"Listen to Us!" Performers, Advocates Speak Out on Mental Health, Self-Care

The following article touches on issues related to depression, anxiety and addiction. Certain topics of discussion may be triggering.

At the 2019 XBIZ Awards this January, host Stormy Daniels was carried to the stage atop a glittering palanquin held by gay porn studs in jock straps and attended by a phalanx of drag queen nuns — nonprofit activist organization The Sisters of Perpetual Indulgence.

Daniels took the stage in a deep blue gown, jewels sparkling, blonde tresses aglow in the spotlight. The ballroom was packed with adult’s best and brightest. They applauded and cheered as she began her opening monologue and paid tribute to the night’s honorees. And then she came to a moment in her speech that brought the clamor of the crowd down to a low hush:

“In a year when sex workers were turned into political props — you may have seen my own name in a headline or two? — and in a year when the adult industry came under attack, yet again, from politicians who can’t quite seem to grasp the concept of free speech, we continued to innovate,” she said. “We kept pushing the national conversation on vital issues, from consent and personal agency, to social media etiquette and individual responsibility. We don’t always get it right, but we get it started. Tonight, we celebrate. But in the days and weeks to come, let’s remember to continue to honor each other. Let’s remember we all belong to the same family; a rising tide lifts all ships. We won’t always agree with each other. But when one of us wins, we all win.”

Earlier that week at the XBIZ L.A. tradeshow, a standing-room-only crowd attended a panel on consent. And it was the performers themselves who voiced their questions and concerns, their fears and their wish list for best practices among their industry colleagues. Time and again, XBIZ heard performers echo Daniels’ words and repeat the concerns voiced in the XBIZ L.A. panels: “Listen to us,” they said.

We’re taking their advice.

XBIZ reached out to industry advocates from various sectors and asked them to talk about mental health and self-care among performers. The conversations were often emotionally raw. There was genuine concern that fans and industry colleagues alike would not want such emotionally fraught topics to potentially spoil their sex-doll fantasies. But as XBIZ prepared this issue to go to print, the news began to circulate of the sudden, shocking death of yet another performer, not yet 30 years old. It is impossible to know what the industry could have done to help them. But the tragic news underscored the pressing importance of this conversation. We’re listening. And so should you.

Stigma

“This is a massive issue in our business, yet no one is talking about it.”

Jessica Drake was frank and direct in her wish to point her interview in a forward-thinking direction. She immediately set about explaining how she felt these issues should be framed.

“The first thing we can do is to start talking about mental health more openly, minus the stigma or labels that can sometimes come with it,” she said. “We cannot call people ‘crazy’ or ‘unstable’ or ‘bipolar’ as insults. We have to understand that this is something that can impact people regardless of who they are or what they do for a living. We need to do this as an entire industry, not solely performers.”

Drake stressed that directors, producers and agents should also be a part of the discussion. “If a director notices something on set, they should ask about it. If an agent knows that someone is having a hard time, or someone is canceling work and taking a mental health day, that needs to be okay. We also need to stand up for one another. If we have knowledge about a situation no one else has that may be used to intervene and save someone’s life, I feel like we should do whatever it takes.”

Casey Calvert echoed the frustrations of many of her colleagues over the opprobrium that often accompanies sex work — from civilians and the media, even fans and industry colleagues. “You should talk about the stigma,” she said. “Every entertainment industry is full of slightly broken people, and porn is no different. It has to be okay for people to talk about their issues without fear of losing all their work. Too many producers and directors have a very old-school idea about how to deal with mental health issues. One wrong word overheard on set about seeing a therapist, taking meds or having some personal issues, and you could quickly find yourself losing work and gaining a reputation for being ‘crazy.’ That has to change.”

Stigma is also a top concern for Ginger Banks. “Talking about how the stigma affects the mental health of performers is important,” she said. “I wish people were more aware of the ways they speak about sex work. When I hear people saying negative things about sex workers it can negatively affect my mental health.”

Lotus Lain’s advocacy work with the Free Speech Coalition provides an open channel to the worries and concerns of her fellow performers. “The most common thing I still hear is that some performers are afraid to speak up in person when they feel uncomfortable,” she said. “Some are afraid to out someone for bad behavior for fear of being blacklisted. And most performers feel that there is still no central place to report grievances of bad on-set behavior.”

The emotional toll of that stigma is a serious point of concern for Missy Martinez. “It is mentally taxing to be viewed often just as a commodity instead of a human being with thoughts, emotions, stressors and bad days. Just because we wear less clothes at our job doesn’t make us exempt from the day-to-day mental and emotional wear and tear of adulthood.”

Lena Paul is passionate about lifting awareness among her fellow performers, as well as fans, about the emotional burden of sex work. “I think the biggest thing I want colleagues and fans alike to know is the cost of this job,” she said. “Mental health while active in the business matters greatly, but I also want performers to think about their mental health after the business and that’s directly tied to how well they plan for their future during their tenure here. Sex work is like playing sports, you come in for a brief couple of years, generally speaking, and you try to get as much done for yourself in that short time span.”

Riley Reyes, through her work with the Adult Performers Advocacy Committee (APAC) — like Lain and the FSC, Alana Evans through her advocacy with Adult Performers Actors Guild (APAG), and others — has seen the effects of untreated, unacknowledged suffering. And she is vehement in her desire to effect change for the better for her colleagues across the industry. “The biggest threat sex workers face to our mental health is stigma. Most problems performers face lead back to that. Working in a stigmatized profession can lead to loss of housing, banking and even the support of our own families,” she said. “The judgment and shame heaped on us by society can be an incredibly isolating force. It’s easy to forget that, while many fans idolize us, many other people demonize us. And neither is accurate.”

Lianne Young is a former adult performer, retired for eighteen years, who works with the Metropolitan Police Sexual Violence Unit in London. Through APAG, she offers free counseling to current and former adult industry performers.

“Every performer should be registered, or at least be made aware of APAG, who work worldwide and can provide an emergency support network outside of regular working hours,” she said. “It’s off the (film) set when performers are most vulnerable and likely to suffer emotional lows.”

