The experiences of people who sell or exchange sex and their interaction with support services: lived experience engagement

2 Methodology

This section will first detail the methods used for the mapping study, and then for the lived experience engagement.

2.1 Mapping Study

The Mapping Study was designed to meet Research Aim 1:

To map the current provision of services in Scotland for people who sell sex or exchange sex, and to identify any gaps in provision.

The mapping study consisted of two short surveys, hosted on SurveyMonkey and designed to be completed by professionals with knowledge of the support available in Scotland for people who sell or exchange sex. The first survey asked participants to identify the specialist services which people who sell sex may access in their local authority area (a list of local authority areas is supplied in Table 1). For each service identified, the survey asked for further information about who was eligible for support, the support offer and the area covered. Participants were then asked about mainstream services in their area: to give a rating of the level of understanding of the needs of people who sell sex in mainstream services in their area, and to provide an explanation for why they had chosen this rating. The full survey questions are included as Appendix A.

Table 1: List of local authority areas in Scotland

Local Authority Areas in Scotland

Aberdeen City

Aberdeenshire

Angus

Argyll and Bute

City of Edinburgh

Clackmannanshire

Dumfries and Galloway

Dundee City

East Ayrshire

East Dunbartonshire

East Lothian

East Renfrewshire

Eilean Siar

Falkirk

Fife

Glasgow City

Highland

Inverclyde

Midlothian

Moray

North Ayrshire

North Lanarkshire

Orkney Islands

Perth and Kinross

Renfrewshire

Scottish Borders

Shetland Islands

South Ayrshire

South Lanarkshire

Stirling Council

West Dunbartonshire

West Lothian

The second survey was sent to each specialist service identified during the first stage of mapping and requested more detailed information about their service offer, and who they support. This survey is included as

Appendix B. Two services contacted at this stage felt that the questions did not allow them to accurately share the specifics of their service provision and arranged to have a discussion with the lead researcher via Microsoft Teams to discuss their service in more detail. This information was included alongside data from the completed surveys.

2.1.1 Participants

The lead officers or chairs of the Violence Against Women and Girls Partnerships (VAWGP)^[3] in each local authority area were initially targeted to complete the mapping survey. The VAWGP leads were considered to be appropriate contacts to provide the required information due to the expectation that the multi-agency nature of the partnerships should result in appropriate strategic oversight, and knowledge of agencies within their area. Additionally, they were targeted due to their role in supporting the delivery of Equally Safe, the Scottish Governments strategy to tackle violence against women and girls, including prostitution^[4]. Leads were identified through the contacts of the Improvement Service, who coordinate the National Violence Against Women and Girls Network. The contacts provided by the Improvement Service included at least one representative from all 32 local authority areas, and in many cases two or three suitable contacts. Where a representative contacted did not feel they were well-placed to respond, they were given the option to nominate someone more suitable. Where a response was not received from the VAWGP lead for an area and an alternative contact not nominated, contact was made with a representative from a specialist service in that local authority area, as their role in referring and supporting women to engage with services makes them well positioned to offer comment on local provision.

Initial contact was made via email, an additional request reminder to participate in the survey was circulated two weeks after, and a final reminder two weeks after this. This provided three different opportunities for participants to complete the survey. Where no information was received from an area at this stage – two phone calls were attempted. Following these steps, the area where no response was received was designated as 'data not received'.

Responses were received from 31 local authority areas out of 32, and this was considered to give a strong representation of the picture across Scotland. Of these 29 responses were received from VAWGP representatives, and 2 from representatives from specialist services. A response was not received from the remaining one area. Where quotations from the mapping survey participants have been used, they have been labelled as MS (Mapping Survey) 1-31 e.g., MS15 would equate to the fifteenth mapping survey participant.

Responses to the second survey were received from 11 specialist services. A further 6 services were identified but no response was received from them after following the outlined steps. The publicly available information on these services has been included in this report, with a note indicating that the information has not been verified by the service.

