New Book an Insightful Guide to the Challenges Faced by LGBT Alcohol and Substance Abuse Patients and Counselors


When it comes to treating LGBT substance abuse know this: LGBT persons know they are the same but different from their straight counterparts.

While treatment and intervention for alcoholism and drug addiction in lesbian, gay, bisexual and trans patients often mirrors that offered to the general population, these services often do not train staff adequately about the complexity of the experiences, emotions and challenges faced by LGBT patients.  Many times they sadly run the risk of being ineffective, counterproductive or even detrimental to recovery.

In “Fundamentals of LGBT Substance Use Disorders,” the new book released by Harrington Park Press (and distributed by Columbia University Press), the well-known and widely published clinician Michael Shelton sums up what is known about the prevalence of LGBT substance abuse and treatment, and emphasizes the importance of affirmative therapy practices—counseling that supports and embraces client sexual identity.

Michael Shelton’s “Fundamentals of LGBT Substance Use Disorders” continues the work begun by Dana G. Finnegan and Emily B. McNally, the married lesbian professional counseling couple widely considered pioneering heroes of LGBT substance abuse research and counseling. The Harrington Park Press book updates and modernizes an older out-of-print classic work by Finnegan and McNally, and includes a Foreword by both of them.

The book looks at not only how lesbians, gay men, bisexuals, and transgender individuals differ in their susceptibility to substance abuse, but stresses that treatment programs must consider many additional factors, including race, ethnicity, age, family relations, and place of residence in order to succeed.

The book is the first new comprehensive resource for LGBT substance abuse counselors to be released since a  government-funded guide was released by SAMHSA (Substance Abuse and Mental Health Services Administration) sixteen years ago, in 2001.

In addition, there have been significant LGBT cultural victories since the publication of the earlier LGBT substance use disorder resources and, as well as more social and political tensions.

“Fundamentals of LGBT Substance Use Disorders” is an introduction, textbook, and handbook for LGBT-focused and general substance use disorder counselors. It synthesizes and summarizes  optimum care guidelines, current terminology and sobering facts about substance abuse, most strikingly regarding those who identify as bisexual, who have the highest rates of alcoholism and substance abuse.

The following are a few key terms and facts from the book:


What to Look for in Effective LGBT Substance Abuse Treatment

LGBT people face barriers entering treatment, and challenges while in a treatment setting. These range from prejudicial and discriminatory treatment from staff and peers to “therapeutic neutrality.” This means being prescribed the same treatment regardless of sexual orientation or gender identity.

Below is a short list of key requirements LGBT people should look for when seeking effective substance abuse treatment.

  • LGBT-specific programs are available.
  • Treatment embraces “affirmative therapy” (see below).
  • Facility operates as a safe place for LGBT patients. Just one bad experience with a staff member or even a random person working in the same building is enough to destroy a clinic’s effectiveness and reputation in the LGBT community.
  • LGBT employees on staff: A clinic or program with no LGBT employees is a red flag and may not bode well for LGBT patient success.


Three Terms You Need to Know When Seeking LGBT Counseling

– Affirmative Therapy

-Trauma-Informed Care

-Cultural Competency

  • Affirmative Therapy recognizes, embraces and supports an individual’s self-identity, and operates on the principle that sexual orientation and gender identity are not the problems for LGBT persons, but societal heterosexism is.
  • Trauma-Informed Care takes into account the more-than-normal distress and suffering from upbringing or discrimination that may have led or encouraged LGBT persons to abuse substances or alcohol and then to seek treatment.
  • Cultural Competency means the treatment staff must have a special understanding and respect for LGBT cultural differences and experiences. They should provide an inclusive, safe (non-hostile) environment that may not exist in a program that is based on therapeutic neutrality (treating LGBT patients and non-LGBT patients in the same fashion).

“It’s Not Me, It’s You”: Heterosexism and 7 More Terms You May Have Heard but Not Considered Particularly Important

  • Minority Stress: Stress caused by just being a member of a minority group, mostly a result of everything on this list. Of course, every LGBT person belongs to more than one minority group.
  • Microaggressions: These are brief and commonplace verbal and behavioral indignities made towards LGBT people (and other minorities). They can be more damaging than overt expressions of bigotry precisely because they are small, and therefore often ignored or downplayed.

