The Health, Care and Wellbeing Needs of People Involved in Sex Work in Essex

Following on from our report into the experiences of prisoners and ex-offenders in 2023, today we have released our latest report looking at the needs of another seldom-heard group in society – sex workers. Through this project, we hope to raise awareness of sex workers’ experiences, as well as contribute to improving outcomes in the realm of health, care and wellbeing.

Our report shows that sex work is happening across Essex, despite some people believing that it only exists in big towns and cities. The hidden nature of the topic, and the unwillingness to accept it is happening, makes it difficult for services to provide support.

The main ‘red-light district’ in Essex is in Southend, and so in Southend there are more support services and a greater sense of community for sex workers than in other areas of the county. Elsewhere, sex work is more fragmented, meaning increased isolation for sex workers and reduced availability of support services. The report also shows that sex work is increasingly happening online, with the rise of OnlyFans, webcam sites and ‘alternative lifestyle’ sites, which present new challenges.

We interviewed six people from across Essex about their experiences of sex work. Their stories were diverse, but there were some commonalities between their experiences:

A quote from Rachel's story - I would have visions of men being on top of me, I didn't know if they were real of hallucinations. At the same time, Bradley was giving me a litre of vodka every day, so I was drugged up to the eyeballs and probably alcoholic.

This quote from Rachel’s story demonstrates the relationship between addiction and coercion.

  • Addiction plays a big role in many of these experiences. Often addiction is encouraged by a perpetrator to create a dependency and to allow them to control the individual. Others use drugs and alcohol themselves to cope with what is happening.
  • Finance can be a big motivator for sex work, although not always in the way that might be expected. Some participants do sex work to support their families financially, but others do it for extra disposable income, or potentially put their careers at risk to engage in sex work.
  • Many of the participants experienced mental health difficulties before and after being involved in sex work. There is a great deal of shame that was expressed in these stories.
  • There was also a lot of trauma in their stories, usually through childhood abuse and domestic violence. It is clear that trauma had featured significantly in many of their lives prior to any involvement in sex work.
  • Most people had been let down by professional bodies or agencies, whether that be police, mental health professionals, or social care. However, a lot of the participants praised the addiction and homelessness services they engaged with for offering a great deal of support.
  • Coercion can come in many forms. Some participants were groomed by their partners. Others felt the pressure from their families to provide for them.

Reflecting on this project, Sharon Westfield de Cortez, Healthwatch Essex’s Information and Guidance Manager and the author of this report, said:

‘Throughout the engagement phase of this project, I was privileged to meet a cross section of people from across the county who were willing to share their lived experiences around sex work. I cannot thank them enough for their honesty and willingness to talk with me, often about highly traumatic and distressing events in their lives.

I hope that this report gives insight into the fact that sex work is happening in many towns and villages and is no longer typified by the red-light district and sex workers out on the street, although that undoubtedly still exists. Digitalisation and social media have diversified sex work immensely, and whilst some participants shared that there was some degree of choice and control in their decisions and actions, it remains evident that for the majority of those involved in sex work, abuse and exploitation features significantly in their lives, along with vulnerabilities such as domestic abuse, addiction and mental health issues.’

This report highlights the need for many improvements to support the health, care and wellbeing needs of people involved in sex work in Essex: increased investment into addiction and homelessness services; improved mental health support; stronger multi-agency approaches to safeguarding; greater awareness of the financial support available; and crucially, improvements in how we speak to and engage with people.

Stigma around sex work still exists. We all need to acknowledge that sex work is happening and reduce this stigma, so that we can fully shape services to meet the needs of those that are, and have been, involved in sex work.

#ItIsHappeningInEssex

To read the report or the collection of people’s stories of sex work, click here. One of our ambassadors, Allie, shared her experiences of childhood abuse and sex work on our Hidden Voices podcast last year – listen to her story.

If you have been affected by any of the issues discussed in this project, please get in touch with our Information and Guidance team to access support or to share your own experiences.