Consent matters: sex work, kink, and the consent of the client and top

I have long said that sex workers are pretty much the experts when it comes to navigating consent in ways that make bioethicists look like bumbling amateurs.  For some sex workers, deciding whether or not to consent to one or other explicit or implied activity is something that they do several times in one shift–assuming that one isn’t stuck on the Tuesday afternoon sprawl in front of Jeremy Kyle and Judge Rinder.  Rarely–perhaps because of the erroneous perception of sex work as being an inherently coercive activity–do we consider the client’s consent, and the sorts of particular contexts that can interfere with that.  Our Saturday night inglorious moment made me rethink that.

On Saturday, a few of our girls had been drinking in the company of a client who, seemingly, had been on the sauce pretty much all day.  The client is a regular of our parlours, a decent sort of a chap, the sort of regular you’d want as a working girl–polite, entertaining, clean, moneyed.  So the girls hustled him and–without the sort of detail that would lead to identification–let’s just say that the client did not end up with what he wanted but instead was paraded naked and drunk through the corridors of the parlour, no services given that he had asked for, and charged pretty well for the humiliation. I’ve no issue with humiliation: most of my own clients request–indeed, insist–on it.  But this client was not there for humiliation.  He was there (at most, given he’d been hustled for hours) for a bidouble, sexy time where he could get his end away in the privacy of a room for three.  This did not happen for him.

Of course, we will be refunding the client.  Of course, we are eating humble pie. But the girls don’t see it like this.  They think he was a job, and they should be paid for it.  But the salient fact is this: he did not consent to all that happened to him and, therefore, he consented to none of it.  Most factions of the kink community, as fractured as we can be, are neurotic about consent.  Whether you’re into SSAC mantras or, like me (pragmatist that I am), RACK, or whatever other acronym to inform how we carry on with mechanical restraints, rope, clamps, whips, pumps, wands and other dreadful things you wouldn’t want to find in your mother’s closet, consent is at the heart of things.  Even here, though, I wonder if we give much thought to the consent of the top.  Again, as with sex work, consent seems to be the domain of the bottom, of the sex worker.  Tops (and clients) rarely have their consent examined.

This needs to change.  I do not appreciate humiliation, but I could have wept at the sight, on our security cameras, of that client, half-naked, his hands covering himself, marched up and down the corridors, 5am on a Sunday morning, by a gaggle of half-witted, unprofessional women.  I felt utterly ashamed.  And it made me realise that there have been times when, both professionally and personally, I have felt obliged to deliver services I did not feel entirely comfortable with at that particular time. I feel proud that, as sex workers, we can help to define consent.  I also feel proud that many of us who practice kink, professionally or personally, place consent at the top of the decision chain.  But without considering the consent of all parties, we may as well admit we’re just paying lip service.  And that risks all of us.

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Is medical ethics a branch of medicine?

Had one of those Delphic moments this morning where I began to despair about the number of medical ethics, and bioethics, departments situated within medical schools.  Lo and behold, my worries happened to coincide with the news that the bioethics centre at my neighbourhood university is about to be subsumed under the School of Medicine.  It’s an insidious move, and one that suggests that the hegemonic privilege of medicine shows no sign of loosening its grip.  Setting aside any considerations of whether academic disciplines must justify their practical utility, the current ethos in higher education demands that disciplines demonstrate ways in which they will be useful (to students, policy makers et cetera).  And, clearly, if medical ethics is to have any useful function, it is as a guide to the practice of medicine and healthcare.  When its role is subordinate to medicine–when it is a sub-speciality–it is, at best, a secondary consideration, or ignored altogether.  At worst, it becomes a vessel for harm.

If medical ethics is situated within medical schools, it runs the risk of being a reactive discipline, waiting for situations that its practitioners can comment upon, mouths for hire whenever someone wishes to die, programme a robot to kill Arab kids or give great blowjobs, or genetically engineer intersex folk out of existence.  This is not what medical ethics should be.  It is also not about finding justifications for things that medical practitioners and researchers want to do.  It is about finding–and teaching–ways to think about healthcare in broad ways.  It is about synthesising all that we understand about the structural issues of communities, administrations, society and environment, individuals, and those we share our worlds with, with the issues faced in healthcare service provision.  It is a rigorous examination of values, and an attempt to resolve the issues that arise when those values clash.

