Sex Work and the City: The Social Geography of Health and Safety in Tijuana, Mexico

Conclusions and Recommendations

Conclusions and Recommendations The implications of legal status on working conditions and occupational risk are clear. Although previous research on sex work in Mexico suggests a statistical correlation between work venues and risk for stis,1 I have demonstrated how work venues affect occupational health and safety more generally as well as how legal status shapes who works in which venue. While some comparative research focuses on street versus bar workers, the legality of these venues and the enforcement practices associated with each have been overlooked. In Tijuana, surveillance and policing of those who work illegally has led to increased violence, harassment, and mental health problems. In this setting, illegal status clearly shapes occupational health and safety. My findings support the claims made by sex worker activists: criminalization of sex work does negatively impact sex worker health and safety.2 However, I would go a step further and claim that criminalization does not impact all sex workers equally: it may benefit some while disenfranchising others.One’s place within the social world influences how legal status operates in determining occupational risk. The resources of legal and illegal workers differ, therefore, and the way risks are managed also differs. Legal status and formalization shape a work venue in a way that opens potential avenues in responding to risk, avenues like reliance on and help from hotel staff, coworkers, and police. These avenues, while not completely absent, are less likely to be available to illegal workers in the informal sector. My findings demonstrate that representations of the formal sector tell only half of the story. It is misleading to rely on data from legal sex workers alone. While regulation might be more effective in lessening the severity and prevalence of occupational risks, it exists within a larger context in which sex workers who work outside of this system are criminalized, harassed, policed, and further marginalized while trying to make a living. It is unlikely that the system of regulation will be dismantled anytime soon or that illegal sex work 144 Conclusions and Recommendations activities will become legal. Although legal status can provide benefits to some workers, it is based on an exclusionary system that increases occupational risks to many while benefiting the few. This system needs to be more inclusive of those who currently work in the informal sector. Currently, the restrictions against undocumented and underage workers in the registration process deny protections to those who most need health services. Increased police surveillance leads more to fear, hostility, and evasion on the part of those who most need social services than to greater compliance. It does not encourage registration. Police violence and corruption should not be tolerated, and police should be paid a better wage so that they might be less inclined to extort money from illegal workers. Registration should not be required in order to protect personal civil rights. While regulation is an effective form of harm reduction in this case, it is also coercive in that specific categories of persons (usually women) are forced to undergo genital health inspections and treatment as well as officially identify themselves as sex workers in order to have the right to work. No other categories of workers are required to undergo these measures, and the need for a mandatory system has yet to be proven. I envision a system in which health card registration is encouraged and rewarded as part of the development of professional identity, something which surely has market value, rather than enforced through the threat of jail, fines, and (unofficially) police violence. Sex workers already employ a variety of strategies to decrease their occupational risk, but policy should focus on improved working conditions that will enable them to make safe choices. In order to decrease the prevalence of stis, municipal services should encourage regular sti screenings for all workers— especially those who, because they don’t work within a sex-related industry, are less likely to be aware of their risk for infection. Public health authorities should reprioritize the areas on which they spend their resources. They should begin to focus on areas that sex workers themselves see as priorities, namely, mental health problems, violence, substance addiction, and unsafe working conditions. stis, while certainly an occupational risk, are not only easier to manage than other risks sex workers face, but also less prevalent than other health hazards. Because of the authorities’ tendency to view prostitutes as vectors of disease rather than as workers facing a variety of occupational hazards, fears about...