It is widely acknowledged that stigma affects both the health and health care access of persons working in the sex industry (PWSI). However, in his highly influential work on stigma, Goffman (1963) also suggested that stigma affects those who are in close contact with stigmatized populations, a lesser discussed phenomenon referred to in the literature as “courtesy stigma” or “stigma by association”. Method and Objective: This paper draws on ethnographic data to examine the extent and impact of courtesy stigma experienced by frontline service providers working in a community-based organization serving PWSI. Results and Conclusions:The data demonstrate that courtesy stigma operates through both structural and psychosocial means to impact the peer-based service environment, day-to-day work practices, and mental health of service providers. However, much like primary stigma, courtesy stigma is not universally felt by service providers but rather varies depending on their educational attainment, social support and other assets. The implications of these findings are considered with regards to the broader issue of health care delivery to vulnerable populations such as persons working in the sex industry.
Conflict of Interest: None disclosed
Financial Support/Funding: Prostitution Licensing Authority
Sydney Australia, April 2007
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