Sex Workers On Onlyfans

Running head: SEX WORKERS ON ONLYFANS
SEX WORKERS ON ONLYFANS: AN EXPLORATORY INVESTIGATION OF
SERVICES ACCESSIBILITY, PSYCHOSOCIAL INFLUENCES, AND ONLINE CULTURE
A DISSERTATION
SUBMITTED TO THE FACULTY
OF
THE GRADUATE SCHOOL OF APPLIED AND PROFESSIONAL PSYCHOLOGY
OF
RUTGERS
THE STATE UNIVERSITY OF NEW JERSEY
BY
JAY N. BOSWORTH, PSY.M.
IN PARTIAL FULFILLMENT OF THE
REQUIREMENTS FOR THE DEGREE
OF
DOCTOR OF PSYCHOLOGY
NEW BRUNSWICK, NEW JERSEY AUGUST 2022
APPROVED:
Karen Riggs Skean, Psy.D.
Nicole Cain, Ph.D.
DEAN:
Ryan Kettler, PhD.
Sex Workers on OnlyFans ii
Abstract
OnlyFans, a subscription-based online company with lax restrictive content policies, has become
synonymous with sex work since its founding in 2016. The platform’s popularity on Twitter,
combined with a surge of individuals signing up as content creators since the COVID-19 pandemic
began, has made online sex work hyper-visible and accessible in an unprecedented fashion. To
address a gap in research on the lived experiences of sex workers in fringe markets, an exploratory
research survey was disseminated online to provide a nuanced understanding of the experiences of
sex workers who are OnlyFans content creators. Following a grounded thematic analysis
methodology to elucidate common themes, several pertinent themes emerged. Participants (n = 19)
experienced healthcare professionals and professionals across common services (e.g., mental
health care and law enforcement) as discriminatory and whorephobic. A major motivating factor
for joining was seeking a primary or secondary income due to the financial impact of COVID-19.
Participants reported increases in their self-confidence and self-advocacy since becoming content
creators. Participants had overall positive perceptions of OnlyFans and Twitter. Participants found
the content creator on Twitter as supportive. Most participants experienced a difficult adjustment
period regarding their utilization of OnlyFans and Twitter due to COVID-19. Participants wanted
fans, followers, and clients to recognize and respect their humanity and to acknowledge that sex
work is real work. This dissertation was conducted with the intent of advocating for this unique
community.
Sex Workers on OnlyFans iii
Acknowledgements
Throughout the writing of this dissertation, I have received a great deal of support and assistance.
I would first like to thank my advisor, Dr. Karen Riggs Skean, for facilitating my development as
a psychologist. Karen, being under your guidance has been one of my biggest sources of joy
throughout the past five years. Thank you for your insightful feedback and always bringing my
work to a higher caliber than I thought possible. One day I wish to aspire to be as nearly an
effective clinician, supervisor, and educator as you are.
I would like to thank my second committee chair, Dr. Nicole Cain, for being a mentor to me.
Your research expertise was invaluable in formulating my research questions and methodology.
Thank you as well for deepening my understanding and appreciation for psychodynamic
psychotherapy through the many courses I was able to take with you and for positively shaping
my professional identity as a psychologist.
I would also like to acknowledge from GSAPP Dr. Angelica Diaz-Martinez, Dr. Connie Hoyos-
Nervi, Dr. Shalonda Kelly, Dr. Andrea Quinn, Dr. Kristen Riley, Ms. Julie Skorny, and Ms.
Sylvia Krieger for always believing in me and for cheering me on. Nobody goes through this
program alone and I am very grateful for your support and advice throughout the years.
To my family, Nana and Papa (in loving memory), Mom and Dad, my siblings Kellie, Veronica,
and Jon, and my cousins Lisa and Hayley, thank you for always being here and for raising me to
Sex Workers on OnlyFans iv
Acknowledgements
be the person I am today. Your unwavering support and encouragement throughout my doctoral
program means everything to me. I could not have done this with you - I love you all so much!
I would like to thank my chosen family of Rachel, Nam, Megan, Lindsay, Dar, Meghan, Sierra,
Sophia, Marcos, Wyatt, Jeff and Roberto, and Jose for every time we hung out, video-chatted,
and talked on the phone since beginning this dissertation. Each of you have helped get me
through the many, many valleys along this journey to reach the next mountain top through your
generosity of spirit and shared sense of humor. Everyone deserves to have friends like you.
In addition, I would like to give a special thank you to my on-call consultants, Dan and Drew. I
am extremely lucky to be in the presence of such brilliant colleagues; your understanding of
psychoanalytic psychotherapy and philosophy has deeply shaped and inspired my thinking as a
researcher and practitioner. To Bella, thank you sincerely for helping make my survey stronger
through your wisdom and feedback.
Finally, I would like to thank the Rutgers Department of Residence Life, with a special thank
you to my supervisors Mrs. Heidi Nicklaus, Mr. Curtis Chan, Mr. Nate Johnson,
Ms. Ruqayyah Abdullah-Johnson, Ms. Deja Jordan, Mr. John Newhouse, and Mrs. Alexandra
Cupello Waters, for being my home base and backbone throughout my time at Rutgers. I am
grateful for having abundant opportunities to learn from each of you the importance of teamwork
and how to foster and positively effect change for in-person and online communities.
Sex Workers on OnlyFans v
TABLE OF CONTENTS
I. INTRODUCTION AND REVIEW OF THE LITERATURE

A. Introduction ...................................................................................................... 1
B. Review of the Literature ................................................................................... 7
C. Statement of Specific Research Questions ....................................................... 90
II. METHODS................................................................................................................... 93
A. Methodology Selected...................................................................................... 93
B. Grounded Theory Methodology ....................................................................... 93
C. Participants ....................................................................................................... 94
D. Data Collection ................................................................................................ 95
E. Procedures ........................................................................................................ 97
F. Data Analyses ................................................................................................... 100
G. The Researcher ................................................................................................. 108
H. Trustworthiness ................................................................................................ 100
I. Ethics ................................................................................................................. 109
III. RESULTS ................................................................................................................... 111

A. Descriptive Statistics ........................................................................................ 112
B. Qualitative Analyses ........................................................................................ 120
IV. DISCUSSION ............................................................................................................. 156

A. Addressing Specific Research Questions and Results ..................................... 153
B. Limitations of the Investigation ....................................................................... 176
D. Implications of OnlyFans Suspending its Sexually Explicit Content Ban ....... 189
V. CONCLUSION ............................................................................................................ 195

Sex Workers on OnlyFans vi
VI. TABLES .................................................................................................................... 205

1. Demographics ................................................................................................... 205
2. Experiences in Sex Work and With Services ................................................... 208
3. Experiences With Only Fans ............................................................................ 211
4. Multidimensional Scale of Perceived Social Support ....................................... 214
5. Rosenberg Self-Esteem Scale ........................................................................... 216
6. Meaning in Life Questionnaire ......................................................................... 218
7. Matrix Coding for Motivation for Joining OnlyFans........................................ 221
8. Matrix Coding for Changes in Self-Perception Since Joining OnlyFans ......... 222
9. Matrix Coding for Overall Experiences Utilizing OnlyFans and Twitter ........ 223
10. Matrix Coding for the Online Culture of the Content Creator and
Follower Twitter Community ........................................................................... 224
11. Matrix Coding for the Impact of COVID-19 on the Utilization of
OnlyFans and Twitter ...................................................................................... 225
12. Matrix Coding for What Followers, Fans, or Clients Should
Understand About What it Means to be a Sex Worker ..................................... 226
VII. FIGURES .................................................................................................................. 227

1. Inclusion/Exclusion of Research Survey Participants ...................................... 227
VIII. REFERENCES........................................................................................................ 228
IX. APPENDICES ............................................................................................................ 260

A. Informed Consent Form… ............................................................................... 260
B. Demographics................................................................................................... 265
C. Experiences in Sex Work with Services and OnlyFans ................................... 268
D. Multidimensional Scale of Perceived Social Support ...................................... 275
E. Rosenberg Self-Esteem Scale ........................................................................... 276
F. Meaning in Life Questionnaire ......................................................................... 277
G. Open-Ended Questions for Thematic Analysis ................................................ 278
Sex Workers on OnlyFans 1
Chapter I: Introduction and Review of the Literature
Introduction
Sex work is work. Though the definition of sex work has historically been as contested as
its legal and moral status, for all intents and purposes, sex work may be defined as an individual
adult attending to the sexual desires of another individual or individuals through various means
of labor or services in exchange for money or something else of value, with all parties involved
consenting and in agreement to the verbal or written contract of the individual who produces
labor. Traditionally, sex work is thought of as an individual’s labor being directly linked to
providing bodily acts or sex. However, such a limited concept falls into a heteronormative,
phallocentric definition of sex work where the buyer is always a cisgender man and the seller is a
cisgender woman who are physically meeting. Even this definition, as far-reaching and flexible
as it tries to be, fails to account for how sex work is contextualized through historical and
cultural precedents. Patriarchal United States society has historically condemned and ostracized
cisgender women who have “a lot of” sexual partners by labelling them “whores” or
“prostitutes” (Scibelli, 1987). As in the ancient Babylonian empire (1895 B.C.E. – 539 B.C.E.),
colonial British-occupied Kenya (1920 – 1963), and elsewhere around the present world,
exchanging sexual acts or labor for money of other things of value can be linked to spiritual
development, the maintenance of a household, or for other cultural practices (Shrage, 1994).
Sex work is work whether it takes place in a physical location (e.g., on the streets, bars,
clubs, cinemas, brothels, strip clubs, and massage parlors), through a hybrid online-physical
mode (e.g., online escorting, BDSM and dominatrix arrangements, and sugar
daddy/momma/baby arrangements), or exclusively through online or mobile technology (e.g.,
webcam modeling, findomme and cash slave arrangements, and phone sex operators). Sex work
may also include those who perform on stage such as burlesque dancers, those who model for
magazines, websites, and other independent photographers or agencies, and many of the
professionals – not just limited to actors - within the adult film industry. What is considered sex
work is becoming more expansive while modern societies continue to selectively legitimize
certain forms of sex work judicially and culturally according to who it benefits most. For
example, a cisgender woman who consensually contracts to be paid for having sex with a
cisgender man is at risk for being arrested, prosecuted, and convicted of prostitution or any of its
associated laws. Consequently, she may be denied admission to colleges, or she may struggle to
successfully apply to jobs to exit sex work. However, adult film companies that pay state and
federal taxes and comply with policies and regulations are paying individuals to act in front of a
camera and not to have sex. These companies likewise produce more taxable income through
their film sales, online subscriptions, and merchandise. The difference here is that the former is
disenfranchised for producing labor characterized by providing a sex act, a performance in which
the client experiences participating in a sexual act through the illusion produced by the sex
worker, and the actors’ artistic expression in the latter is protected under the First Amendment of
the United States (HG.org Legal Resources, 2021; Zatz, 1997). That is to say that there is no
difference.
Today’s patriarchal, hegemonic United States culture under a neoliberal capitalist legal
regime continues promoting the notion that sexuality and money should and cannot mix (e.g.,
“don’t mix business and pleasure” and “money can’t buy you love”) as money, commerce, and
contracts are attributed to the public realm, and intimacy, desire, and pleasure are attributed to
the private realm of familial and other affective relationships (Olsen, 1983). The irony here is
that neoliberal capitalism’s values of economic growth and hyper-individuality have significantly
erased traditional forms of community and home life, thus facilitating intimacy and community
to become more inexplicably tied with sexuality: sex is now a significant form of cement that
binds people together against the self-interestedness of economic markets and the dividing forces
of neoliberal capitalism (Weeks, 1985; Zatz, 1997;). The market and workplace are structured by
desires just as private relationships organize productive and reproductive labor crucial to the
functioning of markets: neoliberalism privileges those whose desires and relationships conform
to having utility for its continuation and punishes groups, like sex workers, whose labor is
delegitimized and devalued because it is an expression of desire within private relationships
(Ferguson, 1989).
Sex work challenges whether an action or form of labor can be identified as simply a
market transaction or the realization of private desire and encourages one to consider power
relations - in terms of consent, choice, who is “really” in control, and what is “actually”
happening - to be based on the significance and meanings both parties bring to these actions
rather than to assume that both parties experience the same event identically (Scott, 1992). As
the erotic significance of sexual acts is dependent on specific contexts, individual desires, and
unarticulated assumptions about the act’s significance for others, and as sex workers often learn
to de-eroticize sex acts when acting in a professional capacity, sex workers’ take power by both
transgressing the barrier between the spheres of sexuality and work and by subverting the notion
that sexual acts cannot be separated from sexuality (Zatz, 1997). If the sexualization and
criminalization of sex work acts to separate it from the legitimate world of business and to
symbolically bifurcate the domains of sexuality and economy, then sex work’s sexualization and
criminalized status reflects society’s deeply felt anxieties about cisgender women “trespassing”
the boundaries between the private and public spheres (McClintock, 1992). Moreover, sex work
contests hegemonic constructions of sex and sexuality that enforce the political and patriarchal
institution of heteronormativity, as sex work is sex without reproduction, sex without desire, sex
without identity, and sex without sexuality; sex organizes a sex worker’s labor and not a sex
worker’s desire (though these features or pleasure for itself can be present or organizing
principles, but they are not universal) (Zatz, 1997).
Considering sex workers’ own understandings of their lives, and their ways of life as
organized by their understandings, is critical for any serious analysis or research on the subjects
of sex work and sex workers, regardless of discipline or intentions. Most of contemporary
medical, psychological, and public health research on sex workers focuses on topics of risk
behaviors, human immunodeficiency virus (HIV) and sexually transmitted infections (STI)
acquisition and transmission rates, alcohol and substance abuse rates, experiences of sexual and
physical violence, and other adversities that negatively impact sex workers’ health and quality of
life. There is less investigative attention given to the lived experiences of sex workers engaging
in more periphery modes of sex work than those who engage in outdoor or street-based sex
work, due to street-based sex workers being one of the most visible sex work populations. A new
form of sex work is being a content creator on OnlyFans.com, a social media website where
content creators set a monthly subscription fee and upload explicit content and engage with their
fans through live streams or having conversations over private messaging. With its seamless
integration and normalization on other social media platforms, especially Twitter.com,
individuals who may never have engaged in any other form of sex work otherwise are now
utilizing OnlyFans as a means of a primary or supplemental income. Likewise, Twitter users are
now more likely than ever to follow and/or engage with OnlyFans content creators either through
their main or “alt” accounts (i.e., a Twitter account commonly dedicated to following explicit
accounts and/or posting one’s own explicit content) as part of their routine social media
consumption. In the zeitgeist of social media influencers, sex positivity, and the gig or side-
hustle economy, OnlyFans content creators are making sex workers and the injustices sex
workers face more visible and more accessible in an unprecedented fashion. As there is little to
no research on the phenomenon of OnlyFans from the field of clinical psychology, this current
research study seeks to address four main questions:
1. What are the demographic trends of sex workers who are OnlyFans content creators from
a random online sample?
2. What correlational trends can be found in how OnlyFans content creators’ identities as
sex workers impacts their experiences accessing common services?
3. What correlational trends can be found in OnlyFans content creators’ rates of perceived
social support, self-esteem, and presence of and search for meaning in their lives?
4. What common themes can be elucidated from OnlyFans content creators’ experiences
and perceptions of their online community of content creators and followers on Twitter?
This exploratory research study seeks to investigate the lived and online experiences of
sex workers on OnlyFans who promote their content on Twitter. From this investigation, this
research study has several other informal aims: 1) to provide a platform for OnlyFans content
creators to speak of experiences and perspectives to inform a policy brief on how nonprofit sex
work organizations ran by sex workers can best uplift and support the OnlyFans community; 2)
to positively contribute to current research and discourse on sex workers and the sex work
industry by providing a nuanced understanding of this unique, online mode of sex work; and 3)
to inspire future research for developing effective community and clinical interventions for
online sex workers.
The following part of this chapter is a review of literature that provides a through line for
how OnlyFans became the next logical iteration of sex work. First, an overview of the history of
sex work throughout western history from 2400 B.C.E. to the present-day United States of
America sheds light on how sex workers have accomplished taking control of narratives of sex
work after being historically shaped by cisgender men in positions of power for millennia.
Second, a contemporary analysis of how sex workers’ experiences of accessing common services
being intertwined with experiences of stigma and discrimination is provided. In addition, how
any society or nation can improve sex workers’ health and quality of life in improving service
accessibility and reducing societal discrimination is addressed. Third, a review of the
biopsychosocial factors influencing and impacting cisgender men sex workers who have sex with
men as an under-researched sex worker subpopulations is provided. Fourth, it is explained what
OnlyFans comprises and how it came to be ubiquitous or socially accepted on Twitter since its
founding in 2016. Finally, neoliberalism and the dual celebritization and pornification of modern
western society is explained and utilized as lenses for understanding how online personas are
constructed and how sexuality is marketed on social media.
At the conclusion of the literature review, specific hypotheses and their predictions for
this research study will be stated. Afterwards, the methods for the research study will be
explained. Inclusion and exclusion criteria for participants, measures for the survey, procedures
and phases of the research study will be outlined, and the proposed analyses of the data collected
will be provided. Furthermore, results from the quantitative analyses and thematic analyses will
be provided followed by a discussion that aims to give explanations for how the results do and
do not meet predicted hypotheses, as well as explaining the limitations for this research survey.
Review of the Literature
An Overview of Sex Work Throughout Western History and in the United States.
Prostitution in western history from 2400 B.C.E. through the 16th century C.E.
OnlyFans stands on the shoulders of predominantly cisgender women throughout history
who have pursued sex work for survival, for a means of living, and for emancipation in men-
centric societies that have deemed women the inferior gender for millennia. Understanding the
history of sex work as a struggle for women’s liberation for labor equality and the right to sexual
expression provides a framework for better understanding how OnlyFans is revolutionary for
furthering the cause of sex workers’ rights as worker and labor rights. If prostitution is “the
world’s oldest profession,” then it is critical to understand how societal attitudes and norms have
fluctuated throughout western history to arrive at this present moment when sex workers are,
more than ever, able to take control of a narrative that has been traditionally defined by men in
positions of power within governments and organized religious orders.
The earliest written record of prostitution is from around 2400 B.C.E. from the Sumer
civilization founded in the Mesopotamia region of the Fertile Crescent between the Tigris and
Euphrates rivers, including parts of the modern countries of northern Egypt, Iraq, Israel, Jordan,
Lebanon, and Palestine. Considered the creators of civilization as modern humans understand it,
the Sumerian word for “female prostitute” occurs in the earliest lists of professions alongside
other female occupations: “lady doctor,” “scribe,” “barber,” and “cook” (Lerner, 1986). It is
assumed that this iteration of prostitution is connected to temple service, whereas male
prostitutes were connected to entertainers such as the Cult of Ishtar, in which both men and
transgender performers entertained the general public with various acts.

After the Babylonian Empire was established in Mesopotamia, its sixth king, Hammurabi
(c. 1810 – c.1750 B.C.E.), enacted the Code of Hammurabi in about 1754 B.C.E., with six of the
282 codes (i.e., about 2% of all codes) specifically mentioning the rights of prostitutes or the
children of prostitutes. For example, Code 192 states: “If a son of a paramour or a prostitute says
to his adoptive father or mother: ‘You are not my father, or my mother,’ his tongue shall be cut
off.” (King, 1910). The Code of Hammurabi is one of the oldest deciphered writings of
significant length in the world and the first to describe how prostitutes’ standing in a society was
regulated.
Legal brothels came into fashion by the seventh century before the common era. Chinese
statesman-philosopher Kaung Chung (710-645 B.C.E.) started legal brothels around 600 B.C.E.
as a means for increasing his state’s income just as Athenian lawmaker and poet Solon (c. 630 -
c. 560 B.C.E.) founded state brothels and taxed prostitutes on their earnings during the fifth
century B.C.E. (Bullough and Bullough, 1978; Vallely, 2006). Athenian prostitutes’ fee for sex
was about the equivalent of an ordinary worker’s day salary. With brothels made legal,
regulating prostitution became easier for governing bodies, which in turn provided legitimacy to
prostitution as an income source (Firebaugh, 2010). By the first century C.E., Roman Emperor
Caligula (12 - 41 C.E.) enacted a tax upon virtually all professions, including prostitutes, to
generate as much revenue as possible for his military and infrastructural programs to win over
the masses (Firebaugh, 2010). Though Caligula may have been partially inspired to include
levying a tax against prostitutes due to the collective treatment of prostitutes as disgraced
persons, the tax provided a further degree of legitimacy to prostitution without seriously harming
the profession in any material sense.

Roughly throughout the Medieval Period from the sixth through 15th centuries (i.e., c.
500 – c. 1500 C.E.), Europe’s feudalistic systems of government fluctuated in their practices of
punishment, regulation, and prohibition of prostitution until the Great Pox (i.e., syphilis)
outbreak began in the 1490s. Some heads of states likely sought to criminalize and punish
prostitutes based on the rising influence of Christianity’s belief systems becoming inseparable
from how the nobility ruled. As the prevailing belief throughout the Medieval Period was that
scaring peasants with harsh punishments was the only way for the nobility to maintain power,
being convicted of prostitution was no exception to this belief system. For example, girls and
women living in the Visigothic Kingdom of Spain in the late 500s C.E. who were convicted of
practicing prostitution were condemned to be flogged with 300 strokes and then banished from
their hometowns (Mizuta and Mulvey-Roberts, 1994). In 1158 C.E., Holy Roman Emperor
Frederick Barbarossa (also known as Frederick I) (1122 – 1190 C.E.) ordered that prostitutes
who traveled alongside his army and were caught in the act to have their noses cut off to make
them less attractive; soldiers caught with prostitutes often had finger cut off or an eye removed
(Hardaway, 2003). In 1161 C.E., King Henry II of England (1133 – 1189 C.E.) permitted the
regulation of London’s brothels under stipulations such as prohibiting forced prostitution,
allowing weekly searches by constables, mandated closings on holidays, and prohibiting
prostitutes from living in brothels or to be married (Evans, 1979). King Louis IX of France (1214
– 1270 C.E.), a devout Catholic, in 1254 C.E. ordered the expulsion of all “women of evil life”
from his kingdom and the confiscation of their belongings, including their clothes, to “extirpate
evil root and branch” (Rossiaud, 1988).
Once the Great Pox began laying waste within Renaissance Europe in 1495 C.E. for
nearly a century, an anti-prostitution stance emerged again emerged due to the recognition of the
venereal nature of the disease, combined with the later moral fervor of various 16th century
Protestant Reformers such as Martin Luther and John Calvin (Bullough and Bullough, 1978).
King Henry VIII of England (1491 – 1547 C.E.) decreed the end of English “tolerance” and
regulation of prostitution in 1546 C.E. to combat the continued Great Pox outbreaks within his
kingdom, referring to them as “dissolute and miserable persons” (Kelly, 2000). Come 1586 C.E.,
punishment against prostitutes increased in severity when Pope Sixtus V (1521 – 1590 C.E.)
declared that prostitution was a “sin against nature” and those convicted of prostitution
throughout the Catholic world would be put to death. Similarly, Lutherans continued shaving off
both the hair and ears of prostitutes while Calvinists branded prostitutes and forced them to carry
large stones around public spaces (Ringdal, 2004).
Prostitution and sex work from colonial America to the present-day United States.
Until World War 1 in 1914, prostitution was not an offense in American common law
and was generally regulated as a sort of vagrancy (Miller, Romenesko, and Wondolkowski,
1993). As the American colonies were first settled, its population consisted of a vast majority of
European men and a small number of women (Jackson, 2004). Of course, some of these women
were also prostitutes. Prostitution was considered lucrative given that the vast majority of men
did not bring their wives and/or children to the New World due to physical and economic
hardships involved in travelling and settling land. This newfound sex trade would expand
alongside the growth of trading between the colonies and other nations as merchants and sailors
increased how frequently they visited. These women also experienced a degree of freedom that
would have been out of reach had they not migrated. Instead of being charged for prostitution as
laws and customs were introduced in time, women would be charged with breaking laws against
adultery, fornication, or for being “common nightwalkers” with immoral intentions. For
example, Massachusetts’ colonial assembly enacted a law against nightwalking in 1699,
reenacted the law via state legislation in 1787, and only in 1917 did Massachusetts make
prostitution itself punishable. However, these laws were largely disregarded by women and their
law enforcement was generally lax.
By 1816, the Boston Society for Moral and Religious Instruction of the Poor had been
formed in response to the majority of prostitutes working in lower-class neighborhoods. The
group estimated that about a million dollars a year (the equivalent to $15 million in 2020 when
adjusted for inflation) was being spent on prostitution and sought legislative reform due to
fearing that the sons of the middle class were spending their inheritance on prostitutes rather than
preserving family estates. As women who were prostitutes continued establishing their personal
and financial autonomy, growing moral codes and increased public awareness objected to the
availability of sex for sale or trade. Colonial society regarded prostitution as a moral infraction
rather than a crime, possibly due to believing that women were morally inferior to men.
By the mid-19th century at the onset of the Victorian era, the Age of Steam made it
possible for large numbers of people to move about the globe freely in a way that was previously
unprecedented in human history (Abramitzky et al., 2012). Railroads and steamships made it
relatively inexpensive for individuals or families seeking a better life to go anywhere where a
better life may be found; gone were the days of dangerous and slow overland traveling (Willis,
2005). With Chinese immigrants moving in mass to California by the 1850s, Americans (i.e.,
white Anglo-Saxon, Protestants who politically and culturally dominated the country at the time)
feared them because of differences in cultural practices and blatant racism rooted in white
supremacy. As many Chinese women immigrants were prostitutes or second wives in

polygamous marriages, Congress passed the Page Law in 1875 to ban the immigration of women
for “lewd and immoral purposes” (Lui, 2009). However, the law backfired in that it did not
prevent Chinese men from immigrating to the United States. Due to the exclusion of Chinese
women, these men either patronized white prostitutes, established small brothels, and/or married
or cohabitated with working-class white women. Needless to say, the seeds of moral panic were
sown.
In addition to moral panic and the general public’s morality being scandalized by non-
white individuals seeking to improve their socioeconomic status and women seeking self-agency
through prostitution (among other means), Americans also had to navigate a collective extreme
cognitive dissonance given the Victorian view that women were intrinsically asexual (McNeill,
2011). Said cognitive dissonance was reconciled through the popular and racist scholarly
position (read: the scholarship of white men) that prostitutes are a regressed “primitive” type of
woman. Thus, white women – especially those of middle-class educations - choosing prostitution
on their own volition was unimaginable to increasingly popular “rescue” movements (Bland,
1992). Whereas men took the position that women chose prostitution because they were
inherently immoral and primitive, women reformers identified prostitution as the corruption of
young girls by men-seducers. Specifically, as women reformers adopted prostitution reform in
the early 1830s during the Second Great Awakening religious movement, they blamed men for
the conditions that facilitated prostitution. The Moral Reform Society, based in New York,
issued this statement in 1835: “Let the condemnation of the guilty of our sex remain entire; but
let not the most guilty of the two – the deliberate destroyer of female innocence – be afforded
even an ‘apron of fig leaves,’ to conceal the blackness of his crimes” (Hill, 1993).
Simultaneously, movements were forming to protest the monopoly of professions by men, and
reasoning followed that women without financial and family resources were easy targets for
men's predatory nature due to having few alternative sources of income. This ideology resulted
in two courses of action: helping women “escape” prostitution, and ostracizing men who
provided the demand and the finances needed for a viable sex industry (Rosen, 1982). This myth
of “white slavery” and exploited young women appealed to the middle-class’ discomfort with
women’s autonomy: women did not leave home to travel to cities and/or decide to do a form of
labor that paid more than traditional “women’s” work that offered better conditions - they were
absolutely manipulated or seduced against their wills by evil, more competent men (Roberts,
1992). The general public’s moral panic to rescue women from prostitution and their own
cognitive dissonance was reinforced through media. “White slavery” became increasingly
popular subjects and themes in books, plays, and motion pictures: between 1890 and 1909, 36
entries in Readers’ Guide to Periodical Literature appear under the heading “prostitution;” 156
entries appear under the same heading between the years 1910 and 1914 (Langum, 1994).
The frenzy over “white slavery” resulted in Congress passing the 1910 White Slave
Traffic Act (also known as the Mann Act) to make “prostitution or debauchery, or…any other
immoral purpose” illegal. Before the act was passed, prostitution itself was not illegal in any
state; by the end of 1914, it was illegal in all 48 states. This act discriminated against the
increasingly large number of women who were employed in brothels that provided comfortable,
safe environments for conducting their labor, while also rupturing the steady stream of revenue
for local governments. “Parlor houses” like New Orleans’ Mahogany Hall and The Arlington,
Chicago’s Evenlight Club, and Washington D.C.’s Mary Ann Hall’s were their times’ equivalent
to present-day Las Vegas, with entertainment for adults where sex was only but one of the
attractions. Prostitutes were to be marginalized, persecuted, and conduct their labor from the
shadows from this point onward within the United States in a similar fashion to drinking alcohol
with Prohibition enacted in 1920. Although Prohibition would be repealed only 13 years later in
1933, the criminalization of prostitution has been relegated to the collective American conscious
as simply being the way things have always been.
Moral panic over “white slavery” and the passage of the White Slave Traffic Act was
also aided by the popularity of germ theory, leading to a social hygiene ideology spreading
throughout the United States in the early years of the twentieth century. In 1913, the American
Social Hygiene Association (a merger between the American Vigilance Association and the
American Federation for Sex Hygiene) was formed to advocate sexual restraint for men and
women; several cities also implemented sex education in schools while avoiding the mention of
actual sexual acts (Carter, 2001).
“Immoral” women were thus targets of public ridicule in the states and abroad during
both World Wars, with soldiers’ sex lives becoming increasingly a national concern. Posters
equated prostitutes to enemy combatants, asserting “most prostitutes (private or public) have
either syphilis or gonorrhea or both” and claiming, “you can’t beat the Axis if you have the VD”
(University of Minnesota: University Libraries, 2003). Regardless of the propaganda against
prostitution and urging of soldiers to serve their country by remaining sexually pure, soldiers
continued hiring prostitutes who could be found near military bases. In 1918 in the final months
of the first World War, Congress passed the Chamberlain-Kahn Act that led to the mass
imprisonment of women believed to be sexually immoral without due process. Under the act, the
federal government quarantined “for the protection of the military and naval forces of the United
States” any woman suspected of having venereal disease; discovery of a venereal infection upon
a forced medical examination constituted as proof of prostitution (Connelly, 1980). Women were
locked away in penal institutions for a matter of days or months, subjected to being injected with
mercury and/or forced to ingest arsenic-based drugs for treating syphilis, and were at risk for
being physically abused, doused with cold water, placed in solitary confinement, or medically
sterilized for failing to demonstrate “proper ladylike deference” (Stern, 2019). Many women
were detained for refusing police and health officials’ demands to have sex, and women of color
and immigrant women were more likely to be targeted and subjected to a higher degree of abuse
once detained. Enforcement of the Chamberlain-Kahn Act ended by the 1970s amid the rise of
the Civil Rights Movement, women’s liberation movement, and sex workers rights movement.
However, every state in the nation has absorbed or amended similar laws as part of broader
public-health statutes. Prostitution continued operating from the shadows for the decades to
come; sex could be purchased through massage parlors and/or through looking for customers at
bars and hotels, and the 1950s saw the rising popularity of escort services. Law enforcement
mostly focused on street workers, the smallest (i.e., roughly 15 percent of all American
prostitutes at the time) but the most visible segment of prostitutes (Prostitutes’ Education
Network, 2013).
As second wave feminism began in the 1960s with Betty Friedan’s The Feminine
Mystique (1963) selling over 3 million copies in its first three years, scores of middle-class white
women became unified in seeking not just political equality as first-wave feminism fought for,
but for social equality as well (Grady, 2018). Feminists encouraged women to assume
responsibility for issues that affected them. The feminist movement facilitated major legislative
and legal victories: The Equal Pay Act of 1963 theoretically outlawed the gender pay gap; the
Supreme Court ruled in Griswold v. Connecticut in 1965 that married couples have the right to
use birth control; the Supreme Court ruled in 1972 in Eisenstadt v. Baird that birth control was
legally accessible for unmarried couples; Title IX of the Education Amendments of 1972
prohibited sex discrimination in any education program receiving federal financial assistance;
and the Supreme Court ruled in 1973’s landmark Roe v. Wade that women were guaranteed the
liberty to have an abortion without excessive government restriction (Grady, 2018).
In 1973, Margo St. James (1937 - 2021), a prostitute and sex-positive feminist, declared
that women needed the right to privacy regarding not just birth control and pregnancy, but also
sex, regardless of whether it was purchased (Jackson, 2004). She thus founded COYOTE (Call
Off Your Old Tired Ethics) to pressure San Francisco officials to abolish prostitution laws that
discriminated against women in general and Black women specifically. COYOTE argued that
women of color prostitutes were subject to increased targeting from police harassment and arrest
due to social inequalities facilitating them having fewer resources through which they could
enter more private businesses such as escort services as opposed to street working. The
Prostitutes’ Education Network explains that:
for many women, because of poverty and lack of alternatives,

prostitution has been their only option, yet the system targets
Black women for punishment. The laws against prostitution are
Enforced disproportionately against women of color. Although 20
to 30% of prostitutes are women of color, the vast majority of these
sentences to jail time are women of color [sic].
(Prostitutes’ Education Network, 2003)
One of Margo St. James’ most impactful contributions for legitimatizing prostitution was
beginning to refer to prostitution as sex work to acknowledge women’s labor as part of a larger
sex industry. Movement leaders insisted that sex labor was considered equal to any other work
that a woman or man may provide. Just as sex work includes the selling of mental, emotional,
and physical labor, so too does the psychologist sell their interpersonal skills, the teacher sells
their instructional skills, the copywriter sells their creativity, and the coffee barista sells their
food safety and hygiene skills (Jenness, 1993). St. James and other movement leaders also
sought to combat the infantilizing discourse of sex workers as helpless victims, as this ideology
demands sex workers leave the industry without offering real solutions to the problems that
women face outside of sex work (i.e., high divorce rates, unequal pay, the pink tax, and the
feminization of poverty).
St. James, alongside COYOTE founding member Priscilla Alexander, founded the North
American Task Force on Prostitution in 1979 to be an umbrella and information network for sex
workers and sex workers rights advocates in the United States and Canada. Similar groups to
COYOTE formed with names to describe their goals of sex work reform and employing
interesting acronyms to generate curiosity among the public. Some of these groups include:
FLOP (Friends and Lovers of Prostitutes); HIRE (Hooking is Real Employment); PUMA
(Prostitute Union of Massachusetts Association); DOLPHIN (Dump Obsolete Laws; Prove
Hypocrisy Isn’t Necessary); PASSION (Professional Association Seeking Sexual Identification
Observant of Nature); and SPARROW (Seattle Prostitutes Against Rigid Rules Over Women).
This network provided the framework for sharing information within and between organizations
and for providing resources for sex workers in their communities, such as legal counsel, safety
advice, health clinics, and crisis hotlines. Moreover, these organizations have been instrumental
in lobbying for sex work reform through traditional efforts such as letter-writing campaigns and
more radical activism. COYOTE organized the first annual Hooker’s Ball in 1974 in San
Francisco, billed as “the social event of the year for heterosexuals, bisexuals, trisexuals,
nonsexuals, homosexuals, and other minorities who feel discriminated against” to fundraise for
COYOTE’s advocacy efforts, newsletters, and bail funds (Chateauvert, 2014). St. James gained
international prostitute networks’ support through organizing the International Committee for
Prostitutes’ Rights, which later hosted two World Whores’ Congresses in 1985 and 1986
(Jackson, 2004). COYOTE presented a Bill of Rights to the congresses that would be
incorporated into a formal ideology and course of action (Pheterson, 1989). This sex workers’
ideology and reasoning behind their goals include:
1. Laws against women have historically been used to harass and oppress
women in the sex industry, not the men who are customers. This means that
laws against prostitution almost amount to de facto laws against women.
2. Laws against activities associated with prostitution also become de facto laws
against women, for example, laws against running a brothel…Such laws effectively
deny prostitutes the right to work indoors in a warm, safe, and clean place.
3. Antiprostitution [sic] laws ensure that prostitutes will be unable to report violence
committed against them to the police…Prostitutes who complain to the police are
likely to be further abused.
4. Criminalizing prostitution has driven the profession underground and resulted in

horrible working conditions for the women involved. Its black-market nature attracts
other illegal activities to the trade.
5. Antiprostitution [sic] laws function as a form of censorship against women, because

they keep prostitutes from speaking up for fear of being targeted by police.
6. To the extent that prostitutes create a public nuisance, laws already exist to prevent
these problems. (McElroy, 1996).
It is an understatement to say that second-wave feminism gave sex workers and sex work
reformers a tremendous platform to protest laws, promote self-advocacy and self-agency, and
provide opportunities to ally with less radical political groups such as the National Organization
for Women (Jenness, 1993). Nevada legalized closed brothels in 1971 and in 1976, COYOTE
filed a lawsuit that in 1980 lead to a settlement which decriminalized prostitution in Rhode
Island until it was re-criminalized by new legislation in 2009 (McNeill, 2013). However, the rise
of the HIV and acquired immunodeficiency syndrome (AIDS) epidemic beginning in 1981
would halt much of the sociopolitical progress made by COYOTE and other organizations as sex
workers and gay men would be scapegoated by Presidents Ronald Raegan (1981 – 1989) and
George H. W. Bush Sr.’s (1989 – 1993) administrations and the general public. The halting of
sex reforming also coincided with the end of second-wave feminism as the Reagan
administration positioned feminists as humorless, hairy-legged, bra-burning, lonely, man-hating
women (Grady, 2018). This opened opportunities for conservative organizations such as
WHISPER (Women Hurt in Systems of Prostitution Engaged in Revolt) and CWA (Concerned
Women for America) to lobby against the progress made for sex work reform, seeking to
promote further criminalization and discrimination against women sex workers but,
coincidentally, not the men who purchase sex.
The increasing access and utilization of the internet beginning in the late 1990s and
throughout the first twenty years of the 21st century has facilitated a prominent return to sex work
reform efforts. The internet has made advertising and client screening for sex workers more safe,
affordable, and easy, has enabled sex workers to work independently out of sight of the police
and off the streets, and has allowed sex workers and sex work organizations to speak for
themselves and reaching a wider audience through social media and blogging. Simultaneously as
sex workers are able to directly share their experiences and dispel myths so as to educate the
general public about their lives and labor, so too are conservative organizations like CWA
doubling down on their efforts in promoting another iteration of the “white slavery” narrative.
Modern sex work reform progress has been slow. On Election Day in 2004, Berkeley,
California voted 63.51% against decriminalizing prostitution whereas Churchill County in
Nevada voted 62.78% to keep brothels legal despite no brothels existing in the county at the
time. (Churchill Official General Election Results, 2004; City of Berkley General Municipal
Election, 2004). In 2007, Hawaiian state legislators sought to propose House Bill 982 to
decriminalize certain sexual favors done in private and designate areas where prostitution was
allowed; the bill ultimately did not receive a hearing (Niesse, 2007). On Election Day in 2008,
the city and county of San Francisco voted 57.56% to 42.44% against a ballot measure that
would decriminalize prostitution by stopping the enforcement of laws related to prostitution and
sex workers (City and County of San Francisco 2008 Election Results, 2008). Though these
tallies indicate that the general American population is more open to the idea of decriminalizing
sex work, there is much further work to be done to enact local, state, and federal protections for
sex workers through decriminalization and resource allocations.
In 2012, the United Nations adopted a policy encouraging the decriminalization of sex
work after a plethora of countries had already decriminalized, legalized, or regulated sex work
either entirely or through banning the purchase but not the sale of sex: Sweden and Denmark in
1999; the Netherlands in 2000; Germany in 2002; New Zealand in 2003; and Taiwan in 2009
(British Home Affairs Committee, 2016; Broomby, 2001; How Sweden tackles prostitution,
2007; Netherlands Ministry of Foreign Affairs, 2005; NZ votes to legalize prostitution, 2003;
Pressured by sex workers, Taiwan OKs prostitution, 2009). Furthermore, since the United
Nations’ resolution in 2012, both Canada and France have banned the purchase, but not the sale,
of sex in 2014 and 2016 respectively (Kaye, 2015; Sydney Morning Herald, 2016).
Currently, one of the biggest threats to the safety of sex workers and their income in the
United States has been the passing of FOSTA-SESTA (i.e., the House of Representative’s Fight
Online Sex Trafficking Act and the Senate’s Stop Enabling Sex Traffickers Act) that was signed
into law in July 2018 under President Donald Trump’s administration (2017 - 2021). FOSTA-
SESTA seeks to extricate illegal sex trafficking online through creating an exception to Section
230 of the 1996 Communications Decency Act. Section 230 states, “no provider or user of an
interactive computer service shall be treated as the publisher or speaker of any information
provided by another information content provider,” meaning that internet service providers and
websites are not responsible for user-generated content. FOSTA-SESTA’s exception to Section
230 is that website publishers would be responsible if its users are posting ads for prostitution
and consensual sex work, with the intention being to better police online prostitution rings
(Romano, 2018). However, the law’s sweeping language has led to numerous websites censoring
or banning parts of their platforms due the challenges involved in policing its content and
seeking to avoid litigation. The law’s language penalizes websites that “promote or facilitate
prostitution” and allows authorities to take legal action against websites for “knowingly
assisting, facilitating, or supporting sex trafficking.” Thus, FOSTA-SESTA does not target
illegal sex trafficking directly and has led to an increase in censoring free speech across the
internet. In the wake of the law’s passing, Craigslist removed its personals section from its
website; Cityvibe, a long-standing escort service, shut down; Pounced.org, a dating site for the
furry community, shut down; Reddit banned multiple subreddits, including r/escorts,
r/maleescorts, r/hookers, and r/SugarDaddy; and both Google and Microsoft began reviewing
and deleting content directly off of its users’ cloud storage products (Romano, 2018). The SAFE
SEX Workers Study Act was introduced in the House of Representatives at the end of 2019 to
direct the Secretary of Health and Human Services to conduct a study to assess the impacts on
the health and safety engaged in transactional sex since FOSTA-SESTA’s passing, but the bill
has not gone further thus far.
Since at least the emergence of human civilization, sex work has been part of its fabric.
Throughout the vast majority of this history, sex work ideology has been dictated by men in
charge of organized religious and political institutions, with attitudes fluctuating between treating
prostitution and sex work as a nuisance, a misdemeanor, a crime, a necessary burden, a source of
government revenue, an immoral act, a vice, and a form of slavery. These ideologies have built
on top of each other and have dictated the terms by which sex workers perform their labor. It is
only in the last 60 years or so that sex workers have formally organized around their fight for
social, political, and economical justice in sex work reform and decriminalization, re-
appropriating their plight as an issue between workers and governments, as opposed to between
the morally pious and the immoral, for the right to privacy and sexual freedom. If men have
controlled the narrative around sex workers for millennia, then it is not surprising that further
suppression and demonization of sex workers would emerge through reactionary legislation as
sex workers seek their liberation and emancipation through the internet, even if it leads to
widespread censorship in violation of the First Amendment. A democratized, subscription-based
service and social media website like OnlyFans may thus be considered a logical next step
towards sex workers’ liberation.

Services accessibility and discrimination.
Across psychological, sociological, public health, ethnographical, epidemiological,
jurisprudence and criminology, feminist studies, and related disciplines’ literature, it is well
documented how sex workers are among the most historically vulnerable and marginalized
groups in society regardless of their respective countries’ criminalization status. The complex
interaction of intrapersonal, interpersonal, community, institutional, and policy factors, coupled
with the influences of societies’ morality towards sexuality and attitudes or fears towards
cisgender women’s sexuality and autonomy (as most sex workers are cisgender women)
facilitates a victim-criminal paradox. Sex workers are simultaneously imagined within the public
psyche as helpless victims who do not have any other choice but to sell their sex due to
unfortunate circumstances and need rescuing, and they are vice-ridden, drug-addicted “happy
hookers” engendering more serious crimes who deserve to be taught a hard lesson, taken off the
streets, and sent to prison indefinitely.
This paradox extends itself to sex workers’ working conditions and ability to access
services: sex workers are exposed to copious occupational health and safety risks yet face serious
barriers to accessing services. When accessing services, their needs may be ignored or their
reasons for seeking services may not be believed; they may be arrested, prosecuted, and/or
sentenced by sharing their job title; they may receive less than adequate services due to
discrimination and whore stigma; they may be outright denied services; and/or they may have
violence perpetrated against them. This literature review first examines sex workers’
relationships and experiences accessing common services of the legal system, law enforcement,
medical and mental health care settings, and shelters and second, explains how to improve sex
workers’ ability to access services and reduce societal discrimination.

Legal systems.
As alluded to, there are five legislative models for managing, controlling, or regulating
sex work (Phoenix, 2009). Full criminalization prohibits all organizational aspects of sex work
and the selling and buying of sex; partial criminalization penalizes some aspects of sex work
(e.g., soliciting sex in public); criminalization of the purchase of sex penalizes clients buying sex
and sex workers who work together under third-party laws; regulation only permits the sale of
sex in certain settings or under certain conditions; and full decriminalization removes all criminal
penalties for adult sex workers and prohibits violence and coercion against sex workers (Platt et
al., 2018). With sex workers’ interdependent health risks and occupational hazards
multideterministic and closely linked to poverty, substance abuse, disability, immigration,
sexism, racism, homophobia, and transphobia, each legal regime uniquely impacts sex workers’
health and welfare and influences their experiences of structural inequalities via policing,
vulnerability to HIV and STI acquisition, violence, access to health care, and a diminished ability
to pursue justice.
Full or partial criminalization models compromise street-based sex workers’ safety by
displacing them to work from isolated areas due to the fear of arrest. In rushing client screening
and negotiations, such as making a split decision to get into a potential client’s car, sex workers
are susceptible to violence and theft by individuals posing as clients or cops who may seek to
bribe, coerce, and/or rape a sex worker due to the power dynamics at play (Shannon et al., 2008).
Indoor sex workers’ ability to directly negotiate with clients are also impeded, and both indoor
and street-based sex workers are less able to effectively communicate with peers about sexual
health concerns and sharing information about clients, undercover cops, and other dangerous
individuals (O’Doherty, 2011). Additionally, sex workers under these legal regimes are at greater
risk for acquiring HIV and/or STI’s due to law enforcement’s ability to use a sex worker being in
possession of condoms as evidence of intent to engage in or solicit sex work; thus, sex workers
are less likely to carry, use, or negotiate for consistent condom use with clients (Anderson et al.,
2016). Full and partial criminalization legal regimes reproduce multiple stigmas and inequalities
that entrench sex workers as historically marginalized people further into socioeconomic
disparities of food insecurity, poverty, homelessness, and shorter life expectancies that are
further compounded by the effects of historical discrimination against sexual and gender
minorities, people who use drugs, women, people of color, formally incarcerated individuals, and
migrants (Krüsi et al., 2016; Shannon, 2008;).
Countries such as Australia and Mexico that regulate sex work increase sex workers’
control and sense of safety through working in regulated venues that provide alarms, fixed
prices, intercoms, mandated condom use, and an ability to work in proximity of other sex
workers and related third parties (e.g., bartenders, bouncers, madams, and security) (Brents &
Hausbeck, 2005). Regulation may provide some sex workers with a sense of protection whereas
others, especially those who use substances, may still seek street-based or unregulated venue
work where the issues of negotiation, control, and high-risk sexual behaviors arise once more.
Regulation via registration or licensing procedures put sex workers at risk for being financially
discriminated against through needing to disclose their work with banks that may in turn lower
their credit score or deny applications for loans (Ham & Gerard, 2014). Across regulated, fully
criminalized, and partially criminalized legal regimes, undocumented or unregistered migrant sex
workers are at risk for being exploited by clients or venue owners via refusing payment, by
landlords charging inflated rents, and they generally are reluctant to report violence and other
crimes they witness or are victims of due to fear of deportation or language barriers (Baratosy &
Wendt, 2017; Katsulis et al., 2010).
In New Zealand, the only country that has fully decriminalized sex work, cisgender
women sex workers report being better able to work safely with laws enacted to protect
them. These sex workers may work in less isolated areas and openly communicate with their
peers, directly negotiate services, refuse prospective clients, seek police to intervene if a client
becomes violent or refuses to pay, and police and sex workers may share information with one
another about incidents or violent or suspicious individuals (Abel, 2014; Armstrong, 2014).
However, the protections afforded by the laws have not eliminated experiences of discrimination
via individuals continuing to verbally and/or physically abuse sex workers (Armstrong, 2015).
The Joint United Nations Programme on HIV and AIDS (UNAIDS), United Nations
Population Fund (UNFPA), World Health Organization (WHO), Amnesty International
(Amnesty or AI), Human Rights Watch (HRW), the peer-reviewed medical journal The Lancet,
and virtually all sex work organizations ran by sex workers have called for nations to
decriminalize sex work to address global public health issues of the HIV/AIDS epidemic, sex
trafficking, alcohol-related harm and substance abuse, poverty, immigration, and food insecurity
(Shannon et al., 2018). Regulation- and criminalization-based legal regimes design their systems
to perpetuate these sociopolitical and socioeconomic conditions because the societies these legal
regimes operate within are responding to the stigma of sex work, which is also inherently the
stigma of sexuality and the stigma of women (MacKinnon, 1989). It is not the case that sex work
(nor expressed sexuality) as part of its character or product is harmful, but rather, it is the
criminalization and denigration of sex work that serves to marginalize, oppress, and constrain the
radical potential of sex workers when acknowledged as full citizens (Zatz, 1997). This regulation
and criminalization positions sex work within a cultural realm of a marginalized sexuality and
isolates it from the status of work, demonstrated by these legal regimes’ focus on sexually
transmitted diseases, ad nauseum reports by sex workers that police officers and/or judges state
that sex workers cannot actually be raped, and the frequent removal of sex workers’ children on
the basis of parental sexual misconduct (McClintock, 1992). Until the stigmas of sex work,
sexuality, women, and other gender and sexual minorities are successfully challenged and
addressed through legal systems, these aforementioned conditions will continue harming one of
the most historically marginalized groups as a blatant human and workers’ rights violation
against sex workers’ personal autonomy and privacy.
Law enforcement.
Criminal laws are the codifications of societal values providing the distinction between
acceptable and unacceptable behavior (Walker, 2008). Acts that produce physical harm or harm
to property are sanctioned because they are perceived to negatively affect society, involving both
an offender and victim; behaviors that are labeled as “victimless” or “vice” crimes (e.g., drug
use, sex work, and gambling) are criminalized because they are in opposition to a society’s
morals and virtues (Patrick, 1965). However, divergence between formal law and law
enforcement practice due to officers’ exercises of discretion creates significant gaps between the
standards of law and the outcomes produced by implementing agencies (Bardach, 1977).
Everyday policing, the socially ambiguous arena of regulating daily life in public places, is
guided more so by the “craft of policing” than mechanically applying delineated laws, with
police attuned to explicit and implicit power relations within the environment and seeking to
assess and address actions - both legal and illegal - within fluid street situations (Chan, 1996;
Ericson, 2007). Thus, law enforcement officers’: 1) internalization and perpetuation of

sexualized, racialized, and gendered stereotypes against women in general, women of color,
transgender women, and transgender women of color; 2) prescribed legal powers and obligation
to profile others; and 3) duty to enforce prostitution laws and associated laws against loitering,
loitering with intent to solicit, public nuisances, and disorderly conduct compound and culminate
in the selective targeting of street-based sex workers for harassment, detention, and arrest
(Amnesty International, 2005; Incite National, 2015).
Per the Sex Workers and Allies Network (SWAN) and the Yale Global Health Justice
Partnership 2020 report, being convicted for prostitution or for related offenses has significant
consequences for sex workers, their families and loved ones, and for their communities. Arrest
and conviction records lead to sex workers facing increased socioeconomic hardships due to an
increased difficulty in finding alternative employment options and exacerbating barriers to
housing, public benefits, and other social supports, thus trapping sex workers into poverty and
chronic socioeconomic hardships. A criminal record also infringes upon their rights, leaving sex
workers unable to vote, qualify for financial aid or college admission, hold public office, get
professional licenses across many states, nor be able to demand basic rights like police
protections, unionization, or opening bank accounts. Conviction and incarceration disrupt sex
workers’ social support systems, separating them from families and friends and causing
reunification challenges with children, making it more likely that children will remain in foster
care. Likewise, in addition to potentially facing financial hardship while a family member or
friend who is a sex worker is trapped within the legal system, family members, friends,
roommates, or partners themselves are at risk for facing criminal penalties for “living off the
proceeds” of sex work or having their close proximity to the individual sex worker being
interpreted under anti-trafficking laws as “pimping, pandering, or promoting” prostitution.

