An Epidemic of Virtue: A Review of Social Work's Complicity in “Prostitution” Interventions

Progressive Era Social Reform

The Progressive Era, spanning from 1890 to 1920, was characterized by middle-class reformers attempting to alleviate social problems presented by industrialization and urbanization (Kennedy, 2008). Mass immigration of Europeans and post-civil war migrations of newly freed Black people from the South to urban centers in the North further contributed to economic and demographic changes (Quinn, 2014). White middle-class anxieties fueled by racism, xenophobia, and misogyny developed in response to the growing multiracial working-class population, feminist movement, expansion of urban environments, and fear of “disease,” “immorality,” and “vice” that might spread within that context (GHJP, 2018; Long & Frost, 2012; Quinn, 2014). Congestion, pollution, poverty, and disease grew alongside industrial capitalism. In response to these problems, Charity Organization Societies (COS), the predecessors of modern social work, posited that urban poverty resulted from individual moral deficiencies. COS workers viewed women as incapable of independently making safe and healthy decisions and believed them to be vulnerable to male sexual desires (Wahab, 2002). Women who engaged in nonmarital sex were thought to be “fallen” women and were likely to be surveilled by COS workers.

Concurrently, the Settlement House Movement, similarly aimed at alleviating social problems and restoring social control, spread across the United States. Their approach differed from COS in that they believed that, by embedding workers within the “slums” and partnering with the community, they could spread democratic values and “civilize” the poor (Wahab, 2006, p. 45). Unlike the COS workers, they employed a structural analysis of economic and political conditions that contributed to the plight of the poor and thus supported reforms such as fair wages for women and labor unionization. Many settlement workers aimed to abolish prostitution and believed they must rescue sex workers from sexual “slavery” (Wahab, 2002). Jane Addams argued that some wayward women had “instincts for decency” instilled by their families, while others were “beyond the protection of the law” (Addams, 1912). This statement reflects a common belief held by anti-prostitution crusaders, including doctors, police, social workers, public health workers, and some feminists. The belief that prostitution was a social evil informed many early social workers’ feminism, highlighting how their relative progressivism did not extend to women's sexual autonomy.

Professionalization for Some Women, Medicalization and Criminalization for Others

The movement against prostitution provided an opportunity for feminists and social workers to establish professional status and mechanisms of social control. As the social work profession consolidated, middle- and upper-class white feminists entered the field in droves, claiming their role as political advocates tasked with social reform (Mac & Smith, 2018). The intersection of professional care work and feminism, paired with white anxiety about mass migrations, urban living, and the “excesses of commercialism and consumerism,” converged on a movement against prostitution (GHJP, 2018, p. 17). To reformers, prostitution represented vice, venereal disease, and a threat to white femininity, the white family, and white women's perceived equality under the law (Long & Frost, 2012; Smolak, 2013).

In 1910, feeblemindedness became a popular diagnosis in medicine and the emergent social work field. Feeblemindedness was grounded in the idea that “an overdeveloped body signaled an underdeveloped mind” (Wahab, 2002, p. 49; Kennedy, 2008). Practitioners of various stripes argued that there was a link between “female criminality” and “low intelligence” (Abrams & Curran, 2000, p. 60; Wahab & Panichelli, 2013). Furthermore, they believed that promiscuous women could spread feeblemindedness across cities. This panic led to nationwide eugenic sterilizations of women deemed “sexually delinquent,” with Black women comprising the majority of women harmed by this designation and procedure (Kennedy, 2008, p. 26). Social workers assessed young women for evidence of “immorality,” including “ruptured hymens,” “low IQs,” and feebleminded characteristics (Kennedy, 2008, p. 32). Police, judges, and social workers marked certain women as sexually promiscuous but amenable to intervention. Professionals sent these women to reformatories (Wahab & Panichelli, 2013). Workers at reformatories taught “wayward” women domestic skills such as cooking and cleaning and instilled Victorian values about sexual abstinence and family life to counter sexual promiscuity (Wahab, 2002).

Medical professionals argued that “prostitutes” were fueling the spread of gonorrhea and syphilis and began working with social workers and Christian reformers to educate and manage sex workers (Smolak, 2013). Through interdisciplinary practice with doctors, female social workers were able to leverage the legitimacy of their male professional counterparts. The pathologizing of women's sexuality advanced a narrative in which professionals could reform some women (white women with intact families) while criminalizing others (immigrant and racialized women). A sex panic emerged from this polarizing approach to young women's sexuality. Police targeted Black women living in urban areas as alleged “prostitutes,” while women of diverse backgrounds in New York City were funneled through “night courts” for sexual licentiousness and screened for mental illness and venereal disease (GHJP, 2018, p. 17). Many were institutionalized in the reformatory system or incarcerated.

