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Choosing​ ​a​ ​Sex​ ​Worker-Affirmative​ ​Therapist

Many therapists do not have experience with sex worker-specific issues, which may result in conflating sex work with sex trafficking, using language describing sex work that is inappropriate/offensive, and assuming sex work is pathological. The following criteria are intended to be used by sex workers in their search for a mental health professional to avoid negative experiences with non-allied therapists who may unintentionally stigmatize sex work due to this bias.

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 behavior.

● 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) and approaches therapy from a harm-reduction perspective.

● 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 understands the minority stress that sex workers may experience in concealing their work and disclosing their work to 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.

● 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.

● 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.

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 clients.

Some therapists also offer telemental health online or over the phone (“distance-counseling”), which can be a good option for people living in smaller, more rural areas.

  • Pineapple Support Network is a newer directory which lists sex-worker affirmative therapists. This could be a useful place to start to see if there are any providers that sound like a good fit and/or offer services in your local area.

  • There are many online directories that are useful and can search for local therapists. Psychology Today is a good place to start as you can search using your zip code (most therapists are state-licensed and can only practice therapy in that state). Update: there is now a "sex worker allied" indicator on Psychology Today - this is a good search criteria to start with.

  • The American Association of Sex Educators, Counselors and Therapists directory is a good list of sex-positive mental health providers - these folks tend to be more open-minded and more aware of sex work and consensual sexual behavior that involves the exchange of money for sexual services

  • The National Coalition for Sexual Freedom kink-aware professionals directory

  • Ask your local SWOP chapter if members have recommendations for local therapists who are competent in working with sex workers.

  • 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 about whether a therapist is a good fit for you, 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?

It is important to find a mental health professional who is understanding , empathic, and supportive of your work and respects your decisions and autonomy. Engaging in sex work is not in and of itself pathological and is something that can be a 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, and is comfortable having an honest dialogue with you about sex and sex work.

If a therapist wants more training on working with sex workers, this brief webinar discusses the basics and is offered for AASECT continuing education credits along with this published journal article.

If you follow these steps and are still struggling for find a sex worker-affirmative therapist, I am happy to help find referrals - send me an email at:

Katie Bloomquist LMFT, CST


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