Sex worker affirmative therapy: conceptualization and case study

Abstract

Prior research reported some segments of the sex worker population are at higher risks of negative health outcomes. Historically, these outcomes were viewed as a result of the work itself without taking into consideration the role of the stigma and often criminalization of the work that may be the contributing factors impacting distress. Therefore, drawing upon minority stress theory and affirmative therapy guidelines for the LGBT population, this article conceptualizes sex workers’ mental health through a lens of stigma and stigma management. From this conceptualization, the article presents competency, assessment, and treatment principles to serve as the basis for sex worker affirmative therapy. A case study detailing a sex worker’s struggles with boundary setting and establishing romantic relationships is presented to highlight how sex worker affirmative therapy can be applied in clinical practice.

Keywords:

• Sex worker
• sex work
• affirmative therapy
• minority stress
• stigma
• mental health
• case study

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 For the purpose of this article, sex work will be defined as the sale of sexual labor or any sexual service for money or other material goods, and can include stripping, escorting, cam-working, porn acting, professional domination/submission, street-based work, erotic massage, and other work performed by those who self-identify as selling a sexual service in some capacity.

2 For the purposes of this article, whorephobia is defined as discrimination and violence toward sex workers (McNamara, 2017).