We can only achieve equal societies and access to sexual and reproductive health and rights for all if we ensure that sex workers are included. This has been the stance since 2012 of IPPF's French member, Le Planning Familial. Since then, the organisation has been defending sex workers’ rights and access to health, including the right to autonomy and bodily integrity and the right to work and live free from violence and discrimination. It describes itself as an ally, listening to and supporting sex worker organisations and adding its voice to calls for decriminalisation as the only way to respect human rights. Since the introduction of the Nordic Model in France in 2016, which criminalised the purchase of sex, reports of violence against sex workers have almost doubled. Criminalisation of clients has had a detrimental impact on the lives and safety of people who do sex work. Mel Noat from Le Planning Familial acknowledged that even now there is confusion about the law: “It is not illegal to be a sex worker but because clients have been criminalised, sex workers can’t work. Police often fine sex workers despite it being legal.” Because of criminalisation, clients want to avoid being fined, which in turn pushes sex workers underground into dangerous situations. With the current legal framework, they are more exposed to violent exploitation, precarious working conditions and are involved in high-risk behaviour just to earn basic wages. Mel said: “People work in dark places, without anyone around to witness violence from clients like stealing money, physical and sexual abuse, sometimes even murder. Sex workers have no choice over their customers, no choice of working hours, and no customer screening.” He added that sex workers face negotiating difficulties due to dwindling clientele. This, she argues, makes it harder to enforce the basics of sexual risk reduction like condom use. Whether it comes to access to healthcare, exposure to violence, discrimination and stigma, or financial insecurity, the harms of the 2016 law have been far greater for groups experiencing intersecting forms of exclusion, such as migrant and trans sex workers.   How the current law creates obstacles to protecting sex workers’ health and rights As a result of the 2016 law, sex workers are moving away from the traditional spaces where they would find and meet clients. Sometimes they have to venture to hidden places, such as apartments, which jeopardises their safety, as they are more isolated if subjected to violence or if a client refuses to pay. Many turn to intermediaries (pimps or sex websites) and end up paying back part of their income, which makes their situation even more precarious and reduces their autonomy over their work. Sex workers are often pushed into homelessness as they are forced to travel to different cities every few weeks to look for clients, now that these are more difficult to find. This affects their health and welfare as, for example, they don’t know where the closest hospital is, or where they can find condoms or information centres. People are also working more online, due to both the law change and the subsequent COVID-19 crisis. This reduces contacts with the community associations supporting sex workers’ rights, making it more difficult to provide information about healthcare and support. Sex workers are highly stigmatised and often face discrimination by medical staff. They find it difficult to talk about the reality of their work for fear of being judged, or for those who are undocumented, being reported to the authorities. However, there are spaces where sex workers can access healthcare. Some branches of Le Planning Familial are supporting people engaged in sex work through outreach and service delivery. In one region they undertake night patrols, offer condoms and rapid diagnostic tests and provide education on sexual and reproductive health. Elsewhere, the organisation collaborates with STRASS, the sex workers’ union, which provides peer-to-peer services in some of Le Planning’s clinics, as community-led services are proven to be one of the most effective way to deliver care to a key population group like sex workers.   The ‘exit programme’ is limiting and tokenistic The French government wrongly conflates sex work with human trafficking and has done little to review the impact that the legislation has had on sex workers. On the contrary, they are planning to implement a national strategy against human trafficking, which wrongly includes sex work. Measures in the 2016 law that are intended to provide a ‘pathway out of prostitution’ are not adapted to the realities and needs of sex workers. The allowance provided as part of this pathway is a measly €343 a month (three times lower than the French poverty line, which is €1,102). People can be granted a provisional residence permit, but only for six months, which makes it difficult for them to access accommodation, particularly social housing, as landlords often require longer residence permits. On top of this, professional opportunities are severely limited and tend to be in precarious sectors such as in cleaning or the hotel trade. The committee that is supposed to monitor the implementation of the law has only met twice in seven years and only those associations promoting the 2016 law were invited to the table, while sex worker-led community associations were excluded from the process. It is shocking that the government has refused to listen to the voices of the people concerned by the legislation, and to organisations that denounce its negative effects.   Partnerships for sex workers’ SRHR in the face of backlash The data is unambiguous: where sex work is criminalised, sex workers are at a much higher risk of violence. Yet, many pro-decriminalisation organisations face intense backlash, not only from conservative, anti-rights groups but also from well-intentioned organisations that claim to want to protect sex workers. This hostility can pose a challenge to advocacy efforts. To help overcome this challenge and speak with one common, stronger voice, Le Planning Familial has formed alliances with like-minded organisations. In conjunction with Médecins du Monde, Act Up-Paris and AIDES, it co-signed an alternative report in the context of the review of France’s implementation of the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). This explained that the 2016 French law criminalising clients negatively impacts sex workers and is counterproductive. The organisation also widely shared and supported a European Court of Human Rights preliminary decision in August 2023, which recognised the admissibility of complaints by sex workers, confirming that the mere existence of the French law has harmful consequences for them.   Mel said: “We do not support the criminalisation or regulation of any aspect of sex work. Le Planning Familial acts and fights to help build an egalitarian society, free from commodification and violence. We are firmly opposed to human trafficking, violence, rape, pimping and slavery. We believe everyone has the right to autonomy and bodily integrity, the right to work and to live free from violence and discrimination. We support everyone's right to make their own choices through informed consent.” *** Mel Noat is the focal point for issues relating to sex work in the Board of Le Planning Familial. Read more about IPPF’s global policy position on sex work, which strongly supports decriminalisation of all aspects of sex work, together with social policies that address structural inequalities, as the only way to protect the health, safety and lives of those who do sex work. Photo by Loïc Fürhoff on Unsplash    