Microaggressions lead the victim to feel self-doubt rather than justifiable anger, and isolated rather than supported.

There are three types of microaggressions: Microassaults (verbal attacks that can include slurs, bullying, and hate speech); Microinsults (rudeness and insensitivity that demean a person’s heritage or identity; an example is “forgetting” to use a trans person’s preferred name or gender pronoun); Microinvalidations, which are interactions that exclude, negate, or nullify a person’s thoughts or feelings. An example might be a straight person stating or implying that minority stress does not exist, offering the platitude: “We are all human beings.”

  • Social Stigma: Extreme disapproval of a person or group based on stereotypes to segregate them from the larger society.
  • Stigma Consciousness: The chronic expectation/fear of being stereotyped by others.
  • Stereotype Threat: The fear of being seen through the perspective of a negative stereotype or of doing something that would inadvertently confirm that stereotype. The MTV short film “American Male” is a good, though exaggerated, example.
  • Heteronormativity: The belief that hetero is not only bettero, but is the only normal sexual orientation.
  • Heterosexism: The “enforcement” of heteronormativity in a clinic or group setting. Heterosexism hurts just as much as other negative “isms: – racism, sexism – but is the expression of heteronormativity (“only heterosexuals are normal”) through discrimination.
  • Implicit Bias: Even if someone feels he or she is not biased, he or she actually is. Examples are assuming a Latina works as a maid, that the black man wearing a hoodie is a thug, or that all gay men are diseased or effeminate.

Five Not-So-Fun Facts about LGBT Substance Abuse

  • Bisexuals make up the largest single population in the LGBT community, have the most practical troubles, and are most susceptible to substance use disorder issues. Yet they remain the least researched and least understood. In more than one study, the odds of substance misuse for bisexual youth were 340% higher than for heterosexual youth.
  • Two-thirds of LGBT people experience at least one of three forms of discrimination based on sexual orientation, gender identity and race. Substance abuse is four times greater among those who experience all three types of discrimination, than those who experience none.
  • LGBT men and women demonstrate a smaller decline (or none at all) in substance use as they age, in contrast to heterosexuals, who typically reduce or end their substance use as they get older.
  • Baby Boomers represent the fastest-growing group in need of substance abuse care.
  • Most gay men and lesbians do not have a substance use issue, although their risk is elevated in comparison to that of heterosexuals. •

Author and publisher details on the following page.

Fundamentals of LGBT Substance Use Disorders
Michael Shelton
November 8, 2016
Harrington Park Press
Distributed by Columbia University Press
ISBN: 9781939594112 paper
Available at Amazon, Amazon UK, Harrington Park Press

Download 300dpi cover image.

Michael Shelton has previously served as a board member for NALGAP (National Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies). Among his previous books are Gay Men and Substance Abuse: A Basic Guide for Addicts and Those Who Care for Them, which was awarded Best LGBT Book of the Year by the Independent Book Publishers Association, and Family Pride: What LGBT Families Should Know About Navigating Home, School, and Safety in Their Neighborhoods.

Harrington Park Press is a specialized academic/scholarly book publisher devoted to emerging approaches to LGBTQ diversity, equality, and inclusivity. Harrington Park Press is distributed internationally by Columbia University Press.


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Victor Minichiello and John Scott eds.:
Male Sex Work and Society
Harrington Park Press, New York 2014, pp. 489

Reviewed by Erwin J. Haeberle

This is a pathbreaking, well illustrated book about many aspects of male sex work – historical, cultural, economical, ethnological, legal, medical, psychological and artistic. As the editors explain their aim (p. 462): “to open and clarify a new conceptually broader perspective on the male sex industry. We hope that …(we) will help put to rest some outdated and negative perceptions of male sex workers (MSWs) and their clients…”.

The work achieves this goal to an astonishing degree. 25 Authors from the USA, Australia, Great Britain, Argentina and China summarize existent, but hitherto scattered research and present their own recent studies. In a total of 17 chapters we are given a detailed, very illuminating overview of what is known today about this long neglected, but increasingly important topic. The entire volume contains a great many suggestions for future research. Each of its chapters provides its own, often very extensive references.

