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Strange Bedfellows

June 20, 20226 min read

Massage therapy has a sex problem. We don’t like to talk about it. We don’t like it when it gets into our workspaces, and we really can’t square the idea that people who pay for sex or who want sex and massage in the same transaction can still be decent humans. We want to draw a bright imaginary line between the importance of our work and the value of sex work; between the upstanding citizens who are our clients and “those people.”

As a profession we’ve been pretending for years that we have a right to be comfortable. This imaginary right has allowed our associations and professional leadership to blithely deny and intentionally avoid the truth about serious problems that prevent us from thriving and moving through challenges that are holding us back. We polarize. We obfuscate. We close our eyes. We have dipped our toe, as safely as possible, into the waters of human trafficking, but we continue to attempt to keep it all at arm’s length and it’s not working.

Sex is number one in the trifecta of cultural taboos, followed only by money and death. Yet, as health care providers, massage therapists should be in full support of sex; an activity that claims many of the same health benefits as massage. While almost 2% of people identify as asexual, sex is important to the mental, emotional and physical health of the remaining 98% of the population and the health of asexual people is still bolstered by intimacy. The belief that people who are uncoupled, or even (gasp!) people who are in unsatisfying relationships should simply go without sex needs to be seriously questioned. This wrong-headed idea dovetails with massage therapists’ perception that massage therapy should somehow happen without intimacy. These convictions are connected; and deeply problematic. Sex and intimacy certainly aren’t the same, but our discomfort with sex makes it difficult for us to practice or to see the world in a way that respects and values both.

hand-painted sign that says sex work is work

Sex work is real work and, when properly regulated, does not impact the practice of licensed massage therapists. It is estimated that there are about six times more sex workers (about 2 million) than massage therapists in the United States. When sex work is criminalized, it creates and perpetuates danger and poor health for sex workers and it pushes would-be sex workers who may prefer to work legitimately into the loopholes and cracks of poorly regulated professions like massage therapy and it leaves seekers or both services in an ambiguous position.

Meanwhile, massage therapists look hard the other way as the cultural and regulatory overlap related to sex work challenges our ability to practice and to be recognized as health care providers. When the Atlanta spa shootings happened last March, the massage therapy profession, fueled by its deep discomfort with the centuries’-old link between sex and massage, by the belief that we “deserve” to be respected, and yes, by racism, went on the defensive.

This response was destructive to our present reality and to our imagined future.

Sex work and sex workers are not preventing us from taking our “rightful place” as health care providers. However, our attitudes toward sex and sex workers may be. Complicating matters further is the sad truth that the spa murders (and other similar incidents) were neither about sex, nor massage therapy. They were about racism and toxic masculinity; two more things we’d rather not address. Our response made it clear that we are unwilling and unprepared to participate meaningfully in these conversations or to own our part of this. It’s time for us to confront the consequences of inconsistent and mediocre massage school admission and education standards as well as laissez-faire and non-existent regulatory structures.

While we’re on the topic, please also consider that, here in the backyard of what is undisputedly “the massage profession,” some franchises are dealing with sexual assault and harassment by deflection, obfuscation and outright denial. Clients who report incidents of sexual misconduct are dismissed and told to pursue the issue through law enforcement. Rather than valuing the story of the victims and decisively ending the employment of massage therapists who engaged in the sexual harassment or assault, many such therapists are simply moved to other locations or nothing is done at all, in the hopes the problem will go away.

Until we can look all of this in the eye, we will continue to squander energy that could be elevating all of us; sex workers and massage therapists. Across the United States, massage therapists and clients are both victims and perpetrators of sexual misconduct. We say, “Let law enforcement handle it,” and we go about our business taking cowardly glances over our shoulders.

When those eight people were killed outside Atlanta, at establishments we pretend are the reason for our ongoing struggles, we wasted an opportunity to step up, open talks with sex work advocacy groups, and work together to advance their cause and ours.

Little more than a year later, those organizations and communities who could have been our allies were (and still are) working to deregulate massage as a solution to the intimidation and profiling they experience when law enforcement “handles” it. If we continue to deny our complicity and to avoid direct and specific engagement with these communities- including a deep and real-world understanding of their complexity- sustainable solutions will not only elude us, they will ultimately be beyond our reach.

The massage profession must step into this conversation with humility and curiosity. It’s time to stop being afraid of sex and sex work. It’s time to stop pretending we’re addressing human trafficking by tossing out superficial continuing education offerings that attempt to put distance between “us” and “them.” Only then can we let our love of safe touch (which can include touch that happens in the sex work realm) and our desire to make that touch possible for those who want it and for those who provide it, lead us to what’s necessary and just for providers and recipients.

Our liberation (and a sustainable, professional future) is tied up with theirs. 

Let’s look at our biases, own them and move through them to a place that empowers us to advocate for a world where people who provide essential human needs like touch and intimacy, and the people seeking to have those needs met, can do so in a variety of safe environments.

Massage therapists are caring people. We have got to remember that and stop making tragedies like the Atlanta spa shootings about us. Blaming “those people” not only deeply undermines our own legitimacy by ignoring the very real harm done to other humans, but it alienates Asian bodyworkers and the sex work community, two groups whose allyship and collaboration will be key to a sustainable, clearly regulated future for massage therapy in the United States.

Let us be brave, collaborative, and generative as we create a future that grows and strengthens us all in community. Let us show that we truly care about all aspects of health, as any true healthcare provider should.  

Not sure where to start? Educate yourself at the Healthcare & Intimacy Virtual Symposium on September 24, 2022.

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Cal Cates

Cal is one of Healwell’s founders and its Executive Director. Cal speaks around the world on a variety of topics related to integrative medicine, emotional self-care for practitioners and the mechanics and politics of introducing massage therapy into clinical settings. They have been participating in research, teaching and developing curriculum for massage therapy courses focused on hospital-based practice, oncology massage and end of life care since 2007. Cal is passionate about elevating the profession of massage therapy and also about broader and more seamless integration of massage therapists into mainstream healthcare.

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