A woman in charge of a program for victims of human trafficking came to my clinic for a grand rounds talk recently. She discussed the nature and current definition of human trafficking, and she expressed skepticism about the notion of “sex work”, suggesting that all such work is inherently exploitive.

In the lives of my disenfranchised patients, desperate in the midst of the demands of extreme poverty and addiction, “trafficking” is a framework that often fits better than “sex work”. I don’t see trades of sex for money working consistently well for the people on the sex side of the exchange. My clinic doesn't see a lot of creative writing majors getting some side money with genteel hotel gigs. And some of my patients have been involved in trafficking situations that are truly horrific, the unique contours of which are, frankly, worthy of more legislative and law enforcement attention than they get.

On the other hand, there are some exceptions. An easy example might be when strippers have organized into unions recognized by law as collective bargaining units. That’s “sex work” by any measure. (And the progenitor of “always look for the union label” jokes by sex worker advocates.) And there are independent sex workers who don't owe their earnings to anyone else but themselves: are they victims?

It’s sometimes tempting to think that sex workers who don’t use a "trafficking" frame are just fooling themselves—allowing their rhetoric to conceal the systems of exploitation (direct and indirect) around them; or, even more commonly in this debate perhaps, using empowerment rhetoric as a way of justifying their involvement in an economy that is inherently disempowering. It’s hard to argue against the idea that the economy of sex work is mostly built on attitudes that are inherently exploitive.

But I liked this article from The New Yorker, following some sex worker advocates at a protest recently. People using the “sex work” frame are angry that people using the “trafficking” frame have shut off one way that sex workers could regulate and control their economic lives and their physical safety, with laws that are aimed at internet trafficking.

I’d consider myself a feminist or at least an aspiring feminist, but I’m no feminist theorist. In this space, the tangles of political philosophy and difficult choices about regulation, safety, and societal values are deep and difficult. But being
from San Francisco—where union strippers and others schooled me in a “sex work” frame—I can at least stay in the space of, its complicated. And I hope we can let the experiences of the people with whom we work—whether they are sex workers, victims of trafficking, or both—guide how we think about the economics of sex.

I know of cases where the internet has been used as a tool of brutality. But I also have heard people's stories of getting into cars or trucks and finding themselves in mortal danger, where my inner reaction has been, maybe a web site might be a better way to do this? Some of the stories I’ve heard from street work have made me want to start internet skills classes for people who are "doing sex work" or "being trafficked", or both. Which is why I worry about whether a law to go after traffickers might instead be endangering the people whose bodies are actually on the line.

I missed the SOSTA/FESTA debate until it was too late to make a difference. With a 97-2 vote in the Senate, clearly a lot of people missed it. Most of the people arguing against this approach were people who cared about the rights of tech companies and internet sites, not sex workers. But now we're left with the world we're left with, which, websites or no websites, continues to be violent against women. Websites or not, the system continues to be stacked more heavily against people who do sex work, or are trafficked, or both, than it is against the people whose money creates markets for sex.

At least some of the people who are operating in a feminist philosophical framework but describing sex work as "trafficking" have a utopian end goal: the end of exploitation and of exploitive sexual and economic relationships. On larger goals like that, I am a pessimist. On small goals--like the idea that by slightly modifying elements of a terrible world, we can make it slightly less horrific--I am an optimist. I find that this inclination, more than any greater philosophical framework, gives me a particular sympathy for the "sex work" frame.

And at the same time, where I actually work and live, my patients who find themselves in the sex economy (primarily because of their relationship to the drug economy) are, in fact, much more "trafficked" than employed. In my small corner of the world, I don't presently know any "sex workers", and I do know a number of "victims of trafficking." A change in jargon alone won't transform that brutal reality.

Still... maybe a web skills class?