The Relationship Between Mental Illness and Sex Work
Tags: Sex Work, PTSD, Mental Illness, Mental Health, Depression

Critics of the sex industry frequently oversimplify and misinterpret the meaning behind studies about sex work and mental health. Often when I discuss the benefits of my profession, people tell me they read about how 48% of us are mentally ill, and 68% of full service sex workers have PTSD, so there's no way it can be anything but damaging. These people fail to realize that establishing a relationship between sex work and mental illness does not mean sex work causes or always exacerbates mental illness. It also doesn't mean the sex industry preys on mentally ill people.

The truth of the matter is that many of us who struggle with our mental health also struggle to meet the demands of a "normal" job. We choose sex work because of our mental illness. That doesn't mean it's our dream job, but that it proved to be the most accessible, least damaging option. It makes sense that we're disproportionately represented in the sex industry, where there are no entry barriers and we have full control over our schedules. Personally, struggling with a psychiatric disability and trauma triggers absolutely played a part in me choosing to make porn.

Every vanilla job I ever had (and I had quite a few) made my symptoms worse. Erratic schedules, the expectation of being able to come in for a shift with zero notice, harassment from customers, harassment from bosses, harassment from coworkers, being coerced into not taking breaks, being coerced into working for 15 hours, being unable to seek treatment due to chaotic hours and low pay, facing aggression for attempting to get accommodations under the ADA. I would have never set foot in any of these work places if it wasn't under threat of starvation. It wasn't until I started making porn that I escaped working 50 hours a week in shitty environments and got help.

After years in the industry, I’ve talked to so many people who chose porn, camming, stripping, and full service sex work due to similar situations. I wanted to speak with them in an effort to get a more clear, honest picture of the relationship between sex work and mental illness. This week I asked 138 mentally ill sex workers about their experiences. 32% were online sex workers, 26% were in person sex workers, and 42% have done both types of work.

Every sex worker who responded except one said they struggled with their mental health before starting sex work. 17% of them said sex work made their symptoms worse. 71% said their mental health was a factor when choosing sex work. 56% said needing flexible hours and the freedom to take time off whenever necessary influenced their decision to start sex work. 40% said they entered sex work after quitting or getting fired from multiple jobs due to their symptoms.

SOME RESPONSES TO

"HOW HAS SEX WORK POSITIVELY IMPACTED YOUR MENTAL HEALTH?

"I finally have the time and financial resources to work through my trauma and afford necessary medications. If not for sex work not only would I not be able to medicate my ADHD and PTSD, but I would not have had the resources to receive my ADHD diagnosis and I would still be living financially dependent on an abuser who exacerbated my PTSD symptoms. And that’s not unique; I’m surrounded by many strong queer women/femmes who just like me have used sex work to catapult themselves out of poverty, abuse, etc. Not only have I found the means to improve my mental health, but I’ve found an entire community of people with similar experiences."

"As a result of sex work, I've been able to explore my sexuality and gender in different ways. I've met other queer, trans, disabled BIPOC sex workers who have given me a sense of community. I feel seen and powerful in my work in a way that I never could've in my previous work."

"Felt financially secure for the first time!!! Felt self-confidence boost from getting good at my job and feeling capable of reading/controlling men. Feel significantly more capable of knowing, communicating and asserting my boundaries in sex, which makes me feel good and probably helped me avoid bad situations. Found community in sex workers, especially queer sex workers. Feel liberated from doing degrading work like hospo - where I'd been consistently underpaid and overworked with little gratitude or respect from bosses. Most degrading thing I've ever done for work was when my old hospo boss made me count my own tips before putting it in the till (their pocket). Now I am my own boss."

"I’m now financially independent again, no longer on benefits, haven’t been in over a decade, I see my kids regularly (who I chose to give care to my parents because of how bad my mental health was before sex work). I’m a survivor of sexual assault and rape before I ever did sex work, sex work has given me the ability to gain back my sexual autonomy and enjoy my sex life again, in and out of work."

