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I suspect there's high mental illness in sex work not because sex work causes mental illness, but because sex work is more likely to be performed by people who are willing to go 'against the grain' for money - common in poverty, poor support networks, or general life difficulty.
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I remember a Scandinavian study showing a higher prevalence of mental disorders in sex workers compared to the background population before they entered the sex work, followed by an increase in mental health issues.
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