Therapy for sex workers, from a clinician who will not ask you to justify your work.

What this page is actually saying

That your work is your work. That I have clients across the industry, that this is unremarkable to me, and that we can get straight to whatever you actually came in for.

Sex workers report some of the worst experiences of mental health care of any group I encounter. Clinicians who treat the job as the presenting problem regardless of what the client said. Assessments that assume trauma as a cause rather than asking. Notes written in a way that could damage someone in a custody dispute. Providers who visibly recalibrate their face. People arrive here having been through several rounds of this and expecting a sixth.

So, plainly: I do not consider sex work inherently pathological. I do not require you to be either happy about it or unhappy about it. I do not need a narrative of how you got here before we can begin. If you want to talk about the work, we will. If you came in about your mother, your panic attacks, or a relationship that is going badly, we will talk about that instead and the job will only come up as much as any client's job does.

What we can work on

Everything anybody else brings. Anxiety, depression, trauma histories that may or may not relate to the work, substance use, relationships, family, grief, planning a change of direction, or the very specific occupational strain of a job that requires sustained emotional performance.

That last one deserves naming, because it is genuinely under discussed. Managing other people's feelings for a living has a cost that is well documented in other emotional labour professions and rarely extended to this one. So does the constant background calculation about safety, screening, and who knows. So does compartmentalisation that works well until it starts leaking.

Confidentiality, in concrete terms

Clinical notes are kept to the minimum required and are written with an awareness that records can be subpoenaed. I do not record your occupation in a way that would sit in a file as a liability. I will explain the legal limits of confidentiality in session one, in full, before you tell me anything, so you can make an informed decision about what you share and when.

If you want to use a working name in my records, we can discuss what is possible. If you have concerns about how information might be used in a family court, immigration or custody context, raise it early and I will be honest about what I can and cannot protect.

If you do want to leave the industry

Then that is a goal we work towards, seriously and practically, without me having decided it for you in advance. Plenty of clients come in ambivalent, and ambivalence is allowed to stay ambivalent for as long as it needs to. The difference between a therapist who supports an exit and one who has an agenda is that the first waits to be asked.