The book is divided into four major sections: 1. Male Sex Work in Sociohistoric Context, 2. Marketing of Male Sex Work, 3. Social Issues and Cultures in Male Sex Work, and 4. Male Sex Work in its Global Context. This is followed by brief characteristics of the contributors, a very useful glossary, and an index.

In the first section, three authors provide some historical and cultural background. Mack Friedman gives us anecdotal “snapshots” of  male prostitution in ancient Greece, Rome, Japan, pre-industrial and 19th century Europe and the US. In addition to providing many illuminating details, his chapter makes clear that, over the centuries, the theory and practice of male sex work has undergone significant changes in all of these cultures, and, most importantly, that the changes were related to changing religious, legal, and economic conditions.
This insight is further elaborated by Kerwin Kaye, who describes male “hustling” in the modern US.
Finally, examining the role of male sex work in film, Russell Sheaffer presents additional evidence for the same socio-cultural trends. Thus, this entire introductory section already makes clear that we are dealing here not with a definite, unchangeable social phenomenon, but that male sex work, like any other work, is shaped by larger historical forces.

This becomes even clearer in the next section concentrating on its economic aspects. In his chapter on marketing male sex work, Allan Tyler introduces the clever abbreviation M$M for ”men who sell sex and sexualized services to men”. He then shows that, in addition to traditional means of advertising like calling cards and magazines ads, the new electronic media are playing an increasingly important role – for both escort agencies and social networks. The new opportunities favor a more sophisticated type of M$M and promise more commercial success. In this context, it is interesting to note that a recent online-article by Grant Stoddard predicted the decline and fall of the porno industry. Under the suggestive title “The Future of Porn Is In Your Hands”, he wrote: “With the X-rated industry in a financial death spiral, porn’s future may be in custom-made, social content. And that may be better for everyone.”  This could very well also be a direction in which many M$Ms may be going.
The following chapter by Trevon D. Logan deals with economic analyses of male sex work. It first offers a discussion of theoretical issues and then presents a study of “men advertising online on the largest, most comprehensive, and most geographically diverse website for male escort work in the US”. (I could not find the exact size of the sample.) The study first offers summary statistics for physical traits of escorts like hair color, eye color, body hair, body build, bevaviors, and then detailed tables illustrating their geographical distribution, the implicit prices of their physical characteristics, of their sexual behaviors (top, bottom versatile etc.), and of their ethnic origin (Black, White, Asian, Hispanic etc.). Limited as this study obviously is, it provides a promising starting point for urgently needed further interdisciplinary, integrated research, which “would enhance and extend our understanding of sexuality and gender in general and male sex work in particular.”

  1. The third section of the book deals with social and cultural issues in male sex work. The clients of male sex workers are described by John Scott, Victor Minichiello(the editors of the volume), and Denton Callander.  As they state at the outset: “Properly describing MSW’s clients is hindered by the legal and social status of sex work.” Thus, the true extent of the client population is not known, and neither are their characteristics and motivations. After citing the few, inadequate studies available so far, the authors present a limited effort of their own. They offer a few tables with detailed self-descriptions of clients, concluding that the clients of male sex workers and those of female sex workers may be” not much different from the general population of men”. As to the motivation of clients, the hitherto available studies suggest three main factors:  Seeking power, seeking intimacy, and seeking sensation. The authors then quote from an ongoing internet study of their own, which shows that “clients do not represent a cohesive or connected community and it is often only the identity of “client” that connects them in any way.” This is followed by a case study – an interview with a client – which throws some light not only on his motivation, but also on the evolution of his sexuality over time. Turning to female clients of MSWs, the authors are forced to conclude that “female clients of MSWs are nearly invisible in the existing literature.” Nevertheless, there is a noticeable trend towards more openness and acceptance, and this may lead to better research opportunities. After discussing various methods of social control, the chapter comes to the conclusion that it would be useful for researchers to engage directly with MSW clients. This could “address gaps not only in our understanding of sex work, but also, more broadly, in our notions of masculinity and gender.”

