Using the stigma engagement strategy in interviews with men who pay for sex

Introduction

Stigmatization refers to the process by which individuals or groups are socially discredited, devalued, or excluded due to characteristics, behaviors, or identities that deviate from societal norms (Becker, 1963; Goffman, 1963). Those who experience stigma often face isolation, unable to find solidarity or connect with others, which not only affects their well-being but also creates challenges for researchers. They may be reluctant to participate in studies due to fear of exposure and potential legal repercussions, and they may distrust researchers, fearing judgment or misuse of their information. These individuals can be categorized as “hard-to-reach, hidden, and vulnerable study populations” (Ellard-Gray et al., 2015). Research involving these populations include difficulties in recruitment, establishing trust, ensuring confidentiality, and preventing harm (Daniel et al., 2023; Dickson-Swift et al., 2007, 2009; Gerassi et al., 2016; Hammond, 2018; Humphreys, 1975; Huysamen, 2015, 2019, 2022; Minichiello et al., 2014; Stardust et al., 2021).

In addition, understanding the lived experiences of stigmatized populations is further complicated by the influence of societal narratives (Lee, 1993; Lee and Lee, 2012). Stigmatizing depictions in legal frameworks and political debates (Lim and Cheah, 2020; Prior and Peled, 2022; Sanders, 2013), as well as the media (Altheide, 1997; Greer and Jewkes, 2005; Jewkes, 2004; Plummer, 2003) shape both public opinion and the self-perception of these individuals, obscuring their realities. As research participants, stigmatized individuals may withhold information or provide socially desirable responses (Adler and Adler, 2003; Ferrell and Hamm, 1998; Lim and Cheah, 2020; Prior and Peled, 2024). Researchers are thus tasked not only with reaching them but also with critically unpacking the societal narratives that shape their identities and actions.

To bridge the gap between public discourses and the personal experiences of stigmatized populations, this article introduces the “stigma engagement strategy (SES)”. This methodological approach uses external stigmatizing narratives – such as newspaper articles and columns – as textual probes in interviews. SES aligns with “material methods” (Woodward, 2019), which incorporate tangible objects or media to engage participants and prompt reflection. SES leverages the materiality of texts to encourage participants to engage critically with societal narratives, offering valuable insights into their lived experiences. Similar approaches, such as object interviews using photos, keepsakes, or personal artifacts, have been shown to stimulate discussion and enrich dialogue, particularly when studying sensitive topics (Collier and Collier, 1986; De Leon and Cohen, 2005; Liebenberg et al., 2014).

This article draws insights from an interview study with Swedish men who have paid for sex, where participants engaged with newspaper articles and columns containing stigmatizing narratives about these activities. The study focused on men who predominately had paid women for sex, though some had other experiences. The stigma these men face may differ significantly from those who mainly pay men or transgender people for sex. Similarly, the newspaper articles and columns used in the study primarily addressed men who pay women for sex, reflecting Sweden’s dominant heteronormative public discourse on paid sex as linked to gender inequality, exploitation, and human trafficking (Grönvall, 2024; Johansson, 2022; Johansson and Östergren, 2021).

The potential usefulness of SES emerged early in the study when a participant spontaneously brought newspaper articles on paid sex to an interview, indicating a willingness to reflect on societal narratives. This observation inspired the systematic incorporation of such materials into the study. SES helped to concretize public discourse, situating broader societal narratives within the interview process. It encouraged participants to critically reflect on the divergence between their lived experiences and stigmatizing narratives, as well as how these narratives shaped their views and actions. By creating a degree of separation between the researcher and stigmatizing discourse, SES fostered an open environment for participants to share their realities. Moreover, it provided a practical means to gain an emic perspective on how these men experience stigmatization, particularly in a context where long-term ethnographic fieldwork was not feasible (Johansson, 2022).

The following sections discuss the Swedish context and literature on researching men who pay for sex and other stigmatized groups. A background to the interview study and the development of SES is then provided, including the selection of newspaper articles and columns. These sections are followed by empirical examples from three interviews, illustrating the strategy’s practical application. The article concludes by examining the benefits, limitations, and ethical implications of using this methodological approach in research with stigmatized populations.