Communities are harmed with “prostitution diversion programs” across the United States that on
paper claim to deliver rehabilitative social services for those who commit low-level offenses, but
in reality enable law enforcement officers and courts to act as gatekeepers to social services,
while consuming valuable resources that could be invested in community-based, non-penal
programs to address sex workers’ tangible needs and provide care and social supports. Law
enforcement officers have immense power to destabilize and disempower sex workers (and their
families, loved ones, and communities), and law enforcement officers are complicit in making
sex workers’ occupational and health risks more dangerous through further marginalizing them
and consequently increasing their susceptibility to violence and stigma.
Suffice to say, law enforcement officers are not a source of protection for sex workers but
are rather an occupational hazard to be managed, as law enforcement is an exercise in social
control of the undervalued more so than it is an exercise in safety (Hudson, 2021). The
criminalization of prostitution and associated activities, coupled with the power dynamics
between law enforcement officers and sex workers, leads to sex workers understandably often
going without reporting to police, thus both enabling law enforcement officers to not take crimes
reported by sex workers seriously and engendering police violence against sex workers (Incite
National, 2015). Police officers bribe and coerce, physically, verbally, and sexually harass,
sexually assault, and rape sex workers with alarming frequency and impunity. A Chicago-based
study on the experiences of exotic dancers and street-based sex workers found that 30% of exotic
dancers and 24% of street-based sex workers who had been raped identified a police officer as
the rapist, with respondents reporting that police officers committed 20% of other forms of
sexual violence surveyed for (Jody & Shapiro, 2002). The Sex Workers’ Project of the Urban
Justice Center found across two studies (2003 & 2005) based in New York City that 17% of
interviewed sex workers reported sexual harassment, abuse, and rape by police. A Washington,
D.C.-based study also reported that one in five actual or perceived sex workers interviewed
reported that a police officer asked them for sex when approached (Different Avenues, 2008).
Police officers violate sex workers’ constitutional rights by pressing false charges for arrest,
using excessive force, humiliating sex workers through public strip searches, exhort sexual acts
or money in exchange for avoiding arrest (and may arrest the individual anyways) or further
physical violence, and engage in overtly sexist, homophobic, racist, and/or transphobic verbal
abuse. When sex workers do seek law enforcement officers’ help, sex workers may be arrested
and subjugated to further violence and trauma as the officers may perceive the circumstances of
violence as “tricks gone wrong” brought upon the sex worker for being “sexually deviant.” This
means that there are innumerable instances of sex workers (read: women) being abused, arrested,
and retraumatized by law enforcement officers (read: men) when reporting being victims of
violence while their perpetrators (read: men) are emboldened to engage in further violence, as
any non-decriminalized legal regime is more preoccupied with punishing women for exercising
their (sexual and labor-productive) autonomy than with those who enact violence against women
(Incite National, 2015).
Although the potential for being arrested is indiscriminate, sex workers develop arrest
avoidance strategies over time and experience. Dewey and St. Germain’s (2014) research on
street-based sex workers’ perspectives on police patrol officers demonstrates that one of most
important skills to develop is the ability to intuitively sense undercover officers via interpreting
social and environmental cues. Rigid body posture, repeatedly asking for the price of particular
sex acts, acting in a dogmatic or persistent manner, immediately asking the sex worker if they are
an undercover cop, and/or wearing a tightly zipped jacket that may be concealing a bullet proof
vest are just some of the cues that sex workers are hypervigilant for. Imploring potential clients
to engage in illegal acts, such as drug use or genital exposure, or to engage in bonding-forming
behaviors such as buying food, are also effective methods for avoiding arrest as police have
cameras in their cars and are unable to engage in certain behaviors, nor are they likely willing to
spend money or time to form an affective bond. Furthermore, seeking to respect law enforcement
officers’ authority through avoiding certain behaviors may decrease their chances of having to
interact with law enforcement: flagging down cars, wearing flamboyant clothing, carrying drug
paraphernalia, being under the influence of alcohol or other substances in public, and/or
committing other crimes other than sex work. Akin to this high-stakes relationship with law
enforcement officers, sex workers also have a precarious relationship to medical and mental
health care providers.
Medical and mental health care.
Accessing health services means using services based on needs in a timely manner and is
accounted for via geographical accessibility, the availability of care, financial affordability, and
the quality of the services provided (Cambell & Roland, 2000; Peters et al., 2008). Sex workers
need health and social services as they experience a myriad of dangerous occupational risks, yet
they encounter serious physical, social, economic, and structural barriers to receiving necessary
and routine care. Medical health-related occupational risks include being at an increased risk for
acquiring HIV/AIDS and STI’s, bladder problems, latex allergies, musculoskeletal injuries,
respiratory infections, unwanted pregnancies, and unsafe abortions (Roguski, 2013). Mental or
behavioral health-related occupational risks include being at an increased risk for abusing
alcohol or other substances and being susceptible to mental illnesses like anxiety, depression,
and various forms of trauma including post-traumatic stress disorder (Rössler et al., 2010). Other
occupational risks also include having money stolen by clients (i.e., stealing physical cash or
refusing to pay after finishing), being verbally harassed by passerby, or being targeted by
“rescue” social work and non-profit organizations to be “saved” (Plumridge, 2001). Sex workers
must also contend with ever-present acute and chronic stress enabled and exacerbated by
political leaders who tolerate structural problems inherent to their respective legal regimes such
as poverty, food insecurity, and housing insecurity. Furthermore, sex workers’ marginalization
and experiences of discrimination makes them uniquely vulnerable to physical and/or sexual
intimidation, harassment, and/or violence perpetuated by passerby, clients, family members or
friends, domestic partners, pimps or johns, roommates or peers, and law enforcement officers
(Incite National, 2015). The level for any specific occupational risk is based on a sex workers’
level of power (i.e., their ability to choose, screen, and negotiate with potential clients) and one’s
venue, with those working in the streets being at the highest risk, brothel workers being at an
intermediate risk, and escort or internet-based workers being at the lowest risk (Ross et al.,
2012). Regardless of one’s power or venue, sex workers’ ability to take care of their health is
impacted by the complex relationship between health-seeking behaviors and their ability to
access care.
Ma, Chan, and Loke (2017) review how sex workers’ health-seeking behaviors reflect
how they are responding to the socioecological environments they are part of. Individually, sex
workers may lack knowledge of where health services are or what kinds of health services are
available or necessary. They may be influenced by their perception of risk with attempting to see
a provider, or they may be navigating their own internalized stigma and may fear disclosing their
occupation. Interpersonally, they may be reliant upon family and friends either through wanting
or needing a loved one to come with them, or wanting to avoid loved ones’ suspicions as to why
or how often they are seeking care. Community wise, sex workers may wish to avoid the social
stigma of being identified in the waiting room or being seen frequently in proximity to the health
care settings. Intertwined at the health organizational level and socio-politically, sex workers
may fear being discriminated against in health care settings via being at risk for breach of
privacy or being unable to access universal testing or free treatment.
How sex workers navigate their socioecological environments reflects the barriers they
face for accessing care from the intrapersonal through policy levels. Intrapersonal barriers
include fears related to medical mistreatment and affordability of services, lacking accurate
information about HIV and STI risks, and an undermined ability to take care of oneself due to
factors such as substance abuse, one’s mental health status, and having to prioritize making
money through sex work (Chakrapani et al., 2009; Hong et al., 2012; Kurtz et al., 2005). These
factors, as well as the higher-level barriers discussed within this paragraph, diminish sex
workers’ ability to adhere to daily regimes such as prescription medication adherence, getting
adequate sleep, or regularly socializing with loved ones (Shannon et al., 2005). Intrapersonal
barriers include: lacking a positive social support network; preferring using peers as primary
sources of health information; and disclosing an HIV-positive status and potentially being
subjugated to domestic violence, homelessness through being forced out of one’s home, and a
loss of income through potential clients discriminating against HIV-positive individuals
(regardless if a sex worker adhered to antiretroviral treatment [ART] to acquire an undetectable =
untransmittable [U=U] status) (Chakrapani et al, 2009). At the community level and regardless
of a country’s income level or degree of sex work criminalization, sex workers are socially
stigmatized and consequently are reluctant to seek care; specifically, sex workers tend to be
concerned with stigmas associated with HIV and STI’s, drug use, and sex work itself (Ma et al,
2017). Sex workers report institutional barriers being anticipating or previously experiencing
poor attitudes and treatment from providers due to whorephobia (i.e., the fear or hatred of sex
workers), inconvenient services with inconvenient hours of operation and locations, non-user-
friendly scheduling appointment systems and long waiting times, and the (purposely-designed)
failure of the fractured United States health care system to deliver comprehensive services for
internal medicine/primary care, sexual health, obstetrics and gynecology (OB-GYN), substance
use, and mental health care (Beattie et al., 2012; Ghimire et al., 2011; Nguyen et al., 2008;
Sawicki et al., 2019). Sex workers in low- and middle-income nations such as India, Guatemala,
and Mozambique face additional structural barriers, with sex workers more likely needing to pay
bribes to providers to receive care for HIV and STI’s, or there being limited laboratory services
and medicine shortages (Beattie et al., 2012; Lafort et al., 2016). Barriers at the policy level are
reflective of a nations’ respective legal regime as discussed in the Legal Systems section above,
and it may be noted that the United States commonly requires legal identity and citizenship
status to access medical care, thus discriminating against migrants and those without stable
housing, while contributing to further fear of arrest for seeking routine or emergency treatment
(Kurtz et al., 2005).
It is important to identify how mental health care poses its own distinct challenges with
accessing care. Most individuals who need mental health services do not or cannot access
treatment that is timely or effective (Kazdin, 2017). To be connected to an appropriate mental
health provider, an individual must: 1) acknowledge and accept that they are struggling with a
psychological or behavioral-health related challenge that is impairing their ability to function in
at least one domain of daily life; 2) potentially need to overcome the intrapersonal or social
stigma of seeking mental health treatment; 3a) contact their insurance company for finding a
provider who is within reasonable traveling distance or who utilizes telehealth platforms and 3b)
who accepts said insurance company either in-network or out-of-network; 4) contact providers to
see if they are accepting new patients; 5) make sure the provider has session availability that
works with one’s own availability; 6a) ensure the provider actually accepts one’s insurance due
to insurance companies not always providing the most up-to-date information and 6b) ensure the
provider has a fee or sliding scale that one can afford; 7) ensure the provider has expertise in the
area of mental health or expertise with one’s identity if deemed important; and 8) see if there is a
promising therapeutic alliance to be formed so as to improve one’s chances for a better outcome
(Becker-Haimes, 2018; DeAngelis; 2019).
This extreme burden individuals must endure is a staggering investment of one’s time
and money. It also does not even account for the fact that laypersons may be confused or
intimidated by the differences and similarities between and within mental health professional
categories (i.e., spiritual counselors, psychiatric nurse practitioners [N.C.L.E.X., P.M.H.N.P.-
B.C.], counselors [L.P.C., L.M.F.T., L.C.A.D.C.] social workers [L.I.C.S.W., L.C.S.W.,
A.C.S.W.], psychiatrists [M.D., D.O.], and psychologists [Ph.D., Psy.D., Ed.D.]. Likewise,
laypersons may not be knowledgeable about different modalities of treatment (e.g., cognitive-
behavioral therapy [CBT], dialectical behavioral therapy [DBT], psychodynamic therapy and
related short-term dynamic models, psychoanalysis, humanistic/existential therapy, couples
therapy, family therapy, group therapy) nor which of these modalities they may respond best to
based on their own personality or needs. However, unless seeking a provider in private practice,
most individuals will have limited options for the provider they see, when they will be seen, and
how often they will be seen based on the treatment setting, with most hospital, community
clinics, and graduate-training clinics overburdened and underfinanced and providing time-limited
services in limited modalities.
Given sex workers’ disproportionate experiences of social and health inequities, they face
a high burden of mental illness based in affective disorders, personality disorders, post-traumatic
stress disorder, and suicidal ideation (Benoit and Millar, 2001; Gu et al., 2014; Roxburgh,
Degenhardt, and Copeland, 2006). Mental illness is linked to sex workers due to the
socioecological environments and legal regimes they must navigate, and due to comorbid
physical conditions, ongoing client or partner violence, self-whore stigma and stigma related to
other salient identities, and histories of childhood trauma and ongoing trauma (Puri et al., 2017).
(It is important to note that although research shows a relationship between sex work and
childhood trauma, it is a dangerous myth or overgeneralization in saying that all sex workers are
victims of childhood trauma or that they are sex workers because of childhood trauma, as this
contributes to the false narrative that sex workers lack agency and need rescuing.) For women of
color, transgender women, transgender women of color, and other gender and sexual minorities,
experiences of racism, transphobia, and queerphobia, and being more likely to be less educated
and have a lower income, also contribute towards impaired mental health (Nemoto et al., 2011).
Venues also contribute to one’s susceptibility to depression, anxiety, and burnout, with street-
based work and informal indoor spaces (e.g., bars and casinos) being more highly associated
with mental health problems than working as an escort or conducting online-based work (Puri et
al., 2017).
Despite mental health providers’ extensive education and rigorous training in identifying
how one’s psychology and environments impacts one’s functioning, providers may be distracted
in not being able to see past a sex workers’ professional identity to help them heal and flourish.
Mental health care providers may engage in or are perceived to be engaging in stigma through
implicitly or explicitly demonstrating disdain or judgement for their patients or blaming them for
destroying relationships, transmitting HIV and STI’s, and increasing crime (Bowen & Bungay,
2016; McCabe et al., 2014; Mellor & Lovell, 2012; Prince, 2013). Providers are susceptible to
over-pathologizing sex workers, medicalizing non-medical aspects and factors of sex workers’
lived experiences, which further vilifies sex workers and denies their agency (International
Committee on the Rights of Sex Workers in Europe [ICRSE], 2017). Providers may also
unconsciously or consciously aim for their patient to exit sex work as a treatment outcome,
regardless of their patients’ own stated goals, as often exiting the trade is thought of a panacea to
all of sex workers’ problems (Burnes et al., 2018). Mental health care providers are regularly
charged with the responsibility of documenting their assessment, affirmation, and approval of
their transgender patients’ desire or need to take hormone therapy or surgeries as part of their
patients’ transitions. However, mental health care providers are culpable to engage in trans-
erasure in which they discount, reject, or diminish the existence and experiences of transgender
people; over-pathologizing sex work and being complicit in whorephobia thus provides further
complications to a tenuous relationship between mental health care providers and trans sex
workers (Benoit et al., 2016). The same logistical and administrative challenges and
confidentiality concerns posed by interacting with medical providers are barriers for accessing
mental health care. Despite mental health care providers mandated reporting obligations being
limited to reporting knowledge or reasonable suspicion of a patient being a danger to themselves
or others (i.e., children, the elderly, and other vulnerable individuals), statues about
confidentiality or communicating with other providers is also dependent upon state laws and/or
treatment settings which further contribute to the stigma sex workers may experience or perceive
with choosing whether or not to disclose one’s profession - even though this may hinder progress
towards one’s treatment goals. It is also a barrier to treatment if a translator is needed. as using
an in-house translator or volunteering loved one or peer poses its own set of challenges to
navigate for both the patient and provider. Taken together, these barriers hinder mental health
service utilization and lead to sex workers avoiding care and relying on hospital emergency
departments for psychological support, consequently disallowing for necessary, ongoing support
to adequately address one’s psychological or behavioral-health problems (Bodkin et al., 2015).
Shelters and single room occupancies.
Housing is a crucial social determinant of health (WHO, 1986). A lack of affordable
housing is a public health problem that facilitates health and social problems at the individual
level, with homelessness and unstable housing being associated with an increased risk for
acquiring HIV, reduced personal safety, higher rates of morbidity and mortality, and increased
barriers to accessing health care (Aidala & Sumartojo, 2007; Krieger & Higgins, 2002; Lewis et
al., 2003; Riley et al., 2007). Homelessness itself is a continuum ranging from those who live on
the streets, living in shelters, sleeping or staying at another person’s place, living in a
substandard accommodation, temporarily renting a room at a hotel or through an app like
AirBNB, and renting a single room occupancy (SRO) unit via a public housing agency (e.g.,
colloquially referred to as Section 8 housing) under the Department of Housing and Urban
Development (HUD) (Echenberg & Jensen, 2008; Evans & Strathdee, 2006). The neoliberal
public psyche finds it easier to imagine homelessness as a social problem affecting certain types
of people who are irresponsible and thus deserving of “reaping what they sow” rather than seeing
homelessness as an institutionally sanctioned economic problem related to housing affordability
(Pascale, 2005). Furthermore, in parallel to the fact that men far outnumber women for shelter
utilization, there is a lack of women-specific services for homeless and marginally housed
women, and homeless women are an often-ignored population within research (Bukowski &
Buetow, 2011; Hwang, 2001).
Homelessness and unstable housing are independently associated with exchanging sex for
money as a means for basic survival (i.e., survival sex) (Corneil et al., 2006). Homelessness and
marginal housing increases susceptibility for engaging in high-risk sexual behavior such as
higher frequency of unprotected sex or a greater number of clients refusing to wear a condom,
and homelessness is independently associated with increased risk for sex workers being victims
of violence by clients and intimate partners (Duff et al., 2011; Shannon et al., 2009). Homeless
and marginally housed women engaging in survival sex may be at a higher risk for these factors
due to prioritizing mitigating immediate risks (e.g., securing a meal, a place to sleep,
transportation, sexual and reproductive health products, over-the-counter medicine) or to buy
drugs such that mitigating other potential harms like acquiring an STI or HIV becomes a
secondary priority (Epele, 2002).
Lazarus et al.’s (2011) Canadian-based study identifies how homeless and marginally
housed women sex workers’ agency, power, and ability to negotiate safety and sexual risk is
impacted by their housing environments from the micro-physical through structural levels. By
the United Nations’ Universal Declaration of Human Rights stating that every person has the
right to safe, secure, and habitable housing, the vast majority of single room occupancy buildings
violate their tenants’ rights through providing unkept and unsanitary rooms with about 100ft2 of
space, shared bathroom facilities, and no kitchen space. General financial neglect by the housing
agencies means that bedbug, mice, rat, and cockroach infestations are common within the
buildings (Lazarus, 2011; United Nations, 2007). These infestations and unsanitary living
conditions compromise one’s health status and makes one more vulnerable to further health
complications, meaning that tenants may feel they are stuck in a cycle of living in unsanitary
conditions, being homeless and living on the streets, and seeking temporary accommodations
where they are at risk for financial exploitation.
Single room occupancy buildings are social environments (Lazarus et al., 2011). Co-ed
housing may lead women who sought shelters or housing accommodations to escape domestic
violence to feel at risk for recreating unhealthy relationships with men, or feeling at risk for
further abuse and exploitation. Staff members who are men may discriminate against women
suspected to be engaging in sex work, such as by enforcing residents’ guests to display legal
identification, and thus reinforcing gender inequities and making women feel that they have less
agency. Conversely, women-only shelters and single room occupancy buildings may increase
women’s agency and decrease their risk for sexual and economic exploitation and violence
through facilitating women’s ability to develop personal friendships and peer support networks.
Said friendships and networks act as an informal safety strategy as women are better able to
work collectively on the streets and share information with one another about potentially
dangerous clients or who may be an undercover cop.
Single room occupancy buildings’ and shelters’ structural environments contain
restrictive management policies designed to regulate women’s behavior and to impose upon their
agency (Lazarus et al., 2011). Strict curfew hours (e.g., checking into a shelter by a certain time
and not being able to re-enter if leaving after curfew) restricts sex workers’ ability to choose
when they work and reduces their ability to earn income. With fewer working hours afforded,
sex workers’ safety and agency through screening and negotiating with potential clients is
diminished by pushing them to work in outdoor areas and to prioritize earning more money with
fewer clients. Guest policies may violate tenants’ rights through regulating their private lives by
disallowing any visitor or having complex and unclear regulations for who could visit, when, and
how often. These guest policies may leave tenants alienated from their friends, partners, family
members, and other support networks, violating tenants’ rights to privacy and personal space. If
suspected of engaging in sex work or caught servicing a client in one’s room, sex workers may
face eviction and many single room occupancy agencies may outright refuse to house women
involved in or suspected to be involved in sex work as well. Shelters and single room occupancy
housing agencies’ environments perpetuate gender-power inequities against women and their
policies represent a normalized symbolic and structural violence against women and all sex
workers (Bourdieu, 2001; Bourgois et al., 2004).
Improving service accessibility and reducing discrimination.
The solutions for improving sex workers’ health and quality of life and ability to access
service and reducing their experiences of stigma and discrimination are simultaneously self-
evident and multiplex, requiring stakeholders across all sociopolitical levels to take action in
bringing about a more just society that benefits not just sex workers, but all historically
marginalized people. The following solutions are cited from multiple disciplines and would not
be in existence without countless sex workers and sex work organizations ran by sex workers
who continue to fight for their liberation and against their oppression through community
investment initiatives, creating partnerships with other sex work and non-sex work organizations
and agencies, outreach programs, peer-led counseling and educational programs, advocacy and
activism, challenging unjust laws in court, conducting and publishing research, organizing
conferences, and many other initiatives to strengthen their collective power and make their
voices known. Respecting and amplifying sex workers’ and sex work organizations’ mottos of
“nothing about us without us” and “nothing for us without us” is fundamental to any solution for
securing sex workers’ universal human rights to equality, freedom from discrimination, right to
recognition as a person before the law, right to equality before the law, freedom from arbitrary
arrest and exile, right to be considered innocent until proven guilty, right to participate in
government and in free elections, right to desirable work and to join trade unions, right to
adequate living standards, right to education, right to participate in the cultural life of
community, and freedom from state or personal interference in these stated rights (United
Nations, 1948).
Full decriminalization of voluntary sex work and all sex work related laws (e.g.,
“loitering for the purpose of prostitution”), apart from stipulating sex workers to practice safe
sex, is the only way to humanize sex workers and legitimize their labor as real work through the
legal system. It is worth reiterating that international organizations, medical journals, academics
across disciplines, and sex work organizations ran by sex workers internationally all endorse full
decriminalization. Reforming current legal regimes to adopt full decriminalization means sex
workers could exercise their basic socioeconomic rights to access education, health care,
housing, banking, inheritance, property, legal services, own a business and be employed, and be
able to participate in their government (TTCELPE, 2010). Full decriminalization means that sex
workers can better protect their health and there could be significant progress in addressing the
ongoing HIV/AIDS epidemic. At a 2011 United Nations sponsored regional consultation on HIV
and sex work in the Asia Pacific region, then-UNFPA Deputy Director Purnima Mane stated:
“Enabling sex workers to openly access prevention services with

dignity must be part of every national HIV [program]. Revising
laws and politics and addressing attitudinal barriers will enhance the
effectiveness of HIV prevention, improve access to health services,
including reproductive health and reduce violence against sex workers.”
To fully decriminalize sex work is to bestow dignity upon sex workers such that
continuing treatment regimens and medication adherence, no longer fearing legal consequences
for sharing their profession to providers, and being able to pursue justice if they are harassed,
judged, or discriminated against by their providers or medical staff is a reality. Likewise, sex
workers would be free of having their rights violated through mandatory HIV and STI testing (as
is the case currently under regulatory legal regimes and possibly if arrested or incarcerated) or
being targeted by “rescue and rehabilitation” programs. Full decriminalization also guarantees
rights into the domestic sphere through being able to marry without having their partner being
sued for supporting prostitution or pimping, and founding a family without fear that that they
may be legally challenged for their fitness to have custody of their children (ICRSE, 2005).
Symbolically, full decriminalization moves any non-decriminalized nation away from a
patriarchal-morality understanding of sexuality, in that sex is further removed from only being an
instrument of reproduction, thus challenging notions of compulsory heterosexuality that curbs
women and other gender and sexual minorities’ (sexual) freedom, and instead promotes
autonomous sexuality and mutually pleasurable, consensual sex, free of guilt and oppression
(Durbar Mahila Samanwaya Committee, 1997).
New Zealand is the only country to have fully decriminalized sex work as of 2003 with
the passing of the Prostitution Reform Act (PRA); the PRA provides the ideal legal framework
for other nations or even state or local governments that may seek to decriminalize sex work.
The major pillars of the Prostitution Reform Act include (Decriminalize Sex Work, 2020):
1. Decriminalize voluntary adult prostitution;
2. Distinguish voluntary from involuntary prostitution;
a. Coercing to provide sexual services remains a crime;

3. Prohibit the purchase of sexual services from persons under 18 years of age;
4. Recognize sex work as legitimate work, affording sex workers with the same labor
protections as other workers;
a. Example: Sex workers were qualified for and received unemployment benefits
during the COVID-19 pandemic;
5. Establish civil laws recognizing contracts between sex workers and their clients;
6. Allow sex workers to refuse to provide services at their discretion;
7. Establish regulations and restrictions on advertising;
8. Prohibit brothels or other employees from promoting sex work as a means of getting off
government benefits;
9. Obligate employees and sex workers to promote and practice safer sex;
10. Allow local governments to establish bylaws regarding zoning and advertising but does
not permit them to prohibit sex work.
New Zealand also sought to further humanize and bring justice to sex workers through the
passing of the Criminal Records (Clean Slate) Act of 2004, removing sex workers’ past
convictions from their records (Decriminalize Sex Work, 2020). Decriminalizing (or even
regulating or legalizing) sex work often evokes the myth and fear that this will lead to an
increase in the amount of people who enter the profession, in the number of crimes committed,
and in the number of victims of human trafficking among other concerns. Of major significance,
New Zealand’s 2008 study on the effects of the Prostitution Reform Act found that: 1) there was
no increase in the prevalence of prostitution with regards to the number of commercial sex
workers in the profession nor the amount of clients purchasing sex; 2) there were fewer reports
of street-based sex workers as most moved into indoor venues of their choosing; 3) there was
increased reporting to police about violence against sex workers (including economical violence
via contract violations perpetrated by clients); 4) sex workers and police officers both reported
improved relations between the two parties; and 5); there was no evidence of increased human
trafficking (Prostitution Law Review Committee, 2008).
Sex workers in New Zealand are empowered through having more balanced relationships
with police. Not only can law enforcement officers and sex workers collaborate in sharing
information with one another about dangerous individuals, but sex workers can also exercise
their rights interacting with law enforcement officers such as by requesting them to leave an area
because it may interfere with business by intimidating clients. Likewise, sex workers are more
confident to report violence with an increased belief that their reports will be taken seriously
(Abel et al., 2007). However, involving law enforcement officers may not always lead to a
contractual dispute being resolved as the law is intended, given that law enforcement officers
may still not recognize exchanging sex for money as a genuine commercial transaction and thus
not interpret clients refusing to pay as true “crime,” but rather as a legal matter to be handled in
court (Armstrong, 2017). Though this indicates that there is still work to be done with how police
officers interpret and practice law enforcement, what is guaranteed is that sex workers’ safety is
still ensured and that these incidents can be addressed without fear of arrest. Likewise, as sex
work does not exist in a social or legal vacuum, police or other individuals may still seek to
harass, abuse, assault, bribe, exploit, extort, or enact other forms of sexual and non-sexual
violence against sex workers (Armstrong, 2017). Regardless, these situations being able to be
addressed and challenged is revolutionary.
For legal regimes championing democracy that are slow to recognize their hypocritical
natures in bestowing full rights to only some of its citizens, there are a few immediate steps that
can be taken for improving sex workers’ quality of life and safety through legislation. Any type
of regulatory framework that seeks to enable a safer sex industry, support sex workers’ human
and labor rights, protect their health, and reduce their vulnerability for HIV/AIDS must include:
1) precise language to describe the regulatory environments for commercial sex, the
consequences of possible regulatory options, and the potential solutions; 2) accurate local data
about the domestic laws, policies and enforcement practices to be remedied and their intended
and unintended impact on the health of sex workers of all genders and sexualities; 3) a
commitment to human rights standards and norms, including the right to work, to equal
protection under the law, to freedom of association, and a recognition of the right of consenting
adults to form sexual relationships of their choice provided others are not harmed; and 4) recruit,
collaborate, and listen to local sex workers and sex work organizations ran by sex workers across
all steps of the policy-decision making process (Overs & Hawkins, 2011). Any legislative
framework that does not adopt nor support sex workers’ rights-based frameworks dangerously
promotes a victimhood framework and consequently conflates sex work with sex trafficking.
Additionally, any sex work organization ran by sex workers or local/state government may look
to San Francisco’s Prioritizing Safety for Sex Workers Policy, enacted by the San Francisco
District Attorney’s Office and the San Francisco Police Department in 2018 and created in
collaboration with members of the Sex Worker Outreach Project (SWOP) and Bay Area Sex
Worker Advocacy Network (BAYSWAN) (Office of the District Attorney, 2018). This policy
creates a legal environment where sex workers may report to law enforcement when they are
victims or witnesses of violent crimes and cannot be arrested or prosecuted for their involvement
in sex work or associated misdemeanors (Lutnick, 2019). Finally, as discussed in the Prostitution
and Sex Work from Colonial America to the Present-Day United States section, the United
States federal government must repeal FOSTA-SESTA as it does nothing to reduce online sex
trafficking as intended and conversely threatens to increase violence against sex workers,
specifically LGBTQIA+ sex worker and sex workers of color (Kosher, 2020).
Regardless of the criminalization status of sex work, health care providers must be held
accountable in truly practicing their own ethics of justice, beneficence, and nonmalfeasance in
the care of sex workers. Improving access to health care and addressing stigma and
discrimination requires structural and interventional innovation (Ross et al., 2012). The St. James
Infirmary in San Francisco, founded by Margo St. James in 1999, provides an excellent example
of innovative health care delivery as the first peer-based non-profit occupational health and
safety clinic in the United Sates ran by sex workers for sex workers (St. James Infirmary, 2017).
The infirmary provides comprehensive medical and psychological health care and social services
to men, women, and transgender sex workers with a majority of staff being former or current sex
workers (Cohan et al., 2006) Furthermore, hospital and clinic staff must collectively advocate to
the board of directors or hospital and clinic executives to provide budgets that include the free
provision of condoms, food, drinks, needle exchanges, showers, and comprehensive women,
transgender, and sexual minority-focused and reproductive, sexual health, and psychological
services as standard practice (Jeal & Salisbury, 2004; Shannon et al., 2005). Moreover, including
sensitivity trainings for treating sex workers and ensuring that non-medical staff and service
providers are treating their patients with respect, privacy, and empathy would go a long way in
beginning to address the harm that these institutions have condoned for far too long. It is critical
that health care providers see themselves as part of and invested in the communities they serve
irrespective of where they geographically live.
Mental health care providers must receive an education and training opportunities to
recognize the needs and challenges of sex workers to better serve them (Sawicki, 2019). To
provide cultural humility-based care, clinicians must: 1) seek out therapy or consultation for
acknowledging and unpacking their own internal biases towards or against sex workers (i.e.,
address beliefs that sex work should be criminalized, that it cannot be a feminist choice, or that it
is not real work); 2) appropriately utilize trauma-informed care that includes the exploration of
relationships between structural, historical, individual, and interpersonal factors (as many sex
workers may have delayed reaction times to process trauma due to stigma and shame); 3)
appropriately utilize a harm reduction approach in therapy via “meeting them where they are,”
and focusing on the impact of risk-taking behaviors in a non-judgmental manner that does not
discount their patient’s agency; 4) connect sex workers to bad date lists, resources for connecting
their patients to needle exchange services, agencies or programs that provide supplies like
condoms and clothes, and sex work organizations ran by sex workers and other community and
social supports; and 5) seek out cultural humility-based trainings on the needs of sex workers and
their communities (Sawicki, 2019; Varga & Fire, 2018).
Health care providers, non-profit sex work organizations ran by sex workers, and any
other agency or non-profit that is an ally to sex workers’ liberation may also promote health
service accessibility through advocating for known facilitators to accessing care across all
socioecological levels (Ma et al., 2017). In any outreach, programming, or direct interventions,
providing education on the benefits of knowing one’s health status and how to take care of one’s
health through explaining different health services improves sex workers’ motivation to seek
care at the intrapersonal level (Beattie et al., 2012). Interpersonally, supporting sex workers to
develop and maintain positive social support and peer influences improves access to care as these
networks often serve as sources of health information and provide emotional and practical
support (Beattie et al., 2012). Likewise, discussing one’s health from the perspective of it being a
commitment to one’s family, friends, and loved ones also encourages sex workers to access
services (Chakrapani et al., 2009). Community-wise, health care providers and non-profit
organizations should have information, resources, and referrals available for providing pre-
exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and ART, financial and housing
assistance, knowledge about sex workers’ legal and human rights, how to access free or
subsidized health care consultations and treatments when appropriate, and advocate for
government support for investing in ending the HIV/AID epidemic through making testing,
medication, and treatment more accessible (Beattie et al., 2012; Chakrapani et al., 2009; Savv,
2013).
Shelters and single room occupancy agencies must be legally challenged and collectively
rallied against for infringing upon their residents’ individual freedoms through excessive
regulation that is selectively enforced by neoliberal governments onto those living in poverty
(Lazarus et al., 2011). There is a critical need for ensuring available housing that meets basic
minimum standards and protects individuals’ rights to safe, secure, and habitable housing -
regardless of if they are homeless, living in poverty or low income, a religious, ethnic, gender, or
sexual minority, living with a disability, formally incarcerated, an undocumented migrant, a sex
worker, or another other “morally deviant” and historically marginalized identity. Government
policies must guarantee that the U.S. Department of Housing and Urban Development and
individual residents are able to hold management and owners accountable to basic minimum
housing standards and legal mechanisms to protect all residents and women’s rights against
sexual exploitation. Strict management and building policies on guests and curfews must be
reformed to protect all residents’ freedom and women sex workers’ ability to assert agency and
negotiate safety and sexual risk reduction (Moore, 2004). Reforming shelters and single room
occupancies is a public health issue that both protects women’s personal and economic agency
and challenges patriarchal ideals given that public housing is historically male-centric in physical
and structural design.
The stated requirements across all socioecological levels are imperative for improving
sex workers’ quality of life, ability to access common services, and systematically addressing
their everyday experiences of stigma and discrimination. However, societal morality and
attitudes - rooted in capitalism - about sex work, sexuality, women, and other traditionally
marginalized and discriminated populations are influencing factors that limit the radical potential
found within protecting sex workers’ innate human and labor rights. Thus, other factors that are
beyond the scope of this literature review but are nonetheless critical to be addressed include:
promoting the true separation of church and state; providing comprehensive sexuality and sexual
health education in public education settings; providing universal preschool and free community
college; passing single-payer Medicare for All; defunding the police and refunding communities;
passing the Green New Deal; restoring and protecting incarcerated and formerly incarcerated
individuals' right to vote and participate in government; and formally making it a constitutional
right to access safe and legal abortions. Only when neoliberal capitalism is reformed to stop the
ruling class from exploiting the working class for their own profit will everyday people truly be
able to flourish with their inalienable rights protected and promoted through having a voice in
their neighborhood, community, and government.

Cisgender men sex workers who have sex with men and biopsychosocial factors.
There is a disparity in the focus or interest in research within different sex work
communities. The majority of sex work research is conducted by academics or researchers not
affiliated with sex work organizations ran by sex workers who focus on street-based cisgender
women, with a minority of research focusing on other communities like transgender women of
color, migrant sex workers, or sex workers living with disabilities. Sex workers are collectively
considered as “hard to reach” groups for researchers to make connections with due to structural
barriers such as stigma, the general relationship between a researchers’ discipline and how this
discipline has historically treated sex workers (e.g., psychologists over-pathologizing sex
workers), and researchers’ susceptibility to forego including sex workers or sex work
organizations ran by sex workers as collaborators in the research study design and
implementation process (i.e., “nothing about us without us”) (Bungay et al., 2016). This
literature review focuses on the lived experiences of cisgender men sex workers in general and
cisgender men sex workers who have sex with men (MSWSM) specifically to exemplify how
much depth and potential there is to better understanding the lived experiences of less-researched
communities or populations within sex work.
The population size and geographic distributions of cisgender men sex workers is largely
unknown due to sex work research traditionally being conducted with street-based cisgender
women sex workers who, while being a more visible and accessible community, only comprise
about 10% of the overall sex work market (Perkins, 1991). Between 2000 and 2007, only 10 of
the 166 research publications on sex work focused exclusively on cisgender men sex workers
(Dennis, 2008). It is estimated that cisgender men sex workers may contract with about 20
different clients per week and it is noted that men sex workers comprise about 20% of arrests in
the United States annually for prostitution crimes and associated misdemeanors (Dennis, 2008;
Klinnell, 2006). Cisgender men sex workers predominantly contract with gay and straight men
while also contracting with women and in addition to having their own noncommercial sex
and/or romantic partners, thus placing men sex workers in a unique social position that
challenges traditional social, economic, and gender theories of sex work (Bernstein, 2005;
Logan, 2010). How sex work is perceived to be exploitive is differentiated by gender because
sex work is largely conceptualized from a patriarchal perspective: whereas women sex workers
are imagined as degraded, passive, and disempowered victims because it is a man purchasing sex
from a woman, narratives of men sex workers are romanticized in the public psyche because
sexual transactions between two men (as women purchasing sex from men is considered
dubious) must mean that there is a certain mutual equality of power between the two parties
(Altman, 1999).
Cisgender men sex workers’ experiences in healthcare settings grossly overlap with the
experiences of their women and transgender counterparts, while having their own unique factors
due to the stereotypes and misconceptions of the kind of men who engage in sex work.
Cisgender men sex workers are less likely to disclose their sex work or men who have sex with
men (MSM) behavior to primary care physicians: a San Francisco-based study found that up to
76.6% of men sex workers “never disclosed” their profession to physicians but are more likely to
disclose their profession with mental health and substance use treatment providers (Cohan et al.,
2006). Cisgender men sex workers’ concerns about confidentiality are related to being seen
attending an HIV testing site or staff breaching sharing their patient health information to other
staff members or others outside of the clinic, thus consequently acting as barriers to care
(Chakrapani et al., 2011). Additionally, cisgender men sex workers are susceptible to having
fatalistic attitudes towards their sexual health regardless of their environments having relatively
low or high resource health systems (Chakrapani et al., 2011). Fatalism, a belief that one lacks
self-agency, may be more prominent for cisgender men sex workers who have sex with men as it
is associated with environments in which social alienation and fragmentation inhibit long-term,
goal-directed behavior (Meyer-Weitz, 2005). Cisgender men sex workers with fatalistic attitudes
may believe that acquiring HIV is an inevitability, that HIV is a terminal disease with poor
prognosis, or that a formal HIV diagnosis would not change their behavior or cause them to seek
treatment to strive towards acquiring a U=U status (Underhill et al., 2014). Moreover, a theme
within cisgender men sex workers with a history of incarceration was that they perceived
clinicians were more focused on ensuring that “sick” men (i.e., those who are living with
HIV/AIDS) do not endanger others rather than meeting individual patient needs (Underhill et al.,
2015). It is important to note that many cisgender men sex workers may engage in MSM
behavior for their profession while not self-identifying as gay, bisexual, pansexual, or queer
(Cohan et al., 2006). This has the unintended consequence of HIV or STI-related outreach
programs and services intended for those who engage in men who have sex with men behavior to
overlook straight men sex workers who have sex with men and/or for said cisgender men sex
workers to not perceive these programs or services are intended for or welcoming of them (Baral
et al., 2014).
In addition to reporting experiencing stigma based on their profession, gender identity,
racial identity, sexual identity, and/or MSM behavior, cisgender men sex workers experience
being discriminated against in health care settings based on their reported histories of substance
abuse, mental illness, homelessness, race, unemployment, poverty, and incarceration status.
These factors may also be compounded with living in poverty or with a low income, being
marginally housed or homeless, or having unreliable or inconsistent transportation options that
act as barriers to seeking care or adhering to treatment or medication regimens. Furthermore,
cisgender men sex workers potentially must also navigate their own internalized stigmas related
to sex work, MSM behavior, and/or HIV status. Cisgender men sex workers’ internalized
stigmas have been associated to an increased likelihood of endorsing negative stereotypes about
themselves, anticipating social rejection, and increasing their likelihood to develop mental health
issues like substance use, depression, and low self-esteem (Brookfield et al., 2019; Livingston &
Boyd, 2010). Additionally, cisgender men sex workers may avoid HIV or STI testing due to the
fear of their sexual behavior becoming known to significant others and fear of how others may
respond if needing to disclose their status: A Puerto Rican-based study on attitudes towards HIV
self-tests found that cisgender men sex workers would not self-test with clients in case a client
became violent if the test result was positive (Giguere et al., 2016).
Hegemonic masculinity, the practice that legitimizes men’s dominant position in society
and justifies both the subordination of the common population of men and women and the
denigration of other expressions of manhood, organizes the structure and organization of men
sex workers (Connell, 2005). Straight men sex workers who engage in MSM behavior can earn a
higher pay than their gay, bisexual, pansexual, or queer counterparts and may accrue a better
status among peers or clients (Allen, 1980). The high appraisal afforded to straight men sex
workers who have sex with men may be due to a myriad of influences, including: a fetishization
of straight men as they are perceived as more conforming to masculine gender roles; responding
to one’s own internalized homophobia and seeking to reduce one’s associated feelings of shame;
seeking to overcome feeling historically disempowered and unwanted by straight men; seeking
out sex with straight men because they are considered an “off limits” or “taboo” group; and
desiring to feel accepted by straight men due to historical disenfranchisement and rejection by
straight men socially, economically, and politically (Lehmiller, 2019).
Masculinity is associated with public spaces in that street-based work is considered low
status whereas indoor work is associated with high status. Street-based men sex workers largely
conform to hegemonic masculinity via being more likely demographically to be younger, straight
men in urbanized settings where they solicit pedestrians for sex; this work is often characterized
as survival sex or “gay for pay” and these men often hold negative attitudes towards being a sex
worker (Bimbi, 2007; Kaye, 2007; Scott, 2003). Likewise, these men are reported to be less
educated, have higher rates of drug use, be more likely to report financial problems, and be less
likely to be tested for HIV and STI’s (Leary & Minichiello, 2007). Indoor work is differentiated
between gay-identified public venues (e.g., gyms, cinemas, bars, clubs, hotels, casinos, massage
parlors, and brothels) and escort work. Public venue men sex workers, excluding those working
in massage parlors and brothels, may not consider themselves as “professional” sex workers in
that they may also be bartering sex in exchange for other necessities; brothel-based workers may
just be one of many shift workers who cater largely to a straight clientele with fixed prices
(Smith & Grov, 2011). Escorts or “call boys” are considered the highest tier of men sex workers,
having sustainable careers via regularly contracting with middle- to upper-class clientele and the
majority defining themselves as gay or bisexual (Miniciello et al., 2013).
Mimiaga, Reisner, Tinsley, et al., (2008) interviewed men who have sex with men street
workers and internet escorts in Massachusetts to contrast several aspects of the lived sex worker
experience. Whereas street sex workers met clients on the streets in addition to in bars, clubs,
and in popular cruising areas, internet escorts reported exclusively using the internet and specific
sites such as Rentmen.eu, adam4adam.com, and Manhunt.net to meet paying partners. Men who
have sex with men street workers often accepted “whatever they could get” for payment while
internet escorts made more money than street workers, with overnight stays costing several
thousands of dollars. With regard to sexual risk and condom use, 69% of all men in the study
reported unprotected sex with an average of 10 men sex partners of an unknown HIV status in
the past 12 months. Fifty percent reported unprotected sex where they bottomed and 31%
reported unprotected sex where they topped with a man of an unknown HIV status within the
past 12 months. Both street workers and internet escorts reported inconsistent condom use with
sex work partners as the vast majority of participants said that discussing HIV or STI status with
partners is not a topic of discussion due to a mutual lack of trust. Some workers also report
saying “what [the client] wants to hear” regarding disclosing HIV status or STI history. About
one third of the sample reported living with HIV and about one fourth reported having been
diagnosed with an STI at some point in their lives; one fourth of participants also reported never
having been tested for an STI as well. Most participants living with HIV reported regularly
disclosing their HIV status to sex-paying partners; a minority of participants felt it was not the
responsibility of the individual living with HIV or sex worker to initiate an HIV or STI
conversation. Both internet escorts and street sex workers sometimes use indirect methods to
ascertain the HIV status of paying clients through looking for medication in the bathroom.
Furthermore, a majority of participants reported being offered more money to have unprotected
sex; internet escorts often reported declining these offers whereas street workers reported
negotiating for unprotected sex for more money while facing financial precarity or engaging in
survival sex work.
The motivations and reasons that participants had for engaging in sex work differentiated
by work setting. While finances were cited as the predominant motivating factor or reason to
engage in sex work, street workers commonly spoke of it in terms of survival – exchanging sex
for basic necessities including money, food, and housing. Street workers used words such as
“desperation” and “survival” in explaining their reasonings, whereas internet escorts described
the “lucrative” nature of sex work as being the main motivational factor, discussing it as an
“easy” way to make a good living or extra supplemental income. A minority of internet escorts
identified needing money for their undergraduate educations as motivating factors as well.
Furthermore, a majority of streetworkers cited supporting a drug habit as a reason for doing sex
work, whereas internet escorts framed their drug use as being part of their encounters to make
the encounter easier or loosen their inhibitions. Feeling empowered in doing sex work and
having control over their sexuality and choices was also often cited as a motivating factor.
As is the case with research pertaining to sex work in general, literature on cisgender men
sex workers who have sex with men is skewed towards understanding the relationship between
engaging in sex work, sexual high-risk behaviors, and HIV acquisition and transmission rates. In
a pilot study examining the mental health of 118 “money boys” in cities of the Shadong Province
in China, the prevalence of anxiety and depression were 46.6% and 68.1% respectively (Tao et
al., 2010). This is aligned with another study that found more than 60% of money boys in
Shanghai had high levels of depressive symptomatology (Wong et al., 2010). It was also found
that straight money boys were more likely to suffer from both anxiety and depression compared
to those whose sexual orientations aligned with the clients they were hired by. The majority of
money boys – regardless of their sexual orientation – may be experiencing anxiety and/or
depression due to being forced to perform unwanted sexual behaviors or experiencing sexual
violence from their clients, compounded by the insidious nature of social discrimination and
homophobia that they experience as well. Relatively high rates of anxiety and depression may
also speak to how this vulnerable group frequently engage in HIV-related risk behaviors in an
urban society that denies access to healthcare and social welfare services to MSM or LGBTQIA+
populations (He N et al., 2007; He Q et al., 2006; Hong et al., 2006; McCoy & Yu, 1999; Wang
et al., 2007, Wong et al., 2008).
The Czech Republic is a popular sex tourism destination among foreigners seeking sex
with men due to decriminalized prostitution and an aggressive gay pornography industry that
markets Czech men as sex objects online (e.g., www.czechhunter.com) (Hall, 2004). Akin to
money boys in China, engaging in this form of sex work is a means of survival and is seen as
easy money for young straight, bisexual, and gay men alike who face financial hardship. Bar-
Johnson and Weiss (2014) surveyed 40 men to find that 33%of gay men, 42% of bisexual men,
and 47% of straight men reported clinical levels of depression, and zero percent of gay men, 28%
of bisexual men, and 17% of straight men reported clinical levels of anxiety. While zero percent
of gay men reporting clinical levels of anxiety should be considered idiosyncratic to this
particular study and these results will likely not be precisely replicable, these results indicate that
gay sex workers’ mental health problems are less likely directly related to their sex work
compared to straight and bisexual men, whose sex work is more likely to be dystonic and may be
more directly related to their sexual orientation (i.e., bisexual men may feel rejected by the
dominant straight culture and the gay community may regard them as in denial about their
sexuality) (Stokes, Vanable, & McKirnan, 1997).
In Vietnam, homosexuality remains highly stigmatized and high HIV prevalence rates are
seen among men sex workers who have sex with men (Berry et al., 2013; Nguyen et al., 2008).
Goldsamt et al.’s (2015) research among this population indicated that of the 710 MSWSM
participating in the survey, 58.2% had clinically moderate levels of depression, 14.1% met
criteria for moderate anxiety, and 4.9 percent met criteria for high anxiety. Participants who were
attracted to both men and women, and those who did not identify as a cis-gender man, reported
the highest anxiety scores via Beck’s Anxiety Inventory (BAI), suggesting there is a relationship
between sexual identity, expression, behavior, and mental health outcomes. Tobacco and
marijuana users were also associated with a higher BAI score, suggesting these men may use
these substances to manage their anxiety associated with this conflict. In a similar study
investigating psychosocial problems related to sex work in Vietnam, Biello, Colby, Closson et
al., (2014), about half of all participants had clinically significant depressive symptoms, over
one-third met screening criteria for alcohol dependence, one fifth reported a lifetime history of
sexual violence, and about one fifth reported a history of childhood sexual abuse.
The mental and emotional demands of engaging in sex work across diverse geographic
locations and work settings (e.g., online, on the streets, in other establishments) as a man who
has sex with men may jeopardize one’s mental health. A rapid shift towards online-based sex
work has facilitated men sex workers who have sex with men finding online communities of
other sex workers while increasing their chances of being physically isolated (Argento et al.,
2016). Additionally, men are subject to the intersection of three kinds of significant social
stigmas: the symbolic stigma of having others make judgements about them due to the
misconception that they pose a threat to society; the whorestigma where workers “sell their
honor” in exchange for base gain; and homophobic stigma of having sex with individuals of the
same gender (Herek et al., 2005; Koken et al., 2004; Pheterson, 1993;). To engage in sex work as
a man who has sex with men is to risk experiencing shaming, harassment, loss of privacy and
normalcy, and social rejection and isolation that stems from the intersection of said stigma and
leads to feelings of sadness and despair (Jiao & Bungay, 2019). The ramifications of the
resulting experiences of stigma contribute to significant distress and disrupt interactions with
friends, family, and partners and potentially deprives them of social support, including the
potential to develop healthy relationships with romantic connections, and other resources for
physical and mental health promotion. Some men perceive their work in a positive light through
viewing their work as a form of helping others, emphasizing that the working relationship is real
and based on the importance of being present and fully engaged (Bernstein, 2007; Koken et al.,
2004). However, sex workers may also need to engage in mental dissociation (i.e., viewing
themselves as “pieces of meat” or their actions as robotic), emotional distancing, self-talk,
rationalization, and other cognitive strategies to cope with the demands of their labor (Smith et
al., 2013).
What is OnlyFans and how did it become ubiquitous on Twitter?
OnlyFans is a subscription-based content service based in London, United Kingdom that
deliberately lacks restrictive content policy and allows content creators to earn money directly
from users (i.e., their “fans”) who subscribe to their content for a monthly fee or for pay-per-
view (Pandora Modeling, 2020). Although content genres range from workout lessons with
fitness experts to comedians sharing standup, OnlyFans has been most synonymous with the
adult entertainment industry since its founding in 2016 (Bernstein, 2019). Although not officially
released by the company, it is estimated that the site has 20 million registered users and claims to
have paid out $400 million to its 200,000 content creators as of February 2020. Part of its appeal
for content creators may be its business model that favors content creators: the company pays 80
percent of the fees collected to the content creator; 12 percent of the fees are kept for the
company’s share; and 8 percent is directed towards merchant and processing fees. Likewise, both
content creators and fans may have been initially interested as, despite having a not-safe-for-
work basis, the site has been increasingly embraced by mainstream media since its founding.
In January 2020, a 20-year-old model known as the Naked Philanthropist raised more than $1
million dollars to be donated to approved Australian charities and evacuation centers in response
to the wildfires that burned millions of acres (Nguyen, 2020). The fundraising strategy was
simple: for every confirmation of at least $10 donated directly messaged to her by a fan, the
Naked Philanthropist would directly message an explicit photo of herself. Likewise, in the era of
COVID-19, workers in the United Kingdom’s adult industry raised money for the National
Health Service (NHS) COVID-19 solidarity fund on OnlyFans in a new campaign called
#WanksAsThanks (Maurice et al., 2020). With new content being uploaded daily and all
proceeds being donated, the campaign works in three parts: 1) Adult performers may donate their
own content from their accounts to be used in the campaign; 2) Individuals can subscribe for $5
per month to access content; and 3) All NHS workers may access the content for free.
Furthermore, Beyoncé, one of the most famous and successful Black women contemporary
recording artists, raps on her remix of Megan Thee Stallion’s “Savage” that she’s “on that
Demon Time…[and] might start an OnlyFans.” (Knowles-Carter et al., 2020). Demon Time is a
stripper performance series on Instagram Live, with performers wearing face masks to conceal
their identities and are tipped via CashApp. These examples provide a cultural temperature check
with American society’s comfortability in discussing its personal relationship with not only
watching pornography, but also with taking ownership with producing explicit content.
The founding of OnlyFans has further decentralized the adult entertainment industry and
provides financially lucrative opportunities to individuals outside of the industry. Estimates as to
how much money the sex industry makes ranges from $6 billion, to $15 billion, to $97 billion a
year due to different methodologies used that may or may not include more niche markets such
as webcam modeling, sex toys sales, advertisement revenues from amateur pornography
websites, or even strip clubs (Benes, 2018). Although revenue estimates are shrouded in privacy,
it is an understatement to say that 4.57 billion active internet users are consuming pornography
online at a rapacious pace: in 2018 alone, there were 92 million daily average visits to
PornHub.com and 4.7 million pornographic videos uploaded throughout the year (Clement,
2020; Rense, 2018). OnlyFans may be viewed by those contemplating joining as content creators
to supplement or provide a primary income in the age of the “gig economy” akin to those who
are drivers for Uber or Lyft, delivering food through DoorDash, or streaming video game
playthroughs on Twitch.tv for tips.