In the next chapter, Thomas Crofts discusses the regulation of the male sex industry and finds that, while there are some similarities to the regulation of female sex work, “the reasons for regulating male sex work and the targets of regulation have been quite distinct”.  Needless to say, as long as male homosexual behavior as such was criminalized, it was barely visible in public, and male sex work was an even more clandestine activity. As a result, there was less pressure to regulate it in any special way. Moreover, since the activity took place between men, the stereotypical pattern of prostitution as patriarchal exploitation did not –  and still does not –  apply. Anyway, as homosexuality itself became more acceptable in society, and various forms of regulation of male sex work were put into practice. Since they differ considerably from one place to another, they are difficult to summarize. (The author refers mainly to the situation in Australia.) However, one can agree with the conclusion that “while there are differences …between male and female sex work that require some differentiated regulation, the overarching approach  … should be one of minimizing harm, reducing factors that lead people to be or to feel coerced into sex work, and increasing the choices and options for those within that industry.”

In the chapter on public health policy regarding male sex work, David S. Bimbi and Juline A. Koken provide some practical, positive examples from the Netherlands and Switzerland.  They demonstrate the wisdom of decriminalizing both homosexual behavior in general and male sex work in particular.

In the next chapter, the same authors then turn to the problem of mental health in MSWs. Since many of them have trouble dealing with the social stigma associated with their work, substance abuse is a major concern as is the experience of violence, both at the hands of clients and of the police. Such problems are likely to be ameliorated with an increasing acceptance of sex work.

Christian Grov and Michael D. Smith follow the development of gay subcultures in the US, beginning in the 1950s. However, it was not until the 1960s that a gradual process of liberalization allowed for the growth of a “gay marketplace”.  Personal ads, the telephone, and finally the internet created new opportunities for sexual services. At the same time, “gay” neighborhoods with legitimate “gay” businesses began to spring up. In short, the growth of a veritable and very visible “gay subculture” is likely to remove much of the traditional stigma attached to male sex work.

Mary Laing and Justin Gaffney examine the health and wellness services for male sex workers.  Quoting from a special British survey of 2009, the authors provide many interesting details about MSWs in the UK, such as demographic information, reasons for engaging in sex work, clients, sexual health, mental health, education and life skills etc. Nearly half of the participants were university or college graduates, half said they sold sex to supplement their income and that they could stop I they chose to. One third had regular clients.  For the other half of the sample, the picture is more diverse with some negative aspects becoming apparent. All in all, however, the survey sample with only 109 participants was very small. Nevertheless, it does offer a starting point understanding the health service needs of MSWs. Moreover, the survey also revealed that male sex work is not restricted to the young, but that men of all ages engage in male sex work. Finally, it has shown that researchers now have to consider the possibility – and reality – that male sex work may also be a rational career choice.

In the forth section of the book, six chapters put the issue in a global context. Male sex work in Southern and Eastern Africa is described by Paul Boyce and Gordon Isaacs. Based on a participatory workshop held in South Africa in 2011, it explores the “social contexts, life experiences, vulnerabilities, and sexual risks” experience by MSWs in Kenya, Namibia, South Africa, Uganda, and Zimbabwe. The stories told by the participating MSWs reveal a varied picture: Some consider themselves “gay”, others “straight”, but their motivation is usually urgent financial need. The stories also document the inadequate, incompetent and, indeed, irresponsible health policies in their countries, especially as they relate to AIDS prevention. The authorities there do not seem to understand their first and most important public duties. Outdated “sodomy laws”, the pernicious influence of Western religious fundamentalists, open prejudice and mistreatment by the police remain serious obstacles to controlling the AIDS epidemic in Africa.

