Book review: Male Sex Work and Society, edited by Victor Minichiello and John Scott

Male sex workers have been the neglected, barely acknowledged, parallel topic to that of female sex workers, who themselves have been only sporadically the subject of serious academic interest, and often mainly with the objective of identifying underlying “pathologies” (Dennis, 2008). So, this collection of papers on male sex work is very welcome. The editors of Male Sex Work and Society, Victor Minichiello and John Scott, have done well by bringing together a range of papers, from historical accounts, to reviews of recent data, to assessments of the impact of sexual and mental health issues, to discussions of the status of male sex work in a variety of settings. And they have also gathered together many key authors who have written about male sex work during the past decade.

The book is formally divided into four sections: sociohistoric context; marketing and economics; social issues, including health and public policy; and global context. The first three sections, comprising about half the book, provide a broad theoretical and contextual framework for understanding the issues underlying male sex work in general, while the “Global Context” section includes six separate pieces describing the local situation in various parts of the world: Southern and Eastern Africa, China, Russia, Latin America, Germany migrant workers, and Ireland.

Nonetheless, several chapters in the first half of the book also include accounts of the situation that applies in specific countries. The authors have used those accounts to discuss the broader theoretical issues those chapters are intended to cover. For the most part, this strategy does permit such discussion. In some cases, however, it is unclear to what extent the specific, local circumstances can really provide sufficient basis for discussing theoretical issues that apply more generally. Probably more important, though, is that the starting point of these early chapters is usually the situation that applies in industrialized, mostly Western countries, with large, visible gay communities. Although these discussions are valuable, the issues raised may often be very different in other cultural settings (Parker, Khan, & Aggleton, 1998). The accounts from the “Global Context” chapters should be reviewed with these issues in mind to consider the likely similarities and differences.

The more detailed discussions of specific national or regional situations that occur in some chapters in the first half of the book could have been gathered together and included with the other chapters in the “Global Context” section. On the other hand, the issues raised in the early chapters are inevitably bound by local cultural, legal, and socioeconomic context. Removing the authors’ direct reference to specific local contexts may have made this even less clear.

Throughout the book, readers will find some chapters are based on a review of the current literature and existing data, as a basis for describing how particular issues play out in relation to male sex work. Other chapters, though, present new data, sometimes for the first time, and sometimes in locations or circumstances where data have not previously been available. Making this information available through this book is very useful. Nonetheless, these data reports, and their interpretations, need to be considered cautiously, noting the limitations in the data and some of the assumptions in their interpretation, and particularly being careful about applying them in other circumstances that may not be appropriate.

The history of male sex work is described from ancient to modern times. The tension in any understanding of sex work, and possibly particularly how this applies to male sex work, emerges from this history. What is defined as sex work varies enormously over time and across cultures, as well as being affected by class, race, and gender issues. And, for male sex work, it is largely contingent on the status of male homosexual behavior (Parker et al., 1998). There is a point, though, at which we need to properly distinguish prostitution from exchanging gifts or material reward in the context of sex. This depends on both individual and contextual factors, and can often be quite subjective. This definitional tension recurs throughout many subsequent chapters. It is, however, far more than just a question of definition, as it involves the boundaries between sexual desire, pleasure and identity, and questions of power, both structural and interpersonal (Vanwesenbeeck, 2013).

Kerwin Kaye explores our modern understanding of male sex workers and what constitutes prostitution on the context of sex between men. He traces this history from mostly working youths, of indeterminate sexuality, servicing a hidden subculture of marginalized homosexual men, to openly gay men purposefully choosing to use their sexuality to derive an income at a time when gay life has become increasingly visible and accepted. His account, however, mainly focuses on Western industrialized countries, and does not easily apply to other contexts, where concepts of both male homosexuality and sex work, and how these relate to masculinity, are often very different (Parker et al., 1998).