Research context: Stigma toward men who pay for sex in Sweden

Sweden’s repressive prostitution policy poses challenges for conducting research, yet it provides a unique opportunity to examine the intersection of stigma, legal frameworks, and public discourse surrounding the exchange of sex for payment. Under this approach, paying for sex is criminalized and sex workers’ clients are subject to intervention by authorities, including social services and the police (Grönvall, 2024; Johansson, 2022). Unlike approaches in New Zealand, which prioritize harm reduction, or regulatory frameworks in parts of Europe that treat sex work as legitimate labor, Sweden’s approach rests on moral condemnation (Johansson, 2022; Johansson and Östergren, 2021; Östergren, 2018, 2020, 2024). It has been described as an instance of “morality politics” (Östergren, 2024).

The criminalization and stigmatization of commercial sex has deep historical roots and is intricately linked to state policing of bodies and societal norms that extend beyond legal frameworks (Ditmore, 2010; Lister, 2021; Östergren, 2024). However, processes of stigmatization are far from uniform, as they reflect varying societal justifications and priorities. In some cases, stigma arises from a broad societal consensus on harmful or exploitative behaviors, such as child abuse, where moral condemnation is intended to protect vulnerable individuals and prevent harm (Mégret, 2013). In contrast, other forms of stigma are more contested, overly simplistic, or ethically problematic. For example, the historical stigmatization of LGBTQ + individuals and the ongoing marginalization of consensual sex work demonstrate how stigma can perpetuate harm by reinforcing inequality and social exclusion, rather than addressing actual harm (Benoit and Unsworth, 2022; Johansson and Östergren, 2021; Östergren, 2024; Weitzer, 2018; Worthen, 2020).

In Sweden, penalties for paying for sex have escalated over time, culminating in the possibility of up to one year of imprisonment as of 2022 (The Swedish Criminal Code, Act 2022:1043, Chapter 6, Section 11). This escalation highlights Sweden’s intensified focus on punishing individuals involved in paid sex, exposing them to both legal sanctions and substantial social stigma. Sweden’s strong campaign against sex for payment is also reflected in public opinion, with most Swedes viewing such exchanges negatively and many as never acceptable (Hansen and Johansson, 2022; Johansson and Hansen, 2024).

Swedish public rhetoric often conflates consensual transactions with issues of exploitation and human trafficking, leaving little room for nuanced discussions about individual motivations or experiences. Men who pay for sex are portrayed as moral transgressors, complicit in perpetuating harm, irrespective of the context or consensual nature of the exchange. This moralizing discourse intensifies the stigma faced by men who pay for sex, shaping their self-perceptions and how they understand and discuss their actions (Grönvall, 2022, 2024, Grönvall et al., 2021, 2022; Johansson, 2022; Johansson and Östergren, 2021; Östergren, 2024).

As a result, men who pay for sex face a unique form of stigmatization in Sweden: they are criminalized by law, condemned by the public, and positioned as perpetrators within a broader narrative of exploitation and gendered violence. These legal and social pressures not only heighten their vulnerability and drive them into concealment but also underscore the need for innovative methodologies to effectively explore and understand their lived experiences.

Researching men who pay for sex and other stigmatized populations

Methodological approach: the development of the stigma engagement strategy

Empirical application: Illustrating the stigma engagement strategy through interviews

Overall, the men uniformly described the Swedish public debate and media narratives about clients and sex workers and the paid sexual encounter as generally overly simplistic. However, their individual responses to these narratives diverged. Some greeted the stigmatizing narratives with an almost humorous ridicule, perceiving them as preposterous and laughable. Conversely, some experienced anger, stirred by the narratives’ portrayal of their experiences and identities. Others exhibited a more ambivalent response, grappling with the complex interplay between societal perception and their own lived reality. In these latter cases, the stigma seemed to have been personally internalized to a greater degree. As such, the interview study underscored the importance of acknowledging the diversity of experiences within this population.

Below, two in-person interviews and one in the form of an email correspondence exemplify differences in the participants’ responses to the stigmatizing narratives from the newspaper articles and columns. These examples also illustrate different ways of deploying SES.

