When Sex Workers Do the Labor of Therapists

Sky is a professional escort. She’s been working at Sheri’s Ranch, a legal brothel located in Pahrump, Nevada, for a little under a year. A few months back, a man came in asking for a group session with Sky, who prefers to be identified by her professional name, and one of her colleagues. He had come around a few times before. He made it a point to keep in touch through Twitter. This time, however, the session took a dark turn. He came in to tell them he was planning on killing himself.

“We see a lot of clients who have mental health issues,” she tells In These Times. Though, this experience was markedly more dramatic than her usual run in with clients who going through a depressive episode. She and her colleague were eventually able to talk the guy down. They sent him home with a list full of resources that specialize in matters of depression. They asked that he continue to check in with them through social media. 

Research suggests that upwards of 6 million men are affected by depression every year. Suicide remains the seventh leading cause of death among men in America. While it’s impossible to gauge exactly what percentage of that demographic frequents sex workers, the experiences of those in the field can offer some insight. During Sky’s last tour at the Ranch, she scheduled about seven appointments. Out of those bookings, only one involved sex. “We do a lot of companionship and intimacy parties,” she says. “The clients who sign up for those bookings are the ones struggling with loneliness.” 

And people with depression aren't the only neurodivergent individuals sex workers encounter on the job. Those suffering from anxiety, a common accompaniment to depression, show up frequently. They also see a lot of people who fall on the autistic spectrum. In fact, Sky says she sees men who fall into the latter demographic relatively often. 

Sky first got her start in the industry working as a professional dominatrix. While she has since pivoted her position in the industry, she’s found ways to incorporate that expertise into life at the brothel. Sure, she offers standard escort services, but she also books sessions dedicated to BDSM, an acronym that can be broken down into three sub categories: Bondage/Discipline, Dominance/Submission and Sadism/Masochism. Each dynamic refers to a specific form impact play that participants can find deeply pleasurable. That kind of tactile experience, she suspects, might offer a certain special appeal to men with autistic spectrum disorder (ASD). And she might be right.

Among the many symptoms of those diagnosed with ASD is a resistance to physical contact. According to the CDC, early signs of the disorder may present in the form of an aversion to touch. At the same time, touch is an important sensation to experience. A lack thereof can lead to loneliness, depression and even a more secondary immune system. Researchers have determined that therapies designed to nurture regular sensory integration can help in this regard. 

Goddess Aviva, who also prefers to be referred to by her professional name, is a lifestyle and professional dominatrix based in New York City. Like Sky, she sees a good amount of clients with autism spectrum disorder (ASD), and also men dealing with depression and anxiety. She takes certain measures to screen clients. After all, violence against sex workers is an ongoing issue in the United States, and the wavering legality of the trade doesn’t exactly help combat the issue. In the wake of new federal legislation that has largely kicked sex workers offline, and with them, the ability to vet clients from afar, sex workers must be more vigilant than ever about whom they decide to take on. The clients who are neurodivergent or live with mental health conditions don’t seem to be the ones sex workers are worried about.

“You don't have to be diagnosed with a mental illness to be a shitty person, and some of my clients who do deal with mental illness are wonderful, kind people with good intentions,” says Aviva. “I've never felt unsafe with a client that makes it all the way to a session. What matters most to me is that someone is respecting my boundaries, time and protocol.”

Sky, too, has encountered a number of undesirable clients throughout her career in the industry. But, similar to Aviva, these experiences don’t seem to be driven by those suffering from mental health or neurodivergent conditions. “My most uncomfortable moments in the industry have always come from men who would be told by a professional that they were completely sane,” she explains.

Fortunately, for Sky, it’s much easier to weed out problematic clients in places where prostitution is legal. According to her, the brothel has a security team monitoring the property. She also says there’s a sophisticated screening mechanism in place. Before booking a session, all clients have to provide ID and agree to an intimate screening to rule out immediate potential health risks. These aren’t typically privileges those operating independently have access to. 

Throughout her career, Sky has encountered clients who have been pointed to the brothel by concerned friends, or family. She even knows of a few who have come by at the suggestion of a therapist. Though, not all mental health professionals would advise that kind of thing. 

“Certainly, there are individuals that struggle with social anxiety, which prevents them from finding a real-life partner, and in those cases engaging with a sex worker can be both therapeutic and pleasurable,” says Dr. Michael Aaron, a sex therapist, writer and speaker based in New York City. “But the best option for a therapist that is looking to provide a patient with real-life experience is to seek out surrogates, who are trained and certified by the International Professional Surrogates Association.” The organization he’s referring too, also known as IPSA, operates around a triangular model of therapy involving a patient, a surrogate and a trained therapist. Together, the three work to improve the patient’s capacity for emotional physical intimacy through a series of structured, sexual experiences. The legal status of the practice is largely undefined in most of the United States. 

And maybe it’s not just in the interest of clients to see someone trained to provide the level emotional support they may be after. “It can be heavy,” says Sky. “I’ve had days where I have to take a minute for myself and get myself back together.”

Still, it seems as though few in the field shy away from providing the emotional labor that clients demand. “There’s this huge misconception that at the brothel we just have sex all day,” Sky explains. “But there are a lot of people who come in to work out some serious emotional issues. It’s really a good chunk of what we do.”

“I love my job,” she adds. “But there are certain parties that make us feel like we’re actually making a difference in the world – that we’re actually doing good things and not just providing a good time. And that can be super fulfilling.”

>> The article above was written by Carrie Weisman, and is reprinted from In These Times.