Experiences of U.S. Transgender/Nonbinary Young Adults Doing Online Sex Work: An Occupational Health Perspective

Online sexual services, like livestreaming and sexual content creation, are common forms of sex work - yet little is known about the occupational health of workers providing these services. There is a particular need for research with transgender/nonbinary (TNB) online sex workers, who may face distinctive marginalization-related challenges. We conducted semi-structured interviews with 14 U.S.-based TNB young adults, ages 22-30 years, who had done online sex work. We triangulated interview data through focus groups with 17 participants who were clinicians and/or advocates working with TNB people and/or sex workers. Using thematic analysis, we developed five themes addressing positive dynamics in online sex work: Skill and career development, artistry and craft, social connection, self-exploration, and promoting healthier sexual norms. We also developed six themes addressing stressful dynamics: Sexual stereotypes and market pressures, negative viewer and customer interactions, conflict and exploitation, volatility in engagement and earnings, restrictive rules and opaque enforcement, and sex work stigma. Finally, we developed two themes addressing protective factors: Financial and housing stability and longer-term sex work experience. Results point to the importance of recognizing the diversity of TNB young adults' online sex work experiences, opposing restrictive laws and policies, and advocating for social safety net programs.