OnlyFans content creators may be commonly found advertising and interacting with fans
through social media – with a bulk of online interactions occurring over Twitter. Yahoo’s
acquisition of Tumblr, a microblogging site that was known as a safe community space for safe-
for-work and not-safe-for-work subcultures alike, at the end of 2018 sparked outrage among the
sex industry when Yahoo announced that adult content would be banned from its platform
(Romano, 2018). In the following two months after this ban went into effect, traffic to the site
fell 29 percent or about 150 million users. Those interested in viewing, liking, following,
reblogging (akin to a retweet on Twitter), or creating adult content in the form of pictures, .gifs,
and videos on Tumblr were unlikely to migrate to other popular social media platforms like
Facebook or Instagram (which is also owned by Facebook) due to the strict rules and policies on
sensitive content (Facebook, 2020). Instead, porn production studios and actors turned to Twitter
due its lax rules and policies on sensitive content.
Thus, Yahoo’s ban of adult content on Tumblr led to the adult entertainment industry shifting
its marketing strategies and online presence from the relatively less popular Tumblr to an
already-mainstream Twitter. For perspective, Tumblr’s growth plateaued in 2016 at just 23
million users, which was fewer than half that of Twitter and a third that of Instagram – which
have both since grown exponentially (eMarketer, 2016). Studios and actors could expand their
fanbase through interacting with more users frequently with hashtags, retweets, likes, responses,
and private direct messages. Unprecedently, social media has made pornography and sex work
mainstream with content creators looking to engage with users when contrasted to historically
indirect, passive, and purely transactional methods of engagement.
Furthermore, the rise of OnlyFans and the mainstream embrace of pornography and sex work
via Twitter owes more to Tumblr other than Yahoo’s adult content ban. Tumblr set the precedent
for a generation of LGBTQIA+ millennial youths’ sexual scripts and cultural templates for their
attitudes towards sex, sexual expression and identity, and pornography consumption. Prior to the
ban, many LGBTQIA+ individuals and other marginalized users found Tumblr to be a positive,
identity-affirming community space that did not exist on other social media platforms
(Revanche, 2016). As the site was intentionally designed in 2007 to have a harmonious
relationship with users via giving bloggers more freedom than other platforms to create and share
the content they wanted, this facilitated Tumblr to become a sex-neutral space as the site had a
neutral or embracing attitude towards users who posted or shared sexually explicit content
(Carrigan, 2011). As Tumblr in its heyday became increasingly associated with users who were
relatively youthful, had progressive politics, and were predominantly queer and feminist, its
embrace of sexually explicit content (whether this erotica depicted more graphic sexual acts for
one’s sexual pleasure or was sexual and evocative in the artistic and creative sense) became a
cornerstone of unashamed self-expression in identity, self-exploration in sexuality for queer
youth, and connection for users seeking an online community (Bryon & Robards, 2017; Herman,
2013; Petronzio, 2016; Solomon, 2017; Women’s Media Center, 2015). Though other sites or
outlets have made inroads with forming online communities through connecting over adult
content before, Tumblr made the experience for youth personal in the historical context of a
simultaneous increase of LGBTQIA+ legislative rights and representation in mainstream media.
Tumblr’s sex-neutrality facilitated a sexual script for how to behave and feel about sexual
content on social media platforms (Donnelly, Burgess, & Simonds, 2014). That is to say, given
the ubiquity of pornography on the internet prior to social media entering a new phase with the
rise of smartphone technology, a platform such as Tumblr may be considered the modern vector
through which individuals – particularly millennials and other LGBTQIA+ individuals - became
inoculated to the normalization of pornography and engaging with others online through sexually
explicit content. Tumblr’s myriad of communities repositioned where one could find
pornography in that explicit content was no longer exclusively found on websites prone to
malicious malware such as pop-ups, viruses, Trojan horses, and other spyware. Rather, sexually
explicit content on social media now had two major functions: to be enjoyed for one’s own
personal pleasure and to be shared with one’s online community for connection.
Through the post-Yahoo acquisition decline of Tumblr’s utilization, its users migration to
Twitter, and Twitter’s continued growth, the sexual script set by Tumblr communities in turn has
facilitated Twitter’s cultural template for also having laxed attitudes towards posting or engaging
with others’ explicit content in a phenomenon that has been called “Horny Twitter” (Iovine,
2018). Several manifestations of Horny Twitter exist: liking a not-safe-for-work tweet, asking
about sexually related topics through a Twitter poll, engaging in sexuality-related discourse in a
Twitter thread, or tweeting or retweeting something not-safe-for-work without context. The
reasons users may be involved with this kind of content may be for social media engagement to
gain followers à la social media influencers, to establish or further foster online friendships, to
promote their sex work à la OnlyFans, to find someone to exchange nudes with or to hook up
with, or to evocatively catch the attention of one’s friends so they might respond with a meme or
make some other comment in a supportive fashion. Horny Twitter creates an online space that
normalizes women’s, LGBTQIA+ individual’s, and other marginalized community’s sexual
expression. Horny Twitter means that discussions or discourse of sexuality and sexual expression
are no longer framed or defined by heterosexual white men acting as gatekeepers as these
discussions have historically been. Likewise, Horny Twitter has the potential to be educational or
least pro-sex education by and for minority communities (Iovine, 2018). Part of the #MeToo
movement’s (i.e., a feminist social movement against sexual abuse and sexual harassment started
in 2006 by activist Tarana Burke as part of her survivor advocacy work) impact is that
discussions of sex and sexuality are more commonplace on social media platforms like Twitter;
this reverberation may lend itself as to why Twitter users are more willing to tweet about or
follow sexually explicit content as well.
Twitter’s cultural template has led the way for the acceptance and normalization of OnlyFans
content creators to market themselves and create a platform through on the social media
platform. A content creator typically will have the link to their OnlyFans (or similar
subscription-based accounts like JustForFans [justfor.fans]), CashApp, Venmo, SnapcChat, or
Instagram accounts in the profile biographies. They may also market themselves through
tweeting about special promotions for their subscription rates (e.g., “the next 10 users who
subscribe will get 30% off my subscription rate for 3 months”), tweet edited safe-for-work or
not-safe-for-work previews of their OnlyFans-exclusive content, engage with their Twitter
followers through likes, retweets, tweet-replies, responding to private direct messages, tweet
about other facets of their lives outside of OnlyFans, and/or create content with other content
creators or followers on Twitter as well. As OnlyFans is now part of the long lineage of sex work
throughout civilization’s history, this iteration of sex work is unprecedented in how accessible
sex workers are to the masses, how this form of sex work has been normalized and is with
minimal legal risk for creators and followers/subscribers alike, and how this form of sex work
may be taken up by any adult without it needing to define their career nor lifestyle. Given this
unprecedented ubiquity, it is important to understand the lived and virtual experiences of content
creators given their unique perspectives, experiences, and motivations for engaging in sex work.
To better understand the lived and virtual experiences of OnlyFans content creators is to provide
a platform for sex workers who are a community unto themselves, part of the larger sex worker
and sex industry community, and for whom society writ large would prefer to keep marginalized,
silenced, and without rights.

Neoliberalism, celebritization, and pornification as lenses for the construction of online

personas and marketing sexuality in the era of social media.
If Twitter is one of the predominant social media platforms utilized by the OnlyFans
content creator community for marketing their accounts, then it is crucial to understand how the
community seeks to attract followers and potential subscribers to gain social and financial
capital. In an oversaturated market where Twitter users have the ability to scroll through a near-
infinite amount of profiles for their sexual gratification, based off the sheer volume of free
photos and/or video clips posted by content creators, promotional accounts, and/or accounts that
share pirated content (and to say nothing of the amount of free pornography that is available
elsewhere online), convincing users to follow and subscribe may be a matter of the construction
of content creators’ online personas as integrated with one’s body capital. To understand the
process of this construction, it is also imperative to deconstruct the economic and cultural factors
that impact the drive to present and represent oneself online through social media. Chiefly, the
embracing of utilizing OnlyFans among the public and sex workers alike can be seen as a natural
response to the forces of neoliberalism as a political, economic, and cultural ideology and the
simultaneous celebritization and pornification of Western culture.
Neoliberalism may be considered the third wave of capitalism as a doctrine of political
economy ushered in over the past thirty to forty years, defined as “the free-market ideology
based on individual liberty and limited government that [connects] human freedom to the actions
of the rational, self-interested actor in the marketplace” (Jones, 2012). Neoliberalism was
facilitated by the increasing deindustrialization of capitalistic Northern and Western nations
through transferring manufacturing and labor more broadly to cheap labor markets in the South
and East. Neoliberalism may also be considered the dismantling of workers’ collective
bargaining power for higher wages, better working conditions, and the rolling back of federal
and state welfare entitlements and employee benefits (e.g., pensions, on-site childcare, retiree or
long-term care insurance, and education benefits) (Glyn, 2006; Harvey, 2005; Klein, 2007). As
French philosopher of systems of thought Michel Foucault (1926-1984) succinctly points out,
putting individuals at the forefront of an economic system as “self-interested actors in the
marketplace” reveals that neoliberalism goes beyond being a doctrine of political economy and a
form of governmentality to reorder the social and cultural spheres of life to refashion the conduct
of the self in the emergence of the neoliberal self (McGuigan, 2014). The neoliberal self, also
known as homo economicus, is an entrepreneur of himself concerned with human capital,
innovation, and growth (Foucault, 2004/2008). He goes on to specify:
What is the function of this generalization of the ‘enterprise’

form?... [It] involves extending the economic model of supply
and demand and of investment-costs-profit so as to make it a
model of social relations and of existence itself, a form of relation-
ship of the individual to himself, time, those around him, the group,
and the family. (Foucault, 2004/2008).
As the construction of the self from early childhood is mediated by the acquisition and
use of language, and further developed and sustained through consuming media, personal
freedom under neoliberal doctrine is best understood not as a bourgeois ideal but as an
institutionalized individualization. This individualization is celebrated through privileging non-
conformity, bohemian posturing, personal experimentation, and geographical exploration. Under
neoliberal capitalism, there will always be a market - either already established or to be
established in the name of innovation or social progress - for the “rational, self-interested actor”
to flex consumer sovereignty upon. For example, June’s Pride Month for the LGBTQIA+
community has become a month-long pinkwashing holiday for corporations like Nike, Colgate,
Absolut Vodka, and Target to heavily market LGBTQIA+-related products and place Pride flags
in their stores’ windows come the first of June only to stop immediately come the first of July.
Thus, individualization is a contradictory phenomenon in that it fosters traditionally
discriminated populations to fight for and achieve equal rights and representation while not
providing any excuses for when things go wrong at the individual or community level. With
previous collective supports and scripts no longer applying, the neoliberal self is solely
responsible for the circumstances one is born into, for one’s personal failures, and for any bad
luck experienced in a highly competitive and relentlessly harsh social environment (McGuigan,
2014). Furthermore, younger generations that embrace being condemned to their freedom and
sole responsibility creates generational tension through rejecting “dinosaur” attitudes cherished
by older generations. Collectivist principles established by the welfare state after the Second
World War are called into question and/or attempted to be systematically dismantled by
neoliberal politics that could only make sense to individualized people, such as the fight to
dismantle the Affordable Care Act of 2010, opposition to universal preschool programs, or the
prioritization of labor and productivity over workers’ safety in the face of the COVID-19
pandemic.
Neoliberal capitalism’s fetishization of compulsory consumerism and individualism is an
ouroboros seduced to eat its own tail. With widespread affluence, twenty-first century late-stage
capitalism has lifted scores of people out of poverty, improved life expectancy and overall
quality of life, and provided people the ability to live meaningful, fulfilling lives through
increased educational and career-based opportunities. Nevertheless, on a global scale, inequality
across the Earth has worsened over the past thirty to forty years, with the rich becoming richer
and the poor either remaining poor or becoming poorer (McGuigan, 2014). The United States, as
a high-income nation that exploits low- and middle-income nations, is not any better off. The
massification of a reduced quality and affordability of a higher education within the United
States places younger generations into a neoliberal trap as well, with young adults facing the
cognitive dissonance of growing up training for a life of consumerism and the bitter post-
graduation prospects of life-long debt dependency, poor job and retirement prospects, high rents
for apartments, and unaffordable homes to purchase that also lead to delaying marriage, moving
out of one’s childhood home, and life expectancies shorter than one’s family of origin.
Responding to such uncertain and unpredictable labor markets, the neoliberal self must fashion
themselves as someone who is self-reliant and flexible. The neoliberal self turns away from
concerning themselves with the fact that others are in the same situation to organize as a group to
do something about these precarious conditions. Paradoxically, the neoliberal self is hyper-
communicative through increasing reliance on mobile and online technology like smartphones
that facilitate an increasingly cocooned and isolated social experience.
Just as the neoliberal self turns to worship corporations and businesses like Apple,
Supreme, or Gucci for incorporating “cool capitalist” signs and symbols of disaffection and
rebellious posturing, so too does the neoliberal self seek to self-actualize through emulating
celebrities across all forms of media and entertainment. With the rise of social media that is
marketed as a form of self-expression and self-empowerment, yet also inherently includes a
manipulation and surveillance of its users, it has never been easier for the individualized digital
experience to include following corporations and/or celebrities that also seek to manipulate
followers through carefully crafted online personas. The average social media user is now
equally likely to consume sponsored content (i.e., “sponcon”) from celebrities and influencers
alike as they are to consume distinctly humanized content from corporations, such as Wendy’s
being known for viral “clap back” tweets or Sunny D commodifying depression by tweeting “I
can’t do this anymore” during the 2019 Super Bowl (Allenbach, 2019). These experiences and
the kind of content regularly engaged with exemplifies how extreme neoliberal logic
reconfigures every social media user into a brand unto themselves, while simultaneously
exemplifying how celebrity culture penetrates the lives and psyches of individuals.
The proliferation of celebrity culture is an extension of neoliberal ideology in that
celebrity status lends itself to a discursive economic and social capital that cannot be ignored and
functions as a general token of success (Bell, 2010; Marshall, 1997). To be a celebrity is to be
“both labor and the thing that labor produces,” again conjuring to mind the ouroboros desperate
to continuously produce enough labor or celebrity to never complete eating its tail (Dyer, 2004).
Two terms that speak to the cultural and societal prominence of celebrity in modern culture are
celebritization and celebrification. The former broadly speaks to the long-term structural
development and changes at the societal and cultural spheres implied by celebrity, and the latter
is the process by which ordinary people or public figures are transformed into celebrities
(Driessens, 2012). Though different processes, celebritization and celebrification share both a
central importance of self-commodification and a relationship to the corporate and public
relation industries behind them.
Celebritization does not simply refer to an increase of celebrity in space and time, but
rather a meta-process that changes the nature of celebrity and its societal and cultural embedding
through the dynamics of democratization, diversification, and migration (Driessens, 2012). The
democratization of celebrity refers to how there is an increase of “ordinary” people who can
become celebrities through the popularity of reality television and expanding access to mobile
media technologies and the Internet. Those who seek fame through reality television, social
media, and/or other interactive platforms like YouTube further propagate neoliberal logic
through turning the self into a self-branding, monetized commodity. The democratization of
celebrity simultaneously offers an opportunity for the increased visibility of marginalized groups
and demonstrates the potential role of celebrity in everyday life (Turner, 2006). Celebrity
diversification refers to both the growing number of media outlets (e.g., social media, interactive
websites like YouTube and blogs, magazines and newspapers, and television channels) for
people to become celebrities and the profit dynamic within different sectors that facilitate people
to pursue fame. Furthermore, migration is defined as the process through which celebrities use
their autonomy as public personalities and their status to pursue other professional activities
either within their original field or to penetrate other social fields (Driessens, 2012). As
celebrities have become democratized and need to adapt to the current attention economy,
migration can be seen as an attempt to capitalize on one’s status to establish a more lasting
career, to gain exposure, a positive image, influence, and/or money. However, there is the risk
that one’s original fanbase or the new fanbase a celebrity is appealing to may not tolerate the
celebrity’s move into other sectors. Migration is also bidirectional, in that entertainment and
sports celebrities may penetrate other fields like politics; politicians, professors, and/or financial
experts may develop celebrity status as well.
There are three molding forces or meta-processes for how modern Western culture has
become increasingly celebritized: mediatization, personalization, and commodification. The
media, broadly encapsulating mass media, social practices, media as organizations, and other
social institutions, is deeply entangled in society and culture. Mediatization is defined as the
meta-process that is “a certain panorama of...interrelation[s] between media communicative
change and sociocultural change” (Hepp, 2012). Namely, mediatization is both the prerequisite
and possible catalyst for celebritization in that mediatized social fields positively facilitate the
creation of media personalities who can acquire a celebrity status. Personalization refers to the
increasing centrality of the disembodied individual over the collective and the personal over the
structural in cultural and historical narratives (Beck and Beck-Gerhnsheim, 2001). As
individuality is at the ideological core of Western culture, and reinforced by neoliberal ideology
glorifying the self-sufficient personality, celebrity culture operates at the center of Western
culture as it resonates so deeply with these (collectively established) individualistic values
(Marshall, 1997). To embrace becoming a celebrity means developing a public persona, meaning
being at the mercy of the three major types of personalization: individualization, privatization,
and emotionalization. Individualization describes how the public scrutinizes one’s professional
qualities; privatization refers to how there will be a shift in focus from the public to the private
lives of the celebrity; and emotionalization details how attention will shift from the public to the
private persona of the celebrity. Commodification speaks to how celebrities as individual
subjects are attributed economic value, echoing Marxist theory which stresses the social
character of commodities, in that they are bought and sold on the market for a price that is the
monetization of the commodity’s exchange value (Driessens, 2012). Celebrities are not only
products and producers of alienated labor, but they too also embody and personify neoliberal
ideology, as Marshall (1997) writes:
[T]he celebrity as public individual who participates openly as a

marketable commodity serves as a powerful type of legitimation of
the political economic model of exchange and value - the basis of
capitalism - and extends the model to include the individual.
It is important to note that celebrities embody capitalism while having the ability to engage in
value-signaling through movies, pictures, advertisements, songs, merchandising, and/or social
media posts or public statements that critique the system that facilitated their ability to amass
fame and fortune in the first place. However, producing labor that is subversive to capitalistic
ideology still puts the celebrity in an economically advantageous position through exploiting said
value-signaling; likewise, there is a fundamental difference between being transgressive about
sexuality, religion, and/or social mores and being transgressive in relation to the institutions and
practices of capitalistic domination (Harvey, 2002). Though challenging unjust economic
systems are and ought to be fought from within, as one must “play by the rules” to a certain
extent to survive, these three engines - mediatization, personalization, and commodification - are
pervasive within modern culture, yet its effects on society are obscured by championing the
individual while disregarding the collective. Being indoctrinated into a culture that demands the
individual to consume before being consumed, the neoliberal self is also tantalized by the
bombardment of implicit and explicit messages celebrating the celebrity whose labor is nearly as
newsworthy as to what the celebrity consumes. The critical impact this has on current
generations, especially Millennials (born between approximately 1981 and 1996) and Gen Z
(born approximately from 1997 onward), is that for the first time in human history, celebrity
status and the financial rewards that are associated with fame are seen as largely attainable to
ordinary people through the explosive utilization of the Internet, smartphones, and social media
(Turner, 2006).
Prior to the rise of social media, a celebrity’s fame was characterized by it being ascribed
(i.e., fame inherited from famous parents or relatives such as royal families), achieved (i.e., fame
due to achievements or talents such as athletes or scientists), or attributed (i.e., fame facilitated
by industry mediators such as movie or television stars). Social media now facilitates anyone
having the potential to attract and direct attention to themselves for the chance to self-commodify
(Hearn and Schoenhoff, 2015; Rojek, 2001). Categorically, a social media celebrity is an
individual who does not have prior ascribed, achieved, or attributed fame who becomes famous
on at least one social media platform (Hearn and Schoenhoff, 2015; Marshall, 2010). To become
a social media celebrity, one must successfully capture the attention of viewers through
consistent self-branding and content posting to amass social capital to be converted into
economic capital (Zulli, 2018). However, social media celebrity is rather a misnomer in that
there are several distinct categories of social media content creators based on the extent to which
the individual can exert influence over their community of followers and the different practices
engaged in to acquire, maintain, and convert social capital into economic capital. Rather, social
media influencers create their own online personas, create their own content to build their
audience, and cultivate a network through self-representation techniques; in other words, social
media celebrities are high-profile social media influencers.
If the overarching goal of any social media influencer is to obtain recognition and
followers to acquire social capital, then there is an inherent hierarchy within this realm based on
one’s audience size, dictating one’s status and monetization opportunities (Zulli, 2018). The
most popular classification differentiates between Micro-, Macro-, and Mega-influencers
(Bullock, 2018). Micro-influencers form the largest group of social media influencers and
generally have anywhere between 5,000 to 100,000 followers (Ruiz-Gomez, 2019). Micro-
influencers, specializing in a particular area to reach a targeted follower base, are generally
perceived to be more authentic and accessible than Macro- and Mega-influencers due to
generating the best ratio of reach and engagement with followers (i.e., the interaction of the
audience with posted content measured by considering viewer response rates in the form of
clicks, likes, and/or comments) (Bernazzani, 2018; Markerly, 2015). Macro-influencers are
divided into two subcategories: “power middle influencers” and “top macro-influencers” (Chen,
2013). The former has between 100,000 to 500,00 followers and the latter have between 500,000
to 1 million followers; these individuals have likely become full-time social media influencers,
utilizing formal business approaches, and are likely to use more than one social media platform
to cross-promote their content. Mega-influencers have at least 1 million followers, having
become extremely well-recognized authorities in a certain field through strategic self-branding,
whereas true social media celebrities, often regarded as traditional celebrities, have at least 10
million followers. Outside of the true social media celebrities, the Micro-, Macro-, and Mega-
influencers can be assumed to be adopting a micro-celebrity mindset, engaging in practices that
include crafting an online persona for public consumption to capture the interest of an audience
by revealing information selected strategically to maintain relevancy and manage their fan base
(Marwick and Boyd, 2011).
One major impact of the celebritization of modern Western culture is that, as at the heart
of celebrity is the ability to direct and maintain attention, social media and the Internet have
facilitated the emergence of an attention economy with attention being the most significantly
valuable commodity. Social media platforms like Instagram, Twitter, and TikTok intensify
attention’s value by designing and promoting their apps to be used in such a way that glancing
and consuming a large amount of content in a short period of time is the dominant form of
consumption (Zulli, 2018). Capturing attention requires the individual to self-brand or
commodify their identity, personality, and portrayal of their online persona to achieve a
competitive advantage to acquire social capital in a crowded marketplace (Gamson, 2011;
Shepherd, 2005). To self-brand, an individual must offer a unique selling proposition that
distinguishes themselves from the mass of other social media influencers to overcome the most
challenging hurdle of building and maintaining an audience that remains invested in the
individual over time. Some key factors of achieving long-term public recognition include
personality (e.g., portraying authenticity and being relatable), providing compelling and distinct
content (e.g., becoming an authentic, credible voice in a field relevant to the intended audience),
reach (e.g., gathering a community of followers) and generating meaningful engagement - both
from influencer-to-followers and follower-to-follower (Kahmis et al., 2017l Tilton, 2011). To
perform authenticity within one’s self-brand, an individual may engage in other practices to
attract and sustain followers so as to build brand equity: carefully selecting images and/or videos
to post, deleting or untagging unflattering images or videos shared by others online,
differentiating what content to post based on the platform utilized, and staging everyday
activities as a performance with front stage behavior (i.e., representations of digital identity) and
back stage behavior (i.e., performing intimacy by creating engagement and emotional connection
with the audience through responding to their comments, likes, direct messages, etc.).
OnlyFans content creators further empower themselves through embracing Western
societies’ present-day celebritization. Adopting the micro-celebrity mindset, content creators
seek to amass a following, attain an organic social reach, and monetize their reach through
leveraging their body capital in their posted visual content and leverage their social capital
utilizing targeted communication techniques (Lykousas, Casino, & Patsakis, 2020). This may be
best exemplified by the common trend that content creators and non-content creators alike
engage in on Twitter where users posts two photos side by side in the same tweet, either one of
their face and a body part or two different body parts, with the caption simply reading, for
example, “the face / the ass.” This trend is also often occurring in the context of users
encouraging one another to create this post as a quote-retweet, meaning that other users see two
different accounts engaging in this display of body capital simultaneously and may feel
encouraged to participate likewise. Sexualized labor becomes a heightened form of emotional
labor. Performing front stage behavior, content creators frequently entice followers by posting
explicit content. Textually, this could take the form of tweeting to express that they are sexually
aroused or sharing a fantasy they have, soliciting followers to participate in sharing their own
explicit content in the reply section of a Twitter thread, and inquiring if any followers or other
content creators live in a location they will be visiting to collaborate in creating content.
Visually, explicit content could include posting content that is solely graphic in nature or
sensationalizes everyday activities, such as posting a photo of themselves posing in their
underwear with a new plant they have bought with the caption deliberately only mentioning the
plant to entice others to point out that the content creator is in their underwear.
On Twitter, retweeting and/or posting about news articles or current-day events, memes,
promoting charities or other fundraising campaigns, and commenting on other facets of culture
also become forms of front stage behavior by appealing to followers by demonstrating their
personality, multidimensionality, and humanity - that one’s identity in real life and online is not
simply confined to being a sex worker and associated sexual labor. Thus, front stage behavior
becomes a means to personalize one’s social media account, in turn reconfiguring their profiles
into both a publicly accessible diary through the ritualized performance of the content creator’s
everyday life and a sexual fantasy playground for followers to consume (Marshall, 2010). Front
stage behavior also includes how the content creator performs their online persona on other
social media platforms such as Reddit, Instagram, and TikTok. Linking to one’s Amazon wish
list can also be included as a form of front stage behavior through the perspective that
consumption is intimately tied to the psychological creation and production of the self: as
products are imbued with certain symbols of identity, consumption communicates to society at
large where one fits within a social structure by reflecting one’s values and one’s innermost
desires (Todd, 2012). Closely related to this is that many content creators list their Venmo and
CashApp handles in their profile descriptions; if one’s Venmo profile is public, Venmo may act
as a further extension of one’s self-representation through making visible who the content creator
sends or receives money from with a required caption that can include words, emojis, and/or
.gifs.
Performing backstage behavior takes the forms of liking and/or responding to others'
comments on one’s own posts or direct messages, commenting and/or liking others’ posts, and
who the content creator follows. On Twitter, these forms of backstage behavior can also be read
as front stage behavior as these extra-textual dimensions of their profiles are available for
followers to see and are thus expansions of self-representation for consumption. Likewise, any
amount of time and labor put into preparing, creating, and editing content traditionally would be
considered off stage behavior, with the caveat that in making a performance of the everyday,
whether these acts in themselves are converted into front stage behavior through creating
“behind the scenes” or “preview” content is a matter of preference, style, and marketing strategy.
A common strategy for capturing the attention of potential and current followers alike is
posting a thirst trap picture or video, a sexually provocative social media post intended to entice
viewers to follow, like, and/or comment on the post to express admiration and/or potentially get
the attention of the influencer in return. The normalization and utilization of thirst traps
represents how social media influencers invest time, energy, and resources into their bodies to
increase their status and to exchange said body capital for economic, social, or cultural goods
(Bourdieu, 1984). The hyper-awareness of and investment in one’s body also represents how the
body is a symbolic container of one’s economic, moral, and social worth (Giddens, 1991; Saguy
& Riley 2005). It is safe to assume that a vast majority of social media influencers seek to
increase their body capital through pursuing narrow definitions of the ideal body. For cisgender
men, this means seeking to obtain high muscle mass and low body fat percentages, larger chests
and biceps, and small waists with v-line abdominals; for cisgender women, this means seeking to
obtain a small waist-to-hip ratio and may include how one styles their hair and/or applies
makeup. These are the ideals that are consistently displayed and reinforced as sexy - and equally
conflated as true definitions of physical health - across media.
However, what kind of body capital any individual social media influencer seeks to
pursue is likely to be influenced by one’s cultural identity and/or one’s exposure to cultural cues
in the external environment. For example, Black cisgender women perceive bigger, thicker, and
more voluptuous figures to be more attractive and tend to have lower levels of body
dissatisfaction when closely identifying with Black culture (Craig, 2006; de Casanova, 2004;
Turnage, 2004). In contrast, Asian cisgender men and cisgender women both tend to endorse
extreme thinness in their body ideals for cisgender women; Asian cisgender women who have
been exposed to Western (read: white) cultural cues about body ideals tend to have higher levels
of body dissatisfaction (Evans & McConnell, 2003; Jung & Forbes, 2007; Wildes, Emery, &
Simons, 2001). Body capital can also be determined by one’s own identity within a community
and/or one’s sexual practices. On Grindr, a location-based social networking and online dating
app for gay, bisexual, trans, and queer people, users can identify themselves on their profiles -
and filter out other users’ profiles - based on “tribes” that are generally based on one’s body,
such as “otter,” “twink,” “rugged,” “bear,” “jock,” and “clean-cut.” For those who identify with
fat fetishism, high body capital would be associated with a partner who is overweight or obese.
Suffice to say, the scrutiny and everyday hyper-awareness of how one moves and presents their
body in real life and online has been magnified by our increasingly media-driven and celebritized
culture, neoliberal ideals that glorify self-actualization and self-investment in the economical,
physical, and social realms, and the underlying pornification of modern Western society.
Pornification, or the mainstreaming of pornographic styles, gestures, and aesthetics, in
Western societies’ popular media cultures has primarily been facilitated through media
technology and the porn industry, through regulations and media policies, and through the
general mainstreaming of sexuality within a given culture (Paasonen, Nikunen, & Saarenmaa,
2007). To define “pornography” itself is dependent upon any efforts to mark the boundary
between acceptable and non-acceptable: it could be equally be defined in terms of content (i.e.,
sexually explicit material) or lack of content (i.e., material without any redeeming values),
intention (i.e., texts intended to arouse consumers), and effect (i.e., texts arousing consumers) as
much as it can be defined by genre, divided between hardcore, softcore, and limitless sub-genres.
Linguistically, “porn” is a morally charged word that is replaced by the sex industry and
journalism with “adult entertainment” or “erotica,” with the latter specifically utilized to separate
the aesthetically tasteful from the tasteless. If a culture’s pornography is conceptualized as a map
of that culture’s borders, the driving influences of media technology and industry, regulation and
policy, and the mainstreaming of sexuality demonstrate the expansion of these borders over the
past 40 years (Kipnis, 1996).
Pornification is directly tied to developments in media technology, media culture, and the
expansion of the porn industry (Paasonen, Nikunen, & Saarenmaa, 2007). Pornography traces its
roots to the development of print technology in the eighteenth century, with pornographic texts
and images, followed by pornographic photography in the nineteenth century through mass-
produced post-cards and stereoscope devices (Sigel, 2000). Pornographic motion pictures were
created as early as the nineteenth century and subsequently created utilizing the newest film
technology, from the standardization of 16mm film in the 1920s through the introduction of
35mm film in the 1970s. Porn production companies would be able to distribute their films
through both theaters and videocassette recorders for at-home viewing by the late 1970s (Miller-
Young, 2007; Paasonen and Saarenmaa, 2007). The creation of amateur pornography has
similarly followed technological innovations, with 16mm film cameras being made available to
the public in the late nineteenth century, followed by the inventions of the portable video
cameras and Polaroid cameras in the 1960s, and digital photo and video cameras in the 1990s.
The rapid accessibility and popularity of the Internet from the 1990s onward provided the porn
industry an opportunity to cultivate unprecedented growth, with pornography becoming one of -
if not the - most successful forms of content production online (Lane, 2001). This has afforded
porn industry companies to amass enough capital to control both production and distribution,
being able to market the same product across different media (e.g., DVD, online, magazines, and
pay-per-view TV), branch out into organizing and participating in adult entertainment
conventions such as AdultCon and Exxxotica, and merchandising branded sex toys, clothing
apparel, and other accessories and products.
Changes in regulation and media policy since the 1960s have also facilitated
pornification, positioning pornography from the boundaries of the public to the mainstream. In
the United States, federal laws pertaining to obscenity have been continuously challenged in
court since being passed in the 1970s with government regulation and/or censorship efforts
diminishing by the 1980s and online materials being regulated by the 1990s. Changes in
television regulation have been the most dramatic within the media industries: digital TV
channels provide 24/7/365 access to porn films through pay-per-view programming; dramas and
lifestyle series regularly incorporate soft-core pornography aesthetics and scenarios into their
plots; and there has been marked increase in television shows that commodify the personal,
emotional, and sexual realms of celebrities and reality television cast members alike (Attwood,
2006; Calvert, 2000; Glynn, 2000). The pluralization of increased sexual representation and
sexual expression within the confines of television alone exemplifies how neoliberal values of
individuality and self-actualization have consistently challenged upheld cultural norms by
democratizing the market economy. However, a pluralization does not guarantee a true
democratization: while hardcore pornography continues to push the boundaries of what is
acceptable for commodification and consumption, such as a recent increased popularity of
incest-themed pornography, popular media with incorporated pornographic aesthetics tend to
produce predictable and stereotypical narratives of gender, sexuality, race, and desire (Paasonen,
Nikunen, & Saarenmaa, 2007; PornHub Insights, 2019). Overall, moving pornographic style and
conventions further into the mainstream produces a positive feedback loop to establish new kinds
of norms and regulatory effects.
Western societies’ pornification has also been facilitated by a general sexualization of
contemporary culture, as exemplified by:
“preoccupations with sexual values, practices and identities; the

shift to more permissive sexual attitudes; the proliferation of sexual
texts; the emergence of new forms of sexual practices; the apparent
breakdown of rules, categories, and regulations designed to keep
the obscene at bay; our fondness for scandals [sic] controversies
[sic] and panics around sex” (Attwood, 2006).
The sexualization of culture, intertwined with pornification as a blurring of boundaries between
the pornographic and mainstream, have given rise to porno chic, an increase in sexually explicit
representations in non-pornographic contexts across art and culture (McNair, 2002). Examples of
porno chic include sexually explicit song lyrics and music videos, thirst traps and other
pornographic elements in online self-representations, advertisement campaigns with sexual

innuendos, and the visual arts (Mey, 2006; Mowlabocus, 2005; Railton & Watson, 2005).
Mainstream porno chic subscribes to heteronormative, hegemonic narratives of desire to be
financially profitable, relying upon highly hegemonic body shapes, styles, acts, and scenarios
(Paasonen, 2006). Within the gay and queer community, Grindr, already offering users a
subscription-based paid version of the app called Grindr XTRA and a premium paid version
called Grindr Unlimited, now operates Grindr Bloop, an online store that sells Grindr-themed art
prints, COVID-19 masks, and apparel like socks and collegial sweatshirts to signify one’s
identity, resonance, and/or embracement of casual hook-up culture.
The sexualization of culture and the rise of porno chic may speak to how the cultural,
social categories (i.e., hierarchies), and boundaries within Western societies’ mass culture are
currently in flux. What is being redefined is the distinction between the public and private, the
acceptable and the shameful, the intimate and the distant, the sexy and the unsexy, norms
regarding sexuality and gender identities and expression, and which communities are accepted or
demonized within the mainstream. What is considered pornographic is, in essence, a
transgression or a counter-aesthetic to dominant norms for bodies, sexualities, and desire itself
(Kipnis, 1996). The pornification of Western society’s popular media can be conceptualized as a
deregulation of the dominant norms of representation and consumption due to “self-interested
actors” exercising their influence upon neoliberal marketplaces, advances in the rights,
protections, and representation of marginalized groups like the LGBTQIA+ community, and said
transgressions being hyper-visible and accessible for discourse across online platforms and
within academia and political theaters. While these social categories and boundaries are in flux,
providing unprecedented opportunities to safely explore one’s self-presentation and self-
representation for privileged and historically marginalized communities alike, what becomes
increasingly available and normalized through social media is an opportunity to invest in oneself
through commodifying the self online.
The ability to become an OnlyFans content creator who constructs an online persona to
market their sexualized labor is a natural “next step” following the extreme logic of neoliberal
late-stage capitalism and the simultaneous celebritization and pornification of modern Western
societies’ popular culture. Late-stage capitalism economic policies and governmentality have
positioned middle- and low-income adults into financially precarious conditions that make
having an OnlyFans account a viable option to obtain financial security. With 49% of adults
reporting that they would have difficulty paying a $400 emergency expense, 25% of adults
skipping necessary medical care because of high healthcare costs, and 80% of Americans living
paycheck-to-paycheck with unstable incomes and no significant savings, to become an OnlyFans
content creator is a means to fight back against an institution that is only concerned with
domination (Board of Governors of the Federal Reserve System, 2019). OnlyFans is an
opportunity to be the head of the ouroboros rather than the tail. If the pornographic - and by
extension sex work - functions as a symbol of anarchy, then OnlyFans content creators empower
themselves by engaging in a struggle over “power...access to the world…[and] control over our
own bodies and our own minds” when neoliberal capitalism continues to leave behind those who
are most vulnerable to its own practices (Kendrick, 1987). Indeed, OnlyFans highlights how
neoliberalism has created a three-way tension between a want or need to sell our sexuality so as
to contain our economic anxiety to survive capitalism, a want or need to empower oneself
through embracing one’s sexuality and sexual expression, and a desire to transgress and disrupt
late-stage capitalism’s exercises of power over the lower classes, women, people of color, people
living with HIV/AIDS, the LGBTQIA+ community, those living with mental illnesses, chronic
illnesses, and other physical and mental or cognitive disabilities, migrants and immigrants, those
formerly and presently incarcerated, and many other historically disenfranchised groups.
When the COVID-19 pandemic first began in March of 2020, there was already a 40-
50% increase in content creator signups by early April of 2020 (López, 2020). This signifies how
OnlyFans and sex work in general is a means to obtain emancipation from neoliberal
capitalism’s covert and implicit attempts to maintain power through controlling narratives of
socioeconomic hierarchies, public polices and legal protections, and reality itself. The United
States of America has the resources available to end COVID-19, poverty, homelessness,
affordable housing shortages, crippling student debt, sky-high health insurance costs, the already
existing climate crisis/collapse, ongoing racial violence and discrimination, police brutality (i.e.,
government- and state-sanctioned violence and murder), a white supremacy-induced mass panic
via the rise of neo-Nazism, fascism, nativism, Q-Anon, and America First/#MAGA politics,
voter suppression and gerrymandering, and other critical problems posing grave threats to
democracy itself. However neoliberal (i.e., individualized) political leaders - and the
corporations that lobby and donate to said leaders - choose to tolerate or exacerbate these issues
through sheer myopia, harmful public policies, and a lacking political courage in the name of
holding onto power and economic gain (Yentel, 2018). A society commits social murder when it
places its people in such a position that they are susceptible to meeting too early a death,
deprives them of the ability to acquire the basic necessities to survive, places them under
conditions in which they cannot have a real chance to prosper, and strong arms its people to stay
in these conditions via being governed by leaders who permit these conditions to remain (Engels,
1845). Neoliberalism disguises this social murder because the offenses systemically enacted
against the masses are ones of omission rather than commission, that society sees the failure,
perishment and death of our fellow Americans as natural, that the individual or the community is
to be blamed for not trying hard enough or being resilient enough. As sexuality and pornography
are conceptualized as distasteful and disorderly forces that create anxiety about the distinction
between the public and the private, so too do they facilitate anxiety over maintaining cultural,
social, and economic categories and boundaries (Attwood, 2004). Thus, while acknowledging
sexuality and pornography are both already overburdened with cultural significance and
symbolism, OnlyFans content creators and sex workers alike hold a unique position in society to
channel sexuality to subvert and transgress the categories, boundaries, and norms reinforced
through financial domination and political minority rule. OnlyFans content creators in this
context use neoliberal conventions of consumerism and self-presentation to challenge the
present-day socioeconomic hierarchy to demand not just social justice and equity, but true social
liberation which addresses the systemic barriers in society, starting with sexual power,
knowledge, and representation.
Furthermore, being an OnlyFans content creator who utilizes and invests sexualized and
non-sexualized labor into Twitter and other social media platforms represents the unique way
this form of sex work reflects the widening dimension of the public self for commodification and
consumption. OnlyFans content creators signify the “demotic turn” of society, where the media
and social media users alike are enticed by the ordinary aspects of extraordinary public figures
(Turner, 2004). In turn, there is an expanding desire of the population to be part of the public, to
turn one’s self-presentation and representation into a spectacle as a means for self-affirmation
and validation from others. In a hyper-communicative society further reliant upon social media,
one’s online persona is an extension of the neoliberal self’s investment in one’s own capital and
innovation. The online persona is consistently worked upon for the commodification of the self
and is vital to the maintenance and centrality of one’s identity. (Marshall, 2010). As sex work
has often been at the forefront of technological and cultural changes and advancements, being an
OnlyFans content creator represents a new cultural reality of expanded sexual inclusivity, where
people of any gender, sexuality, color, race, size, ability, citizenship status, and age (meaning 18
or older) can monetize the performance of the self and their sexual labor for a global audience
(Bankov, 2019). Though this emerging cultural reality can only be considered a marginal culture
at best, as OnlyFans is still relatively new and is likely to be replaced by another platform akin to
Tumblr’s fate, being an OnlyFans content creator represents how sex work will be continuing to
be an option within utilizing future online platforms and technological and augmented reality
advancements (Bankov, 2019).

Statement of Specific Research Questions
The purpose of this research study was to explore the lived and online experiences of
adult OnlyFans content creators who create explicit content and who promote their OnlyFans
profiles through their Twitter accounts. This research study sought to shed light on potential
trends in the demographics and experiences of OnlyFans content creators while exploring their
perceptions of the shared online culture on Twitter between content creators and followers.
Furthermore, this research study sought to explore trends within sex workers’ self-reported
perceptions of social support, self-esteem, and how they discerned meaning and search for
meaning in their lives. As OnlyFans has become a cultural phenomenon since its founding in
2016, the platform has normalized and increased the visibility and diversity of the online sex
worker community. Seeking to better understand the lived and online experiences of content
creators may provide nuanced understanding of this unique, online mode of sex work, positively
contribute to current research and discourse on sex workers, inspire future research for
developing effective healthcare or community-based interventions, guidelines, and/or resource
allocations to address the unique needs of online sex workers.
This investigation sought to elucidate: 1) Themes within experiences of accessing
common services; 2) Trends within self-reported perceptions of ones’ social supports; 3) Trends
within self-reported perceptions of one’s self-esteem; 4) Trends within self-reported perceptions
of the presence of and search for meaning in one’s life; 5A) Themes within content creators’
motivations for joining OnlyFans; 5B) Themes within content creators’ perceived changes in
self-perception since joining OnlyFans; 5C) Themes within content creators’ overall experiences
utilizing OnlyFans and Twitter; 5D) Themes within content creators’ engagement with and
descriptions of the content creator and followers/fans culture on Twitter; 5E) Themes of how
content creators perceive how the COVID-19 pandemic had impacted their utilization of
OnlyFans; and 5F) Themes from what content creators wanted followers/fans to know about
what it means to be a sex worker.
This research study sought to generate theories in answering the following research
questions:
Research questions pertaining to accessing common services.
1A. What common themes or experiences will be elucidated from participants’ overall
experiences accessing shelters?
1B. What common themes or experiences will be elucidated from participants’

experiences accessing medical services?
1C. What common themes or experiences will be elucidated from participants’

experiences accessing mental health services?
1D. What common themes or experiences will be elucidated from participants’

experiences accessing legal aid services?
1E. What common themes or experiences will be elucidated from participants’

experiences accessing law enforcement?
Research questions pertaining to the Multidimensional Scale of Perceived Social

Support.
2A. What is the relationship between OnlyFans content creators and their perceived
family social support?
2B. What is the relationship between OnlyFans content creators and their perceived
friends social support?
2C. What is the relationship between OnlyFans content creators and their perceived
significant other social support?
Research questions pertaining to the Rosenberg Self-Esteem Scale.
3. What range of self-esteem will OnlyFans content creators report?
Research questions pertaining to the Meaning in Life Questionnaire.
4A. What range of presence of meaning will OnlyFans content creators report?
4B. What range of search for meaning will OnlyFans content creators report?
Research questions pertaining to the perceptions and experiences of the online

OnlyFans content creator and follower/fan community on Twitter.
5A. What common experiences or themes will be elucidated from a grounded thematic
analysis of OnlyFans content creators’ motivations for joining OnlyFans?
5B. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators have observed changes in their self-
perception since joining OnlyFans?
5C. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators describe their overall experience with
utilizing OnlyFans and Twitter?
5D. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators experience their online communities of other
content creators and their followers?
5E. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators have been affected in their role as content
creators by the need for social distancing in response to the COVID-19 pandemic?
5F. What common experiences or themes will be elucidated from a grounded thematic
analysis of what OnlyFans content creators want their followers, fans, and/or clients to
understand about what it means to be a sex worker?
Chapter II: Methods
Methodology Selected
A qualitative study is appropriate when the goal of research is to explain a phenomenon
by relying on the perceptions of a person’s experience in various situations, whereas a
quantitative approach is appropriate when a researcher seeks to understand a relationship
between variables (Creswell, 2003; Stake, 2010). As the research study’s original purpose was to
examine the lived and online experiences and perceptions of OnlyFans content creators who
produce explicit content through analyzing demographic information, open-ended questions, and
psychological measures with Likert-scales alike, a mixed-methods approach was appropriate.
However, as recruitment stopped prematurely (as to be explained at the beginning of Chapter III:
Results) and there were difficulties with recruiting (as to be explained in Chapter IV:
Discussion), there was a sample size significantly smaller than anticipated (n = 19). Thus, it was
necessary to pivot from a mixed-method approach to a qualitative approach, focusing on the
open-ended questions where there was an abundance of responses from participants to conduct
grounded thematic analyses.
Grounded Theory Methodology
This research study was conducted using grounded theory methodology, a means to move
from individual knowledge to collective knowledge and to discover theory from data (Glaser &
Strauss, 1967; Stake, 2010). For this research survey, grounded theory methodology was utilized
to have theories emerge by methodologically coding open-ended questions with terms that
succinctly and conceptually summarize phrases, lines, words, and/or overall responses (Glaser &
Strauss, 1967). Constructivist grounded theory was utilized to conceptualization the phenomenon
of OnlyFans content creators’ experiences, to understand it in abstract terms built through coding
participants’ responses to open-ended questions, and to generate theories based on the
interpretation of their shared experiences (Charmaz, 2006). The generated theories are the
researcher’s interpretation of the data, consistent with constructivist grounded theory (Charmaz,
2006).
Participants
The sample was drawn from an online community of sex workers who utilized OnlyFans
and Twitter in tandem. Participants needed to have met the following criteria via the pre-screen
questionnaire preceding the research survey’s informed consent form to take the research survey:
1) Participants needed to be at least 18-years-old at the time taking the research survey; 2)
Participants needed to live in the United States of America or one of its territories (i.e., Puerto
Rico, Guam, U.S. Virgin Islands, Northern Mariana Islands, and American Samoa); 3)
Participants needed to have at minimum a professional working proficiency of the English
language; 4) Participants needed to have a OnlyFans account that was used to produce explicit
content; 5) Participants needed to have a Twitter account that was associated with promoting
one’s OnlyFans account.
Of note, the original research design of this investigation aimed to recruit at a minimum
of 115 OnlyFans content creators. This number was determined by analyzing statistical power
with G*Power, a free-to-use software that calculates statistical power. As there were three
psychological measures and six open-ended questions being in used in the survey, it was
determined that 111 participants were required to detect a small effect (Faul et al., 2009). To take
into consideration participants who did not qualify for the survey and completed it nonetheless
(i.e., participants who passed the pre-screening questionnaire but had responses to open-ended
questions that demonstrated that they did not most likely have experience with OnlyFans and/or
Twitter), those who did not respond to questions but made it to the debriefing form nonetheless,
those whose responses were extreme outliers, and/or those whose responses demonstrated that
the participant was not intentionally responding to questions (e.g., participants who respond with
“0 – No Answer” across all three psychological measures), 115 participants were determined to
be an appropriate necessary minimum amount for detecting any small effects. Ultimately, the
sample size (n = 19) would not have enough statistical power for detecting a small effect.
However, the six open-ended questions for thematic analysis, and potentially generating up to
114 responses within this section of the research survey alone, still permitted for the grounded
thematic analyses to occur as originally intended.
Data Collection
This study used an anonymous research survey and including the following sections: 1)
The pre-screen questions to determine eligibility; 2) The informed consent form with the need
for a signature waived to protect confidentiality (Appendix A); 3) Demographics (Appendix B);
4) Experiences accessing common services and with utilizing OnlyFans (Appendix C); 5) Three
psychological measures (Appendixes D - F); 6) Open-ended questions about the Twitter and
OnlyFans online community for thematic analysis (Appendixes G); and 7) Debrief information.
The research survey was only available online through Qualtrics.
All responses to the five pre-screen questions were recorded. For participants who met
full eligibility following the pre-screen questions and consented to participate in the research
survey, only those who made it to the Debriefing page, the final page of the research survey, had
their responses recorded to protect confidentiality. The research survey took about 15 to 25
minutes to complete depending on how long participants reflected on questions prior to
responding to questions and how much participants sought to write for their responses to open-
ended questions. No research survey was attempted or completed by participants without
providing consent to participate in the research project; it was assumed that participants
completed the research survey in a single attempt.
The raw survey data was stored in the principal investigator’s Qualtrics account that only
the principal investigator had access to. Upon beginning to analyze the data, the principal
investigator downloaded the data as an Excel spreadsheet and set a password on the file. The
spreadsheet, in addition to any other documents created for this research project, was stored in
the principal investigator’s university-based Google Drive which had the two-factor
authentication feature on to sign-in. When needed, the file was downloaded from Google Drive
onto the principal investigator’s computer (which had a password for signing in) and the file was
then permanently deleted from the computer and re-uploaded into Google Drive upon finishing
work before logging off Google Drive. Likewise, the principal investigator logged off the NVivo
(Release 1.0) software, which only the principal investigator only had access to as well, upon
finishing working on the grounded thematic analyses. The research survey project and its data on
Qualtrics, the NVivo (Release 1.0) software, and all documents or files on Google Drive
containing data that were not already shown in this dissertation were permanently deleted
following approval from the dissertation committee upon successfully completing all
administrative tasks for submitting the final version of this dissertation.

Procedures
After approval by the dissertation committee and the Institutional Review Board (IRB),
the researcher began recruiting participants to complete the anonymous online Qualtrics research
survey as described above in the Participants section of this chapter.
Paid monetary compensation to participants for their successful completion of the survey
was not provided. The principal investigator included in the research survey’s flyer, in all
outreach communications, in all social media posts, and in the Qualtrics online survey informed
consent form and debriefing page, that he would, first, be donating form personal funds $1.00 to
the New Jersey Red Umbrella Alliance (NJRUA; njrua.org) for each participant who completed
the survey, and second, using the results from the survey to create a policy brief to be shared
with non-profit sex work organizations and allied health clinics for how to best support the
OnlyFans sex work community. As the sample size would have resulted in a donation of $19.00,
the principal investigator donated $100.00 to NJRUA to better match the anticipated sample size
prior to prematurely stopping recruitment. Likewise, the policy brief could not be created as
intended due to the ssample size and not being able to analyze statistical power of the three
psychological measures, or to elucidate themes of participants’ experiences accessing common
services provided that the majority of participants did not provide responses to this series of
questions.
A Google Sheet containing the information of all locations or online list-serves was
created to keep track of recruitment efforts. The Google Sheet was organized by type of site (i.e.,
Clinical Psychology List-Serve, Non-Profit Sex Work Organization, [State] Adult Entertainment
Store) and information collected included the site’s name, phone number, business hours,
physical address, and contact email address. Three columns were dedicated for contact attempts,
with the writer recording the date of the attempted contact and the outcome (e.g., “Emailed
3/18/21; Declined” or “Email 4/1; Distributed to volunteer network”). The principal investigator
waited at least a week before attempting to contact a site a second or third time and did not
attempt to contact a site after three attempts.
Professional psychology list-serves through the American Psychological Association
were chosen by their potential relevancy to the online sex work community. The principal
investigator researched non-profit sex work organizations ran by sex workers across the nation
and checked their websites to see if said non-profits listed other non-profits that they supported
or were in association with to find more sites to contact; non-profits were then emailed. Adult
entertainment stores across two metropolitan states were located by searching “adult
entertainment store” on Google Maps. Stores were then called with the principal investigator
asking for permission to come by to drop off a flyer to be hung up in the store. Health clinics
across the same two metropolitan states as the adult entertainment store were located through
researching for community clinics that were either low-fee or had specialties in OB/GYN,
LGBTQIA+, and HIV/AIDS care.
The principal investigator also created a Twitter and Instagram account
(@Survey4OnlyFans) that was used to promote and recruit participants for completing the
survey. The posts were pictures formatted as infographics, e.g., graphic visual representations of
information. Topics of posts included information on the research survey for recruitment efforts,
how to find a sex-worker affirmative therapist, defining sex work, and what the criminalization
of sex work represents. Hashtags included in the caption (e.g., #onlyfanscreators,
#onlyfansshoutouts, #guysofonlyfans) were chosen based on popular hashtags OnlyFans content
creators use on social media (Myfavecelebs.com, 2022) The investigator followed Rutgers,
psychology, non-profit sex work agencies and organizations, and other appropriate academic &
news outlets. The principal investigator deleted both social media accounts upon successfully
defending his dissertation.
Recruitment occurred between January 2021 through August 2021. The principal
investigator did not look at any of the raw data in Qualtrics until the end of the recruitment. By
the end of this period, dissemination occurred through one local university’s department of
residence life, three local graduate student email list-serves, and one local university-wide
LGBTQIA+ graduate student group chat to encourage members of these list-serves to post the
digital version of the flyer on their own social media. Dissemination also occurred through
emailing four list-serves from divisions of the American Psychological Association. Sixteen non-
profit sex work organizations ran by sex workers located across the United States were contacted
through email: Three of these non-profits agreed to disseminate information; nine non-profits did
not respond to the three outreach attempts; and four non-profits declined to disseminate
information. Flyers were distributed in-person to eight adult entertainment stores across two
local metropolitan states after calling the stores to explain the research survey and asking for
permission to distribute flyers. Nine community clinics were contacted through email and none
of the clinics responded to outreach attempts. Flyers were distributed in-person to two local
Planned Parenthoods after calling the sites, explaining the research survey, and asking for
permission to distribute flyers. Research survey flyers were distributed to laypersons viewing a
major city’s Pride Parade in June 2021. There were ten Instagram and Twitter posts made.
Data Analyses
“Cleaning” the data for determining the sample size.
Upon ending recruitment, the principal investigator first “cleaned” the data. Qualtrics
recorded 90 responses. Of the 90 responses (100%) recorded, 19 (21.11%) met criteria for
inclusion for analysis following checking and “cleaning” the data. Of the 71 responses (78.89%)
who did not meet inclusion eligibility, 56 participants (62.22%) responded “No” to one of the
five pre-screening questions prior to reaching the research survey’s informed consent form and
were redirected from participating. For the first pre-screen question, all 90 (100%) participants
responded “Yes” to being 18 years or older at the time of taking the research survey. For the
second pre-screen question, 82 participants (91.11%) responded “Yes,” and nine participants
(10.00%) responded “No” to permanently residing in United States or its territories. For the third
pre-screen question, all remaining 82 participants responded “Yes” to having at a minimum an
intermediate or professional working proficiency of the English language. For the fourth pre-
screen question, 48 participants (53.33%) responded “Yes,” and 34 (37.78%) participants
responded “No” to having an existing OnlyFans account utilized as a content creator. For the
fifth pre-screen question, 34 participants (37.78%) responded “Yes,” and 13 participants
(14.44%) responded “No” to having an existing Twitter account that is utilized to promote their
OnlyFans account.
All 34 participants who responded “Yes” to all five pre-screening questions also
consented to participant in the research survey. Of these 34 participants, 24 participants (26.57%)
did and 10 participants (11.11%) did not progress through the research survey to reach the
debriefing page to have their responses recorded. Of the 24 participants who did have their
responses recorded, 5 participants (5.56%) did not answer a majority of questions and were
removed from the final inclusion for analysis. Please see Figure 1 (Page 230) to see a visual
breakdown of participant’s inclusion and exclusion from the final analyses.
Grounded thematic analysis for experiences access common services.
Participants’ experiences with accessing common services were originally intended to be
analyzed in a grounded thematic analysis using the NVivo (Release 1.0) software to elucidate
common experiences and themes. However, provided that there was a low number of responses
(ranging from one to eight) for each of the open-ended questions (i.e., “…what was helpful,
unhelpful, and what you would tell [providers or staff members] about how to best serve people
who are involved in the sex work industry), the principal investigator conducted a grounded
thematic analysis in Microsoft Excel using the constant comparative method, sorting and
organizing the responses into coding groups according to their attributes (Glaser and Strauss,
1967). Participants’ responses were sorted by columns, with each column containing the
responses to medical services, mental health services, legal aid services, and law enforcement
services respectively. As no one endorsed having utilized shelters for this part of the survey, no
participants were shown the related question of what was helpful or unhelpful in working with
staff at shelters.
The principal investigator then utilized open coding, the process of breaking down,
examining, comparing, conceptualizing, and categorizing the data, for each of the responses
(Strauss and Corbin, 1990). This translated to reading a response sentence by sentence, applying
a code or codes that best described the experience spoken of in the first sentence (e.g., Disclosure
Was Setting Dependent or Need for Sensitivity Training), and reading the following sentence to
see if another code could be or needed to be generated, and repeating this process until the entire
response had been read through. The complete response was then reread while keeping the codes
generated in mind to consider if there were potential codes that could more succinctly or more
accurately describe the experience or sentiment associated with either individual sentences or the
entire response. For subsequent responses, this process was repeated in addition to determining
whether any of the previously established codes best captured the experience or sentiment
described in the current response being analyzed. New codes were generated if none of the
previously established codes best described a sentence or the overall response. Axial coding, the
process by which data is put back together in new ways after open coding to make connections
between categories, was attempted following completing open coding for all responses
pertaining to each helpful-unhelpful service question (Strauss and Corbin, 1990). However, axial
codes were not generated given the limited number of responses for each helpful-unhelpful
service question (Strauss and Corbin, 1990).
Psychosocial influences.
Multidimensional Scale of Perceived Social Support.
The Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet, Dahlem,
Zimet, & Farley, 1988) addressed the subjective assessment of social support adequacy. It was
designed to assess perceptions of social support adequacy from three sources: family, friends,
and a significant other.
The MSPSS contained 12 questions that directly addressed perceived social support with
4 questions each determining the Family, Friends, and Significant Other subscales. The response
options to each item were one of the 7-point Likert-type choices: very strongly disagree (1),
strongly disagree (2), mildly disagree (3), neutral (4), mildly agree (5), strongly agree (6), and
very strongly agree (7). An eighth option, no answer (0) was included in the survey for
participants who did not feel comfortable answering a particular item. Scores ranged from 0 to
84: higher scores indicated higher levels of perceived social support for the respondents (Zimet,
Dahlem, Zimet, & Farley, 1988).
In a study analyzing the mediating effect of perceived social support on the influence of
insecure attachment orientation on internalized homophobia in a group of 70 Italian gay men, the
Italian version of the MSPSS revealed good internal reliability and adequate psychometric
properties (Di Fabio & Busoni, 2008). In Zimet et al.’s (1988) original study constructing the
MSPSS investigating associations between undergraduates, perceived social support, and
depressive and anxious symptomology, the team of researchers correctly hypothesized that: 1)
Perceived support from Family was significantly inversely related to both depression and
anxiety; 2) Perceived support from Friends was related to depression symptoms but not anxiety
and 3) The Significant Other subscale was minimally but significantly related to depression, as
was the scale as a whole.
Cronbach’s coefficient alpha was obtained for the scale as a whole and the three
subscales. The reliability of the total scale was .88; for the Significant Other, Family, and Friends
subscales, the values were .91, .87, and .85 respectively. These values indicated good internal
consistency for the scale as a whole and for the three subscales.
The Multidimensional Scale of Perceived Social Support was scored by calculating the
raw score for the Family, Friends, and Significant Other subscales (0-28) as well as the total raw
score (0-84) for each participant. All respective raw total subscale scores (0 – 532 per subscale)
and raw total scores (0 – 1596) were added together and then divided by the number of
participants (19) to calculate the mean scores for the subscales and the total score; a percentage
equivalent, median score, mode score, and range was also calculated for the subscale and total
mean scores as well. A mean score, percentage, median, mode, and range were also calculated
for each of the 12 individual questions.
Rosenberg Self-Esteem Scale.
The Rosenberg Self-Esteem Scale (RSE) (Rosenberg, 1965) is a widely used self-report
measure for evaluating global self-worth by measuring both positive and negative feelings about
the self via a unidimensional scale with questions related to overall feelings of self-worth or self-
acceptance. People high in self-esteem may claim to be more likeable and attractive, to have
better relationships, and to make better relationship than people with low self-esteem, who are
more susceptible to depression and less experimentation.
The RSE originally contained 10 items, however, one question was mistakenly omitted
from the online research survey. All items were answered using a 4-point Likert scale with the
following response options: strongly disagree (1), disagree (2), agree (3), and strongly agree (4);
items 2, 5, 6, and 9 are reverse scored (Rosenberg, 1965). A fifth option, no answer (0) was
included in the survey for participants who did not feel comfortable answering a particular item.
Scores ranged from 0 to 36: higher scores indicated higher self-esteem (Rosenberg, 1965).
The RSE has been found to have: excellent test-retest reliability (ICC = 0.85 – 0.89) in a
study of high school juniors and seniors (Rosenberg, 1965; n = 5,024), excellent internal
consistency (ICC = 0.85 – 0.88) in a study of university students in Spain (Martin-Albo et al.,
2007; n = 415), and excellent concurrent validity in a study of high school students (Myers and
Winters, 2002; n = 1,686). Furthermore, the RSE has been utilized in previous research
pertaining to gay men. Canali et al. (2014) evaluated self-esteem in gay men (n = 310) with a
mean age of 24 from southern Canta Catarina, Brazil. Most of the participants studied (80.9%)
had high self-esteem; participants who only studied up to the primary school level, were
unemployed, had been subjected to bullying in the last year, and those with a history of
psychotherapeutic and psychiatric treatment had significantly lower self-esteem than others.
The Rosenberg Self-Esteem Scale was scored by calculating the total raw scores (0-36;
one question was mistakenly omitted from the online research survey) for each participant and
converting the total raw score into a percentage. A mean score, percentage equivalent, median,
mode, and range was also calculated for the scores for each individual question.
Meaning in Life Questionnaire.
The Meaning in Life Questionnaire (MLQ) (Steger et al, 2006) is a widely used self-
report measure for evaluating how people understand and track their perceptions about their
lives. Specifically, the MLQ measured how full respondents feel their lives are of meaning
through the Presence subscale and how engaged and motivated respondents were in efforts to
find meaning or deepen their understanding of meaning in their lives through the Search
subscale.
The MLQ contained 10 questions answered with a 7-point Likert scale with the following
options: absolutely untrue (1); mostly untrue (2); somewhat untrue (3); can’t say true or false
(4); somewhat true (5); mostly true (6); and absolutely true (7). An eight option, no answer (0),
was included in the survey for participants who did not feel comfortable answering a particular
item. The Presence and Search subscales each contained five questions with scores ranging from
0 to 35. There are four possible interpretations for participants’ scores based on whether they
score above or below 24 on the two subscales. Scoring above 24 on both Presence and Search
indicates feeling that one’s life has a valued meaning and still exploring one’s meaning. Scoring
above 24 on Presence and below 24 on Search indicates feeling that one’s life has a valued
meaning and not actively exploring the meaning in one’s life. Scoring below 24 on Presence and
above 24 on Search indicates feeling that one’s life does not have a valued meaning and actively
searching for meaning in one’s life. Scoring below 24 on both Presence and Search indicates
feeling that one’s life does not have a valued meaning and not actively searching for meaning in
one’s life (Steger, 2006).
The MLQ has demonstrated good internal consistency for both the Presence (.86) and
Search (.87) subscales; the MLQ has also demonstrated good test-retest reliability for both
Presence (.70) and Search (.73) subscales (Steger et al., 2006). There is no previous research
conducted on sex workers utilizing the MLQ. However, previous research utilizing the MLQ on
special populations has demonstrated that presence of meaning in life is generally higher among
older individuals and that American younger adults report greater presence of meaning, whereas
Japanese young adults report greater search for meaning (Steger and Shin, 2010).
The Meaning in Life Questionnaire was scored by calculating the raw score for the
Presence and Search subscales (0-35 per subscale) to determine if the participant scored above
or below 24 on both subscales to determine one of four score interpretations (Steger, 2006). The
total raw score and percentage equivalent, mean score, median, mode, and range were also
calculated for each individual question.