Collecting data at a local authority level is acknowledged to have some limitations where the size and population distribution of each area varies so substantially. However, within the constraints of this project, this was considered the most effective way of ensuring that maximum geographic coverage of Scotland for the mapping study was achieved.

2.1.2 Data Analysis

The responses from the mapping survey were compiled on to three maps. The first displaying geographic coverage of specialist service provision, and the second the rated level of expertise in mainstream services by local authority areas. A third interactive map was compiled providing more detailed information on service locations and the support they provide. This interactive map was designed to form the basis for a living document which could be updated as service provision evolves.

Responses to the free-text question asking for explanations of their chosen rating for the level of understanding of mainstream services in their area, and any additional detail they wished to provide, were analysed thematically, following the procedures of Braun and Clarke (2006)^[5]. This reflexive thematic analysis was chosen for its suitability for use with qualitative survey data, and the scope to present the range of views provided by participants.

2.2 Lived Experience Engagement

The lived experience engagement was primarily planned to address Research Aim 2 and 3:

To understand how people who sell or exchange sex experience engaging with mainstream and specialist support services in Scotland including identifying barriers to access

To gather views from those with lived experience on future service design

Additional information was gathered to meet Research Aim 1:

To map the current provision of services in Scotland for people who sell sex or exchange sex, and to identify any gaps in provision.

2.2.1 Data Collection

Participants were offered three methods of taking part: a facilitated survey, an individual interview or a focus group interview. The priority with the design was to engage as many people as possible with lived experience, using a method that felt comfortable to them through offering different levels of engagement. The methods were designed and refined in conversation with members of the Encompass Network^[6]. All materials used were reviewed by the lead team at Scottish Government as part of the development process.

The facilitated survey involved participants answering closed questions about mainstream service access, as well as three sections of free-text questions focussed around accessing services, experiences and impact, and future service design. The survey was either completed online with the support of a worker at the facilitating service, completed online independently, or completed on a paper copy which was then inputted into the online survey website and securely destroyed. Where necessary, surveys were facilitated with the assistance of a translator. A full schedule for the survey is included in Appendix F.

Before beginning data collection, facilitating services attended a short training session. This ensured that services were clear on their role in providing participants with the information on the study, and around taking informed consent. Participants were given a copy of the participant information sheet including details about privacy and confidentiality to read, or a worker would read with them, and they were given the opportunity to ask any questions (

Appendix C). An alternative easy-read version of the participant information was also made available to ensure genuinely informed consent through making the information as accessible as possible (Appendix E). This easy-read version was only provided where the facilitating worker had the full study information available and was able to accurately address any requests for further detail or information, and the importance of this was emphasised during training. Immediately following completion, participants were given a £20 Tesco voucher as a thank you for sharing their time and experience.

The interviews conducted were semi-structured. The interview schedule reflected the three key themes covered in the facilitated survey: accessing services, experiences and impact, and future service design. Additionally, the semi-structured technique gave participants the opportunity to direct the interview towards the elements they thought were most relevant, and space to share any additional information they wanted considered in the research. A copy of the interview schedule is included (Appendix G).

To take part through an interview, participants were invited to make contact via email. They were then sent the participant information and given the opportunity to ask any questions before deciding if they wished to take part (Appendix D). Interested participants were asked to complete a short survey which asked for consent, and asked questions including demographic information and about service access (see Appendix H). Following completion of this, an interview was arranged, to be conducted by one person from the research team, using an online platform. Interviews were audio recorded, transcribed and then the recording securely deleted or via telephone call. Where a participant did not wish for their interview to be recorded, anonymised fieldnotes were taken. These are notes which may contain verbatim quotations from participants, but largely consist of the researcher paraphrasing information shared. As such, they reflect the researcher understanding of the information being shared. Details obtained using this method have been highlighted as such within the analysis. Any identifying details were removed at the point of transcription.

The focus group strand was designed to allow any existing groups to take part collectively should they feel more comfortable this way, with the option to nominate their own facilitator, or take part with a member of the research team facilitating online. No groups elected to use this method to participate.