Black sex workers bore the brunt of social stigmatization and criminalization. Black sex workers’ resistance to “public propriety” and “sexual purity” posed a threat to whiteness (Blair, 2010). At the same time, they were “[negotiating]…working-class notions of respectability, individual self-respect, and economic self-reliance” by trading sex in an economy designed to limit their physical and economic autonomy (Blair, 2010, p. 11). Black sex workers “embodied tensions between sexual pleasure and sexual danger,” and journalists, police, and social reformers portrayed their workplaces as “unsafe and disorderly” (Blair, 2010, p. 93). These portrayals, conjured from “white male constructions” of their sexuality, divided sex workers by race and contributed to the segregation of brothels and “leisure resorts” (Blair, 2010). Police and buyers justified violence against sex workers with these racist portrayals. As urban migration increased, anti-prostitution activists pressured police to further intervene on brothels and resorts that allowed interracial sex trading. By 1924, more than half of all women arrested for prostitution in Chicago were African American (Blair, 2010). The policing of Black women's bodies depressed sex workers’ wages and threatened their freedom.

Criminalization became the leading paradigm for controlling women's sexuality, punishing immigration, and enforcing the race line. While white women entered the political sphere equipped with new rights, immigrant men and women faced state repression via anti-prostitution laws. White social workers, Christian reformers, feminists, medical doctors, and criminal legal professionals sensationalized the white slave trade, a myth of immigrant men sex trafficking white women (Long & Frost, 2012; Wahab, 2002). The panic culminated with the passage of the Mann Act, supported by leading feminists, a racist law that prohibited the trafficking of women for the purpose of prostitution. This law aimed to “protect” white women from racialized men and white men from “disease-carrying prostitutes” (Wahab, 2002). It also transformed previously tolerant approaches to brothel-keeping, using raids and police violence to intervene on sex trading in red-light districts (Blair, 2010). Few sex workers reported being trafficked, which reveals how the criminal legal system and much of the social reform movement were strategies for managing racist fears of cultural and racial “contamination,” vice, and the changing role of women (Wahab, 2002, p. 42).

Fiscal Reforms

Fiscal reforms in the 1970s and 1980s reflected a new government approach to societal management, economics, and welfare provision (Incite!, 2007). Economic reforms set in motion under Ronald Reagan's presidency relied heavily on the concepts of government non-intervention and personal responsibility yet require the massive expansion of carceral interventions in the working class and poor (Incite!, 2007). The “social insecurity” produced by the “casualization of wage labor” and the diminishment of welfare provision under neoliberal policy required constant capitalist intervention via policing the poor (Wacquant, 2012, p. 38). As the state retracted its responsibility for the welfare of its population, new programs emerged to provide “soft control” via non-profit and for-profit social services to relieve the “social disorder” created by lack of access to employment, fair wages, and benefits (Incite!, 2007, p. XVI; Kim, 2018).

Simultaneously, the state invested heavily in criminal legal interventions, giving rise to a carceral apparatus that doubled the prison population over Reagan's eight-year presidency (Cullen, 2018). These economic reforms relied heavily on racist and patriarchal discourses that blamed marginalized people for their “failure” to participate in a racially and sexually stratified labor market. As a result, large swathes of the population, especially immigrants and people of color, became dependent on the state for paltry welfare allowances while being criminalized. This trend towards punishment, which Lloyd and Whitehead (2018) refer to as “neoliberal penalty,” had three “limbs:” the “reproduction of social insecurity…exclusionary punishment, and prison” (p. 60). Currently, policing and imprisonment continue to dominate approaches to social problems, even as discussions of criminal justice reform abound. Retributive punishment is an essential feature of neoliberalism across time.

Criminal legal responses to the 1980s AIDS epidemic in the US demonstrated this phenomenon. The gay community “bore the brunt” of “media-induced panics” about AIDS, were heavily stigmatized, and were required to navigate a private health system aimed at “[limiting] its liabilities and [constraining] costs” (Bell, 2018, p. 8). Sex workers were also prominently scapegoated despite showing low prevalence rates for HIV infection during the 1980s (Scambler et al., 1990). As a result, sex workers were further stigmatized, surveilled, and criminalized. Many US states introduced mandatory HIV testing of sex workers (Baskin et al., 2016). They criminalized the transmission of AIDS, adding “prostitution-while-HIV-positive statutes,” which “expand and exceed the penalties normally available for the underlying prostitution-related crime” (Baskin et al., 2016, p. 386). Here, the stigmatization, medicalization, and criminalization of sex workers were directly linked. As a result, sex workers were left to manage their personal safety within a context of limited access to services, an increased sense of danger, and continued criminalization. Unfortunately, there is a gap in the literature on social work interventions on sex work throughout this period (NASW, n.d.).

