The Healthcare Workers Doing Sex Work On the Side

This article originally appeared on VICE France.

Health work and sex work aren’t often seen as adjacent industries. But each involves assisting with bodily needs, each is often seen as “women’s work” and each is undervalued by society, albeit in different ways. Sex work can be profitable but is stigmatised, while health work and caregiving is seen as noble, but is under-compensated.

After a career as a porn actress, producer and director Liza Del Sierra, 35, decided to resume her nursing studies in 2018. Del Sierra also volunteers for the French Medical Reserve Corps, a group of health professionals that can be called in to assist medical teams in times of need. During the first wave of the pandemic she was asked to work at a resuscitation unit in a French hospital (she didn’t want to say where), dealing with COVID-19 patients. The job was unpaid, but her school counted it as training. To make ends meet, she kept up her OnlyFans page in her spare time. 

At the hospital, healthcare workers were on the frontline of the crisis. “We ran out of drugs and supplies, and some patients ended up dying in horrible conditions,” she said. “Sometimes they'd struggle until their last breath, for up to 45 minutes [because they didn’t have enough drugs like painkillers]. It really hurt to see that.” Del Sierra said she couldn’t stop thinking about how isolated patients were far from friends and family in those final moments. Amongst the chaos and sadness, she noticed this was the first job where colleagues didn’t give her a hard time about her career in porn. “It felt good to be looked at as a professional,” she said.

Del Sierra is far from the only sex worker in scrubs. With an average salary of €1,800 per month before tax in France, and a stressful daily routine, many healthcare workers use sex work to top up their wages, and as a kind of release. Layna, a nurse in her thirties, began stripping while she was a student. She said the side hustle helped her cope with her high-stress job caring for people with serious illnesses.

“I used to dance two or three nights a week,” she said. “That’s what saved me from burnout.” Over the years, she was assigned more and more patients to care for, and had to compromise on her standards. “Basically, we’re forced to mistreat people,” she said. “At night, I’d go home and replay my day in my head, blaming myself for everything I should have done differently. I was so exhausted.”

During the first wave of the pandemic, Layna was called to a hospital near Paris to fill in for colleagues on sick leave. “We had 35 patients per nurse, and two nurse’s aids in total,” she said. She finished late each night and her next shift would start at 7AM, meaning she would often end up sleeping in her car. “We couldn’t get the shifts covered, even for the cleaning staff – literally everyone was suffering,” she said. “Worst of all, I didn’t have the time to be compassionate with people anymore.” 

When the temporary job came to an end, Layna decided to leave for Guadeloupe, a French region in the Caribbean where strip clubs remained open. There, she took up dancing at a safe distance from her audience while wearing a mask. “It cleared my mind,” she said. “Suddenly I had this feeling of control.” At the moment, she’s taking a break from her healthcare job, which she said is still her “number one love”, to regain her mental strength.

Fouad*, 30, wears three hats: escort, PhD student and at-home caregiver. The latter, a female-dominated profession, consists of housekeeping, preparing meals, grooming and doing administrative work for elderly and disabled people. It can also involve more menial tasks, depending on the client. “One of my young disabled clients asks me to help him text his friends and swipe on dating apps,” said Fouad when we met in a park outside Paris. 

Like Del Sierra and Layna, Fouad also worked overtime during the first wave, up to 60 hours a week. “There was such a huge demand for caregivers – plus, we needed to fill in for the workers who’d been exposed to the virus,” they said, adding that they weren’t paid extra for night shifts or overtime. “We couldn’t even claim the bonus they gave to healthcare workers after the first wave,” they explained, since the bonus didn’t include caretakers who work for individuals. 

Later in 2020, Fouad began working as an escort, for reasons they didn’t want to go into. “Both are service jobs – they aren’t really all that different to me,” they said. But their double career posed another moral dilemma: the fear of infecting a patient with COVID-19 after being with a client. Eventually, Fouad came to terms with the decision to continue their sex work, since they believe their side job isn’t any riskier than many other lines of work. “I see four clients a month, that’s it. The rest of the time, I work alone at my computer,” they said. “It’s easy to point fingers at a stigmatised group while everyone else is busy crowding the subway and supermarkets.” 

In France, being an escort is not illegal, but soliciting sex worker’s services was criminalised in 2016. This type of legislation aims to penalise clients while legally protecting sex workers, and is known as the Nordic model, since it was first introduced in Scandinavian countries. But according to French sex workers, the law made their job more dangerous, as many now have to perform their services in well-hidden areas so that their clients can avoid the cops.

Camille, 33, is a single mum affected by an invisible disability. She works as a dental surgeon in a private practice and as a professional dominatrix. Camille says her sex work is a source of extra income, and is compatible with her need for flexible hours and with her condition. In May, when dentists opened back up after six weeks of lockdown, Camille’s practice had a huge influx of patients, which drove her to exhaustion. 

She eventually stopped working at the practice and turned to sex work to compensate for several months of lost income. But this also meant putting up with working conditions she would never have accepted if she wasn’t strapped for cash. “Clients now come to my place because many of them are married, plus there are more restrictions on movement now,” she said over Skype. “I had to put my safety aside and risk bringing COVID into the house. I didn’t really have a choice.”

Camille said her clients aren’t very considerate about following safety measures, so she tries to only book in the minimum amount she needs to pay the bills. The risk she has to manage illustrates another thing health and sex workers share: the pandemic has put them in a precarious situation.

*Name changed.

A quote about patients struggling to breathe was updated.