37. Unlikely bedmates: A critical look at the history of public health and prostitution

The trope of the prostitute as a vector of sexually transmitted disease is longstanding, though not as old as the profession itself. The regulation and control of sex work also boasts of an incredibly long history; the practices that have developed into the field of public health in particular have been an important source of the ideology suffusing sex work, as well as the social identities associated with sex workers. A general form of a ‘medical police’ (to borrow from Foucault) emerged rather abruptly in the 18th Century, gaining greater support with the advent of positivism in the early 19th Century. The developing methods of epidemiology were intertwined with the uncovering of correlations between poverty, class, and disease, providing both a methodological and ethical foundation for public health interventions and social control, including the legal regulation and sequestering of women thought to be prostituting, forced medical examinations, as well as moral rehabilitation campaigns directed toward sex workers. The breadth of interventions justified by the interests of public health demonstrates that the relationship between public health and prostitution is far deeper than the use of population statistics and outbreak investigations to curb the spread of disease. In this paper, I consider some of the various ways in which prostitution has been constructed through norms regarding class, gender, and sexuality, and how aspects of the historical relationship between public health practices and prostitution have influenced, and been influenced by, these understandings. Appreciating the historical context of sex work and public health is of significance, given that current ideas about appropriate interventions and regulations continue to be informed by this type of politics of health. Bell S. Reading, Writing, and Rewriting the Prostitute Body. Indiana University Press, 1994. Brock D. Making Work, Making Trouble: Prostitution as a Social Problem. Toronto: University of Toronto Press, 1998. Lupton D. The Imperative of Health: Public Health and the Regulated Body. Sage Publications, 1995