Second-Wave Feminism and the Sex Wars

The second-wave feminist movement grew out of mass social movements for racial and economic justice in the United States, spanning from 1960 to 1980 (Drucker, 2018). The movement's famous dictum: “The personal is political,” revealed the inextricable ties between women's personal and political struggles (Drucker, 2018). It challenged the idea that women's lives should be constrained to homemaking and other reproductive labor and argued for equality.

In the late 1970s, the movement became polarized due to internal debates about women's relationship to the sex industry (Phipps, 2017). For “radical feminists,” porn and prostitution were inherently oppressive and were causally linked to sexual violence against women and male entitlement (Mac & Smith, 2018; Phipps, 2017). Radical feminists took positions like those of early twentieth-century social reformers who saw prostitution as a site of women's oppression and aimed to abolish it. By contrast, “sex-positive” feminists argued that there could be agency and gratification in sex work (Mac & Smith, 2018). Sex positive feminists began to align with neoliberal discourses, arguing for “consumer choice” and seeing the market as a site of “empowerment” for women (Phipps, 2017, p. 307). Unlike the radical feminists, they tended to avoid advocating for police intervention on sex work.

Alongside the rise of neoliberalism, a binary emerged that ruptured the feminist movement. Women could frame sex work as a free choice, embracing the “happy hooker” narrative, which equates “selling sex” with “joyful sexuality” and tends to minimize the experience of sex workers experiencing coercion, violence, stigma, and labor and immigration abuses (Mac & Smith, 2018, p. 83). Or they could identify sex work as a site of coercion, violence, and oppression, seeing sex workers through the lens of victimhood. Despite Black feminist and socialist feminist efforts to support sex workers’ labor rights, this binary narrative foreclosed nuanced discussions of sex work in the mainstream feminist movement, alienating sex workers who were organizing throughout the 1970s (Chateauvert, 2013).

A significant failure of the mainstream feminist movement was its inability to see sex work as a site of the “intersectionality of capitalism, patriarchy… sexual apartheid,” and racism (Beloso, 2012, p. 61). By separating sex workers from the feminist movement, feminists failed to account for the fact that prostitution is not a “unique form of exploitation” but deeply tied to other forms of women's oppression (All the Work We Do As Women, 2012). Many women provide men with sexual services in exchange for “access to money” by nature of the structure of the nuclear family and heterosexual relations, and “all workers sell their bodies and time in exchange for money” (All the Work We Do As Women, 2012). Anti-criminalization feminists have long pointed out that unlike housewives, sex workers are compensated for their services. This assertion denaturalizes the relation mainstream feminists aimed to eradicate – the idea that women belong in the home raising children and caring for their husbands, and they do it uncompensated out of love or natural inclination (All the Work We Do As Women, 2012). The idea that sex work is inherently violent arose as “truth” out of the ashes of the movement. The convergence of the state “crime control apparatus” and the anti-violence movement resulted in a focus on regulation and criminalization as opposed to women's sexual autonomy (Bumiller, 2008, p. XII). This convergence created another harmful duality: those who need to be criminalized for harming women versus rescuable women requiring therapeutic intervention (Bumiller, 2008, p. XII).

Violence Against Women, Criminalization, and the Therapeutic State

Many white feminist anti-violence activists understood that they could gain “support and resources” from the state if they joined it in framing sexual violence against women as a criminal legal issue (Bumiller, 2008). Women of color forewarned that collaboration with the state and police would harm women and men of color (Kim, 2018).

Throughout the 1980s, the state used various “panics,” fueled by the “AIDS epidemic,” “the war on drugs,” and “shifting gender norms,” to justify increased criminal and therapeutic interventions for social problems (Bumiller, 2008, p. 20). Interventions included “increased prosecutorial power, mandatory sentences, and an unprecedented rise in the prison population” (Bumiller, 2008, p. XII). This shift also included the “professionalization” of the feminist anti-violence movement (Mehrotra et al., 2016, p. 155). Through new alliances with the state, organizations could procure funding for services. Funding was allotted only to organizations run by professionals instead of community organizers, and the state required that non-profits provide “financial records, case notes, and program evaluation results” (Incite!, 2007; Mehrotra et al., 2016, p. 155). “Business-oriented language and regulations” further distanced workers from the grassroots origins of anti-violence work (Anasti, 2017, p. 416). The emphasis on the professionalization of workers and therapeutic modalities gave rise to the influx of social workers into anti-violence organizations, resulting in a decreased focus on consciousness-raising, peer counseling, and community organizing (Mehrotra et al., 2016).

