Out On The Couch
By Manny Kemphues, MA
People often seek out therapy due to dissatisfaction with work life and a desire to change jobs or careers. This is no different for people who do sex work. Unfortunately, when therapists are uncomfortable with sex and sexuality it can be difficult for sex workers to access the same supportive and non-judgmental career counseling that civilians (non-sex workers) get. In order to begin closing that gap, this article offers some reflective questions and exercises that are intended to get underneath sex-negative bias and anti-sex work sentiments without jumping to idealization on the opposite end of the spectrum.
If you are an experienced sex worker having doubts about your career path, exploring open-ended questions about your work experiences can help build awareness and clarity. I invite you to read through the following questions using an open-minded and curious approach. That way, you maintain the possibility of learning something new about yourself. “Aha!” moments are more likely to come when you allow yourself to be surprised by your responses. It may also be helpful to have a journal or some paper to write down your answers to these questions as you go.
If you have access to a sex-positive therapist, I recommend that you share your process of considering these questions with them. They might be able to help with curious follow-up questions or help you deepen your process of self-reflection. If you start to explore these topics with a therapist and notice that they seem to have a sex-negative bias or other unhelpful assumptions, it may be worthwhile to tell them what you’ve noticed and give them a chance to reflect on their biases. The ability to have and resolve conflict with a therapist can actually strengthen your relationship and allow you to do even better work together.
However, if the therapist is not open to exploring your experiences with you, or is unreceptive to your feedback about their bias, then it may be time to find a new therapist who is sex-positive. If you do not currently have access to a sex-positive therapist, I encourage you to be gentle with yourself and to take a break from reading and reflecting if you start to feel overly upset or overwhelmed. Those feelings might be your body’s way of telling you that you don’t have enough support to be doing this exploration right now. You might also consider sharing this article with a sex worker friend or colleague so that you can support one another through the process.
Is this article relevant to me?
To be clear, this article is not about sex trafficking, in which a person is forced or coerced into sexual acts. Instead, it is about a variety of types of consensual sex work including stripping, other erotic dance, escorting, sugar-babying, camming, professional Dom/mes or submissives, porn, phone sex, and more. Sex work is work. Like any gig, occupation, or profession, it can have perks and challenges. Unlike most other work, though, there are cultural stories about sex work being inherently demeaning, harmful, immoral, and even traumatizing (Farley, 2004). I believe that, like every other kind of work, sex work can be the perfect choice for some people, a terrible choice for others, and somewhere in between for most.. This article aims to help you reach more awareness of what works for you.
The level of power and control you feel in your day-to-day work is a major factor in whether or not sex work is a good (or good enough) fit for you. Two people doing the exact same work may experience it very differently. What is emotionally safe for you might not be emotionally safe for someone else. Similarly, what is just fine for someone you know could be re-traumatizing for you if you are carrying unresolved trauma from past experiences. What some random person finds disgusting might bring you pleasure or fulfillment.
How do you feel right before, during, and after working?
Your body is a source of intelligence. I find it can be helpful to start with body sensations before going into thoughts and stories. Thoughts are often filled with “shoulds” that we have taken in from outside. Sometimes our thoughts are looping recordings of judgmental family members saying, “Can’t you just do something ‘normal’ and respectable?” There may be cultural scripts saying, “having sexual encounters with lots of people makes you impure and dirty.” There may be voices of an abuser who told us some version of, “you’re worthless.” By listening to our bodies, we can get past this noise and get information about how it actually feels to do the work.
If you need help identifying your body sensations, you can search for a list of sensation words or find a short guided body scan on YouTube. I recommend John Kabat Zinn’s body scan for any time you are able to treat yourself to 30 minutes of gentle attention. Some guided body scans focus on helping you relax. These can be lovely. But for the purposes of this exploration, you will want to focus on simple awareness and curiosity, allowing yourself to feel discomfort if it is present for you. Sensations like nausea, tension, and numbness might tell you that your body knows this work isn’t good for you. Sensations like relaxation, openness, or energy might indicate that all is well and your body knows it. Try doing a quick body scan both before and after working for a few days in order make space for your body to share its wisdom.
How and why did you start doing this work?
Sometimes our expectations can be pretty different from reality. Maybe you expected easy money, but are now struggling to pay your bills. Maybe you imagined it would be fun and exciting, but the work has lost its thrill. If you had high hopes for this work, but have been disappointed, it may be helpful to return to that original intention. If you still want something similar, can you think of any other ways of getting the experience you wanted?
It’s also possible that you started doing this work because you couldn’t find other work, and you just thought you could bear it. Have you found any unexpected job satisfaction? It’s important to be able to allow ourselves to recognize what’s actually happening, rather than getting stuck with what we imagined it would be like.
