The Therapist and The Sex Worker
Therapist and Sex Worker
Madonna and Whore, Revisited
Two sides of the same care economy — both dehumanized as the only safe receptacles for human vulnerability.
I once had a client who was a cannibal. On a cool fall afternoon, I sat across from a man who told me exactly that. Which role do you think I was playing in that moment — therapist or sex worker? Honestly, it didn't matter. I scanned the room for exits and for people who might hear me scream if I needed them to. I walked away unscathed that day, but the roles I've played across every facet of my life have often involved the same thing: holding compassion, care, support, and sometimes eroticism, without safety, support, or reciprocity from the person or the system.
I was trained — indoctrinated, really — to be of service from the moment I was assigned female at birth. With that came every socialized expectation a highly neurodivergent, traumatized, and isolated "girl" learns and perfects: fawning, masking, surviving, changing avatars and roles to meet the moment.
One of my survival strategies was diversifying my labor. The same neurodivergence that made survival necessary also let me see through the systemic extraction baked into clinical professional spaces. I could teach clients to use their voice and set boundaries, but I couldn't do the same inside these systems — even when harm occurred — because I was also an object used to perpetuate pathology and system compliance.
That dissonance changed my relationship to labor early in my life. If I was going to be objectified and extracted from in order to survive, I wanted at least to control the means and the method. This is a more common path than people admit — clinicians and care workers who believe that succeeding as a therapist will finally prove their labor professional and worthy under capitalism.
In the power imbalance of abusive systems, smart, aware women-coded people learn to survive by loving the martyr. Self-sacrifice. White savior. Mommy. Wet nurse to an entire workforce, family, and internet, all of it sucking at the same life force. The martyr and the source. Christianity gave the world some beautiful things — but it's also at the root of this idealized dichotomy, the belief that we have to be one or the other, when every human being contains multitudes, transformations, identities, all at once.
The patriarchal systems we live inside make any real differentiation between these roles an illusion. Therapists hold onto the idea that their education and credentials protect them, that credentials guarantee their worth in the system. But the ease with which AI therapy emerged reflects exactly how Big Tech sees this work: something to be outsourced and extracted, the same as sexuality. The care economy as a whole is undervalued because care is a liability under capitalism.
The Therapist and the Sex Worker.
The Madonna and the Whore.
Two sides of the same exploitative labor spectrum.
The chart below shows the impact of colonization, racist and gendered labor structures, and the nature of this specific relationship. We've been isolated from community and collective, handed therapy as the "answer" to maximizing our well-being, while being shamed for the sexual and relational experiences that were lost in that isolation. As vulnerability was subjugated under patriarchy, feeling, depth, touch, and affection came to live in smaller and smaller boxes. The parts we could show, we brought to therapy. The parts we couldn't, we brought to our sex worker. And now, all of it is going to AI — which holds our vulnerability the way a colander holds water over a river: our softness and our presence with ourselves dispersed among intimate data, our words fragmented, our stories reshaped to optimize feedback for someone else.
When we look at how power and resources actually move, we see whose labor counts and with what title attached to it. Whorephobia and whorearchy — the hatred of sex workers, and the internal stratification of different kinds of sex work — are tools built to keep this extractive system running and to keep dehumanizing the people inside it. Mainstream digital sex work already operates inside the exact same consumer model as therapy: a primary tool people reach for to feel okay. The shame baked into our religiously conservative culture is what blocks the healthier, more collaborative models that would actually challenge a labor system built to exclude sex workers in the first place.
Therapists can apply for insurance, take paid leave, attend a conference free from harm. Sex workers face hatred and the threat of violence just for existing in public — particularly those doing street-based work, particularly those holding more marginalized identities. Do you need an office to be worthy of basic respect for your work? A name plaque? To be white? Able-bodied?
What would it mean to name these dynamics out loud, instead of around them? The reasons someone chooses or finds themselves in sex work are valid and important — and not so different from the reasons people end up in therapy roles. Sex work also offers far more flexibility for people who are parents, neurodivergent, disabled, traumatized, or mentally ill than most licensed care work ever will.
Until we stop culturally treating the sex worker as the object of hatred, shame, and isolation — and until therapists stop quietly reinforcing that — we can't shift the trajectory of human relating. Anyone who can dehumanize another person inside a transactional context will do it to others in their life too, especially women and queer people. Sex workers don't want to be the receptacle for the worst parts of humanity. We want to be a vital resource in the ecosystem of human care.