Kim (2013) suggests that the “fetishization of safety,” which puts “excessive focus” on “physical safety and the presumption of safety” in the treatment of survivors, constrained the efforts of social service workers. It also contributed to a heightened focus on criminal legal interventions (p. 1282). As a result, workers focused on the separation of abuser and survivor, failing to recognize that more “complex changes” needed to be made in the lives of survivors (Kim, 2013). Indeed, separation and incarceration are individual solutions with vast social implications. These solutions fail to engage with the broader social conditions that produce gender violence and further perpetuate the criminal legal logic that “dangerous, criminal classes” need to be removed from society (Kim, 2013).

In this carceral model, workers prioritize safety over survivors’ self-determination. Through this transformation, the state bestowed non-profit services with a “soft-control function” inherited from the welfare sector, which was ravaged by neoliberal reform. “Neoliberal penalty” focuses interventions on punishing abusers while limiting social change and survivors’ access to community and material support (Lloyd & Whitehead, 2018). In short, it favored therapeutic intervention for survivors and incarceration for abusers.

The “nonprofitization” of the anti-violence movement completed the transformation of violence against women from a social issue to a criminal legal, medical, and psychological phenomenon (Bumiller, 2008; Incite!, 2007). Advocates and activists fighting against domestic violence contested these changes (Kim, 2013). They argued that “criminal legal interventions” and “professionalization” would depoliticize the movement (Kim, 2013, p. 1276). However, many feminists joined this reorganization seeking to fight the “gender war,” a phrase employed by the state to justify intervention, “regulate sexual practices,” and target men and women for “therapeutic treatment or regulation” (Bumiller, 2008, p. 18; Mehrotra et al., 2016).

The convergence of carceral feminism, social services, and the state consolidated over the last century to the detriment of sex workers. The narrative of women as victims of patriarchal violence is rooted, in part, in the anti-sex work feminism of the late 1970s and the social reform narratives of the early 1900s. Survivors of violence could now choose between the “private patriarchy” of the family and home, or the “public patriarchy” of social services, which administered resources based on women's cooperation, respectability, and subordination (Bumiller, 2008, p. 97). The latter is often referred to as the “penal welfare system,” and its hostile view of sex workers as unruly victims of patriarchy is well documented (GHJP, 2018). Moreover, the medicalization and criminalization of sex work paved the way for the state to apply a similar logic to sexual violence.

The Violence Against Women Act and Mass Incarceration

In 1994, the federal government passed the Violence Against Women Act, injecting 800 million dollars into law enforcement agencies to increase arrest policies, prosecute domestic violence, and create services for survivors of domestic violence (Panichelli, 2018). It also sent 100,000 more police into the streets and earmarked 10 billion dollars for prisons (Mac & Smith, 2018). This legislation led to the incarceration of hundreds of thousands of Black and poor Americans. Just as Black feminists warned would happen, it also contributed to an increase in arrests of women, due in part to “dual arrest policies” that gave police the discretion to arrest both partners at the scene of a domestic violence incident (Mac & Smith, 2018, p. 272). By turning to police to curb gender violence, well-intentioned feminists and social workers contributed to the policing of women of color, LGBTQ + people, and others. The imprisonment rate doubled from 1994 to 2009 (Eisen, 2016). Importantly, social service agencies could now provide services for “victims,” engaging in “social service work,” rather than “social change work,” individualizing problems that require structural change to ameliorate (Incite!, 2007, p. 129). This allowed social workers to professionalize their role further and feel good about intervening on gender violence while serving the interests of funders and the state.

“Militarized Humanitarianism”

Carceral feminism refers to the strain of mainstream feminism that “mobilizes the criminal justice system” in the name of gender justice, and it is associated with whiteness, anti-prostitution feminism, and the wing of the anti-violence movement that collaborates with police and the courts (Bernstein, 2012, p. 220; Kim, 2018). In the early-1990s, “abolitionist feminists,” a term that refers to their goal of abolishing prostitution, developed a partnership with liberal and conservative officials and right-wing evangelicals to end prostitution (Bernstein, 2010; Grant, 2018). They are also known as Sex Worker Exclusionary Feminists (SWERFS) (Mac & Smith, 2018). Decades of feminist collaboration with the criminal legal apparatus and a new sex panic formulated by the Christian right-wing, some celebrities, and eventually peddled by George Bush all helped to facilitate this new coalition (Grant, 2018; Haynes, 2014).

