Acting out or just working?
Institutional stigma for sex workers is something we still encounter in Australia despite some big steps forward like (partial) decriminalisation taking place in Victoria, more (brave!) people coming out and sharing their lives online as sex workers making them human to non SW’s.
We are told to "seek help." We are told that "therapy is for everyone." But for many in the industry, walking into a GP clinic or a psychologist’s office feels less like seeking help and more like entering an interrogation room.
The discrimination isn't always overt. Sometimes, it’s a raised eyebrow. Sometimes, it’s a shift in tone. And sometimes, it’s a flat-out denial of care based on a fundamental misunderstanding of who we are.
I recently heard from a colleague and dear friend in the industry who applied for a Dialectical Behavior Therapy (DBT) group specifically designed for Borderline Personality Disorder (BPD). This is a group meant to help people manage intense emotions and find stability.
The lead psychologist denied her entry. The reason? They claimed her sex work was "acting out"—a clinical term often used to dismiss behavior as impulsive, self-destructive, or a symptom of the disorder rather than a legitimate career choice.
Think about the irony!!!! A person seeking professional tools for stability was denied those very tools because the professional couldn't separate their personal stigma from their clinical duty.
The Problem with the "Acting Out" Label
When a clinician labels sex work as "acting out," they are doing three dangerous things:
Removing Agency: They decide that you aren't a person making an economic or personal choice; you are a symptom to be managed.
Pathologising Survival: They ignore the reality that work—regardless of the industry—is often what provides the stability (rent, food, therapy) needed to manage a mental health condition.
Closing the Door: By pathologising the work, they create a barrier to the very treatment that might actually help the client navigate their life.
Traditional healthcare often operates on a "Moral Model" hidden behind "Medical Language." If a doctor or psychologist hasn't done the work to unlearn their own biases about sex work, they will always see your job as the "Problem" instead of seeing you as the person with a life, a history, and a set of needs.
During my years as a case manager supporting young women at risk of homelessness and sex workers I found many of my clients went so far as to avoid doctors all together out of fear of being judged. This is why many workers lie to their therapists. And this is why so many workers remain underserved.
At Face the Strange, your work is not a diagnosis.
We don't view your career as "acting out."
We don't view your choices as symptoms.
We view you as a whole human being navigating a complex world.
If you have been told you are "too much," "too chaotic," or "too high-risk" for traditional therapy because of your job, I want you to know: The problem isn't you. The problem is the gatekeeper.