Grounded thematic analysis for experiences and perceptions of the OnlyFans

content creator and follower community on Twitter.
A grounded thematic analysis was conducted utilizing the NVivo (Release 1.0) software
for the responses from the six open-ended questions related to participants’ experiences and
perceptions of the OnlyFans community on Twitter. NVivo was chosen to be utilized for the
research project’s grounded thematic analyses for several reasons. The software allowed for a
systematic approach to analysis via keeping all documents stored in one place and allowing for
the process of elucidating themes to be as uniform as possible. NVivo is also not
methodological-specific, meaning that it was appropriate to use for grounded thematic analyses.
Utilizing NVivo allowed for efficiency in creating, editing, keeping track of, and comparing
codes for themes and subthemes as they emerged. The software provided the matrix coding table
function to better visualize the relationships between themes and popular words associated with
open-ended question respectively.
One document per open-ended question was created to contain participants’ responses
and the six documents were then uploaded into NVivo. Each response was manually coded by
the principal investigator and the software was not utilized in any form to suggest or generate
codes on behalf of the principal investigator. The principal investigator utilized the constant
comparative method via open coding and axial coding as described above in the Grounded
Thematic Analysis for Experiences Accessing Common Services section (Glaser and Strauss,
1967). The process of open coding resulted in generating “minor” themes that described the
response as specifically as possible (e.g., Emotionally Intensive and Physically Intensive). Axial
coding was then utilized to compare all codes generated to determine if two or more codes may
be related and described by a superordinate or “higher order” phenomenon or experience,
resulting in the “major” themes (e.g., Labor being superordinate to the Emotionally Intensive and
Physically Intensive minor themes) (Strauss and Corbin, 1990). On a handful of occasions, a
response was coded with only a major theme whereas the vast majority of responses were coded
with at least one minor code the associated major theme. After completing axial coding for each
of the six questions, NVivo’s matrix coding table function was utilized to visualize how many
times each minor theme was coded with other minor codes. The matrix coding tables were then
analyzed to see how many times minor and major themes were coded and to understand the
relationships between minor and major themes.
The Researcher
The researcher earned a Bachelor of Science in Psychology with a minor in Sociology for
his undergraduate education; he earned a Master of Psychology in Clinical Psychology and was a
doctoral candidate at the time of conducting the research and writing. No participant had a direct
relationship with the researcher that represented a conflict of interest, such a reporting
relationship, contract, or any relationship with the researcher that may have imparted bias on the
research study.
The researcher had been trained in the skills necessary to carry out the designed study.
The researcher’s skills included research methodology, research design, and familiarity and
experience with various psychological measures and scoring, in addition to having taken
undergraduate-level and graduate-level courses in statistical methods and in advanced statistics
and research design.

Trustworthiness
Credibility, transferability, confirmability, and dependability are necessary to establish
the trustworthiness and validity of qualitative research (Lincoln and Guba, 1985). Credibility and
transferability were established within the pre-screen questionnaire by ensuring participants were
of legal age, that they understood the information contained within the informed consent form
and understood what was being asked of them in the research survey by having at minimum a
working proficiency of the English language, that they had the shared experience of residing in
the United States or one of its territories where sex work is criminalized, and that they were
utilizing both OnlyFans and Twitter prior to taking the research survey. Transferability was
simultaneously limited given the small sample size (n = 19) and the uniqueness of the OnlyFans
sex work community in the context of the larger online sex work community. Confirmability was
established by manually coding the open-ended responses following the constant comparative
method as part of the grounded theory approach to ensure a deeper understanding of the data and
to ensure no researcher bias. Research bias was also minimized by both not looking at any of the
raw data in Qualtrics until the end of the recruitment period and manually coding the open-ended
responses using grounded theory methodology to facilitate an objective interpretation of the data.
Dependability was established as the research procedures were documented within this
dissertation to be able to allow someone to follow, audit, and critique the research process
(Sandelowski, 1986).
Ethics
Following the methods and procedures as outlined above in this chapter ensured validity
of the study. Potential participants who answered “no” to any of the five pre-screen questions or
answered “I DO NOT AGREE to participate” after reading the informed consent form were
redirected to a page explaining that they were not able to participate in the research survey. The
informed consent form that participants were instructed to read prior to providing consent or
declining to participate in research survey is shown in Appendix A. The informed consent form
followed U.S. federal guidelines including “a fair explanation of procedures, description of risks
reasonably to be expected, a description of benefits reasonably to be expected, an offer of inquiry
regarding the procedures, and an instruction that the person is free to withdraw (Frankfort-
Nachmias and Nachmias, 2008). The research survey was anonymous and participants did not
need to include their name, email, or other identifying information to consent to participate in the
research survey to protect confidentiality. Participants were not encouraged to disclose any
identifying information within any instructions or questions contained within the research
survey.
The risks to human subjects associated with the research study were minimal.
Participants were informed they could skip questions or withdraw from the study altogether if
they felt uncomfortable because of any questions. Participants were provided resources for
emotional distress, for LGBTQIA+ individuals, for domestic violence and sexual assault, for
alcohol and substance dependency, for mental health services, and for HIV and STI testing
within the informed consent form. Participants were also instructed to call 911 if they were
experiencing a psychiatric crisis while taking in the research survey. All participants were at
least 18 years of age. All files or documents containing data of any kind and the NVivo program
on the principal investigator’s computer were permanently deleted following final approval by
the dissertation committee to minimize any future risks associated with confidentiality.
Chapter III: Results
On August 19th, 2021, OnlyFans announced that the company would be implementing a
ban of sexually explicit content from its platform in October 2021 (Cole, 2021). Six days later,
OnlyFans announced that the company had “secured assurances necessary to support [their]
diverse creator community and [has] suspended [emphasis added] its planned October 1 policy
change,” effectively reversing the ban (OnlyFans, 2021). The policy announcement and its
reversal fundamentally changed the conditions for how potential participants of this research
survey may now approach the research survey compared to participants who completed the
survey prior to the initial announcement. Considering this, this dissertation committee and
principal investigator came to a consensus to end recruitment and to analyze the data already
obtained. Utilizing Pearson correlation statistical analyses to address research questions
regarding the Multidimensional Scale of Perceived Social Support, the Rosenberg Self-Esteem
Scale, and the Meaning in Life Questionnaire respectively were not achievable provided that the
final number of participants who provided adequate responses was 19 (n=19) after checking and
“cleaning” the data in preparation for analysis.
Regardless, there is no question that the information obtained is still indispensable and
insightful for beginning to better understanding the experiences of OnlyFans content creators
specifically and online sex workers in general. The following two sections within this chapter
will, first, provide descriptive statistical information and, second, will provide a thematic
analysis obtained from the research survey’s open-ended questions. The final Discussion chapter
will address theories generated from the data, address the limitations of the data obtained from
these analyses and the overall utility of this research survey, and address the implications of
OnlyFans’ sexually explicit content ban announcement and subsequent policy “suspension.”
Descriptive Statistics
Demographics.
Regarding age, seven participants (36.64%) participants were between 21- to 29-years
old, eight participants (42.11%) were between 30- to 39-years-old, and two participants (21.05%)
were between 40- to 49-years-old.
Cisgender women comprised the majority gender identity, with 14 (73.68%) participants
total. Three cisgender men (15.79%) and two transgender women (10.53%) participated.
The majority of participants identified as part of the LGBTQIA+ community. Five
participants (26.31%) identified as pansexual. Four participants (21.05%) identified as bisexual.
Three participants (15.39%) participants identified as gay or lesbian. Two participants (10.30%)
identified as queer, and two participants identified as straight. One participant (5.26%) identified
as questioning their sexual orientation; one participant identified as a sexual orientation not
listed; and one participant chose not to provide their sexual orientation.
The majority of participants racially identified as white or European Americans (n=11,
57.90%). Five participants (26.32%) identified as biracial. One participant (5.26%) identified as
Black or African American, one identified as Middle Eastern and one chose not to provide their
racial identity.
The majority of participants identified living with one or more disabilities or
impairments. Five participants (22.73%) identified living with a mental health disorder; five
participants identified living with a learning disability. One participant each (5.26%) identified
living with a long-term medical illness, a mobility impairment, and/or a disability or impairment
not listed. Eight participants (36.36%) did not identify with a disability or impairment and one
participant (5.26%) chose not to answer this question.

All 19 participants (100%) had earned at least a high school-level education. Three
participants (15.39%) specifically earned at least a high school degree or equivalent. Four
participants (32.05%) had engaged in some college but did not earn a degree. One participant
(5.26%) had graduated from a vocational program. One participant had earned an Associate
degree. Seven participants (36.84%) earned their Bachelor’s degree. Two participants (10.53%)
had earned a graduate or professional degree.
Participants had diverse household statuses. Ten participants (52.63%) were renting an
apartment. Five participants (26.31%) were either in the process of buying a home or had bought
a home. Two participants (10.53%) were living in a condominium. One participant (5.26%) was
living in a shelter and did not specify what kind of shelter it was; one participant identified
having another household status not listed.
Please see Table A (Page 208) for a summary of participants’ demographics.
Experiences in sex work and with services.
Participants’ ages at which they first experienced exchanging something sexual for
money or something else of value ranged from being a teenager to being an adult. Six
participants (31.58%) were between the ages of 15- to 19-years-old; seven participants (36.84%)
were between the ages of 20- to 24-years-old; six participants (31.58%) were between the ages of
31- to 34-years-old; and one participant (5.26%) was 40-years-old or older.
Most participants, 14 total (73.68%), identified being the sole provider for their families.
Four participants (21.05%) were not the sole provider. One participant (5.26%) identified having
some other provider structure.

Nine participants (47.37%) identified being currently independent in terms of the number
of family members they were currently supporting. One participant (5.26%) was supporting one
other family member. Four participants (21.05%) were supporting two other family members.
Three participants (15.39%) were supporting three other family members. One participant was
supporting four family members (5.26%).
The majority of participants sought common services since beginning to engage in sex
work, with the exception of three participants (15.39%) who responded that they have not
utilized any services since beginning to engage in sex work. Eleven participants (57.90%)
endorsed utilizing medical services. Eight participants (42.11%) endorsed accessing mental
health services. Four participants (21.05%) sought legal aid. One participant (5.26%) identified
using another common service not listed. No participants identified having utilized a shelter,
while one participant had previously responded that they were currently housed in a shelter in an
earlier part of the research survey.
Participants’ willingness to disclose their professional identity as sex workers was
dependent upon the type of services sought. For medical providers, four participants (21.05%)
had disclosed their professional identity while six (31.58%) had not. Eight participants (42.11%)
had other experiences about disclosing their professional identity that will be addressed in the
qualitative analysis. Seven participants (36.84%) had disclosed their professional identity to
mental health professionals while 12 participants (63.16%) chose not to answer this question.
One participant (5.26%) endorsed disclosing their professional identity to legal aid practitioners;
two participants (10.53%) denied disclosing their professional identity to legal aid practitioners;
one participant (5.26%) had another experience about disclosing their professional identity to a
legal aid practitioner; and 15 participants (78.95%) chose not to answer this question. One
participant (5.26%) endorsed disclosing their professional identity to a law enforcement officer;
three participants (15.30%) denied disclosing their professional identity to a law enforcement
officer; and 15 participants (78.95%) chose not to answer this question.
Participants had mixed responses when inquired about if they had experienced being
victims of either sex trafficking or exploitation. One participant (5.26%) endorsed being a victim
of sex trafficking and nine participants (47.37%) denied having been victims. Nine participants
(47.37%) chose not to disclose if they were victims of sex trafficking. Regarding exploitation
(e.g., wage theft, being overworked or undercompensated, or entering workplace conditions that
are unsafe), nine participants (47.37%) endorsed being victims of exploitation and nine
participants (47.37%) denied being victims of exploitation. One participant (5.26%) chose not to
disclose if they were a victim of exploitation.
Please see Table B (Page 211) for a summary of participants’ experiences in sex work
and with services.
Experiences with OnlyFans.
The years that participants joined OnlyFans ranged from 2017 to 2020. One participant
(5.26%) became a content creator in 2017. Three participants (15.39%) joined the site in 2018.
Two participants (10.53%) started in 2019. The majority of participants became content creators
in 2020, with 12 participants total (63.16%). One participant (5.26%) chose not to disclose the
year they joined OnlyFans.
Participants’ ages for when they joined OnlyFans ranged from being a young adult to an
adult. One participant (5.26%) joined between 18- to 20-years-old. Eight participants (42.11%)
started their OnlyFans between the ages of 21- to 29-years-old. Five participants (26.32%)
started between the ages of 30- to 39-years-old. Four participants (21.05%) began between the
ages of 40- to 49-years-old. One participant (5.26%) declined to disclose the age they joined
OnlyFans.
Participants’ years of experience working with webcam modeling, videography and film,
and/or photo medias ranged from novice to professional. Six participants (31.58%) had zero to
one years of experience. Four participants (21.05%) had two to three years of experience. Three
participants (15.39%) had four to five years of experience. One participant (5.26%) had six to
seven years of experience. Two participants (10.53%) had 10 or more years of experience. One
participant (5.26%) declined to disclose their years of experience.
Most participants were currently engaging in other forms of sex work in addition to being
an OnlyFans content creator. Specifically, four participants (21.05%) were only engaged in sex
work via OnlyFans; 14 participants (73.68%) of participants were currently engaging in other
forms of sex work; and one participant (5.26%) declined to disclose if they were engaging in
other forms of sex work currently.
For said 14 participants (100.00%), they were currently engaging in an array of other
forms of sex work. Webcam modelling was endorsed by six participants (42.86%). Sugar
daddy/momma and sugar baby arrangements were endorsed by six participants (42.86%)
Pornographic film performing was endorsed by five participants (35.71%). Escort services were
endorsed by five participants (35.71%). Exotic dancing was endorsed by four participants
(28.57%). BDSM or dominatrix-based work was endorsed by four participants (28.57%).
Sexting via the “Other – Please Specify [Open Text Box]” option was endorsed by three
participants (21.43%). Massage or massage parlor related work was endorsed by one participant
(7.14%). One participant (7.14%) declined to disclose the kinds of sex work they were currently
engaged in.
Participants reported a range of average weekly hours of labor dedicated to their
OnlyFans and Twitter accounts. Five participants (26.32%) endorsed zero to nine hours of
weekly labor. Six participants (31.58%) endorsed 10 to 19 hours of weekly labor. One
participant (5.26%) endorsed 30 to 39 hours of weekly labor. Two participants (10.53%)
endorsed 40 to 49 hours of weekly labor. Two participants endorsed 50 to 59 hours of weekly
labor. One participant (5.26%) endorsed 60 to 69 hours of weekly labor. Two participants
(10.53%) declined to disclose how many hours of weekly labor they dedicate to OnlyFans and
Twitter.
The majority of participants endorsed experiencing having someone try to threaten,
exploit, and/or get freebies from them since joining OnlyFans and Twitter. Fourteen participants
(73.68%) endorsed having someone attempt to threaten them. Three participants (15.39%)
denied experiencing having someone attempt to threaten them. One participant (5.26%) had
another experience that will be addressed in the qualitative analysis. One participant (5.26%)
chose not to answer this question.
Becoming a content creator had increased participants’ abilities to connect to non-profit
sex work organizations ran by sex workers. Before joining OnlyFans, ten participants (52.63%)
were connected to a non-profit sex work organization ran by sex workers and seven participants
(36.84%) were not; two participants (10.53%) chose not to disclose this information. Since
joining OnlyFans, 14 participants (73.68%) were now connected to non-profit sex work
organizations ran by sex workers, three participants (15.39%) were not connected, and two
participants (10.53%) chose not to answer this question.

Please see Table C (Page 214) for a summary of participants’ experiences with OnlyFans.
Participants perceived they had the least amount of social support from family, more
social support from friends, and the most social support from their significant others. Please note
that subscale scores were out of 28 (100.00%). The mean score on the Family subscale was 16.4
(58.6%), the median score was 16 (57.14%), and the scores were quad-modal with two
participants each scoring 4 (14.29%), 12 (42.86%), 15 (53.57%), and 16 (57.14%). The mean
score on the Friends subscale was 20.6 (73.6%), the median score was 24 (85.71%), and 25
(89.29%) was the mode score with four participants. The mean score for the Significant Other
subscale was 23.0 (82.1%), the median score was 24 (85.71%), and 28 was the mode with seven
participants. Combining the three subscales for a total or global perception of one’s social
support, the mean score out of 84 was 61.4 (73.1%), the median score was 64 (76.19%), and the
mode score was 79 (94.05%) with four participants.
Please see Table D (Page 217) for a summary of the subscale and total scores and a
summary of scores for each individual question.
The Rosenberg Self-Esteem Scale contained scores that could range from 0 to 36 with
higher scores indicating higher self-esteem (Rosenberg, 1965). Scores from the 19 participants
ranged from 9 (25.00%) to 36 (100.00%) and with the mean score being 27.9 (77.50%). The
median score was 28 (77.78%) and the mode score was 36 via three participants. Of note, the
lowest score of 9 (25.00%) was the only score that fell below 50.00%; for context, the second,
third, and fourth lowest scores were 19 (52.78%), 23 (63.89%), and 24 (66.67%) respectively.
Please see Table E (Page 219) for a summary of the total scores and a summary of scores
for each individual question.
There is a discrepancy between the interpretation of the mean Presence and Search
subscale scores and the frequency of participants’ scores. For the Presence subscale, the mean
score out of 35 was 17.1 (48.7%) and the median score was 16 (45.71%). For the Search
subscale, the mean score out of 35 was 22.0 (77.5%) and the mean score was 28 (80.0%). The
total score category with respect to the two mean subscale scores is defined as being below 24 on
Presence and below 24 on Search. This is interpreted to indicate “feelings that one’s life does
not have a valued meaning and purpose” and that participants are “not actively exploring this
meaning or seeking meaning in one’s life.”
However, the breakdown of other three subscale combinations may suggest a different
global experience for participants. Four participants (21.05%) scored above 24 on Presence and
above 24 on Search, indicating feelings that one’s life has a valued meaning and purpose, while
still openly exploring one’s meaning or purpose. Eight participants (42.11%) scored below 24 on
Presence and above 24 on Search, indicating feeling one’s life has a valued meaning and
purpose while not actively exploring the meaning or seeking meaning in one’s life. Seven
participants (36.84%) scored below 24 on Presence and below 24 on Search, aligning with the
total Presence and Search mean score interpretation above.

Please see Table F (Page 221) for a summary of the total scores and a summary of scores
for each individual question.
Qualitative Analyses
Accessing services, trafficking, and exploitation.
Accessing services.
Two general organizing principles discerned from OnlyFans content creators’ reported
experiences accessing common services (i.e., medical and mental health, legal aid, law
enforcement, and shelters) is that, first, whorephobia is both deeply embedded and felt within
these public systems and that, second, it is the lack of whorephobia experienced within these
encounters that are considered services successfully rendered. As there was an open-ended
question for each service soliciting feedback on what has been helpful and unhelpful, and how
providers or professionals may best serve sex workers, the number of participants who selected
the “I choose not to answer” response may act as a barometer for how explicit whorephobia or
hostility is experienced within each service. For example, “I choose not to answer” was selected
by 17 participants (89.47%) (i.e., the greatest number of participants who selected “I choose not
to answer” for this series of questions) when inquired about law enforcement, whereas five
participants (26.32%) responded to the following optional law enforcement question inquiring if
there was anything else participants wished to share. All five of these responses denounced law
enforcement officers. On the other hand, only nine participants (47.37%) (i.e., the lowest number
of participants who selected “I choose not to answer” for this series of questions) selected “I
choose not to answer” with respect to providing feedback on what has been helpful and unhelp
when accessing mental health services. One may surmise that participants’ willingness to engage
in these inquiries maps onto a health-judicial binary of engagement, with participants more
willing to tolerate experiences of whorephobia for personal care out of necessity than to risk
further disenfranchisement and violence from those that enforce law and uphold social order.
When inquired about medical services specifically, themes of disclosure being setting-
dependent, perceived judgement from providers, and calls for the need for sensitivity training
emerged. Setting-dependent disclosure encapsulates how participants avoided disclosing their
sex-worker status to mitigate receiving a lesser quality of care and seeking specific institutions
that are known to provide competent care to sex workers. Interesting, Planned Parenthood was
namechecked twice: one participant noted they say “no” when staff inquire about sex work
because they “don’t know what they do with the info,” whereas another participant commented
that they “find it hilarious that an employee at planned parenthood [sic] told me that I shouldn’t
get tested for STI s [sic] so often in a judgmental tone…I stopped going there and went to a
community clinic instead.”
Callen-Lorde Community Health Center, a well-recognized and commended LGBTQIA+
healthcare setting based in New York City, was contrastingly the other institution namechecked,
with one participant commenting that they sought medical services from Callen-Lorde because it
is “very [sex work]-inclusive. They manage my [hormone replacement therapy]. They have
education and understanding in sex work and are affirming and non-judgmental.” Here, in
understanding Planned Parenthood as predominantly aligned with women’s healthcare and
Callen-Lorde as predominantly aligned with gender- and sexual orientation-inclusive care, it is
the former that contains deeply felt anxiety about women’s sexuality and the latter that embraces
said sexuality.
Another setting-dependent disclosure comment synthesizes this Planned Parenthood-
Callen-Lorde polarity, with the participant stating, “I think invasive questions particularly
without the explicit culture within the org [sic] of being [sex work]-friendly are inappropriate.
This includes how questions are phrased or specific use of language (ex. “prostitute”).” Thus,
medical settings that do not make explicit their ability and willingness to provide sex worker-
competent care jeopardizes alienating their respective local sex work community and not having
whorephobic practices (even when treating a patient not engaged in sex work) go unchallenged.
One participant’s response makes explicit the nuance in how sex work is further demonized in
medical practices, commenting that “I don’t tell [medical providers] for fear they will think im
[sic] drug seeking.”
Perceived judgement from providers was indicated to be both anticipated and
experienced. The same participant who noted they were judged by a Planned Parenthood staff
member for getting regularly tested for sexually transmitted infections also shared that they
“always kept it to myself that I was a sex worker because of the stigma and I didnt [sic] schedule
appointments to be lectured nor did I want to sacrifice quality of care.” Medical providers may
be aware of and consider occupational risks in the treatment of their patients, while it is with
patients who are engaged in sex work where this consideration is intensified – rather, this
consideration is transformed into an assertion. Though medical providers may have the right to
add something akin to “high risk sexual behavior” to any patient’s electronic medical record,
there is a unique conflation of a sex worker’s occupation as an indicator of one’s sexual health
practices. One patient points this out succinctly: “At a doctors [sic] office, they don’t ask. And I
think that’s good. My sexual health isn’t dependent on my profession.” Another participant
shares, “in my 20s, I was misdiagnosed with PID (Pelvic Inflammatory Disease) and medicated
for an ‘untreated STI’ because my doctor assumed my pain was unrelated to my history of
polycystic ovaries. I would tell medical professionals that occupation is not necessarily an
indicator of unsafe sexual practices.” Whorephobia expressed as medical misdiagnosis has the
potential to cause unnecessary pain, healthy anxiety, undue stress, further medical complications,
and wastes time and money.
Calls for the need for sensitivity training were directly stated. One participant pondered
that “perhaps sensitivity training would help” address how “there is still a lot of judgement in the
medical field.” Another participant states, “there is a desperate need for services that won’t
stigmatize or [proselytize] in such a way as to push people in the sex trades away from seeking
healthcare,” and one participant succinctly expresses that “we need non-judgmental, culturally
competent healthcare.” Though these were the only direct responses calling for sensitivity
training, it is not farfetched to understand from all the responses about medical services that
culturally competent healthcare for sex workers is urgently needed.
The three responses to the optional medical services question (i.e., “Is there anything else
you would like to share about medical services?) drives home how much work there is to be
done for bridging the gap between medical providers and sex workers. As one participant points
out: “medical services and providers, overall, are whorephobic.” This perception is very likely a
common sentiment across the sex industry. Likewise, having sex workers as patients routinely
withhold pertinent information about their lives to avoid feeling judged is characteristic of a
system that is actively – and selectively - hostile towards those the system deems undeserving of
patient-centered care as the system is more interested in recapitulating social order. Healthcare
systems (i.e., medical providers, administrators, CEO’s, health insurance companies) that will
not or cannot listen to sex workers to address how whorephobic practices “stigmatize or
proselytize…to push people in the sex trades away from seeking healthcare” is a moral failure
that gravely harms individuals and the communities said healthcare systems dedicate themselves
to serving.
With regards to what has been helpful and unhelpful while utilizing mental health
services, themes of practitioners being non-judgmental and/or sex work-friendly emerged in
addition to descriptions for how whorephobia presents itself in the therapy chair. One basic
principle of exploratory and/or supportive psychotherapeutic modalities is to follow the patient’s
lead as they are encouraged to free associate to facilitate better insight into one’s intrapsychic or
interpersonal dynamics as related to their presenting problem(s). Thus, one basic principle for
providing sex work-friendly psychotherapy is to not “bring [sex work] up unless [the patient]
initiates the conversation,” or else the practitioner runs the risk of making their patient “feel
judged” or that sex work is “invalid work.” Rather, to have a sex work-friendly practitioner who
is “well versed in the topic,” who “understands terms, doesn’t judge, doesn’t try to talk [patients]
out of [sex work] or carry a bias about [sex work]” fosters a psychological safe environment in
which patients are “able to be open and honest.” One participant “suggest[s] mental health
professional[s] learn how to provide culturally competant [sic], trauma-informed, [sic] care,” as
there is clear overlap between trauma-informed care and providing sex work-friendly care.
However, to find a mental health professional, let alone a sex work-friendly practitioner,
is not without its challenges. One participant commented that “finding a sex work competent
therapist who takes my health insurance is impossible and so I have to pay out of pocket.” If a
basic tenet of psychotherapy is to follow the patient’s lead, then the practitioner’s whorephobia
expresses itself when the practitioner brings in sex work as part of the dialogue when the patient
has not mentioned it. To assert that sex work is material to be worked through when not initiated
by the patient is to express one’s anxiety or a narcissistic unconscious wish to control or

transform their patient into the “good patient” who seeks to please their therapist. One participant
remarked that they were “turned away by therapists because of [their] sex trade involvement,
even though- or perhaps because- [sic] it was not something [they] wanted to address in
therapy.” Likewise, another participant shares: “I feel like a lot of mental health professionals
use my involvement in [sex work] as a [sic] end all be all for all of my mental health issues and
urge me to consider getting into different more ‘civilian’ types of work.” These two responses
highlight how whorephobia in mental health settings is rooted in the myth that exiting sex work
is a panacea for all of one’s mental health problems and/or supposed degeneracy. Turning away a
potential patient because they do not see their involvement in sex work as a problem or to be
seriously interfering with their ability to manage their various domains of life reflects how
whorephobia conflates sex work with being untreatable, or, as another participant points out,
“sex work may be conflated with sex trafficking.”
Interestingly, both two responses for the optional mental health question focus on social
work and psychology graduate programs. One participant notes how “sex work is not taught in
grad [sic] therapy programs, and if it is, it’s conflated as trafficking.” The other response
critiques their own graduate program:
“I just completed the [mental health graduate] program at [university]

and felt I constantly had to advocate for evidence-based practices
and policies to be taught in my classes related to sex work and sex
trafficking. I finally brought these concerns to the administration
and was dismissed. There is a crisis in higher education when it
comes to education practitioners on these issues, and it’s something
I seek to address in my future career in [mental health].”
These two optional responses reflect how addressing whorephobia means intervening at the
graduate-training level where emerging mental health practitioners begin or continue their
clinical training and may have the most plasticity in terms of their views, biases, and therapeutic
identities and styles. Certainty, this is not to say that continuing education trainings, conferences,
publications, and advocating to establish sex work competencies and ethics at the city (e.g.,
Brooklyn Psychological Association), state (e.g., New Jersey Psychological Association) and
national organization (e.g., the American Psychological Association and its respective 54
divisions) levels would be unimpactful or nonbeneficial. Intervening at all levels of the
respective social work, counseling, and psychology fields is an aspirational ideal. Focusing on
the upcoming generation of practitioners, supervisors, professors, training directors, and
organizational leaders may facilitate the biggest and quickest shifts in attitudes towards including
a sex work competency to become part of the already established cultural or diversity
competencies within graduate programs.
There were only four responses total provided across the two helpful-unhelpful and
optional legal aid questions, with this being the second least number of responses for this series
of questions with shelters having zero responses. This may suggest that there is a general stance
of mistrusting and/or avoiding legal professionals, as one’s profession as a sex worker may have
damaging legal consequences beyond the scope of why the individual originally needed to
interact with the legal system. Legal advice and information are sought and shared from within
one’s respective sex work community: “it is overwhelming other sex workers I have had to rely
on to find out my legal rights in regard to unemployment as well as housing and obviously sex
trade criminalization.” Additionally, one participant identifies how “the legal field is similar to
the medical and mental health field: lots of whorephobia.” As sex work may be conflated with
seeking drugs in medical settings, the origin of all of one’s suffering in mental health settings,
and with sex trafficking in single room occupancy buildings, so too within legal systems must
sex workers defend that sex work is “a profession, not an indicator of criminality [and]
morality.” In having to interact with legal systems, using different job titles may help mitigate
the chances of encountering potential legal harm:
“I needed a pro bono attorney to finally access [underemployment

insurance] benefits this past year because I had been supporting
myself through grad school on in-person work, and the shift to
online work was quite difficult, and I couldn’t get by on that alone.
I told my attorney I was a model and performer because I didn’t
want to deal with any stigma, but it would have been helpful if I
felt I could be honest with him.”
It may also be noted that the resources, connections, and services provided by online
communities, legal aid hotlines, mutual aid networks, and non-profit sex work organizations may
globally function as a replacement for having to interact with public legal systems.
Responses were overall negative when inquired about law enforcement. One participant
concisely wrote, “ew,” and two participants responded with “ACAB [All Cops Are Bastards],”
with one of these two also adding that “in my life ive [sic] never been helped by alaw [sic]
enforcement. Not with assault, abuse, being robbed or anything.” Another participant asks, “why
would I seek help from law enforcement? Law enforcement is only there to serve white, upper
class males.” Another participant notes how law enforcement is dangerous to sex workers’
safety:
“It is not possible for law enforcement to be safe for sex workers.
I’ve been assaulted, robbed, and trafficked and would never in a
million years approach a cop. They are one of the most common
sources of violence against us, and we need to disinvest from
policing and invest those resources in non-judgmental, non-
coercive, trauma-informed and culturally competent social
services for people in the sex trades.”
One participant commented that law enforcement professionals “need serious training in
[domestic violence], sex work, etc.”

Trafficking and exploitation.
There were two responses provided when inquired about if there was anything
participants wished to share about sex trafficking. One participant noted that “trafficking and
[sex work] are not the same,” while another participant shares insight on how even the general
understanding of sex trafficking requires more nuance:
“I’ve been a [research assistant] on several studies of trafficking

and the sex trades and it wasn’t until that experience I realized
that I had been trafficked. The current conception of consensual/
trafficking dichotomy is false, there is a spectrum of labor
exploitation happening in the sex industry like all industries, and
I believe we need to move beyond this binary understanding. For
the record, it was criminalization of consensual work that resulted
in my trafficking experiences.”
There were four responses provided when inquired about if there was anything
participants wished to share about exploitation. Two responses describe experiences of
exploitation in in-door settings. One participant shares how “strip clubs are beyond exploitive. I
thought it was fine when I was there but [in] retrospect haa [sic] helped me realize that it was an
abusive environment.” Another participant comments that “the clubs collect commission on
rooms and alcohol sales; and still collect additional money from our pockets. Enforce dress
codes, force us to schedule base without base pay.” One’s risk for experiencing exploitation may
be dependent upon one’s setting and overall amount of experience: “This was when I was new
and potential clients scammed me for services. It was both embarrassing but caused me to better
protect myself online.” One participant differentiates between exploitation and trafficking: “Most
exploitation does not rise to the level of trafficking but because of criminalization, sex workers
have no labor protections and pretty much all of us have faced one form of exploitation or
another. We need decriminalization now.”

OnlyFans content creators’ experiences of online culture.
Motivation or goals for joining OnlyFans.
The five major themes that emerged across 18 responses when asked to respond to the
prompt, “Thinking back to when you first decided to join OnlyFans as a content creator, what
motives or goals did you have for joining?” included: COVID-19, Higher Education (minor
theme: Student Debt), Financial (minor themes: Easy Money, Primary Income, and
Supplementary Income), Prior Sex Work Engagement (minor themes: Sex Work History and
Career Platform Building), Interpersonal (minor themes: Lonely and Peer Influence), and Self
Expression (minor themes: Exploring Sexual Identity, Autonomy, Novelty, and Sexual
Expression).
COVID-19 as a major theme was only coded in 5 of the 18 (27.78%) responses.
However, considering that 12 of 19 (63.16%) participants identified having created their
OnlyFans accounts in 2020 and the substantial impact COVID-19 had on the emotional, social,
and financial wellbeing of the public calls for an a priori assumption that COVID-19 very likely
facilitated the conditions necessary for other participants (and other recently starting content
creators since at least March 2020) to create OnlyFans accounts. Two of these responses are
from participants who were already engaged in sex work via working in a club and utilizing
OnlyFans as a new primary form of income when clubs closed in the wake of the need for social
distancing:
Quote 1.1: “I joined OnlyFans during the United States shutdown

in 2020 during the coronavirus pandemic. I am an exotic dancer and
when my club shut down I was unable to make ends meet even with
the stimulus. I thought OnlyFans was going to be quick easy money
but it proved to be much harder than I thought. It took some time but
I finally caught on to how to promote and make money on OnlyFans.”
Likewise, a participant expressed how the impact of COVID-19 changed their motivation from
seeking to earn a supplementary income to transitioning full time to sex work:
Quote 1.2: “I wanted to make extra money in addition to my day

job as a barista, but when that pandemic hit I transitioned to full
time sexwork, ie. [sic] Onlyfans and cam modeling”
The need for social distancing in the context of the spring and summer of 2020 also engendered
people in lockdown to consider alternative means for finding connection and intimacy:
Quote 1.3: “One of my motives was because [of] being single in

quarantine, I was lonely and horny. I had shared naked pictures
and content on the Internet before but not for money. I knew I’d
be good at it and the extra money was also a big motive.”
As one participant stated directly that their motivation was Quote 1.4: “income, esp [sic] during
[the] pandemic,” financially based motivations or goals were the most common for joining
OnlyFans.
The major Financial theme comprised of three themes coded 19 times across the 18
responses: Primary Income (n=6; 33.33%), Supplementary Income (n=10; 55.56%), and Easy
Money (n=3; 16.67%). Using OnlyFans as a means for a primary income was closely related to
both the socioeconomic conditions engendered by COVID-19 as discussed above and there being
prior or current engagement in sex work.
Quote 1.5: “I was already engaging in sex work before the

pandemic. In my area, the first thing to close before any national
statements were made. my [sic] club was closed with no hope for
unemployment or income. I started my page after selling directly
through social media. Onlyfans [sic] made it so much easier to
collect payments and keep in touch with fans. However
they take percentages of not just my sales, but tips!”
A need or desire for a supplementary income was the most cited motivation or goal for
joining OnlyFans, being cross coded with all other major themes. For some participants, their
motivations were purely for establishing a supplementary income:

Quote 1.6: “Money, like everyone else. I don’t get the need for
attention like other girls do…Overall it’s lazy money. I could get
a different second job, but it is easy to do cam shows and I am lazy.”
Quote 1.7: “Purely financial motivation. I wanted a passive income

to supplement. My other forms of income, including [my] vanilla
career.”
Quote 1.8: “Simply put, I needed money to pay the bills. I live in
a [city] apartment that is not easy to afford and work in a field
[redacted] that notably underpays its salaried [redacted]. I joined
OnlyFans for no other reason than that: I have to find a way to keep
food on the table, I was already experienced with sex work through
photos and videos, so why not try running an OF account?”
For other participants, utilizing OnlyFans as a means for a supplementary income was derived by
one’s prior engagement in sex work and knowing the financial potential of the industry:
Quote 1.9: “I had a premium snapchat at the time and a friend said
I could make more money on OF. I had no specific goals, I just
wanted to make more money, which I did.”
Quote 1.10 “When I first joined OnlyFans, my goal was simply to

add an additional income stream. I previously had a solo model
website…and wanted a place to post content that might be flagged
on social media without fear of getting deplatformed.”
Some participants noted how earning a supplementary income was the cherry-on-top of joining
OnlyFans as a means for self-expression broadly and sexual expression specifically:
Quote 1.11: “I am in a relationship with someone who I love very

much but has a much lower sex drive than I do. Creating adult
content is a mean of sexual self expression [sic] for me. I am
financially secure with my full time job, and the revenue I make
through OnlyFans is fun bonus for me.
Quote 1.12: “I wanted a way to create an income from my art. I

was going through a sexual awakening and exploring my own
sexuality so creating an OnlyFans account was a perfect fit. I was
also starting out as a full time artist & live streamer, and sales were
slow. My art for the last 2 years has an erotic theme. I also saw
OnlyFans as a way to document my experience while gaining
support. I promoted my page by completing [redacted] days of
consecutive [redacted] live streams on periscope/ twitter & funneled
ppl to my OnlyFans from there. So I also documented [myself]
improvement along with my erotic content.”
In three of the quotes, there is the subtle theme found of perceiving being an OnlyFans
content creator to be “easy money” There was the exotic dancer (Quote 1.1) who “thought
Onlyfans [sic] was going to be quick easy money” after their club shut down and were unable to
make ends meet with the support of the stimulus. One participant (Quote 1.3) perceives that
because they “had shared naked pictures and content on the internet before but not for money,”
they “knew [they would] be good at” OnlyFans. And there is the participant (Quote 1.6) who
remarks that they perceive themselves to “be lazy” and equate utilizing OnlyFans as “lazy
money.”
The two (11.11%) of eighteen responses that comprise the major Higher Education theme
reference utilizing OnlyFans as a means for a supplementary income as well. Though there is an
argument to be made that Higher Education should be considered a theme within the major
Financial theme, Higher Education is still considered its own major theme given the unique
context of an individual engaging in OnlyFans to support oneself through a higher education
program or paying off student debt compared to the participants who only report joining
OnlyFans for the sake of earning additional money in itself. Thus, for clarity, Higher Education
is a major theme positioned to be overlapping with the Financial theme.

Quote 1.13: “I joined OnlyFans as a way to get additional income.

As a master’s level professional in education I have high student
debt with lower income. However, as an [redacted] I am afraid to
show my face in pictures and videos as I worry about potential
retaliation from an employer. By not showing a face I feel as
though I will have less of a following overall.”
Quote 1.14: “I was using in-person sex work to support myself

through the [graduate] program, as the [training experience]
(actually, [a training experience] I was paying for) combined
with my disabilities made other work impossible…I am the only
one I can rely on to support myself financially. I had retired from
work several years prior and returning was very difficult post
SESTA-FOSTA. For the first time, I had to regularly do full-service
sex work to get by because it is higher paying than non-full-service
BDSM work and our advertising sites have been decimated. I even
started working for a madame again things got so bad. Prior to
SESTA-FOSTA it was much easier to get by independently and only
doing partial nudity/manual release/non-full-service work. If it's
helpful to know, originally started in the sex trades in my [age], first
as a means of exploration after sexual assault and then, primarily, for
survival and eventually subsistence, during which time I was eventually
able to complete my undergraduate degree. When I began an OnlyFans
(and [two other platforms]) last year, I had never done virtual sex work,
as the time-to-money ratio is essentially the opposite for in-person work,
and chronic illness and mental illness make that kind of consistency
difficult for me. However, when the pandemic hit and I was unable to
access [unemployment insurance] benefits for months, I felt I had no
choice. I only made around 12k in online work last year and largely
survived the first few months of the pandemic through sex worker
mutual aid funds. Once I got a pro bono attorney and finally was
awarded [unemployment insurance] in [summer], it was a huge relief.
Having this government money has made both in-person and online
work much safer and more stable because I have the financial ability
to turn away questionable offers.”
The major Prior Sex Work Engagement theme comprises of two themes coded 15 times
(83.33%) across the 18 responses: History of Sex Work (n=8; 44.44%) and Career/Platform
Building (n=7; 38.89%). Interestingly, the two themes are coded across all major themes except
for the major Interpersonal theme (to be discussed below). Prior Sex Work Engagement being a
major theme is contextualized as 14 of 19 participants (73.68%) reported currently engaging in

other forms of sex work in addition to utilizing OnlyFans. It is clear from the quotes provided
thus far how having a history within sex work facilitated participants to utilize OnlyFans to
aspire towards their other motivations and goals. Intertwined with this history is thus seeing
OnlyFans to build one’s current career and/or platform within sex work:
Quote 1.15: “I had a premium snapchat at the time and a friend

said I could make more money on OF. I had no specific goals, I
just wanted to make more money, which I did.”
Quote 1.16: “I was recovering from a surgery and needed to take

time off from the strip club and was quite frankly, bored at home.
I had seen it mentioned on twitter a lot and my fans were starting
to ask me if I'd do it so I did it.”
Quote 1.17: “I have been a sex and kink educator for many years
and Onlyfans [sic] gave me a platform to help others via lessons and
instructions that wasn't censored like other social media. There is a
sad lack of sexual education in America and a lot of people suffer
from garbage sex lives or do dangerous stuff because they're not sure
where to ask those questions.”
The major Interpersonal theme comprises of two themes coded twice (11.11%) across the
18 responses: Loneliness (n=1; 5.56%) and Peer Influence (n=1; 5.56%). These two themes were
loosely connected via cross-coding to the COVID-19, Financial, and Self-Expression major
themes. There is the aforementioned participant (Quote 1.3) who describes how they felt inspired
to join OnlyFans during quarantine because they were “single,” “lonely[,] and horny.” Another
participant describes that their motivations were partly inspired by perceiving many people
joining as content creators en masse, including others the participant looked up to:
Quote 1.18: “Ability to control my own content; interesting

business model; lessening stigma (everyone seems to have an OF);
people whose opinions I respect were increasingly incorporating it
into their businesses.”
The major Self-Expression theme comprises of four themes coded seven times (38.89%)
across the 18 responses: Exploring Sexuality and Identity (n=1, 5.56%), Autonomy (n=1,
5.56%), Novelty (n=1, 5.56%), and Sexual Expression (n=3; 16.675%). Self-Expression as a
motivating factor is loosely related to the major themes of COVID-19, Financial, and Prior Sex
Work Engagement. As mentioned, one participant (Quote 1.12) sought to utilize OnlyFans while
“going through a sexual awakening and exploring [their] sexuality” while creating an income
from art. One participant (Quote 1.18) wanted to become a content creator to have the autonomy
to have the “ability to control [their] own content” while enjoying the novelty of an “interesting
business model.” Likewise, for one participant (Quote 1.11), becoming a content creator was a
“mean of sexual self[-] expression” while navigating a relationship with a partner who “has a
much lower sex drive than” themselves.
Please see Table G: Matrix Coding for Motivations and Goals for Joining OnlyFans
(Page 224) for further details on the relationship between themes.
Changes in self-perception since joining OnlyFans:
The three major themes that emerged across 18 responses when asked to respond to the
prompt, “Since Joining OnlyFans as a content creator and promoting your account through
Twitter, have you noticed any changes in how you think of or relate to yourself?” included:
Intrapsychological (minor themes: Increased Body Confidence, Increased Communication,
Increased Creativity, Increased Self-Advocacy, Increased Self-Confidence, Decreased Self-
Confidence), Labor (minor themes: Increased Skillset and Negative Work Adjustment),
Sexuality (minor themes: Increased Sexual Exploration and Increased Sexual Expression), and
Worldview. A minor theme that emerged was having a history in sex work (i.e., Sex Work
History). Levels of change were categorized by No Change, Slight Change (i.e., participants
endorse a modest shift in how they experience themselves), and Change (i.e., participants
endorse a considerable shift in how they experience themselves).
The major Intrapsychological theme comprises of five subthemes coded 18 times across
the 18 responses: Increased Body Confidence (n=3; 15.79%), Increased Communication (n=1;
5.26%), Increased Creativity (n=1; 5.26%), Increased Self-Advocacy (n=4; 21.05%), Increased
Self-Confidence (n=8; 42.11%), and Decreased Self-Confidence (n=1; 5.26%). All six
subthemes were strongly associated with experiencing Change and loosely associated with major
themes of Sexuality and Labor. Of those who reported an increase in their body confidence, one
also reported a coinciding increase in their self-confidence, self-advocacy, sexual exploration,
and sexual expression:
Quote 2.1: “I definitely feel more confident in my body. I have

expanded my kinks. I feel more confident asking men for money
to see my content or sext with me.”
One participant reported a coinciding increase in their self-confidence:
Quote 2.2: “OF is a bit of an ego boost. It's nice knowing people
will pay real money monthly -- and regularly -- to see you naked.
Most of my fans are queer clients, so I get a mixture of cis and trans
women, nonbinary people, and bisexual or pansexual men. The
former two groups are some of my favorite to interact with, and when
I feel low on myself or my body, sometimes thinking about them
helps cheer me up.”
One participant reported a coinciding increase in their ability to communicate about their body:
Quote 2.3: “I'm definitely more comfortable with my body, especially

discussing sexual stuff regarding body parts I used to not identify with
at all.”
Regarding creativity, one participant (5.26%) reported that they have felt more creative in
addition to feeling an increase in their self-confidence, sexual exploration, and sexual expression:
Quote 2.4: “I do feel like sex work in general has helped grow my
confidence and my self esteem. I’m starting to realize new things
about my sexuality as a result from doing only fans and thinking
creatively when it comes to what kinds of sexual content I want to
make has also been a new form of creative fun for me.”
With respect to the four participants (21.05%), including the participant (Quote 2.1)
quoted above who feels “more confident asking men for money,” who reported increased self-
advocacy, one participant also experienced a coinciding increase in their self-confidence:
Quote 2.5: “I’ve become far more confident and comfortable

advocating for myself. One must have fairly thick skin to deal
with the amount of insults and judgement that come with creating
adult content, and having to come to terms with that is making me
more assertive in all facets of my life.”
One participants’ experience of increased self-advocacy also coincided with an increase in their
self-confidence and technical skill:
Quote 2.6: “Oh yes! I have so much more confidence!! I love

myself more than I ever have. It’s pushed me beyond my comfort
zone overand over but through that I have grown strong, resilient
and sure of myself. I learned many valuable lessons in content
creation, marketing, photo & video editing, building relationships
& finances.”
One participant who noted that they have a history in sex work shared how, although they are
part of OnlyFans, they primarily identify themselves as working an advocate roll and having a
negative experience regarding adjusting to the kind of labor needed for OnlyFans:
Quote 2.7: “Honestly, no. I am of the pre-Twitter sex work era,

when we didn't need to engage with clients regularly in unpaid
interactions in order to survive and generally loathe this kind of
interaction. I spend as little time as possible on work Twitter and
engage with my sex work community in an advocacy capacity
instead. This is primarily how I conceive of myself and my
relationships in regards to sex work: as worker advocacy that is
merely funded by the sex work.”
Eight participants (42.11%) reported increased self-confidence, with five participants
having been quoted above. One participant contended that their increased self-confidence is not
associated with being a content creator:
Quote 2.8: “Yes. I've always been a happy and healthy person.
But I'm much more confident now. However, I'd wager My higher
level of confidence is from age and wisdom, not from Onlyfans
[sic] work.”
Two participants expressed that they have also experienced an increase in their sexual expression
and sexual exploration in addition to experiencing an increase in their self-confidence:
Quote 2.9: “I feel as though I am more confident in my sexuality

and sexual practices. OnlyFans has also promoted a healthy
exploration of sexual fetishes and kinks.”
Quote 2.10: “I view myself much less harshly; and value my q

uirks more.”
Of note, one participant reported a decrease in their self-confidence that coincides with a
negative work adjustment:
Quote 2.11: “Yes. I used to not care what people thought. I don't
care if they think i am a gay crossdressing whore. But now that some
pics are out on the net, it gets depressing. I look gross doing some of
those videos. I hate seeing them and it gets tougher to act happy on
onlyfans [sic]. But with chaturbate and all the sites they sell my stuff
to, it is some money. Not as much as you would think. Every site
takes so much off the top, money is almost not worth whoring my
life out for.”
The major Labor theme comprised of two subthemes coded five times across the 18
responses: Increased Skillset (n=1; 5.26%) and Negative Work Adjustment (n=4; 21.05%).
Responses were associated across all levels of change and loosely associated with the major
Intrapsychological and Worldview themes. As discussed, one participant (Quote 2.6) reported an
increased skillset in learning about “content creation, marketing, photo & video editing, building
relationships, and finances,” and two participants reported a negative work adjustment, with one
(Quote 2.7) stating they “loathe” having to engage “with clients regularly in unpaid interactions”
and the other being the participant quoted directly above. With respect to negative work
adjustment, one participant with a history in sex work noted a slight change in adjusting how
they provide labor:
Quote 2.12: “I think doing any form of Sex Work can change how
you think/relate to yourself and I think I had that realization early
on in my exotic dancing career so when I joined a OnlyFans there
wasn’t much of a change. I did find it hard to give myself breaks
when first starting OnlyFans because people expect you to be
available 24/7”
One participant likewise noted that that there is difficulty in navigating the rate by which they
produce labor, while also reflecting how being a content creator has changed their worldview:
Quote 2.13: “I do feel overwhelmed by trying to create content all

of the time and making sure its sellable and of a quality that my fans
will be satisfied with. It hasn't really changed my self worth [sic] so
much as my world view, I've now realized certain men will pay for
anything.”
The major Sexuality theme comprises of two subthemes coded six times across the 18
responses: Increased Sexual Exploration (n=3; 16.67%) and Increased Sexual Expression (n=3;
16.67%). Sexuality was associated with strongly associated with both Change and the
Intrapsychological theme. These two subthemes were coded synonymously, with the three
responses coded as Increased Sexual Exploration also coded as Increased Sexual Expression.
This is not to say that recorded experiences of sexual exploration and sexual exploration are one
and the same, but rather that there is a positive correlation between utilizing OnlyFans as a
content creator, learning about one’s own bodies, gender roles, and sexual behaviors, and how
one expresses their sexual behavior, desire, arousal, and lust. The three responses corresponding
with the major Sexuality theme are quoted above (i.e., Quotes 2.1, 2.3, and 2.9).
The major Worldview theme comprised of two (11.11%) of 18 responses and was loosely
associated with experiencing change and no change. In addition to the response quoted above,
with the participant (Quote 2.13) who “realized certain men will pay for anything,” another
participant reflected on the interaction of online sex work and whorephobia:
Quote 2.14: “No, I've noticed how much whorephobia aims to