When it becomes nothing but a compulsory bolt-on to medical training or research applications, and a chortling justification of trauma, misery and suffering in the name of ‘science’, medical ethics becomes the vehicle for the very things it is intended to prevent.

Launching, and speaking out

After a couple of false starts, I’m relaunching.  I think it’s fair to say that the past year and a half have been pretty tough for me, which makes for rocky and sporadic blogging of an embittered or timorous nature; it’s also fair to say that I have been prone, in the past, to trying to be something that I’m not.  Or not quite. Or someone not entirely consonant with her past.  So let’s lay that out on the line, given that these are the things that I am preoccupied with, that I would like to talk about, and that are the things that I can bring my own experience to bear upon.

Fair to say that I will have things to say here about being intersex.  At some point I’ll get more into that; suffice to say, for now, that this has been something of a nightmare and a point of pride for me over the years, although for the past decade and a half I have been–except with closest and oldest friends–invisible intersex.  This desire to be invisible sharpened for me moving to New Zealand, back in 2002, after the death of someone very dear to me, although I had started to hide before that for a range of reasons, personal and professional.  One rarely approaches a new life trying to be an outsider, so that, along with sex work, kink, being queer, all got boxed up in the effort to escape the pain of mourning; funnily, in all that I hid, I became more of an outsider than I had ever been.  But, inasmuch as the past year and a half have been traumatic for a range of reasons, that trauma has also led to my being increasingly unable to hide–not least because of hospitalisations in the wake of adrenal crises.  The fun of having CAH.  This, along with taking a long hard look at my life, has caused me to reassess my decision to remain invisible as far as being intersex is concerned.  I admit to a certain level of discomfort and shame, although much of this relates back to the way my ‘condition’ has been dealt with; I just have not wanted to have those conversations, to talk about the humiliations and the pain and the hiding and the awful abuses, accidental and deliberate, that seem to accompany the experiences of way too many intersex people.  When you hide, you don’t know what you lose, and I think I have lost a lot, not least the companionship of people whom I could have called friends.

I’m also keen to talk about sex work.  I am not going to make any apologies for my commitment to sex work as work, and for my view that portraying sex work as a special domain of exploitation is a vile form of oppression.  Too much shame is piled upon people of all genders doing legitimate work, and that shame–in turn–is justified by reliance on a lot of nasty myths about people trafficking, modern slavery and the one about silly vulnerable people who get preyed upon by dinosaur pimps gobbling up virgins by the dozen.  Nor is that shame shoveling particular to sex workers; our clients are also subject to that, with suppositions that those who purchase sex in whatever form are exploitative, careless, brutish, immoral, misogynistic, desperate, pathetic et cetera (pretty much the same sort of labels that get leveled at us).  My clients–male and female–have rarely displayed any of those characteristics, unlike the sex work excluding feminists who maintain that ‘whore’ is a vile slur (looking at you, JK Rowling).

Another of my preoccupations is mental health, and mental healthcare.  Fair to say that I have used mental health services in the past, in the main as a consequence of the enduring traumas resulting from being an intersex kid.  It’s only been over the past year or so that I’ve been able to conceptualise my anxiety, depression and abject terror (as well as my pathetic optimisms!) as part of complex post-traumatic stress, and I’m really keen to explore (here and in my work elsewhere) how that intersects with things like agency, autonomy and identity.  I’m fascinated by attachment, and the ways in which we relate to each other as humans, and I tend to look at these things through a psychoanalytic lens.  I’ve been criticised for this in the past: as a person who is generally queer (my straight relationships, as limited as they have been, have been unmitigated disasters…), and unequivocally intersex, it seems odd to pick a paradigm that, on the surface, seems to depend on binary structures and a preoccupation with reproductive functioning.  Let me just throw it out there: I think Freud was misunderstood, and I think the extent to which psychoanalysis has wedded itself to theories that depend upon gender binaries driven by reproductive urges is misguided and has limited its utility.

I think that’s more than enough for a first post.  I will wake up at 3am and realise I sound like a pretentious arsehole, or worry that X or Y person will see this and I will again be the subject of ‘lol more crap from her’ emails (or worse), but there you have it.  Not sure what is worse: people reading this or nobody reading it.  Let’s see how it goes.  I’m not all misery and dark plots; bear with me 🙂