricky questions. Do I disclose my HIV status? Do I ask
for my partner’s? What about rimming? What about sucking?
What about swallowing cum? In any encounter, but especially
for sex workers who have an added responsibility, what’s
important is frank and honest discussion so that if there are
any risks involved, the risk is knowingly shared by both
partners.
Another ethical issue for sex
workers is getting tested frequently for STDs and being
mindful of exposing clients to communicable infections like
crabs or herpes. It’s embarrassing as hell to have to call
up a sex partner and say “I have crabs or scabies or
gonorrhea and you should get treated for it.” Among sexually
active gay men, this is an ethical issue that we don’t
address enough, in my opinion. But I think sex workers have an
especially important responsibility to model integrity around
sharing risks and contacting people about STDs if they show
up.
I know that many of the
questions I’ve had to face come from the active imaginations
of my clients. One of my clients who likes to ejaculate while
having his prostate stimulated one day posed this question to
me: “What if you got some blood under your fingernail from
the last guy?” It was a perfectly reasonable question, and I
assured him that I washed my hands after every session, but I
made a note to myself to question any buttplay without a glove
or a finger cot. Another client said, “I liked it when you
sucked me, but what if the guy at 2:00 had gonorrhea or
chlamydia?” Good question.
When I hear questions like
that, I definitely have to sort through layers of guilt and
shame and defensiveness in response. But I really appreciate
knowing that my clients are partners with me in looking at sex
work as health care.
For anyone considering sex
work as an occupation, you can look at sex work as an easy way
to make money. You can treat it as something animalistic and
mechanical and squirt-oriented and something to get over with
as fast as possible. But you have to consider whether your
attitude is supporting sex-shame and sex-negative messages
from the culture and whether you’re missing the opportunity
to have and provide someone with a transcendent experience.
I’ve partaken of almost
every possibility in the gay male sexual subculture and have
definitely had ecstatic experiences in bathhouses and
bookstores, parks and porn theaters. But I’ve also had
plenty of experiences in gay sex venues that felt alienated
and heartless, and I’m aware that sex workers are part of
that landscape. I really don’t want my work to contribute to
feelings of emptiness and spiritual deadness. I want more
erotic abundance and sexual generosity in the world. And sex
workers have the opportunity -- maybe even the responsibility
-- to be community leaders in advocating healing through
pleasure.
Originally prepared as a talk
for the Boulder Gay Men’s Health Summit in 1999, first
published in Genre magazine, March 2000
To find out more about my bodywork practice, you can visit my
webpage here.
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