(and often successful does) beat down sex workers in all areas
of their lives including financially, emotionally, how they exist
online, etc.”
Six participants (33.33%) of 18 reported experiencing no changes in their self-perception
since joining OnlyFans. Two of these responses (Quotes 2.7 and 2.14) have been quoted above.
The four remaining responses were to-the-point:
Quote 2.15: “No”
Quote 2.16: “Nope, not really. It’s just work like any other work.”
Quote 2.17: “No, not really.”
Quote 2.18: “No, my thoughts about myself are not tied to social
media or my work as a whole.”
Please see Table F: Matrix Coding for Changes in Self-Perception Since Joining
OnlyFans (Page 225) for further details in the relationship between themes.
Overall experience utilizing OnlyFans and Twitter.
The three major themes that emerged across 17 responses to the prompt, “How would
you describe your overall experience with utilizing OnlyFans and Twitter,” included Financial
(minor themes: Bad Pay and Supplemental Income), Labor (minor themes: Labor Intensive and
Easy to Use), and Platform Utilization (minor themes: Censorship Concern, Company Concern,
and Secondary Effects); the three types of experiences categorized are Negative, Ambivalence
(i.e., participants identified both a negative and positive experience), and Positive. The following
results will be primarily organized by the three types of experience for clarity.
Three respondents (17.65%) of 17 reported an overall negative experience utilizing the
platforms. One response was solely coded as a negative experience:
Quote 3.1: It is whoring no matter how you describe it. Twitter is

just so stupid and vapid. Narcissistic promo sites are garbage and
onlyfans [sic] is just the new fad taking advantage of many, many,
girls who are whoring to get by. The really young girls from [country]
have it the worst. Poor single mothers being whores for minimum
wage is not right.”
Two of the responses were related to the major Labor theme; the former is solely associated to
the Labor Intensive subtheme, and the latter is associated to both the Labor Intensive theme and
Bad Pay subtheme under the major Financial theme:
Quote 3.2: “Very saturated. Takes lot of work and a lot of hustle. :(“
Quote 3.3: It’s exhausting. I am not used to having to do that

much unpaid and consistent sexual labor, and I am planning on
moving away from it as I graduate and move into social work with
my sex work community. I will still need to [do] some in-person
work thanks to student loans, however.”
Six respondents (35.29%) of 17 responses contained ambivalent responses,
acknowledging both positive and negative aspects of utilizing OnlyFans and Twitter. These
responses were loosely associated with the Financial theme, associated with the Labor theme,
and strongly associated with the Platform Utilization theme. Two of these responses
simultaneously corresponded with the Company Concern and Censorship Concern subthemes
under the Platform Utilization theme:
Quote 3.4: “They tale a lot of our [money], 20 cents on every

dollar is A LOT so it’s a mediocre experience at best. I’m just
thankful to have a space that isn’t [sic] censored”
Quote 3.5: “Twitter has the potential for driving traffic but also
has a tenuous relationship with sex workers. I am cautious not
to actively promote NSFW content in an attempt not to [lose] my
Twitter account or be shadowbanned. I do not direct link or allow
OnlyFans to auto-tweet my posts so as to not risk losing my
Twitter account.”
The former quote above also is associated with the Bad Pay subtheme. One participant’s
response corresponds with the Easy to Use subtheme under the Labor theme while expressing
concern for how the intent or interests of OnlyFans staff member; another notes that there are
technical difficulties utilizing OnlyFans while noting that they have been able to earn a
supplemental income:
Quote 3.6: “My experiences with [OnlyFans] as [sic]been mainly

good, but I do worry about some of the things that go on behind
the scenes and what kinds of people are involved. I worry about
all the content that is on only fans and how vulnerable that content
could potentially be if there is shady activity going on. I am
working on building my own website now because I’ve realized
that I would much rather have 100% control over my own platform,
money, and brand. But overall only fans for me has been very easy
to utilize and I’ve gotten a lot of positive feed back from my
subscribers.”
Quote 3.7: “[OnlyFans] is a janky site with a lot if bugs but it has
helpedme [sic] supplement my income for very little time and
effort so im [sic] grateful”
One participant differentiates between their experiences on OnlyFans and Twitter, commenting
that the former has been an overall positive experience while seeing both the negative and
positive aspects of utilizing Twitter:
Quote 3.8: “[OnlyFans] has been overall positive, painless, and

self-driven. I like it a lot. Twitter is precarious and, while a major
source of fans (and thus income), likely to devolve into harassment
or horizontal violence.”
The last ambivalent response provided expresses how being a content creator can be labor
intensive and requires diligence:

Quote 3.9: “It can be exhausting doing everything myself, but

I’m careful to stick [to] the business plan I’ve developed.”
Eight responses (47.06%) of 17 contained positive responses, with one of these responses
(Quote 3.8), having been discussed above, and with responses being loosely associated with the
Financial theme, associated with the Labor theme, and strongly associated with the Platform
Utilization theme. Two participants only had positive things to say:
Quote 3.10: “I find it to be a good experience with little pressure.”
Quote 11: “I’m quite pleased with that platform and what I get out
of it. Quite honestly I wish I’d found out about it a long time ago.
I would have started sooner.”
One participant acknowledged how being a content creator is solely associated with earning
“financial freedom:”
Quote 3.12: “[OnlyFans] is simply a means to an end for Me [sic].

The experience has not given Me [sic]any epiphany or purpose;
just more financial freedom.”
Another participant commented how they appreciate how both platforms are easy to use and that
they do not need to worry about censorship:
Quote 3.13: “It’s been mostly and easy to use. Those are 2 platforms
that I haven’t experience censorship yet.”
One participant shared that they have felt supported when technical difficulties arise with one of
the platforms:
Quote 3.14: “Good; there are still issues with the site overall but
have had support.”
Lastly, two participants report positive experiences while encountering secondary effects of
networking opportunities and needing to establish boundaries as a content creator:
Quote 3.15: “It’s interesting and I enjoy connecting with people

and getting paid for it so it doesn’t feel meaningless, or not
worth my time.”
Quote 3.16: “Overall, it is a good experience. Setting boundaries

while having another full time [sic] job is difficult. But generally it’s
a ton of fun.”
Please see Table I: Matrix Coding for Overall Experiences Utilizing OnlyFans and
Twitter (Page 226) for further details in the relationships between themes.
Online culture of the content creator and follow/fan Twitter community.
The five major themes that emerged across 17 responses to the prompt, “How would you
describe your overall experience with utilizing OnlyFans and Twitter,” included: Platform
Impression (minor themes: Negative OnlyFans, Mixed Perception, Positive Twitter, Negative
Twitter), Content Creators (minor themes: Positive Content Creators, Negative Content Creators,
Small-Large Follower Dichotomy, Supportive), Followers (minor themes: Positive Followers
and Negative Followers), Engagement (minor themes: Positive Engagement, Negative
Engagement, Low Twitter Use, Positive Engagement as a Historically Marginalized Identity),
and Labor (minor themes: Market Saturation and Exploitation). The following results will be
organized by Platform Impression (i.e., participants’ impression of both platforms having a
globally positive and/or a negative culture) for clarity.
One response (5.88%) of 17 commented directly on their negative perception of the
culture on the OnlyFans platform, noting how content creators seek to differentiate themselves
from other accounts and technical difficulties with the company that result in lost income, while
noting a positive experience on Twitter:

Quote 4.1: “Only fans has definitely become saturated. To have

success it seems like you have to always be thinking of ways to
make your content stand out and how you can make yourself
appear different from everyone else. There does seem to be a lot
of issues between the only fans creators and the platform. I’ve
heard of glitches happening within the system, creators not
receiving their money or not being able to withdraw, subscribers
receiving unauthorized charges from [OnlyFans] etc [sic], it seems
like to be a different experience for everybody. But twitter is a great
place to advertise only fans content and find subscribers.”
Seven responses (41.18%), including the quote above, of 17 commented directly on
having positive perceptions of the culture on Twitter, with a positive perception of Twitter being
strongly associated with finding other content creators supportive and having positive global
engagement with other accounts. Five of these seven responses identify finding other content
creators as supportive to positively contribute to their perception of Twitter:
Quote 4.2: “The Twitter OF creator communities are generally

pretty supportive and respectful. I had never used Twitter before
and it is not my main source of promo.”
Quote 4.3: “It’s a good supportive community. The creators have

found ways to organize & help one another. Every fan I’ve ever
had has been respectful.”
Quote 4.4: “Very collegial; people are very willing to share ideas
and let off steam. It's generally a very supportive community.”
Quote 4.5: “SW support each other in a large scale, from retweeting
to support groups, forums and other resources. Even mentoring
programs”
Quote 4.6: “The OF Content creators I follow on Twitter are great

about retweeting one another, sharing political views, and feel
good content outside of their promotional ad posts. Most followers
appear to be good people, with many having a linear view of sex
workers and only engaging in the content from a superficial lens.”
Another participant emphasizes how they feel that their historically marginalized identities are
supported on Twitter:
Quote 4.7: “I think that Twitter is a great tool to promote

yourself and your content. The culture, especially as a heavier set
queer man, has been overwhelmingly positive.”
Seven responses (41.12%) directly comment on having negative perceptions of the
culture on Twitter, with these perceptions being associated with negative perceptions of other
content creators, associated with the Low Twitter Use subtheme, strongly associated with
negative global engagement with other accounts, and strongly associated with perceiving Twitter
culture to be characterized by exploitative practices. Two participants aptly described the culture
to be:
Quote 4.8: High school
Quote 4.9: Brutal and harsh. Shit talking and hidden threats.
Girls getting robbed and shit. It’s a horrible place to be.
One participant observed how other content creators are supportive while their followers
frequently ask for free labor:
Quote 4.10: “I think OF content creators are helpful and we

always try to help each other but the fans on Twitter just seem
to ask for too many freebies”
Likewise, three participants observed how their negative perceptions of Twitter stem from
having to navigate avoiding exploitative practices, such as content creators frequently positing
free promotional material and feeling a need to oblige fans with freebies, and thus not frequently
using Twitter in preference for utilizing other platforms for promotion:
Quote 4.11: “I do use Twitter to promote my OnlyFans page, but

not much. I’ve found other platforms to be much more beneficial
([redacted]). In my experience, content creators using Twitter
post quite a bit of free promotional material which makes it difficult
to convince anyone to leave that platform or to pay for it.”
Quote 4.12: “Toxic. I stay away from it. I'm afraid of doxing
so I stay away from reddit and the promise twitters all want money.
This isnt [sic] my primary source of income and I'm doing well
enough on it so I dont [sic] need them. Plus I dont [sic] want to get
ripped off by other people who I pay for promo who dont [sic] deliver.”
Quote 4.13: “…I try to spend as little time on work Twitter as

possible. It seems like a lot of posturing for promotion and petty
fights, and I prefer to engage in an advocacy capacity with other
sex workers on non-client-facing accounts where we can be
honest about the difficulties of the work.”
One response uniquely observed how their negative perception of the culture on Twitter stems
not from other content creators or followers but rather from the cultural impact the content
creator/follower Twitter community has on other forms of sex work:
Quote 4.14: “A few years ago it was largely just SW's and fans
engaging. After Beyonce/Meg made Savage (Remix) which
mentions OF, OF became a household name and the appropriation
of SW (in combination with the pandemic) has shifted the culture
in a negative way, overlooking the material needs and safety of
*actual* SW's.”
Four responses (23.53%) of 17 contained both positive and negative perceptions of
Twitter’s culture, including Quote 4.1, with mixed perceptions being associated with the Content
Creator theme, associated with the engagement subtheme, and loosely associated with the Labor
theme. One participant provides an exemplary mixed-perception statement:
Quote 4.15: “That varies greatly so it is hard to just give one or

another view. Some have friendly interactions, some are all business.”
Interestingly, two responses also correspond with the Small-Large Account Dichotomy
subtheme, meaning that participants notice differences in how content creators engage with other
content creators depending on the number of followers they have:

Quote 4.16: “I enjoy most established creators and connecting

with them, but lots of smaller creators who don't know tha [sic]
ropes make tha [sic] few waves I've seen in tha [sic] community.
Other than drama over underhanded stuff, I'd say tha [sic]
community is very supportive”
Quote 4.17: “It's complicated. There is sex worker solidarity in

some parts, and pettiness + messy egos in others. There are a lot
of amazing, affirming, lovely queer content creators, but there are
also people who largely see their income amount and standing as
a status symbol to lord over other girls. I like the trans and queer
side of it the most, and find straight models are much harder to
deal with”
Please see Table J: Matrix Coding for the Online Culture of the Content Creator/Follower
Community) to further details on the relationship between themes.
Impact of COVID-19 on the utilization of OnlyFans and Twitter.
The three major themes that emerged across 17 responses to the prompt, “How has the
COVID-19 pandemic and the need for social distancing influenced or impacted how you utilize
OnlyFans? Has it changed the way you work, market yourself, set your rate?” included: Overall
Adjustment (minor themes: Positive Adjustment; Neutral Adjustment; Negative Adjustment),
Utilization (minor themes: Joined in Pandemic; No Change; Increased Utilization; Decreased
Utilization), and Interaction (minor themes: Increase in Followers; Decrease in Socialization),
and Sex Work History. The following results will be organized by reported overall adjustment
for clarity.
Five responses (29.41%) of 17 describe a positive adjustment in response to COVID-19
and the need for social distancing, with responses being loosely associated with having a sex
work history and joining OnlyFans during the pandemic and associated with an increase in
utilization. Specifically, three responses simultaneously corresponded with the Sex Work History
and Increased Utilization subthemes:

Quote 5.1: “I am a person who does really well in-person. And

I’ve been doing well for myself in the biz for 17 years, on and off.
Digital marketing and connecting virtually are entirely new skills.”
Quote 5.2: “I've been more active on it and creating more POV
content since the onset of the pandemic. I went from sporadically
posting to posting 5 x a week”
Quote 5.3: “Due to COVID-19, I ramped up my OnlyFans

production schedule to include masturbation content. I also hired
a management company for day-to-day operations, (scheduling
posts, engaging in chats with subscribers, booking 1:1 video calls,
selling merch, etc.)”
The other two responses noted how participants have an overall positive adjustment with no
significant changes in their utilization of the two platforms:
Quote 5.4: “Not really. It does make it a lot easier to shut down
anyone who asks to meet in person because that’s an easy excuse.
However I don’t believe it effects how I market or set my rates.”
Quote 5.5: “Yes. My OnlyFans really picked up after the first

lockdown in March 2020. Since then it’s been steady. I didn’t
change anything I was already doing prior, there was just now
more of an available audience.”
Four responses (23.53%) of 17 acknowledged experiencing an adjustment to the
pandemic and the need for social distancing without signifying if their adjustment has been
positive and/or negative and are thus considered neutral adjustments. The first two responses
expressed having joined OnlyFans during the pandemic; the third and fourth responses
acknowledges an increase utilization of the platforms:
Quote 5.6: “I started my account during the pandemic so I have

just been learning the ropes this whole time”
Quote 5.7: “I started my OF during quarantine so definitely.”
Quote 5.8: “It pushed me more into the virtual realm for certain, but
now goes hand in hand. I give less freebies in one sense but more
in others”
Quote 5.9: “I definitely do a lot more interaction for free on

Onlyfans [sic] and during cam shows because I have no other
outlet for social interaction or performance. I have been spoiling
my fans and if I ever get to go on stage again I will likely have to
slowly disengage from my current level of interaction.”
Six responses (35.29%) of 17 described experiencing negative or adverse adjustments in
response to the pandemic, with responses being loosely associated with having a history in sex
work and a subsequent decrease in utilization of the platforms. Two responses described the
relationship between having a sex work history and transitioning to primarily online work:
Quote 5.10: “I have not worked in person very much, as my clients

are generally older and more careful about their health in general.
Now everyone is getting vaccinated so things are relaxing more.”
Quote 5.11: “It is the only reason I started using it! It has
profoundly impacted the number of hours i need to devote to sex
work, which I consider a hustle rather than a career. I have tried
to keep it consistent with my in-person marketing and rates, but
it's been a challenge.”
Two responses commented on how they have decreased their utilization of the platforms because
of the pandemic:
Quote 5.12: “I don't go out anymore, so I find myself less inspired

to make content than I was before. Working for myself from home
is difficult”
Quote 5.13: “I think that COVID-19 has make it more difficult to

find partners to safely make content with. However, I have seen a
number of creators film with new partners weekly.”
Two other responses noted having negative adjustments to the pandemic for separate reasons,
with the former acknowledging how they navigate followers/fans demanding freebies and the
latter feeling disconnected from the sex work community:
Quote 5.14: “More pushy guys and assholes demanding sex

acts for free. And then they never pay you. But [OnlyFans] still
takes a cut”
Quote 5.15: “It's definitely given me more OnlyFans followers --

people are horny, bored, and looking to spend some excess income
on sex -- but I'm gutted I'm separated from my community and can't
film with other models. It makes work much better financially but
harder socially”
The remaining two remaining responses (11.767%) did not acknowledge there being an
overall adjustment to the pandemic while acknowledging there had been no change in their
utilization of either platform:
Quote 5.16: “Covid [sic] itself doesn’t really change how I

advertise or how I work. Since only fans is all online and it’s
all online advertising, Covid [sic] doesn’t really seem to make
much of an impact on that. There’s no social distancing online
LOL”
Quote 5.17: “It hasn't [because] I retired from [full-service sex

work] in 2019. I have been exclusively online for a while and
have continued that way.”
Please see Table K: Matrix Coding for the Impact of COVID-19 on the Utilization of
OnlyFans and Twitter for further details in the relationship between themes.
What followers, fans, or clients should understand about what it means to be a sex
worker.
The three major themes that emerged across 16 responses to the prompt, “What do you
want followers, fans, or clients to understand or to know about what it means for you to be a sex
worker?” included: Humanity (minor themes: Family; Real; Respect), Labor (minor themes:
Labor Intensive; Physically Intensive; Emotionally Intensive; Negative Experiences with Men),
and Socioeconomics (minor themes: Normalization of Sex Work as Work; Reclaim Ownership
of Narratives of Sex Workers; Calls for Labor/Worker Rights; Morality and Socioeconomics).
The following results will be organized by the major Socioeconomic theme for clarity.
Eight responses (50.0%) of 17 provided narratives that normalize sex work as work, with
responses being associated with the Humanity subtheme and strongly associated with the Labor
Intensive and Taking Ownership of Narratives of Sex Workers subthemes. Seven of these eight
responses directly expressed that sex work is work and just like any other job:
Quote 6.1: “Sex work is work, it's a job like any other job.”
Quote 6.2: “That it is a JOB. Its work.”
Quote 6.3: “We are human, we are to be valued. Sex work does not
effect my real morals or personal life. It is a part I play.”
Quote 6.4: “That it's a real job, it's not an easy one, it involves
a lot of emotional investment, and we have our days where we
just can't work. That's OK, there's nothing wrong with it, but
clients must have patience with us -- just as we're patient with them”
Quote 6.5: “I am proud to be a sex worker. I want people to

realize that it’s just a job and it has nothing to do with my respect
for myself. Sex work is a very draining job, physically and
emotionally and it isn’t as easy as people make it out to be”
Quote 6.6: “That I’m a real, normal person too. I have a real life
and real kids and want to be treated and talked to like a human.”
Quote 6.7: “That I'm still a person with pain receptors and such.”
Eight responses (50.0%) of 16 reclaim ownership of narratives of sex workers by
addressing negative misconceptions, myths, and stereotypes of sex workers, with this subtheme
being strongly associated with Reclaiming Narrative of Sex Work and Labor Intensity subthemes
and associated with the Humanity theme. One participant touched upon the nuance of what
consists of being a sex worker:

Quote 6.8: “Just because I am a sex worker doesn’t mean I have

no respect for myself. Yea [sic] I have sex on camera and I do paid
sex shoots but that doesn’t mean I’m going to have sex with
anybody and everybody. It IS a professional job and there’s all
kinds of rules, guidelines, contracts etc [sic] that go into it. A lot of
guys seem to think a sex worker or a porn star is someone who is just
a big nympho who has sex with anybody for the fun of it (and maybe
that does exist) but we are doing it for WORK and we do have
expectations that come with it. Being a sex worker also doesn’t mean
we are limiting ourselves to other opportunities out in the ‘real world.’
We have the same rights, opportunities, and capabilities as anybody
else.”
Another response reflected how they are not defined solely by their engagement in sex work, that
they have more identities beyond being a sex worker:
Quote 6.9: “I like my work and my clients; I'm an ordinary person

(also a mom, non-profit professional and community volunteer).”
Seven responses (43.75%) of the 16 corresponded the ethics of sex worker rights, labor,
and consumption; expressed differently, these responses reflect how sex workers’ socioeconomic
and sociopolitical standing in society is tied to mainstream society’s moral treatment towards sex
workers. Three of these responses captured the essence of this subtheme in brief:
Quote 6.10: “I'm not doing anything meaningful for a man for
free, literally anything”
Quote 6.11: “It is completely exhausting. People expect you to

want to do it for free. Men are disrespectful. Almost none of
them are decent people”
Quote 6.12: “To unpack their whorephobia, stop watching free/

unethical porn and to include SW's in conversations around
needs/[decriminalization]”
Two of the seven responses commented on the intensive emotional labor of sex work while
discussing how non-sex workers denigrate sex workers based off their profession and expect sex
workers to be embody the “happy sex worker” trope:

Quote 6.13: “I’ve been in retail and customer jobs for a long time,
and sex work is similar as far as how draining those jobs can be,
but far more so. The emotional labor it takes to pretend you’re
aroused all the time can be exhausting, especially when dealing
with things in personal life which would cause one to have low or
no sex drive.”
I also wish it weren’t assumed that anyone who participated in

sex work is either a “whore” or impoverished and desperate for
a money. I’m in a committed monogamous relationship, as well
as an entrepreneur and small business owner outside of my sex
work, so while insults about sex worker income or promiscuity
are always uncalled for, it’s especially annoying considering how
untrue and ignorant they are.”
Quote 6.14: “The expectation for emotional authenticity is absurd

and [exhausting] -- demands that we 'enjoy' our work when few
other non-credentialed workers enjoy what they do shows there is
a double standard for sex work driven by consumer guilt. There is
no ethical consumption under capitalism; all you can do is tip us
well, stop demanding authentic and unpaid engagement, and if you
truly care about our feelings and well-being, support sex worker
organizations and advocacy efforts financially. Asking "But do you
really like this? Are you getting off on this?" is just creating more
work for us around your own feelings. Like most sex workers, I do
this work because it makes the most financial sense for me given
other limitations…This doesn't mean I'm a victim or that I hate it,
but it means I don't owe you authentic enjoyment, merely a
compelling performance.
Two responses acknowledged that they face the risk of being condemned and thought of
as sub-human because of their profession:
Quote 6.15: “That we are people too. Some of us are parents or

have spouses. For many we chose this work because it’s a good
fit but we take a big risk by doing so. Shame, exclusion,
censorship, amongst other things. That paying for porn, sexual
content of any kind is a good thing to do. Just like you would pay
to go to a concert or pay for a particular meal from somewhere.”
Quote 6.16: “Sex working is not a negative field to be involved

with. Working in [redacted], I have experienced a number of people
who look down on sex workers as though sex workers are from a
“lower class”. I want fans to know that this is a healthy and legal
way to explore the sexual side of one’s identity and to advocate for
their sexual needs.”
A 17th response was provided for this prompt; however, it was an outlier as the
participant positions themselves as having a negative perception of the sex worker community:
Quote 6.17: “That we are messed up people and need help but you
can not [sic] help us. No one who jerks off to your video is going to
help get girls to not be whores. Tip well and leave us alone. Remember
that all girls have boyfriends. All of them. No matter what they say.”
Please see Table L for a thematic coding matrix on the strength of relationships between
themes.
Chapter IV: Discussion
Addressing Specific Research Questions and Results
The current study sought to explore the lived and online experiences of sex workers on
OnlyFans who promote their content on Twitter. Broadly, this study aimed to address: 1) What
the demographic trends of OnlyFans sex workers were; 2) How identifying as an OnlyFans sex
worker impacted one’s experience accessing common services; 3) What the trends were for
OnlyFans sex workers’ rates of perceived social support, self-esteem, and presence and search
for meaning in their lives; 4) What common themes could be elucidated from OnlyFans sex
workers’ experiences and perceptions of the content creator and follower/fan community on
Twitter.
As previously stated, the research project pivoted from its originally intended mixed
methods approach to homing in on a qualitative approach via the grounded thematic analyses
following OnlyFans announcement of its explicit content policy ban. From a qualitative
approach, the research questions thus served as guides and starting points for recursive
exploration. The interpretations of the data following each research question below are informed
by the literature review and by following grounded theory methodology. These interpretations
may function to generate hypotheses for future empirical work on larger samples of OnlyFans
content creators who produce explicit content or on larger samples of other online sex work
communities.
The current exploratory study identified several overarching themes. Experiencing
whorephobia from professionals and staff members of commons services was widespread. From
the psychological measures, participants perceived having at least sufficient social support from
others and adequate self-esteem, and participants were searching for meaning in their lives.
Participants were primarily motivated to join OnlyFans for financial reasons, they experienced
positive Intrapsychological changes since joining, they had a positive impression of OnlyFans as
a platform, they found other content creators to be supportive, participants increased their
utilization of OnlyFans since the COVID-19 pandemic began, and participants wanted their
clients, followers, and fans to understand that sex work is real work.
Accessing common services.
1A. What common themes or experiences will be elucidated from participants’ overall
experiences accessing shelters?
While one participant identified being currently residing in a shelter in the demographics
portion of the survey, no participants endorsed having utilized shelters in this corresponding
portion of the research survey and thus were not shown the “helpful-unhelpful” shelter question.
Therefore, it is not possible to address this question.
1B. What common themes or experiences will be elucidated from participants’

experiences accessing medical services?
Sex workers are more likely to utilize Medicaid or have an individually purchased health
insurance plan due to the self-employed or independent contractor nature of their profession
(SWOP USA, 2017). Therefore, while it may be possible that the 11 participants who chose the
“I choose not to answer” response to this “helpful, unhelpful” question are participants
expressing their foregoing care, it is more constructive conceptualizing sex workers on OnlyFans
as having the means to access medical services while anticipating needing to navigate
whorephobic medical systems and practitioners. As stated, participants primarily experienced
discrimination in the form of judgement from their providers and sought to mitigate being
discriminated against by disclosing their profession based on the setting and their individual
relationship to their providers.
1C. What common themes or experiences will be elucidated from participants’

experiences accessing mental health services?
It is not the case that participants who were engaged in sex work prior to joining
OnlyFans frequently reported foregoing mental health treatment due to an inability to find
providers with specializations or training in sex work or reported higher rates of utilizing
community clinics or agencies. It is also not the case that participants reported being in therapy
with presenting problems being organized around something aside from their identity as sex
workers. Rather than participants reporting about how they forewent seeking mental health care
altogether, participants discussed their attempts for seeking care being frustrated by: an inability
to find sex work competent practitioners through their insurance companies; being discriminated
against by whorephobic providers who sought to have sex work be the material to be worked
through against their patient’s intentions; and/or practitioners seeing exiting sex work as a
panacea to one’s psychological or behavioral difficulties.
1D. What common themes or experiences will be elucidated from participants’

experiences accessing legal aid services?
There were only four responses provided across the two legal aid questions. The lack of
responses to this question may serve to indicate that the resources, connections, and services
provided by online communities, legal aid hotlines, mutual aid networks, and non-profit sex
work organizations ran by sex workers may globally act as a replacement for having to interact
with legal aid professionals or paraprofessionals in a majority of situations or judicial contexts.

1E. What common themes or experiences will be elucidated from participants’

experiences accessing law enforcement?
There were only five responses provided for the two law enforcement questions that all
denounced law enforcement. This overall denouncement speaks to how law enforcement,
historically and presently, have discriminated and enacted violence against sex workers and sex
workers’ loved ones and community. This unanimous denouncement of law enforcement also
makes salient sex workers’ resiliency via the strategies they have developed to circumvent law
enforcement’s discriminatory practices.
2A. What is the relationship between OnlyFans content creators and their perceived family
social support?
Of the three subscales, the Family subscale had the lowest mean score of 16.4 of 28 (58.6%).
Family members may be perceived as providing the least amount of social support to participants
provided that participants or sex workers globally may feel less inclined to share their profession
with family members for multiple reasons. Likewise, it is possible that family members who
know of their kin’s involvement in sex work may have negative associations of sex work based
upon morally driven narratives of sex work that collapse the criminalized status of sex work with
other dangerous myths of sex workers, such as sex workers being drug abusers or being vectors
for sexually transmitted infections. It is of note that despite perceived family support had the
lowest scores of the three subscales, 58.6% as a mean score percentage indicates that participants
see their family members as providing neither inadequate nor abundant social support.
2B. What is the relationship between OnlyFans content creators and their perceived friends
social support?
The Friends subscale had the “middle” mean score of 20.6 of 28 (or 73.6% mean score
percentage) across the three subscales. Given that a majority of participants were engaged in
other forms of sex work other than OnlyFans and the online-community nature of OnlyFans and
Twitter, it is not surprising that participants reported high or adequate levels of social support
from friends. These friends may comprise of other sex workers, those who are allies or
supportive of sex workers, and/or those who do not mind or enjoy consuming sexually explicit
content on Twitter or other social media platforms. Additionally, unlike family members who
(for the most part) remain constant fixtures in one’s life unless completely cut off, it may become
increasingly difficult or not sustainable to maintain friendships with those who are not supportive
of one’s engagement in sex work unless one’s professional identity is not disclosed, which brings
further complications in navigating one’s friendships.
2C. What is the relationship between OnlyFans content creators and their perceived
significant other social support?
Participants reported the highest rates of perceived social support from their significant
others, with the Significant Other subscale having a mean score of 23.0 out of 28 (or 82.1%
mean score percentage). It is understandable how participants would report the highest amount of
perceived social support from their significant others, as logistically, emotionally, mentally, and
physically – especially if cohabitating with one’s significant other(s) – it may be extremely
difficult to hide or conceal one’s professional identity or engagement in sex work from one’s
intimate partner indefinitely.

3. What range of self-esteem will OnlyFans content creators report?
The vast majority of participants reported at least adequate levels of self-esteem that
ranged from 63.89% through 100.00%, with the two lowest percentages preceding 63.89% being
25.00% and 52.78%. There is a possibility that the inclusion of the mistakenly omitted eighth
question, “I wish I could have more respect for myself,” could have provided slightly more
variability in the scores, but there is a clear trend of participants perceiving themselves as having
relatively high levels of self-esteem as is.
Certainly, there may be a base or healthy level of self-esteem necessary to regularly post
content of oneself, especially if the content creator includes their face as part of preview content
on Twitter or even if seeing one’s face is exclusive to subscribing to one’s OnlyFans account.
Likewise, being part of a social media community in which one’s content garners consistent
positive engagement from fellow content creators and followers alike may in part fulfill the need
to be appreciated by others and thus bolster one’s appreciation for oneself in a positive feedback
loop. Nevertheless, that participants had scores with percentages that ranged from 25.00% to
100% deconstruct the myth that sex workers’ self-esteem is based in their ability or a need to
arouse or satisfy their clients, subscribers, and/or followers.
4A. What range of presence of meaning will OnlyFans content creators report?
Of the four combinations of subscale scores (i.e., above/below Presence and
above/below Search), only four participants scored above 24 on Presence indicating that their life
has a valued meaning and purpose, whereas 15 participants scored below 24 indicating that they
perceive their lives as not having a valued meaning or purpose.
Regardless of one’s financial success, ability to support oneself and others, and utilization
of sex work as a means to support one’s ambitions and motivations towards one’s life projects, it
is also difficult to feel that one’s life has a meaning and purpose if one is subjugated to the
alienation of their labor (Marx, 2007). Again, that the dominant narrative is that sex workers see
their engagement like any other job, it would be of no surprise that sex workers are as susceptible
as any other laborer under neoliberal capitalism’s machinations. As OnlyFans may be considered
a newfound means for achieving the American Dream, content creators are still compromising
their ability to engage in free, creative labor in exchange for financial security.
Yes, sex workers as content creators do have control over the content they produce, and,
yes, content creators may have an actualized sense of creativity and see the content they produce
as a form of healthy sexual or self-expression. Yet the content they produce may not be a real
expression of their own goals and projects and their labor activity is a form of self-expression
and creativity annexed to the specific domain of sex work that mainstream society seeks to
relentlessly discriminate against, to exploit, and to oppress, and thus sanctions a moral tyranny
against sex workers. To say nothing of the psychological impact of the in-progress climate
collapse, successful attacks on women’s rights to access safe and legal abortions, and widening
economic inequality, it would be surprising for more participants to express perceiving their lives
containing more meaning when one’s job puts oneself at an increased risk for experiencing
violence and marginalization – all while needing to navigate the stressors of late neoliberal
capitalism in the midst of an ongoing pandemic.

4B. What range of search for meaning will OnlyFans content creators report?
Of the four combinations of subscale scores (i.e., above/below Presence and above/below
Search), 12 participants total scored above 24 on the Search subscale indicating that they are
actively searching for meaning in one’s life. This is a logical interpretation when the majority of
participants identified that their lives do not presently have a meaning or purpose. It is deeply
embedded within human nature to find meaning in one’s life: searching for life’s meaning has
been the work of artists, theologians, philosophers, scientists, psychologists, sociologists, and
everyday people since the dawn of civilization if not prior. Even those who identify with the
philosophical school of thought of existentialism, which rejects human life having any inherent
meaning, appeal that it is the task of individuals to define their own life’s meaning. That there
were 7 participants who scored below 24 both on the Presence and Search subscales may be seen
as an example of the dangers of how not perceiving a present meaning or purpose in one’s life
may lead up to giving up searching for meaning.
Perceptions and experiences of the online OnlyFans content creator and

follower/fan community on Twitter.
5A. What common experiences or themes will be elucidated from a grounded thematic
analysis of OnlyFans content creators’ motivations for joining OnlyFans?
Participants were primarily motivated to join OnlyFans to acquire a supplementary or
primary income: across the 18 responses for this question, 10 were coded for a supplementary
income and six were coded for a primary income.
Engaging in sex work through OnlyFans is a lucrative opportunity in the context that, as
the once-majority American middle class continues to shrink, the wealth divide among upper-
income families and middle- and lower-income families is rapidly and sharply widening as a
greater share of the nation’s aggregate income is going to upper-income households. (Pew
Research Center, 2020). Put in perspective, from 2001 to 2016 upper-income families have seen
their median net worth, the value of all assets minus the total of all liabilities, increased 33%;
middle-income families’ median net worth has fallen by 20%, and lower-income families’
median net worth has fallen by 45%. As the vast majority of Americans’ net worth’s have either
stagnated or fallen, the Consumer Price Index, the U.S. Bureau of Labor Statistic’s measure of
the average change over time in the prices paid by urban consumers for a market basket of
consumer goods and services, has increased 5.4% from September 2020 through September 2021
(Cox, 2021). Thus, price increases have outpaced compensation growth throughout 2021,
causing real worker compensation (i.e., wages and benefits adjusted for inflation) to fall 2%
below pre-pandemic trends (Peterson Institute for International Economics, 2021). Even if
individuals of middle- and lower-income tax-brackets have been provided at least $2000 from
the federal government in stimulus checks, have earned a raise in their jobs, or have taken on a
job with a higher income and/or better benefits in the past two years, many individuals will not
have noticed significant improvements in their quality of life as they actually ended up with pay
cuts as the rising cost of living consumes their earned extra wages. As businesses across sectors
face a labor shortage yet offer dismal wages and benefits (if any), individuals of all backgrounds,
especially those with prior or current experience in sex work and those who are historically
discriminated against via wage gaps such as women, people of color, the LGBTQIA+
community, those living with disabilities, and previously incarcerated individuals, may seek
becoming OnlyFans content creators or sex workers in general to have control in determining
their fees, the hours they work, and an ability to hold onto other jobs or invest in other skillsets
for future jobs (Fox, 2021).

Participants identified becoming content creators as means to better understand how they
relate to and experience themselves and the world. Given that participants identified positive
changes in perceptions of body confidence and self-confidence since joining OnlyFans, as
addressed in the previous Results chapter and to be further discussed below, one may posit that
an unintended benefit of the normalization of content creators on Twitter is the transformation of
utilizing social media in general and OnlyFans specifically as creative solutions to fulfill one’s
hierarchy of needs. Specifically, that themes of self-expression were elucidated speaks to how
content creators may be motivated to join OnlyFans to address a need to grow through seeking
experiences that help them understand, explore, and better know their egos that act in the service
of self-actualization (Maslow and Lowery, 1988). In aspiring towards self-actualizing, content
creators may be fostering better abilities to incorporate an ongoing freshness of appreciation of
life, maintain a concern for their personal growth, and may more regularly achieve peak
experiences characterized by strong, positive memories (Maslow, 1954).
5B. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators have observed changes in their self-
perception since joining OnlyFans?
Participants reported experiencing higher self-esteem and self-confidence since joining
OnlyFans, with eight of 18 responses coded for increased self-confidence. Three responses were
likewise coded for increased body confidence and four responses were coded for increased self-
advocacy; these changes in perception may be considered positively related to self-confidence.
The overall high number of responses coded for increased self-confidence, body confidence, and
self-advocacy are also reinforced by the vast majority of participants reporting scores on the
Rosenberg Self-Esteem Scale with percentage equivalents over 50.00%.

While sex work is generally held in contempt in public discourse across nearly all
countries, even in countries where sex work is decriminalized or regulated, trends in sex
workers’ levels of self-esteem are still varied dependent upon demographics, the setting(s) in
which they work, and other adverse factors (e.g., substance use, vulnerability to exploitation,
concealing one’s engagement in sex work). Whereas over 75% of United States street-based sex
workers reported decreased self-esteem after becoming involved in sex work, and about 90% of
New Zealand indoor-based sex workers report feeling as good or better about themselves than
most people, some studies have also reported sex work as enhancing self-esteem for those who
worked in other indoor-based venues such as bars, strip clubs, brothels or escort agencies, and
those who freelance in-calls or out-calls (Bellhouse et al., 2015; Kamise, 2013; Kramer, 2004;
Romans et al., 2001; Scull, 2015).
For OnlyFans content creators on Twitter, perceiving oneself as having a healthy to
higher sense of confidence and ability to advocate for one’s needs in relation to others may be
attributed to the sense of control one has in their work, the abundance of positive engagement
from followers and other content creators, and one’s own consumption of media on Twitter
being characterized by seeing the same positive engagement aimed towards other content
creators. These experiences online, combined with the overall acceptance and ubiquity of explicit
content on Twitter, creates a “status shield” against perceived stigma and being considered a low
social status; the shield in turn mitigates against the adverse impact of others expressing
disapproval or disparaging views (e.g., “trolling”) (Hochschild, 1983). Furthermore, a simpler
explanation for the common thread of participants reporting increased body confidence, self-
confidence, and self-advocacy is that one may enjoy having sex with others or pleasuring onself
as a content creator, one may feel better about themselves knowing that others want to have sex
with them, and that one may feel better about themselves knowing that others are willing to pay
money to see them enjoying their sexuality.
It was surprising that one topic not addressed by participants for this question was
perceiving themselves as forming more liberal political views. This omission as a topic does not
necessarily mean online sex workers already possess liberal political views. However, positing
that sex workers in general have liberal political beliefs would align with a core tenet of
liberalism being that individuals are free and equal citizens entitled to the full benefits of
economic, political, and social freedoms and opportunities (Gutmann, 2001). Additionally, the
sex worker rights movement is a labor and workers’ rights movement at its core that has
significant historical and intersectional overlap with human rights frameworks, the LGBTQIA+
rights movement, the women’s rights movements, the disability rights movement, and racial
justice movements, all which champion for civil, economic, and political protections and
equality. Thus, to engage in sex work is to contend with the values and agency of humanity
within a capitalistic society that sanctions sexism, racism, classism, ableism, ageism, and
heteronormativity to oppress sex workers and to protect and keep in power those in control of the
means of production (Gabryszewska, 2014). Yet it is also important to note that becoming an
OnlyFans content creator, especially considering the amount of time and unpaid labor that goes
into building a platform on Twitter and other social media platforms, and regularly interacting
with followers and subscribers, means that content creators have a certain level of class-based
privilege as no physical interaction is technically necessary with consumers, producing content
can be done from the safety of one’s residence, and capital must be available to invest in the
technology to even begin producing content (e.g., a ring-light or other lighting-related
equipment, video or photo editing software, high quality cameras or recording devices)
(Gabryszewska, 2014). As all sex workers have political agency (defined as both capacity and
action), OnlyFans content creators have the potential through the privileged positions within
online spaces to help facilitate a social climate that legitimizes sex work as labor, that champions
civil and economic freedom, and that supports the plight of sex workers who are unable or
unwilling to come forward in political organizing or advocacy work due to legal circumstances,
stigma, and safety.
5C. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators describe their overall experience with
utilizing OnlyFans and Twitter?
While participants reported a need for a supplementary or primary income as a primary
motivating factor for joining OnlyFans, finances were also connected to participants’ overall
experiences utilizing OnlyFans and Twitter. There were three responses coded for supplementary
income, with participants reporting positive sentiments for having an ability to earn a
supplementary income. There were also three participants’ responses coded for bad pay, noting
how the company allegedly takes 20¢ for every dollar earned and how there is a significant
amount of free sexual labor invested into the platform for gaining and maintaining subscriptions.
Responses address how one’s degree of success in earning said income may be influenced by
varied other factors. These factors may include how much capital one has prior to becoming a
content creator, where one falls on the supplementary-primary income spectrum (which in turn
may reflect whether one is using OnlyFans as more akin to a “side hustle” than being partly
dependent upon the platform as a means for survival), and the relative ratio of time and labor
invested into OnlyFans to the rate of accumulating subscribers. Additionally, one’s success in
earning an income may also be derived from the marketability of one’s body capital, tapping into
one’s pool of current clients if already engaged in sex work, what strategies are employed for
marketing oneself, how one cross- promotes oneself on other social media platforms (e.g.,
utilizing Reddit’s r/onlyfanspromotion or r/sexsells subreddits), or one’s ability to network with
other content creators and/or willingness to pay promotional accounts.
Participants addressed concerns related to censorship and the OnlyFans and Twitter
companies. Participants identified how OnlyFans simultaneously makes a significant profit from
explicit content creators while not actively supporting them through the site’s own/marketing
strategies and how there is cause for concern for Twitter censoring content creators despite
relatively lax policies regarding posting explicit content. Thus, a major drawback is being at the
whims of platforms whose priorities in making a profit may be antithetical to supporting sex
workers as content creators.
5D. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators experience their online communities of
other content creators and their followers?
Participants perceived other content creators as supportive, friendly, and entertaining,
with eight responses coded for positively perceiving other content creators. Multiple participants
described the community as “supportive,” noting how content creators uplift each other through
promoting each other’s content through retweets and replies, posting “feel good” content, engage
with one another’s ideas, and organizing supporting groups and mentoring programs for the
community. While the sex work industry is considered supportive, this translating to OnlyFans
and Twitter may in part be contributed by how Twitter provides the opportunity for content
creators of different backgrounds – those with prior sex work history, porn stars, those utilizing
OnlyFans as a hobby or side hustle, those whose first engagements with sex work is through
OnlyFans, those without OnlyFans but who post explicit content on “alt” accounts – to interact
with each other. The introduction of Twitter Spaces (e.g., live audio conversations hosted by one
account), the now-defunct Twitter Fleets (e.g., content that was only available for viewing and
private comments for a limited time akin to Instagram Stories), and the rapid and viral nature by
which memes cycle through Twitter timelines to be enjoyed together, provide further dimensions
to build a sense of community and to humanize oneself and one another – to reject being
flattened to the limitations of 280 characters, videos, and pictures for the sole sake of seeking
profit. It is this blurring of utilizing Twitter for both business and pleasure that partly facilitates
the community to strive for authenticity in the construction of their online personas that in turn
engenders a drive for not only supporting one another but creating genuine friendships and
networking opportunities alike. Of note, while participants did comment on how content creators
can be “posturing for promotion” and have “messy egos,” this again speaks to how OnlyFans
content creators can reject the fantasy-narrative of one-dimensional sex workers whose only
concerns are the consumer’s pleasure.
Regarding perceptions of followers, one participant identified how followers on
OnlyFans “ask for too many freebies” but others did not share similar sentiments. This is not to
say that content creators do not experience some proportion of followers or fans as ingratiating
or as entitled in asking for more content or for free access to one’s OnlyFans account (possibly in
exchange for explicit content from the follower requesting this or some other non-monetary
compensation). Rather, that this was not discussed more by participants may speak to how this is
perceived as a normalized part of the culture on Twitter that is a routine “part of the job” of
being a sex worker on a free, public social media platform. Additionally, content creators are
empowered to interact with followers or fans as they see fit such that they can choose not to
respond to any direct messages or Tweet responses, and they may also block anyone who they
wish. Therefore, content creators may anticipate there always being a minority of followers or
fans who treat content creators as digital avatars for their own pleasure while ultimately having
more power in how to navigate these interactions.
Participants reported perceiving both insularity and inclusiveness from other content
creators, acknowledged through the lenses of a dichotomy in one’s number of followers and a
straight-queer binary. There was a mixed perception of smaller and larger accounts, with one
participant positively positioning accounts with many followers as “established” and negatively
positioning smaller accounts as not knowing the “ropes” or social norms as to how to behave as a
content creator. Another participant noted how accounts with large number of followers can use
their popularity as a “status symbol to lord over other girls,” while also expressing that straight
content creators are “much harder to deal with” than the “affirming, lovely queer content
creators.” It is expected for content creators (who are ultimately subscribing to a microcelebrity
or social media influencer mindset) to have different strategies and motivations for accumulating
and utilizing their social, body, and economic capital. How one strategically seeks to accumulate
or utilize one’s capital – and how one perceives how others seek capital - will be influenced by
one’s culture and intersectional identities. That is to say, how one’s demographics or identities
impact one’s ability and strategies for accumulating capital is in relation to a dominant Western
culture that privileges (monogamous) heterosexual white cisgender men who are neurotypical,
living without a disability, are of at least a middle to middle-high socioeconomic status, and who
are at least college educated.
Participants reported witnessing in-group conflicts between content creators. Three
participants expressed perceiving there being “drama over underhanded stuff” and noting how
content creators use their status to “lord over other girls,” and there being a “a lot of posturing
for promotion and petty fights.” As content creators are being able to use Twitter for personal
means outside of building their brand, content creators may incidentally draw the ire of other
Twitter users (regardless of affiliation to OnlyFans) as they express one’s opinions on present-
day affairs in entertainment, breaking news and political developments, on other niche conflicts
already occurring on one’s timeline (i.e., colloquially spoken of as someone being considered the
“Twitter villain of the day. The limitations of expressing oneself through a condensed
combination of 280 characters of texts and emojis with an attached. gif, video, or image (acting
as a “reaction meme”) is open to interpretation and invites further responses from other users.
5E. What common experiences or themes will be elucidated from a grounded thematic
analysis of how OnlyFans content creators have been affected in their role as content
creators by the need for social distancing in response to the COVID-19 pandemic?
Participants reported questioning their ability or willingness to continue producing
content due to the COVID-19 pandemic and the need for social distancing. Two participants’
responses were coded for a decrease in utilization of OnlyFans, with one noting that they feel
“less inspired to make content” because they “don’t go out anymore” while another comments
that it is “more difficult to find partners to safely make content with.” Likewise, other
participants express experiencing global difficulties with adjusting to utilizing either platform
during a pandemic, such as recognizing an increased number of hours needed to dedicate
towards OnlyFans for earning an income or feeling separated from the sex work community.
These responses are contrasted by the six responses coded for an increased utilization of
OnlyFans, which is further contextualized by the large number of participants who acknowledge
being motivated to join OnlyFans because of the impact of the pandemic on their ability to work
and a need for an income. Additionally, one participant described that the pandemic had made it
difficult to safely make content with other partners and another participant implied there was a
period in which they had “not worked in person very much” due to their clientele being
“generally older and more careful about their health.” Ultimately, this research question retained
little long-term viability as participants would have approached this question differently
dependent upon how easily accessible the COVID-19 vaccine series was to them at the time of
taking them taking the research survey, if they were vaccinated or not at the time of responding
to this question, their comfortability with socializing with others with respect to their city’s or
state’s general vaccination rate, and their personal sense of civic and familial duty in striving to
prevent transmitting the virus to others.
Participants also reported experiencing no changes in their utilization of OnlyFans due to
COVID-19. Four responses were coded for no change, with a common thread between these
being that the participants were already on OnlyFans prior to the beginning of COVID-19 or
were working exclusively online prior to COVID-19. These responses reinforce how there is no
one way of being a content creator.
5F. What common experiences or themes will be elucidated from a grounded thematic
analysis of what OnlyFans content creators want their followers, fans, and/or clients to
understand about what it means to be a sex worker?
Participants reported wanting followers, fans, or clients to acknowledge that OnlyFans
content creators have their own lives independent of their social media presence. Six responses
were coded for content creators wanting to be recognized as real people, four responses were
coded for stating that content creators are inherently deserving of being treated respectfully, and
three responses were coded for identifying themselves as having families of their own. All these
responses fall under the broader theme of content creators wanting their basic humanity
acknowledged and wanting to be respected by followers, fans, and/or clients. As one sex work
slogan is, “it’s a business doing pleasure with you,” these responses may call on followers, fans,
and/or clients to be able to internalize the dialectic that a component of content creators’ labor is
creating the fantasy that the consumer’s pleasure is central while also acknowledging that sex
workers cannot be thought of or treated as less than because of their profession. This sentiment
may not be unique to OnlyFans content creators, while it also may be more salient for the content
creator community as their utilization of their Twitter accounts is multifaceted, that it is for
building their brand and for their personal utilization too.
Participants reported wanting followers, fans, and clients to acknowledge the intensity of
their labor. Seven responses spoke to how being a content creator is labor intensive in general
and three responses spoke to the intensive emotional labor required for being a content creator.
One response also addressed how followers or subscribers should “stop demanding authentic and
unpaid engagement” in the context of calling out followers or fans’ “expectation for emotional
authenticity” for sex workers. That more participants did not share a similar sentiment in wanting
their uncompensated labor on Twitter to be acknowledged may also highlight content creators
seeing their uncompensated labor on Twitter, and on other social media platforms like Reddit
and Instagram, as being “part of the deal” for accumulating social and economic capital.
Participants reported wanting followers or fans to be educated on the sex work
community and engaged in sex work related cultural, legislative, and/or social media policy
related issues. The same participant who expressed wanting followers to stop expecting sex
workers to be emotionally authentic also called for followers or fans to “support sex worker
organizations and advocacy efforts financially.” Likewise, other participants advocated for
follower or fans to acknowledge that sex work is work and is to be considered as real as any
other kind of job. Participants also sought for followers or fans to acknowledge that engaging in
sex work does not reflect the morality of sex workers, that sex workers and content creators are
as complex as any other individual, with their own feelings, desires, needs, goals, and wants.
These responses seek to have followers or fans acknowledge their own internalized whorephobia
and recognize how paying a monthly subscription fee is only one of many other means by which
followers or fans can support content creators who remain in a precarious position both online
and in society.
Limitations of the Investigation
This exploratory investigation on the lived and online experiences of sex workers on
OnlyFans sought to address four main questions: 1) What are the demographic trends of content
creators from a random online sample?; 2) What correlational trends may be found in how
content creators’ identities as sex workers impacts their experiences accessing common
services?; 3) What correlational trends may be found in content creators’ rates of perceived
social support, self-esteem, and presence and search for meaning in their lives?; and 4) What
common themes may be elucidated from content creators’ experiences and perceptions of their
virtual community of other content creators and followers on Twitter?
While these questions were answered, the greatest limitations on the quality and depth of
the findings and ability to answer both these questions and their respective hypotheses included:
1) not having a large enough number of participants to conduct statistically significant
quantitative and qualitative analyses; 2) a lack of connections to non-profits and health clinics; 3)
a lack of funding; 4) a lack of time to carry out recruitment; and 5) the minimal utility of the
research survey.
Having a small number of participants (n=19) removed the possibility of any findings
being statistically significant nor having findings being generalizable to the greater sex worker
OnlyFans community or to other online sex work communities. A minimum of 111 participants
were needed for conducting Pearson correlation statistical analyses for detecting small effects
from the data from the three psychological measures and for conducting NVivo thematic
analyses for elucidating both themes in accessing common services and themes in perceptions of
the content creator-follower Twitter community. A small n also prevented being able to analyze
any of the hypotheses’ respective data in combination with participants’ demographic trends,
such as exploring how differences in age groups, sexual orientations, or having and not having a
prior history in sex work prior to becoming a content creator may potentially be associated with
unique trends in responses.
Probability sampling, the selection of a sample from a population based on the principle
of randomization, is likewise compromised due to there being clear demographic majorities: the
majority of participants identify as European American (i.e., white), college-educated, cisgender
women between the ages of 21-39 who identify as LGBTQIA+, not identifying as living with a
physical or cognitive impairment or disability or mental illness, and living in an apartment.
Noting this should not be interpreted as minimizing or invalidating the significance,
contributions, or experiences of participants who share some combination of these identities nor
participants whose identities do not map onto these majorities. In fact, that the majority of
participants identify as LGBTQIA+ and that the findings are informed by a queer perspective is
itself noteworthy given that OnlyFans content creators are a niche and relatively newly-formed
sub-community within the larger online sex worker community that is considered historically
challenging – at least from the perspective of the field of psychology – to engage with for
conducting research. Nevertheless, these demographic majorities skew the findings as
participants’ experiences and perspectives are contextualized by American society privileging
college-educated white women who part of an age bracket that is not deemed “too young” or
“too old” and who are able-bodied and able-minded (i.e., one’s physical and cognitive ability
status is often taken for granted while people living with visible or invisible disabilities are a
historically marginalized population). For example, though beyond the scope of this paper, it is
likely that white women’s success and satisfaction in utilizing OnlyFans is partially informed by
American society and subscribers that (unconsciously or consciously) favor Eurocentric beauty
standards (that work to reinforce the values of white supremacy) of straight blonde or brunette
hair, blue or green eyes, small nose, fair skin, and waifish or non-curvy figures. Yet as the
overarching aim of this exploratory investigation was to capture a “snapshot” of who OnlyFans
content creators are and what their experiences are like in navigating the world and online
spaces, the participants’ biggest contribution is providing critical clues for informing future
studies on OnlyFans or other online modes of sex work.
Lacking connections to non-profit sex worker organizations and health clinics, funding,
and time to carry out recruitment are limitations in themselves that also directly contributed to
the small number of participants included in data analyses. While there was more success in
contacting and having recruitment materials distributed by five local graduate student list-serves,
four list-serves from a national psychology organization, and eight adult entertainment stores
across two densely-populated states, only three of the sixteen (18.75%) non-profit sex work
organizations ran by sex workers that are located throughout the United States and two of the 11
(18.18%) health clinics across two densely-populated states that specialized in sexual health,
LGBTQIA+ health, OB/GYN health, and HIV/AIDS health were responsive to outreach efforts
and agreed to distribute recruitment materials. In total, 22 of the 45 (48.88%) individual list-
serves, non-profits, health clinics, and adult entertainment stores contacted agreed to distribute
recruitment materials. Having more success in contacting non-profit sex work organizations and
health clinics and their agreeing to distribute materials, especially over social media, would have
increased the reach of the research survey to sex workers or non-sex workers alike who either are
on OnlyFans or may have known someone who is on OnlyFans to share a flyer to.
There are a few reasons as to why there was relative non-success with contacting non-
profit sex work organizations ran by sex workers and health clinics. Namely, the most salient
reason is that this investigation’s research survey was being conducted from an academic setting
and by a principal investigator who is not part of the sex work community. It is understandable
that non-profit sex work organization staff members (and even potential participants who passed
on participating in the research survey) would not want to invest time or energy into an
academic-based project that ultimately does not serve their organizations’ mission, research
projects, other in-development and ongoing projects, advocacy and political work, and health,
legal, housing, and other resource-based services. Being contacted by an outsider of the
community who is from the field of psychology and is seeking to conduct research on a
historically marginalized community for the purpose of one’s education (as the principle
investigator made his status as a clinical psychology doctoral candidate and the purpose of this
research survey as part of this dissertation known in his initial communication with all entities)
may be read by non-profit sex work organizations ran by sex workers as having to decide
whether or not potentially risk the trust of those who utilize their services by associating
themselves with a researcher from a field that has historically medicalized and pathologized sex
workers and turned a blind eye to its own code of ethics. It is also possible that these non-profits
may have strict guidelines or even “zero tolerance” policies on being contacted for solicitation or
research endeavors. Being unsuccessful in contacting health clinics is contextualized by
recruitment occurring amid the ongoing COVID-19 pandemic, meaning that many health clinics
have change their staffing and hours of operation, how patients are seen in-person and/or through
telehealth services, how they communicate with outside entities, and other policies for how to
operate including how willing they may be to work with outside researchers for sharing
information with their patients. Those in charge of the health clinics at some level may also not
wish to alienate non-sex work patients by sharing information about and for sex workers who
may also be treated at these clinics. Additionally, dependent upon whether they are funded in
part or full by their respective city or state government, funded in part or full by private persons
or other philanthropic entities, or associated with a university, there may be certain requirements
specifically for how the health clinic uses its physical space for flyers and other informational
papers in its hallways and waiting rooms or how it utilizes its own list-serves, newsletters, and/or
social media accounts.
Lacking funding to pay participants for taking the time to complete the survey impacted
the ability to successfully recruit. There was an optional question immediately prior to the
debriefing page of the research survey that asked “Thank you sincerely for taking this survey! Is
there anything else you would like to say about anything? Please comment below or feel free to
proceed to the debriefing page.” One participant’s response to this prompt best encapsulates the
issue with not having funding: “You’ll get a lot more responses from politically engaged sex
workers if you pay us, as this is the cultural standard within most of our communities around
academic research ;-).” Although in all flyers and initial outreach communications it was
explained that one dollar was to be donated to the New Jersey Red Umbrella Alliance (njrua.org)
for each participant who completed the survey, this is most likely not a compelling reason for
potential participants or organizations to participate in the survey or to help with dissemination
respectively. Paying sex workers directly for their labor, or at least having a raffle with gift cards
as an alternative, would be the most ethical route as an ally and outsider of the community given
the myriad of ways banks, apps like Venmo and PayPal, and clients seek to enact financial
violence against sex workers by not paying them for their labor. Likewise, being able to pay
participants would lend the research survey with a greater legitimacy as an actual academic-
based research project.