2.2.2 Confidentiality and Data Management

Existing research and experience from the sector indicate that confidentiality is a prominent concern for many people who sell or exchange sex. For this reason, none of the methods necessitated the collection of data by which a participant could be identified. The facilitated survey, in particular, was entirely administered by support services, which meant the research team did not collect names or any contact details for participants. In order to make initial contact, interview participants were required to email, but were encouraged to use an anonymous email address where possible, and to use a pseudonym. Following their interview their email address was securely deleted.

The demographic information requested was limited. To minimise the potential for participants to be identified they were only asked their age range, their sex, their gender identity, and their location. Information about ethnicity or nationality was not collected as the risk of identification for individuals through this was considered too high.

All participants were provided with a copy of the participant information and given the opportunity to ask questions before agreeing to take part in the research. A copy of this has been included in

Appendix C (Facilitated Survey) and Appendix D (Interview). Additionally, an easy-read version was provided, for use in the services facilitating the survey, where staff were available to answer additional questions (Appendix E).

All data collected for this research was securely stored and processed in line with UK GDPR requirements.

2.2.3 Recruitment

This research was interested in the views and experiences of adults with lived or living experience of selling or exchanging sex in Scotland. The inclusion and exclusion criteria are detailed below (Table 2)

Table 2: Inclusion and Exclusion Criteria for participants in the lived experience surveys and interviews

Inclusion Criteria

Adults (over 18)

Have sold or exchanged sex

Have at least ONE of the following connections to Scotland:

• have sold or exchanged sex in Scotland
• have experience of selling or exchanging sex elsewhere and currently live in Scotland
• have experience of seeking support relating to selling or exchanging sex from services in Scotland.

Exclusion Criteria

Children (under 18)

Have never sold or exchanged sex

Meet ALL of the following criteria, meaning they do not have suitable connection to Scotland:

• Have not sold or exchanged sex in Scotland
• do not currently live in Scotland
• have not sought support relating to selling or exchanging sex from services in Scotland.

As there is no comprehensive demographic information for people who sell or exchange sex in Scotland, convenience sampling was used. As data collection progressed – purposive sampling was employed to target male participants, who the initial recruitment methods had not yet successfully engaged.

Participants were primarily recruited through services which provide support to people who sell or exchange sex, either directly through workers or through posters displayed within the service. Engagement of facilitating services was attempted through direct contact with services including sexual violence support, domestic abuse charities, housing, addictions, peer support organisations, community organisations, employment support and sexual health. The result was that 12 services facilitated the survey – with 1 additional service attempting recruitment unsuccessfully. The types of services which facilitated the survey are detailed below (Table 3).

Table 3: Support services which facilitated the lived experience survey by type

Type of Service	Number facilitating survey
Addictions Support	1
Community Projects	2
Faith-based Organisations	1
Housing Support Provider	1
Police-led Partnership	1
Sexual Health Services	1
Specialist Services	5

Recruitment also took place through the use of posts on forums (including forums for people who sell or exchange sex specifically such as 'Tartan Ladies', and also general discussion sites which have designated areas for advertising research including The Student Room and Mumsnet). Social media posts were shared by the research account on Twitter, and also by services who have a more established online presence (such as the Roam Team Instagram). The call for participants was further circulated through the Equally Safe in Higher Education networks, and NHS Gender Based Violence services. Participants were additionally invited to share the research details with anyone else they knew who might be interested in taking part.

Table 4: Location of Participants

Location	Number of Participants
Aberdeen	3
Dundee	21
Edinburgh	18
Glasgow	20
Other	9

The resulting sample consisted of 71 participants. Most completed a facilitated survey (n=62) and a smaller number took part through an individual interview (n=9). Of the total participants, 65 were female, 3 male and 3 described their gender identity as non-binary. Table 4 shows the location of participants.

The distribution of participants by age is shown in

Figure 1. The majority of participants were aged 35-44 (n=32), with the second largest group age 25-34 (n=22). There were smaller numbers of participants in both the 18-24 (n=4) and Over 55 (n=2) age group. 2 participants did not disclose their age.

