Trans Men: Sex Work and Health

Like many of our communities, sex work populations reflect a diverse spectrum of experiences and identities. Trans men who are providing sexual services are little talked about, and even more rarely will there be services especially tailored to trans men. There are spaces online for workers to communicate and support each other, but service providers as well need to create spaces and resources for trans men and trans women that do not treat both groups as one and the same. Trans women have unique experiences and needs in the sex industry, and so too do trans men. In brief, we will discuss the possibilities for care in the four areas of health – mental, social, physical, and sexual.

Mental Health

As with any community, the experiences within are not necessarily the same across the board for everyone. Some workers may not identify within the gender binary while working but will do so in their personal lives, just as some providers who are trans may not bill themselves as such in seeking work. For example – someone who identifies as a man may find it is easier to find clients and work arrangements if they bill themselves as a woman for the purpose of work. This, while sometimes a necessity in order to meet their bottom line, can have a negative impact on the security and self-esteem of an individual already experiencing dysphoria or difficulty in expressing their gender in a way that is right for them.

Within Vancouver, through our comprehensive trans health program through Vancouver Coastal Health, we are fortunate to have mental health resources readily available within our communities. Mental health supports can be accessed via VCH, GSHI, Qmunity, and HIM – counsellors, life coaches, and support groups created as spaces for gender variant and trans individuals may help to reduce a sense of isolation. Trans Lifeline is a phone-in service for transgender people experiencing crisis or struggling with their identities, and is staffed by trans volunteers to provide supports and service referrals.

Social and Physical Health

Isolation is dangerous – when we are isolated, we may develop clinical depression, or existing feelings of anxiety, loneliness and depression may worsen. This is especially true for marginalized individuals existing in communities where they feel they are on the fringes or unsure of how to involve themselves. Sex workers have strong communities online, but these may be harder to find offline.

Our physical health plays an important role in overall wellbeing – there are a variety of social and physical wellness groups offered by HIM open to trans identified men, as well as cooking groups, social groups and support groups offered by Qmunity.

FTM Etc is a local Vancouver group for individuals assigned female at birth that identify as men all or part of the time (folks who are questioning their gender are also welcomed) that meets monthly. The Trans Taking Care of Business group is a trans sex worker group that meets weekly on Mondays for meals, information and community building, as well as access to harm reduction supplies.

Sexual Health

Sexual health is an important piece of peoples’ lives – trans men have unique needs and may not feel comfortable or safe accessing resources that do not have an understanding and respect for the trans community. Health care providers are urged to access competency and sensitivity training in working both with sex workers and trans individuals across the spectrum to aid in lessening this stigma and apprehension.

Trans men may need regular access to sexual health care that includes pap tests, gynecological exams, pregnancy supports, and ready access to condoms or dental dams. Condoms are readily available for free in many locations within Vancouver – bars and clubs along Davie have HIM condom dispensers, sexual health clinics provide safer sex materials, or your doctor may be able to assist you. HUSTLE outreach is also able to deliver or aid in access to materials.

(A condom can be used as a dental dam in a pinch by cutting off the tip and slicing the condom lengthwise!)

If you have experienced sexual violence, BC Male Survivors of Sexual Abuse supports men and trans individuals who have a history of sexual abuse or are currently in abusive situations.


Trans Health Program @ VCH
Trans Taking Care of Business
BC Male Survivors of Sexual Abuse
Trans Lifeline

(For a full list of local supports, please see Redbook Online)