Young, also known as “Billie Britt” during her time as a performer, advocates frank discussion with newcomers. “There is a bad side to the industry and this needs to be acknowledged and explained to new workers entering the industry. What I feel needs to change is production companies need to start supporting the union and develop an open and honest relationship with them, not see them as people interfering between them and their performers.”

Mistress Mila Von Mayhem is a domme and clip artist who advocates for increased protections within the industry for its performers. “I wish I saw more conversations about warning signs to look out for when it comes to abusive and manipulative behavior,” she said. “I feel like the industry is getting better about speaking out about blatantly violent acts and sexual assault — as it damn well should be. But we forget how insidious these things can be.”

She cites “shitty boyfriends and managers, shady agents and mentors,” as well as “anyone else who tells you their way is the only way to be successful, that there’s something inherently wrong with you or that you shouldn’t talk to anyone but them about your job. If these kinds of people were obvious, no one would fall for it: the ones that try to break your self-esteem down. These people seek out inexperienced performers,” she said. “Anything that you would witness in an actual abusive relationship can also happen in a business relationship.”

Romi Rain has observed the punishing effects on models who feel the pressure to compete.

“There’s still an awful lot of body shaming within the industry, in particular from performers and even some folks behind the scenes,” she told XBIZ. “So many people are already against porn we really should be supporting each other, given our shared experiences. We should never forget how brave every single one of us is to expose ourselves to such a degree. There is room for absolutely everyone in porn. Desire is literally a matter of personal preference! If we were generally kinder and more understanding to each other’s personal feelings the adult industry — every industry, really — would be much better off.”

Drake returns to the pressing concerns of the mental costs of the stigma faced by sex workers and adult industry performers.

“Suicide is a topic we need to cover,” she said. “We can’t keep taking a soft approach because we’re scared or it feels awkward to handle. I feel like we also need to talk harm reduction, because sometimes people self-medicate depression or anxiety or a slew of other emotions with drugs or alcohol.”

Drake knows that self-medication isn’t specific to the adult industry. But the daily pressures faced by members of the adult industry are unique.

“It’s hard. I think often the perception of sex work is that we party and have orgies all the time, and all we do for work is have sex — just lay on our backs and get paid — when it can’t be further from the truth,” she said. “In order to make it in the industry, we have to work so hard: book jobs, do scenes, memorize dialogue, buy our own wardrobe and supplies, market ourselves via social media where we are bombarded by fans who think we should answer every message, send nudes and be accessible 24/7. Plus, many of us travel, and that’s certainly not the glamorous thing some may imagine it to be. Some of us produce our own content and run our own websites and that takes another level of skill.”

Layered atop all of the typical career pressures is the stigma attached to this work: “At the end of the day, no matter how accepting mainstream purports to be, there are banks that are closing our accounts, exes that take custody of children because a judge may rule in favor of the parent who doesn’t do porn, landlords who won’t rent to us, jobs outside of the industry that fire us when our other job is discovered and so on. Couple that with societal beauty standards, and a side of misogyny, and it’s just…” She drifts off for a moment. “It’s just hard.”

Resources and Solutions

Kristel Penn, the marketing and editorial director for trans powerhouse Grooby Productions, decided to pursue a master’s degree in counseling and apply it to her daily work. “Mental health is of personal importance to me and I think the framework I’m learning in school is applicable to our industry and can help with its sustainability,” she told XBIZ. “We are in a business where our product involves the bodies of our performers and thus should be held with reverence. If industries outside of porn can value the mental health and happiness of their employees, we absolutely have a responsibility to do the same in our communities.”

Penn has words of advice for adult industry advocates who are not on-camera. “I think it’s important to remember that people enter the industry for a variety of reasons and come from a variety of different backgrounds. While people in our industry may be more susceptible to certain stresses and areas of concern, like depression or anxiety, I caution from making blanket assumptions about why,” she notes. “Non-performers, like myself, should practice being allies and advocates for sex workers while being very aware of the space we take up and should uplift the voices of sex workers themselves.”

She is keenly aware that an industry as vast as adult entertainment, with a wildly diverse talent pool, cannot be covered by a one-size-fits-all solution. “I’d like to see companies contribute resources, financial or otherwise, to help create more access to intersectional — this is also key — sex-worker-affirming mental health services for our performers. It is (crucial), first of all, that any professionals we send our performers to are sex-worker-affirming, but we also want to make sure performers are seen,” Penn said. “We all hold multiple identities, often with both marginalization and privilege, and it is important that people working in our community understand that.”

Further, “companies who say they want to help need to follow through in concrete ways rather than just pay lip service to this ongoing discussion. At this point, good intentions are not enough. We need action and we needed it yesterday.”

Penn, performer-activist Buck Angel and Grooby’s Steven Grooby have created the Trans Adult Industry Foundation (TAIF) to support the unique needs of trans performers. “We created our organization as a conduit to allocate resources that make sense for the trans community, keeping in mind that transgender individuals face a disproportionately high percentage of violence and discrimination compared to other groups,” she said.

Additionally, she notes, “I think we all need to do our due diligence when examining mental health resources being made available to our industry. We shouldn’t immediately assume an organization is sex-worker-affirming just because they say they are. We do not have to accept every opportunity being handed to us. It is our right to ask questions and keep on asking them if something about it feels uneasy.”

Protecting the mental health of our performers is “an ongoing task,” said Leya Tanit, the founder and president of Pineapple Support. “But I think with the current movement to end the stigma around ill mental health and providing talent the educational resources to better understand it and the adult industry, we are definitely on the right path.”

She notes the “growing number” of companies and studios who have thrown resources behind Pineapple Support, which recently marked the first anniversary of its mission to connect performers and sex workers with vital mental health resources. “I think as a whole, the industry is starting to take action to improve the well-being of their performers,” she said. “Many studios have implemented more in-depth policies for on set, cam sites are paying attention to the problems with online bullying.”

Tanit believes new performers, particularly those entering the industry through camming and self-generated content production, underestimate the inherent pressures of a career that requires them to shoulder work that would typically be shared by numerous people: pre-production, post-production, publicity, scheduling, money management and more.

