Let’s talk about sex: Discourses on sexual relations,sugar dating and “prostitution-like” behaviour in drug treatment for young people

Theoretical framework

In unpacking the discourses on sexual relations and identifying the subject positions these make available for young people in drug treatment, we draw on the work of Bronwyn Davies (1991), especially her concepts of discourse and positioning. Davies argues that subjectivity – the experience of being a person – is constituted through discourses in which people are positioned by themselves and others (Davies & Harré, 2018). Following Davies, we define a discourse as a multi-faceted public process through which meanings are progressively and dynamically achieved (Davies & Harré, 2018, p. 26). For example, discourses on gender may, over time, change the meaning of being a woman. The process is public in the sense that discourses concern shared rather than private meaning, and it is progressive in the sense that the meaning-making never starts from scratch but relates to already existing discourses.

Further, we define positioning as the practice of relating persons to discourses in ways that constitute their subjectivity (Davies, 1991; Davies & Harré, 2018). Positioning happens in relation to prevailing discourses that feature as “cultural master-narratives” (Herold, 2015, p. 194), and in relation to the other people involved; i.e., it is about the wider context as well as immediate interpersonal relations (Jansen, 2015, p. 34). Cultural master-narratives may shape people’s perceptions of, e.g., “normal” sexuality and can have detrimental consequences for those who do not conform (Compton, 2020). Various discourses may be contradictory and the ways we think and feel about ourselves shift according to the subject positions we take up in various storylines (Jansen, 2015).

In counselling, therapists position themselves (e.g., as authorities), and at the same time they offer the person in therapy a position – or a choice of positions (Winslade, 2005, p. 253). These positions are loaded with meaning, and positioning may be described as manifestations of the politics of meaning-making (Winslade, 2005). What does it mean, for example, to be a young woman who engages in sexual relations with a man who offers drugs or clothes? The process of making meaning entails a production of subject positions and identities which are dynamically suggested, disputed and changed. As Maria Herold explicates:

[P]eople continuously construct themselves and others through discursive practices which are carried out within, in opposition to, or in continuation of existing cultural understandings of for example drug use, romance, gender and age. (Herold, 2015, p. 194)

The opportunities to oppose a suggested subject position are, however, not the same for everyone. People who have insights into the constitutive power of discourses and learn to control them have greater opportunities to challenge positionings (Davies & Cath, 2000, p. 161). Young people enrolled in drug treatment often find themselves in vulnerable life conditions that may make it difficult for them to oppose the positions they are offered by counsellors. This means that “the socially available repertoire of storylines” (Davies, 1991, p. 49) in the counsellors’ discourses on sexual relations can have major consequences for young people.

An important concern in our study is therefore whether the young people in drug treatment have “access to a subject position in which they have the right to speak and be heard” (Davies, 1991, p. 51) and whether the discursive constitution of that person allows them to “author their own multiple meanings and desires” (Davies, 1991, p. 51). Cases where the young people do contest the counsellors’ positioning of them are particularly telling in relation to this. A young woman, for example, may angrily reject a counsellor’s positioning of her as a prostitute, and if the counsellor, in response, aims to make her realise that in fact she is a prostitute, this counsellor enacts – we argue within this theoretical framework – a discursive approach that curbs the young woman’s right to speak and be heard. As pointed out by John Winslade (2005), positioning cannot be released from the politics of meaning-making, but a counsellor can offer a person in therapy a choice of positions and seek to secure her right to author her own meanings and desires.

Data and methods

Empirically, this study draws on 16 qualitative individual interviews with counsellors working in drug treatment for young people conducted in 2018 by Ida Friis Thing and Viola Marie Skovgaard (Skovgaard and Thing, 2018). The study was developed in response to queries raised by Ditte Andersen's ethnographic research (Andersen, 2020). Her research indicated that counsellors and young people in drug treatment frequently talked about sexual relations and that the counsellors approached the theme in different ways depending on whether they were talking with a young woman or a young man. However, talk about sexual relations was not the focus of the original research project and hence the current study was designed to investigate this topic.

