The environmental‐structural communication approach attempts to reduce the prevalence of individual health risks to female sex workers' (FSW) through community‐level interventions. However, I argue that this approach narrowly defines health and such communication efforts are focused on changing the work environment to facilitate the reduction of individual risk prevalence. Based on 35 in‐depth interviews, I use lived experiences of FSWs as a case study to discuss the relationships between gender and health. The intersectionality framework allows health communication efforts to incorporate analysis of multiple and simultaneous influences of gender relations, gender identities, and class on the transmission of health risks. These intersections draw our attention to think differently about inequalities and vulnerabilities that shape health and health behaviors of FSWs.