Within this report, participants have been labelled as FS (facilitated survey) 1-62 and I (Interview) 1-9 e.g., FS32 would indicate Facilitated Survey 32, and I7 would indicated Interview 7.

2.2.4 Data Analysis

A mixed methods analysis was conducted. The majority of the data collected was qualitative and was analysed using reflexive thematic analysis following the six-stage framework developed by Braun and Clarke (2006). This method is appropriate for both interview and qualitative survey data and aids the production of the rich qualitative insight this research requires. The qualitative data was analysed manually, without the use of analytic software. The numeric data was analysed using Microsoft Excel. The word clouds were created by conducting a content analysis focused on the descriptive words within the selected questions and displaying these graphically using the Microsoft Add-In 'Pro Word Cloud'.

2.2.5 Limitations

This use of facilitated surveys had substantial advantages, meaning that for many, their concerns about confidentiality were addressed, that participant information was shared by a trusted worker, and that there was support available immediately should they feel uncomfortable at any point during the survey. The disadvantages however are that completing the survey in a service, and often with the worker typing their answers for them, may have impacted on the information that they shared, especially on positive reflections on their experience with that service. The research attempted to address this through training given to facilitating services, as well as through ensuring the research asked about experiences at previous services as well as the service they were currently engaged with. That there were more negative experiences than positive reported in these engagements can be considered indicative that these measures were successful. It is the opinion of the researchers that if the facilitated survey option was not given then the majority of individuals who took part through this method would not have taken part at all. This is considered especially likely as the project was conducted on a tight timescale and remotely due to restrictions of the Covid-19 pandemic. The facilitated surveys were therefore utilised, with the potential limitations highlighted.

The facilitated survey method is additionally susceptible to selection bias; where facilitating services select participants with certain views. This was mitigated for by recruiting across a range of mainstream and specialist services, which do not represent one homogenous group in terms of approach or political standpoint. Additionally, participants were welcomed into the interview strand of research without any prior knowledge of their views or experience. The diversity of experience shared in this research indicates success in capturing a range of views.

The majority of the data gathered for this research is qualitative. Unlike statistical data sets, or work which mainly relies on numeric data, sample sizes tend to be much smaller for qualitative work. This allows for detailed engagement with the information each individual shares and appreciation of the nuance of their circumstances. Rather than looking for a definitive answer, qualitative research aims to explore the range of views and experiences available, and this is not possible with some of the very large datasets you might see in quantitative analysis. The sample size for this research is at the larger end of what you might expect for this type of study, with some robust qualitative research being conducted with participant numbers in single figures. The researchers took the decision to include as broad a range of voices and experiences as possible. This however does not constitute a representative sample and the results cannot be generalised to a wider population. Any researchers looking to make claims on a population level would have to perform further scoping and analysis.

The scope of this research extended as far as support provision, and discussion around the broader legislation and policy background are largely outwith this. The research team began from a standpoint that comprehensive support, when wanted, should be available to anyone, however they conceptualise selling or exchanging sex. In order to achieve this aim, all identified steps were taken during the research process to try and engage individuals holding a wide range of contrasting viewpoints, particularly ensuring that both those who view selling sex as work, and selling sex as exploitation were heard from. Steps taken include the use of neutral language and assurances that this report will not use their words to advocate for a particular approach (such as the Nordic model or decriminalisation). To a broad extent these measures can be considered a success. Although not asked for directly, a number of participants did volunteer their views on the appropriate framework, and this revealed that participants did include those who felt selling sex was exploitation, those who considered it work, as well as those whose views fell somewhere in between. However, this report does sit within a wider suite of research, and has a clear remit to feed into discussions around a new approach for Scotland. Whilst the information fed in from these participants is solely around support, this complexity of positioning was something that individuals holding strong views may have felt difficult to reconcile. One service, following consultation with their members, cited this political complexity as a reason for not facilitating or advertising the research. It is possible that for some individuals too, this may have provided a reason not to engage. For others, this attempt at neutrality of language may in itself have presented a barrier to engagement. Women who had been trafficked in particular reported not feeling that 'selling or exchanging sex' represented their experiences. Within facilitating services, workers were able to explain the language choices and which experiences it was intended to encompass, but for individuals outwith services, this may have provided a barrier to engagement with the research. Whilst there is no clear solution identified here, in the interests of transparency, it is important that this complexity is acknowledged.