To develop an anti-trafficking campaign, these professionals and politicians employed radical feminist anti-sex work politics and coalition-building strategies strikingly similar to Progressive Era collaboration between feminists, Christian reformers, social workers, and the criminal legal apparatus (Bernstein, 2010; Grant, 2018). Their shared commitment to the neoliberal model of humanitarianism manifested in the framing of prostitution as trafficking, regardless of whether it was voluntary or forced. By framing prostitution as forced labor and conflating sex work and sex trafficking, these activists established anti-sex work politics as a “humanitarian issue” (Bernstein, 2010, p. 57). They used this crisis to manage prostitution and incarcerate marginalized people. Evangelicals also seized this opportunity to secure “heteronormative family values” under the guise of feminism and “human rights” activism (Bernstein, 2010, p. 57). Together, they used federal and state legislation to pass anti-trafficking bills that functioned as anti-sex work bills (Mac & Smith, 2018). For example, the 2000 United Nations international agreement on “combatting human trafficking,” also known as the Palermo Protocol, highlights how this coalition used drafting sessions for the agreement to further mainstream anti-prostitution politics and foster international backing for the framing of trafficking as a border and crime issue (Chuang, 2006).

The Unites States’ criminal legal position on sex work and sex trafficking reflects what Bernstein (2010) refers to as a “militarized” approach to “humanitarian” endeavors (p. 58). In the early 2000s, the United States emerged as the “global sheriff” of anti-trafficking, passing the Victims of Trafficking and Violence Protection Act weeks before the Palermo Protocol (Chuang, 2006). This legislation did not provide a “distinct definition of trafficking,” again allowing for the conflation of sex work and sex trafficking (Chuang, 2006; Hu, 2019, p. 424). The anti-trafficking campaign had a pronounced impact on social service provision. The Department of Justice, which provides anti-trafficking grants to social service agencies, explicitly stated in its funding request that prostitution is “inherently harmful” and “dehumanizing” (DOJ, 2020, p. 6). Furthermore, it prohibited agencies from using funds to advocate for its legalization, regulation, or decriminalization (DOJ, 2020).

Racism, ethnonationalism, and anxieties about women's sexuality and commercial sex are central to immigration policy and the story of social work and US feminism. As is true of the Progressive Era, modern anti-sex trafficking laws position men of color and immigrant men as sex traffickers, women of color and immigrant women as victims, virus carriers, or hypersexualized threats, and white women as potential victims (Mac & Smith, 2018). These laws require an “iconic victim,” who is a woman, a “good witness,” will cooperate with law enforcement, and has been “rescued” by police or social services, leaving out innumerable survivors (Schwarz, 2021, p. 615). Framing the problem of trafficking as an issue of the “cultural backwardness” of the “Third World” is a settler-colonial framework that positions the global North as the righteous rescuer of women from the “deviant” global South (Hu, 2019, p. 423). Furthermore, it ignores the fact that sex workers are more likely to be victimized by systemic issues produced or ignored by the global North (such as poverty, gender inequality, racial violence, violent immigration policies, and housing insecurity) than by individual actors in the global South (such as pimps and traffickers). This framing also harms trafficked people and sex workers because domestic police and border police use their discretion to decide victimhood or perpetration in cases of commercial sex.

We argue that when the criminalization model prevails, it results in feminist collusion in the deportation of migrant sex workers, investment in a rescue industry that fails to account for sex workers’ material needs, and a preoccupation with innocence. Indeed, professionals often demonize and refuse the victim status of Black women, LGBTQ + people, and people who choose to do sex work, which further exposes them to harm through the criminal legal process. Furthermore, the anti-trafficking campaign fails trafficked women who are trying to migrate because it seeks to rescue them by creating restrictive immigration policies and deporting them (Mac & Smith, 2018). As with all policies aimed at policing gender violence, US feminists will find that the criminalization of migrant women legitimates carceral interventions on women more broadly.

Reckoning with Mass Incarceration Through “Problem-Solving Courts”

Decades of policing social problems in the United States resulted in the largest prison population in the world, peaking at 2.3 million in 2009 (Ghandnoosh, 2019). From 1980 to 2019, there was a 700% increase in the number of incarcerated women, with Black women nearly twice as likely to be incarcerated as white women (The Sentencing Project, 2020). While carceral feminism cannot be said to have a causal relationship with the rise of incarceration of women, it has reified widespread belief in the efficacy of criminalizing social problems, which does relate to the massive incarceration rate (Kim, 2013). Furthermore, carceral feminism has impaired the relationship between movements for gender justice (i.e., sex workers’ rights and anti-violence movements) and the movement against mass incarceration.

However, a social reckoning with mass incarceration was born in the wake of the shooting death of Trayvon Martin, a Black teenager shot by George Zimmerman. The movement shed light on the systemic violence of white supremacy, policing, and prisons. In search of solutions to mass incarceration, “problem-solving courts,” which began to surface in the 1990s, and “diversion programs,” which proliferated in 2011, became attractive prison reform choices for government officials (GHJP, 2018). These approaches alleviated some prison and jail overcrowding, responded to critiques of mass incarceration without overhauling the system, and were more cost-effective than incarceration (GHJP, 2018, p. 19).