For this study, we recruited counsellors from public drug treatment programmes for young people in eight different municipalities covering both rural and urban Denmark. More women than men work as counsellors in Danish drug treatment (Benjaminsen et al., 2019; Albæk et al., 2019), and reflecting this 11 of the counsellors were female while five were male. Before each interview, the counsellors were provided verbal and written information about consent, the use of pseudonyms, and the retention of confidential data. The voluntary participation in the research project and the right to withdraw were emphasised. All interviewees gave informed consent and all the names of persons and places have been changed to protect the participants’ identities.

In preparing for the interviews, the counsellors were encouraged to each think of three cases involving young people where sexual relations had been a concern. We started the interviews by inviting the counsellors to talk about these individual cases in as much detail as possible. This resulted in descriptions of 48 cases (16 × 3 cases) involving young people aged 15–25 years. We also asked the counsellors more general questions about whether and how they talked with the young people about issues such as contraception, sexually transmitted diseases, suspected or actual involvement in sex selling and whether addressing sexual relations was unnecessary or inappropriate in some cases. The purpose of asking the counsellors to talk about specific cases from the outset was to encourage detailed, contextualised stories that enabled a nuanced analysis of how they ascribed meaning to the young people’s sexual relations. The interviews were organised around a loose structure that allowed for digressions and provided space for novel surprising storylines in the empirical material (Mason, 2002). The interviews lasted 50–93 minutes. They were audio recorded and transcribed verbatim.

In the process of analysis, Thing and Skovgaard read the transcripts several times in order to gain an understanding of the empirical material and avoid a mechanic ad hoc coding (Coffey & Atkinson, 1996, p. 37). The cases chosen by the counsellors were summarised in ways that preserved coherent and detailed stories about each of the individuals. Subsequently, cross-sectional coding across interviews and stories was performed using QSR International’s NVivo 10 qualitative data analysis software. Employing an abductive approach (Coffey & Atkinson, 1996, p. 47) the coding was carried out through a process of zooming in on details in the material, stepping back to see patterns, conceptualising findings and returning to the material. In this way we identified, among other things (Skovgaard and Thing, 2018), three discourses that legitimise sexual relations as a theme in drug treatment, and a storyline on “prostitution-like” behaviour which we present in the following section.

Discourses on sexual relations in drug treatment for young people

This section presents the findings of the analysis. The first part describes the three main discourses counsellors activate when legitimising sexual relations as a theme in drug treatment. In this part, we address the question of why sex and sexual relations should be a topic in drug treatment for young people. The second part addresses the questions of how the discourses on sexual relations are activated differently in cases with young women than young men and what the consequences are for the young people in terms of subject positions. Specifically, we examine a gendered storyline related to a discourse on sexual relations in exchange economies, i.e., relations where sex and resources (such as money, drugs or goods) are exchanged between the parties. Some of these sexual relations are referred to as sugar dating, and are described by some counsellors as “prostitution-like” behaviour.

Discussion: Gendered storylines and the possibility of multiple readings

Sexual relations remain an intimate topic, even in Denmark, which, by international standards, have relatively relaxed attitudes about sex and sexuality (Hald, 2006). Consequently, the counsellors in drug treatment need to legitimise their attention to sexual relations in order to distance themselves from a violation of the young people’s privacy. This study demonstrated how counsellors activate discourses that link sexual relations to pleasure, risks or traumas when they legitimise the theme of sexual relations in drug treatment.

The mere establishment of sexual relations as an important theme does not, however, provide guidance for how to address the theme. Drawing on the theoretical framework of Davies (1991), our study further argues that the ways in which counsellors discursively address the theme provide the young people with a limited or, conversely, diverse repertoire of subject positions (Winslade, 2005). This was exemplified through an analysis of the counsellors’ storylines on young women with sexual relations in exchange economies. The majority of counsellors positioned these young women as engaged in “prostitution-like” behaviour. In contrast, an alternative approach offered the young women access to a subject position from which they could draw on discourses other than deviance, victimhood, or prostitution, for example allowing the young women to position themselves in the storyline of a sexual adventure.