"Sex work has given me more control over my life and my ability to manage my mental illness and disabilities. My husband and I are closer now than ever before, we are more connected and secure in our relationship because I’m not pushing myself to work and be “normal”."

"Everything I do is on my own time and done by my choice. That's really empowering when you have PTSD. Also I constantly need days off, so I can take mental health days without worrying about being fired. I don't even have words to express how much it's healed my sexual trauma too! It's brought me radical self acceptance, rejection of purity culture, and taught me how to have boundaries and self worth."

"I have PTSD associated with homelessness, this has led to abuse from partners who took advantage of this by making it so I wasn't in control of my finances. Being able to be financially independent has made me feel more confident and safe. I'm in control not only of my finances but my life. I don't feel like I have to waste time working a 9-5 and struggling. Working for minimum wage I couldn't afford healthcare, so literally being able to see a therapist has helped me and that's a result of sex work."

"It made me realize I do have a good work ethic. I've done all kinds of sex work for 8 years and I've paid my bills, started building credit, and even helped take care of my family and members of my community because I wasn't living paycheck to paycheck. Before sex work I was encouraged to go on disability."

SOME RESPONSES TO

"HOW HAS SEX WORK NEGATIVELY IMPACTED YOUR MENTAL HEALTH?"

"Sex work can make dealing with addiction very complicated and it's hard to access typical venues for help while also being a sex worker. I did not feel safe at AA. My alcoholism is very linked to working at a strip club. When I was working a lot I found it very isolating because of my late night schedule and because I was often physically, mentally, and emotionally depleted by the work. I found myself becoming purposefully isolated from family and friends and unwilling to form new friendships because I dreaded talking to people about my job or searching for acceptance when it can be hard to find."

"Stigma associated with this work means a lot of cruelty and anger directed at me from ignorant (churchgoers) seeking to shame me for what they don’t understand. A lot of isolation periods to regroup myself and judgement passed on me by people I don’t know has really hurt my self confidence in being up front and open about my lifestyle. I have also been sexually assaulted, raped, and trafficked, and didn’t receive legal support or help with acquiring my freedom and safety; when you are not protected in any way from harmful people, even when you need it and legally should, it’s a mindfuck!"

"Paranoia has been a huge for me. Always worried about the what ifs and potential of family finding out. Worrying about clients who I might no longer be in contact with exposing me. Clients who may be mad at me for some reason, posting private photos and videos. Trying to please everyone to avoid conflict at all costs."

"I overwork myself and burn out fast because I struggle with boundaries. Also a lot of harassment from men on the internet and fear for my privacy and safety. This is also due to civs from my personal life trying to intervene in my work."

"Sometimes a buyer will do or say something that triggers my PTSD. Thankfully I have the coping skills I need to deal with flashbacks so I'm able to work through triggers now. Another way it damages my mental health is my own comparison of myself to other sex workers. I am judgmental of my own appearance and success."

"Stress and anxiety regarding coming out or being outed, fear of rejection leading me to hiding it, encounters with numerous entitled pricks and misogynists. And sometimes sex when I don't feel up to it can have negative consequences mentally."

"Simultaneously while feeling like I have a lot of freedom and agency within my work I also feel constantly in danger. I cannot use technology like civilians do for fear of being banned. The fact that at any moment my financials could be seized is incredibly frightening. As a full-service sex worker I have very bad anxiety preparing for work because I fear arrest or brutalization from police. It takes a major toll on my mental health working as hard as I do but not being able to use the internet as a tool to advertise because I constantly face deplatforming and doxxing. It's so isolating and makes me feel like I don't belong here. It would help my mental health so much if this work was respected and decriminalized."

In conclusion, remember that if you cite studies about high rates of mental illness in sex workers, you better be working to decrease the stigma around sex work, educating yourself and others about mental illness, fighting for decriminalization, and advocating for better mental health and disability services, instead of just running your mouth to make our lives worse.

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