In this context, the prostitution diversion program emerged as a hybrid of problem-solving court and diversion programming (GHJP, 2018; Shadaimah & Bailey-Kloch, 2014; Wahab, 2006). New York City's Human Trafficking Intervention Court (HTIC), established in 2013, is an example. In the name of abolishing human trafficking, it uses the prosecution of prostitution-related offenses to identify sex trafficking victims and mandate social services as an alternative to jail time (GHJP, 2018; Halley et al., 2018). The “reconceptualization of prostitution crime” from “low-priority, quality of life” misdemeanor prosecution to “war on human trafficking” hinges on the idea that prostitution is a form of domestic violence that requires state intervention, a narrative indebted to decades of carceral feminist organizing (Halley et al., 2018). By framing prostitution as victimization, HTIC removes prostitution from its social and economic context and places it within the realm of individual emotional pathology, feminine helplessness, and family dysfunction. It also serves to transform the court into a “resource-heavy social welfare [institution],” using crime management to control sex workers under the guise of court reform while keeping social services financially lean (GHJP, 2018; Halley et al., 2018). Anasti (2020) describes this as the “detention to protection pipeline,” in which social services, such as victims’ advocates, disguise the punitive goals of the criminal legal apparatus (p. 50).

Modern Prostitution Diversion: An Integration of Social Reform and Penal Approaches

There are various iterations of prostitution diversion programs (PDPs). They generally include: “abstinence programs” that aim to stop women from doing sex work, harm reduction programs that intend to alleviate sex workers’ exposure to harm, and diversion programs that mandate services for justice-involved sex workers (Koegler et al., 2020, p. 3; Wahab, 2006). Most PDPs are a court-mandated fusion of the three iterations. There is little published research on PDPs because prosecutors’ offices lack transparency; programs vary significantly in their approaches to diversion; and programs lack standardization and often fail to establish guidelines and protocols for their work (Leon & Shdaimah, 2012; Shadaimah & Bailey-Kloch, 2014).

In all approaches uncovered in the literature, sex workers were entered into PDPs through arrests by police (Leon & Shdaimah, 2012; Wahab, 2006). Most programs provide defendants arrested for prostitution-related charges with the opportunity to abstain from the legal process before plea bargaining by instead offering therapy and case management services to connect women to secure housing, benefits, and employment opportunities. Upon arrest, sex workers must exhibit a willingness to submit to therapeutic change rhetoric and fill out forms that divulge “diagnoses…abuse history, addictions” and other private information (Dewey & St. Germain, 2016). Social workers use this information to develop a treatment plan. These plans tend to reflect “paternalistic ideas of what would be best for the participant's own good” (Capous-Desyllas et al., 2021, p. 526). Social workers often fail to inform participants of the purpose of these documents, and women who question this process may be perceived as ill-equipped for programming (Dewey & St. Germain, 2016). Programs generally lack written criteria for successful completion of programming and give social workers who deliver services wide discretion in determining success (Bailey-Kloch et al., 2013; Dewey & St. Germain, 2016). Those who complete PDPs generally have charges against them dropped or expunged (Leon & Shdaimah, 2012; Wahab, 2006). Those who are unsuccessful often face increased surveillance, harsher sentencing, or the “activation of a guilty plea” (Leon & Shdaimah, 2012, p. 253).

Legal workers, reformers, and social workers present this programming as a progressive alternative to incarceration, but the neoliberal treatment model it represents is problematic on various fronts. Dewey and St. Germain (2016) refer to this as the “criminal justice-social services alliance,” which they define as “a punitive-therapeutic confederation of federal, state, and municipal law enforcement agencies and state, municipal, or independent non-profit social service entities” (p. 3). Inherent to this model of service provision are three beliefs: 1) that trading sex is inherently harmful and the result of women's trauma histories, 2) that these women require arrest, incarceration, or mandated treatment, and 3) that these women demonstrate “accountability,” “readiness to change,” and “compliance” with programming (Dewey & St. Germain, 2016). Unfortunately, these programs fail to incorporate the needs and goals of sex-working defendants – as voiced by them. In fact, one of the most common critiques of diversion programming levied by sex workers is that it is not “truly voluntary,” illustrating how professionals are blind to certain kinds of coercion (such as mandatory service provision) while commonly espousing the belief that sex work itself is not voluntary (GHJP, 2018, p. 58). Despite reframing sex workers as victims in need of therapeutic intervention, they are still criminalized and mandated to programs that stigmatize and homogenize their work. Programs fail to intervene in the socioeconomic forces that constrain women's capacity to leave the sex trade or to remain in it safely (Shaver, 2005). Unsurprisingly, PDP service providers have reported that sex workers’ self-identified problems, including physical and mental health issues, substance abuse, housing insecurity, unemployment, and transportation issues continued to threaten their diversion (GHJP, 2018; Leon & Shdaimah, 2012; Shadaimah & Bailey-Kloch, 2014; Wahab, 2006).

