Sex Workers Make Great Therapists – But They're Locked Out of the Job

People in sex work say that the two roles have huge amounts of overlap, but they're shunned by the therapy profession.
September 11, 2019, 11:07am
Participants of a demonstration hold a sign in their hands which reads 'Sex work is real work' as they protest against the planned bill on prostitution by the German government in Berlin, Germany
Protesters on a sex workers rights demonstration in Berlin, Germany. Photo: Joerg Carstensen/dpa/Alamy Live News

“Ultimately, it feels like I have to hide half of myself. It’s incredibly suffocating,” says Tamara of her experience training as a psychotherapist while not feeling safe to be out as a sex worker. “I know that I have an absolute breadth of sensitivity, understanding and material experience that directly reinforces my strengths as a mental health practitioner – and I’m not permitted to share that pride with anyone.”


Sex work and therapy, or transitioning from one to the other, appears to be a well-trodden path. As is often the case with sex work – which is often hidden, with people moving frequently in and out of the industry – no data exists, but anecdotal evidence suggests a link between the two.

It’s not hard to understand why. The professions have transferable skills – active listening, empathy – and since the cost of therapy training runs so high (around £20,000, often more) with very few funding options available, sex work is one option for those who would otherwise find themselves financially excluded. While barring sex workers from therapy training is not usually explicit in policy, social stigma and institutionalised discrimination are still felt hard by those attempting to break into the field.

Back in July, sex worker activists and allies on Twitter shared a statement published on the College of Sexual and Relationship Therapists’ (COSRT) website, which appeared to outline their position on sex work. COSRT is the UK’s professional body for therapists and counsellors specialising in psychosexual and relationship issues.

“COSRT would like to clarify that active sex workers cannot participate in COSRT-accredited training courses,” it read. “Sex workers are defined in this instance as individuals who receive money or goods for sexual services, and who consciously define those activities as income generating even if they do not consider sex work their occupation.”


In a reply on Twitter, COSRT claimed that the statement was “not an organisational policy but an internal holding position posted in error.” A follow-up tweet also stated that sex workers engaging in therapy training was “a grey area” about which the organisation had “very recently begun vital discussions” to develop policy.

In a statement to VICE UK, COSRT said their current position is that “any candidate who meets the strict entrance criteria of the third-party training courses approved by COSRT may join and train,” providing they meet the criteria in their new ‘code of ethics’. However, there has been little transparency around where or who in the organisation the statement came from, or how it ended up being published.

“To restore trust, they need to condemn this discrimination against sex workers and explain how it won’t happen again,” one therapist, who is currently setting up a network of therapists who are sex workers and allies, tells me. “Saying they have no position is not enough.”

This issue is far from unique to COSRT, though. When Chloe was looking to train with Relate in 2016, she was rejected because they discovered she did fetish modelling after Googling her ahead of the interview.

“Instead of interviewing me, they interrogated me about what they had found,” she tells me. “I felt too shocked and humiliated to really defend myself.” The interviewers said that, before finding the images, they really liked how Chloe came across on the phone and in her application. “I’m middle-class and evidently not what they associate with sex work,” she says.


Chloe eventually trained elsewhere and now works for a sexual violence charity, but felt “completely demoralised" for some time after the interview.

“Relate is committed to equality and diversity and positively encourages training applications from people of all backgrounds," Ammanda Major, Head of Service Quality and Clinical Practice at Relate, told VICE UK. "Each training application is carefully considered on individual merit, across a range of criteria. Our primary concern is recruiting students who demonstrate the potential to support clients through the complex and challenging issues they experience.” Incidentally, that course became COSRT-accredited in 2018.

Anna encountered similar issues when she decided to train as a therapist after working as a full-service sex worker and as a stripper for ten years. She was accepted onto a course, but encountered discrimination when looking for placements to fulfil the training requirements.

Anna’s college advised her to stick closely to the truth in her application forms, so she wrote ‘self-employed dancer’ on her CV. She secured three interviews out of 12 applications, one of which went very well until she specified that she was a stripper, at which point they “they hurried me out of there.” Another interviewer kept asking: “To get out of what you’re doing, why not just work in a bank?”

As a result of her trouble getting accepted onto a placement, it took Anna two extra years to complete her course. “I was heavily pregnant and so stressed trying to get my hours that my son came early,” she tells me. “It pushed me over the edge and I gave birth at 34 weeks.”


Allie – a therapist, sex worker and sociologist focusing on sex work stigma in mental health – tells me that the institutionalised discrimination faced by sex workers in therapy training bodies is a form of “moral judgement”. This certainly fits the wider picture in the UK. A national campaign driven by sex workers is calling for the decriminalisation of sex work in the UK, but most politicians so far don’t seem to be listening. Anxieties about the industry mean MPs continue to propagate stigmatising rhetoric and push for legal models that harm sex workers, rather than listening to sex workers themselves.

Psychotherapist Pamela Gawler-Wright tells me that COSRT and other training bodies operate on the “misunderstanding that sex workers would be conducting sex work with clients who were also their psychotherapy clients.”

Keeping any two professions separate would be a generic requirement for many therapists. A screenshot from the same COSRT webpage also stated that people working in “non-sexualised touch-based professions are free to participate in COSRT-accredited training” so long as they “commit to guaranteeing any therapy clientele is completely excluded from any other services.”

Sex workers are ‘othered’ as uniquely incapable of this professional requirement, but Gawler-Wright says it’s actually sex workers who “often have the most deeply honed knowledge and practice of ethical principles, such as boundaries and confidentiality, of any profession.” The exclusion of sex workers from therapy training, she believes, is not only wrongful discrimination but a great loss to the profession.


Tamara tells me there is a “huge crossover” between her jobs. “Sex work entails an awful lot of emotional labour that’s not just similar to certain roles you have as a therapist, but absolutely identical,” she explains. “For instance, the notion of being a reflective surface or a conduit for the client where everything that makes up your subjectivity has to take a sideline so that the client can process his desires, or his neuroses, or his needs – this is fundamental to sex work and it’s fundamental to therapy.”

Anna also tells me that her experience as a sex worker makes her a better therapist. “I don’t bat an eyelid at anything,” she says. “I heard people’s deepest, darkest secrets, so when I had clients come to me with stories of abuse and things that they’ve done themselves, it was very easy to step into their world because I was used to the diversity of all the people that I’ve met.”

Dominic Davies from Pink Therapy, the UK's largest independent therapy organisation working with LGBTQ clients, believes sex workers are often especially qualified to train as therapists. “[Sex workers] will be competent in helping people articulate their difficulties and feelings about their sexual difficulties and be familiar with managing sexual shame and embarrassment,” he tells me. “They’re more likely to have sex positive and norm-critical approaches to human sexuality, and an un-shockable attitude.”

Spurred on by the incident with CORST, a group of former and current sex workers who are therapists, and allies, are now in the process of setting up their own network. One therapist involved with the network tells me it will aim to address the “real need for higher competency on sex work within therapist training”, including the need for sex workers themselves to be able to find good therapists who will not pathologise them.

“Part of my motivation for training is to become the person that would have helped me when I needed it,” Tamara tells me. “I want every institution to make a stand, explicitly in support of sex worker rights, including their right to engage in other vocations if they so wish. We have laws on discrimination for a reason and they seem to be dysfunctional where sex work is concerned.”


This article originally appeared on VICE UK.