Travis S. K. Kong writes about male sex work in China. Stating that “male prostitution is a booming industry in China”, the author then provides some tentative figures: “While the actual size of this population is unknown, it is estimated that the population of men who have sex with other men is between 2 and 20 million … Of this population it is estimated that between 5 percent and 24 percent are money boys”. This latter tem refers to MSWs serving men, while those serving women are called nan gonguan (male public relations officer). The general term for MSWs is yazi(duck). The author has conducted focus groups and personal interviews with 70 money boys in Shanghai, Beijing, and Shenzhen. Reminding his readers of the traditional tolerance of homosexuality in imperial China, Kong quickly moves through the periods of the first republic, the rule of Mao Zedong, and the years before the current economic reforms. Today, private homosexual acts are no longer punished as crimes or officially considered pathological in China. (Popular opinion is another matter.) At the same time, “the state’s promotion of the market economy coincides with the resurgence of a sex market that encourages the commodification of the body. This has provided an alternative way to earn quick and easy money, especially for migrant workers.” However, both female and male prostitution are actively discouraged as socially harmful. At the same time, the latter is also stigmatized by mainstream society and the “gay community”. The author distinguishes between four categories of MSWs in China: The full-time independent operator, the full-time brothel worker, the part-time freelance worker, and the “houseboy” being kept by a client. The clients of WSWs are usually business men aged 20-60 from other Chinese provinces or from Hong Kong, Taiwan, Japan, Singapore, Korea, and even from the US. The advantages of easy money, however, must be balanced against several disadvantages  –  raids and harassment by the police, extortion and violence, and, the risk of sexually transmitted infections. All of this notwithstanding, most of those interviewed “made a conscious and rational choice to enter this occupation.” The author sums up his findings this way: “The life of money boys reflects a more general picture of many rural-to-urban migrants caught up in China’s pursuit for globalization: they are passionately seeking freedom, happiness, and wealth…. While they search for independence, control, and empowerment, however, they also face displacement, alienation, and dislocation”.

In the following chapter, Linda M. Niccolai discusses male sex work in today’s Russia. The author quotes a St. Petersburg study of 434 men having sex with men, of whom 23 percent reported having had sex for pay. In 2011, Niccolai and her colleagues conducted a qualitative study of their own with no sample size given in the text (p. 348 ff.). However, her summary reveals that “male sex work in St. Petersburg occurs in both organized and unaffiliated ways, and it spans the spectrum from highly paid escorts to men who work on the streets for subsistence.” Several quotes from interviews round out the picture and illustrate the growing role of the internet in making connections. Russian MSWs face “multiple social vulnerabilities … including …disclosure of their identity and profession, threats to their personal safety, lack of risk perception, and lack of appropriate health and social services.” Needless to say, at the present time, homosexual behavior as such, while no longer subject to criminal prosecution, is faced with a new kind of hostile religious and nationalist propaganda with its accompanying social discrimination. Under the circumstances, more research is needed, for which the author makes several sensible suggestions.

Victor Minichiello, Tinashe Dune, Carlos Disogra, and Rodrigo Mariño explain male sex work from Latin American perspectives. For this, they have divided the text into three parts –
a discussion of masculinity and sexuality, a review of popular media dealing with male sex work, and an Argentinian study of the sexual interactions between MSWs and their clients. As for the Latin American stereotype of masculinity (the man as macho breadwinner and head of his family), there are some differences between different Latin American countries (e.g. Brazil vs. Mexico) and also between social groups and classes. However, there is a general agreement that “real men” have to be “on top”. In same-sex erotic encounters, this is to be understood quite literally. At the same time, as the authors state: “For most Latin American societies, the Western dichotomy of male sexual orientation – straight or gay – does not speak to how men actually experience their sexuality.” Therefore: “Considering that male sexuality and sexual behavior in Latin America are fluid, the sexual services provided by MSWs are quite varied and can be fairly lucrative”.  The chapter then discusses various details, such as types of WSWs (street workers, independent operators, transvestites, and transsexuals), prices, educational level, safe sex practices, etc… Once again, the internet proves to be an increasingly common tool for making connections. The text also makes one important point: Male sex work has been legalized in many, but not all Latin American countries (regrettably, no examples given for the latter). The authors then point out that same-sex marriage has been approved in Argentina, Uruguay, and Brazil. Same-sex civil unions are accepted in Ecuador and Columbia. Obviously, this has had an effect on the image of homosexuals in the general population. Still,  MSWs have remained largely invisible. Even so, there have been some newspaper articles and movies that portray their world, albeit in a gloomy, rather negative way. The internet, however, offers a more nuanced picture: Researching two web sites advertising the services of MSWs, the authors found the following: On the first site, with a total of 92 escorts, 51% gave their ages as being between 20 and 24,  35% were between 25 and 30, a few said they were over 30 or under20. 64% described themselves as “top only”, 29% as “versatile”, and 7% as “bottoms”. 56% advertised services for males, females, and couples. A second web site with 151 escorts presented very similar results:  57% called themselves “tops”, and 28% “versatile”. Once again a majority, i.e. in this case 64% offered their services to males, females, and couples. Some also reported that they were unavailable because of their traveling overseas, indicating a growing trend toward sexual tourism. Two studies conducted in Argentina between 2001 and 2008 revealed, among other things, the following about its 145 participants: Their ages ranged from 16-43, the majority worked in the sex industry mainly for money or for lack of other job opportunities. 42% identified as gay, 28,6% as straight, and 27,8% as bisexual. The vast majority works privately and advertises in the electronic media. The consumption of tobacco, alcohol, marijuana, and cocaine was relatively high, although not alarming. More worrisome was the fact that one third of the MSWs avoided public and private health services for fear of having to give self-incriminating answers to questions. Many also found the services to be inaccessible. On the whole, however, due to the legality of male sex work in Argentina, the MSWs had fewer problems than their colleagues in many other countries. The general situation of male sex work in Latin America is still unsatisfactory, especially with regard to HIV/AIDS prevention. Nevertheless, the authors conclude: ”The business of selling sex among men is evolving toward greater societal openness, acceptance, and inclusivity.”