Lacking time for recruiting impacted the ability to have more potential participants
included in the research survey. Recruitment needed to end after seven months due to the
OnlyFans company announcing a ban of sexually explicit content in August 2021. How potential
participants would approach the research survey prior to this ban being announced would be
radically different from how potential participants would approach the research survey post-
policy announcement, regardless of the OnlyFans company soon after announcing that the
impending ban would be “suspended.” While there may have been some apprehension about
utilizing OnlyFans as a means to earn an income as the company’s relaxed policies about the
kind of content that could be posted may have seemed “too good to be true,” it was not until the
announcement of this ban that OnlyFans would actually break its sex worker content creators’
trust. Furthermore, as recruitment started in January 2021, about four months of recruitment
efforts were lost as recruitment originally began in September 2020 for a more specific, hard-to-
reach demographic within the OnlyFans content creator community. After consulting with
COYOTE Rhode Island, the principal investigator stopped recruitment to work on expanding the
scope of the research survey and making it more inclusive with respect to demographics. The
timeframe of September 2020 to the beginning of January 2021 was then spent reorganizing the
dissertation, researching and writing literature reviews that reflected the expanded scope of the
research survey, creating new recruitment materials, and editing materials to be resubmitted to
the university Institutional Review Board to begin recruitment with the new iteration of the
research survey.
A final significant limitation about this investigation is the minimal utility of the research
survey for future endeavors. This exploratory investigation sought to explore questions about
how sex workers related to themselves, how connected they feel to others, how they perceive
their identities may influence how they navigate the world, and how they experience and
perceive the OnlyFans community and culture. These questions could be freely explored in an
academic setting as the design and implementation of the research survey was not influenced by:
grant or scholarship requirements; any obligations or need to be published in academic or other
professional journals; needing to meet certain professional guidelines or standards for obtaining,
maintaining, and/or advancing one’s employment or tenure portfolio; nor needing any findings to
match any hypotheses to be utilized for developing future research, advocacy, community
services, and/or other intervention-based endeavors. The investigation’s research survey thus
may have little potential to be utilized by future researchers given that a majority of medical,
psychological, and public health research on sex workers seeks to understand the population, for
example, in terms of risks for acquiring STI’s and HIV, chronic medical conditions, mental
illnesses, or rates of intimate partner violence. These research topics are critical for better
understanding how to provide services to sex workers yet fall short of considering how sex
workers’ perceptions and understandings of their lived experiences contribute to the health
factors just mentioned. While it is unlikely that future researchers may wish to replicate this
investigations’ research survey given the multiple domains of life being investigated within it
(i.e., basic demographics, sex work-specific demographics, accessing common services, three
psychological measures, and online culture) through a mixed-methods survey, the investigation
was always intended to function as a starting point for future research endeavors focused on
online sex workers’ lived experiences. Non-profit sex work organizations ran by sex workers and
academics across disciplines (e.g., anthropology, sociology, clinical or social psychology,
feminist studies, queer studies, public health, medical, etc.) may find this dissertation and seek to
focus on certain questions or clusters of hypotheses in relation to OnlyFans content creators in

general, certain demographics or online sex workers, and/or sex workers of other settings.
Ultimately, the limitations of this research project do not supersede the untapped potential future
researchers may find within this exploratory investigation for the sake of working to uplift and
support sex workers.
Proposing a direction for future studies.
There are several ways to improve upon the methodology of this investigation that future
researchers may take into consideration in researching the experiences of sex workers online.
The first, most critical consideration for any kind of research being conducted on the sex work
community is for researchers who are not directly part of the sex work community to consult
and/or collaborate with sex work organizations ran by sex workers. “Nothing about us without
us” and “nothing for us without us” are not just catchy slogans but are clearly communicated
ethical standards that need to be respected. Failure to consult and/or collaborate with a sex work
organization ran by sex workers may be read as believing oneself to be more knowledgeable
about what is best for sex workers while also robbing sex workers as a historically discriminated
group of their autonomy to make decisions for themselves, regardless of the researchers’
expertise, discipline, and/or the systematic level they are operating within (i.e., local
neighborhood, community, city, state, national, or online). Another slogan, “save us from our
saviors,” comes to mind for those who believe they do not need to be working alongside the sex
work community. Likewise, it has been intentional throughout this dissertation to identify “non-
profit sex work organizations ran by sex workers” as sex work organizations that are not ran by
sex workers will have different moral and ideological goals and intentions regarding sex
workers’ material realities than those organizations ran by sex workers themselves. Thus,
researchers must also ensure that the organizations – or health care clinics – they seek to partner
with are positively reputable and credible by those who are in the sex work populations they seek
to conduct research about.
It is an imperative to pay participants and any organizations that agree to provide
consultation for their labor and time. This will improve a researcher’s chances of successfully
recruiting as sex work organizations or participants may be more likely to share information
about one’s research project as there is a transparent transaction benefiting both parties, with sex
workers being directly compensated. Paying sex workers for participating in the research also
may increase the chances of recruiting individuals who may otherwise not be able to afford to
participate due to time or financial restraints, who may distrust researchers, or who may not be
aware of the research being conducted without information being passed through word-of-mouth
by those who already participated or intend to participate. There are arguments to be made in
opposition to offering a financial incentive for participating in research: it may cloud potential
participants’ judgement in choosing to participate in the first place; it may lead to individuals to
misrepresent themselves to be eligible to participate for the financial reward; and providing
financial compensation may overburden or overrepresent those of a low socioeconomic status in
the data (Grady, 2005). However, these arguments are misguided. Money is but one motivating
factor individuals have for choosing to participate in research. Having airtight screening process
and eligibility criteria, in addition to considering a modest deferment in payment (e.g., being paid
at the end of recruitment rather than immediately upon finishing participating in the survey if
appropriate) will greatly reduce the chances of potential participants misrepresenting themselves
solely for the sake earning “quick cash.” Lastly, not offering a financial incentive may lead to
overrepresenting sex workers of a middle or higher socioeconomic status; having an

“overrepresentation” of participants who are more likely to be socioeconomically disadvantaged
is closer to the realities of the majority of sex workers in the first place.
With respect to being sensitive and efficient to time in the recruitment participant, it will
be important for researchers to meet sex workers where they are online. This primarily includes
posting recruitment information across social media channels such as TikTok, Instagram,
Twitter, YouTube, Meta (formerly known as Facebook), Reddit, and Snapchat. It would be wise
to increase one’s outreach by paying Facebook and Instagram to tailor who is likely to consume
the content being produced. TikTok is known for having new viral video formats (sometimes
referred to as “challenges”), which researchers can use to their advantage by creating
promotional material that fits the format of these viral challenges and in combination with
smartly selected hashtags.
The utility of this investigation’s research survey can be improved through changing the
content of the survey. As there were over 70 Likert-scale and open-ended questions included,
shortening the research survey with a tighter focus in what questions the researchers seek to
address will greatly improve the chances of participants finishing the research survey. Likewise,
restructuring the research survey to be exclusively quantitative or qualitative through Likert-
scale or open-ended prompts respectively may reducing the chances of participant fallout in
having to continuously switch one’s mindset in their approach to the survey (i.e., only clicking
buttons for Likert scales or typing out responses for open-ended questions). If interested in
understanding online modes of sex work in comparison to other modes of sex work, it will be
important to design the survey such that a version of the survey that is appropriate to the
comparative setting can be created, with only modest changes, such as changing some of the
language in the questions to match the sex workers’ setting.

Researchers need to consider the accessibility of their research survey as well. Consider
having the research survey available in common non-English languages spoken in the United
States including Spanish, Cantonese and Mandarin, Tagalog, French, Vietnamese, Korean,
Swahili, Haitian Creole, German, Italian, and Braille if the survey is to be distributed physically.
For making the research survey accessible to those who are visually impaired, have the option
for the research survey to be read in a large font size. With posting or disseminating any
promotional or recruitment material that is image-based, describe the image in the caption as this
text may be read aloud by a special screen reader software for those who are visually impaired or
blind. Similarly, if posting any kind of video on any social media, include subtitles for those with
hearing impairments or for those who may find English difficult to engage with. Make all URL’s
descriptive (e.g., tinyurl.com/OnlyFansSurvey) for screen readers for the visually impaired and
blind. Make the research survey’s clickable assets, such as a textbox or selecting a Likert-scale
response, as large as possible for the physically impaired to easily be able to select something
while navigating the survey. Avoid jargon at all costs and ensure the readability of the research
survey is no greater than a 7th or 8th grade equivalence as this is the benchmark for the medical
industry.
With these guidelines considered, some questions that future researchers may wish to
consider based off this dissertation and research survey include:
1. How do content creators perceive the long-term sustainability of OnlyFans and Twitter,
with respect to their individual accounts and the platforms’ tolerance of sexually explicit
content?
2. How do content creators and other online sex workers perceive the future of online sex
work?
3. Are there trends in how or why content creators seek to stop being OnlyFans content
creators?
4. How do content creators identify themselves and their labor in relation to being sex
workers? What are the similarities and differences in attitudes, frequency and kinds of
content produced, and demographical trends between content creators who do and do not
identify as sex workers?
5. Are there identifiable trends in the progression for how one becomes an OnlyFans
content creator?
6. How do content creators perceive and seek to protect themselves from between-content
creator violence?
7. How connected do content creators feel to the larger sex work community? How do other
communities of sex workers perceive the OnlyFans content creator community?
8. How do non-profit sex work organizations ran by sex workers seek to support the
OnlyFans content creator community and the NFT/cryptocurrency sex work community?
9. How do content creators and other online sex workers believe they can best be supported
by non-profit sex work organizations ran by sex workers?
10. Are there trends for medical providers’ attitudes, biases, misconceptions, and outcomes in
working with (online) sex workers? How do medical providers believe they can better
work with sex workers?
11. Are there trends for mental health professionals’ attitudes, biases, misconceptions, and
outcomes in working with online sex workers? How do mental health professionals
believe they can better work with sex workers?
12. Are there trends for shelter staff members’ attitudes, biases, misconceptions, and
outcomes in working with online sex workers? How do shelter staff members believe
they can better work with sex workers?
13. Are there trends for legal aid professionals’ attitudes, biases, misconceptions, and
outcomes in working with online sex workers? How do legal aid professionals believe
they can better work with sex workers?
14. Are there trends for law enforcement professionals’ attitudes, biases, misconceptions, and
outcomes in working with online sex workers? How do law enforcement professionals
believe they can better work with sex workers?
15. What are the trends in rates of body dysmorphia for women content creators and muscle
dysmorphia for men content creators compared to sex workers of other online settings
(e.g., escorting and webcam modeling) and non-online settings, social media influencers
and other micro-celebrities, and laypersons?
16. What are the trends for how the general public perceives the OnlyFans content creator
and how has the popularity and ubiquity of OnlyFans on social media changed their
perceptions of sex work and sex workers?
17. Are there certain trends for which legislative model (i.e., full criminalization, partial
criminalization, criminalization of the purchase of sex, regulation, decriminalization)
content creators and online sex workers believe is the best model to advocate for? To
what extent do online sex workers feel it is their obligation or responsibility to advocate
for legislative change?
18. How does feminist theory, psychoanalytic theory, queer theory, sociological theory, and
Marxist theory explain the phenomenon of OnlyFans and online sex work? How can
these theories be translated to praxis for the advancement of sex workers’ rights as
worker/labor rights and for the betterment of sex workers’ material realities?
19. How does one’s cultural identity or identities influence one’s attitudes and perceptions of
engaging in online sex work?
20. From a psychoanalytic perspective, are there certain trends for how content creators’ and
online sex workers’ personalities are organized (i.e., depressive, manic, narcissistic,
hysterical, obsessive-compulsive, masochistic, dependent, counter-dependent) compared
to sex workers in other settings and/or laypersons? What clinical implications may be
derived from these trends in terms of expected transference and countertransference
issues and the overall arc of psychotherapy treatment?
Implications of OnlyFans Suspending Its Sexually Explicit Content Ban
It is an understatement to say that OnlyFans’ initial announcement and soon after
“suspension” of its policy banning sexually explicit content in August 2021 was a disruptive and
distressing shock to the thousands of content creators whose livelihoods are dependent upon the
platform (Bernstein, 2021). The company has since sought to convince its content creators and
fans alike that the company has “secured assurances necessary to support [its] diverse creator
community,” solely blaming “powerful” banking and credit card companies not wanting to
“unwittingly process payments for material around which issues of consent later arise,” nor deal
with their own porn-consuming customers who “are among the most likely to dispute
transactions” (Bernstein, 2021). While the billion-dollar companies’ messaging may boil down
to proclaiming that everything is back to being “business as usual,” this event and its
ramifications are a pulse-check on the evolving nature of late-stage capitalism and online sex
work.
Another explanation as to why banks, credit card companies, and/or payment processors
would be willing to continue making porn-based transactions – and why Twitter and other social
media platforms (to varying extents) are willing to continue having sex workers on their
platforms – is because surveillance capitalism is swiftly evolving in parallel to hegemonic
neoliberal capitalism. If neoliberal capitalism made the “rational, self-interested actor” the
organizing principle in the free market, then, by way of modern life being rampantly facilitated
by and lived through technological and online means, surveillance capitalism is a “deeply
intentional and highly consequential new logic of accumulation” of the near-infinite stream of
data produced by the neoliberal self to ultimately “predict and modify human behavior as a
means to produce revenue and market control” (Zuboff, 2015). One’s desires, hopes,
preferences, beliefs, values, and relationships are increasingly being predicted, shaped, packaged,
and sold to oneself. This is occurring, first, before having opportunities to engage in these basic
human experiences for the cultivation of the self without outside influence, and, second, while
effectively being forced to agree to data extraction in order to utilize everyday services (e.g.,
credit cards, music streaming services, virtual assistant technologies) and for basic social
participation online without having an opportunity to then access the data one generates.
It may be argued that Twitter and OnlyFans are indifferent to having sex workers
utilizing their services because they not only keep users on their platforms to generate data to be
sold, but also because keeping sex workers attracts new people to join who would not sign up
without having access to sex workers or to market one’s sex work. This is especially true for
Twitter provided that the company has only seen a modest increase in monetizable daily active
users in the past two years, with 166 million users in the 1st quarter 2020 when the COVID-19
pandemic began, to 211 million users by the 3rd quarter 2021 (Statista, 2021). For comparison,
TikTok’s monetizable daily active users has grown from 583 million in the 1st quarter 2020 to
1.037 billion by the 3rd quarter 2021 (Business of Apps, 2021). Twitter and OnlyFans may also
wish to keep sex workers on its platforms to continue attracting the emerging key demographic
of young adults as part of the Gen Z population for whom becoming an OnlyFans content creator
and/or posting explicit content online as means for both social and economic capital is an
aesthetic expression of internalized “cool capitalism” via the consumer-self posturing online with
symbols and text of dissent, ironic detachment, hedonism, and (non-pathological) narcissism
(McGuigan, 2012). Furthermore, those in charge at Twitter may be painfully aware of the
cautionary tale that is Tumblr’s fall into irrelevancy when it banned “adult content” in late 2018,
causing a mass departure from its various #NSFW communities to Twitter and other online
platforms.
It is easy to minimize or dismiss that OnlyFans’ “suspension” of its sexually explicit
policy ban is related to the emergence of hegemonic surveillance capitalism. Yet consider how
one’s online activity on Twitter is already being manipulated. Every keyboard tap and
backspace, tweets with .gifs, hyperlinks, videos, and photos, deleting tweets, interactions of
replies, retweets, likes, follows, unfollows, muting or blocking profiles, follow and unfollows,
using the search feature, exploring others’ profiles, bookmarking tweets, and all of the
information that is captured in joining a Twitter Space, are all components of the user experience
that are collected, aggregated, analyzed, packaged, and sold for purposes unbeknownst to data
brokers outside of U.S. statutory consumer protections and without consumers’ knowledge,
consent, or rights of privacy and due process (U.S. Committee on Commerce, Science, and
Transportation, 2013). In turn, users see other profiles recommended to them, other users’ likes,
replies, and retweets are featured in one’s own timeline, personalized sponsored Tweets try to
sell users products, and timelines are non-chronological by default with content that users are
most likely to interact with placed at the top of the timeline. It is safe to assume that OnlyFans
and other social media platforms that sex workers cross-post their content to are also engaging in
similar data-collection projects too. Twitter’s prediction-based features appear innocuous
provided they function at face-value to connect users to one another to form an online
community based one own’s interests. However, this experience only makes salient how
asymmetrical the relationship between hyperscale companies like Twitter, Meta (formerly
known as Facebook), and Google and users are: utilizing these platforms for social and labor
needs or a lack of knowledge altogether leads to an inability to resist surveillance that then leads
to a psychic numbing to the reality of being tracked, data-mined, and behaviorally modified
without transparency in how this is occurring (Zuboff, 2015). This process erodes psychological
self-determination as there is a crucial difference between conscious behaviors one may wish to
engage in and the behaviors chosen to perform in response to invasive, manipulating powers
online. As surveillance capitalism reorganizes politics and social relations by redistributing who
does and does not have the rights to privacy in ways that are yet to be fully understood, there is a
real threat for reality itself to be commodified and monetized under the gist of one’s self-
determined “behavior” as data about one’s behavior, minds, and things are collected and
manipulated in real-time.
In addition to the delayed financial gain made from selling one’s data to secret brokers
through anti-democratic processes, banks, credit card companies, payment processing
companies, and OnlyFans may desire keeping sex workers utilizing their services for the
immediate financial gain of automated, recurring subscriptions through using credit cards. Not
only would these stakeholders lose millions of dollars in revenue (with OnlyFans’ socio-
economic capital effectively doomed in the aftermath), but the alternative is possibly more
horrifying for these companies: for sex workers and their subscribers/fans to utilize en masse and
further popularize decentralized cryptocurrencies (i.e., secure digital currency networks based on
blockchain/distributed-ledger-network technology) and NFT’s (i.e., non-fungible tokens used as
proof of ownership of digital art as typically part of the popular cryptocurrency’s Ethereum
blockchain) (Clark, 2021; Frankenfield, 2021). OnlyFans currently does not accept
cryptocurrencies through crypto payment systems (e.g., Coinbase, Bitpay, SpectroCoin,
Coingate) whereas its created-by-sex-workers-for-sex-workers rival JustForFans (justfor.fans)
accepts Bitcoin and Pornhub likewise accepts 16 different cryptocurrencies (Taylor, 2021).
OnlyFans would rather capitulate to banks than navigate potential legal ramifications by
accepting cryptocurrency. The now-defunct Craigslist-alternative Backpage.com highlights the
real legal risks of accepting cryptocurrencies, as it was shut down in 2018 by the Department of
Justice after it began accepting Bitcoin and its CEO was convicted on charges of money
laundering (Benson, 2021).
Though OnlyFans seeks to dispel the idea that its content creators have anything to worry
about, the writing is on the wall with its sex worker content creators left in an even more
precarious position. PayPal and Venmo financially censor and discriminate against sex workers
by freezing or shutting down entirely the accounts of suspected sex workers without warning or
due process (Holston-Zannell, 2021). Visa, Mastercard, and American Express ended their
customers’ abilities to use their respective credit cards on Pornhub in December 2020 due to
allegations of the site hosting “unlawful content” on its site (Reuters Staff, 2020). It is only a
matter of time before OnlyFans either reinitiates its policy banning sexually explicit content, or it
loses cultural relevancy by way of Tumblr. There is now more incentive for OnlyFans-like
platforms, like JustForFans and ManyVids, to aggressively market themselves as sex-work-safe
alternatives to OnlyFans. Another direction companies may go in is being a decentralized all-in-
one platform. For example, NaftyToken is a Canadian-based company offering cryptocurrency
of the same name specifically for sex workers; since launch it now offers sex workers the
NaftyArt market for selling erotic-based NFT’s, Nafty.tv as a content subscription platform akin
to OnlyFans, and Nafty.me as a social network for creators and fans akin to Instagram
(NaftyToken Home Page, 2021). Online sex workers would be incentivized to mint and sell
NFT’s as they can retain copyright and reproduction rights to set their own royalty fee
percentages for when a respective NFT is resold (CyberScrilla, 2021). Online sex workers
utilizing cryptocurrencies and NFT’s not only reclaims power from financial corporations that
are influenced by the societal moralization of sexuality. These decentralized currencies and
platforms symbolically overturn the societal misconception of sex workers and pornography as
being disposable while more concretely training people to pay for pornography and to stop
exploiting sex workers and their labor through the unethical consumption of stolen or pirated
pornography hosted on “free” porn sites (McDowell & Page, 2019).
Online sex workers moving to cryptocurrencies and NFTs advances the fight for sex
workers’ labor and worker rights by destigmatizing sex work by both explicitly connecting sex
work’s labor to artistic expression and providing safe platforms for sex workers and consumers.
(Cryptonatrix, 2021). Sex workers using cryptocurrencies and NFT’s in tandem further
challenges subjective boundaries of aesthetic sexuality and sexiness and has the potential to
further dismantle the self-stigmatization and repression of one’s own sexual exploration, desire,
and expression. Likewise, utilizing these platforms is a small yet critical step in resisting banks’
and company’s ability to track, predict, and modify one’s behavior through implicit, non-
consensual means à la emerging surveillance capitalism. OnlyFans, Twitter, and associated
banks will continue earning money from sex workers’ labor without lobbying or advocating for
the rights of sex workers. The experiences of sex workers on OnlyFans demonstrates how social,
sexual, and economic freedom is compromised through relying upon late-stage capitalistic
institutions; sex workers’ liberation and attainment of labor and worker rights may then, in part,
be found in abandoning capitalism altogether for decentralized, peer-to-peer online networks in
tandem with traditional in-person support and advocacy efforts through non-profits ran by sex
workers.
Chapter V: Conclusion
The theaters of journalism and pop culture have become continuously more invested in
OnlyFans since beginning this dissertation over a year and a half ago. The company’s popularity
and notoriety in mainstream culture has been accelerated through news of high-profile
individuals joining the platform such as celebrities like Cardi B and Tyler Posey, RuPaul’s Drag
Race fan-favorites Shea Couleé and Plastique Tiara, reality television stars like Dorinda Medley
and Sonja Morgan of Bravo’s The Real Housewives of New York, and LGBTQIA+ icons and
social media influencers Brentman Rock and Tana Mongeau. Hulu released its documentary,
OnlyFans: Selling Sexy, at the beginning 2021. The original social media influencer Paris Hilton
and singer-songwriter Sky Ferreira are set to appear in an upcoming OnlyFans-inspired horror
film, 18 & Over. To say nothing of the fact that the popularity in OnlyFans has occurred in the
context of a global pandemic that has ushered in an era of people spending an increasing amount
of time at home and physically separated from others, this is the certainly the golden age of
OnlyFans and Twitter pornography.
Researchers and academics alike have also sought to examine OnlyFans in a multitude of
interesting ways. Typing in “OnlyFans” into Google Scholar revealed 336 search results when
filtering by the year 2020 and 232 search results when filtering by the year 2021 at this time of
writing in December 2021. Cardoso and Scarcelli (2021) conducted thematic analyses on semi-
structured interviews with “young Italian women” who produced sexualized OnlyFans content (n
= 20) to investigate how bodies were conceptualized in relation to content production and how
labor influenced one’s somatic existence. While participants reported overall positive
experiences with OnlyFans, the young women viewed themselves and their bodies as things to
be transformed for financial gain and faced exhaustion as they invested increasing amounts of
time and energy (i.e., unpaid labor) into producing content. Cardoso and Scarcelli’s findings
contextualize this research study’s findings of participants discussing how producing content
may be physically, mentally, and emotionally intensive by making explicit the connection
between work of the body and self-branding: sexually explicit content creators run the risk of
becoming trapped in a cycle of demands on the body and reorganizing one’s lifestyle such that
the borders between work and leisure and public and private expressions of intimacy are blurred.
Murphy’s (2020) dissertation conducting corpus-assisted critical discourse analyses on
Twitter users’ perceptions of sex workers on OnlyFans revealed how the subject of money was
an overwhelming focal point in public discourse and how there was no definitive correlation
between positive or negative social perceptions of sex work and the passage of time. Just as most
participants of this research study were cisgender women, the critical discourse analyses showed
how women partaking in sex work discourse were more likely to view OnlyFans as viable
financial option. That there was no definitive correlation on social perceptions and time makes
salient how participants of this research study expressed concerns about how Twitter and
OnlyFans operate as companies. As discussed in Safaee’s (2021) thesis interviewing OnlyFans
content creators (n = 6), there appears to be a consensus among OnlyFans sex workers that the
OnlyFans company profits off the labor of content creators without enacting any meaningful
policies to meaningfully support its sex work community and the company sidesteps any
responsibilities for the challenges by the community as well. Thus, it is not surprising that there
would be only greater varied perspectives about sex workers expressed online. Additionally,
Murphy (2020) identifies how negative sentiments towards sex workers were noticeably more
often expressed by men, reinforcing the minor Negative Experiences with Men theme identified
within this research study and calling into question to what extent participants’ experiences of
labor intensity is exacerbated by men as followers/fans.
Hsiao, Steele, and Weber (2021) examined how digital intimacy was presented on
Twitter and OnlyFans through via a walkthrough method, investigating each platforms’ interface
for its design, verbal and visual cues, and technological affordances. Their research found that
Twitter presents digital intimacy through a highly individualized and user-focused interface and
OnlyFans facilitates immediacy through its direct messaging system with an embedded payment
feature. For participants of this research study who commented on the intensive nature of
producing content or who commented having an overall negative experience of OnlyFans, this
was often in the context of identifying needing to engage with clients in unpaid interactions. If
digital intimacy is becoming a norm within online spaces, then further investigative attention
should be paid to better understand the strategies content creators and similar online sex workers
employ to facilitate digital intimacy and minimize how much digital intimacy labor goes unpaid.
Relatedly, Bonifacio, Hair, and Wohn (2021) interviewed how creators on the digital platform
Patreon (n = 21) engaged in relational labor, the practice of communicating with patrons in a
purposeful and sustained manner intended to cultivate an intimate relationship and to secure
financial support, with their patrons (i.e., subscribers) (Baym, 2018; Craig and Cunningham,
2019). The authors found that relational labor was dependent upon creator-fan dynamics, with
creators viewing relationships as either purely transactional, creators reporting an emotional
investment into their fan relationships, and some creators having “top” or “most loyal” fans.
Although the authors reference OnlyFans as a platform with dynamics likely similar to creator-
patron dynamics, the intersections of online sex work, digital intimacy, and relational labor
should be studied in the context of OnlyFans provided that creator-fan dynamics would be
impacted by mainstream society’s moral treatment towards sex workers.
Furthermore, DePasquale’s (2020) semi-structured interviews with women who were
online sex workers (n = 13) on how their app-based sex work impacted their sense of autonomy
found themes of: Creators being able to thrive form working outside of patriarchal organizations;
Setting professional boundaries mitigated the effects of performing non-commodified emotional
labor; Autonomy was significantly impeded by how apps have imposed rules and restrictions
since FOSTA-SESTA’s passing to enforce gendered inequality and disrupt sex workers’ revenue
streams by policing nudity and sexual content. Similarly, Persaud’s (2021) preliminary digital
ethnographic research on social media subcultures and sexual content moderation addresses how
sex and sexuality has become increasingly censored on social media, with sexual content
becoming increasingly restricted in limited visibility settings (i.e., Instagram’s Close Friends
Stories or direct messaging on mainstream social media platforms) and with OnlyFans having
changed its term of services to prohibit sexual expression that falls outside “normal” parameters
(e.g., BDSM and body modification). Themes of autonomy, increased sense of self-advocacy,
increased sense of self-confidence, censorship concerns, and company concerns also emerged
within this current study, suggesting that discriminatory policing of sex workers online is
universal while unevenly applied depending on one’s identities and how “deviant” one’s sexual
expression is considered by mainstream society.
Sex workers’ present visibility online and accumulated socioeconomic capital has
skyrocketed in a matter of a few years through utilizing OnlyFans. This unique, new online mode
of sex work warrants careful exploration and understanding for contemporary sexual values and
erotic labor in a hyper-online world. From this research endeavor, it is revealed that becoming a
sexually explicit OnlyFans content creator who markets themselves on Twitter and other social
media platforms is understood as the next logical iteration of sex work through neoliberal
capitalism’s centering of the individual as a “rational, self-interested actor” in the marketplace
and the individual’s internalization of compulsive consumerism and individualism that celebrates
ironic detachment, bohemian posturing, and non-conformity. Considering the integration of the
internet, social media, and smart technology into everyday life, increased legal rights and
positive representations in media for gender and sexual minorities, and shared Western
sentiments of sex positivity and within social media specifically, sexual content online has
inevitably become a means for personal satisfaction and for fostering one’s digital community.
To become a sex worker as an OnlyFans content creator is a means to attain social and economic
capital to improve one’s quality of life and one’s station in life in a neoliberal world that
continues becoming increasingly inequitable, stratified, and hostile to those who are at or below
a lower-middle socioeconomic status. The simultaneous pornification and celebritization of
Western mass culture over the past 40 years offers another lens for understanding how content
creators create, market, and monetize their carefully curated and crafted online personas:
becoming a brand unto oneself as a content creator is to incorporate pornographic gestures and
aesthetics and to perform intimacy with followers so as to maximize engagement and attention
from one’s followers and fans alike.
Although none of findings may be considered statistically significant given a small
number of participants (n=19), this dissertation’s research survey provides important indications
for the lived and online experiences of sex workers on OnlyFans that contains near-unlimited
potential for future research to expand upon. Participants’ demographics were hegemonic, with
the majority of participants being domiciled white, queer, cisgender women who have previous
sex work experience outside of utilizing OnlyFan, and who received at least a high school-level
education. Participants’ ages at which they first experienced exchanging something sexual for
money or something else of value ranged from their teens through adulthood. The majority of
participants reported being the sole provider of their families or currently being financially
independent. Over half of the participants created their OnlyFans accounts in 2020 with one-third
of participants have little to no experience in webcam modeling, videography and film, and/or
photo editing software. Nearly three-fourths of participants were engaging in at least one other
form of sex work outside of being an OnlyFans content creator, three-fourths of participants
endorsed experiences of someone trying to threaten, exploit, and/or get freebies from them since
joining OnlyFans, and three-fourths of participants reported being connected to a non-profit sex
work organization ran by sex workers since joining OnlyFans.
Experiencing whorephobia from providers or professionals was an overarching theme of
participants’ experiences with accessing common services. Participants’ willingness to disclose
their sex work profession to medical providers was setting-dependent, and participants both
anticipated and experienced perceived judgement from providers. Experiences with mental
health professionals were more nuanced, with themes of providers being perceived as being non-
judgmental and/or sex-work friendly being as common as themes of mental health professionals
identifying one’s sex work as the root of their patients’ challenges and/or pathology. The
majority of participants elected not to share their experiences with legal aid professionals,
making salient both sex workers’ appropriate mistrust of the field due to its overlap with law
enforcement and criminal justice systems and sex workers’ preference for navigating legal affairs
with the guidance of non-profit sex work organizations or other sex workers. Participants
likewise expressed warranted disdain towards law enforcement professionals, noting how
engaging with law enforcement is extremely dangerous for sex workers’ lives and livelihoods.
Participants reported psychosocial influences of perceived social support, self-esteem,
and presence and search for meaning in one’s life. With respect to perceived social support,
participants overall felt most supported by their significant others, closely followed by their
friends, and least supported by their families. The majority of participants reported having
normal-to-high levels of self-esteem. Most of the participants reported feeling that their lives do
not have a valued meaning and purpose and that they are actively searching for meaning or
purpose in one’s life.
Themes pertaining to the participants experiences and perceptions of OnlyFans and the
content creator-follower Twitter community were also discerned. Participants’ motivations for
joining OnlyFans were predominantly facilitated by the need for a supplementary or primary
income due to losing income streams in the face of the COVID-19 pandemic. Since joining the
platform, the majority of participants reported experiencing an increase in their self-confidence.
Participants reported positive overall experiences with utilizing OnlyFans and Twitter, with
about one-third of participants having more ambivalent experiences with the platforms. The
online culture of the content creator-follower Twitter community was characterized as
experiencing other content creators as very supportive of one another, while participants also
noted how they felt exploited due to the significant amount of uncompensated labor put into
maintaining and growing one’s audience on Twitter. Participants reported an increased
utilization of both platforms at the onset of the COVID-19 pandemic and reporting mixed
experiences adjusting to unique demands of marketing oneself on OnlyFans and Twitter. When
asked what participants wanted their followers, fans, and clients to understand what it means for
them to be sex workers, participants discussed that they want their humanity and basic goodness
recognized, that being a sex worker is more labor intensive – both physically and emotionally –
than what popular discourse about sex work would suggest, and that being a sex worker is real
work.
This dissertation’s research survey faced serious limitations. Recruiting participants was
difficult due to the principal researcher being an outsider of the sex work community as
positioned within academia and the field of clinical psychology, two fields that have historically
generated more harm in their respective discourses and praxis than service and allyship. Lacking
funds made it difficult to increase potential reach through online advertising and not
compensating participants for their time and labor in completing the research survey broke from
the community standard of compensating sex workers for their labor. OnlyFans’ sexual content
policy ban announcement and subsequent “suspension” fundamentally changed how potential
participants would engage with the research survey and thus cut short the recruitment period.
To think about, to research, and to discuss the intricate nuances of sex, sexuality, and sex
work is to face being dismissed as immature, perverse, or even dangerous. Yet now is the time to
talk honestly and urgently about the internal politics, inequities, and modes of oppression of sex,
sexuality, and sex work, for it is in periods of time in which people must live with the real
possibility of unthinkable destruction that societies become dangerously crazy about sexuality
(Rubin, 1984). Consider that the average person living in the United States of America is
presently tasked with: continuing to work during a pandemic that has already killed 800,000
people; to survive in the face of ongoing climate collapse via more frequent and fatal hurricanes,
wildfires, tornadoes, flooding, and droughts; to make enough money to pay off exorbitant student
and medical debts, housing, and insurance to access adequate healthcare that each uniquely
threaten to trap people into cycles of poverty and to lower life expectancies; to ignore the
continued concentration of capital and power to an elite political-corporate class and the
subsequent class-stratification of society; to repeatedly provide thoughts and prayers to victims
of the preventable epidemics of gun violence, school shootings, and opioid overdose; to not take
seriously the grave threats to democracy brought upon by concerted efforts for passing
restrictive voting laws, gerrymandering that facilitates minority political rule, and rapidly visible
and mobilizing neo-fascist/white supremacist political groups and armed militias (that are
effectively one-in-the-same); to believe in the might of the United States military as the nation is
entangled in a second “cold war” with both Russia and China; and, depending on one’s political
stance, either to celebrate or to resist oppressive laws that criminalize getting an abortion, ban
the ability to provide healthcare to transgender youth, criminalize homelessness and poverty, and
invade peoples’ privacy through mass surveillance programs. It is these overwhelming
experiences of contemplating potential (symbolic, material, and environmental) annihilation
combined with American sexual discontents historically rooted in Puritanism that gives sex and
sexuality such immense symbolic weight in the public psyche. Contemporary conflicts over
sexual values and behaviors are thus displaced social anxieties that are discharged with equal
levels of emotional intensity (Rubin, 1984).
Becoming an OnlyFans content creator who markets themselves on Twitter has made
online sex work visible and accessible on social media and in popular culture in a precedented
fashion. Discourse of OnlyFans in pop culture, journalism, academia, and on social media should
be considered as evidence for how OnlyFans is a key organizing principle for discharging
contemporary social anxieties onto sexual behavior and expression during the era of late-stage
capitalism and COVID-19. This dissertation sought to address how OnlyFans came to
prominence and bestowed such immense cultural weight, in addition to addressing how utilizing
and OnlyFans and Twitter influences one’s experiences in accessing common services,
psychosocial influences, and perceptions of the OnlyFans-Twitter community. This line of
research has only just begun to illuminate how intertwining sexual expression and sex work into
social media consumption at the individual level transgresses and renegotiates boundaries of the
social self, erotic life, and labor to emerge new hegemonic attitudes towards sex and its social,
economic, and political reality and potential. OnlyFans was never going to remain the “newest”
iteration of sex work and the migration to decentralized markets via NFT’s and cryptocurrencies
has in fact already begun. Thus, to continue researching the psychology of online sex workers is
to better understand and identify both how human beings create new sexualities in a hyper-online
world that reflect fluid social systems and how human beings impose erotic injustice and sexual
oppression onto those who seek to financially gain from the creation of these new sexualities.
Chapter VI: Tables
Table 1
Demographics
Age
Category n % Category n %
18-20: - - 21-29: 7 36.84%
30-39: 8 42.11% 40-49: 2 21.05%
50-59: - - 60 or older: - -
I choose not to answer: - -
Gender Identity
Cisgender Man 3 15.79% Cisgender Woman 14 73.68%
Transgender Man: - - Transgender Woman 2 10.53%
Agender: - - Bigender: - -
Genderqueer: - - Gender Non-Conforming: - -
Nonbinary: - - Two-Spirit: - -
Other: - - I choose not to answer: - -
Sexual Orientation
Straight: 2 10.53% Gay/Lesbian: 3 15.39%
Asexual: - - Bisexual: 4 21.05%
Pansexual: 5 26.31% Queer: 2 10.3%
Questioning: 1 5.26% Other: 1 5.26%
I choose not to answer: 1 5.26%
Table 1 (Continued)
Demographics
Race
Native American or
- - Asian: - -
Alaskan Native:
Black or Native Hawaiian
1 5.26% - -
African American: or Pacific Islander
White or
11 57.90% Latino or Hispanic: - -
European American:
Middle Eastern: 1 5.26% Biracial: 5 26.32%
Other: - - I choose not to answer: 1 5.26%
Developmental and Acquired Disability*

I do not identify with a
8 36.36% A learning disability: 5 22.73%
disability or impairment:
A long-term
1 4.55% A mobility impairment: 1 4.55%
medical illness:
A disability or
A mental health disorder: 5 22.73% 1 4.55%
impairment not listed:
*Participants were able to choose more than
one response
Table 1 (Continued)
Demographics
Educational Level
Less than a High school degree
- - 3 15.39%
high school degree: or equivalent:
Some college
Vocational school: 1 5.26% 4 32.05%
but no degree:
Associate degree: 1 5.26% Bachelor’s degree: 7 36.84%
Graduate or
2 10.53% I choose not to answer: - -
professional degree:
Household Status
Apartment: 10 52.63% Condominium: 2 10.53%
House (in the process of
Co-op: - - 5 26.31%
buying or have bought):
Public housing: - - Shelter: 1 5.26%
Other 1 5.26%
Table 2
Experiences in Sex Work and With Services
(Based off Rhode Island Chapter of COYOTE, 2015)

Age of First Experience with Sex Work
14 or younger: - - 15-19: 6 31.58%
20-24: 7 36.84% 25-29: - -
30-34: 6 31.58% 35-39: - -
40 or older: 1 5.26% I choose not to answer: - -
Sole Provider for Family

Yes: 14 73.68% No: 4 21.05%
Other: 1 5.26% I choose not to answer: - -
Number of Family Members Supporting

0 (Independent): 9 47.37% 1: 1 5.26%
2: 4 21.05% 3: 3 15.39%
4: 1 5.26% 5: - -
6 or more: - - Other: - -
Services Sought Since Starting Sex Work*

None: 3 15.39% Shelters: - -
Medical services: 11 57.90% Mental health services: 8 42.11%
Legal aid: 4 21.05% Other: 1 5.26%
*Participants were permitted to choose more
than one response
Table 2 (Continued)
(Rhode Island Chapter of COYOTE, 2015)

Shelters:
Type of Shelter
Not applicable: 19 100% Homeless shelter: - -
Domestic violence shelter: - - Adult shelter: - -
Youth shelter: - - Other: - -
Shelters:
Staff Aware of Sex Work Engagement*
Not applicable: - - Yes: - -
No: - - Other: - -
*This question was only accessible if
I choose not to answer: - - participants chose Services in the “Services
Sought Since Starting Sex Work” question
Medical Services:
Providers Aware of Sex Work Engagement
Not applicable: - - Yes: 4 21.05%
No: 6 31.58% Other: 8 42.11%
Mental Health:
Providers Aware of Sex Work Engagement
No: - - Other: - -
Table 2 (Continued)
(Rhode Island Chapter of COYOTE, 2015)

Legal Aid:
Practitioners Aware of Sex Work Engagement
No: 2 10.53% Other: 1 5.26%
Law Enforcement:
Officers Aware of Sex Work Engagement
No: 3 15.30% Other: - -
Victim of Sex Trafficking

Yes: 1 5.26% No: 9 47.37%
Victim of Exploitation
Yes: 9 47.37% No: 9 47.37%
Table 3
Experiences With OnlyFans
Year of Creating OnlyFans

2016: - - 2017: 1 5.26%
2018: 3 15.39% 2019: 2 10.53%
2020: 12 63.16% 2021: - -
Age of Joining OnlyFans

18-20: 1 5.26% 21-29: 8 42.11%
30-39: 5 26.32% 40-49: 4 21.05%
50 or older: - - I choose not to answer: 1 5.26%
Years of Webcam, Video, and/or Photo Experience

0-1: 6 31.58% 2-3: 4 21.05%
4-5: 3 15.39% 6-7: 1 5.26%
8-9: - - 10 or more: 2 10.53%
OnlyFans As Sole Sex Work Income

Yes: 4 21.05% No: 14 73.68%
Table 3 (Continued)
Other Current Forms of Sex Work Engaged In*

Not applicable: - - Bar or casino-based work: - -
BDSM or Brothel or bathhouse
4 28.57% - -
dominatrix-based work work:
Escort services: 5 35.71% Exotic dancing: 4 28.57%
Massage or massage parlor Pornographic film
1 7.14% 5 35.71%
related work: performing:
Sugar daddy/momma and
Street-based work: - - 6 42.86%
sugar baby arrangements:
Webcam modeling: 6 42.86% Other: 3 21.43%
*Participants were able to choose more than
one response
Average Weekly Hours of Labor for OnlyFans

0-9: 5 26.32% 10-19: 6 31.58%
20-29: - - 30-39: 1 5.26%
40-49: 2 10.53% 50-59: 2 10.53%
60-69: 1 5.26% 70 or more: - -
Experienced Threats, Exploitation, or Attempted Freebies Since Joining OnlyFans

Yes: 14 73.68% No: 3 15.39%
Other: 1 5.26% I choose not to answer: 1 5.26%
Table 3 (Continued)
Connected to Sex Work Organization:

Before Joining OnlyFans
Yes: 10 52.63% No: 7 36.84%
Connected to Sex Work Organization:

Since Joining OnlyFans
Yes: 1 5.26% No: 3 15.39%
Table 4
Multidimensional Scale of Perceived Social Support
(Zimet, Dahlem, Zimet, & Farley, 1988)
0: No Answer 1: Very Strongly Disagree

2: Strongly Disagree 3: Mildly Disagree
4: Neutral 5: Mildly Agree
6: Strongly Agree: 7: Very Strongly Agree
Significant
Subscale: Family Friends Total
Others
Mean Mean
Score 16.4 20.6 23.0 Score 61.4
of 28: of 84
Mean Mean
58.6% 73.6% 82.1% 73.1%
Score % Score %
Median Median
Score 16 24 24 Score 64
of 28: of 84
Mode 4, 12, Mode
25 28
Score 15, 16 Score 79 (n=4)
(n=4) (n=7)
of 28: (n=2) of 84
Mean Mean
Question Subscale Mean Score % Median Mode
Category
1. There is a special person
Significant Mildly 7
who is around when I am in 5.7 82.0% 6
Other Agree (n=9)
need.

with whom I can share my 5.6 80.5% 6
Other Agree (n=8)
joys and sorrows.
3. My family really tries to 6, 7

Family 4.6 65.4% Neutral 5
help me. (n=4)
4. I get the emotional help

5, 6
and support I need from my Family 4.0 57.1% Neutral 5
(n=3)
family.
Table 4 (Continued)
Multidimensional Scale of Perceived Social Support
0: No Answer 1: Very Strongly Disagree

2: Strongly Disagree 3: Mildly Disagree
4: Neutral 5: Mildly Agree
6: Strongly Agree: 7: Very Strongly Agree
Mean Mean
Question Subscale Mean Median Mode
Score % Category
5. I have a special person

who is a real source of 5.9 85.0% 7
Other Agree (n=10)
comfort to me.
6. My friends really try to Mildly 6, 7

Friends 5.2 77.4% 6
help me. Agree (n=6)
7. I can count on my friends Mildly 6

Friends 5.6 80.0% 6
when things go wrong. Agree (n=10)
8. I can talk about my Mildly 2, 7

Family 3.9 56.6% 4
problems with my family. Disagree (n=4)
9.I have friends with whom

Mildly 6
I can share my joys and Friends 5.5 79.0% 6
Agree (n=8)
sorrows.

in my life who cares about 5.7 82.0% 7
Other Agree (n=20)
my feelings.
11. My family is willing to 1, 5, 6

Family 4.9 56.4% Neutral 5
help me make decisions. (n=4)
12. I can talk about my Mildly 6

Friends 5.8 83.5% 6
problems with my friends. Agree (n=8)
Table 5
Rosenberg Self-Esteem Scale
(Rosenberg, 1965)
0: No Answer 1: Strongly Disagree

2: Disagree 3: Agree
4: Strongly Agree
Mean Score Mean

Median Mode
of 36 Score %
Total
36
27.9 77.5% 28
(n=3)
Mean Mean
Question Mean Median Mode
Score % Category
1. On the whole, I am satisfied
2.4 60.5% Disagree 3 4 (n=9)
with myself.
2. At times I think I am no good

2.6 65.8% Disagree 3 2 (n=7)
at all.*
3. I feel that I have a number of

3.3 82.9% Agree 4 4 (n=11)
good qualities.
4. I am able to do things as well

3.3 82.9% Agree 4 4 (n=10)
as most other people.
5. I feel I do not have much to

3.4 85.5% Agree 4 4 (n=10)
be proud of.*
6. I certainly feel useless at

2.4 59.2% Disagree 2 2 (n=7)
times.*
*Items 2, 5, 6, 8, and 9 were reverse scored.
Table 5 (Continued)
Rosenberg Self-Esteem Scale
(Rosenberg, 1965)
0: No Answer 1: Strongly Disagree

2: Disagree 3: Agree
4: Strongly Agree
Mean Mean
Question** Mean Median Mode
Score % Category
7. I feel that I’m a person of
worth, at least on an equal plane 3.5 86.8% Agree 4 4 (n=12)
as others.
9. All in all, I am inclined to

3.1 78.9% Agree 4 4 (n=11)
feel that I am a failure.
10. I take a positive attitude

2.7 67.1% Disagree 3 3 (n=8)
toward myself.
*Items 2, 5, 6, 8, and 9 were reverse scored.
**Question 8, “I wish I could have more respect for myself,” was mistakenly omitted from the
Qualtrics research survey
Table 6
Meaning in Life Questionnaire
(Steger, 2006)
0: No Answer 1: Absolutely Untrue 2: Mostly Untrue

3: Somewhat Untrue 4: Can’t Say True or False 5: Somewhat True
6: Mostly True 7: Absolutely True
Mean
Mean
Subscale: Score of Median Category
35 Score %
*Scoring below 24 of Presence and

Presence 17.1 48.7% 16
below 24 on Search indicates feelings
that one’s life does not have a valued
meaning and purpose and not actively
Search 22.0 77.5% 28 exploring this meaning or seeking
meaning in one’s life.
Total scores above 24 on Total scores above 24

Presence and above 24 on 4 21.05% on Presence and 0 -
Search1 below 24 on Search2:
Total scores below 24 on *Total scores below

Presence and below 24 on 7 36.84% 24 on Presence and 8 42.11%
Search3: above 24 on Search:
1: Indicates feeling one’s life has a valued meaning and purpose while not actively exploring
the meaning or seeking meaning in one’s life.
2: Indicates feeling one’s life has a valued meaning and purpose while not actively exploring
the meaning or seeking meaning in one’s life.
3: Indicates feeling that one’s life does not have a valued meaning and purpose, while actively
searching for meaning or purpose in one’s life.
Table 6 (Continued)
(Steger, 2006)

Mean Mean
Score % Category
1. I understand my life’s Mostly 3
Presence 2.7 38.4% 3
meaning. Untrue (n=5)
2. I am looking for Can’t Say

6
something that makes my Search 4.7 67.7% True or 6
(n=8)
life feel meaningful. False
3. I am always looking to Somewhat 6

Search 5.6 80.5% 6
find my life’s purpose. True (n=8)
4. My life has a clear sense Somewhat 3

of purpose. Untrue (n=5)
5. I have a good sense of

Mostly 2
what makes my life Presence 2.8 39.8% 2
Untrue (n=10)
meaningful.
6. I have discovered a Somewhat 3

satisfying life purpose. Untrue (n=5)
7. I am always searching Can’t say

5, 6
for something that makes Search 4.1 58.6% True or 5
(n=4)
my life feel significant. False
Can’t say
8. I am seeking a purpose 5
Search 4.2 59.4% True or 5
or mission for my life. (n=7)
False
Table 6 (Continued)
(Steger, 2006)

Mean Mean
Score % Category
9. My life has no clear Somewhat 7
purpose. True (n=6)
Can’t Say
10. I am searching for 5
Search 4.0 57.1% True or 4
meaning in my life. (n=4)
False
Table 7
Matrix Coding for Motivation for Joining OnlyFans

Table 8
Matrix Coding for Changes in Self-Perception Since Joining OnlyFans

Table 9
Matrix Coding for Overall Experiences Utilizing OnlyFans and Twitter

Table 10
Matrix Coding for the Online Culture of the Content Creator/Follower Twitter Community
Table 11
Matrix Coding for the Impact of COVID-19 on the Utilization of OnlyFans and Twitter
Table 12
Matrix Coding for What Followers, Fans, or Clients Should Understand
About What it Means to be a Sex Worker

Chapter VII: Figures
Did Not Answer Majority

of Questions (5, 6%)
Did Not Live in

USA or Territory
(9, 10%)
Did Not Have

Did Not Reach OnlyFans…
Debriefing
(10, 11%)
Did Not
Have Twitter
(13, 14%)
Met Full Inclusion

Crteria
(19, 21%)
Figure 1: Inclusion/Exclusion Criteria of 90 Research Survey Participants

Chapter VIII: References
Abel, G. M. (2014). A Decade of Decriminalization: Sex Work ‘Down Under’ But Not
Underground. Criminology and Criminal Justice, 14(5): 580-92.
Abel, G. M., Fitzgerald, I., and Brunton, C. (2007). The Impact of the Prostitution Reform Act
on the Health and Safety Practices of Sex Workers. Department of Public Health and
General Practice, University of Otago.
Abramitzky, R., Boustan, L. P., and Erickson, K. (2012). Europe’s Tired, Poor, Huddled
Masses: Self-Selection and Economic Outcomes in the Age of Mass Migration. American
Economic Review, 102(5), 1832-56. DOI: 10.1257//aer.102.5.1832.
Aidala, A. & Sumartojo, E. (2007). Why Housing? AIDS Behavior, 11: S1-S6.
Allen, D. (1980). Young Male Prostitutes: A Psychosocial Study. Archives of Sexual Behavior,
9: 399 – 389.
Allenbach, N. (2019). “A Critical Breakdown of Brand Humanization on Social Media.”

