Sex Negativity and its Impact on the Creator Economy and Mental Health

At our mental health practice, Brooklyn Minds, we are one of the first of a handful of practices to have a Sex Positive Team of clinicians focused on serving our community of sex workers, LGBQTIA+ individuals and others with marginalized sexual identities and practices. When we heard the news that OnlyFans was initially planning to ban explicit content in October ostensibly in response to pressure from payment processors and investors, this news hit home for us. We know that OnlyFans has been important in the lives of a number of our staff members and clients and that such a ban would disproportionately impact individuals often overlooked by other platforms, including those who are neurodivergent, BIPOC, kinky or who have a wider range of body types than what tends to gain traction on mainstream adult sites. While OnlyFans eventually dialed back their plans to ban this type of content, knee jerk decisions like this are only the latest in a long line of sex negative actions that permeate our society. 

Decisions around restricting online platforms where sex workers make a living can have dire consequences. A research study by a collective known as Hacking/Hustling found that dismantling of an online-based sex work environment had played a role in the increased economic instability for 72.45 percent of the online participants of this survey, with 33.8 percent reporting an increase of violence from clients. Those of use not in the sex industry tend to take for granted things like being able to use standard payment processors and platforms like Visa, Mastercard, Stripe and Paypal, to be listed on professional directories for our given industry like Psychology Today and to not wake up and suddenly find our social media account has been suspended (or shadowbanned) indefinitely for using the word sex instead of s*x.

New Frontiers: Clubhouse Embracing Sex Positivity

On our New Frontiers show on Clubhouse, we heard from sex workers who have been deplatformed, dismissed and denied access to the banking system. Our panel, including Lila Donnolo the host of the podcast Horizontal with Lila and the wildly popular Clubhouse Creator First Show Positively Sex: Sex Ed With Pleasure, has been advocating for a world in which sexuality amongst consenting adults is not relegated to the most darkest and dangerous corners of the internet and the back alleys of our cities and towns. Lila shared that even though her content is educational in nature, on Patreon, a platform that is a significant income source for her, she is essentially shadowbanned and does not show up in searches (do check out her Patreon!) Her experience is far from unique for sex educators, sex workers and sex therapists simply trying to earn a living and help other humans.

We heard from J. Leigh Oshiro-Brantly, a Senior operations, program and research consultant a the the New York Transgender Advocacy Group who is very active in the movement to decriminalize sex work. J. is the co-Founder and Co-Director of the Ishtar Collective and the president of the New York State Gender Diversity Coalition. I recommend checking out the organizations they are involved with to support these important efforts and amplifying their messages on Twitter with hashtags including #SexWorkIsWork. They spoke in particular about how many online content creators, including sex workers, are at the mercy of the whims of these online platforms and that in an ideal world, platforms built for and by the community they serve would be less likely to make decisions that exploit and ultimately undermine their core content creators. Our IT Director at Brooklyn Minds, who has a longstanding interest in fighting censorship online and who actually reads the Terms of Service, mentioned that these type of decentralized self-hosted platforms may be more likely to exist outside of the United States and to rely more heavily on cryptocurrency. He mentioned one such platform that is not quite ready for prime time but there is definitely a lot of interest in this space. 

We were also joined by dominatrix Venus Cuffs, who was recently featured as one of 115 Service Workers who kept NYC alive during its darkest moments for hosting educational online workshops during the pandemic on BDSM that brought people together safely. Her comments, as well as those of several others who joined from the audience, centered around black and brown sex workers being particularly impacted by anti-sex worker legislation like FOSTA-SESTA and the OnlyFans threat. Having read a piece in Vice News that profiled 11 OnlyFan Creators, her words really resonated with the stories shared there. Some of the more heteronormative, non-kinky, white female creators spoke in the piece about a potential slight decrease in traffic but felt their content would be minimally impacted whereas those with more marginalized identities and kinkier content worried they would not be able to afford basic necessities should they lose OnlyFans. 

Sex Positive Mental Health Care

A lot has been written elsewhere about the OnlyFans decision, FOSTA-SESTA and the reasons why sex workers make easy targets for puritanical individuals hell bent on convincing everyone that anything to do with sex is a quick descent to sex trafficking of minors. But what we really want to emphasize here, as mental health professionals, is that sex negativity is poison to mental health. We need more mental health professionals who are culturally competent or at least culturally curious to work in a sex positive manner. It’s been disappointing to us as a practice at Brooklyn Minds that because we put ourselves out there as having a Sex Positive team, led by Gina Pellicci, LMSW, a gifted social worker, we have received wildly ludicrous accusations such as that we are luring patients into an underground sex cult and that we are promoting bestiality and of course pedophilia too! One of our therapists, Annie Block, was discouraged by supervisors during her previous training to bury behind a wall of shame the sex positive parts of her identity because it was somehow “unprofessional” to do so. Let me be perfectly clear: being a sex positive therapist does NOT mean the therapists engage in sexual activities with their clients or discuss their personal sexual practices. There are many heteronormative therapists out there who do not identify as kinky and we do not assume these therapists are sharing the details of the missionary lovemaking they had with their monogamous spouse and yet somehow, clinicians who identify as kink-knowledgeable or even LGBQTIA+ are somehow frequently assumed to have salacious intentions and zero boundaries. These accusations are pernicious and need to stop. If someone does not want to come to our practice because we are culturally competent when it comes to a wide range of human behavior, good riddance to them! We would rather proudly scream from the social media (and NYC) rooftops that we are sex positive than hide in the shadows under the guise of outdated and oppressive concepts of “professionalism.”   

One of our sex positive Team Members, Julia Koerwer, LMSW, highlighted an extensive recently published report called What Happens When Sex Workers Actually Need Mental Health Support. A key finding was that many BIPOC, migrant and transgender sex workers experience intersectional stigma in relation to their race, gender identity and ethnicity as an important burden on their mental health.Others in the study emphasized that the way sex work will affect one’s mental health depends on the personality and individuality of the worker, like in any other job or profession. The vast majority (93%) felt sex work was an important part of their lived experience and that it should be disclosed in therapy - even if they saw it as separate from their mental health problems. Unfortunately, 58% of sex workers who disclosed sex work had bad, judgmental and stigmatizing experiences and found the care damaging rather than helpful. This is why it is so important that practices and teams like ours exist as we still face an uphill battle when it comes to the stigmatized role of sex work within our society. 

Resources and Consultations

Finding accessible mental health care is challenging at baseline, let alone when seeking someone who identifies as sex positive. While this list is not as comprehensive as any of us would like it, is at least a start and please comment if you recommend other resources: 

If you are interested in getting consultation around how to build your own Sex Positive team at your mental health practice or how to incorporate Sex Positive programming into your organization (including schools), please get in touch with Gina Pellicci at

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