One note: some therapists and sex workers move within the PMC and aren't aligned with liberation or justice — they're motivated by the same thing as everyone else in that class structure. Proximity to power gives the illusion of success, and that illusion de-incentivizes changing the system at all.
My cannibal client, it turned out, was a closeted gay man. Not because being gay made him dangerous — but because a lifetime of being told his desire made him unacceptable left him no permitted container for it except domination. He didn't have a name for what he wanted, so he built one out of hatred and called it appetite. He eroticized consuming women instead of risking being known as himself.
This is what the care economy, seated in a system of extraction, can't actually heal. The root of what's happening — socio-culturally, generationally — is deep hatred for the other, profound isolation, lineages of trauma passed through abusive and oppressive families and systems, all of it thriving in a structure that limits vulnerability to whatever is commodifiable. You can buy an hour of being witnessed. You cannot buy your way out of needing to be known by someone who isn't being paid to stay.
Picture a person who can't get a date. Can't find a partner. Can't access care when they're sick. Can't get belonging, love, the simple fact of being wanted. Unmet, that need doesn't just sit there — it turns. Hate. Sexual assault. Deepfakes. Digital sexual violence. Workplace harassment. This exists because we left the collective for individualism, traded community for competition, and let capitalism convince us that belonging and joy and wellbeing are things you achieve alone. Isolation. Skills lag. Mental health. Neurospiciness with nowhere to land. No place to simply exist.
The care economy got outsourced as a commodity. You consume it. You buy it. You extract it. Which meant the people doing that labor — therapists, sex workers, healers — became objects too. At the exact moment we objectified healing, we were also deciding what wellness meant, what could be sold: beauty, bodies, love, class. At the same time, we were objectifying sexuality, shrinking it into smaller and smaller boxes.
So vulnerability in the therapist's room got limited to what could survive a performance culture — your feelings, processed, so you can get better at your job, perform harder, adapt to capitalism. And everything else — the shadow, the shame, the taboo, the eroticism, the dreams, the identities — got shoved into a smaller box that could only exist with a sex worker. Still not as a full human experience, because whorephobia won't let it integrate. Just contained. Paid for. Kept separate.
Imagine it as one trash can. Feelings and safety, dumped on the therapist. Shame and pleasure and taboo, dumped on the sex worker. Neither of us gets to be human in these exchanges. We are both playing roles the system built as the only palatable containers left for care. The Madonna and the Whore were never opposites. They were split apart on purpose, dichotomized to keep the patriarchy running — when we are one and the same.
And here is the part that doesn't get said enough: because we are both dehumanized in this exchange, we are also both left out of receiving care ourselves. The therapist who holds everyone's feelings has nowhere built to bring their own. The sex worker who holds everyone's shame is rarely offered tenderness without a transaction attached. The objects of care do not get to be subjects of it. That exclusion is not an accident. It's the same mechanism, working both directions at once.
When we lost the collective and the care economy became commodified, it turned providers into objects on both sides of the labor spectrum. Care was no longer part of a balanced exchange. It became a tool for capitalism, or a shameful splurge — either way, moving wealth upward, and maintaining the belief that those who provide care, the madonnas and whores of history, were things to be extracted from. Drained entirely, until we were no longer deemed useful by breeding standards or beauty standards. But the whores always fought to keep providing care to the collective anyway.
I felt more at home in a room with a sex work client than I ever did with a therapy client. I could be more myself in an erotic role than in a professional one. And that is the exact work I could be murdered for.
Both kinds of clients — usually white men — are swimming in the same ecosystem of care providers, the people they extract from, emotionally and sometimes erotically, and never actually change anything about how they think, feel, or act toward the women in their lives. One man told me he'd had over a thousand psychedelic journeys, and just as many hours of therapy. He was seventy-five. He still had an abusive relationship with his wife. He no longer spoke to her, or to their child. My question to him was simple: in all of those sessions, all of those sits — did the universe, or a single professional, ever once teach you to respect and nurture the woman actually in your life?
We are all failing. The system, its media imagery, and the expectations we hold for ourselves. Be skinny. Be fit. Have a booty and a personality, but not too many feelings. Work normal jobs, normal hours. Dress like a standard human. Don't love or play too intensely, or with too many parts of yourself.
Vulnerability is first relational. Safe relationships exist in presence and acceptance with another — regardless of the role.
The road back is humanizing everyone, and building a new ecosystem — where labor equity, safety, and well-being are rights, where interdependency is collective care, and where care work itself is integral, protected, and supported.