“I don’t think people understand just how much work it takes to be successful in this industry,” she said. “Particularly when you are starting out as an indie performer. You are a one-man band and need many skill sets. From public relations, social media and video editing to costume design, performers work really damn hard and as with any business, particularly in entertainment, it takes some serious man-hours and a lot of blood, sweat and tears to make it a full-time career.”

The stigma unfairly attached to an adult entertainment career, and a lack of affordable, readily accessible mental health resources, are added burdens.

“The problem I hear about most is online bullying,” observed Tanit. “Mostly peer-to-peer, which is just heartbreaking. We are a stigmatized group of individuals who need to stick together and lift each other up rather than tear each other down. Competition in the industry is fierce and emotions can run high. It’s easy to lash out at someone when you yourself are feeling targeted or vulnerable. Be the person to stop the cycle. Start spreading the love. Let kindness be the new cool.”

Rain is a proponent of calling out abuse when she sees it. “Telling people where the trash is makes it easier to take it out,” she said.

She also warns against burnout. “It’s very important for a performer to be honest and speak up when they need a break from shooting or private time for their own well-being. Never forget your health needs to come first! I know very few people in this industry that don’t have at least one story they want to share so even if all we can do is listen, we should. Bottom line: we just need to respect each other.”

Director Jacky St. James believes it is time for companies and agencies to step up their level of responsibility. “Providing resources is imperative but it’s not the only solution,” she told XBIZ. “I’ve heard so many complaints from performers about their general safety and that is something that needs to be enforced — not just on the production level but on the agency level.”

St. James is direct about what needs to be done right now: “We need to support the studios that practice safe business practices and stop sending talent to companies that are known for unsafe and unethical business practices. We have to stop making this just about the bottom line and actually be ethical human beings here.”

She is committed to a work environment that prioritizes the mental health and safety of its performers, and angered by the notion that any performer would harbor concerns over turning down a job for fear of losing future work. “A lot of performers have shared that they say ‘yes’ only to make sure their agent doesn’t get mad,” she said. “The talent needs to be empowered to take control of their careers without fear of being punished for saying ‘no.’ Performers, agents and producers need to have open communication so that nothing is a surprise the day of a shoot. The talent needs to be able to [approve] what they are doing the day of the shoot and not rely solely on their agents to answer for them because, sadly, sometimes things are lost in translation or not communicated accurately.”

She dismisses a common counter-argument. “A lot of people worry that empowering performers will create bigger issues, more cancellations and greater problems. I disagree. The more control performers have over their careers, the more excited they will be about the projects they are involved in because they had a hand in the decision-making process.”

St. James re-emphasized the need to foster a supportive work environment. “We really need to take greater care in ensuring that performers want to go to work by creating an environment they want to work in. For agents, that means not sending talent to producers that abuse or mistreat talent. For producers and directors, it is about creating a safe environment for all talent on set and making sure that everyone approves of the content they are shooting and the talent they are shooting with.”

Kayden Kross echoes the sentiments of St. James and her colleagues. “Mental health is not a sector that any one industry or government or group has ever really gotten a firm and effective grip on,” she told XBIZ. “That said, I think improvements are made with concerted efforts on the part of agents, production companies, fellow talent and crew on set. Those who know what an individual performer’s baseline looks like are more likely to notice a change, and I think agents have a huge responsibility here.”

Kross believes everyone shares a level of responsibility. “From the outset, I believe there is also a responsibility to not steer potential performers toward the work in the first place if there is concern about mental health. On the part of directors, crew members and scene partners, I think we need to be able to recognize discomfort early and leave space to address it,” she said. “Production companies need to have policies in place that make the crew feel like the product does not come before the people in it. Ultimately though, the change is not going to be a policy — it will be a culture that fosters communication and understanding.”

She described “an extreme amount of psychic weight put on a director, for lack of a better term.”

The pressure, for a director, can be intense. “We’re all prancing around with our delicate egos and personal hang-ups and ideas about ourselves, and when we trust a director to shoot us we are putting on loan that very fragile, very muddy thing,” she said. “A director should do their best to hand the thing back to the performer in better condition than when it was handed to them at the beginning of the day, and if it is not returned in good condition, the director has failed in a key way.”

The pressures inherent in directing have been on Casey Calvert’s mind as she steps behind the camera for the first time for Gamma Entertainment. “This is a complex problem with no easy answers,” she admits. “One thing would be to introduce some actual barriers to entry for the adult industry, or, at the very least, education. The people coming into the business at 18- or 19-years-old often have very little actual life experience, and a somewhat unrealistic idea of how the real world will react to their new life as a porn performer. APAC has followed the mold originated by Sharon Mitchell at Adult Industry Medical by educating new performers getting into the business, but the agents should really be leaning into this. They are often the first point of contact, and first line of defense for new talent, and they should be involved in advising and evaluating prospective talent before they put themselves and their bodies on the internet forever.”

Calvert remains frustrated by how the glamorous aspects of adult entertainment obscure its potential cost.

“Porn can be a lot of fun,” she said. “But it’s a job and sometimes it’s not easy. Every performer has had to work with people they aren’t attracted to, or who they might not like much. We’ve all had to do scenes we find silly or frustrating or difficult. That’s why it’s a job! They pay us to do it because we’re professionals, and our job is to make you believe we want to be there more than anything else in the world, every single time. Some days it’s really easy, and some days it’s tough, but that’s what we get paid to do.”

The nature of the job itself is often a barrier to understanding and empathy. “Just because it’s sex, and just because we might be having sex we don’t want to have, doesn’t mean we’re being abused or exploited; no one enjoys working the fryer at Burger King, and when they bitch about their job, everyone nods and says, ‘Yeah, that sucks!’ If we bitch about our jobs, it’s political because we’re exchanging body fluids. I’d love to be able to just let off steam about a bad day at work once in a while without it becoming melodramatic.”

Lotus Lain expressed gratitude for companies that have boosted the efforts of Pineapple Support and the Free Speech Coalition (FSC), which recently launched the Inspire Program, a performer-created resource designed to provide guidance and support to adult industry newcomers.

“When I joined FSC I was given the resources and the influence to create something like Inspire,” she said. “On my own, I wouldn’t have had the reach, so I’m really grateful for my position there. Through FSC, I am able to reach out to a wide range of performers and include their voices, not just my own.”