The difference between the approach enacted by the majority of counsellors and the alternative approach is two-fold. First, there is a difference in terms of the content of the storyline. The majority approach discursively linked the sexual relations in exchange economies to social problems, regardless of whether the young women themselves experienced these sexual relations as problematic; the alternative did not. Second, there is a difference regarding who is positioned as the author of the meaning (Davies, 1991). The majority approach positioned the counsellor as the author of meaning; the counsellor was an authority who sometimes needed to make the young women “realise” the problems of sexual relations in exchange economies. In contrast, the alternative approach positioned the young women as the authors of their own multiple meanings and allowed them to express their concerns.

On the one hand, the alternative approach created a potential for young women to understand their sexuality in more varied ways, and it may facilitate a treatment alliance built upon trust and respect (Bjønness, 2011). Reviewing the approach through the theoretical lenses inspired by Davies, it appeared that the alternative storyline worked as a disruption with liberating potential by providing young women access to a broader range of subject positions (Davies, 2007, p. 203). On the other hand, the alternative approach could also be viewed as failing to address genuinely risky sexual relations. Thus, it could be perceived as neglectful rather than liberating. Empirical studies indicate that young women are more likely than men to experience sexual assaults and generally have a higher exposure to sex-related risks (Oldrup et al., 2016, p. 107). Such findings call for a greater awareness of the risks for women engaged in sexual relations in exchange economies.

Nevertheless, counsellors need to be aware of the pleasures, risks, and problems experienced by both young women and young men (Groes et al., 2021). The gendered storyline linking the sexual relations in exchange economies exclusively to young women is empirically flawed, as research indicates that young men may have more experiences with selling sex than young women (Bjønness & Jensen, 2019, pp. 33–36; Dahl & Østergaard, 2021, p. 7). Moreover, the gendered storyline is unsound given the goal of drug treatment for young people: namely, the facilitation of their pursuit of “the good life”. For the young women, the current mainstream storyline produced a gendered shame, e.g., by making them see their sexual relations through the eyes of disapproving others. For the young men, the counsellors’ avoidance of the theme inadvertently created a taboo.

The gendered storyline made it difficult for the young women to talk about their sexual relations in the exchange economy without being positioned as either a victim or a deviant. For the young men the storyline made it difficult to discuss their experiences of selling sex and to address the possible related risks and feelings of vulnerability. Therefore, in terms of practical recommendations, the study indicates that counsellors need to develop ways of talking about sexual relations in exchange economies that avoid the creation of shame and taboos.

The absence of young men in the stories of sexual relations in the exchange economies reflects differences in the socio-cultural narratives available for young men and women (Henriksen et al., 2019). While counsellors can and do make significant efforts to be sensitive in accommodating the individual needs of young people, the treatment sessions take place in a societal context that frames them within a set of discourses. While the Scandinavian context is characterised by ideals of gender equality, female users of drugs still experience gendered expectations and often encounter a pressure to enact traditional femininities (Dahl & Sandberg, 2015). The gendered shame and taboos identified in this study are thus not an “on-site invention” produced by these particular counsellors. Rather, the gendered storyline echoes the “cultural master-narratives” (Herold, 2015, p. 194) of the society in which the sessions are embedded (Dennis, 2008; Järvinen, 1993). Recent research calls into question the gendered stereotypes of sex selling, and contributes to a more nuanced picture of differences – and similarities – in the experiences of young men and women (Järvinen & Henriksen, 2018). In line with this research, our study stresses the need for change in the societal discourses: change that goes well beyond the reach of individual counsellors.

Conclusion

This study identified three discourses activated by counsellors working in the context of public drug treatment in Denmark in their explanations of why sexual relations are an important theme to be addressed in during the treatment of young people. The discourses linked sexual relations to (a) pleasures, (b) risks, and (c) problems. Further, the study called attention to how the discourses on sexual relations are activated differently in cases with young women than with young men and what the consequences are for the young people in terms of subject positions. Specifically, the study documented how the counsellors routinely described a concern of “prostitution-like” behaviour among young women in a way that produced gendered shame targeting young women, while inadvertently making sexual relations in the exchange economies taboo in cases with young men. Counsellors need, this study suggests, a repertoire of ways to talk with young people in drug treatment about sexual relations in exchange economies that is neither neglectful of the risks and harms the young people may experience nor curbs their right to speak and author their own meaning. We demonstrated in this study how an alternative discourse has the potential to provide young people with an expanded range of subject positions to the benefit of all genders.