Medium. Retrieved April 27th, 2021, from https://nathanallebach.medium.com/good-and-
bad-ways-to-criticize-brands-being-human-on-social-media-cf61665fe7ca.
Altman, D. (1999). Foreword. In P. Aggleton (Ed.), Men Who Sell Sex: International
Perspectives on Male Prostitution and HIV/AIDS (pg. xiii – xix). London: UCL Press.
Altman, D., Aggleton, P., Williams, M., Kong, T., Reddy, V., Harrad, D., et al. (2012). Men
who have sex with men: stigma and discrimination. Lancet; 380 (9839): 439 – 45.
doi: 10.1016/S0140-6736(12)60920-9 22819652
American Psychiatric Association Work Group on Eating Disorders. (2006). Practice guidelines
for the treatment of patients with eating disorders. Retrieved from
http://www.psychiatryonline.com/pracGuide/loadGuidlinePdf.aspx?file=EatingDisorders
3ePG_04-28-06.
Amnesty International. (2005). Stonewalled: Police Abuse and Misconduct Against Lesbian,
Gay, Bisexual and Transgender People in the U.S. 13-18, AMR 51/122/2005.
Anderson, S. Shannon, K., Li, J., Lee, Y., Chettiar, J. Goldenberg, S., et al. (2016). Condoms and
Sexual Health Education as Evidence: Impact of Criminalization of In-Call Venues and
Managers on Migrant Sex Workers Access to HIV/STI Prevention in a Canadian Setting.
BMC International Health and Human Rights, 16(1): 30.
Argento, E., Taylor, M., Jollimore, J., Taylor, C., Jennex, J., Krusi, A., & Shannon, K. (2016).
The loss of Boystown and transition to online sex work: Strategies and barriers to
increase safety among men sex workers and clients of men. American Journal of Men’s
Health, 1-12. doi.: 10.1177/1557988316655785
References
Armstrong, L. (2010). “Out of the Shadows (and Into a Bit of Light): Decimalization, Human
Rights and Street-Based Sex Work in New Zealand, in K. Hardy, S. Kingston and T.
Sanders, New Sociologies of Sex Work. Routledge, UK.
Armstrong, L. (2014). Screening Clients in Decriminalized Street-Based Sex Industry: Insights

Into the Experiences of New Zealand Sex Workers. Australian and New Zealand Journal
of Criminology, 47(2): 207-22.
Armstrong, L. (2015). “Who’s the Slut, Who’s the Whore?”: Street Harassment in the
Workplace Among Female Sex Workers in New Zealand. Feminist Criminology, 11(3):
285- 22
Armstrong, L. (2017). From Law Enforcement to Protection? Interactions Between Sex Workers
and Police in a Decriminalized Street-Based Sex Industry. British Journal of
Criminology, 57: 570-588.
Aron, N. R. (2018). “At the Hookers Ball, strippers, dancers, and activists took over San
Francisco and partied for sex workers rights.” Retrieved February 1, 2021, from
https://www.timeline.com/the-hookers-ball-kicked-off-the-sex-workers-rights-
movement-fd075b22b91f
Attwood, F. (2004). Pornography and Objectification: Re-reading the picture that divided
Britain. Feminist Media Studies, 4(1), 7-19.
Attwood, F. (2006). Sexed Up: Theorizing the Sexualization of Culture. Sexualities, 9(1), 77-94.
Bankov, K. (2019). Cultural transformations of love and sex in the digital age. Digital Age in
Semiotics and Communication, 2(1), 7-17. DOI: 10.33919/dasc.19.2.1.
Bar-Johnson, M., & Weiss, P. (2014). Mental health and sexual identity in a sample of male sex
workers in the Czech Republic. Medical science monitor: international medical journal
of experimental and clinical research, 20, 1682–1686.
https://doi.org/10.12659/MSM.891092
Baral, S., Beyrer, C., Muessig, K., Poteat, T., Wirtz, A. L., Decker, M. R., et al. (2012). Burden
of HIV among female sex workers in low-income and middle-income countries: a
systematic review and meta-analysis. Lancet Infectious Diseases, 12, 7, 538 – 49.
doi: 10.1016/S1473-3099(12)70066-X 22424777
Baral, S. D., Friedman, M. R., Geibel, S., Rebe, K., Bozhinov, B., Diouf, D., et al. (2014). Male
sex workers: practices, contexts, and vulnerabilities for HIV acquisition and transmission.
Lancet Infectious Disease, 385 (9964): 260–73. doi: 10.1016/S0140-6736(14)60801-1
25059939
References
Baratosy, R. and Wendt, S. “Outdates Laws, Outspoken Whores”: Exploring Sex Work in a
Criminalized Setting. Women Studies International Forum, 62: 34-42.
Bardach, E. (1977). The implementation game. Berkeley, CA: University of California Press.
Baym, N. K. (2018). Playing to the Crowd: Musicians, Audiences, and the Intimate Work of
Connections. (Volume 14 of Postmillennial Pop). New York, NY: NYU Press.
Beattie, T. S., Bhattacharjee, P., Suresh, M., Isaac, S., Ramesh, B., Moses, S. (2012). Personal,
interpersonal and structural challenges to accessing HIV testing, treatment and care
services among female sex workers, men who have sex with men and transgenders in
Karnataka state, South India. Journal of Epidemiology and Community Health, 66(2): 42-
48.
Beck, U. & Beck-Gernsheim, E. (2001). Individualization: Institutionalized Individualism and

Its Social and Political Consequences. London, United Kingdom: Sage.
Bell, C. E. (2010). American Idolatry: Celebrity, Commodity and Reality Television. Jefferson,
NC: McFarland
Bellhouse, C. Crebbin, S., Fairley, C. K., & Bilardi, J. E. (2015). The Impact of Sex Work on
Women’s Personal Romantic Relationships and the Mental Separation of Their Work and
Personal Lives: A Mixed-Methods Study. PloS one, 10(10).
Benes, R. (2018). Porn could have a bigger economic influence on the US than Netflix.
Retrieved May 18, 2020, from https://finance.yahoo.com/news/porn-could-
bigger-economic-influence-121524565.html
Benoit, C., and Millar, A. (2001). Dispelling Myths and Understanding Realities: Working
Conditions, Health Status, and Exiting Experiences of Sex Workers. Department of
Sociology, University of Victoria.
Benoit, C., Ouellet, N., & Jansson, M. (2016). Unmet Health Care Needs Among Sex Workers
in Five Census Metropolitan Areas of Canada. Canadian Journal of Public Health,
107(3): 266-271.
Benson, J. (2021). Pornhub Embraced BitCoin. Why Didn’t OnlyFans?. Decrypt.co. Retrieved
December 12, 2021, from https://decrypt.co/78988/pornhub-embraced-bitcoin-onlyfans
Bernazzani, S. (2018). “Micro-influencer Marketing: A Comprehensive Guide.” Retrieved April

27th, 2021, from HubSpot Blog: https://blog.hubspot..com/marketing/micro-influencer-
marketing
References
Bernstein, E. (2005). Desires, Demand, and the Commerce of Sex: In E. Bernstein & L.
Schaffner (Eds.), Regulating sex: The politics of intimacy and identity (pg. 101 – 128).
New York: Routledge.
Bernstein, E. (2007). Sex work for the middle classes. Sexualities, 10, 473-488.
doi: 10.1177/1363460707080984
Bernstein, J. (2019). How OnlyFans Changed Sex Work Forever. The New York Times.
Retrieved May 11, 2020, from https://www.nytimes.com/2019/02/09/style/onlyfans-
porn-stars.html
Bernstein, J. (2021). OnlyFans Reverses Its Decision to Ban Explicit Content. The New York
Times. Retrieved December 11, 2021, from
https://drive.google.com/drive/folders/1Vclvs91fWUVQ_t5ZQVJxL5ludW61fwhO.
Berry, M. C., Go, V. F., Quan, V. M., Minh, N. L., Ha, T.V., Mai, N.V., Sarin, E., & Beyer, C.
(2013). Social environment and HIV risk among MSM in Hanoi and Thai Nguyen. AIDS
Care: Psychological and Socio-medical Aspects of AIDS. 25:38–42.
Bimbi, D. S. (2007). Male Prostitution: Pathology, Paradigms, and Progress in Research. Journal
of Homosexuality, 53: 7 – 36.
Bland, L. (1992). ‘Purifying’ the Public World: Feminist Vigilantes in Late Victorian
England.” Women’s History Review, 1(92), 397-412. DOI: 10.1080/09612029200200013.
Board of Governors of the Federal Reserve System. (2019). Report on the Economic Well-Being
of U.S. Households in 2018. Retrieved May 2nd, 2021 from
https://www.federalreserve.gov/publications/files/2018-report-economic-well-being-us-
households-201905.pdf
Bodkin, K., Delahunty-Pike, A., & O’Shea, T. (2015). Reducing Stigma in Healthcare and Law
Enforcement: A Novel Approach to Service Provision for Street Level Sex Workers.
International Journal for Equity in Health, 14(35). DOI: 10.1186/s12939-015-0156-0.
Bourdieu, P. (1984). Distinction: A social critique of the judgement of taste. Cambridge, MA:
Harvard University Press.
Bourdieu, P. (2001). Masculine Domination. Stanford, CA: Stanford University Press.
Bourgois, P., Prince, B., & Moss, A. (2004). The Everyday Violence of Hepatitis C Among
Young Women Who Inject Drugs in San Francisco. Human Organizations, 63(3): 253 –
264.
References
Bowen, R. & Bungay, V. (2016). Taint: An Examination of the Lived Experiences of Stigma
and Its Lingering Effects for Eight Sex Industry Experts. Culture, Health, & Sexuality,
18(2): 186-199.
Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code

development. Thousand Oaks, CA: Sage.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in
psychology, 3(2), 77-101.
Brents, B. G. and Hausbeck, K. (2005). Violence and Legalized Brothel Prostitution in Nevada:
Examining Safety, Risk, and Prostitution Policy. Journal of Interpersonal Violence,
20(3): 270-95.
British Home Affairs Committee. (2016). Prostitution: Third Report of Session 2016-17 (United
Kingdom, House of Commons, Home Affairs Committee). London, UK: House of
Commons.
Brookfield, S., Dean, J., Forrest, C., Jones, J., & Fitzgerald, L. (2019). Barriers to Accessing
Sexual Health Services for Transgender Sex Workers: A Systematic Qualitative Meta-
Summary. AIDS and Behavior, 24: 682 – 696.
Broomby, R. (2001). German prostitutes get new rights. British Broadcasting Corporation
Europe. Retrieved February 1, 2021, from
http://news.bbc.co.uk/2/hi/europe/1721434.stm.
Bukowski, K. & Buetow, S. (2011). Making the Invisible Visible: A Photovoice Exploration of
Homeless Women’s Health and Lives in Central Auckland. Social Sciences & Medicine,
72: 739-746.
Bullough, V. L., & Bullough, B. (1978). Prostitution: An illustrated social history. Buffalo, NY:
Prometheus Books.
Bungay, V., Oliffe, J., & Atchison, C. (2016). Addressing Underrepresentation in Sex Work
Research: Reflection on Designing a Purposeful Sampling Strategy. Qualitative Health
Research, 26(7): 966 – 978.
Burnes, T. R., Rojas, E. M., Delgado, I., & Watkins, T. E. (2018). “Wear Some Thick Socks if
You Want to Walk in My Shoes:” Agency, Resilience, and Well-Being in Communities
in North American Sex Workers. Archives of Sexual Behavior, 47(5): 1541-1550.
Busiess of Apps. (2021). TikTok Revenue and Usage Statistics (2021). BusinessofApps.
Retreived December 11, 2021, from https://www.businessofapps.com/data/tik-tok-
statistics/.
References
Byron, P., & Robards, B. (2017). There's something queer about Tumblr. Retrieved
May 18, 2020, from https://theconversation.com/theres-something-queer-about-tumblr-
73520
Calvert, C. (2000). Voyeur Nation: Media, Privacy, and Peering in Modern Culture. Boulder,
CO: Westview Press.
Canali, T. J., de Oliveira, S. M. S., Reduit, D. M., Vinholes, D. B., & Feldens, V. P. (2014).
Avaliação da autoestima de gays do sul de Santa Catarina, Brasil [Evaluation of self-
esteem among homosexuals in the southern region of the state of Santa Catarina, Brazil].
Ciência & Saúde Coletiva [Collective Science & Health], 19, 11.
https://doi.org/10.1590/1413-81232014911.15982013
Cardoso, D. and Scarcelli, C. M. (2021). The bodies of the (digitised) body: Experiences of
sexual(ised) work on OnlyFans. Journal of Media and Communication Research, 71, 98-
121.
Carrigan, M. (2011). “There’s More to Life Than Sex? Difference and Community Within the
Asexual Community.” Sexualities (14) 4: 462-478.
Carter, J. B. (2001). Birds, Bees, and Venereal Disease: Towards an Intellectual History of Sex
Education. Journal of the History of Sexuality, 10(2), 213-249.
Chakrapani, V., Newman, P. A., Shunmugam, M., Kurian, A. K., Dubrow, R. (2009). Barriers to
free antiretroviral treatment access for female sex workers in Chennai, India. AIDS
Patient Care and STDs, 23(11): 973-980.
Chan, J. (1996). Changing police culture. British Journal of Criminology, 36(1), 109-134.
Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative

Analysis. London, UK: Sage.
Chateauvert, M. (2014). Sex Workers Unite. Boston, MA: Beacon Press.
Chen, C. (2013). Exploring personal branding on YouTube. Journal of Internet Commerce,

12(4), 332-347.
Chen, Y., Latkin, C., Celentano, D. D., Yang, X., Li, X., Xia, G., Miao, J., & Surkan, P. J.
(2012). Delineating interpersonal communication networks: a study of the diffusion of an
intervention among female entertainment workers in shanghai China. AIDS and
Behavior, 16,7-14.
References
Churchill Official General Election Results. (2004). Churchill Issues – Churchill County –
Question No. 3. Retrieved February 1, 2021 from
https://www.nvsos.gov/SOSelectionPages/results/2004General/Churchill.aspx
City of Berkley General Municipal Election. (2004). Measures – Enforcement of State

Prostitution Laws (Angel’s initiative) [Document]. Retrieved February 1, 2021, from
https://www.cityofberkeley.info/uploadedFiles/Clerk/Elections/110204resultsfinal.pdf
City and County of San Francisco 2008 Election Results. (2008). San Francisco Government –
November 4, 2008 Consolidated Presidential General Election – Proposition K. Retrieved
February 1, 2021, from https://sfelections.sfgov.org/election-summary-november-4-2008
Clark, M. (2021). NFT’s, explained. The Verge. Retrieved December 12, 2021, from
https://www.theverge.com/22310188/nft-explainer-what-is-blockchain-crypto-art-faq
Clement, J. (2020). Global digital population 2020. Retrieved May 18, 2020, from
https://www.statista.com/statistics/617136/digital-population-worldwide/
Cohan, D., Lutnick, A., Davidson, P., Cloniger, C., Herlyn, A., Breyer, J., Cobaugh, C., Wilson,
D., & Klausner, J. (2006). Sex worker health: San Francisco style. Sexually Transmitted
Infections, 82,418-422
Cole, S. (2021). OnlyFans to Ban the ‘Sexually Explicit Content’ That Made It Rich. Vice
Magazine. Accessed September 13th, 2021 from
https://www.vice.com/en/article/m7ewk4/report-onlyfans-plans-to-ban-sexually-explicit-
content
Connell, R. W. (2005). Masculinities (2nd ed.). Berkeley, California: University of California

Press. ISBN 9780745634265.
Connelly, M. T. (1980). The Response to Prostitution in the Progressive Era. Chapel Hill, NC:
University of North Carolina Press.
Corneil, T. A., Kuyper, I. M., Shoveller, J., Hoggs, R. S., Li, K., Spittal, P. M., et al. (2006).
Unstable Housing, Associated Risk Behavior, and Increased Risk for HIV Infection
Among Injection Drug Users. Health & Place, 12: 79-85.
Cox, J. (2021). Inflation climbs higher than expected in June as price index rises 5.4%. CNBC.
Retrieved November 6, 2021, from https://www.cnbc.com/2021/07/13/consumer-price-
index-increases-5point4percent-in-june-vs-5percent-estimate.html
Crago, A-L. (2009). Arrest the violence: human rights abuses against sex workers in Central and
Eastern Europe and Central Asia. Sex Workers' Rights Advocacy Network.
References
Crago, A-L., (2014). "“Bitches Killing the Nation”: Analyzing the Violent State-Sponsored
Repression of Sex Workers in Zambia, 2004–2008," Signs: Journal of Women in Culture
and Society, 39, No. 2, 365-381. https://doi.org/10.1086/673087
Craig, D. and Cunningham, S. (2019). Social Media Entertainment: The New Intersection of
Hollywood and Silicon Valley. New York, NY: NYU Press.
Craig, M. L. (2006). Race, beauty, and the tangled knot of a guilty pleasure. Feminist Theory, 7,
159-177.
Creswell, J. W. (2003). Research Design: Qualitative, Quantitative, and Mixed Methods

Approaches (2nd ed.). Thousand Oaks, CA: Sage.
Cryptonatrix. (2021). Destigmatizing the Blockchain: Sex workers in NFT CryptoArt. The
Defiant. Retrieved November 28, 2021, from https://thedefiant.io/destigmatizing-the-
blockchain-sex-workers-in-nft-cryptoart/
Cyber Scrilla. (2021). NFT Royalties: What are They and How do They Work? Cyber Scrilla.
Retrieved December 12, 2021, from https://cyberscrilla.com/nft-royalties-what-are-they-
and-how-do-they-work/
de Casanova, E. (2004). 'No ugly woman': Concepts of race and beauty among adolescent
women in Ecuador. Gender & Society, 18, 287-308.
Deb, S. (2008). Mental disposition of commercial sex workers (CSWs) with HIV/AIDS. Journal
of the Indian Academy of Applied Psychology, 34, 90-100.
Decriminalize Sex Work. (2020). New Zealand: The Ideal Legal Framework for Decriminalized
Sex Work. Retrieved June 22, 2021 from https://decriminalizesex.work/why-
decriminalization/briefing-papers/new-zealand-ideal-legal-framework/
Dennis, J. (2008). Women are Victims, Men Make Choices: The Invisibility of Men and Boys in
the Global Sex Trade. Gender Issues, 25: 11 – 25.
DePasquale, J. (2020). “Working from Home: Analyzing the Autonomy of App-Based Adult
Content Creators”. Master’s Thesis, Portland State University, Dissertations and Theses.
Dewey, S. and St. Germain, T. (2014). “It Depends on the Cop:” Street-Based Sex Workers’
Perspectives on Police Patrol Officers. Sexuality Research and Social Policy, 11: 256-
270. DOI: 10.1007/s13178-014-0163-8.
References
Di Fabio, A. & Busoni, L. (2008). Misurare il support sociale percepito: Proprietà psicometriche
della Multidimensional Scale of Perceived Social Support (MSPSS) in un campione di
student universitari [Measuring perceived social support: Psychometric properties of the
Multidimensional Scale of Perceived Social Support (MSPSSP]. Risora Uomo, 14(3),
339-350.
Different Avenues. (2008). Move Along: Policing Sex Work in Washington, D.C. Retrieved June
17, 2021 from https://dctranscoalition.files.wordpress.com/2010/05/movealongreport.pdf.
Donnelly, D., Burgess, E. O., & Simonds, W. (2014). “Sexuality and Social Theorizing.” Sex
Matters, Pg. 88-99.
Dos Santos Filho, C. A., Tirico, P. P., Stefano, S. C., Touyz, S. SW., Claudino, A. M. (2016).
Systematic review of the diagnostic category muscle dysmorphia. Australian and New
Zealand Journal of Psychiatry, 50, 322-333. https://doi.org/10.1177/0004867415614106.
PMID: 26553217.
Driessens, O. (2012). The celebritization of society and culture: Understanding the structural
dynamics of celebrity culture. International Journal of Cultural Studies, 16(6), 641-657.
DOI: 10.1177/1367877912459140.
Duff, P., Deering, K., Tyndall, M., Gibson, K., & Shannon, K. (2011). Homelessness Among a
Cohort of Women in Street-Based Sex Work: The Need for Safer Environment
Interactions. BMC Public Health, 11: 643.
Durbar Mahila Samanwaya Committee. (1997). Sex Workers’ Manifesto. Theme paper of the
First National Conference of Sex Workers in Calcutta, India, November 14-16.
Dyer, R. (2004). Heavenly Bodies: Film Stars and Society, 2nd ed. New York: Routledge.
eMarketer. (2016). Tumblr Struggles to Grow Its User Base. Retrieved May 18,
2020, from https://www.emarketer.com/Article/Tumblr-Struggles-Grow
-Its-User-Base/1013596
Echenberg, H., & Jensen, H. (2008). Defining and Enumerating Homelessness in Canada.
Library of Parliament: Parliamentary Information and Research Services. Retrieved June
21, 2021 from
https://lop.parl.ca/staticfiles/PublicWebsite/Home/ResearchPublications/BackgroundPape
rs/PDF/2020-41-e.pdf
References
Engels, F. (1845). Results. The Condition of the Working Class in England. Marx/Engels Internet
Archive. Retrieved May 2nd, 2021 from
https://www.marxists.org/archive/marx/works/1845/condition-working-class/ch07.htm
Epele, M. E. (2002). Gender, Violence, and HIV: Women’s Survival in the Streets. Culture,
Medicine, and Psychiatry, 26: 33-54.
Ericson, R. (2007). Rules in policing: five perspectives. Theoretical Criminology, 11(3): 367-401
Evans, H. (1979). Harlots, Whores, and Hookers: A History of Prostitution. New York, NY:
Taplinger
Evans, L. &Strathdee, S. A. (2006). A Roof is Not Enough: Unstable Housing, Vulnerability to

HIV Infection and the Plight of the SRO. International Journal of Drug Policy, 17: 115-117.
Evans, P., & McConnell, A. (2003). Do racial minorities respond in the same way to mainstream
beauty standards? Social comparison processes in Asian, Black, and White women. Self
and Identity, 2, 153-167.
Facebook. (2020). Community Standards. Retrieved May 18, 2020, from

https://www.facebook.com/communitystandards/adult_nudity_sexual_activity
Farley, M., Cotton, A., Lynne, J., Zumbeck, S., Spiwak, F., Reyes, M. E., et al. (2003).
Prostitution and trafficking in nine countries: An update on violence and posttraumatic
stress disorder. Journal of Trauma Practice, 2, 33 - 74.
Faul, F., Erdfelder, E., Buchner, A., Lang, A.G. (2009). Statistical power analysis using
G*Power 3.1: Tests for correlations and regression analysis. Behavior Research
Methods, 41, 1149-1160.
Ferguson, A. (1980). Blood at the Root. London: Pandora.
Firebaugh, W. C. (2010). The Satyricon of Petronius Arbiter. Rockville, MD: Wildside Press.
Footer, K. H. A., Silberzahn, B. E., Tormohlen, K. N., & Sherman, S. G. (2016). Policing
practices as a structural determinant for HIV among sex workers: a systematic review of
empirical findings. Journal of the International AIDS Society, 19(4), 3.
Foucault, M. (2004/2008). The Birth of Biopolitics: Lectures at the College de France 1978-
1979, translated by Graham Burchill. London, United Kingdom: Palgrave Macmillan.
References
Fox, M. (2021). As small businesses recover from the pandemic, they face a new obstacle:
finding workers. CNBC. Retrieved November 6, 2021, from
https://www.cnbc.com/2021/05/06/small-businesses-struggle-to-find-workers-as-
pandemic-eases.html
Frankenfield, J. (2021). Cryptocurrency. Investopedia. Retrieved December 12, 2021, from

https://www.investopedia.com/terms/c/cryptocurrency.asp
Frankfort-Nachmias, C. and Nachmias, D. (2008). Research Methods in the Social Sciences (7th
ed.) New York, NY: Worth.
Gabryszewska, M. (2014). Sex Work and Class. Class, Race and Corporate Power, 2(3).
Retrieved November 7, 2021, from
https://digitalcommons.fiu.edu/classracecorporatepower/vol2/iss3/4/
Gamson, J. (2011). The unwatched life is not worth living: The elevation of the ordinary in
celebrity culture. PMLA, 126(4), 1061-1069.
Ghimire, K., Smith, W. C. S., van Teijlingen, E. R. (2011). Utilisation of sexual health services
by female sex workers in Nepal. BMC Health Services Research, 11(1): 1.
Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age.
Stanford, CA: Stanford University Press.
Giguere, R., Frasca, T., Dolezal, C., Febo, I., Cranston, R. D., Mayer, K., et al. (2016).
Acceptability of Three Novel HIV Prevention Methods Among Young Male and
Transgender Female Sex Workers in Puerto Rico. AIDS and Behavior, 20(10): 2192 –
2202.
Glaser, B. G. & Strauss, A. L. (1967). The Discovery of Grounded Theory: Strategies for
Qualitative Research. New York: Aldine De Gruyter.
Glynn, A. (2006). Capitalism Unleashed – Finance, Globalization, and Welfare. Oxford, United
Kingdom: Oxford University Press.
Glynn, K. (2000). Tabloid Culutre: Trash Taste, Popular Power, and the Transformation of
American Television. Durham, NC: Duke University Press.
Goldsamt, L. A., Clatts, M. C., Giang, L. M., & Yu, G. (2015). Prevalence and Behavioral
Correlates of Depression and Anxiety Among Male Sex Workers in Vietnam.
International journal of sexual health: official journal of the World Association for
Sexual Health, 27(2), 145–155. https://doi.org/10.1080/19317611.2014.947055
References
Grady, C. (2005). Payment of clinical research subjects. Journal of Clinical Investigation,

115(7), 1681-1687. Retrieved November 27, 2021, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1159153/pdf/JCI0525694.pdf
Grady, C. (2018). The waves of feminism, and why people keep fighting over them,
explained. Vox. Retrieved February 1, 2021, from
https://www.vox.com/2018/3/20/16955588/feminism-waves-explained-first-second-third-
fourth
Gu, J., Lau, J. T. Li, M. Li, H. Gao, Q., Feng, X., et al. Socio-Ecological Factors Associated with
Depression, Suicidal Ideation, and Suicidal Attempt Among Female Injection Drug Users
Who are Sex Workers in China. Drug and Alcohol Dependence, 144: 102-10.
Gutmann, A. (2001). Liberalism. International Encyclopedia of the Social & Behavioral

Sciences, 8784-8787.
Hall, T. M. (2004). Forms of transactional sex in Prague among young men who have sex with
men. Czech Sociological Review, 43, 89-109.
Ham, J. and Gerard, A. (2014). Strategic In/visibility: Does Agency Make Sex Workers
Invisible? Criminology and Criminology Justice, 14(3): 298-313
Hardaway, R. M. (2003). No Price Too High: Victimless Crimes and the Ninth Amendment.
Westport, CT: Praeger.
Harvey, D. (2002). The art of rent: globalization, monopoly, and the commodification of culture.
In: Panitch, L. and Leys, C. (eds) Socialist Register. New York: Monthly Review Press.
Harvey, D. (2005). A Brief History of Neoliberalism. Oxford, United Kingdom: Oxford

University Press.
He, N. (2007). Sociodemographic characteristics, sexual behavior, and HIV risks of

rural-to-urban migrants in China. BioScience Trends, 1, 72-80.
He, Q., Wang, Y., Lin, P., et al. (2006). Potential bridges for HIV infection to men who have sex
with men in Guangzhou, China. AIDS and Behavior, 10, 17-23.
Hearn, A. & Schoenhoff, S. (2015). From celebrity to influencer, Tracking the diffusion of
celebrity value across the data stream. A companion to celebrity, 194-212.
Hepp, A. (2012). “Mediatization and the ‘molding force’ of media.” Communications, 37(1), 1-
28.
References
Herek, G. M. (2007). Confronting sexual stigma and prejudice: Theory and practice. Journal of
Social Issues, 63, 905-925. doi: 10.1111/j.15404560.2007.00544x.
Herman, L. (2013). The Tumblr Effect: Millennials Getting Millennials to Reblog

about Healthcare. Retrieved May 18, 2020, from https://www.mic.com/articles
/75919/the-tumblr-effect-millennials-getting-millennials-to-reblog-about-healthcare#.
dqNW87L5e
HG.org Legal Resources. (2021). Why is Pornography Legal and Prostitution is Not. Retrieved
July 3, 2021 from https://www.hg.org/legal-articles/why-is-pornography-legal-and-
prostitution-is-not-31164.
Hill, M. W. (1993). Their Sisters’ Keepers: Prostitution in New York City, 1830-1870. Los
Angeles, CA: University of California Press.
Hochschild, A. (1983). The Managed Heart: Commercialization of Human Feeling. Berkeley:

University of California Press.
Holston-Zannnell, L. B. (2021). PayPal and Venmo are Shutting Out Sex Workers, Putting Lives
and Livelihoods at Risk. ACLU. Retrieved November 28, 2021, from
https://www.aclu.org/news/lgbtq-rights/paypal-and-venmo-are-shutting-out-sex-workers-
putting-lives-and-livelihoods-at-risk/
Hong, Y., Stanton, B., Li, X., et al. (2006). Rural-to-urban migrants and the HIV epidemic in
China. AIDS and Behavior, 10, 421-430.
Hong, Y., Zhang, C., Li, X., Fang, X., Lin, X., Zhou, Y., et al. HIV testing behaviors among
female sex workers in Southwest China. AIDS and Behavior, 16(1): 44-52.
How Sweden tackles prostitution. (2007). British Broadcasting Corporation News. Retrieved
February 01, 2021, from http://news.bbc.co.uk/2/hi/uk_news/6343325.stm
Hsiao, W., Steele, R., and Weber, L. (2021). Touched Through a Screen: Digital Intimacy on
Twitter and OnlyFans. Retrieved April 17, 2022 from Masters of Media:
https://mastersofmedia.hum.uva.nl/blog/2021/10/29/touched-through-a-screen-digital-
intimacy-on-twitter-and-onlyfans/
Hudson, S. [@sandela]. (2021). Policing is about social control of the undervalued, not safety.
#TOpoli [Tweet]. Twitter.
https://twitter.com/sandela/status/1407712098654724097?s=21
References
Human Rights Campaign Foundation. (2018). A National Epidemic: Fatal Anti-Transgender

Violence in America in 2018 Retrieved June 29th, 2020, from
https://assets2.hrc.org/files/assets/resources/AntiTransViolence-2018Report-
Final.pdf?_ga=2.6776245.686028675.1593438492-1411497122.1593017856
Hwang, S. W. (2001). Homelessness and Health. Canadian Medical Association Journal,

164(1): 229-233.
Incite National. (2015). Policing Sex Work.

https://web.archive.org/web/20170514022243/http://www.incite-
national.org/sites/default/files/incite_files/resource_docs/4668_toolkitrev-sexwork.pdf
International Committee on the Rights of Sex Workers in Europe. (2005). The Declaration of the
Rights of Sex Workers in Europe. Agreed at the European Conference on Sex Work,
Human Rights, Labour and Migration in Brussels, Belgium. Retrieved June 22, 2021
from https://www.sexworkeurope.org/sites/default/files/userfiles/files/
join/dec_brussels2005.pdf
International Committee on the Rights of Sex Workers in Europe. (2017). Understanding Sex
Workers’ Rights to Health: Impact of Criminalization and Violence. Retrieved June 20,
2021 from
http://www.sexworkeurope.org/sites/default/files/userfiles/files/ICRSE_Briefing%20pape
r_HEALTH%20RIGHTS_October2017_A4_03.pdf
Iovine, A. (2018). Why People Are so Horny on Twitter Lately. Retrieved May 20,
2020, from https://www.vice.com/en_us/article/8xpvyp/why-people-are-so-
horny-on-twitter-lately
Jackson, A. L. (2004). The History of Prostitution Reform in the United State (Undergraduate
honors thesis). Retrieved February 1, 2021 from
https://trace.tennessee.edu/utk_chanhonoproj/754.
Januraga, P. P., Mooney-Somers, J., Ward, P. R. (2014). Newcomers in a hazardous

environment: a qualitative inquiry into sex worker vulnerability to HIV in Bali,
Indonesia. BMC Public Health, 14(1), 832.
Jean, N. & Salisbury, C. (2004). Self-Reported Experiences of Health Services Among Female
Street-Based Prostitutes: A Cross-Sectional Survey. British Journal of General Practice,
54: 515 – 519.
Jenness, V. (1993). Making It Work: The Prostitutes Rights Movement in Perspective. New
York, NY: Aldine de Gruyter.
References
Jiao, S. & Bungay, V. (2019). Intersections of Stigma, Mental Health, and Sex Work: How
Canadian Men Engaged in Sex Work Navigate and Resist Stigma to Protect Their Mental
Health, The Journal of Sex Research, 56:4-5, 641-649, DOI:
10.1080/00224499.2018.1459446
Jody, R. and Shapiro, D. L. (2002). Sisters Speak Out: The Lives and Needs of Prostituted
Women in Chicago. Chicago Coalition for the Homeless, 2002.
http://impactresearch.org/documents/sistersspeakout.pdf
Jung, J., & Forbes, G. B. (2007). Body dissatisfaction and disordered eating among college
women in China, South Korea, and the United States: Contrasting predictions from
sociocultural and feminist theories. Psychology of Women Quarterly, 31, 381-393.
Kamise, Y. (2013). Occupational Stigma and Coping Strategies of Women Engaged in the
Commercial Sex Industry: A Study on the Perception of “Kyaba-Cula Hostesses” in
Japan. Sex Roles, 69, 42-57.
Katsulis, Y., Lopez, V., Durfee, A., and Robillard, A. (2010). Female Sex Workers and the
Social Context of Workplace Violence in Tijuana, Mexico. Medical Anthropology
Quarterly, 24(3): 344-62.
Katz, J. (1995). The Invention of Heterosexuality. Dutton; New York, NY, USA.
Kaye, J. (2015). Canada’s Flawed Sex Trade Law. The New York Times. Retrieved February
1, 2021, from https://www.nytimes.com/2015/01/21/opinion/canadas-flawed-sex-trade-
law.html
Kaye, K. (2007). Sex and the Unspoken in Male Street Prostitution. Journal of Homosexuality,
23: 37.- 73.
Kazdin, A. E. (2017). Addressing the treatment gap: A key challenge for extending evidence-
based psychosocial interventions. Behavior Research and Therapy, 88: 7-17.
Kelly, H. (2000). Bishop, Prioress, and Bawd in the Stews of Southwark. Speculum,
75(2), 342-388. doi:10.2307/2887582
Kendrick, W. (1987). The Secret Museum: Pornography in Modern Culture. Berkley, Los
Angeles: University of California Press.
King, L. W. (1910). The Code of Hammurabi, translated by L. W. King.
Kipnis, L. (1996). Bound and Gagged: Pornography and the Politics of Fantasy in America.
New York: Grove Press.
References
Khamis, S., Ang, L., & Welling, R. (2017). Self-branding, ‘micro-celebrity’ and the rise of
Social Media Influencers. Celebrity Studies, 8(2), 191-208.
Klein, N. (2007). The Shock Doctrine: The Rise of Disaster Capitalism. London, United
Kingdom: Allen Lane.
Klinnell, H. (2006). Clients of Female Sex Workers: Men or Monsters? In R. Cambell & M.
O’Neill (Eds.), Sex work now (pg. 141 – 168). Cullompton, England: Willan.
Knowles-Carter, B., Pete, M., White, A., Sessions, Jr., B., Milano, D., Nash, T. Y., Thorpe, J. K.
L., Carter, S. C., Hazzard, B. S. (2020). Savage Remix (feat. Beyoncé) [Recorded by
Megan Thee Stallion]. On Single [Digital Download]. Los Angeles, CA: Warner Music
Group.
Koken, J. A., Bimbi, D. S., Parsons, J. T. & Halkitis, P. N. (2004). The experience of stigma in
the lives of male Internet escorts. Journal of Psychology & Human Sexuality, 16, 13-32.
doi: 10.1300/J056v16n01_02
Kosher, R. (2020). Sex Workers’ Rights Are Human Rights: Repeal FOSTA-SESTA. Rights
View, Institute of the Study of Human Rights, Columbia University Information
Technology. Retrieved June 22, 2021 from
https://blogs.cuit.columbia.edu/rightsviews/2020/12/17/sex-workers-rights-are-human-
rights-repeal-fosta-sesta/
Kramer, L. (2004). Emotional Experiences of Performing Prostitution. Journal of Trauma

Practices, 2(3-4), 186-197.
Krieger, J. & Higgins, D. L. (2002). Housing and Health: Time Again for Public Health Action.
American Journal of Public Health, 95(2): 758-768.
Krüsi, A. Kerr, T., Taylor, C., Rhodes, T., and Shannon, K. (2016). “They won’t change it back
in their heads that we’re trash”: The Intersection of Sex Work-Related Stigma and
Evolving Police Strategies. Sociology of Health & Illness, 38(7): 1137-50
Kurtz, S. P., Surratt, H. L., Kiley, M. C., Inciardi, J. A. (2005). Barriers to health and social
services for street-based sex workers. Journal of Health Care for the Poor and
Underserved, 16(2): 345-361.
Lafort, Y., Lessitala, F., Candrinho, B., Greener, L., Greener, R., Beksinska, M., et al. (2016).
Barriers to HIV and sexual and reproductive health care for female sex workers in Tete,
Mozambique: results from a cross-sectional survey and focus group discussions. BMC
Public Health, 16(1): 608.
References
Lakshmana, G., Dhanasekarapandian, R., &Ahmed, A. (2010). Social support of female sex
workers. Indian Journal of Social Psychiatry, 26, 117-123.
Lane, F. S. III. (2001). Obscene Profits: The Entrepreneurs of Pornography in the Cyber Age.
New York: Routledge.
Langum, D. J. (1994). Crossing over the Line: Legislating Morality and the Mann Act (Chicago
Series on Sexuality, History, and Society). Chicago, IL: University of Chicago Press.
Lau, J. T., Gu, J., Tsui, H. Y., Chen. H., Holroyd, E., Wang. R., Hu, X. (2012). Prevalence and
associated factors of condom use during commercial sex by female sex workers who
were or were not injecting drug users in China. Sexual Health, 9(4), 368–76.
Lazarus, L., Chettiar, J., Deering, K., Nabess, R., & Shannon, K. (2011). Risk Health
Environments: Women Sex Workers’ Struggles to Find Safe, Secure and Non-Exploitive
Housing in Canada’s Poorest Postal Code. Social Science & Medicine, 73: 1600-1607.
Leary, D. & Minichiello, V. (2007). Exploring the Interpersonal Relationships in Street-Based

Male Sex Work: Results from an Australian Qualitative Study. Journal of
Homosexuality, 53, 75 – 110.
Lehmiller, J. (2019). Why Gay Men Often Fetishize Straight Men. Vice. Retrieved June 30, 2021
from https://www.vice.com/en/article/mbz9ny/why-gay-men-often-fetishize-straight-men
Lerner, G. (1986). The Origin of Prostitution in Ancient Mesopotamia. Signs, 11(2), 236-254.
Retrieved January 25, 2021, from http://www.jstor.org/stable/3174047
Lewis, J. H., Andersen, R. M. & Gelberg, I. (2002). Health Care for Homeless Women: Unmet
Needs and Barriers to Care. Journal of General Internal Medicine, 18(11), 921-928
Li, Q., Li, X., Stanton, B., Fang, X., & Zhao, R. (2010). A multilevel analysis of gatekeeper
characteristics and consistent condom use among establishment-based female sex
workers in Guangxi, China. Sexually Transmitted Diseases, 37(11), 700.
Lincoln, Y. and Guba, E. G. (1985). Naturalistic Inquiry. Newbury Park, CA: Sage.
Livingston, J. D. & Boyd, J. E. (2010). Correlates and Consequences of Internalized Stigma for
People Living with Mental Illnesses: A Systematic Review and Meta-Analysis. Social
Science & Medicine, 71(12): 2150 – 2161.
Logan, T. D. (2010). Personal Characteristics, Sexual Behaviors, and Male Sex Work: A
Quantitative Approach. American Sociological Review, 75: 679 – 704.
References
Lottes, I. I., & Kuriloff, P. J. (1994). Sexual socialization differences by gender, Greek
membership, and religious background. Psychology of Women Quarterly, 18, 203-219.
https://doi.org/10.1111/j.1471-6402.1994.tb00451.x
López, C. (2020). People are turning to OnlyFans to earn money after losing their jobs during
the pandemic. Insider. Retrieved May 2nd, 2021 from https://www.insider.com/people-
are-creating-onlyfans-accounts-after-losing-jobs-during-pandemic-2020-6
Lui, M. T. Y., (2009). Saving Young Girls from Chinatown: White Slavery and Woman
Suffrage, 1910-1920. Journal of the History of Sexuality, 18(3). DOI:
10.1353/sex.0.0069.
Lutnick, A. (2019). The “Prioritizing Safety for Sex Workers Policy:” A Sex Worker Rights and
Anti-Trafficking Initiative. Anti-Trafficking Review, 12: 140-154.
Lykousas N., Casino F., Patsakis C. (2020) Inside the X-Rated World of “Premium” Social
Media Accounts. In: Aref S. et al. (eds) Social Informatics. SocInfo 2020. Lecture Notes
in Computer Science, vol 12467. Springer, Cham. https://doi.org/10.1007/978 - 3-030-
60975-7_14
Ma, P. H. X., Chan, Z. C. Y., and Loke, A. Y. (2017). The Socio-Ecological Model Approach to
Understanding Barriers and Facilitators to the Accessing of Health Services by Sex
Workers: A Systematic Review. AIDS and Behavior, 21: 2412-2438.
Macioti, P. G., Grenfell, P., & Platt, L. (2017). Sex work and mental health. Leicester:
University of Leicester.
Mai, N. (2009). Migrant workers in the UK sex industry: final policy-relevant report. London:
London Metropolitan University.
MacKinnon, C. (1989). Toward a Feminist Theory of the State. Cambridge, MA: Harvard
University Press.
Markerly. (2015). “Instagram Marketing: Does Influence Size Matter?” Retrieved April 27th,
2021, from Markerly Blog: https://markerly.com/blog/instagram-marketing-does-
influencer-size-matter/
Marshall, P. D. (1997). Celebrity and Power: Fame in Contemporary Culture. Minneapolis:

University of Minnesota Press.
Marshall, P. D. (2010). The promotion and presentation of the self: celebrity as marker of
presentation media. Celebrity studies, 1(1), 34-48).
References
Martin-Albo, J. Nuniez, J. L., Navarro, J. G. & Grijalvo, F. (2007). The Rosenberg Self-Esteem
Scale: translation and validation in university students. Spanish Journal of Psychology,
10(2), 458-467.
Marwick, A. & Boyd, D. (2011). To see and be seen: Celebrity practice on Twitter.
Convergence, 17(2), 139-158).
Marx, K. (2007). Estranged Labor. Economic and philosophic manuscripts of 1844. (M Milligan,
Trans.). Dover Publications.
Maslow, A. (1954). Motivation and personality. New York: Harper.
Maslow, A. & Lowery, R. (Ed.). (1988). Toward a psychology of being (3rd ed.). New York:
Wiley & Sons.
Maurice, E. P., Duffy, N., Kelleher, P., Milton, J., & Wakefield, L. (2020). Finally,
some good news! Instead of running 5km, you can raise money for the NHS by
masturbating. Retrieved May 11, 2020, from https://www.pinknews.co.uk/2020/
04/19/nhs-wanks-as-thanks-onlyfans-alexxa-vice-adult-industry-solidarity-covid-19
-fundraiser/
McCoy, V. H., Yu, Z. (1999). The effect of migration patterns on exposure to HIV prevention in
a migrant community. Population Research and Policy Review, 18, 155-168.
[1] McGrath-Lone, L., Marsh, K., Hughes, G., & Ward. H. (2014). The sexual health of
female sex workers compared with other women in England: analysis of cross-sectional
data from genitourinary medicine clinics. Sexually Transmitted Infections, 90(4), 344-
350. doi: 10.1136/sextrans-2013-051381 24493858
[2] McGrath-Lone, L., Marsh, K., Hughes, G., & Ward. H. (2014). The sexual health of male
sex workers in England: analysis of cross-sectional data from genitourinary medicine
clinics. Sexually Transmitted Infections, 90(1), 38-40. doi: 10.1136/sextrans-2013-
05132024273126
McCabe, I., Mills, R., Murphy, D., Winders, S. J., Hayden, J., Reynolds, D., McCabe, J., &
McQuaid, A. (2014). A Psychocultural Comparison of Male Street Prostitutes in Dublin
and San Francisco. The Irish Journal of Psychology, 35(2-3): 91-105.
McClintock, A. (1992). Screwing the System: Sexwork, Race, and the Law. boundary 2, 19(2):
70-95.
McDowell, C. L. & Page, A. M. Free porn is unethical. The Runner Online. Retrieved December
12, 2021, from https://therunneronline.com/24903/opinion/free-porn-is-unethical/
References
McElroy, W. (1996). Sexual Correctness: The Gender-Feminist Attack on Women. Jefferson,

NC: McFarland & Company.
McGuigan, J. (2012). The Coolness of Capitalism Today. tripleC: cognition, communication, co-
operation, 10(2): 425-438. ISSN: 1726-670X.
McGuigan, J. (2014). The Neoliberal Self. Culture Unbound: Journal of Current Cultural
Research, 6(1), 223-240. DOI: 10.3384/cu.2000.1525.146223
McNair, B. (2002). Striptease Culture: Sex, Media and the Democratization of Desire. New
York: Routledge.
McNeill, M. (2011). Déjà Vu. The Honest Courtesan. Retrieved February 01, 2021,
from https://maggiemcneill.wordpress.com/2011/06/25/deja-vu/
McNeill, M. (2013). Challenge. The Honest Courtesan. Retrieved February 1, 2021, from
http://maggiemcneill.wordpress.com/2013/05/02/challenge/
Mellor, R. & Lovell, A. (2012). The Lived Experiences of UK Street-Based Sex Workers and the
Health Consequences: An Exploratory Study. Health Promotion International, 27(3):
311-322.
Mey, K. (2006). Art and Obscenity. London, United Kingdom and New York: I. B. Tauris.
Meyer-Weitz, A. (2005). Understanding Fatalism in HIV/AIDS Protection: The Individual in

Dialogue With Contextual Factors. African Journal of AIDS Research, 4(2): 75 – 82.
Miller, E. M., Romenesko, K., and Wondolkowski, K. (1993). “The United States,”
Prostitution: An International Handbook on Trends, Problems, and Policies / edited by
Nanette J. Davis. Westport, CT: Greenwood Press.
Miller, C. L., Kerr, T., Shdee, S. A., Li, K., & Wood. E. (2007). Factors associated with
premature mortality among young injection drug users in Vancouver. Harm Reduction
Journal, 4, 1. doi: 10.1186/1477-7517-4-1 17201933
Miller-Young, M. (2007). “Let Me Tell Ya ‘Bout Black Chicks: Interracial Desire and Black \
Women in the 1980s’ Video Pornography.” In book: Pornification: Sex and Sexuality in
Media Culture. Oxford, United Kingdom: Berg.
Mimiaga, M. J., Reisner, S. L., Tinsley, J. P., Mayer, K. H., & Safren, S. A. (2008). Street
Workers and Internet Escorts: Contextual and Psychosocial Factors Surrounding HIV
Risk Behavior among Men Who Engage in Sex Work with Other Men. Journal of Urban
Health, 86(1), 54–66. doi: 10.1007/s11524-008-9316-5
References
Minichiello, V., Scott, J., & Callander, D. (2013). New Pleasures and Old Dangers: Reinventing
Male Sex Work. Journal of Sex Research, 50: 3 – 4.
Mizuta, T., & Mulvey-Roberts, M. M. (1994). Perspectives on the History of British Feminism:
The Rights of Married Women. London, UK: Routledge/Thoemmes.
Moore, D. (2004). Governing Street-Based Injecting Drug Users: A Critique of Heroin Overdose
Prevention in Australia. Social Science & Medicine, 59: 1547 – 1557.
Mowlabocus, S. (2005). Being Seen to be Gay: User Profiles and the Construction of Gay Male
Identity in Cyberspace. In Burkitt, K. & Simon, G. (eds), Working Papers in
Contemporary History and Politics. Manchester, United Kingdom: European Studies
Research Institute.
Murphy, O. (2020). “LonelyMans, PhoneyScams, and HornyGrans: A corpus-assisted critical

discourse analysis of Twitter users’ perceptions of postmodern online sex work on
OnlyFans.” Doctoral dissertation, Leeds Beckett University.
Myers, K. & Winters, N. (2002). Ten-year review of rating scales. II: Scales for internalizing
disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 41(6),
634 – 659
Myfavecelebs.com. (2022). Best hashtags for Onlyfans [sic] on Instagram, Tiktok [sic], Twitter –
2022. Retrieved March 26, 2022, from https://myfavcelebs.com/best-hashtags-for-
onlyfans-on-instagram.
NaftyToken Home Page. (2021). NaftyToken. Retrieved December 12, 2021, from
naftytoken.com.
National Institute of Mental Health. Eating disorder statistics. 2008. Retrieved from
http://www.gurze.com/client/client_pages/printable_pages/eatingdisorderstats.html.
Nemoto, T., Bödeker, B., and Iwamoto, M. (2011). Social Support, Exposure to Violence and
Transphobia, and Correlates of Depression Among Male-to-Female Transgender Women
with a History of Sex Work. American Journal of Public Health, 101(10): 1980-1988.
Netherlands Ministry of Foreign Affairs, Dutch Policy on Prostitution (2005). Netherlands

Ministry of Foreign Affairs. Retrieved February 1, 2021, from
https://prostitution.procon.org/wp-content/uploads/sites/50/netherlands.pdf
Nguyen, M-C., Venne, T., Rodrigues, I., Jacques, J. (2008). Why and according to what
consultation profiles do female sex workers consult health care professionals? A study
conducted in Laval, Quebec. Health Care for Women International, 29(2): 165-182.
References
Nguyen, T. (2020). Nude photos raised over $1 million for the Australia fires.
Retrieved May 11, 2020, from https://www.vox.com/the-goods/2020/1/8/21056863
/australia-fires-nudes-charity-porn
Nguyen T. A., Nguyen, H. T., Le. G. T., & Detels, R. (2008). Prevalence and risk factors
associated with HIV infection among men having sex with men in Ho Chi Minh City,
Vietnam. AIDS and Behavior, 12, 476–482.
Niesse, M. (2007). Prostitution Bill Gains Support. Honolulu Star-Bulletin. Retrieved

February 1, 2021, from http://archives.starbulletin.com/2007/02/13/news/story08.html.
NZ votes to legalise prostitution. (2003). British Broadcasting Corporation News. Retrieved