Researching with a population with known concerns around confidentiality brings additional complexity. The large number of participants who felt able to engage is testament to the success of many of the measures in assuring participants that their information would remain safe and secure. The facilitated survey in particular was likely successful due to the participants never disclosing any personal or identifiable information to the research team. In contrast, to participate in an interview, participants were required to make direct contact with the research team and this was likely a barrier to engagement with the research for some. One participant shared that:

'I have a couple of friends who were scared to even participate in this, because I forward this link to a handful of my friends that I know [sell sex] and was they said I'm not going to I'm too afraid for my privacy, or for their parents, or their other job that they have now or friends or university or other people finding out. They don't dare to talk about it' [I8]

The result of this, is that the majority of participants participated through services, and this means that responses were largely gained from participants who had been able to successfully engage with a service. It is likely that the experiences of those who were particularly concerned around confidentiality, and who were also not connected in with any support service have not been captured.

The sample of men included in this research was small – although many of their concerns and needs reflected those of women, some were distinct. It is likely there would be a benefit in exploring the distinct needs of men in further research. Potential fruitful avenues for recruiting more men could be through using online advertising on platforms such as Grindr, and perhaps having a male researcher on the team. The research was not successful at recruiting people who identified as trans, or they chose not to share this. Whilst members of the trans community represent a distinct demographic, who likely have distinct needs from services, the research does provide some insight into what may provide additional barriers for this community. In particular the findings indicating that it was important to explicitly flag who was welcome at services may be important for trans men and women to know which services will support them. Additional insight is likely to be taken from other participants who identified themselves being at the intersection between multiple stigmatised identities, for example the non-binary participants and those who are lesbian or gay. Their insights would indicate that multiple stigmatised identities can amplify existing issues around judgement and the associated fears which provide barriers to engaging with support. It is suggested that future research may want to attempt to gather the views of the trans population who sell or exchange sex to ascertain if they have any distinct needs in accessing and engaging with support, which have not been identified within this report.

Whilst participants across all age groups engaged with the research, there was smaller numbers aged 18-24, and over 55. It is unclear whether this reflects differing support needs for these demographics, less engaged with support services, or limitations of the recruitment process for the research. In a snapshot report provided by the Encompass Network detailing the women they supported during one week at the end of 2021, the women they were supporting were mainly aged between 30 and 40^[7]. Reflecting the current study, the oldest and youngest age groups also represented the smallest numbers. Whilst this congruence indicates that these may be the demographics most likely to engage with support rather than representing an issue with recruitment, further research is suggested with these age groups to ascertain whether they are impacted by additional barriers to accessing support.

2.3 Production of the report

Two researchers with lived experience were invited to read and comment on the draft report, and their feedback incorporated. The researchers were asked to focus on evaluating whether the analysis offered was logical and coherent, and the use of terminology, to ensure the understandings of the research team matched their own. They were additionally invited to offer alternative interpretations for the selected quotations where they saw them. This feedback sits alongside that of the rest of the research team in the report, to ensure that as full range of views and interpretations are presented here as possible.

The researchers with lived experience chose to remain anonymous but were paid for their time and expertise and offered future support (such as employment references) in line with what any member of the research team could reasonably expect.

The inclusion of people with lived experience at the analysis and report production stages, reflects the value of their expertise at all stages of the research, as well as attempting to address the power balance inherent in research of this kind by removing some of the distinction between the researchers and the researched. Whilst this is a step towards co-production, the timescale of the project did not allow for people with lived experience to be involved at all stages of design and data collection, which is otherwise considered best practice.