By Anna-Giselle Funes-Eng

“We’re not out to change the world; we’re not making anybody’s political careers, we just want to make a safe space where we get a little support and respect”—is what the Sex Workers Alliance of Toronto wrote in their newsletter in the early ‘90s. 

The text sits above the outline of a lipstick-stamped kiss and was distributed as a paper zine by what is now known as Maggie’s Toronto and their Sex Workers Action Project, stored in Canada’s national 2SLGBTQ+ archives.

Maggie’s Toronto has been advocating, building community and serving sex workers in ways that centre their agency and wellbeing since 1985, when it was called the Toronto Prostitutes Community Service Project, according to their website. While the organization was originally funded by the City of Toronto’s Board of Health, Maggie’s became a registered charity in 2009 and receives funding from donors.

The history of sex work in Toronto is one of legislative attacks on autonomy and denial of care. Studies done by the Canadian Public Health Association (CPHA) have found “sex workers have greater unmet health needs and greater barriers to accessing the components of health and well-being,” than the overall population. 

They trace this back to four main barriers; the criminalization of sex work, stigmas around sex work, structural marginalization and lack of research on the diverse needs and realities of sex workers. In a 2017 paper, the CPHA called for a public health approach to sex work. 

When it was founded in the late 1980s, Maggie’s was originally a public health initiative. 

Coral Beaton, a third-year collaborative nursing student, completed her placement at Maggie’s this past December. Beaton spent the semester researching and working in community outreach with Maggie’s, centring people’s needs and autonomy to choose what care worked best for them. 

Sex workers are very resilient, they’re resourceful. They know what they need

While Maggie’s is built on support for sex workers by sex workers, Beaton came to the organization without any experience. She dedicated herself to learning more about sex workers’ realities without stigma, how different paths lead people to it and the importance of harm reduction in this work. Along with learning from healthcare resources, Beaton worked with Maggie’s street outreach programming and learned through listening to people in the community about their needs. As part of this, Beaton was trained in administering naloxone for overdoses, safe injections and care kits. 

“Sex workers are very resilient, they’re resourceful. They know what they need. They know what they don’t need. And it’s not my place to tell them,” she said. 

“I tried my very best to keep an open mind and kind of let them tell me what they needed.”

Their needs are wide-ranging and diverse, which means that the kind of care and resources to support them also need to be wide-ranging, intersectional and considerate of those complex realities. 

“It’s important to have the appropriate training regarding substance use and how to do it safely. And if, you know, God forbid, something happens, how to navigate that,” she said.

Barbara Chyzzy is an assistant professor of nursing at TMU and the year three lead for the collaborative nursing program. Her teaching focuses on giving students a social justice-based understanding of care, acknowledging structural issues that impact people’s health. 

“If somebody [is experiencing] poverty, if somebody is experiencing racism, if somebody has been in a violent situation, if they have gender based violence, all of these are intersectional. They intersect together and then they compound,” Chyzzy said. 

Beaton prides herself on being able to educate other people in her life about their misconceptions of sex work. Though her placement ended in December, she hopes to keep volunteering with Maggie’s. 

Beaton says the public’s stigma around sex work can revolve around many things—substance use, houselessness and the nature of sex work itself is discriminatory and can prevent people from seeking care. Beaton hopes people understand that sex work is just like any other job, “these people are trying to survive and work just like any other individual,” she said. 

Beaton said while it’s disheartening to hear people bring up those stigmas during her placement, she found informing them with the right information helped them change their minds. 

She’s been passionate about community-based healthcare ever since her work at Maggie’s wrapped up. “Health is very much all about prevention. And prevention and education go hand in hand,” said Beaton.

Chyzzy’s courses teach the trauma-informed training that students are required to get in their third year. After working across different healthcare spaces including hospital emergency rooms, her speciality is now in community-based healthcare. 

“The definition of trauma informed is not asking people, ‘what’s wrong with you?’ It’s like, ‘What happened? What in your past experience may have influenced you…to have mental health or even physical health stressors?’” Chyzzy said. 

Harm reduction is something we all, in some way, partake in in our everyday lives

While acute care focuses on specific, immediate issues, like those treated in an emergency room, Chyzzy said community-based healthcare looks at how social determinants of health impact people’s relationship to their health and interactions with the healthcare system. For Chyzzy, it’s about seeing the person not just as a single issue to treat, but seeing health as intrinsically connected to the communities you belong to.

Chyzzy said in nursing, these are seen as “social determinants of health.” Conditions people are born into, access to power and resources all impact people’s experience with their health, according to the World Health Organization (WHO). “People who have limited access to quality housing, education, social protection and job opportunities have a higher risk of illness and death,” the WHO writes in their official definition.

Chyzzy said the idea of public health as a way to keep entire communities healthy and safe requires an understanding of intersectional harm reduction. For her, safety means people having access to the resources they need, with their past traumas considered.

Chyzzy said harm reduction is something we all, in some way, partake in in our everyday lives—it can look as simple as wearing a helmet, a seatbelt or a condom. She explains when we consider how an action we take might come with a risk, we take steps to reduce the potential impact. This kind of framework applies to sex work—where considerations can be anything from mental health, to first-aid or other supports. 

“You’re just speaking with humans and they just want to be treated as human beings,” Beaton said. “That’s really what it boils down to, to have the same rights, same treatment, same experiences and the availability of social services as the rest of us.”