La base material

Another reason for not telling about their sex work to health personnel was due to the fact that many of the women separated this from the life lead in their home country or staying country. Many spoke about sex work as something they only did in Oslo and that it was something secret or hidden from their social network at home or in their staying country. For many of the informants it was important to underline that sex work was not something they wanted to do the rest of their lives, it was rather a condition due to family obligations of economic nature or economic hardship. Many of the women spoke about their previous work, their family lives and relations outside Norway. It was important for them to make a distinction between sex work and their life at home or in their staying country. Sex work was seen as just work, while their true lives and identities were elsewhere. In the interviews it was important for many to emphasize and describe their “proper lives where they had normal jobs and families”. Logically the side of their lives which involved selling sex was not something they wanted to tell or share with people at home or in a staying country, not even health personnel. As one of the women explained:

[...] that is why when you asked me that with my doctor in Italy, [We had previously talked about if she could tell her doctor in Italy about selling sex in Norway] I cannot tell him, this is my secret, I can’t. In Italy much of them they don’t even know what I am doing [...]

Disclosure about sex work to health personnel in their home or staying country then

translate into a wider frame, not only relating to fear or prejudices from health personnel. It is also a way of enforcing the duality of one‟s life, by protecting the life that is lived outside the realm of sex work. The external aspect of this protection strategy can be seen as preventing someone at home or in your staying country finding out about the sex work. For example one informant said that her regular doctor was a friend of the family and she therefore could not tell him, in case he would come to their home and tell her family. Fear of someone finding out is thereby linked to the aspects of stigma and moral views about sex work in society.

Keeping sex work a secret from family member or other social relations has been pointed out in several studies on sex work (Chacham et al. 2007, Skilbrei 2007, Bucardo et al. 2004, Sanders 2004, Renland 2002, Alexander 1998, Høigård &Finstad 1992). The fear of someone finding out is something which stays with the women throughout their lives, and can result in psychological stress (Sanders 2004). This fear is built on cognitive constructs about how a potential disclosure would affect one‟s relationship with family and also wider social networks. The negative connotations of sex work in most societies will therefore reinforce this fear, making it crucial that disclosure does not occur, as illustrated by this qoute:

[...] this is my private. I not talk about me there, old friends other. I have son go to school, other mamas, son go together school, I never speak about my business here over there [...]

At the same time the internal reason for not wanting to tell anyone outside Norway about selling sex can be seen in relationship to the separation of one‟s lives into one sphere with sex work and another one at home or in a staying country. The geographical distance that these women have between their two lives also underlines and facilitates these two realms of their lives. The division made between these two lives can be seen as a way of protecting oneself. It is a way of distancing oneself from sex work and preventing it from becoming a part of one‟s identity. By building and maintaining this duality in their lives, it is easier to see the sex work as “just” work where one plays a role in a specific setting. One of the women put it like this: [...]I just do this for work you know, for me it’s not that I am thinking with heart you know, this is just work. As this quote shows the sex work setting is separated from

one‟s personal lives, feelings, values or identities. The distance this duality creates and rebuilds is functioning as a strategy to shut out the shame and disrespect related to sex work when one is at home or living their “normal” life. Day (2007) discuss a similar finding in her book about sex workers in UK. She points out how different rules were drawn up by female sex workers as protection strategies in order to separate sex work, from their private lives.

This is a much discussed issue in the literature on sex work (Day 2007, Skilbrei 2007, Sanders 2004, Renland 2002, Warr & Pyett 1999, Høigård & Finstad 1992). However as Shaver (1994) has argued such strategies are not unique to sex workers, as other professions also has strategies and methods for creating distance. Sometimes emotional distancing is required as a way of emotional protection while working, in other cases it is integral to professional ethics. The last part is especially true for people working in care profession, like nurses, doctors and social workers. Still, it remains an important strategy for sex workers when it comes to protecting their private lives. For example, Høigård and Finstad (1992) describe how Norwegian sex workers have different strategies for protecting their private live. One method was to create a new identify, by specific clothes, wigs and make-ups, and be strict about not revealing anything personal. This was usually combined with other strategies, such as drawing bodily borders where certain activities and areas were off limit¹⁵. In this way the sex worker distances herself from the client, but is also creates distance between her and sex work. Framing sex work into an explicit role, with a specific uniform, facilitates the boundaries set between this role and one‟s private life and self (Høigård &

Finstad 1992). Having a doctor reserved for this role can then be seen as an important part of this protection strategy.

Having two doctors, one confined to the “normal life” and one for the life as a sex worker, is a physical structure underlining the separation of these two lives. Disclosing sex work to a doctor or health personnel at home will lead to a merging of these two cognitive constructs, thus bringing the shame and stigma of sex work into the sphere of the “normal” live. The consequences of this can be difficulties in relation to their families and friends in their home and/or staying country, translating into shame for both the family and oneself. At the same time the internal consequences would be that the protection made by this separation of

15 The women interviewed for this study, mentioned similar protection strategies when talking about risk of disease transmission.

oneself is ruined and that sex work would become part of one‟s identity in both spheres of life. However it should be questioned whether this separation of one‟s live and consequently distancing oneself from sex work, treating it as just work, is a possible mechanism in the long term. Høigård & Finstad (1992) found that the mechanism of keeping sex work

separated from one‟s private life became complicated in the long run and that the boundaries between the two realms got more difficult to maintain with time.

In this study it was clear that social stigma or self-stigma of sex work prevented many of these women from telling their doctors or other health personnel about this side of their lives.

The reluctance to tell health personnel about their sex work experience is complex and has many layers. It is tied to the stigma in terms of negative expectations if health personnel were to find out, but it also relates to an internal protection strategy of separating one‟s live into two parts: a private part and sex work. Using two doctors can then be seen as a physical tool for separating these two realms of one‟s life, where the threshold for bringing sex work into an arena of one‟s private life, like a general practitioner, is seen to be high. As sex work involves special health needs and a high morbidity (Jeal & Salisbury 2004), a negative outfall is likely to be that these health needs are not addressed or met. In this way the social moral and values regarding sex work, as well as these women‟s own protection strategy can act as barriers for these women‟s health behaviour, even when risk or disease are recognized by the women themselves. In the absence of other services the affect on their health can be grave. However, in this study it was found that the women used an alternative health service targeted at sex workers for health purposes relating to sex work. How this service was viewed and it‟s perceived significance will be addressed in the following section.