The FSC’s membership includes access to the NexGen benefits program, which provides crucial assistance in a variety of ways, including “really important discounts to providers of legal assistance, such as free consultation, agency contract negotiations, living will and trusts, legal name change procedures, 24/7 Teladoc services, so you can have symptoms diagnosed over the phone, and dental discounts so procedures that would normally cost thousands of dollars get reduced,” she said. “I’ve used them a couple of times for legal advice and medical questions and they are immensely helpful, kind and remarkably responsive. I got substantial legal advice within an hour of calling the line.”

Lain wants every performer, not just newcomers, to know they have help available to them. “It’s really wonderful the amount of benefits we can access that can give any of us that are going through something the ability to feel more empowered and on top of our own affairs, while saving money — which also leads to peace of mind and a healthier mental state,” she said.

Beyond taking advantage of existing benefits, her colleagues “can always be more mindful of how they speak and interact with each other online,” Lain said. “We can also ask that more production companies do more proactively to help performers and directors have a good experience. For example, an aftercare checkup for performers that have had a really hardcore scene,” whether in the form of a phone call, an email or a post-scene interview when the performer is still on the set. Such steps “can help a performer feel like they’re being heard, listened to and cared about,” said Lain. “It can also give the director peace of mind as well as feedback or insight on how to improve future performers’ experiences.

Lain is also an advocate of anonymous assessments or surveys. “Performers could give feedback of how the atmosphere on set was for them (and) say how they felt about the director or if they felt comfortable, listened to and if they’d return to that set.”

Alana Evans, through APAG, shares Lain’s concern that too few performers realize there is help available to them.

“I think a lot of people who aren’t familiar with (APAG) wonder what we do, or why they don’t know about us,” she told XBIZ. “Getting a union off of the ground in an industry that has never been organized has been an incredible task and a learning experience. With a constant influx of performers, staying ahead of the curve isn’t always easy.”

She described APAG as “a resource and ally for our workers,” including cam models, clips artists and phone sex operators. “We help with agency contract issues and legal assistance when performers file claims of on-set abuse. We help performers procure health insurance and offer peer support on a personalized level. We also fight against performer discrimination, from legislation support to legal battles. We work to make sure testing protocols follow performers’ interests and safety.”

Riley Reyes emphasized the Performer Bill of Rights and Performer Code of Conduct drafted by APAC.

“Behaving in a respectful and ethical fashion, to create a better industry and community, will improve the mental health of everyone on set, performer or not,” she said. “If someone is struggling with mental health, don’t just label them as a ‘trainwreck’ or dismiss them as a lost cause. Treat them with some empathy. It could save a life.”

Many performers, Reyes said, may reach out for help from a therapist who will judge or shame them for their work. “A lot of sex workers worry about seeking mental health support, because they fear stigmatization at the hands of their therapist. It’s hard to be vulnerable with someone when you can tell they disapprove of your job. In fact, many therapists will actively try to steer sex workers into quitting the business, as opposed to focusing on the mental and emotional struggles that led them to therapy in the first place. I don’t want someone telling me to quit my occupation: I want someone to treat my depression!”

Reyes and her colleagues at APAC have sought out solutions to this particular concern. “APAC has a directory of industry-friendly professionals in the resources section of our website. This directory includes mental health care providers. If a performer needs professional therapeutic support, they may consult the directory. Or if they would like to nominate their own therapist to be listed, they can email us.”

Joy Hoover, the president and founder of The Cupcake Girls, shares a similar mission to the FSC, APAC, APAG and Pineapple Support. Their starting point is to consider each client as a unique individual.

“As with any industry, if we want to see a change, often the very best place to begin is by listening,” Hoover told XBIZ. “To continue breaking the stigma of mental health, we need to be willing to hear each person’s unique story instead of lumping them into statistics. Every single one of us as humans comes complete with our own set of needs, obstacles, and strengths. In particular, what we’re hearing from our clients is a desire to see more people empowering the performers to have agency over what type of work they do and setting them up for success in several ways. Through this empowerment, we are fighting to break the stigma and marginalization and build inclusion between the square and adult communities.”

Hoover returns to the pressing need to listen to performers. “Break the stigma. Many performers don’t always feel comfortable discussing with others what they do, and this can inhibit anything from receiving healthcare to getting taxes done,” she said. “Performers should be heard, and it is important to be listened to. It is also important to use a performer’s preferred pronouns and terms for their role in the industry. This kind of communication is called ‘person-centered language’ and these are a few ways to break the stigma and help performers feel comfortable communicating.”

She notes another common concern over boundaries. “Boundaries are real and all boundaries need to be respected. A job is a job, and no one should be allowed to touch you without consent, period. In this industry, it is important to respect people’s boundaries and stand up for others. When you see something, say something and do something.”

Ginger Banks touts the idea of “small communities within the industry” that could be promoted and encouraged. “In my opinion the isolation from this job is one of the hardest parts of it. I think empowerment seminars teaching performers on how to handle the negative things that go along with the stigma surrounding our job could also help in the long run,” she said. “Encouraging sobriety within the community would have a lot of benefits as well.”

Missy Martinez visualizes several immediate steps that could be taken by the industry to promote stronger mental health.

“Comprehensive support groups for mental health are vital for our community,” she said. “The hardest part of implementing such an infrastructure would be making it impartial and not tied to a specific company or organization with monetary ties to the porn industry. A small yet hugely important step that can be taken immediately is simply by sending the script to the talent before the shoot. There can be trigger words or scenarios in scripts that might cause anxiety, panic attacks or even PTSD to flare up. We don’t always know what a person has been through in his or her life, and a small courtesy, such as a simple preview of the script, can help prevent a potential mental health issue.”

Lena Paul offers frank advice to her colleagues. “Some sex workers come in and play smart and exit the industry having set themselves up for a future — using their earnings to continue their education in other fields, investing their money or transferring into the backend management side of the business,” she said. “However, others do not do as well with their post-porn planning.”

