ican Indian (28 percent), multiracial (27 percent), 
Latina (23 percent), and Asian (22 percent) re-
spondents were more likely to have participated in 
sex work than the overall sample. 
(4) In the 2015 United States Transgender 
Survey, respondents who experienced homelessness 
in the past year (17 percent) were more than three 
times as likely to have participated in sex work dur-
ing that year compared to the overall sample. 
(5) On a broader scale, internet platforms fos-
ter connections between people and play an integral 
part in American society. Meaningful regulation of 
internet platforms must take into account the role 
they play in the health, safety, and privacy of all 
people’s lives. 
(6) While policymakers, representatives of inter-
net platforms, and some advocates have discussed 
ways to mitigate the use of internet platforms to de-
crease exploitation, people who consensually trade 
sex are rarely involved in the drafting of legislation 
or policies, or in assessing their impact, despite 
being amongst the populations who are impacted by 
legislation and policies related to the regulation of 
these internet platforms. 
VerDate Sep 11 2014 
01:46 Dec 27, 2019
Jkt 099200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5448.IH
H5448
kjohnson on DSK79L0C42 with BILLS
(7) On February 27, 2018, the House of Rep-
resentatives passed the Allow States to Fight Online 
Sex Trafficking Act, known as SESTA/FOSTA. 
While SESTA/FOSTA holds websites liable for user- 
generated content that facilitates sex trafficking, it 
also impacts online platforms where users discuss 
consensual sex work and related topics. 
(8) Contemporaneously with the passage of 
SESTA/FOSTA in the Senate on March 21, 2018, 
websites preemptively shut down, some directly cit-
ing the law’s passage as the rationale for closure. 
(9) One week before President Donald Trump 
signed SESTA/FOSTA into law (Public Law 115– 
164), the Department of Justice seized Back-
page.com and arrested Backpage employees, citing 
promotion of prostitution and money laundering 
charges, similar to the Department of Homeland Se-
curity’s seizure of Rentboy.com only a few years 
prior. 
(10) While these websites and individual ac-
counts have been closing down, there has been no 
national investigation rigorously examining the im-
pact of losing access to these platforms on the health 
and safety of people in consensual, transactional sex 
work. Regional and anecdotal information from 
VerDate Sep 11 2014 
01:46 Dec 27, 2019
Jkt 099200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5448.IH
H5448
kjohnson on DSK79L0C42 with BILLS
health and safety service providers and sex workers 
has pointed to significant impacts on the health and 
safety of people who engage in consensual, trans-
actional sex. 
(11) Community organizations have reported 
increased homelessness of sex workers, including of 
sex workers who are caretakers for their families 
and have lost the economic stability provided by ac-
cess to online platforms. 
(12) Sex workers have reported a reduced abil-
ity to screen potential clients for safety, and nego-
tiate for boundaries such as condom use, resulting in 
reports of physical and sexual violence. 
(13) Many sex workers have turned to street- 
based work, which has historically involved higher 
rates of violence than other forms of transactional 
sex. Street-based sex workers have frequently noted 
practices which harm their health and safety, such 
as the confiscation of condoms by police, or use of 
condoms as evidence of arrest for prostitution. 
(14) With this new level of precarity, isolation, 
and vulnerability, there is substantial anecdotal evi-
dence that members of the sex work community are 
more frequently being contacted by third parties 
seeking to engage in management activities. This in-
VerDate Sep 11 2014 
01:46 Dec 27, 2019
Jkt 099200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H5448.IH
H5448
kjohnson on DSK79L0C42 with BILLS
cludes both sex workers who had always worked 
independently, as well as those who have previously 
experienced violence and exploitation by a third 
party. 
(15) The United States Government has long 
discussed the importance of assessing collateral con-
sequences when looking at other industries. A com-
prehensive study is essential to evaluate the impact 
on the health and safety of those involved in consen-
sual, transactional sex, who are increasingly losing 
access to digital platforms, which have been used for 
harm reduction information and techniques, and to 
screen clients. Informed government policies begin 
with seeking out relevant information to better guide 
our actions moving forward. 
SEC. 3. STUDY ON UNINTENDED IMPACTS ON HEALTH AND 
SAFETY OF PEOPLE ENGAGED IN TRANS-
ACTIONAL SEX AS A RESULT OF THE LOSS OF 
CERTAIN ONLINE RESOURCES. 
(a) STUDY.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) 
in consultation as appropriate with the Director of the 
Centers for Disease Control and Prevention, the Director 
of the National Institutes of Health, and the Assistant 
Secretary for Mental Health and Substance Use shall 
VerDate Sep 11 2014 
01:46 Dec 27, 2019
Jkt 099200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H5448.IH
H5448
kjohnson on DSK79L0C42 with BILLS
study the impacts on the health and safety of people en-
gaged in transactional sex resulting from the loss of access 
to interactive computer services (as defined in section 
230(f) of the Communications Act of 1934 (47 U.S.C. 
230(f))) in connection with the closure of websites (includ-
ing Backpage.com) that host information related to con-
sensual sexual exchange, on or after February 27, 2018, 
in anticipation of, or in response to, the enactment of the 
Allow States and Victims to Fight Online Sex Trafficking 
Act of 2017 (Public Law 115–164). 
(b) INTERVIEWS AND SURVEYS.—The study under 
subsection (a) shall include interviews with, and surveys 
conducted by, nonprofit and community-based organiza-
tions that provide direct services to people engaged in 
transactional sex. 
(c) TOPICS.—The study under subsection (a) shall in-
clude assessment of the following impacts on people en-
gaged in transactional sex: 
(1) Changes in access to technology-related 
harm reduction services. 
(2) Changes in ability to negotiate terms with 
potential clients. 
(3) Changes in experiences of violence from cli-
ents. 
VerDate Sep 11 2014 
01:46 Dec 27, 2019
Jkt 099200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H5448.IH
H5448
kjohnson on DSK79L0C42 with BILLS
(4) Changes in interactions with law enforce-
ment officials, including changes in police surveil-
lance, stops, and arrests. 
(5) Changes in contact from third parties. 
(6) Changes in relationship to and reliance on 
third parties. 
(7) Changes in experiences of exploitation. 
(8) Impacts on access to economic resources. 
(9) Impacts on homelessness and housing sta-
bility. 
(10) Impacts on mental health. 
(11) Impacts on vulnerability to the trans-
mission of HIV and other sexually transmitted infec-
tions. 
(12) 
Changes 
in 
participation 
in 
other 
criminalized behavior. 
(13) Disparities in these effects on key popu-
lations typically underserved by service providers, 
specifically LGBTQI+ individuals, people living in 
rural areas, racial and ethnic minorities, Tribal com-
munities, people experiencing exploitation and traf-
ficking, and undocumented and documented foreign 
nationals. 
VerDate Sep 11 2014 
01:46 Dec 27, 2019
Jkt 099200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H5448.IH
H5448
kjohnson on DSK79L0C42 with BILLS
(14) Any other impacts on people engaged in 
transactional sex, as determined appropriate by the 
Secretary for inclusion in the study. 
(d) REPORT.—Not later than one year after the date 
of enactment of this Act, the Secretary shall submit to 
the Congress a report on the results of the study under 
subsection (a) and make such report available to the pub-
lic. 
Æ 
VerDate Sep 11 2014 
01:46 Dec 27, 2019
Jkt 099200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6301
E:\BILLS\H5448.IH
H5448
kjohnson on DSK79L0C42 with BILLS