Sex worker participants have expressed that the choice to participate in PDPs feels coerced in that the alternative, incarceration, posed a threat to their life and well-being (Leon & Shdaimah, 2012). Participants often felt that program stipulations were more intensive than probation, including drug screening, curfews, therapy sessions, and classes, highlighting the stark similarities between carceral solutions and more humane approaches to intervention (Gerassi, 2020; Leon & Shdaimah, 2012). Sex workers also acknowledged that while service providers may “perform acts of kindness” during treatment, the punitive treatment model they work within “reinforces the marginalizing forces that compel women” to trade sex in the first place (Dewey & St. Germain, 2016, p. 8). These acts of kindness, along with service connection to benefits and other resources, are far outweighed by the power and control that police and providers have over participants’ lives (Dewey & St. Germain, 2016). Capous-Desyllas et al. (2021) found that criminalized sex workers often lost employment or custody of their children, lost affordable housing, or were unable to attend school. With these shortcomings in mind, it is troubling that fear of consequences such as jail sentences motivate participants to remain engaged with PDPs even when their needs are not being met (Wahab & Panichelli, 2013). As Jungleib (2018) notes, efforts at rescuing sex workers are often the “largest barrier” to leaving the sex trade.

In addition, sex worker participants frequently report that they will continue trading sex, and research has shown that PDPs fail to curb recidivism, which means that PDPs do not achieve the criminal legal system's objectives (Koegler et al., 2019; Wahab, 2006). Some participants name the harmful ideology that underlies therapeutic intervention and mandated treatment more generally: workers consider these women troubled, pathological, or “fallen” and believe they must be “cleaned up” (Wahab, 2006, p. 79). Success story “narratives” shared by PDPs often portray stereotyped “non-Western racialized migrant women” as weak and “in need of heroic rescue” by Western anti-trafficking non-profits (Hu, 2019, p. 432). They also portray the global South as a place of risky people or traffickers and equate migration with trafficking. Often, survivors are valued for their “victim stories” instead of their “expertise” (Jungleib, 2018).

Both program participants and PDP staff express that “bureaucratic problems,” “gaps in services,” and “restrictive state policies” hinder participants from improving their well-being or desisting from sex work (GHJP, 2018; Leon & Shdaimah, 2012, p. 263). Service providers face intense pressure from funders who expect demonstrated success, often defined by the “number of women who stop trading sex…as a result of receiving their services” (Dewey & St. Germain, 2016, p. 8). This oversimplification of “success” belies the fact that sex workers often see sex work as the best available means for meeting their basic needs and that “arrest and its consequences” are “their primary occupational risk” (Dewey & St. Germain, 2016, p. 130). As a result, women engaged in PDPs must “conjure the ideal client,” one who has been victimized by life circumstances, including the sex trade, and require professional help (Dewey & St. Germain, 2016). This expectation obscures the strengths, survival skills, and resilience needed to navigate the sex trade.

Many researchers argue that the coalescence of the criminal legal system and the field of social work presents an inherent contradiction. From the court's perspective, PDPs are useful for gathering information about the sex work community, highlighting a contradiction between criminal legal and social work values (Leon & Shdaimah, 2012). This information gathering is “manifested in sting operations” by law enforcement, where frontline workers confront sex workers or people suspected of being trafficked “in public spaces and perceived locations of trafficking” (Schwarz, 2021, p. 621). Police officers see sting operations as “opportunities to detain and arrest suspected sex workers, trafficked persons, and traffickers” (Schwarz, 2021, p. 622). Researchers have found that arrests “further perpetuate a cycle of power and control that police hold over sex workers,” even when the aim is to prosecute traffickers (Capous-Desyllas et al., 2021, p. 513). Despite this finding, Anasti (2020) found that 70% of service providers interviewed at one PDP believed that “law enforcement and carceral mechanisms can be a useful force” in dealing with sex workers (p. 62). Because service providers are responsible not only to participants but also to the criminal legal system, they contribute to the harm experienced by sex workers through criminalization (Roe-Sepowitz et al., 2014). Torres and Paz (2012) found that sex workers’ “bad encounters” with social services increased when social services worked with law enforcement. Pressure from funders places service providers in a position to make rapid assessments about sex workers’ intentions and motivation for treatment that have “life-altering” consequences regarding women's freedom from coercive control (Dewey & St. Germain, 2016). This pressure results in a superficial understanding of the conditions that lead to women's choice to trade sex. For example, Anasti (2020) found that most service providers involved with one PDP believed that involvement in the sex trade is not voluntary, “even in the absence of third-party coercion” (p.58).