Post-adult planning can help a performer avoid numerous pitfalls. “We all have the horror story of watching a top-billed star go from a comfortable lifestyle to homelessness and bankruptcy, which can have tremendous impact on your mental health,” she said. “To some degree, like athletes, the level of success you manage to achieve with what you earn in porn often has to do with the socioeconomic training and background you had before porn. We wind up suffering immense discrimination for our past in this business. We acknowledge that a lot of doors will be closed in our face. Even though the cultural attitudes are shifting, we are seen as lesser humans. There are no benefits in porn, no 401k. On many production sites, not even workers’ comp is available. This should be sobering to all performers. You are one bad car wreck away from poverty and discrimination, or alternatively you are one good savings plan away from a comfortable life.”

Mental health, Paul notes, is “not an abstract concept. In addition to genetics and life history, it’s also tied to very practical quality-of-life concerns.”

She recalls her first weeks and months in adult as “completely different” from her perspective as an established star “with insider information and options.” Information is key.

“Lack of resources and knowledge makes new performers especially vulnerable to being taken advantage of,” she said. “We often see young girls with tremendous potential come into the industry and be booked twenty-plus days a month of extremely taxing labor — with advanced scenes like hard anal and not enough recovery time — by unscrupulous agents who only care about their bottom line, who then turn around and complain when these young girls start cancelling shoots because they’re physically sick and overwhelmed by their first real job. We see them encouraged to accept the advances of studio heads and directors at the behest of some of these agents, or simply because they feel they can’t risk incurring that powerful person’s ire and lose out on bookings. We watch them later as they crash and burn on a social media blowup, then shake our heads and have the audacity to call the girl ‘crazy’ for finally cracking under immense pressure for teenagers or barely twentysomethings. This isn’t histrionics; this is, in many cases, mild PTSD. The inhumane way we treat other’s trauma as a joke or an excuse for a Twitter pile-on is unacceptable. We need to do better and it starts at an individual level.”

Don’t participate in a social media pile-on, “as tempting as they might be,” she advises. Systemic change, Paul said, involves “senior girls in agencies protecting and watching out for the newcomers. It involves agents looking at girls as long-term investments instead of short-term cash cows. We have to create real job training resources for these young women and decentralize that trove of information to help performers make fully informed decisions about their health, career and finances even if they have the misfortune, as I did, of starting in the business with a shady suitcase pimp agent who didn’t want me making informed decisions.”

Mistress Mila Von Mayhem shares the concern over social media pressures. “I think sometimes people forget that you don’t usually see the bad days on social media. Not everyone is comfortable being raw and real with their fans and that’s okay,” she said. “The downside to this is (when) you are going through something hard and you spend your time on social media thinking everything is better everywhere and you are alone in your distress and pain. We are all human. We all struggle in our own way and that is normal and okay.”

Mayhem returns to the “emotional labor” a job in adult entertainment requires. “I wish the fans knew just how much they ask of us. If I answered every single message, I would never have time to do anything else in the day. Even well-intentioned fans can forget that I don’t just do this for fun. It’s my career and I expect to be compensated for my time. Why is my time less important? Set boundaries for yourself and don’t allow others to break them.”

Advice

“I’ve always been a fan of therapy,” said Drake, “through times in my life when things are great, and also, more recently, in crisis. The key is finding someone you vibe with and that’s tougher to do when you’re in the thick of things. I personally strive to be as honest and open as I can with my therapist without worrying about being judged. If you can’t open up or don’t trust that person, find another one. We have a fairly large network of therapists that help sex workers, porn performers, the LGTBQIA community, people into kink, you name it.”

Otherwise, she notes, “I meditate, I do dance class and another class I found that’s an intense cardio and emotional workout. I get outside. I take my dogs to the dog park. I read. I spend time learning new things — whether that means watching tutorials, taking online classes, going to conferences, workshops, anything. I also volunteer with a few local organizations, because when I’m doing things for other people, it gets me out of my own head. As hard as I work in the industry, I always try to have friends and interests that have nothing to do with it, too. I have learned that when I am not okay, I have to say I’m not okay.”

Tanit emphasizes “self-care and remembering to take time for you, to be you.”

“As a performer, it is so easy to forget to take time for yourself, with camming and social media, performers become therapists and friends to their fans,” she said. “It is so important to set emotional boundaries for yourself, to know when to step back and separate yourself from the situation. Taking at least an hour a day to do something you love, without your phone or using social media, be it taking your dog for a walk, going to the gym, painting or drawing. Having that time to relax and reflect is so important to keeping a healthy mind.”

Rain relies on her “maintenance days.”

“I really enjoy my peace so when I’m not working I always try to take time for myself,” she notes. “I’m taking care of my body, primping, polishing and resting for days I am full steam ahead. It’s definitely important to let loose but I don’t think it’s the best idea to mix too much business with pleasure. It’s vital to maintain a semblance of privacy.”

For self-care, Rain recommends turning off the phone "for a few hours" besides meditation, exercise, proper sleep and "time with friends doing nonsexual things. It's important to remember that we are not show ponies and deserve a rest and relaxation, whatever that means to us."

Rain has concrete advice for performers when they are actively filming. "I think it’s important to bring up on-set hygiene regarding locations, productions and crews," she said. "Every so often a set won't have any of their own sanitation products, towels, clean sheets and blankets or anything to clean surface areas they tell performers to use. It’s not just productions to blame; shoot locations and houses we rent out should be held to a higher standard.”

She recommends performers pack a "set bag" with their own personal cleaning products. "It is important to always have a small package of your own baby wipes, sanitizing wipes, hydrogen peroxide or iodine for douches, and shower products like Hibiclens to use after most scenes, especially if you are having sex on floors, in gyms or outside," she said. "Your body being well is everything in our work and it’s important to take pride in it."

A focus on physical health and meditation are essential, notes both Banks and St. James. “One should never neglect their health — both physically and mentally. Find people you can trust and feel safe confiding in,” said St. James. “Sometimes it helps to speak to somebody with more industry experience who can offer sound, sage advice from having been in this business and seen the ups-and-downs. It’s important to surround yourself with positive influences not negative ones.”

Young emphasizes her “focus” during her time in adult entertainment. “It started with a dream and some passion. I knew I had the skills to make money from the world’s biggest industry, I knew sex sold everything. I began by writing a two-year business plan covering finances and marketing and I made a start. It really was that simple.”

