India’s sex-work debate has traditionally been framed around women. The laws, public-health programmes and social conversations surrounding prostitution have largely focused on women, trafficking and rehabilitation. Men who sell sex occupy a more complicated space: they exist within the same informal economy, but are often counted under broader categories such as men who have sex with men (MSM), rather than being recognised as a distinct population. That invisibility has consequences.
India does not have a reliable national count of male sex workers. Instead, they are identified through HIV programmes, outreach initiatives, population mapping and health surveys. Dr Sheeba Iram, consultant psychiatrist at Prakriya Hospitals, says the available numbers should therefore be treated as “estimates or programme-based counts rather than a complete census of all male sex workers in India.”
The problem is not simply statistical. When a population is difficult to count, it can also become difficult to design healthcare, legal aid and violence-prevention systems around its needs.
“Male sex workers have historically been grouped under the broader category of MSM rather than being identified separately,” Iram says. “This results in lack of concentrated efforts in MSW-related research.”
That distinction matters because sex work can introduce risks that are not necessarily captured when all MSM are treated as one population.
A 2008–09 study of 483 high-risk MSM attending STI clinics in Mumbai and Hyderabad found that around 70% reported transactional sex. Those who sold sex reported more male partners than other MSM—8.9 compared with 2.5—and higher rates of receptive anal sex. HIV prevalence was 43.6% among male sex workers, compared with 18.1% among other MSM in the study. The researchers also found that HIV prevalence among male sex workers increased with the duration of sex work.
The figures are not a national estimate—the study involved high-risk clinic populations in just two cities—but they reveal why male sex workers warrant attention as a distinct group.
For Iram, however, the health consequences of sex work extend far beyond HIV and STIs.
“Health consequences of male sex work that receive the least attention often go beyond HIV and STIs,” she says. “These include mental health problems such as stress, anxiety, depression, physical and sexual violence, substance use, sexual injuries and poor access to routine healthcare.”
And accessing that healthcare can itself become a risk.
“Male sex workers face several barriers to accessing healthcare which primarily include stigma and discrimination from healthcare providers, fear that their sex work may be exposed to family or society, and a lack of healthcare services specifically designed for their needs,” Iram says.
There is also fear of institutions themselves. “They may also avoid formal healthcare because of fear of police involvement, harassment, social judgement, or other negative consequences,” she says.
The result is a paradox: the person who needs healthcare may be least willing to enter the institution providing it.
The violence that stays hidden
The same pattern appears when the issue is violence. A study of male sex workers in Chennai found that violence was not an abstract risk. Among participants, 43% reported being forced not to use a condom for anal sex, 29.3% reported physical abuse and 13% reported forced anal sex. Those whose only source of income was sex work were nearly six times as likely to report verbal abuse as those who had another source of income. But violence against men who sell sex is particularly difficult to report because it collides with expectations about masculinity.
“Male sex workers may be less likely to report sexual violence because of stigma around male victimhood and expectations about masculinity,” Iram says. They may fear being perceived as weak. They may fear that reporting a client will cost them income. They may worry about retaliation or exposure
“Stigma surrounding sex work and same-sex sexual behaviour may also make them afraid that their occupation or sexual behaviour will be exposed to their personal circle, employers, police, or the wider community,” Iram says.
There is another, more complicated possibility: some men may not identify what happened to them as sexual violence at all. “Some men may also be unaware of where to seek help or may not recognise certain experiences as sexual violence,” she says.
For Mumbai-based psychologist Rasshi Gurnani, masculinity is central to understanding this silence.
“Men are often socialised to be financially independent, sexually confident and emotionally resilient, so admitting vulnerability can feel like admitting failure,” she says.
A male sex worker can therefore find himself performing masculinity while simultaneously experiencing circumstances that make him vulnerable.
Gurnani describes this as “masculine role strain”—the conflict between expectations of what a man should be and his lived experience.
“This can encourage emotional suppression and make it harder to acknowledge anxiety, fear or exhaustion even privately,” she says. And that burden can become cumulative.
“The psychological burden isn’t necessarily the work alone,” Gurnani says. “Sometimes it’s having to constantly prove that the work hasn’t affected you.”
Sex work does not mean exploitation
It is important, however, not to turn every male sex worker into a victim.
Research from Chennai found that while 37% of participants said they had wanted to stop sex work at some point, nearly three-quarters—72%—said they usually or always felt good about engaging in sex work. The study also found that participants’ motivations were not uniformly coercive.
Gurnani stresses precisely this complexity. “Some men may actually find the work empowering, particularly if it gives them financial independence or control over their sexuality, while others may experience identity dissonance when their work conflicts with how they believe a ‘man’ is supposed to behave.”
In other words, sex work itself cannot explain every psychological outcome.
