Epistemic injustice and public health policy: the case of occupational health in porn production

Webber, Valerie (2022) Epistemic injustice and public health policy: the case of occupational health in porn production. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

This dissertation examines occupational health protocols used to prevent the transmission of STIs and HIV in porn production, both those imposed by governmental health agencies and those developed by porn performers themselves. There is much disagreement over what protocols are best for the industry. Using critical interpretive medical anthropology from a sex worker rights perspective, this research asks what is at stake in these disputes over appropriate porn health practice. Qualitative data was collected through 40 interviews with 36 porn workers, in-person and digital fieldwork across several sites, textual analysis of relevant media and documents, and auto-ethnography as a porn performer. I trace how government and lobby groups have routinely discounted porn performers’ testimony about what would make their working conditions safe and comfortable, and the many ways that the porn industry has responded. In doing so, I make three primary arguments: First, porn workers have been ignored in conversations around the management of their occupational health. This is an example of epistemic injustice—the state of being wronged in one’s capacity to know and be known. Second, this marginalization puts pressure on the porn industry to focus on securing legitimacy among mainstream healthcare critics—what I call the Responsibility Defense. When pushed to focus on respectability, the occupational health solutions produced by the porn industry reinforce rather than challenge status quo sexual health practice, which can lead to exclusionary, discriminatory, and ableist occupational health protocols, like the exclusion of HIV+ performers. On the other hand, when porn performers manage health and safety on their own terms, they offer compelling alternatives that trouble and expand key concepts—like autonomy, community, and consent—that form the heart of public and occupational health praxis. Third, this demonstrates how important it is for public health and health policy makers to centre epistemically marginalized subjects—not just to iii ensure that policies meet the needs of those they are meant to support, but also to ensure that we benefit from the rich and unique contributions of all social members.

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