Date of Award
Spring 2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Counselor Education and Counseling Psychology
First Advisor
Alexandra Kriofske Mainella
Abstract
ABSTRACT:
This dissertation examines the mental health implications and experiences of individuals engaged in sex work, employing a constructivist grounded theory approach to explore the nuanced realities of this marginalized population. Through in-depth interviews with sex workers, this study reveals the complex interplay of positive aspects (enjoyment and empowerment), and the negative (severe risks faced by individuals in this field, including verbal abuse, physical violence, and sexual assault). The findings underscore the critical need for a holistic and nuanced understanding of sex work, challenging prevalent stereotypes and emphasizing the importance of ongoing consent, communication, and respect for sex workers' boundaries. Participants in this study represented a diverse group of individuals in sex work. Gender identities for participants included cisgender women, transgender woman, and agender. Participants engaged in a range of forms of sex work including prostitution, phone sex services, exotic dancing/stripping, among other forms. 90% of participants identified as black/African American with 10% identifying as white/Caucasian. In accordance with grounded theory, participants had the opportunity to review transcripts, and make additions if needed. The transcripts were then analyzed by the dissertation team via initial coding, focused coding, and theoretical coding. Constant comparative methods and memo-writing were employed by the dissertation team. The implications for practice and policy are shared, including suggestions that mental health practitioners should adopt a trauma-informed approach and that policymakers should prioritize the decriminalization of sex work. The integration of sexuality courses in mental health graduate programs is also proposed to enhance understanding and support for this population. Future research directions are identified, emphasizing the need for longitudinal studies on mental health outcomes, resilience factors, and the impact of legal and cultural contexts on sex workers' well-being. This dissertation contributes to the burgeoning discourse on sex work and mental health, advocating for comprehensive, inclusive, and culturally competent approaches to support the well-being, agency, and rights of sex workers. It calls for a reevaluation of societal, legal, and healthcare practices to better accommodate the needs of individuals engaged in sex work, urging a shift towards more equitable and inclusive mental health support systems.