Are you physically safe while working?
By physical safety, I mean, do you have the ability to protect yourself from STIs and injuries? Are you able to screen clients and end an experience if you start to feel afraid? If using toys or doing bondage, are you able to use equipment that is good for your body and unlikely to cause serious injury? For example, are you empowered to swap out metal handcuffs for leather restraints that are less likely to damage your wrists? Do you get to choose when to use condoms? Do you experience police violence?
Many sex workers have written about the harmful effects FOSTA/SESTA has had on sex workers (Lake & Roux, 2018; McCombs, 2018). It might be important to you to resist this legislation and continue doing the work as an act of resistance in an increasingly hostile environment. At the same time, it will be up to you to figure out whether sex work is still a safe enough option for you as more and more platforms discriminate against sex workers. You don’t have to be a martyr; your wellbeing is important.
While these are serious concerns, it is important to put them in perspective. Lots of work has physical risks. One study showed that office workers might underestimate the negative health risks of sitting at a desk all day (Flint et al., 2017). Most food services workers are at risk of getting cuts and burns, some of which are quite serious! Working in an elementary school exposes you to disease and infection. A bad case of strep throat can be more dangerous than gonorrhea (Health Grades, 2015). Working as a therapist puts me at risk of secondary trauma, which can have long-term effects on my psychological well-being (Pearlman & Mac, 1995). For me, I’ve decided that those risks are worth the rewards of being a therapist and I find ways to manage those risks even though I can never eliminate them completely. Sex work is no different. You get to decide the level of risk that feels worth the income and other rewards of the work.
How (if at all) is sex work hurting you?
If, when you ask yourself how sex work is hurting you, loud answers like, “it’s killing my soul” or “I am starving myself in order to appeal to clients/employers” immediately come to mind, that’s a good sign that you are ready to move on from this work and find something different. Or maybe it’s only certain parts of the work that clearly have to go. For example, in lots of professions, sometimes it’s just that one client that creates most of a worker’s problems. It can be hard to let a high-paying client go, but sometimes it’s worth it to preserve your own wellbeing.
If the answers come more quietly and are about things like boring and annoying clients, mild to moderate stress about your appearance, or social stigma, then these hurts might be on a comparable level to other imperfect work options. I know I’ve never had a job that didn’t include some compromise. You can always go after something that’s a better fit, but if the benefits outweigh the costs then that’s okay too.
Oftentimes when we look to friends and “experts” for guidance, we already know the responses we’re looking for on some level. What answer or advice are you hoping to get from this article? There may be wisdom in this. If you would feel a big sense of relief from getting reassurance that sex work isn’t a good fit for you right now, then please take this article as that reassurance.
How (if at all) is sex work nourishing you?
There is a reason you do this work. If you truly got NOTHING from sex work, you wouldn’t be doing it. Maybe the main thing you get is financial security, and that might be okay for you. Lots of people work generally draining 9-5 civilian jobs and find most of their nourishment outside of work. Certain kinds of sex work provide a huge amount of schedule flexibility that makes it much easier to prioritize the non-work aspects of your life.
Or maybe you actually enjoy your work. Maybe you get pleasure from certain acts with certain clients. Maybe you experience fulfillment through providing comfort connection, healing, and companionship. Maybe you get to be playful and creative. Maybe you understand what you do from a spiritual lens that provides meaning to your life. Maybe you’ve found a way to heal yourself through your work. It’s a lucky thing to be able to find work that gives you more than a paycheck, so if you’re truly benefitting on a deeper level from being a sex worker, don’t let sex-negative culture take that away from you.
Unlike people who work in other industries, people in the sex industry may feel a particular pressure not to experience pleasure at work. One way that sex workers have resisted stigma is by creating very clear distinctions between the sexual contact they have for pleasure and the sexual contact they have for work (Kontula, 2008). While in some cases, this emotional boundary may be important and supportive, it is worth checking in to see how and whether it is serving you.
Imagine a barista who prevents themself from finding joy in small talk with customers. Imagine the chef who feels they must create the illusion of a lovingly prepared meal while saving the real deal for their partner at home. Imagine a therapist who does not let themself feel real affection and closeness with their clients. These people would probably feel pretty dissatisfied with their work! So, if you’re feeling unhappy at work, might it be because you’ve learned that it’s not okay for you to feel happy at work? Have you internalized messages that if you enjoy it, that means you’ve lost control, that you’re impure, unprofessional, or, for women and femme sex workers, colluding with the patriarchy? If so, consider ways you might begin to let in some of the nourishing possibilities of your work.
Whose voice are your worries, really?
