Changing sexuality and the normalisation of male sex work
Is the male sex industry a reality or fiction? This question might seem a strange way to begin, but it helps provide important context for this article. When society talks about the sex industry – mainly through discourses of popular culture – it is most commonly through the archetypes of women as sellers and men as buyers that these issues are cast. Yet, Internet technologies have made one thing very clear: there is a sizeable section of the sex industry where men are the sellers. Recently, our edited collection,
Male Sex Work and Society, provided an up-to-date account of some of the key topics associated with male sex work (MSW) [
1]. This collection, alongside an increasing number of diverse international studies, highlights several important points about the male sex industry. First, the phenomenon of MSW has ‘global’ visibility. MSW exists in all societies and researchers have recently recognised the diverse structural and organisational aspects of MSW as it is practiced in various locations [
1]. Second, by all accounts there remains a strong demand for male sex workers (MSWs) in many parts of the world [
1]. Third, the growth and evolving shape of the male sex industry has challenged traditional or hegemonic gender constructs. For example, men are no longer the exclusive consumers of sex and the male body can be represented as a desirable commodity for others. And finally, although contemporary constructions of sex work have moved beyond sex workers as mere vectors for disease transmission, MSWs still represent a population at-risk for HIV and other sexually transmissible infections (STIs). The purpose of this paper is not to offer a comprehensive review of the research on MSWs (we have previously reviewed the literature in this area [
2]) but instead to highlight some evolving and key issues of interest to the public health field and society broadly. It is our contention that effective public health research and policy agendas must make use of the shifting face of MSW and draw deeper into the arenas of lifestyle and sexuality.
It is first necessary to recognise the complicated language that surrounds the sex industry and sex work. ‘Sex work’ is used over ‘prostitution’ because it helps challenge the long history stigmatisation associated with being a prostitute and evokes important notions of industry and employment [
3]. The expression ‘male sex worker’ is used in this paper to refer to sex workers whose sex as determined by biological markers was deemed male at the time of birth. This nuance deliberately excludes transgender sex workers in recognition of the different issues faced by that population. Most of the research cited in this article adopted this same definition of MSW and instances where this was not so have been made explicit. It is also necessary to recognise that sex work is often organised – particularly in research – according to location and we have therefore considered the places or contexts in which MSWs operate, such as on the street, in brothels, or online.
It is important to recognise that sex work among men is not a new phenomenon. Friedman, for example, reviewed the cultural conditions of MSW as it existed in ancient Greece and Rome, pre-modern and Renaissance Europe, and Japan in the days of the samurais [
4]. It is equally important to recognise that MSWs are not a homogenous population. Research has found significant differences between street, escort and brothel sex workers with respect to types of services offered, education, age, sexual identity, race [
5,
6]. Globally, research has also found vast differences in income and rates of HIV among MSWs [
5,
7], further highlighting the diverse experiences and situations relevant to this population. Research has also shown that physical positioning, based on masculine norms – top (insertive/dominant) or bottom (receptive/submissive) – plays some part in determining what MSWs charge their clients [
5]. It has also been reported that masculinity along with sexual identity can also influence safer sex behaviours among MSWs [
8,
9].
In the past century, sex work has represented the archetypal form of gendered deviance in modernity, being variously problematised as a criminal activity and a source of contagion [
10]. As we have observed elsewhere, MSW itself has not always been considered socially problematic [
2] with MSW historically characterised as a ‘deviant’ social behaviour not because of the sale of sex but because of the association with male homosexuality. Social concern around MSW also focused on the challenges it presents to gender norms and hegemonic forms of masculinity. For example, MSW, by definition, presents the male body as a commodity and in doing so may confront expressions of masculinity that rely on agency or aggression. MSW also presents challenges to class and generational boundaries, as seen through the ideas of ‘rough trade’ (slang for working-class men who had sex with other, usually wealthier, men for money) and ‘kept boys’/’sugar daddies’ (slang, an older man financially supports a younger man, which may involve sexual or romantic components) [
10]. Female sex work has largely been viewed within feminist theories as a gendered institution, which oppresses women while explicitly exploiting them for male consumption [
11]. Female sex work, however, also raises questions about agency, sexual liberation and empowerment, which is why some earlier writing referred to it as a ‘dilemma’ for feminist theory [
12].