During our third in-person interview in a hotel room in Copenhagen, Roland and I looked at a newspaper article in the free Swedish newspaper Metro presenting a typology of so-called “sex-buyers” including: 1. The bored family-father, 2. The traveling businessman, 3. The successful power-seeker, 4. The sex-tourist, and 5. The insecure” (Johansson and Wikén, 2017, p. 8, see Appendix A). In the more detailed descriptions of these different types, there is one common thread: they are all depicted as sexually frustrated men with an unquestionable sense of entitlement and peculiar ideas about sex and women. After I finish reading the types out loud, I ask Roland what comes to mind when he hears condemning narratives about paid sex like these. Roland responds: “They sound a bit condescending, but I guess I’m the last and second last”. Meanwhile, Roland finds the emphasis on “sex” somewhat misleading and points out that “sightseeing is as much a part of the reason for traveling as meeting escorts”. Moreover, Roland describes how his appointments are about more than sex. Roland enjoys the sexual aspect, but it is not his favorite part. Roland explains: “You want that close contact, to sense the warmth of another person when cuddling. It’s not only about intercourse. It’s also the touch, the conversations, the feeling of being loved”.

Roland and I also looked at a column from the same newspaper entitled “I remember all the sex buyers I’ve arrested” (Häggström, 2017), authored by a prolific police officer who is frequently invited to speak about the sex trade in Swedish media. Roland responded to column somewhat exasperatedly: “It’s like a witch-hunt and it’s not a fair portrayal, but you can’t really say anything because then you end up disclosed”. Roland further explained that sometimes he feels “like a homosexual man in the 1950s′ Sweden”. Roland’s impression is that, nowadays, Swedish authorities treat men who pay for sex “as mentally ill”.

The interview with Roland provides insights into the effectiveness of SES. As Roland engages with the newspaper article detailing the sex-buyers typology, he identifies to a degree with elements in the described types but also critiques the condescending tone. As such, Roland acknowledges certain parallels between the stigmatizing narratives and his own experiences. This response aligns with SES’s intent to bring societal discourse into the interview situation, allowing participants to reflect on and challenge prevailing narratives. Roland’s emphasis on the broader motivations for his engagement with sex workers, beyond mere sexual aspects, highlights the strategy’s potential to unveil nuances and counter stereotypical portrayals.

The contrast between my interview with Roland, who engaged with textual probes, and my interview with Anders, who did not, highlights the impact of introducing concrete examples to discussions about stigma. Without textual probes, Anders relied on his subjective impression of the stigmatizing narratives surrounding men who pay for sex. By contrast, in my interview with Roland, textual probes concretized the discourse and invited him to engage directly with specific examples of how men who pay for sex are depicted in Swedish media. He was able to articulate not only his reaction to these portrayals but also how they intersected with his personal experiences. This comparison underscores the added value of using textual probes in interviews to foster more nuanced discussions.

Roland’s exasperation and the “witch-hunt” analogy in response to the police officer’s column underscore the importance of creating a space where participants feel they can discuss and process their experiences with someone. His comments, including his perception of being treated as “mentally ill” by authorities, reveal the weight of societal stigma faced by some men who pay for sex. Overall, the interview situation highlights the strategy’s ability to encourage multifaceted reflections by providing participants with a chance to engage critically with stigmatizing narratives, emphasizing the need for a sensitive and supportive approach to foster open dialogue.

Another participant, Tim, expressed a strong negative sentiment towards the same police officer during our first interview at my home when shown an article describing how the officer “oversees the police’s hunt for Johns” (Nilsson, 2016). In the article, the officer states: “Many believe that sex buyers are men who are struggling, very lonely, handicapped, ugly, or just generally find it difficult to meet women. This is the biggest myth, which unfortunately creates an acceptance as in what do we do with all those poor men who can’t get closeness” (Nilsson, 2016, para 20). Tim’s responds angrily:

He is terrible, he is disgusting, really. I saw an interview with him where he said that people often praise him and say, “No, we're not heroes”, he said. But by saying that, he kind of makes himself one. I've had dealings with the police, and I know what damn bastards they can be. I remember sometimes when I was using drugs, I thought that narcotics officers could twist things around. I mean, the police are necessary, and there are probably decent cops, but him, he's disturbed in some way. I think he's sick, I mean [...] I saw that he claims everyone he has met is a victim or something, but I saw someone wrote that he had stormed into her apartment and ensured that she got evicted and such. I find him creepy.