However, eighteen years ago, the industry was markedly different. “It was pre-internet. The salary was very attractive, some weeks I easily made $10,000 depending on what, or when, I chose to work. Did my business plan work? You bet it did. Did I sleep myself to the top of my workplace? Damn right I did! I was supposed to!”

Young also made the choice to undergo “intense therapy” when she was 30 years old. “Not because of having been a porn actress, but because of some people who had tried to destroy me with their beliefs of how I should have been living,” she recalls. “I had to suffer mental and emotional abuse because I put myself and my own needs first, and not theirs. Everyone has a right to be themselves. My advice? It is perfectly normal to seek help, just as it is healthy to go to the dentist every six months. You need to keep a check in with yourself and do it regularly.”

Finally, she urges performers to take full advantage of the resources available to them. “Get equipped with the right contacts, unions and support network that will cover both your physical and mental health,” she said. “And stay away from drugs and any other addiction you can’t control. Your body is your income — use it wisely.”

Penn notes that “big-picture stuff can be overwhelming,” and advises creating “small, concrete goals to get through the day. Break up tasks in manageable chunks. Most important, however, is to be kind to yourself when you can’t complete a task. For example, if you are having a hard time leaving the house due to depression, set smaller goals for yourself like, ‘Today, I will leave my bed,’ and if you are successful, tomorrow’s goal can be to take a shower, and so forth. Then let’s say you are unable to take a shower, remind yourself it’s okay and that you can try again tomorrow.”

She observes that “isolation plays all kinds of dirty tricks on your mind,” and recommends adopting a buddy system for support in the form of a therapist, a friend, a family member. “Or, even better,” Penn notes, “multiple buddies.”

Seth Gamble urges rigorous “self-awareness.”

“I’m a recovering alcoholic and an addict. I don’t make it a private thing,” he told XBIZ. “Having the platform that I do, and what I’ve built for myself in my career, I feel like showing people that you can come from a very painful place in your life, and come from something you don’t feel like you have any control over, and get past it and overcome it, is something that would be helpful for other people to see.”

He relies on a variety of self-care tools, from a daily gratitude journal — “It really works! Because then my perspective is ‘I’m grateful’ and not stuff that attacks my ego or my pride that aren’t necessary or don’t serve me” — to staying active in the gym to self-improvement books and the tenets of a 12-Step Program. All of these tools help Gamble separate his self-esteem and self-worth from the gnawing doubts and insecurities that can plague any performer.

“I learned from making mistakes. I deal with an addictive personality on a day-to-day basis. Because of that, throughout my life, I’ve used those alluring, addictive things as validation for my own mental health,” he notes. “And once everything was quiet, and nothing was happening, I didn’t feel good about myself. In order to start feeling good about me, I had to start appreciating what I do have, thinking outside myself, building a brand and making that a part of me, but not who I am.”

Gamble agrees that separating his porn life from his daily life is an essential tool for self-care. “‘Seth Gamble’ is a brand I represent,” he said. “And I have to make that brand a sellable brand by promoting something to other people who find me alluring. But I don’t attach that to me, personally. If I attached that to me personally, I would be an egotistical, arrogant fucker, you know what I mean?”

He acknowledges the challenges of building and maintaining a public persona, particularly in the age of social media. “I don’t involve myself in unnecessary drama and bullshit. I’m into meditation. I’ve been to therapy. I do things that have enlightened me to change the way that I perceive things,” he notes. “My perception is the most important thing in my life. If I start perceiving things in the wrong way, (then) I start reacting in a poor way and it affects my life and my relationships with anybody — work or personal.”

Gamble is amused by the contradiction of being a professional performer who has found balance and peace-of-mind by not thinking about himself as much as possible. “It’s a daily practice. Look, I work 300 days a year. I might have seven or eight bad days a month. A bad day for me might not look as bad as someone else’s bad day, but it’s still a bad day for me. I still suffer from feeling like I have to be perfect all the time; my mind tells me that. That’s not reality. You have to just do your absolute best every day and your absolute best might change every day. It’s not always going to be the same.”

His focus is on the positive side effects of plain-and-simple “good energy,” a marked change from his hard-partying younger years as “that token rock-star-porn-dude.’

“I want to bring good energy to everywhere I go. The less I think about me, the more I’m a pleasure to be around on set, the more everything else goes smoothly in my life,” he notes. “There are severe mental illnesses where people need medication; it’s a chemical thing. But I also think there’s mental illnesses (resulting from) your lifestyle. I’ve completely changed my lifestyle. I used to be a party animal. It’s all I wanted to do. That’s how I lived for a very long time. It was fun, and then it became fun-with-problems, and then it became just ‘problems.’ At the end of the day, I want to bring good things to people. The main objective of stress and anxiety, for me, has to do with what I’m thinking about myself and my own shit. The things my head might tell me. But a lot of time my head isn’t telling me the right shit. The less I think about myself, the better.”

Gamble stresses the importance of a strong support system and acknowledges the difficulties inherent in building such a support network in such a highly competitive field. He returns to his simple-yet-effective daily practice: “Every time I go to work, I do the best fucking job I can do. I don’t think about what anybody else is doing. And when someone else is doing great, I cheer them on. If I can bring good energy to people around me, I feel better about me. If I feel better about me, I don’t care what anybody else thinks. That’s what helps me.”

He is forthright about his priorities. “I put my sobriety and my mental health before everything,” he said. “When I do that, everything else falls into place, maybe not exactly the way I’d want it, but it falls into place the way that it should. Whatever you want to call it, the universe, the way that the stars align, they do it because I’m not focusing on the bullshit.”

Trans star Jessy Dubai urges her colleagues to stop keeping secrets.

“Talk about it,” she told XBIZ. “That is one of the answers I will give you. Something that we can do in the adult industry is actually listen to people. Sometimes, when we deal with depression, performers like me who are public figures, sometimes we post on social media things that have hurt us and we cry out for help. And some people want to put (forth) their opinion, their prejudices and they add to the depression. Just listen!”

At the same time, Dubai has come to rely on the support of her ardent followers. “When it comes to my depression, I let it out. I try to talk to people,” she said. “And if I don’t have people near me, I go to my social media. I rely on the positivity of my fans when I am feeling depressed.”

