Developing An Intersectional Feminist Trauma- And Violence-Informed Practice Framework for Mental Health Services For Women In Sex Work

Abstract This PhD by project examines the impacts of intersectional oppression in women’s lives, specifically the mental health impacts of gendered violence for women in sex work (WISW). WISW face particularly complex forms of intersecting oppression compounded by high levels of social stigma. The significant marginalisation of WISW means it is difficult to obtain accurate information about the prevalence, nature and impacts of gendered violence for affected WISW. However, evidence that exists indicates the rates of gendered violence among WISW are higher than among the general population of women, and that WISW require access to mental health services to address the traumatic impacts of gendered violence. Despite the high prevalence of gendered violence among WISW, trauma-informed mental health services remain inaccessible due to barriers caused by social stigma and inadequate resourcing of the service sector with very limited practice guidelines for what such services should look like. Grounded in an intersectional feminist framework, this research sought to gather existing practice knowledge from the perspectives of practitioners to inform the development of practice guidelines for trauma-informed mental health services for WISW. The research question was: o What is a trauma-informed practice framework for mental health services for women in sex work impacted by gendered violence? The sub-research questions were: o From the perspective of service providers, what is the current practice for trauma-informed mental health services for women in sex work impacted by gendered violence? o How might intersectional feminism build on current trauma-informed practice of mental health services for women in sex work impacted by gendered violence? The methodology was informed by qualitative feminist research and with the data collection tools of survey, interview and document analysis this research gathered rich descriptions of trauma-informed mental health service practice from organisations who work with women in sex work. The findings of this research provide in-depth practice advice for how trauma- and violence-informed care approaches can be applied within mental health services for women in sex work and how this practice can integrate an intersectional feminist framework. This framework effectively situates the issue of gendered violence within its social context, naming the drivers of violence and impacts of intersecting oppression, all of which this research argues need to be acknowledged and addressed throughout mental health service delivery. This thesis contends that the issue of gendered violence against WISW be framed as part of the wider issue of violence against women (VAW) and not be siloed as separate due to the sex work context surrounding such violence. WISW can also be victim-survivors of gendered violence and should have the same rights to service support as do victim-survivors outside of sex work. This research has gathered evidence to inform a robust practice framework for such trauma-informed complex trauma mental health services and has produced practice guidelines for the implementation of this framework by organisations and practitioners. These practice guidelines outline a promising practice theoretical framework, practice approaches, practice frameworks and modalities for service delivery and they accompany this thesis.