Is it your inner voice? Or is it someone else’s? It’s possible that rather than being your own voice, these worries actually come from a disapproving parent, a religious teacher from your childhood, or a jealous partner. It could be the personification of every media representation of sex work you’ve ever seen, or echoes of verbal abuse you experienced in the past. Whenever you’re making a decision, it’s important to try to identify where your worries come from. This can help make your own perspective clearer.
In order to identify the source of your concerns and figure out whether or not they belong to you, you can start by writing a list of all of the worries about your work that bounce around in your head. Once you’ve written them down, read through them and make a note of the first time you came across each one. Did you hear it from someone in your life? If so, who? If it was an original thought in your head, what was happening when it first popped up? Sometimes it will be hard to find the source of a worry. That’s okay.
Next, go through your list again. For any ideas about why sex work is bad for you that you clearly heard from someone else, ask yourself whether that someone else a person whose advice you generally trust. Then, ask yourself if you agree with them in this case. Even people who love us can sometimes be wrong about our lives. Cross out any worries that you don’t agree with. What’s left? If you’d like, you can spend a little more time journaling about these remaining concerns or brainstorm ways to address them.
What stories do you tell yourself about the work you do?
Stories like, “well, if I’m going to have sex I’m not into, then I might as well be paid for it.” Or “people only value me for my body and I have nothing else to offer” are limiting and might push you to do sex work even if it’s not a good fit for you. If you have these thoughts, looking for exceptions and alternatives can help you see more complex pictures with more choices. To address the second example, you might take a deep breath and try to think of a time when someone has valued you for something other than your body. You can also ask yourself about any of your strengths and gifts that no one but you has acknowledged, but that you know you have.
If you respond with a story that paints you as someone in control of your life and choices, then it is much more likely that you’re on the right path. People who feel good about their work are more likely to tell stories about choosing the work, the value it adds to their life, the personal strengths it allows them to exercise, or how it fits in positively with their sense of identity. For example, Alex Empire tells her story in two tweets. She writes, “The very very first time I engaged with the sex industry it was survival sex work. I was 22 and the boyfriend I shared an apartment with and I had just broken up and I was days away from homeless with no money to pay the rent. So I put ads out, and paid the rent…About 4 years later I rejoined the industry because I wanted to. Now I’m thriving in a high rise apartment I pay for through fulfilling work that I love. My life would *not* be better for having been forced into homelessness for lack options” (msalexempire, 2018). Even if it’s not a perfect story of empowerment, what matters is how you feel about your work now.
If this article stirred up more than you are able to process on your own, that’s okay. Take a few deep breaths. Then, set aside some time to do research online to see if there are any sex-positive therapists in your area who might be able to provide individualized support for your ongoing exploration of these questions.
If this article supported you in discovering that sex work is not something you want to be doing at this time in your life, then I am excited for the next steps in your journey as you find your way toward a different kind of work that is a better fit for you. Maybe this change can begin immediately, or maybe you will need to reach out for support in finding alternative sources of income. If this change happens more slowly than you would like, keep in mind that you have survived this bad-fit job so far. This points to your strength and resilience. It may help to be intentional about recognizing and increasing positive coping strategies that support your wellbeing while you look for a way out.
If there are certain parts of the job that are worse for you than others, can you reduce or remove those parts of your work? Creative thinking will be your friend during this time. In the LA area, Queens of the Underworld is a resource that may be able to help. Founder Romina Rosales works with women and femmes who do sex work. She particularly prefers working with Black, Indigenous, People of Color and trans survival sex workers.
If this article helped you increase your clarity and confidence that it’s okay (and maybe even awesome) for you to continue doing sex work, then congratulations! I am so happy to have helped disentangle sex-negative thinking from your own lived experience.
Farley, M. (2004) ‘Bad for the body, bad for the heart’, prostitution harms women even if legalised or decriminalised. Violence Against Women, 10(10), 1087–1125.
Flint, S. W., Crank, H., Tew, G., & Till, S. (2017). “It’s not an obvious issue, is it?”: Office-based employees’ perceptions of prolonged sitting at work: A qualitative study. Journal of Occupational and Environmental Medicine, 59(12), 1161–1165.
Health Grades Inc. (2015). Deaths from strep throat. Right Diagnosis from Health Grades. Retrieved from https://www.rightdiagnosis.com/s/strep_throat/deaths.htm
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Kontula, A. (2008). The sex worker and her pleasure. Current Sociology, 56(4), 605-620.
Lake, A. & Roux, L. (2018). Incomplete list of legal discrimination against sex workers. Retrieved From https://docs.google.com/document/d/1c1nqawo1QuiVlpA3bhS8xyDxzDDlRq6BoogAoc91OmU/edit
McCombs, E. (2018). “This bill is killing us”: 9 sex workers on their lives in the wake of FOSTA. Huffington Post. Retrieved from
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