If sex work is a crime – for the sake of simplicity here, set aside all the politics and nonsense related to the illegality of some forms of sex work in some contexts — and you “confess” something through the course of therapy, are you going to get in trouble?
Here’s a question I recently came across via the interwebs:
I used to escort for a while, during the fall semester of college. I pulled out (no pun intended) from the business so I could have a normal life and so I could work a vanilla job. Now I’m thinking of seeing a psychiatrist once I get my health coverage from work. A lot of things happened for me over the past six months (including but not limited to sex work), and I really need to process them in a healthy way.
I don’t know if any of you sexy women have seen a counselor/psychologist/psychiatrist or currently see one, but if you do: Is it safe to reveal participation in the industry? Will I get in trouble with the cops? I really don’t know, and I’m desperate for answers. On the one hand I feel I need to talk about it. On the other I don’t want to go to jail! Any insight would be greatly appreciated.
To start us out, what this person is asking about seems to get at physician-patient privilege. I’m not a lawyer by any means, so take this with a non-expert grain of salt, but as I understand it: Physician–patient privilege is a legal concept related to medical confidentiality that protects communications between a patient and their doctor from being used against the patient in court.
Almost every jurisdiction that recognizes physician–patient privilege, either by statute or though case law, limits the privilege to knowledge acquired during the course of providing medical services. This means that whatever you discuss with your therapist during an official session is protected. If you talk to your service provider “off hours” though, not so much.
The privilege may cover a situation wherein a patient confesses that they committed a particular crime. The rule generally does not apply to confidences shared with physicians or therapists when they are not serving in the role of medical providers.
All that said, here’s what other members of the community had to say.
Regarding physician–patient privilege:
They’re doctors and aren’t allowed to tell anyone what you discuss unless you are in immediate danger to yourself or others.
Here are some more distinctions:
Mental health professionals are mandated reporters, which only applies to situations where you are a danger or a threat to yourself or others. Usually this covers homicidal feelings, suicidal feelings with a possibility of following through, sexual thoughts involving minors with or without a desire to act on them, or informing your counselor that you as a minor have been sexually abused whether you want to report/press charges or not. (This has bad implications for victims of child sex abuse, like me, but that’s a whole other thread.) It doesn’t apply to generally illegal behavior, like drug use, vandalism, sex work, or confessions of previous crimes such as assault etc.
Also, regarding some positive experiences with a thereapist:
I see one, and it has been really wonderful for me. I have heard of other workers having bad interactions before, but I’ve never heard of anyone facing legal consequences. In most cases, it should be illegal for the counselor/psychologist/psychiatrist to divulge client details as they are considered privileged medical information. Though there might be some state to state variation in how that’s handled.
A good little summary can be found here: http://www.apa.org/helpcenter/confidentiality.aspx
Editor’s note: This is a great link!
Here, another person weighed in on distinctions between different types and specializations of care providers:
If you’re looking for help processing, a psychiatrist is not what you want. Psychiatrists manage symptoms and don’t provide therapy. You want a therapist, marriage/family therapist, or a psychologist. If you have symptoms that need controlled, the therapist will tell you to find a psychiatrist who will prescribe medication.
I just feel like this is a really important distinction that a lot of folks aren’t aware enough of and it could save a lot of time and effort.
There seem to be a lot of rules and contingencies regarding patient privacy in this context. Make sure, above all else, that you learn the rules within the parameters of you: who you are talking to, what city, state and/or country, and what you are talking about. Like one person mentioned, certain situations mandate reporting.
Erika Chan is a sex positive people watcher (and writer). Email her at firstname.lastname@example.org.