Part II of our Fellow Series with Leslie Chase brings our focus to her work, some specifics on her project, and be sure to look out on the NSRH Social Hub App (on google play and the App Store) for ways to support her fundraiser to assist with supporting the necessary work Leslie discusses below.

NSRH: How did you recognize the need for this service, and how did you center those most impacted in the development of this project? 

Leslie Chase: Through my work with Planned Parenthood, we initiated gender-affirming hormone therapy at our affiliate. With that came the search for many different resources in all of our regions for that population of patients that we were starting to serve. I was involved in that search. In that search, we created a relationship with the Transgender Health and Wellness Center, and actually, my work with them pointed out this specific need. A lot of their clients were sex workers who needed services. So that's how I identified this specific population. I think my work in my master's program when I was working on SRH and looking into that worldwide. It's just something that kept coming up. This need existed. 

NSRH: What are some of the biggest misconceptions you hear within the nursing and health profession related to people who engage in sex work/bodywork? 

Leslie Chase: Unfortunately, I see a lot of evidence of stigma in general, especially around sex. there's a lot of assumption that people who engage in sex work or bodywork are irresponsible or don't care about their own health, or they somehow deserve any adverse health outcomes because of the "risk associated with their work." There's a lot of that kind of language, and that somehow it's our place as nurses or providers to judge them instead of caring for them. It's pretty heavily laden with stigma. I see that a lot, especially from other students who maybe have only worked in primary health care settings or urgent care settings. Another assumption is assuming that every sex worker does not want to be in sex work. Like in any other job, some find it to be empowering, or they see it as their job, or some don't want to be in it. I think that it's essential not to assume that every person who engages in sex work does or does not want to be in sex work.

Another thing is it's important to reinforce to some of my colleagues that sex work is work, full stop. I think people forget that. Just like any other patient, they're deserving of our non-judgemental care and respect, and it's our job to deconstruct our stigma around it. 

 NSRH: What frameworks or education models do you think would be helpful in classrooms for people becoming health professionals who may work with patients engaging in sex work?

Leslie Chase: I think harm reduction is beneficial. Substance use disorder and sex work often overlap, so I think that's an excellent way to frame it. I believe that the harm reduction model applies to how we approach youths to engage in what we've labeled as "risky behaviors." I also try to view all my work through a health equity framework. That's been helpful in just removing yourself from any personal or moral judgment or attachment, and doing it through health equity or reproductive justice framework is powerful as well. 

NSRH: What are the most significant barriers to care you see through your work with sex workers? Has the pandemic illuminated this?

 Leslie Chase: In our initial survey, many folks mentioned that they need help getting connected to services in mental health specifically. Even if they can get connected to a therapist or someone similar, a lot of that service still comes to judgment and stigma. I think a huge barrier to them is accessing non-judgmental services. There's a specific request for, "how can I get services from providers who have had experience with sex workers, who are sex workers themselves, or did do sex work previously?" So that they can not only relate better to specific challenges or experiences of sex workers but also ensure that they were not getting care. A considerable barrier is not knowing if it's safe to divulge your activity in sex work to whatever provider you're going to get care of. It's a huge barrier. 

Through the pandemic, there's a lot of language about irresponsible people, not wearing masks, not social distancing, and things like that. This population is being forgotten. We're calling other professions that have had to continue to work through the pandemic heroes but giving very little understanding to people who do sex work and have to continue to live through the pandemic. They have no other choice. The population is being disproportionately judged, stigmatized, and left behind because of the stigma around sex and sex work during the pandemic. 

* Leslie's virtual fundraiser to build and issue out these essential care kits is set for 11/13/2021! More details to come on how to support this amazing project!