The “Universal Health Coverage” (UHC) that Canada is globally applauded for is not as universal as it appears to be, as numerous women, recent immigrants, and Indigenous communities face multiple institutional barriers when trying to access good quality and appropriate health services.
Although a myriad of factors may account for this alarming discrepancy in health access among im/migrant sex workers in particular, the two most critical determinants at the root of this issue are: (1) sex work-related barriers, including criminalization and stigma, which deter sex workers’ health-seeking behaviours for fear of disclosure and judgment (among other factors); and (2) im/migration-related barriers, including but not limited to precarious legal status, language barriers, and difficulty obtaining both public and private insurance.
Notably, Canadian immigration policies prohibit newcomers and temporary workers from engaging in the sex work industry. In fact, work permit conditions explicitly state that they are “not valid for employment in businesses related to the sex trade such as strip clubs, massage parlours, or escort services.”3 As a result, racialized im/migrant sex workers are subjected to a dual risk of incarceration and deportation, which increase their vulnerability to various forms of violence, which then becomes seen as normal or justified. In turn this “dual burden of criminalization”4 shapes im/migrant sex workers’ access to health services, including but not limited to HIV/STI testing and care.
While various human rights organizations— from Amnesty International globally to PACE and Pivot Legal Society locally—have repeatedly shared that criminalization of the sex industry perpetuates and further exacerbates harms that violate the human rights of those engaged in sex work, Canada continues to criminalize sex work through ‘end-demand’ laws that prohibit the purchasing and organizing of sex work services.8 Instead of neglecting evidence-based research on these harms, it is imperative for Canada to take action and adopt rights-based policies at federal, provincial, and municipal levels to ensure that im/migrant sex workers have access to social support and health services without stigmatization, discrimination, and criminalization.