Background

Due to the stigma of sex work, sex workers can be vulnerable to microaggressions and minority stres​s and can experience​         discrimination when they access basic services, like healthcare or therapy.  As such, this guide is intended to help people with sex work experience in finding a mental health professional that approaches sex work from a harm-reduction, workers-rights perspective.

Many therapists are unfortunately not trained in sex worker-specific issues, conflate sex work with sex trafficking, use language describing sex work that is inappropriate/offensive, and assume sex work is pathological. This criteria are intended to be used by sex workers in their search for a mental health professional.

What are the criteria for sex worker-affirmative therapists?

• A therapist who is sex worker-affirmative recognizes that sex work can be a normal part of the sexual spectrum of behavior and is able to distinguish sex work from non consensual sexual exploitation.
• The therapist has educated themselves about sex work via books, articles, websites, discussion groups, and by talking to sex workers about their experiences.
• The therapist is aware of what constitutes safer and less safe types of sex work (acknowledging that different people may have different standards for this).
• The therapist is aware of different types of sex work and expectations/definitions of said work that are commonly encountered in the sex work community.
• The therapist understand the minority stress that sex workers may experience in keeping their work a secret/concealing it from their friends, family, partners, etc.
• The therapist has worked with a number of clients from the sex work community, and are explicitly welcoming of such therapy clients in their advertising materials.
• Finally, the therapist is aware that for many sex workers, sex work might not have anything to do with the reason that the client is coming in for therapy. Often, sex work is just another facet of someone’s life, like their vegetarianism or their hobby of knitting.
• In smaller towns, it may be more difficult to find a therapist who meets all of the above criteria. The next best option may be to find a therapist who, while not necessarily sex worker-affirmative, is sex work-aware. Such a therapist may not be explicitly trained or experienced in working with sex workers and needs of people in the industry, but they would be willing to maintain an open mind, and can commit to not being judgmental towards their therapy client. Some therapist are also offering online therapy (“distance-counseling”), which can be a good option for people living in smaller, more rural areas.
• The therapist will welcome your suggestions about books and other resources that they can use to expand their awareness about sex work. Often this type of therapist has worked with other sexual minority clients, like members of the lesbian, gay, bisexual and transgender communities and kink and/or polyamorous folks.

How do I actually find a therapist?

• There are many online directories that are useful and can search for local therapists. Psychology Today is a good place to​  start.
• The American Association of Sex Educators, Counselors and Therapists director​y
• The American Association of Sex Educators, Counselors and Therapists director​y
• The National Coalition for Sexual Freedom kink-aware professionals director​y
• Ask your local SWOP chapte​r if members have recommendations for local therapists who are competent in working with sex​
• When searching these directories, look for therapists who mention sex positivity, offer LGBTQIA+ affirmative care, and specialize in sexual health issues – this does not guarantee they are sex worker-affirmative, but they may have more knowledge about sex work in general and be more open to learning.
• If you have questions, reach out and ask the therapist! Some good questions for therapists could be:
• Have you worked therapeutically with sex workers before?
• What is your therapeutic style?
• Do you use harm-reduction practices?
• Are you familiar with the sex workers outreach project?
• Do you view sex work from a labor-perspective? Have you done any abstinence-based work in the past (regarding drugs/alcohol)?

In conclusion, it is important to find a mental health professional who is understanding , empathic, and supportive of your work and respects your decisions. Sex work is not in and of itself pathological and is something that can be a very healthy part of your life and identity. You deserve to find a therapist who has information about sexual diversity and range of sexual expression, including sex work.