A letter to the professional I am about to see for my mental health.
You may be a doctor, a counsellor, a social worker, a support worker, a psychologist or a psychiatrist. I am coming to an appointment and I am very nervous. You see, I am a sex worker. In the past I have seen professionals for my mental health in emergency rooms, therapist offices and doctor offices only to be leave feeling less than. I am writing you this letter as a sex worker, to discuss some of the things you should know.
- I have internalised stigma. This means that when you make certain comments, use problematic language, reinforce untrue stereotypes or pass judgement through body language you can reinforce this internal struggle. I know sex work is real work, I know I enjoy it. However, I face the struggle of societies whorephobia and when I am vulnerable someone I am trusting with my mental health can confirm these. I will walk away feeling like my choice of occupation, my life, myself is not worthy of help, is not allowed to be helped. Alternatively, I may walk away assuming you are part of the problem, angry and defiant. This will guarantee that anything helpful I could have taken from this appointment will be disregarded.
- Do not make assumptions on my past, present or future. Do not assume that story follows that of stereotypes, pop culture or the other sex worker you met. Let me tell you my story and listen. Do not ask me, in thirty different ways, about the trauma, pressure or drug use that ‘pushed’ me into ‘that line of work’. Trust my answers to your questions the first time.
- Try to avoid looking me up and down. It shows you are judging me. This action causes me to assume you are thinking things like ‘people actually pay to touch that thing in front of me’ or I assume you are being incredibly leery and inappropriate. Neither of which make me feel safe with you.
- Leaving the sex industry will not magically cure me. I like my job, it allows me to pay to see you and provides me with freedom. Even if I didn’t like my job, pressure to leave can be insurmountable with financial pressures, gaps in my resume and self-doubt. If I want to discuss leaving the industry I will bring it up. I will ask for advice on certain things. Do not be the professional who bases my mental health around my leaving my job.
- Your language matters. I may call myself a lot of things. I have been told off by countless professionals for calling myself crazy in your offices. This shows you understand the power of problematic language. Do not use stigmatising language. The accepted term is sex worker. However, if you not sure ask how I would like you to refer to my job.
- I have a life, relationships, friendships and commitments outside sex work. If I do not want to discuss sex work in every appointment that is okay. Sex work is not the cause of my mental illness and ignoring the large portion of my life that occurs outside of my work is not going help.
- Do not make stigmatising comments or jokes in our sessions. This includes problematic language, pop culture references and anything that reinforces the stigma. This will break my trust and likely result in me leaving your service.
These are seven things I wanted you to know. The final, and to me most important, thing is this; I do not trust you. I am in a position of requiring help with my mental health. I want to get well and understand that honesty will assist this, so I am telling you about sex work. But you need to understand that I don’t trust you. I am going to be difficult, I am going to judge your reactions and comments harshly. Please don’t isolate me by putting any of your moral objections to my occupation onto me.
Understand I will be difficult. I may ask to see your note. I may tell you to not write my occupation down. I might be stubborn. I may cry. If you can’t do these things, if your personal ethics do not allow you to see me as equal then please tell me straight up. I want someone willing to work with me. I want a professional who is willing to listen. I don’t trust you, but I want to.
Sincerely,
The nervous sex worker who is scared you are another professional that is going to betray my trust.
Thank you for this insightful message to mental health workers about the stigma associated with this job that people in my field should know more about. I run a very large mental health service and very little training is provided to our professionals on the issues associated with stigmatisation in sex work and it’s detrimental effects on mental health. I’ve sent a number of sex workers over the years in my practice and the sex work has never been the focus of our sessions. I find it difficult to understand why professionals would take one part of someone’s life and focus exclusively on that for moralistic reasons rather than the clients mental health needs. I’m a male clinical psychologist and I know there are a lot of referrals that specify a female psychologist only. I’m not too sure the bias is only gender related. I would like to see all mental health professionals trained in this area so that I don’t further exacerbate our clients difficulties because of moralistic judgement or bias in their work. Thank you again for sharing your insights into your experiences in mental-health and hopefully this will pave the way for action to be taken to improve mental health professionals training.
Thanks for your thoughtful feedback Brendan! We are always looking to improve our community’s interactions with mental health professionals, and we appreciate your support