Tim’s response and detailed critique of the police officer’s actions suggest that the strategy stimulated emotional engagement and contributed to the creation of a space for participants to engage with, reflect on, and challenge societal stigmatization. The negative sentiment expressed toward the officer indicates the potential effectiveness of SES in challenging dominant narratives. Tim’s broader critique of the police reflects a loss of faith in authorities when they are perceived as moralizing or acting unjustly. His personal history with narcotics officers adds another layer to his distrust. His response underscores the power of participatory research methods, such as incorporating stigmatizing media narratives, to evoke critical reflection and provide participants with an opportunity to counter these portrayals.

In another instance, Eric also responded to the newspaper article describing the sex-buyer typology (Johansson and Wikén, 2017, p. 8), which he received via email. Eric is someone with whom I have maintained long-term contact. Over the years, we have spoken on the phone and met in-person numerous times. Additionally, he has sent me many messages and emails to share updates on recent events and his reflections. As part of this specific online interaction, he was provided with several newspaper articles and columns along with the following questions: 1. How do you think sex for payment is portrayed in the text? 2. How do you think individuals involved in this type of sexual relationship are portrayed? 3. How does the image presented relate to your own experiences? 4. How are you affected by the text? 5. What feelings and thoughts arise when you read the text? 6. If you were to write a brief response to the text, what would you say?

These questions were similar to those I asked during in-person interviews. Eric’s response provides valuable insights into how men who pay for sex interpret stigmatizing societal narratives but also highlight the flexible applicability of SES. His response also illustrates how SES encourages participant to provide long and detailed responses. This approach proved effective both in-person and in digital formats, showcasing its adaptability in facilitating rich discussions regardless of the mode of interaction.

The different “profiles” of sex buyers are so exaggerated that I can’t help but smile. However, the underlying reasons described for buying sex could be very real and occur in various combinations among different sex buyers […] I recognize my reasons for buying sex from three of the different profiles. In the beginning, I was very uncertain and shy and eventually realized that the only opportunity for sex was to go to a sex worker. To see sex workers as “kind-hearted consolers” might be an exaggeration, but I have experienced some almost therapeutic aspects in the encounters with sex workers. I know that, in the beginning, I expected a rather “cold and clinical” experience but instead encountered warmth and care. I can also recognize some of the “rational” thinking in the “traveling businessman” who sees sex as an experience that can be scheduled.

In his response to the article, Eric provides a nuanced perspective, highlighting the discrepancy between personal experiences of those involved in paid sex and the dominant public discourse, but also intersections. He critiques the article’s portrayal of women and expresses a desire for more positive and balanced representations of paid sex encounters. While Eric identifies with some elements of the narrative, he emphasizes the diversity of reasons for paying for sex, challenging oversimplified stereotypes. Notably, his engagement with the material demonstrates that participants were not merely trying to construct a favorable narrative about themselves. Instead, they engaged sincerely with the textual probes, pointing out both inaccuracies and truths within these representations.

This interaction highlights a broader pattern across the interviews. Many participants described their experiences in paid sex as rewarding social interactions, often rooted in intimacy and companionship. These accounts stand in stark contrast to prevailing narratives that depict men who pay for sex as sexually frustrated and entitled. By sharing their perspectives, participants sought to counterbalance the overwhelmingly negative portrayals in public discourse while presenting themselves as multifaceted individuals with complex motivations. Their willingness to engage with both the stigmatizing and relatable aspects of the narratives underscores the diversity of their lived experiences and provides valuable insights into how stigmatization operates.

These are a few examples of how the use of stigmatizing narratives from Swedish newspaper articles and columns as textual probes in this study proved instrumental in revealing how societal discourse shapes the lives of men who pay for sex. These probes allowed participants to reflect on their experiences within the broader social and political context, highlighting the ways in which public stigma influences their behaviors and self-perceptions. By integrating external narratives into the interview process, SES created opportunities for participants to articulate how stigmatizing discourses affected their lives while also fostering discussions that contextualized their perspectives within Sweden’s socio-legal and cultural framework.