She has observed the anxiety and depression that can result from “living two lives,” she said. “Industry and non-industry. When I became ‘Jessy Dubai,’ I said, ‘No! I am going to live my true self.’ That is one thing that has helped me (stay) sane and not go overboard: everyone in my personal life knows what I do. I don’t keep it a secret.”

Dubai acknowledges the “Pandora’s Box” that surrounds a performer who is keeping all or most details of their professional life a secret. “‘What are the teachers at school going to think? What is the pastor in my church going to think?’ You’re dealing with so many emotions and prejudices from everyone. We are not killing anyone! We are doing good for people. We are giving them a pathway to release tension in a sane, safe, comfortable space. We’re doing something good for the people. Porn stars rock! That is one of the reasons that I love being Jessy Dubai.”

Dubai admits to a recent struggle with depression that still has her feeling raw. “It is painful and it is triggering, even right now as I talk to you about it, I am going through so many emotions,” she said. “Just talking about it is how you let it out. Just like crying; water washes off the dirt. Tears cleanse your soul. Cry it out. Let it all out! And then you’re going to wipe those tears off and you’re going to pat yourself on the back and you’re going to do what’s best for you — even if it’s the hardest thing to do. You say, ‘I’m sorry if I break your heart when you find out that I’m a porn star. But you should love me, no matter what my decisions are. I love you no matter what you’ve done in your past or what you’re doing right now.’”

She regularly wrestles with the contradictions inherent in her work. “Nobody likes to be vulnerable and exposed. That’s why everybody is so Puritan. That’s why every time you say ‘cum’ in a public place, everyone gasps,” she said. “But we, as porn stars, that’s our job. They’re paying me to put my fears, my self-consciousness about my body, in a box and lock it there for a few hours while I’m performing, so that I can perform with no judgment, no pretenses, no second thoughts. If someone lifts my skirt in public, of course I’m going to get mad. But if someone does it in porn? ‘Oh, it’s okay! I love it! It’s sexy!’ But this is our job and we chose it.”

Dubai has taught herself to advocate for herself. “Do not force yourself to do something you don’t want to do,” she said. There is always another option, even if it is not immediately obvious.

“A plant or a tree grows from a seed. But it grows from the inside out. We cannot ask the general public to come and help us, especially because they don’t know what we’re dealing with,” she said. “It has to start within the industry, within the community. Stop judging each other. Stop trashing each other. Stop shaming each other. Listen to each other!”

She enjoys her role as a sexual surrogate, role model and adviser, particularly to fans who are naïve about transgender people. (“They ask me, ‘How did you get a dick put on?’ They really ask this! I say, ‘No, dear, I got tits. It’s the other way around.”) She loves seeing her movies and being reminded about her sexual adventures with beautiful people. What truly helps Dubai, on a day-to-day basis, is an affirmation of her love for her work. “I’ve always wanted to perform. I’m a showgirl,” she said. “I love cameras and all that stuff. I’m going to do what makes me happy. This makes me happy.”

Kross is direct in her best advice for self-care. “The word ‘No’ is a big one. I don’t take work just because it’s work, I take work because it’s the work I want to have in order to be in the place I want to be in my life and my career,” she said. “I try to identify burnout and make time for it to wear off. I’ve always kept interests in my personal life that are completely separate from the industry, and they’re the first place I go when I need to get away. Finally, I’ve always tried to control the way my persona is branded within the industry — I think it becomes unsustainable when performers allow themselves to be shot or branded in a way that doesn’t make them proud of their work. Eventually they want to just throw the whole persona out.”

Calvert is equally frank about her self-care routine. “The honest answer is I make a real effort to have a life outside the industry. I think that’s the most important thing. The adult community is like a big, dysfunctional family, and if you surround yourself with porn people, even in your off-time, it’s too easy to become obsessed with the gossip and the social media drama. I have industry friends I see in the real world, but only a few. Mostly my private life is people with no connection to adult.”

She strongly advises developing “life goals, plans and hobbies” that are not related to adult. “With all the platforms available to performers to monetize their online persona, it’s all too easy to feel guilty for stepping out of character. You sit down to watch ‘Game of Thrones’ and feel guilty for not sharing it with Instagram or Twitter or OnlyFans or Snapchat. It starts to feel more important than your real life, and that’s dangerous. When your very identity is your work, it’s hard to leave the office, but it’s vital for your sanity.”

Lain is a proponent of simply taking a day off. “It’s certainly tempting to accept every single booking that comes along, filling up one’s schedule and bank account to the brim,” she said. “But it is so important to take time for yourself to do other non-sex, non-porn activities. Taking time to self-analyze and reflect on how one truly feels about their career trajectory can give someone that mental clarity that may get fogged in the middle of constant bookings and sex work. Taking the time to heal, emotionally and physically, from anything is a commendable act. Yet so many people get caught up in the push to hustle and always be closing and always be making money, they burn themselves out and forget how to relax and have fun just for fun’s sake, not for clout or popularity’s sake.”

She urges her colleagues not to forget they are more than their online persona. “We all know we’re fun and sexy people. But let’s not forget we have so many other skills and talents. Too many people isolate themselves or feel isolated if they’re not providing or producing sex and sex work,” she said. “We need to allow ourselves to be our full selves, not just our sexual selves, around each other. But sometimes letting your more of yourself be known about the fact that you’re a parent, or you’re in school, or you run another business, can give people a different way to see you and cherish your inclusion in their lives.”

Martinez admits to a “trial-and-error” approach to protecting her mental health. She agrees that fostering hobbies, interests and friendships apart from adult is a crucial strategy. “After being in the industry for a decade, the biggest relief for me has come from having a life outside of the XXX world. I’m only ‘Missy’ in front of the camera and on my social media; all other times I’m just a regular civilian,” she said. “Making sure I have that hard and distinct separation really helps protect my mental health and well-being.”

In the race to cultivate and grow an online persona, it’s easy to lose one’s authentic sense of self, she said. “‘Missy’ has no problems. She is happy, horny and laughing, 24/7, which is unrealistic for anyone to attain. For a brief while, when I first started becoming successful, I lost sight of who I truly was to the detriment of my happiness and mental well-being. Keeping that strict, hard line separating my persona from my actual identity has done wonders.”