As we have shown, the PDP approach to sex work abolition integrates decades of anti-sex work practices, legislation, and ideology. It conflates sex work and sex trafficking, puts sex workers and sex buyers at risk of police violence and incarceration, mandates services that contradict social work ethics, and fails to meet sex workers’ material needs (NASW, 2017). Modern PDPs are situated between the Victorian model employed by social reformers, the anti-sex work politics of the fractured feminist movement, and the punitive welfare model imposed by neoliberal reform. In the following sections, we will explore how these interventions have been challenged by sex workers and their allies throughout time.

Alternative Service Approaches

Policing compromises sex worker health and safety due to abuse, arrest, harassment, humiliation, and sexual assault, among other violations. Due to decades of sex worker organizing, many alternative programs provide services for sex workers without police involvement. St. James Infirmary in San Francisco, which developed out of the movement in the 1970s, is an example (St. James Infirmary, 2020). St. James Infirmary serves as a blueprint for programming that meets sex workers’ needs. It also reflects social work values, returning power to sex workers through harm reduction and peer-led initiatives. It provides peer counseling, HIV and STI testing, medical care, harm reduction supplies, and other holistic healing services to sex workers. To protect sex workers from violence, they collect and share information about “bad dates” – anyone who engages in behaviors that violate sexual exchanges (St. James Infirmary, 2020). This non-coercive approach to service provision centers on responsive care and harm reduction instead of prostitution abolition and policing.

Sex workers and feminist organizers are spearheading education, outreach, and destigmatization efforts through the Sex Workers Outreach Project (SWOP) (SWOP, 2020). It is a national network of sex workers who raise awareness and destigmatize sex work by engaging in media and policy efforts, funding sex worker-led projects, and providing mentoring and peer support (SWOP, 2020). Some chapters, SWOP-Chicago in particular, work with human service non-profits, a legal clinic, and provide in-house social services for sex workers (Anasti, 2017).

It is important to keep in mind that alternative programming for sex workers has undergone similar transformations to domestic violence services, including the professionalization of staff and the procurement of public funding (Anasti, 2017). Many of these organizations try to “mainstream” their services to increase public support for sex workers but do so with the recognition that this professionalization may distance them from radical activists and the people they serve (Anasti, 2017). Creating a more palatable human services “image” may benefit advocacy efforts and provide political clout, but decriminalization continues to be a contentious issue. Restrictive funding mechanisms and government oversight associated with professionalization can limit radical organizing among sex workers and their allies (Anasti, 2017).

Call for Full Decriminalization

We argue that all social work practices, policies, and interventions aimed at supporting sex workers should be rooted in the full decriminalization of the sex trade. Decriminalization removes criminal penalties for advertising, offering, selling, or purchasing sex and renting out and sharing spaces with sex workers (Abel, 2014; Luo, 2020; Mac & Smith, 2018). Decriminalization implies there are no laws that criminalize sex workers or sex buyers – only laws that protect sex workers’ labor rights, acknowledging that sex work is service work. This framework recognizes that sex workers sell sex on a “continuum” of choice (free of coercion), circumstance (for economic survival), and coercion (forced through “violence, fraud, or threat”), and sees sex workers’ and trafficked peoples’ struggles as interconnected but distinct (Luo, 2020, p. 4). This perspective makes it possible to see how violent social and economic factors drive harm, not the sex trade itself.

Take for example a sex worker who screens clients and determines if, when, and where she will sell sex to maximize safety. Then, imagine she encounters a police officer that coerces her into having sex under threat of arrest. Here, the risk of sexual and physical violence, arrest, and incarceration drive the worker's lack of safety and autonomy. As a result, the sexual act is no longer one of choice. The sex trade continuum is an analytical corrective to the dichotomous thinking that characterizes popular policies and beliefs about the inherent violence of sex work. Decriminalization challenges neoliberal policies that seek to rescue or criminalize people involved in the sex trade by granting legal and labor protections.

Decriminalization is also an anti-trafficking policy because it facilitates effective responses to trafficking. Specifically, it ends cycles of criminalization, stops deportations (which prevent people from “accessing health care and building economic stability”), and allows sex workers and trafficked people to “seek legal remedies for violence and exploitation” (Luo, 2020, p. 9). In addition, without the fear of criminalization and negative impacts on their livelihood (through the criminalization of sex buyers), sex workers can be allies in fighting trafficking and developing appropriate services for trafficking victims. Anti-trafficking work by countries that have fully decriminalized sex work substantiates these propositions. For example, New Zealand, “which decriminalized sex work in 2003, is judged by the United States State Department to be among those countries doing the most effective work on human trafficking” (Open Society Foundations, 2015, p. 7; United States Department of State, 2014). Furthermore, full decriminalization does not rely on racist, patriarchal policing – it involves divesting from police, prosecutors, and prisons as remedies for social problems and creating space for sex workers to orchestrate their safety and well-being.