The situation of migrant sex workers in Germany has been studied by the American anthropologist Heide Castañeda. As she explains at the outset, most of them are now coming from Bulgaria and Romania, which joined the European Union in 2007.  She continues: “Thus,unique to the German situation is not only the fact that prostitution is a legal activity but also these migrant MSWs are not “illegal” because they are EU citizens”. Nonetheless, at the time of the study (i.e. before 2014), migrants from these countries did not receive work permits and thus had no access to health services. Moreover, the increased influx of migrant MSWs to Germany has resulted in competition, and over-supply for the existing demand, and a drastic lowering of prices. This created “antagonism between migrants and German sex workers.” At the present time, most of the migrants selling sex are ethnic “Roma” between 17 and 30 (formerly called “Zigeuner” (Engl. “gypsies”)). They belong to the most disadvantaged ethnic group in Europe, still suffering the severest discrimination. Many of the MSWs from this group have girlfriends or even wives and children. The chapter provides many interesting details about their lives, but its emphasis is on their health needs, especially their risk of HIV/AIDS infection. Various obstacles to receiving the necessary health services are described, leading the author to argue for “going beyond targeting “risky men”, which leads to further stigma, and focusing instead on the ways men move in and out of risky social contexts and how focusing on their structural vulnerability can help us understand mutually reinforcing insults that have a negative impact on health at the economic, political, cultural, and individual levels.” (On a personal note, I would like to add here that I find it gratifying, but not surprising, that someone from the US had to come to Germany and conduct this valuable research. Once upon a time, German sexologists were leading in this field, but today their small and steadily dwindling number is preoccupied with only a few, very narrow issues of sexual medicine and sex therapy and shows little interest in their larger socio-cultural context.)

In the last chapter, Paul J. Maginn and Graham Ellison discuss male sex work in the Irish Republic and Northern Ireland. Pointing out that, compared to female sex work, almost nothing is known about its male counterpart, the authors then discuss the various limited studies that are available. They break new ground with an empirical study of the largest Irish escort web site. In the year 2012, a total of 5,394 escorts advertised their services on this site. (Some caveats: Many escorts may be counted several times, as they present themselves under multiple, different identities, and these may be related to geographically specific strategies. Also, not all of the escorts are available everywhere at all times.) The study presents some interesting charts covering four types of escorts: Male, female, transsexual, transvestite. The vast majority of male escorts identifies as bisexual, (thus indicating that they will serve both male and female clients), their ages range from 18 – 49, with the average age being around 25. Their nationalities are: 17.8% from Latin America/Caribbean, 38% from other European countries, and 9.1% are British/Irish. After discussing these and other findings in detail, the authors conclude that: “The landscape of commercial sex work in Ireland, north and south, has been fundamentally altered by the development of the Internet”. One curious aspect of their survey is the relatively small number of MSWs who identify as “Irish” or “British”. The most common identifications are Brazilian, Spanish, and Italian.  This could mean that native-born MSWs operate more sporadically and prefer other means of advertising. In any case, “advertisements and profiles appear and disappear with rather rapid abandon, sometimes staying live for only a few days at a time. …(This) suggests that sex work for some young men is something that they dip in and out of depending on circumstances; it is not a fixed identity”. In conclusion, the authors emphasize that the escorts studied here represent the top of a multi-layered commercial world. At its bottom are male street workers in large cities like Dublin and Belfast. They earn less money, are subject to violence and abuse at the hand of clients, and are more likely to engage in “unsafe” sexual practices. In between these extremes, there appears to be another category of local sex workers, mainly between 18 and 25 years old, who drift in and out of commercial sex work “as the need arises.” Reminding the readers of the dire economic conditions in both parts of Ireland, the authors suspect that many Irish young men are “trying to supplement their income” with sex work. And this could also be true for many young, male immigrants. As a helpful policy measure, the authors recommend a model program implemented by the city of Manchester, England. Its “emphasis is on harm reduction, not on enforcement per se.” However, they are not hopeful that this model will soon be followed in Ireland.