Paul has discovered an unexpected path towards keeping herself sane and grounded. “Content creation is the biggest key to my mental health, honestly. By ensuring that the bulk of my income comes from streams that I own and manage, and this was true even before I was a ‘name’ in porn, I’ve managed to steer clear of a lot of trauma,” she said. “If something happens to me, or someone I care about, I can speak without fear of retaliation because I’m financially secure. I’ve declined shoots I might have otherwise felt pressured into taking, to my own detriment. There are no truly dirty acts between consenting adults, but when you feel forced into a corner economically speaking, you cause yourself trauma by violating your own boundaries and it’s key to be reflective before you take shoots that aren’t your typical fare.”

She also urges her colleagues to seek out a sex-work-friendly therapist. “I feel that everyone should have a therapist but this is doubly true for members of a group so often targeted for abuse as sex workers. Even seeking advice from other senior industry people comes with the bias of how life is in our own little porn bubble. It’s nice to get a reality check from someone who is sympathetic and supportive to the work, but not necessarily as enmeshed in the politics and alternative subculture of the business,” she notes.

However, it is content creation that been “the biggest contributor,” she said, to her quality of life. “When I get burned out from pro porn, I can work a few hours a day from home and make comparable wages via Snapchat, OnlyFans and camming,” she said. “I’m about to go to a cabin for a week to unplug from (Porn Valley), meditate and hike but I don’t feel stressed about leaving work because my content platforms will take care of me. It takes time and hard work to grow them, but having the freedom to structure your life as you please because you have a side hustle isn’t just a good idea, I would argue it’s virtually impossible to survive in our industry without them anymore, both in terms of mental health and economic reality.”

Reyes sees the potential in meaningful relationships within the industry, particularly with people from different sectors. “Whether it’s a mentor relationship, a group beach trip, or an APAC social event, connect with other people in the business. Do it somewhere where you can hear each other talk and vent, somewhere without heavy substance use, where you can really connect. Those relationships will carry you through the years.” Further, she notes, “There are links to some great guides to dealing with burnout on the APAC blog. And if you know you have a mental illness, seek professional help. It can be tempting to try to manage things alone, but it’s so much better to speak with someone who is qualified to provide you with care.”

Von Mayhem is grateful for the flexibility her career provides when she needs to take some personal time.

“One of the reasons sex work is so wonderful to me is the incredible amount of autonomy it allows. I am an independent performer, therefore I’m able to set my own schedule,” she said. “I am able to take a mental health day if I need it and time off if an emergency arises. When I worked in the private sector, I never had such flexibility.”

She also appreciates the pros and cons of her online fanbase. I feel very welcomed to share how I am doing mentally, via social media, to my fans and kink family. I am open about my struggles with depression and anxiety. I never feel as though have to hide or be stigmatized if I’m dealing with mental health issues,” she said.

“That being said, sometimes one of the best things to do for me is just to log off of social media, which is hard as I truly enjoy interacting with my fans. I feel it’s important though to remember that my persona and my career are not the entirety of my being. Sometimes you must get off the computer and take a break from shooting and just do something you enjoy, anything that’s just for your soul,from going outside for a walk or having a meal at your favorite restaurant to spending time with friends. Get out of your own head! It helps me.”

Evans has observed the particular stress that comes from her specific line of work. “It’s easy to become consumed by work when you’re helping others. You can’t just take a break when people need you and calls for help can come at all hours of the night,” she said. “Sometimes certain issues pull at your emotions, while others can trigger past issues of PTSD. I’ve learned that meditation can be a great stress reliever. I’ll quiet my office, turn on my essential oil mister and take a few minutes to clear my mind.”

She has struggled with the pros and cons of social media engagement. “I find that social media can add unnecessary stress, so if that is the culprit, I’ll close out the apps and take a break. If none of those steps help me, I know when to ask for help. I think having someone to talk to, a counselor or therapist, is important when serious issues such as losing a loved one, a relationship ending, or other trauma causes you pain or conflict.”

Dr. Chauntelle Tibbals is the author of 2015’s “Exposure: A Sociologist Explores Sex, Society and Adult Entertainment” and has moderated several key panels on consent and porn production for XBIZ tradeshows.

“In society in general, the state of mental health is in very poor shape. This is not new, but I believe it is intensifying,” she told XBIZ. “A number of factors — from technology to the changing economy and job market to age-old judgment against people seeking to manage their mental health — contribute to this. Even in instances where support is available and judgment is not present, we have longstanding collective beliefs and patterns associated with this issues that can impact a person’s course of action. Like, thinking you’re going to get judged is probably just as intense as actually being judged.”

This pressure can be especially intense for performers. “Within this wider social environment, we have performers — a collection of diverse humans who deal with mental health issues like everyone else, who are also working within the context of what’s still one of the most stigmatized and front-facing — porn is so public — communities around. This added dimension really ups the ante.”

Tibbals has written frequently about sex work stigma. “Though the experiences are different, with people who perform actual sexual labor getting a qualitatively different and certainly more intense measure of stigma, all people who work in the industry in some capacity or are associated with it in some way are stigmatized. This is an issue we don’t address and can certainly have a negative impact on individuals who experience it.”

She has direct self-care advice for adult industry members. “For all people in the business, dealing with stigma and public judgment can be an issue. There is a litany of ways people can manage the stress, pressure, willful ignorance and unrepentant inaccuracies that are all-too-frequently levied against members of the community: Don’t read the comments, ban/block users, and everything that goes along with it — though for many who need feedback from consumers, that’s difficult.”

Hoover and the Cupcake Girls work with performers on “clear communication about their preferences and needs,” ensuring they are heard.

“While we all have different stories and goals we want to achieve, most of us as humans want to know that somebody has our back and that we’re not alone,” she said. “Mental health means healthier, happier people, and happier people tend to perform better in the areas that matter most to them. It can be such a win-win to see the industry supporting mental health!”

She underlines the takeaway lesson from this concern: “Listen to each performer’s unique story. Finding common ground and normalizing our human experiences can be really empowering. Performers are amazing, resilient, incredible humans.”