Access to health is a fundamental human right, yet for sex workers across Europe and Central Asia, this right remains systematically denied. Sex work does not produce health inequalities. Instead, criminalisation, stigma, racism, transphobia, poverty, and punitive drug policies determine who is able to access care, whose experiences are taken seriously, and who is left behind.  

Negative health outcomes are the direct result of systems built on structural exclusion, where access to timely, quality, affordable, and culturally competent healthcare is reserved for those with the greatest social privilege. For many sex workers, every step towards healthcare is obstructed by fear of discrimination, violence, criminalisation, or deportation. 

As highlighted in ESWA's 'Two Pairs of Gloves’ research on stigma and discrimination in healthcare settings, healthcare providers continue to reduce sex workers’ identities to nothing more than their work, failing to recognise them as a whole and individual people with diverse health needs throughout their lives. Like everyone else, sex workers seek fertility guidance, maternal care, gender-affirming care and mental health support and recognition for their symptoms of menopause, ageing, and chronic disease management.

Yet when a sex worker comes to the doctor… consultations are structurally brought back to their work. Symptoms unrelated to sex work are dismissed, reproductive choices are questioned, experiences of menopause or chronic illness are overlooked, and many sex workers report that healthcare professionals assume they should not be caregivers or parents. Rather than receiving person-centred care, they are met with judgement, stereotyping, and lower-quality of treatment.