Although MSW remains criminalised in many parts of the world, questions of its normalisation are warranted. In post-structuralist and post-modernist conceptualisations of risk, the construction of ‘deviance’ is a consequence of social groups increasingly encountering one another as risks [
13]. As mentioned, MSW has historically been viewed as deviant because of its association with homosexuality so the decriminalisation of homosexuality in many countries may have resulted in less policing, both socially and legally, of MSW [
2]. Kaye has argued that new social meanings for MSW in the 1970s were derived through the, “progressive integration of male prostitution into the gay cultural orbit” [
14] and there have been legislative reforms that allow gay men and women to present more visibly as social groups and communities. This change helped facilitate the appearance of more gay-identified men in samples of MSWs in the USA, with some men reporting a positive and professional approach to their work [
15]. For the first time, researchers began to challenge the constructions of male prostitution as a criminal (MSWs as victim) or health (MSWs as agent) problem. Recent research suggests that MSWs who identify as gay or bisexual tend to identify sexual pleasure as an important aspect of their work along with other positive work related experiences, such as earning ability, flexibility of work, skill development and client satisfaction [
16].
There have also been important social shifts regarding masculinity. In recent years, masculinity and male bodies have in been openly represented in eroticized cultural terms in art, fashion and film, which have worked to change popular thinking about male sexuality and masculinity [
17]. Giddens’, for example, has spoken about ‘plastic sexuality’ [
18] to emphasise the way in which sexuality has been decentred in recent decades, having been freed from its links with reproduction. Bauman’s arguments around ‘liquid love’ highlight the weakening of traditional bonds such as marriage and familial relations and how notions of love have become commoditized in recent decades [
19]. Specific to MSW, the fluidity that this introduces to sexual identities and relationships may contribute to willingness for diverse types of men to engage in sex work, which can be seen, for example, through the growing phenomena of straight-identifying men engaging in same-sex work or pornography, known as ‘gay for pay’ [
20].
The growing fluidity of sexual experiences is further highlighted by the declining currency of sexual dichotomies like heterosexual/homosexual. Indeed, the pluralisation of ‘sexualities’ is further evidence of this point. The idea of ‘gay for pay’ is but one manifestation of this social trend and it carries with it significant public health implications for the male sex industry: interventions that target a homogenous group of gay men as workers or clients may no longer be wholly valid. For example, our work with MSWs in Argentina found that men of diverse sexualities make complex decisions about working as a sex worker and providing sexual services to both men and women [
21]. Likewise, our review of the online profiles of male clients of MSWs revealed that these men are not easy to stereotype: they are young, old, blue-collar workers, professionals, gay, bisexual, straight, married, in relationships, bachelors, fit, overweight, homely, and handsome [
22]. This diversity highlights the many different kinds of experiences that are maintained by both clients and workers, not to mention varying degrees of victimization, exploitation, agency and choice.
While shifting social mores have had a role in the normalization of MSW – especially in terms of social responses to same-sex attraction – it also clear that material conditions have impacted on the way in which this industry is structured and organised [
2]. Here we highlight and discuss the impact of globalisation as witnessed via the increase mobility of MSWs, particularly from countries like the USA, Canada and Europe, to travel within and between countries, partly as a result of the emerging Internet technologies has changed the face of the male sex industry.