In his economic analysis of male sex work, Trevon Logan claims that it confounds theories of power and gender, partly because prostitution is about both sexuality and economics. Sex work may become problematic for some male sex workers (MSW) who only engage in sex work for economic reasons, because even being paid for something that is unenjoyable or distasteful is always challenging. This may well apply to many of the MSW that Logan describes, who are not themselves gay or bisexual and yet find themselves providing sexual services to an overwhelmingly male clientele. Certainly this appeared to be the case in the past, but this may not apply so clearly now. Nonetheless, Logan argues that the marketing and relative value, both of particular types of MSW, and of specific services, reflects the relative valuing of aspects of hegemonic masculinity. Logan also makes a particular, and interesting, point about the seeming lack of a premium for either “safe sex” or MSW who represent little risk. He argues that if “safe sex” is prized highly, because it protects against HIV and other STIs, then market forces would be expected to attach a greater value to “safe sex.” However, given that condom use appears to be the norm among MSW in the Western industrialized settings he describes, this is perhaps not surprising. Indeed, in that context, there would likely be a premium on MSW willing to engage in condomless sex, because it is less available.

The pervasiveness of the Internet in all aspects of contemporary life and how that has fundamentally affected the way male sex work is represented, and how it functions, is discussed by many of the authors in several chapters. Allen Tyler describes how male sex workers advertise their services to potential clients, with an unsurprising focus on online advertising. Relying partly on his own research, he notes how the use of imagery now dominates sex work advertising.

While male sex workers have been underserved in the literature, their male clients have been largely invisible. Scott et al. discuss the mainly negative portrayals of the clients of MSW, as well as their own primary research using nearly 800 client profiles on a sex work related Web site. They also describe how arguments regarding male domination and gender violence in sex work are often undercut by the circumstances of the male clients of MSW.

Crofts helpfully characterizes the different policy approaches to sex work as: prohibition, risk-reduction, rights, and regulation. The legal response is, however, not the same as the social response. Although stigma and homophobia undoubtedly still exist, it may be questionable to suggest that anti-gay stigma remains the primary factor in understanding any current stigma against male sex workers.

In considering public health policy, Bimbi and Koken cite restrictive legal frameworks and negative public discourse as key impediments to developing appropriate and effective responses to the occupational and other health needs of MSW. They also note the limitations in existing data: How does HIV prevalence among MSW compare with local populations of gay and bisexual men in general? What factors increase or decrease HIV risk among MSW? Unfortunately, the potential impact of recent biomedical research evidence regarding HIV treatment as prevention and preexposure prophylaxis for HIV is not discussed. These developments are likely to raise both challenges and opportunities for male sex workers; future research and public health policy and practice will need to take account of them.

Regarding mental health, Koken and Bimbi discuss the impact of stigma, substance use, and trauma. They note, however, that most of the attention has been from a public health perspective, specifically regarding HIV transmission, with little focus on the individual psychological health, coping strategies, and resilience of MSWs. They nonetheless question why the literature tends to pathologize MSW, with assumptions that mental disorders are necessarily linked to male sex work. In reviewing the literature, they note the apparent increased vulnerability of MSW (to mental health disorders), but that none of these studies are able to identify causative relationships.

Grov and Smith discuss the place of male sex work in gay culture and, particularly, how these have adapted to changes in forms of communication, especially through the Internet. These shifts in communication have revolutionized the way MSW advertise and reach potential clients. There are parallel threads between gay culture, sexuality, and the commodification of sex that have incorporated aspects of male sex work within specific gay subcultural forms.

Overall, this book does what Minichiello and Scott set out to achieve: It has opened up new discussion on an under-discussed subject; and it has provided information that at the very least questions some of the common misconceptions and assumptions about MSW. There is of course, far more research needed, and far more discussion of the issues to be had. Also, much of the material presented in this book provides an initial exploration, and critical responses to what has been presented are needed to take the discussion of these issues further, and to encourage more detailed investigations, using a variety of methodological approaches.

Reviewed by Garrett Prestage