Unlike conventional qualitative methods that rely primarily on self-reflection or interviewer guidance, SES distinguishes itself by encouraging participants to engage directly with tangible societal portrayals. This approach elicited richer and more nuanced responses that initial interview questions, uncovering how participants navigate and resist public stigma. Through SES, participants challenged one-dimensional portrayals of paid sex as wholly negative, instead framing themselves as complex individuals with diverse motivations and experiences. By bridging personal and public narratives, SES offered a deep understanding of this stigmatized population, illustrating how individuals position themselves in relation to dominant societal discourses and how these discourses shape their lived realities.

Concluding discussion

This article has explored the utility of incorporating textual probes into interview research, using newspaper articles and columns that contain stigmatizing narratives about men who pay for sex. Referred to as SES, this approach aims to concretize public discourse, contextualize interview discussions, and juxtapose diverse narratives about paid sex. SES offers a promising alternative to other methods, such as long-term ethnographic fieldwork or conventional semi-structured interview, for gaining emic understandings of how societal discourses and socio-legal and cultural frameworks shape the lived realities of stigmatized individuals. By providing participants with material for reflection and fostering a comfortable interview environment, this strategy made it possible to delve into the nuances of stigmatization and its effects on individuals’ lives.

SES provided a valuable space to explore participants’ agency, motivations, and the impacts of stigmatization. The contrast between stigmatizing media narratives and participants' personal accounts in this study revealed significant discrepancies and intersections between public discourses and lived experiences. This approach helped uncover the complexities of participants’ perspectives on paid sex, which might not have been fully captured through traditional interview questions alone. The use of external narratives allowed for a concrete engagement with stigmatizing discourses and enhanced the rapport between interviewer and interviewee by creating a degree of separation between stigmatizing societal narratives and their interaction, making it possible to discuss sensitive topics with depth. SES, thus, offers a useful tool for exploring the relationship between societal narratives and personal experiences, which may be especially relevant for studying other groups facing societal condemnation or stereotypical portrayals.

Nevertheless, the implementation of SES does present several ethical challenges. Engaging participants with stigmatizing texts requires careful attention to potential harm and the risk of reinforcing existing stereotypes. Ethical reflection throughout the research process is essential, as researchers must balance the desire to capture authentic perspectives with the need to protect participants from emotional distress. Ethical considerations go beyond adherence to standard procedures and require ongoing reflection about the broader impact of research methods on vulnerable populations.

Another key consideration is the issue of generalizability and the potential for researcher bias in the selection of textual probes. Allowing participants to bring their own texts offers advantages in terms of personal relevance and engagement but may introduce variability in the quality and relevance of the texts. In contrast, researcher-selected texts provide greater consistency, allowing for systematic comparisons across participants. A hybrid approach, in which participants select some texts while the researcher introduces others, may offer a balance between personal relevance and research control, depending on the research goals, ethical considerations, and dynamics of the study population. Researchers should weigh these factors carefully when deciding which approach to use.

While SES provides a time-efficient alternative to more resource-intensive methods like ethnographic fieldwork, it also has limitations. For instance, SES relies on participants’ ability to reflect critically on societal narratives, which may not be equally accessible to all participants, depending on their experiences or cognitive resources. Moreover, the approach may not fully capture the richness of lived experiences that might emerge from long-term, participant-observed interactions in naturalistic settings. Despite these limitations, SES presents a valuable method for engaging with stigmatized populations and understanding the interplay between societal discourse and individual experience.

Moving forward, researchers should continue to refine and expand SES as a methodological tool for studying stigmatized populations. As no single approach can fully capture the complexity of lived experiences, combining SES with other qualitative methods — such as ethnography or longitudinal interviews — may provide a more comprehensive understanding of stigmatized behaviors and their societal implications. Through a combination of methods and a focus on ethical sensitivity, researchers can contribute to a nuanced understanding of controversial social issues, such as paid sex, while avoiding further harm or reinforcement of stigma.