February 1, 2021 from http://news.bbc.co.uk/2/hi/asia-pacific/3019896.stm
O’Doherty, T. (2011). Criminalization and Off-Street Sex Work in Canada. Canadian Journal of
Criminology and Criminal Justice, 53(2): 217-45.
Office of the District Attorney, City and County of San Francisco. (2018). Prioritizing Safety for
Sex Workers. Retrieved June 22, 2021 from
https://sfgov.org/dosw/sites/default/files/DA%20Prioritizing%20Safety%20for%20Sex%
20worker%20Policy.pdf.
Olsen, F. (1983). The Family and the Market: A Study of Ideology and Legal Form. Harvard
Law Review, 96(7): 1497 – 1578.
OnlyFans (@OnlyFans). 2021. Thank you to everyone for making your voices heard. We have
secured assurances necessary to support our diverse creator community… Twitter.
Accessed September 13th, 2021 from
https://twitter.com/OnlyFans/status/1430499277302816773.
Operario, D., Soma, T., & Underhill, K. (2008). Sex work and HIV status among transgender
women: systematic review and meta-analysis. Journal of Acquired Immune Deficiency
Syndrome, 48(1), 97-103. doi: 10.1097/QAI.0b013e31816e3971 18344875
Overs, C. & Hawkins, K. (2011). Can Rights Stop the Wrongs? Exploring the Connection
Between Framings of Sex Workers’ Rights and Sexual Reproductive Health. BMC
International Health and Human Rights, 11(S6).
Overs, C., & Loff, B. (2013). Towards a framework that protects and promotes sex workers
human rights, Health and Human Rights Journal, 15(1), 186-196.
Paasonens, S. (2006). Email from Nancy Nutsucker: Representation and Gendered Address in
Online Pornography. European Journal of Culture Studies, 9(4), 403-420.
References
Paasonen, S. Nikunen, K., & Saarenmaa, L. (2007). “Pornification and the Education of Desire.”
In book: Pornification: Sex and Sexuality in Media Culture. Oxford, United Kingdom:
Berg
Paasonen, S. & Saarenmaa, L. (2007). “The Golden Age of Porn: Nostalgia and History in
Cinema.” In book: Pornification: Sex and Sexuality in Media Culture. Oxford, United
Kingdom: Berg.
Pandiyan, K., Chandrasekhar, H., Madhusudhan, S. (2012). Psychological morbidity among

female commercial sex workers with alcohol and drug abuse. Indian Journal of
Psychiatry, 54(4), 349-351.
Pandora Modeling. (2020). OnlyFans Guide for Adult Video Chat Models. Retrieved May 11,
2020, from https://www.pandoramodeling.com/only-fans-for-adult-video-chat-models/
Pascale, C-M. (2005). There’s No Place Like Home: The Discursive Creation of Homelessness.
Psychological Assessment, 76(4): 461-471.
Patrick, D. (1965). The Enforcement of Morals. London, UK: Oxford University Press.
Perkins, R. (1991). Working girls. Australian Studies in Law, Crime and Justice Series.
Canberra, Australia: Australian Institute of Criminology.
Persaud, C. A. (2021). Paper 1. “Your Vault Was Cleaned Due to Prohibited Content”:
Platforming Independent Pornography. In(ter)dependence in Platformed Creation. Panel
presented at AoiR 2021: The 22nd Annual Conference of the Assocation of Internet
Researchers. Virtual Event: AoiR. Retrieved from http://spir.aoir.org.
Peterson Institute for International Economics (PIIE). (2021). Worker pay has fallen in 2021
when adjusted for inflation. Peterson Institute for International Economics. Retrieved
November 6, 2021, from https://www.piie.com/research/piie-charts/worker-pay-has-
fallen-2021-when-adjusted-inflation
Petronzio, M. (2016). Tumblr is the one social platform taking action ahead of
Trump's America. Retrieved May 18, 2020, from
https://mashable.com/2016/12/09/action-on-tumblr-election/#bSRdAjksE8qj
Pew Research Center. (2020). Most Americans Say There is Too Much Economic Inequality in
the U.S., But Fewer Than Half Call it a Top Priority. Retrieved November 6, 2021, from
https://www.pewresearch.org/social-trends/2020/01/09/trends-in-income-and-wealth-
inequality/
References
Pheterson, G. (1989). A Vindication of the Rights of Whores. Seattle, WA: The Seal Press.
Pheterson, G. (1993). The whore stigma: Female dishonor and male unworthiness. Social Text,
37, 39-64. doi: 10.2307/466259
Phoenix, J. (2009). Regulating Sex for Sale: Prostitution Policy Reform in the UK. Bristol, UK:
Bristol University Press. doi: 10.2307/j.ctt9qgvwj
Platt, L., Grenfell, P., Meiksin, R., Elmes, J., Sherman, S. G. et al. (2018). Associations Between
Sex Work Laws and Sex Workers’ Health: A Systematic Review and Meta-Analysis of
Quantitative and Qualitative Studies. PLOS Medicine, 15(2): e1002680.
Plumridge, A. L. (2001). A “segmented” sex industry in New Zealand: Sexual and personal
safety of female sex workers Australian and New Zealand Journal of Public Health, 25:
78-83. DOI: 10.1111/j.1467-842X.2001.tb00555.x.
PornHub Insights. (2019). The 2019 Year in Review. Retrieved May 2nd, 2021 from
https://www.pornhub.com/insights/2019-year-in-review#searches
Poteat, T., Reisner, S. L., Radix, A. (2014). HIV epidemics among transgender women. Current
Opinion in HIV and AIDS, 9(2), 168-173. doi: 10.1097/COH.0000000000000030
24322537
Potterat, J. J., Brewer, D. D., Muth, S. Q., Rothenberg, R. B., Woodhouse, D. E., Muth, J. B., et
al. (2004). Mortality in a long-term open cohort of prostitute women. American Journal
of Epidemiology, 159(8), 778-785.
Pressured by sex workers, Taiwan OKs prostitution. (2009). Reuters. Retrieved February 1,
2021, from https://cn.reuters.com/article/us-taiwan-prostitution/pressured-by-sex-
workers-taiwan-oks-prostitution-idUSTRE55N1OY20090624
Prince, L. (2013). Self-Perceived Healthcare Needs for African American Women in Street-
Level Prostitution: Strategies for Interventions. Journal of the Association of Black
Nursing Faculty in Higher Education, 24(1): 5-9.
Prostitutes’ Education Network. (2003). “Black Women and Prostitution.” Retrieved February
1, 2021, from, https://www.bayswan.org/Racism.html.
Prostitutes’ Education Network. (2013). Prostitution in The United States - The Statistics.
Prostitutes’ Education Network. Retrieved February 1, 2021, from
https://www.bayswan.org/stats.html.
References
Prostitution Law Review Committee, New Zealand Ministry of Justice. (2008). Report of the
Prostitution Law Review Committee on the Operation of the Prostitution Reform Act
2003. Retrieved June 22, 2021 from https://prostitutescollective.net/wp-
content/uploads/2016/10/report-of-the-nz-prostitution-law-committee-2008.pdf
Puri, N., Shannon, K., Nguyen, P., and Goldenberg, S. M. (2017). Burden and Correlates of
Mental Health Diagnoses Among Sex Workers in an Urban Setting. BMC Women’s
Health, 17: 133.
Railton, D. & Watson, P. (2005). Naughty Girls and Red Blooded Women: Representations of
Female Heterosexuality in Music Video. Feminist Media Studies, 5(1), 51-63.
Rense, S. (2018). The Human Race Really Outdid Itself with Porn Searches in
2018. Retrieved May 18, 2020, from
https://www.esquire.com/lifestyle/sex/news/a52061/most-popular-porn-searches/
Reuters Staff. (2020). Visa continues Pornhub ban, to allow card use on some of its parent sites.
Reuters. Retrieved December 12, 2021, from, https://www.reuters.com/article/us-
pornhub-visa/visa-continues-pornhub-ban-to-allow-card-use-on-some-of-its-parents-
sites-idUSKBN28X2D0
Revanche, J. (2016). Tumblr was my savior. It made me see I wasn't monstrous and
unlovable. Retrieved May 18, 2020, from
https://www.theguardian.com/commentisfree/2016/aug/24/tumblr-was-my-saviour-it-
made-me-see-i-wasnt-monstrous-and-unloveable
Riley, E. D., Gandhi, M., Hare, C. B., Cohen, J. & Hwang, S. W. (2007). Poverty, Unstable
Housing, and HIV Infection Among Injection Drug Users. Social Science & Medicine,
65(5), 1026-1044.
Ringdal, N. J. (2004). Love for Sale: A World History of Prostitution. New York City, NY:
Grove/Atlantic.
Roberts, N. (1992). Whores in History: Prostitution in Western Society. New York City, NY:
Harpers Collins.
Rojek, C. (2001). Celebrity. John Wiley & Sons, Ltd.
Roguski, M. (2013). Occupational health and safety of migrant sex workers in New Zealand.
Prepared for the New Zealand Prostitutes Collective. Retrieved June 19, 2021 from
https://www.nswp.org/sites/nswp.org/files/Roguski-2013-OSH-of-migrant-sex-workers-
in-NZ-1.pdf
References
Romano, A. (2018). Tumblr is banning adult content. It's about so much more than
porn. Vox. Retrieved May 18, 2020, from
https://www.vox.com/2018/12/4/18124120/tumblr-porn-adult-content-ban-user-backlash
Romano, A. (2018). A new law intended to curb sex trafficking threatens the future of the
internet as we know it. Vox. https://www.vox.com/culture/2018/4/13/17172762/fosta-
sesta-backpage-230-internet-freedom.
Romans, S. E., Potter, K., Martin, J. & Herbison, P. (2001). The mental and physical health of
female sex workers: a comparative study. The Australian and New Zealand journal of
psychiatry, 35(1), 75-80.
Rosen, R. (1982). The Lost Sisterhood: Prostitution in America, 1900-1918. Baltimore, MD:
John Hopkins University Press.
Rosenberg, M. (1965). Society and adolescent self-image. Princeton, NJ: Princeton University
Press.
Ross, M. W., Crisp, B. R., Månsson, S-A., and Hawkes, S. (2012). Occupational health and
safety among sex workers. Scandinavian Journal of Work, Environment & Health 38(2):
105-119. Retrieved June 19, 2021 from https://www.jstor.org/stable/41508873.
Rossiaud, J. (1988). Medieval prostitution. (Prostituzione nel Medioevo). Oxford, NY:

Blackwell IX.
Rössler, W., Koch, U., Lauber, C., Hass, A. K., Altwegg, M., Ajdacic-Gross, V., Landolt. K.
(2010). The mental health of female sex workers. Acta Psychiatrica Scandinavica,
122(2), 143-152.
Roxburgh, A., Degenhardt, L., & Copeland, J. (2006). Posttraumatic stress disorder among
female street-based sex workers in the greater Sydney area, Australia. BMC Psychiatry,
6(1), 24.
Rubin, G. S. (1984). Thinking Sex: Notes for a Radical Theory of the Politics of Sexuality. First
published in Carol S. Vance, ed., Pleasure and Danger: Exploring Female Sexuality
(1984).
Ruiz-Gomez, A. (2019). Digital Fame and Fortune in the age of Social Media: A Classification
of social media influencers. aDResearch ESIC International Journal of Communication
Research, 19(19), 8-29. DOI: 10.7263/adresic-019-01.
Safaee, A. (2021). Sex, Love, and OnlyFans: How the Gig Economy is Transforming Online Sex
Work. Master’s thesis, San Diego State University. SDSU University Library.
References
Saguy, A. C. & Riley, K. W. (2005). Weighing both sides: morality, mortality, and framing
contests over obesity. Journal of Health Politics, Policy, and Law, 30, 869-921.
Sandelowski, M. (1986). The problem of rigor in qualitative research. Advances in Nursing

Sciences, 8(3), 27-37.
Sanders, T., & Campbell, R. (2007). Designing out vulnerability, building in respect: violence,
safety and sex work policy. The British Journal of Sociology, 58(1), 1-19.
doi: 10.1111/j.1468-4446.2007.00136.x 17343635
Sanders, T., & Cunningham, S. (2017). Sex work and homicide. Leicester: University of
Leicester.
Savva, H. (2012). Factors Associated with the Utilization of Health Services by Female Sex
Workers in South Africa: School of Public Health, University of the Witwatersrand.
Sawicki, D. A., Brienna, N. M., Read, K., Heinz, A. J. (2019). Culturally competent health care
for sex workers: an examination of myths that stigmatize sex workers and hinder access
to care. Sexual and Relationship Therapy, 34(3): 355-371.
Schneebaum, A., & Badgett, M. V. (2018). Poverty in US Lesbian and Gay Couple
Households, Feminist Economics, DOI: 10.1080/13545701.2018.1441533
Scibelli, P. (1987). “Empowering Prostitutes: A Proposal for International Legal Reform.”

Harvard Women’s Law Journal, 10(Spring): 117-57.
Scott, J. (1992). “Experience.” In Feminists Theorize the Political, ed. Judith Butler and Joan
Scott. New York: Routledge.
Scott, J. (2003). A Prostitutes’ Progress: Male Prostitution in Scientific Discourse. Social

Semiotics, 13: 179 – 199.
Scull, M. (2015). The Self-Concept as a Side Bet: How Stripping Enhances the Self-Views of
Men Who Dance for Women. Deviant Behavior, 36(11), 890-909.
Sex Workers and Allies Network, Yale Global Health Justice Partnership. (2020). The Harmful
Consequences of Sex Work Criminalization on Health and Human Rights. Retrieved June
17, 2021 from
https://law.yale.edu/sites/default/files/area/center/ghjp/documents/consequences_of_crimi
nalization_v2.pdf
Sex Workers Outreach Project-USA (SWOP USA). (2017). The American Health Care Act:
Community Briefing for Sex Workers. Retrieved October 30, 2021 from
https://swopusa.org/blog/2017/03/22/american-healthcare-act-sexwork/
References
Sex Workers Project of the Urban Justice Center. (2003). Revolving Door: An Analysis of Street-
Based Prostitution in New York City. Retrieved June 17, 2021 from
https://sexworkersproject.org/downloads/RevolvingDoor.pdf
Sex Workers Project of the Urban Justice Center. (2005). Behind Closed Doors: An Analysis of
Indoor Sex Work in New York City. Retrieved June 17, 2021 from
https://sexworkersproject.org/downloads/BehindClosedDoors.pdf
Shannon, K., Crago, A. L., Baral, S. D., Bekker, L. G., Kerrigan, D., Decker, M. R., Poteat, T.,
Wirtz, A. L., Weir, B., Boily, M. C., Butler, J., Strathdee, S. A., & Beyrer, C. (2018). The
global response and unmet actions for HIV and sex workers. Lancet (London,
England), 392(10148), 698–710. https://doi.org/10.1016/S0140-6736(18)31439-9
Shannon, K., Kerr, T., Allinott, S., Chettiar, J., Shoveller, J., Tyndal, M. W. (2008). Social and
Structural Violence and Power Relations in Mitigating HIV Risk of Drug-Using Women
in Survival Sex Work. Social Sciences and Medicine, 66(4): 911-21.
Shannon, K., Kerr, T., Strathdee, S. A., Shoveller, J., Montaner, J. S., & Tyndall, M. W. (2009).
Prevalence and Structural Correlates of Gender Based Violence Among a Prospective
Cohort of Female Sex Workers. British Medical Journal, 339, b2939.
Shannon, K., Strathdee, S. A., Shoveller, J., Rusch, M., Kerr, R., Tyndall, M. W. (2005).
Structural and Environmental Barriers to Condom Use Negotiation with Clients Among
Female Sex Workers: Implications for HIV-Prevention Strategies and Policies. American
Journal of Public Health, 99(4): 659 – 665.
Sheperd, I. D. (2005). From cattle and coke to Charlie: Meeting the challenge of self marketing
and personal branding. Journal of Marketing Management, 21(5-6), 589-606.
Shrage, L. (1994). Moral Dilemmas of Feminism: Prostitution, Adultery, and Abortion. New
York: Routledge.
Shushtari, Z. J., Sajjadi, H., Forouzan, A. S., Salimi, Y., Dejman, M. (2014). Disclosure of HIV
status and social support among people living with HIV. Iranian Red Crescent Medical
Journal, 16(8).
Sigel, L. Z. (2000). Filth in the Wrong People’s Hands: Postcards and the Expansion of
Pornography in Britain and the Atlantic World, 1880-1914. Journal of Social History,
33(4), 859-885.
Smith, M. D. & Grov, C. (2011). In the Company of Men Inside the Lives of Male Prostitutes.
Santa Barbara, CA: Praeger.
References
Smith, M. D., Grov, C., Seal, D. W., & McCall, P. (2013). A social-cognitive analysis of how
young men become involved in male escorting. Journal of Sex Research, 50, 1-10.
doi: 10.1080/00224499.2012.681402
Solomon, D. (2017). Why Tumblr Is Hosting A Planned Parenthood Rally Instead Of Its
Usual SXSW Party. Retrieved May 18, 2020, from
https://www.fastcompany.com/3068911/why-tumblr-is-hosting-a-planned-parenthood-
rally-instead-of-its-usual-sxsw-party
St. James Infirmary. (2017). Who We Are. Retrieved June 24, 2021 from
https://www.stjamesinfirmary.org/wordpress/?page_id=2.
Stake, R. E. (2010). Qualitative Research: Studying How Things Work. New York, NY:
Guilford Press.
Statica. (2021). Number of monetizable daily active Twitter users (mDAU) worldwide from 1st
quarter 2017 to 3rd quarter 2021. Statica. Retrieved December 11, 2021 from
https://www.statista.com/statistics/970920/monetizable-daily-active-twitter-users-
worldwide/
Steger, M. F. (2010). The Meaning in Life Questionnaire (MLQ). Retrieved March 26, 2022 from
http://www.michaelfsteger.com/wp-content/uploads/2013/12/MLQ-description-scoring-
and-feedback-packet.pdf
Steger, M. F., Frazier, P., Oishi, S., & Kaler, M. (2006). The Meaning in Life Questionnaire:
Assessing the presence of and search for meaning in life. Journal of Counseling
Psychology, 53, 80-93.
Steger, M. F. and Shin, J. Y. (2010). The relevance of the Meaning in Life Questionnaire to
therapeutic practice: A look at the initial evidence. The International Forum for
Logotherapy, 33, 95-104.
Stern, S. W. (2019). America's Forgotten Mass Imprisonment of Women Believed to

Be Sexually Immoral. History.com. Retrieved February 01, 2021, from
https://www.history.com/news/chamberlain-kahn-act-std-venereal-disease-imprisonment-
women
Stokes, J., Vanable, P., McKirnan, D. (1997). Comparing gay and bisexual men on sexual
behavior, condom use, and psychosocial variables related to HIV/AIDS. Archives of
Sexual Behavior, 26, 383-397.
Strauss, A. L. & Corbin, J. (1990). Basics of Qualitative Research: Grounded Theory

Procedures and Techniques. Newbury Park, CA: Sage Publications.
References
Suls, J., Wills, T. A. (1991). Social comparison: Contemporary theory and research. Erlbaum,
Hillsdale, NJ, pp. 237-257.
Sydney Morning Herald. (2016). France Overhauls Prostitution Laws, Makes It Illegal to Pay
for Services.” Retrieved February 1, 2021, from tinyurl.com/yco6xqnv
Tao, X., Gai, R., Zhang, N., Zheng, W., Zhang, X., Xu, A., & Li, S. (2010). HIV Infection and
Mental Health of "Money Bosy:" A Pilot Study in Shandong Province, China. Southeast
Asian J Trop Med Public Health, 41(2), 358–368.
Taylor, M. As the Sun Sets on OnlyFans, the Only Way Forward is Crypto. Mel Magazine.
Retrieved November 28, 2021, from
https://drive.google.com/drive/folders/1F5_u1WShe5g-Nv6054hCtyAswVEArhzq
Thematic Task Team on Creating an Enabling Legal and Policy Environment (TTCELPE).
(2010). Creating an Enabling Legal and Policy Environment for Increased Access to HIV
& AIDS Services for Sex Workers. 1st Asia and the Pacific Regional Consultation on
HIV and Sex Work.
Tilton, S. (2011). “Nanocelebrity: How to combine expertise with voice.” Retrieved May 2nd,
2021 from the 2011 SxSW [South by South West] Conference Future 15 “Post Post-
modern celebrity” Session”
Todd, D. (2012). You Are What You Buy: Postmodern Consumerism and the Construction of
Self. Hohonu: A Journal of Academic Writing, 10, 48-51.
Turnage, B. F. (2004). Influences on adolescent African American females’ global self esteem:
Body image and ethnic identity. Journal of Ethnic and Cultural Diversity in Social Work,
13, 27-45.
Turner, G. (2004). Understanding celebrity. London, United Kingdom: Sage.
Turner, G. (2006). “The mass production of celebrity, ‘celetoids,’ reality tv, and the ‘demotic
turn.’” International Journal of Cultural Studies, 9(2), 153-165.
Underhill, K., Morrow, K.M., Colleran, C. M., Holcomb, R., Calabrese, S. K., Operario, D., et
al. (2015). A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk
Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have
Sex with Men: Implications for Biomedical HIV Prevention. Journal of Urban Health,
92, 667–686. doi: 10.1007/s11524-015-9961-4
References
Underhill, K., Morrow, K. M., Colleran, C. M., Holocomb, R., Operario, D., Calabrese, S. K. et
al. (2014). Access to Healthcare, HIV/STI Testing, and Preferred Pre-Exposure
Prophylaxis Providers Among Men Who Have Sex with Men and Men who Engage in
Street-Based Sex Work in the US. PLOS One, 9(11): e112425.
United Nations. (1948). Universal Declaration of Human Rights. Retrieved June 22, 2021 from
https://www.un.org/sites/un2.un.org/files/udhr.pdf
United Nations. (2007). Fact Sheet No.21, the Human Right to Adequate Housing. Office of the
United Nations High Commissioner for Human Rights. Retrieved June 21, 2021 from
https://www.un.org/ruleoflaw/files/FactSheet21en.pdf
U.S. Committee on Commerce, Science, and Transportation. (2013). A review of the data broker
industry: collection, use and sale of consumer data for marketing purposes, Office of
Oversight and Investigations. Retrieved December 11, 2021, from
http://educationnewyork.com/files/rockefeller_databroker.pdf
University of Minnesota: University Libraries. (2003). “American Social Hygiene

Posters.” [Poster]. Retrieved February 1, 2021, from
https://digital.lib.umn.edu/IMAGES/reference/swhp/SWHP0032.jpg.
Urada, L. A., Morisky, D. E., Hernandez, L. I., & Strathdee, S. A (2013). Social and structural
factors associated with consistent condom use among female entertainment workers
trading sex in the Philippines. AIDS and Behavior, 17(2), 523-535.
Vallely, P. (2006). “Brothels in England? Sure.” History News Network. Columbia

College of Arts and Sciences, The George Washington University. Retrieved January 25,
2021, from https://historynewsnetwork.org/article/20781
Varga, C. & Fire, Kalash KaFae Magenta. (2018). Increasing Competency for the Therapeutic
Care of Sex Workers. [PowerPoint Slides]. Retrieved June 24, 2021 from
https://www.dropbox.com/1/sc1/AADvm7O3B9CLqg_y1OXE-xoxqMU2nQ2mKOw
Walker, S. (2008). Sense and Non-Sense About Crimes, Drugs, and Communities. Belmont, CA:
Wadsworth.
Wang, B., Li, X., Stanton, B., Fang. X., Lin. D., Mao, R. (2007). HIV-related risk behaviors and
history of sexually transmitted diseases among male migrants who patronize commercial
sex in China. Sexually Transmitted Diseases, 34, 1-8.
Ward, H., Day, S., Weber, J. (1999). Risky business: health and safety in the sex industry over a
9 year period. Sexually Transmitted Infections, 75(5), 340-343.
Weeks, J. (1985). Sexuality and Its Discontents. London: Routledge & Kegan Paul.
References
Willis, C. A (2005). Destination America: When Did They Come? PBS. Retrieved
February 1, 2021, from http://www.pbs.org/destinationamerica/usim_wn.html
Wildes, J. E., Emery, R. E., & Simon, A. D. (2001). The roles of ethnicity and culture in the
development of eating disturbance and body dissatisfaction: A meta-analytic review.
Clinical Psychology Review, 21, 521-551. doi:10.1016/S0272-7358(99)00071-9
Wong, F. Y., He, N., Huang, Z. J., Young, D., O’Conor. C., Ding, Y. Y., Fu, C., Arayasirikul S.
(2010). Migration and illicit drug use among two types of male migrants in Shanghai,
China. Journal of Psychoactive Drugs, 42, 1-9.
Women's Media Center. (2015). These Ten Tumblr Posts Were My Feminist Education.
Retrieved May 18, 2020, from https://www.womensmediacenter.com/fbomb/these-ten-
tumblr-posts-were-my-feminist-education
World Health Organization. (1986). Ottawa Charter for Health Promotion. First International
Conference on Health Promotion. Ottawa. Retrieved June 21, 2021 from
https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference
Yang H, Li X, Stanton B, Fang X, Zhao R, Dong B, Liu W, Liang S, Zhou Y, Hong Y. (2005).
Condom use among female sex workers in China: role of gatekeepers. Sex Transm Dis;
32(9): 572.
Ye, X., Shang, M., Shen, T., Pei, B., Jiang, X., Cai, Y. (2012). Social, psychological, and
environmental-structural factors determine consistent condom use among rural-to-urban
migrant female sex workers in shanghai China. BMC Public Health., 12(1), 599.
Yentel, D. (2018). Point of View – Poverty is a Choice. National Low Income Housing
Coalition. Retrieved May 2nd, 2021 from https://nlihc.org/resource/point-view-poverty-
choice
Zatz, N. D. (1997). Sex Work/Sex Act: Law, Labor, and Desire in Constructions of Prostitution.
Signs, 22(2): 277-308.
Zimet, G. D., Dahlem, N. W., Zimet, S. G. & Farley, G. K. (1988). The Multidimensional Scale
of Perceived Social Support. Journal of Personality Assessment, 52, 30-41.
Zuboff, S. (2015). Big other: surveillance capitalism and the prospects of an information
civilization. Journal of Information Technology, 30, 75-80. DOI: 10.1057/jit.2015.5
Zulli, D. (2018). Capitalizing on the look: insights into the glance, attention economy, and
Instagram. Critical Studies in Media Communication, 35(2), 137-150.
Chapter IX: Appendices
Appendix A: Informed Consent Form
TITLE OF STUDY: Sex Workers on OnlyFans: An Exploratory Investigation of How Identity

Impacts Services Accessibility, Psychosocial Influences, and Virtual Culture
PRINCIPAL INVESTIGATOR: Jay Bosworth, Psy.M.
This online consent form is part of an informed consent process for a research study and it will
provide information that will help you decide whether you want to take part in the study. It is
your choice to take part or not. If there is anything in the form that is not clear to you, please
email the principal investigator (jbn38@gsapp.rutgers.edu). If you decide to take part,
instructions at the end of document will tell you what to do next. Your alternative to taking part
in the research is not to take part in it.
WHO IS CONDUCTING THIS RESEARCH AND WHAT IS IT ABOUT?
You are being asked to take part in research conducted by Jay Bosworth, Psy.M. a doctoral
candidate for the Doctor of Psychology in Clinical Psychology with Rutgers Graduate School of
Applied and Professional Psychology. The purpose of this study is to investigate your
perceptions of your lived and virtual experiences as an OnlyFans content creator. We anticipate
100 subjects to take part in the research.
WHAT WILL I ASKED TO DO IF I TAKE PART?
The survey will take about 15 to 25 minutes to complete depending on how quickly you read and
type. You will be asked to complete demographic questions, questions of your experiences
accessing common services and OnlyFans, 3 self-report questionnaires about your thoughts,
feelings, and behaviors, and respond to 6 open-ended questions about your experiences with the
OnlyFans community on social media.
WHAT ARE THE RISKS AND/OR DISCOMFORTS I MIGHT EXPERIENCE IF I

TAKE PART IN THE STUDY?
No identifying information is asked of you; however, breach of confidentiality is a risk of harm

but a data security plan is in place to minimize such a risk. Also, some questions may make you
feel uncomfortable. If that happens, you can skip those questions or withdraw from the study
altogether. If you decide to quit at any time before you have finished the survey your answers
will NOT be recorded.
Appendix A: Informed Consent Form (Continued)
(Please note: Names underscored were embedded with a hyperlink to the site’s homepage.)
If you experience discomfort or psychological distress during your participation in the

survey, please call 911 if you are experiencing a true psychiatric crisis, or call any of the
following numbers:
Resources for Emotional Distress

• HIPS (Helping Individual Prostitues Survive): Call 1-800-676-4477
o Offers a 24/7 hotline to provide emotional support, schedule supplies deliveries,
and get connected to health and supportive services
• SWOP (Sex Workers Outreach Project) USA's Community Support Line: Call 1-
877-776-2004
o Staffed by sex worker peers who can help figure out your next steps. They do not
give advice or make recommendations, but have resources to share. If you have
been arrested, charged, or recently released from prison or jail, SWOP USA can
get you connected to things you need.
• National Suicide Prevention Lifeline: Call 1-800-273-8255

o Provides 24/7, free, and confidential support for people in distress, prevention,
and crisis resources for individuals or their loved ones, and best practices for
professionals
Resources for LGBTQIA+ Individuals

• The Trevor Project: Call 1-866-488-7386 OR Text START to 678-678
o Leading national organization providing crisis interventions and suicide
prevention services to LGBTQIA+ young people under 25
• LGBT National Hotline: Call 1-888-843-4564 Mon-Fri from 1pm-9pm EST and Sat
from 9am-2pm EST
o Provides an anonymous and confidential safe spaces for callers to speak of issues
and concerns, including, but not limited to, coming out issues, gender and/or
sexuality identities, relationship concerns, bullying, workplace issues, HIV/AIDS
anxiety, safer sex information, suicide, and more
• Trans Lifeline's Peer Support Hotline: Call 1-877-565-8860

o A peer support service run by trans people, for trans and questioning callers,
inviting those in crisis or needing someone to talk to call
Resources for Domestic Violence and Sexual Assault

• U.S. National Domestic Violence Hotline: Call 1-800-799-SAFE (7233) OR text
LOVEIS to 22522
o Free anonymous, confidential, 24-hour national hotline with trained services and
support for victims of domestic abuse and violence. If you need help, get help. Do
not hesitate.
• RAINN (Rape Abuse + Incest National Network) National Sexual Assault Telephone
Hotline: Call 1-800-656-HOPE (4673)
o Provides safe, confidential services in finding a local health facility trained to care
for survivors of sexual assault and offer services like sexual assault forensic
exams, referrals for long term and local support, information about laws in your
community, basic information about medical concerns
Resources for Alcohol and Substance Dependency

• SAMHSA's (Substance Abuse and Mental Health Services Administration) National
Helpline: Call 1-800-662-HELP (4357)
o A free, confidential, 24/7, 365-day-a-year treatment rreferral and information
service in English and Spanish for individuals and families facing mental and/or
substnace use disorders. This service provides referrals to local treatment
facilities, support groups, and community-based organizations.
• Sober Sex Workers AA Meeting: @SexWorkersAA on Twitter

o Sundays on Zoom - the entire community is welcome. DM @SexWorkersAA on
Twitter for access
• Pride Institute LGBTQ Dependency: Call 1-888-616-5031

o Substance dependency organization with no-cost assessment and other programs
Resources for Mental Health Services

• Community Health Centers (CHC)
o Federally funded non-profits providing health care to the underserved, with or
without insurance. Sliding scale.
• SWOP Checklist for Finding a Sex Work-Positive Therapist

o A helpful guide for questions to screen potential therapists via SWOP USA
Resoure for HIV and STI Testing

• HIV.gov: Call 1-800-CDC-INFO (232-4636)
o Provides free consultation for information or questions pertaining to HIV/AIDS,
Viral Hepatitis, STI's, TB, or HIV testing sites.
o locator.hiv.org to locate nearby HIV prevention, housing, mental health,
substance abuse testing, or treatment services
ARE THERE ANY BENEFITS TO ME IF I CHOOSE TO TAKE PART IN THIS

STUDY?
There are no direct benefits to you for taking part in this research. However, taking part in this
research survey will: 1) contribute to providing a nuanced understanding of this unique online
mode of sex work; 2) positively contribute to current research and discourse of sex workers and
the sex work industry; 3) inspire future research for developing effective healthcare- and
community-based interventions for OnlyFans content creators; and 4) contribute to the creation
of a policy brief to be distributed to non-profit sex work organizations and allied health clinics
focused on recommended clinical- and community-based interventions, program initiatives,
resource allocations, and next research steps for uplifting and supporting the OnlyFans content
creator community.
WILL I BE PAID TO TAKE PART IN THIS STUDY?
You will not be paid to take part in this study. For each fully completed survey the principal
investigator is donating $1.00 to The New Jersey Red Umbrella Alliance (NJRUA) [hyperlink to
njrua.org], a non-profit organization dedicated to promoting, defending, and advocating for the
human rights of sex workers in the state of New Jersey.
HOW WILL INFORMATION ABOUT ME BE KEPT PRIVATE OR CONFIDENTIAL?
We will use Qualtrics to collect our anonymous responses and no identifying information is
asked of you. We will download your responses to a secure file that requires a password to
access. Only the principal investigator will have access to the password. Responses will be
deleted from the file after analysis is complete. Study findings may be professionally presented
or published; no information that can identify you will appear in any professional presentation or
publication.
WHAT WILL HAPPEN TO INFORMATION I PROVIDE IN THE RESEARCH AFTER

THE STUDY IS OVER?
The information collected about you for this research will not be used by or distributed to
investigators for other research. Only the published dissertation will be accessible for public
access.
WHAT WILL HAPPEN IF I DO NOT WANT TO TAKE PART OR DECIDE LATER

NOT TO STAY IN THE STUDY?
Your participation is voluntary. If you choose to take part now, you may change your mind and
withdraw later. If you do not click on the ‘submit’ button after completing the form, your
responses will not be recorded. However, once you click the ‘submit’ button at the end of the
form, your responses cannot be withdrawn as we will not know which ones yours are.
WHO CAN I CONTACT IF I HAVE QUESTIONS?
If you have questions about taking part in this study, you can contact the principal investigator
by emailing Jay Bosworth at jbn38@gsapp.rutgers.edu or Karen Riggs-Skean, Psy.D., his faculty
advisor, at kskean@gsapp.rutgers.edu.
If you do not wish to take part in the research, close this website address. If you wish take part in
the research, follow the directions below:
By beginning this research survey, I acknowledge that I have read and understand the
information presented and I meet the following eligibility criteria:
1. 18 years of age or older;

2. Permanently reside in the USA, Puerto Rico, the U.S. Virgin Islands, the Northern Mariana
Islands, or American Samoa;
3. Have an intermediate or professional working proficiency in the English language;
4. Have an existing OnlyFans account as a content creator;
5. Have an existing Twitter account utilized to promote said OnlyFans account;
Please print out, screen record, or copy and paste this consent form into a personal document if
you would like a copy of it for your files.
Do you AGREE or DISAGREE to participate in research survey, with the knowledge that you
are free to withdraw your participation in the research study without penalty?
o I AGREE to participate
o I DO NOT AGREE to participate
Appendix B: Demographics
1. AGE – What is your current age?

a. 18-20
b. 21-29
c. 30-39
d. 40-49
e. 50-59
f. 60 or older
g. I choose not to answer
2. GENDER IDENTITY – What is your gender?

a. Cis Man
b. Cis Woman
c. Trans Man
d. Trans Woman
e. Agender
f. Bigender
g. Genderqueer
h. Gender Non-Conforming
i. Nonbinary
j. Two-Spirit
k. Other – Please Specify [Open-Ended Text Box]
l. I choose not to answer
3. SEXUAL ORIENTATION – Which of the following best describes your sexual

orientation?
a. Straight
b. Gay
c. Lesbian
d. Asexual
e. Bisexual
f. Pansexual
g. Queer
h. Questioning
i. Other – Please Specify [Open-Ended Text Box]
j. I choose not to answer
Appendix A: Demographics (Continued)
4. RACE – What is your race? (Mark as many that apply)

a. Native American/Alaskan Native
b. Asian
c. Black or African American
d. Native Hawaiian or Pacific Islander
e. White or European American
f. Latino or Hispanic
g. Middle Eastern
h. Other – Please Specify [Open-Ended Text Box]
i. I choose not to answer
5. DEVELOPMENTAL AND ACQUIRED DISABILITY – Do you have a

disability/ability status? This identification does not need to be based on whether you
typically request accommodations for this disability (Mark as many that apply)
a. I do not identify with a disability or impairment
b. A sensory impairment (vision or hearing)
c. A learning disability (e.g., ADHD, dyslexia)
d. A chronic medical illness (e.g., epilepsy, cystic fibrosis, HIV/AIDS)
e. A mobility impairment
f. A mental health disorder
g. A temporary impairment due to illness or injury (e.g., broken ankle, surgery)
h. A disability or impairment not listed above
6. EDUCATIONAL LEVEL – What is the highest level of school you have completed or
the highest degree you have received?
a. Less than a high school degree
b. High school degree or equivalent (e.g., GED)
c. Vocational school
d. Some college but no degree
e. Associate degree (e.g., AA, AS)
f. Bachelor’s degree (e.g., BA, BS)
g. Graduate or Professional Degree (e.g., MA, PhD, MD, JD)
h. I choose not to answer
Appendix A: Demographics (Continued)
7. HOUSEHOLD STATUS – Which of the following best describes your current living
situation?
a. Apartment
b. Condominium
c. Co-op
d. House (in the process of buying or have bought)
e. Public housing
f. Shelter
g. Other – Please Specify [Open-Ended Text Box]
h. I choose not to answer
Appendix C: Experiences in Sex Work with Services and OnlyFans
Experiences in Sex Work with Services.
(Rhode Island Chapter of Call Off Your Old Tired Ethics [COYOTE RI], 2015)
1. AGE OF FIRST EXPERIENCE WITH SEX WORK – How old were you when you had
first experienced exchanging something sexual for money, drugs, rides, places to stay, or
for something else of value?
a. [Range from 1 to 100]
b. I choose not to answer
2. SOLE PROVIDER FOR FAMILY – Are you the sole provider for your family?
a. Yes
b. No
c. Other – Please Specify [Open-Ended Text Box]
d. I choose not to answer
3. NUMBER OF FAMILY MEMBERS SUPPORTING – How many family members are

you supporting?
a. 0 (Independent)
b. 1
c. 2
d. 3
e. 4
f. 5
g. 6 or more
h. Other – Please Specify [Open-Ended Text Box]
4. SERVICES SOUGHT SINCE STARTING SEX WORK – Since beginning to engage in

sex work, have you sought any of the following services? (Mark as many that apply)
a. Shelters
b. Medical services
c. Mental health services
d. Legal aid
e. Other – Please Specify [Open-Ended Text Box]
f. I choose not to answer
Appendix C: Experiences in Sex Work with Services and OnlyFans (Continued)
5. SHELTERS A: TYPE OF SHELTER - If you sought shelter, what kind of shelter was it?
(Mark as many that apply)
a. Not applicable
b. Homeless shelter
c. Domestic violence shelter
d. Adult shelter
e. Youth shelter
f. Other – Please Specify [Open-Ended Text Box]
6. SHELTERS B: STAFF AWARE OF SEX WORK ENGAGEMENT – If you sought

shelter, were they aware of your involvement in the sex work industry?
a. Not applicable
b. Yes
c. No
d. Other – Please Specify [Open-Ended Text Box]
e. I choose not to answer
7. SHELTER C: FEEDBACK – If you sought shelters, please comment on what was

helpful, unhelpful, and what you would tell shelter providers about how to best help
people who are involved in the sex work industry.
a. [Open-Ended Text Box]
8. SHELTERS D: OPTIONAL – Is there anything else you would like to share about
shelters?
a. [Open-ended Text Box]
9. MEDICAL SERVICES A: PROVIDERS AWARE OF SEX WORK ENGAGEMENT–

If you sought medical services were they aware of your engagement in sex work?
a. Not applicable
b. Yes
c. No
d. Other – Please specify [Open-ended Text Box]
10. MEDICAL SERVICES B: FEEDBACK – If you sought medical services, please

comment on what was helpful, unhelpful, and what you would tell medical providers
about how to best serve people who are involved in the sex work industry?
11. MEDICAL SERVICES C: OPTIONAL – Is there anything else you would like to share
about medical services?
12. MENTAL HEALTH A: PROVIDERS AWARE OF SEX WORK ENGAGEMENT – If

you sought mental health services, were they aware of your engagement in sex work?
a. Not applicable
b. Yes
c. No
13. MENTAL HEALTH B: FEEDBACK – If you sought mental health services, please
comment on what was helpful, unhelpful, and what you would tell medical providers
about how to best serve people who are involved in the sex work industry?
14. MENTAL HEALTH C: OPTIONAL – Is there anything else you would like to share
about mental health services?
15. LEGAL AID A: PRACTITIONER AWARE OF SEX WORK ENGAGEMENT– If you

sought legal aid, were they aware of your engagement in sex work?
a. Not applicable
b. Yes
c. No
16. LEGAL AID B: FEEDBACK – If you have sought legal aid, please comment on what
was helpful, unhelpful, and what you would tell legal aid providers about how to best
serve people who are involved in the sex industry?
17. LEGAL AID C: OPTIONAL - Is there anything else you would like to share about legal
aid?
18. LAW ENFORCEMENT A: PROFESSIONALS AWARE OF SEX WORK

ENGAGMENT– If you sought law enforcement services, were they aware of your
engagement in sex work?
a. Not applicable
b. Yes
c. No
19. LAW ENFORCEMENT B: FEEDBACK – If you have sought law enforcement services,
please comment on what was helpful, unhelpful, and what you would tell law
enforcement how to best serve people who are involved in the sex industry?
20. LAW ENFORCEMENT C: OPTIONAL – Is there anything else you would like to share
about law enforcement?
21. VICTIM OF SEX TRAFFICKING A – Have you been a victim of sex trafficking?
Trafficking is defined as work in the sex industry due to force, fraud, or coercion or the
involvement of minors in the sex industry.
a. Yes
b. No
22. VICTIM OF SEX TRAFFIKCING B: OPTIONAL: Is there anything else you would like
to share about trafficking?
23. VICTIM OF EXPLOITATION A – Have you experienced forms of exploitation within

the sex industry that you would not consider trafficking? Examples may include wage
theft, being overworked or undercompensated, entering workplace conditions that are
unsafe.
a. Yes
b. No
24. VICTIM OF EXPLOITATION B – OPTIONAL: Is there anything else you would like to
share about exploitation?
Experiences With OnlyFans.
1. YEAR OF CREATING ONLYFANS – What year did you create your OnlyFans
account?
a. 2016
b. 2017
c. 2018
d. 2019
e. 2020
f. 2021
2. AGE OF JOINING ONLYFANS – How old were you when you created your OnlyFans
Account?
a. Range from 18 to 100
3. YEARS OF WEBCAM, VIDEO, and PHOTO EXPERIENCE – How many years of

experience do you have working with webcam modeling, video, and/or photo medias?
a. 0-1 Years
b. 2-3 Years
c. 4-5 Years
d. 6-7 Years
e. 8-9 Years
f. 10+ Years
4. ONLYFANS AS SOLE SEX WORK INCOME – Is OnlyFans currently your only sex
work-related form of income?
a. Yes
b. No
5. OTHER CURRENT FORMS OF SEX WORK ENGAGED IN – What other forms of sex
work have you been in engaged in or are currently engaged in? (Mark as many that
apply)
a. Bar or casino-based work
b. BDSM or dominatrix-based work
c. Brothel or bathouse work
d. Escort services
e. Massage or massage parlor related work
f. Pornographic film performing
g. Street-based work
h. Sugar daddy/momma and sugar baby arrangements
i. Webcam modeling
j. Other – Please Specify [Open-Ended Text Box]
k. I choose not to answer
6. HOURS OF ONLYFANS LABOR – How many hours per week on average do you
engage in labor directly related to OnlyFans and your affiliated Twitter account (e.g.,
editing, creating, or planning content, interacting with followers/fans, other
administrative or platform-building labor)?
a. Range between 1 to 70 hours
7. THREATS, EXPLOITATION, OR ATTEMPTED FREEBIES SINCE JOINING

ONLYFANS A – Has anyone tried to threaten, exploit, or get freebies from you since
joining OnlyFans/Twitter?
a. Yes
b. No
8. THREATS, EXPLOITATION, OR ATTEMPTED FREEBIES SINCE JOINING

ONLYFANS B: OPTIONAL – Is there anything else you would like to share related to
threats, exploitation, and/or freebie via OnlyFans/Twitter?
9. CONNECTED TO SEX WORK ORGANIZATION A: BEFORE JOINING

ONLYFANS: Before joining OnlyFans, did you know how to connect to local sex
workers rights organizations that are led by sex workers?
a. Yes
b. No
10. CONNECTED TO SEX WORK ORGANIATION B: SINCE JOINING ONLYFANS:

Since joining OnlyFans, do you know how to connect to local sex workers rights
organizations that are led by sex workers?
a. Yes
b. No
Appendix D: Multidimensional Scale of Perceived Social Support
Instructions: We are interested in how you feel about the following statements. Read each
statement carefully. Indicate how you feel about each statement below.
Circle the “0” if you are providing No Answer

Circle the “1” if you Very Strongly Disagree
Circle the “2” if you Strongly Disagree
Circle the “3” if you Mildly Disagree
Circle the “4” if you are Neutral
Circle the “5” if you Mildly Agree
Circle the “6” if you Strongly Agree
Circle the “7” if you Very Strongly Agree
1. There is a special person who is around when I am in need. 0 1 2 3 4 5 6 7

2. There is a special person with whom I can share my joys and 0 1 2 3 4 5 6 7
sorrows.
3. My family really tries to help me. 0 1 2 3 4 5 6 7
4. I get the emotional help and support I need from my family. 0 1 2 3 4 5 6 7
5. I have a special person who is a real source of comfort to me. 0 1 2 3 4 5 6 7
6. My friends really try to help me. 0 1 2 3 4 5 6 7
7. I can count on my friends when things go wrong. 0 1 2 3 4 5 6 7
8. I can talk about my problems with my family. 0 1 2 3 4 5 6 7
9. I have friends with whom I can share my joys and sorrows. 0 1 2 3 4 5 6 7
10. There is a special person in my life who cares about my 0 1 2 3 4 5 6 7
feelings.
11. My family is willing to help me make decisions. 0 1 2 3 4 5 6 7
12. I can talk about my problems with my friends. 0 1 2 3 4 5 6 7
The items tended to divide into factor groups relating to the source of the social support, namely
family (Q: 3, 4, 8, 11), friends (Q: 6, 7, 9, 12), or significant other (Q: 1, 2, 5, 10).
Higher scores indicate higher levels of perceived social support for the respondents.
Appendix E: Rosenberg Self-Esteem Scale
(Rosenberg, 1965)
Instructions: Below is a list of statements dealing with your general feelings about yourself.
Please indicate how strongly you agree or disagree with each statement.
0 1 2 3 4
No Strongly Disagree Agree Strongly
Answer Disagree Agree
1. On the whole, I am satisfied with myself. O O O O O
2. At times I think I am no good at all. O O O O O
3. I feel that I have a number of good qualities. O O O O O
4. I am able to do things as well as most other O O O O O
people.
5. I feel I do not have much to be proud of. O O O O O
6. I certainly feel useless at times. O O O O O
7. I feel that I’m a person of worth, at least on an O O O O O
equal plane as others.
8. I wish I could have more respect for myself. O O O O O
9. All in all, I am inclined to feel that I am a O O O O O
failure.
10. I take a positive attitude toward myself. O O O O O
Scoring Items 2, 5, 6, 8, 9 are reverse scored. Give “Strongly Disagree” 4 point, “Disagree” 3
points, “Agree” 2 points, and “Strongly Agree” 1 points. Sum scores for all ten items. Scores
may range from 0 to 40.
Scores 0-20 are considered low self-esteem.

Scores 21-33 are considered normal self-esteem.
Scores 34-40 are considered high self-esteem.
Appendix F: Meaning in Life Questionnaire
(Steger, 2006)
Instructions: Please take a moment to think about what makes your life and existence feel
important and significant to you. Please respond to the following statements as truthfully and
accurately as you can, and also please remember that these are very subjective questions and that
there are no right or wrong answers. Please answer according to the scale below:
No Absolutely Mostly Somewhat Can’t Say Somewhat Mostly Absolutely

Answer Untrue Untrue Untrue True or False True True True
0 1 2 3 4 5 6 7
1. I understand my life’s meaning 0 1 2 3 4 5 6 7

2. I am looking for something that makes my life feel 0 1 2 3 4 5 6 7
meaningful.
3. I am always looking to find my life’s purpose. 0 1 2 3 4 5 6 7
4. My life has a clear sense of purpose. 0 1 2 3 4 5 6 7
5. I have a good sense of what makes my life meaningful. 0 1 2 3 4 5 6 7
6. I have discovered a satisfying life purpose. 0 1 2 3 4 5 6 7
7. I am always searching for something that makes my life feel 0 1 2 3 4 5 6 7
significant.
8. I am seeking a purpose or mission for my life. 0 1 2 3 4 5 6 7
9. My life has no clear purpose. 0 1 2 3 4 5 6 7
10. I am searching for meaning in my life. 0 1 2 3 4 5 6 7
MLQ consists of the Presence (1, 4, 5, 6, and 9-reverse-coded) and Search (2, 3, 7, 8, and 10)
subscales. Each subscale has scores that may range from 0 to 35.
Scoring above 24 on Presence and above 24 on Search indicates feeling that one’s life has a
valued meaning and purpose, while still openly exploring one’s meaning or purpose.
Scoring above 24 on Presence and below 24 on Search indicates feeling one’s life has a valued
meaning and purpose while not actively exploring the meaning or seeking meaning in one’s life.
Scoring below 24 on Presence and above 24 on Search indicates feeling that one’s life does not
have a valued meaning and purpose, while actively searching for meaning or purpose in one’s
life.
Scoring below 24 on Presence and below on Search indicates feeling that one’s life does not
have a valued meaning and purpose and not actively exploring this meaning or seeking meaning
in one’s life.
Appendix G: Open-Ended Questions for Thematic Analysis
Instructions: Please aim to type your response for at least 30 seconds. However, please feel free
to write as much as you want until you are satisfied with your response before proceeding.
1. Thinking back to when you first decided to join OnlyFans as a content creator, what motives
or goals did you have for joining?
2. Since joining OnlyFans as a content creator and promoting your account through Twitter, have
you noticed any changes in how you think of or relate to yourself?
3. How would you describe your overall experience with utilizing OnlyFans and Twitter?
4. How would you describe the culture on Twitter within the OnlyFans content creator and
follower/fan communities?
5. How has the COVID-19 pandemic and the need for social distancing influenced or impacted
how you utilize OnlyFans? Has it changed the way you work, market yourself, set your rate?
6. What do you want followers, fans, or clients to understand or to know about what it means for
you to be a sex worker?
7. OPTIONAL QUESTION: Thank you so much for taking this survey! Is there anything else
you would like to say about anything? Please comment below or feel free to proceed to the next
page.

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Running head: SEX WORKERS ON ONLYFANS

SEX WORKERS ON ONLYFANS: AN EXPLORATORY INVESTIGATION OF

SERVICES ACCESSIBILITY, PSYCHOSOCIAL INFLUENCES, AND ONLINE CULTURE

SUBMITTED TO THE FACULTY

THE GRADUATE SCHOOL OF APPLIED AND PROFESSIONAL PSYCHOLOGY

THE STATE UNIVERSITY OF NEW JERSEY

JAY N. BOSWORTH, PSY.M.

IN PARTIAL FULFILLMENT OF THE

REQUIREMENTS FOR THE DEGREE

NEW BRUNSWICK, NEW JERSEY AUGUST 2022

Nicole Cain, Ph.D.

effective clinician, supervisor, and educator as you are.

my professional identity as a psychologist.

am extremely lucky to be in the presence of such brilliant colleagues; your understanding of

through your wisdom and feedback.

I. INTRODUCTION AND REVIEW OF THE LITERATURE

III. RESULTS ................................................................................................................... 111

IV. DISCUSSION ............................................................................................................. 156

V. CONCLUSION ............................................................................................................ 195

VI. TABLES .................................................................................................................... 205

VII. FIGURES .................................................................................................................. 227

VIII. REFERENCES........................................................................................................ 228

IX. APPENDICES ............................................................................................................ 260

Chapter I: Introduction and Review of the Literature

daddy/momma/baby arrangements), or exclusively through online or mobile technology (e.g.,

delegitimized and devalued because it is an expression of desire within private relationships

principles, but they are not universal) (Zatz, 1997).

integration and normalization on other social media platforms, especially Twitter.com,

research study seeks to address four main questions:

online sex workers.

accessibility and reducing societal discrimination is addressed. Third, a review of the

men as an under-researched sex worker subpopulations is provided. Fourth, it is explained what

constructed and how sexuality is marketed on social media.

Review of the Literature

OnlyFans stands on the shoulders of predominantly cisgender women throughout history

positions of power within governments and organized religious orders.

transgender performers entertained the general public with various acts.

the profession in any material sense.

regulation of London’s brothels under stipulations such as prohibiting forced prostitution,

allowing weekly searches by constables, mandated closings on holidays, and prohibiting

evil root and branch” (Rossiaud, 1988).

large stones around public spaces (Ringdal, 2004).

example, Massachusetts’ colonial assembly enacted a law against nightwalking in 1699,

law enforcement was generally lax.

formed in response to the majority of prostitutes working in lower-class neighborhoods. The

supremacy. As many Chinese women immigrants were prostitutes or second wives in

young girls by men-seducers. Specifically, as women reformers adopted prostitution reform in

as simply being the way things have always been.

actual sexual acts (Carter, 2001).

(University of Minnesota: University Libraries, 2003). Regardless of the propaganda against

liberty to have an abortion without excessive government restriction (Grady, 2018).

Prostitutes’ Education Network explains that:

for many women, because of poverty and lack of alternatives,

(Prostitute Union of Massachusetts Association); DOLPHIN (Dump Obsolete Laws; Prove

Hypocrisy Isn’t Necessary); PASSION (Professional Association Seeking Sexual Identification

ideology and reasoning behind their goals include:

4. Criminalizing prostitution has driven the profession underground and resulted in

5. Antiprostitution [sic] laws function as a form of censorship against women, because

administration positioned feminists as humorless, hairy-legged, bra-burning, lonely, man-hating

coincidentally, not the men who purchase sex.

California voted 63.51% against decriminalizing prostitution whereas Churchill County in

sex workers through decriminalization and resource allocations.