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Intersection of Health, Disability, Gender and Sex Work

My gender and my sex work are inexplicably linked. I’m not claiming that to do sex work you have to play up to gender stereotypes, there are lots of queer, non-binary and trans workers out there doing really well as their 100% queer selves and smashing it… but that’s not me.


I started doing sex work when I was unable to do other forms of work due to long Covid. I’ve always been very open sexually and I’d considered it before but, fearful of the stigma,I only started when I was in need.


This meant that during days when my fatigue wasn’t completely debilitating, I could use the few spoons I had to go on cam and earn what I could before I was running on empty again.


I created ‘Kiki Katz’ - big eyelashes, tits out, hyper femme. The fact that I’d felt pretty gender fluid and mostly non-binary didn’t come into this decision making process, I was trying to appeal to a mass audience and use whatever I had, to make the money I needed to survive. I couldn’t rely on a slow build of loyal followers that liked my unique take on gender and my body.


I had carefully considered what going into sex work might do in terms of friends, partners and family (my dad still thinks I have an online marketing job). I didn’t consider how it would feel presenting so ‘high-femme’ on a day to day basis.


I could still go out with a binder on and my moustache when feeling particularly masc… but there are certain elements of myself that I keep purposefully femme for ease of creating content or jumping on cam whenever I need to (or have the energy to!).


I have grown out my undercut to give a softer look. I keep my nails long and have eyelash extensions. All these steps make it easier for me to portray ‘Kiki’… but… not being able to decide each morning to present exactly how I feel is jarring.


I’m not sure if this uncomfortable feeling of not being able to express myself in what I define as my ‘masc mode,’ will eventually feel like a massive loss or compromise one day.


But there is another decision lurking in my near future that may change everything. I have recently found out I have a 50% chance of carrying a BRCA gene fault. It runs more strongly in people with Jewish heritage, so my dad and my siblings are all getting tested via ‘The Jewish Community’s NHS BRCA Screening Programme’. This is available for free for anyone living in England with at least 1 Jewish grandparent, so I highly recommend anyone eligible to do so. It turns out my dad has this gene mutation, hence my 50% chance. If I do have this gene mutation, my risk of breast and ovarian cancers goes up a lot.



With this in mind, along with lifestyle changes and a few pharmaceutical options, having my breasts and/or ovaries removed at some point in my life is a real possibility for my future.


With that idea floating around in my head, part of me is saying ‘woohoo! Free top surgery!’


But at the same time, so many other questions come into play.


Will I be able to make a living as a more visibly trans sex worker?


What about having kids?


Will I miss my ‘femme mode’ just as much or more than I currently miss ‘masc mode’?


I know I may be jumping the gun here, I haven’t received my results back yet. But I can’t help but question where this potential diagnosis might lead me.


Could this result lead me to a more authentic gender experience and add to my overall well being?


Or could it lead down a path of lost clients (and therefore income), more mental and physical strain, and a more difficult life in general?


I don’t have the answers… For now, I’m focusing on the present and doing what I can to stay positive and afloat in these uncertain times.


By Kiki Katz (They/She)










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