Conclusions
New information technologies have assisted in developing a ‘global’ perspective on MSW sensitive to cultural variations in the expression of masculine norms. Information technologies have also changed the way in the sex industry is organised and structured, and assisted in the development of a collective response among the sex industry to issues that have marginalised sex workers as dangerous criminals. The political organisation of sex workers since the 1970s has been aimed at promoting the human rights of sex industry workers alongside issues of occupational health and safety. During the same period civil libertarian groups and some feminist organisations allied themselves with sex workers to lobby for legal reform. More recently, various sex worker rights organizations have attempted to coordinate such activities, setting up the International Committee on Prostitute’s Rights. While much of this work was centred on female sex work by specifically targeting associated gender biases and stigma, MSWs have also been politically active with their work best understood through a prism of the evolving gay rights movements. Recent MSW-specific advocacy and support groups include Hook (Online), the Global Network of Sex Worker Projects, Sex Worker Education and Advocacy Task (South Africa), The Asia Pacific Network of Sex Workers, Scarlet Alliance (Australia), Sex Professionals of Canada, The Network of Sex Workers (Latin America), and the European Network on Male Prostitution. The Internet has strengthened efforts to coordinate the political activity of sex workers nationally and internationally [
92].
While in the past MSW was constructed as pathological or deviant, research is now documenting much more clearly how MSW unfolds and evolves as part of some people’s everyday experience. Much current research has re-framed MSW according to an occupational perspective that argues MSW can be a rationally chosen and satisfying activity for both client and MSW. As a result, we can better conceptualise and capture these transactional moments of sexual intimacy between MSWs and their clients with greater accuracy, realism and sympathy [
93]. From a public health perspective, however, the criminalisation of same-sex relationships and sex work hinders the translation of these theoretical conceptualisations into improved health outcomes. Criminalisation of sex work not only creates a space rife for violence and sexual health risk [
94] but it also challenges the basic implementation of health and safety initiatives by interfering with their successful operation. It has been reported, for example, that carrying condoms has been used as an excuse to harass female sex workers in the USA [
95]. Avoiding social sanctions such as these means that sex workers remain hidden from public view, which challenges important work around disease surveillance and outreach initiatives [
96]. Confronting state-sanctioned stigma and discrimination is a key component of more a more effective public health approach for both MSWs and their clients.
Safer sex must be negotiated alongside fantasies, intentions, motivations, power, and desire. In some cases the desire for intimacy and fulfilment may exceed the desire for protection. In others, MSWs and clients may seek expressions of masculinity and dominance by penetrating without condoms. In some situations, MSWs may be unable to negotiate condom use due to threats of violence or lost revenue. Further, as pre-exposure prophylaxis (“PrEP”) is increasingly touted as a major component in the international effort to combat HIV, particularly among high-risk populations, the stage is set for new questions about how this medication will be used by or provided to MSWs in diverse contexts. Research must therefore move beyond identifying MSWs and clients and seek instead to better understand the human dimensions that underpin such relationships. This approach will help inform the development of more effective public health policies and interventions.
This article’s discussions and arguments should be considered in the context of their limitations and strengths. First, epidemiological comparisons of HIV or other STIs among MSWs are not always appropriate given vast global differences in reporting requirements, not to mention the potential stigma or legal redress associated with identifying as a ‘male sex worker’. Second, this paper is an overview of key issues defining MSW at the moment and not a comprehensive review of the available literature. Finally, comparisons between male and female sex workers and their male and female clients are always challenged by the very different ways that these groups are thought about in and constructed by society and academia. Although we have drawn comparative arguments throughout, far more work is required to systematically unpack the similarities and differences.
This article comprehensively reviews sex work among men by accounting for how the globalisation of MSW through changes in society, legality and technology. By providing an overview of HIV and STI burden among members of this population, this paper contributes important epidemiological information relevant to advocacy, outreach and health promotion. Consideration for the contemporary paradigms in which MSW now operates, this paper is well-situated to continue the discussion around MSW and help foster more nuanced and targeted public health initiatives. With women increasingly visible as clients and with the demographic diversity of men who buy and sell sex, it is clear that there is need for a major rethink of how MSW is regulated and professionalised to ensure appropriate public health services and outcomes for both MSWs and their clients.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
This work has been supported by an Australian Research Council grant in which all three authors are investigators. VM contributed to the conceptualization of the article and all three authors took responsibility for writing sections of the paper. All authors read and approved the final submitted paper.