The IPPF Sex Work Policy makes clear the position and commitments of our Federation globally with regards to sex work. This is the first time IPPF has taken a position on sex work, and presents human rights-based values and principles which apply broadly to all contexts, without being prescriptive about approaches or actions. It is rooted in positions taken by sex-worker led organisations and networks across the world, and in existing IPPF documents.  Find out more and download the policy here.  In line with IPPF’s global policy position, IPPF European Network is opposed to any measures in EU policy or legislative instruments that would criminalise any aspect of sex work, including clients and third parties. Read below the summary of IPPF's Sex Work Policy laying out our guiding principles and calls to action for policymakers.

IPPF recently adopted a global policy position on sex work that focuses on the measures we need to protect people who do sex work from harm. The position strongly supports decriminalisation of all aspects of sex work, together with social policies that address structural inequalities. In 84 countries around the world, our Federation provides sexual and reproductive healthcare to sex workers, mostly women, and in many of these contexts, an IPPF clinic might be one of the few places where people feel safe to come. It is this concrete experience and these relationships that guided us.  Arriving at our position started out as a complex process. Conversations about upholding people’s sexual and reproductive health and rights are always complicated because they touch upon deeply held values. They touch upon beliefs and emotions that can be very hard to let go of, even when the facts, and the women and men, and all people, we wish to protect, tell us we need to think again. This was a journey of listening and learning, of looking at research and evidence, and of taking the time to let human concerns and fears come to the surface and then talking them through. But in the end, it became simple, because we had the privilege of being able to hear directly from the people at the heart of these discussions about the realities of their lives. So our conversations were fully inclusive of the people who actually do sex work and know their situation best. They guided our efforts to stand in solidarity with them, and not decide anything on their behalf. In many countries, from Ireland, France and North Macedonia, to Thailand, Mexico and Kenya, we heard the same thing: criminalisation of clients and third parties causes harm. Though it may be intended to protect, it stigmatises sex workers and impedes their access to healthcare. By forcing them to work underground, it isolates them and leaves them far more vulnerable to violence and oppression, whether perpetrated by government and state institutions, especially law enforcement, or by criminal networks or clients. It also prevents them from exercising their rights, including to self-organisation and collective action, which is key to preventing violence and seeking redress. Decriminalisation is the only way to protect the health, safety and lives of those who do sex work. We also heard loud and clear that sex work should not be conflated with intolerable rights violations such as human trafficking, exploitation and forced labour – such conflation is untrue and is harmful to sex workers. Full decriminalisation – an inclusive feminist position IPPF is an inclusive feminist organization, and supporting decriminalisation as the only way to protect and stand with sex workers is an entirely feminist position, in line with our core values. We became a Federation in 1952, when contraception was illegal in most countries. Many of our members were founded by doctors who saw what happened to women when they were unable to control their own bodies. They listened to women and provided what they wanted. The reproductive justice movement has taught us that abortion goes beyond a simply binary ‘choice’, and so it is with sex work. Many factors come into play. People make the decisions that are best for them according to the conditions they face, and we must respect individuals’ autonomy always. At the same time, we must assume our shared responsibility to ensure that our laws promote social justice by reducing systemic inequalities that affect people’s options and choices in all areas of their lives, as well as providing protection from harm. The way to protect people is always to enable them to exercise their rights. If people work in a context of criminalisation, we deny them these rights. Sex workers have been telling the world this over and over. Every day that sex work is criminalised is a day of violence, danger and fear for those who may already be facing the greatest hardships. It is essential that we keep listening to sex workers and working together, not only to improve the conditions that they face, but to contribute to the wider social change we all want to see. *** IPPF EN is a proud supporter of the European Sex Workers’ Rights Alliance and a signatory of ESWA's feminist manifesto. In line with IPPF’s global policy position, IPPF EN is opposed to any measures in EU policy or legislative instruments that would criminalise any aspect of sex work, including clients and third parties. *** Image credit: Marek Tartal 

This series of four Report Cards explores the challenges of HIV prevention for sex workers in Kazakhstan, Kyrgyzstan, Tajikistan and Russia. It was produced by IPPF European Network with the support of the Sex Workers' Rights Advocacy Network (SWAN) and the United Nations Population Fund (UNFPA). The Report Cards are available for download here in English and Russian.