“We shouldn’t assume that sex work itself automatically causes mental-health problems,” she says. “Stigma, discrimination, violence, financial insecurity and lack of social support can be major contributors.”
That distinction matters because otherwise the system risks treating the worker—not the conditions surrounding the work—as the problem.
What does the law protect?
Legally, the situation is equally complicated. Consensual sex work between adults is not, by itself, a criminal offence in India. In 2022, the Supreme Court directed that sex workers are entitled to equal protection of the law and that where an adult is participating with consent, police should refrain from interfering merely because of the person’s occupation. The Court also said that when a sex worker makes a complaint of a criminal or sexual offence, the police should take it seriously.
But surrounding activities—including brothel-keeping, procuring and certain forms of soliciting—remain criminalised under the Immoral Traffic (Prevention) Act.
For male sex workers, however, one of the biggest legal gaps emerges when the worker becomes the victim.
Under Section 63 of the Bharatiya Nyaya Sanhita, the statutory definition of rape is framed around acts against a woman.
That means an adult man who experiences sexual violence cannot ordinarily invoke the statutory offence of rape in the same way a woman can.
“The law should recognise that men can also be victims of rape and serious sexual violence,” says legal expert Shreya Sharma, founder and CEO of Rest The Case. “A person’s gender or occupation should not determine whether the law recognises the harm they have experienced.”
For Sharma, this is not simply a problem with the wording of one offence. It is part of a larger failure to recognise male sex workers as rights-bearing individuals.
“There is no separate criminal offence simply because the sex worker is a man or because the client is male,” she says. “The same basic legal framework applies to consensual adult sex work.”
The decriminalisation of consensual same-sex relations through Navtej Singh Johar v. Union of India removed another layer of criminalisation around consensual same-sex intimacy. But Sharma points out that it “did not create a comprehensive legal framework for male sex workers.”
Questions of exploitation, violence, privacy, trafficking and access to remedies remain governed by different parts of the law.
The right to protection doesn’t disappear
This becomes especially important when a client assaults, threatens, robs or blackmails a sex worker.
“Being a sex worker does not take away a person’s right to legal protection,” Sharma says. “The victim’s occupation does not give a client the right to commit an offence against them.”
The Supreme Court’s 2022 directions reinforce that principle, stating that criminal law should apply equally on the basis of age and consent and that police should take sex workers’ complaints seriously. But Sharma argues that having a legal right and being able to exercise it are not the same thing.
Police training is therefore as important as legislative reform, she says. The Supreme Court has already directed law-enforcement agencies to treat sex workers with dignity and not subject them to violence or harassment. “The next step is ensuring those directions are consistently implemented,” she says.
The invisible sex worker
The consequences of invisibility extend into mental healthcare. Gurnani says one of the biggest obstacles is anticipated stigma: expecting that a doctor, therapist, police officer or even a friend will judge or misunderstand you.
“If someone has already experienced discrimination or violence, they may develop a form of learned mistrust toward institutions and authority figures,” she says. That can create a particularly cruel cycle.
“The person may genuinely need support but avoid seeking it because seeking support itself feels unsafe.”
Iram sees similar concerns in healthcare more broadly. Male sex workers may fear that their sexual behaviour or occupation will be disclosed, leading them to delay or avoid treatment. “Because of these concerns, they may altogether avoid or delay seeking treatment or accessing healthcare services,” she says.
The health system, therefore, can become another place where invisibility is reproduced.
A population missing from the conversation
There is no single experience of being a male sex worker in India. Some men may identify as gay or bisexual; others may not. Some may enter sex work because of financial necessity, while others may experience it as a source of autonomy. Some experience violence or exploitation; others do not.
What they have in common is a system that has historically struggled to see them as a distinct population.
“Male and LGBTQ+ sex workers [are] comparatively underrepresented in policy and legal discussions,” Sharma says. “The result is a visibility gap: if the system does not recognise a community as potential victims, it is less likely to design reporting mechanisms, legal aid, healthcare and rehabilitation systems around their specific needs.”
That gap has tangible consequences.
It determines whether someone gets tested for HIV. Whether a client who assaults them is reported. Whether a doctor feels like a safe person to approach. Whether a man experiencing depression sees a therapist. Whether the police see a complainant—or simply a sex worker.
Sharma believes the starting point is much simpler than a sweeping overhaul of India’s sex-work laws. “A person’s occupation does not make them less entitled to dignity, safety or protection of the law.”
For male sex workers, the problem may be that India’s institutions formally recognise that principle while still struggling to build systems that allow them to experience it.
The men are there. The research is beginning to catch up. The law has recognised some of their rights. But until healthcare, policing and policy begin to see male sex workers as a population in their own right, many will remain visible only when something goes wrong.