When former sex worker Catherine Healy received a letter asking if she would accept a damehood from the Queen, she thought it was junk mail. 

She was about to throw it away when she noticed the stamp, and realised it looked quite official. “I thought ‘Oh, this is a little bit different’ and I immediately thought I might be in trouble,” she told HuffPost UK.

Closer inspection revealed the truth. The former primary school teacher, who was instrumental in bringing in a new law in 2003 which gave full employment rights to sex workers, was being recognised with an Order of Merit.

The news, which came on Monday in her homeland of New Zealand, “was quite a shock”, Healy said. “Our lives are quite ordinary. It really resonates because of that underlying feeling of not quite being part of the establishment.”

Dame Catherine was working at a school in Wellington during the 1980s when she took a job as a receptionist at a massage parlour to top up her earnings.

“I was so naïve. I really sincerely thought the women were massaging in the rooms, until the second night when somebody told me they were prostitutes.

“I became a sex worker myself after two months. They were short-staffed and I just fell into it.”

Working in the parlour, Dame Catherine, who had experience of unions as part of her work as a teacher, quickly became aware of how unsafe the profession could be, and how scant official protection was for its workers.

As it does in Britain, New Zealand’s law stated it was illegal to ask for money for sex (to solicit), though it was not illegal for a client to pay for sex. It effectively criminalised the woman. Healy’s activism was borne of indignation about how her colleagues were treated and the climate of fear they were forced to live in.

“The police loomed large in our lives but not as people who would protect us. They were there to enforce, monitor and control.

“I came to work one night and somebody said: ‘Oh Susie’s not here, she’s been arrested’ and it was all whispered about because people got quite scared. The police had come in and done an undercover thing and pretended to be clients and so Susie was off the rota. She was gone. It just felt wrong.”

In 1987, she formed the New Zealand Prostitutes Collective (NZPC), which continues to advocate for sex workers’ rights.

“We didn’t have that language of rights and occupational health and safety. We just felt that we wanted to be treated properly and respected and certainly not arrested. Some sex workers would say: ‘If my family found out I was a prostitute, I’d kill myself’.”

Dame Catherine herself comes from a liberal and supportive family, she said, but though her mother stood by her, she still received a backlash. “That’s what happens when anyone mentions sex work,” she sighed. “It’s such an ‘us and them’ division. It’s why this recognition is a step towards bringing us in from the cold, we’re getting nearer the warmth.”

The NZPC began life as a newsletter giving out sexual health information, and Dame Catherine went on to help draft the Prostitution Reform Act, which passed in 2003 and allowed brothels to operate as legitimate businesses. It also entitles sex workers to ordinary employment and health and safety rights.

It made New Zealand one of almost 30 countries – including the Netherlands and Germany – which have legalised or decriminalised prostitution. Meanwhile Canada, Sweden and Norway have introduced laws to punish the client without criminalising those in sex work.

“The act is really important because it means that sex workers have choice in the ways that they can work,” Dame Catherine explained.

The NZPC website offers information on safe sex practices for work, the rights of sex workers – such as the fact they may receive benefits if they wish to leave the industry – immigration law, and the legal right to decline clients without providing a reason.

Women’s rights campaigners who support decriminalisation or legalisation  hope Dame Catherine’s honour will help tackle stigma.

“Stigma and criminalisation create an environment of impunity in which violence and exploitation thrive,” Luca Stevenson, of the International Committee on the Rights of Sex Workers in Europe, said.

“It is crucial that the needs of the most marginalised, such as undocumented migrant sex workers, trans women sex workers, or sex workers who use drugs, are listened to and prioritised. Sex workers, even the most stigmatised, can speak for themselves,” she said. 

But there are those who argue the decriminalisation does nothing to protect those selling it. Radical feminist Julie Bindel, the author of The Pimping of Prostitution: Abolishing the Sex Work Myth, has branded Dame Catherine’s honour a “disgrace” and claims legitimising the trade does not protect its workers, but simply enables exploitation.

Other activists call for the abolition of prostitution and say most sex workers are victims of human trafficking and have been lured, duped or forced into sexual slavery by pimps and traffickers, largely due to their poor socio-economic status. The royal endorsement given to Dame Catherine is a “slap in the face to women everywhere”, said Rachel Moran. 

But Dame Catherine, who stopped sex work in the early 1990s and now works full time for NZPC, believes evidence shows the opposite. The NZPC now works with the police to develop resources to assist sexual assault teams. It employs 12 full-time staff as well as a number of volunteers in five branches across the country.

“It’s so arrogant for people to tell others what to do. And it’s very dangerous of them to impose and support any kind of repressive model that can cause harm for sex workers,” she said. 

“I certainly have friends who are against sex work and feel very uncomfortable about it.

“It’s important to respect others’ opinions, but not if it causes harm.”

New Zealand awards such honours twice a year – at New Year and to mark the official birthday of Queen Elizabeth in June. They are approved by the Queen, as head of state, on the advice of the prime minister.