The editors, having the last word, arrive at the following summary of the “postmodern view” presented in their book: “We must not forget the powerful social and economic forces that shape how commercial male-to male sex is viewed. Our knowledge about the male sex worker has been constructed over a historical arch and has changed from era to era… Researchers…have offered enormously useful insights into ….the role of masculinity, sexualities, and individual agency. They also have examined the impact of gender, age, race, and sexual orientation on the sexual choices and careers of MSWs.” After a discusion of age and its role played here and a further discussion of the highly problematic concept of “race” and its influence on “safe” sex practices, the authors have several useful suggestions for further research. Having edited this volume, they can confidently assert that ”the male sex industry is larger and and more widespread than heretofore believed.” Since MSWs are not a product of capitalism or Western “decadence”, but exist around the globe, more research in many more countries is needed for the sake of improved public health alone.

For this reviewer, the book has been an eye-opener, and I suspect that it will have the same effect on many other readers. Especially all those involved with public health issues – from doctors and nurses, social workers and community leaders to the police and the criminal justice system, to public officials and politicians  – would greatly profit from reading the various papers included in this volume. In addition, journalists at every level should study this book. This will help them to avoid simple-minded reporting. After all, they have a special responsibility to inform the public, and without an informed public the necessary health policies will have no chance of being implemented. It is also clear that those funding research as well as the researchers themselves would be well advised to take note of the increasingly important role of the internet in the sex trade. In the future, the multiple new electronic venues may lead to a great many new research opportunities and, at the same time, to new serious social problems for both MSWs and their clients. The fact is that not only they, but all of us are now entering an age of total electronic surveillance. This means, among other things, that, sooner or later, many long-denied sexual realities will reassert themselves everywhere as they become visible to an ever wider public. How this public and its elected representatives will react to these revelations, is an open question. And it’s not only governments that are likely to find out everything about us. A much greater danger may be the steadily growing collection of “big data” in the hands of private corporations. In the end, i.e. in the not too distant future, all of this may lead to a new “transvaluation of values”, and the sexual values may undergo the most surprising changes of all.

Finally, a little addendum of my own: So far, sexological textbooks have not dealt with the topic of male prostitution at any length. However, one of my online courses now offers at least some very basic introductory information:

In English:

In Chinese (simplified):

In Chinese (traditional):

In Russian:

In Spanish:

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Male Sex Work

Male Sex Work.

In recent decades, male sex work has emerged as an important area of study, as well as a social activity in its own right. As new ways of thinking and speaking about male sex work have emerged, it is no longer conflated with homosexuality or the female sex industry. Historical and cultural variations in male sex work are now acknowledged, enabling this activity to be understood in complex and dynamic terms, thus challenging older perspectives that view male “prostitution” as deviant and pathological. Previously neglected aspects of male sex work, such as servicing a female clientele (the gigolo) and upper income types of service (escorts), have gained both scholarly and popular attention.

Recent scholarly writing on the male sex industry has largely come from two areas: the social sciences (e.g., psychology and sociology) and the humanities (e.g., history). A range of popular works on male sex work in the visual arts has also emerged, including cinema and literature, most of which has not been accounted for in scholarly writing. For the first time, this work integrates these separate disciplinary approaches in one comprehensive volume.

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Male Sex Work

Forthcoming comprehensive volume….

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