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Suzy Favor Hamilton, 44, who is married, a former Olympic US track star, a motivational speaker and who appeared in an ad for Nike (and promotional work for Disney), has admitted to also working as a $600-an-hour prostitute.

Why would she do that? What could drive a woman seemingly not in desperate need of funds to have sex with men for money?

First, there are likely women whose interest in being hired for sex is so strong that, for all intents and purposes, it is their "sexual orientation." They are sexually excited far more (or almost exclusively) by sex with strangers, and with as little emotion as possible (hence, they exchange in the act for money).

In this way, these women are not different (only in their particular tastes) from other women (and men) who want to be hurt during sex or who want to dress in clothing of the opposite gender prior to sex. -- A woman wanting to sell herself because she thinks it is exciting is not much more dramatic than a man who wants to dress as a ballerina in order to feel excited.

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Second, while the intensity of desire to participate in prostitution could be so compelling as to constitute something akin to a sexual orientation, that orientation may well be well be rooted in life events during childhood and adolescence that left that girl feeling powerless or manipulated or unloved. Reproducing such feelings can be an extremely magnetic force.

Prostitutes I have treated have told me that getting calls from strangers wanting to have sex with them reinforces (in an unfortunate way, of course) their belief that they are special and attractive. And it may well be that entering and leaving hotel rooms and apartments where these women could certainly be badly hurt is a way of—sadly--demonstrating their invulnerability (when they were badly hurt as children, often at home).

Third, there are probably a minority of women (and men) in the business of prostitution for whom it carries no stigma and is lucrative.

If we assume that Ms. Hamilton had ten clients a week (and she may have had many more), then she could have been making $300,000 a year in cash, which is, even prior to the so-called "fiscal cliff," like making $400,000 a year in taxed income.

If she had 20 clients a week (and some of the prostitutes I have treated as a psychiatrist have had 20 clients a week), then she would have made $600,000 a year -- in cash.

Ms. Hamilton may have had some income as a motivational speaker, and her husband may have made some money, but, unless they were extremely wealthy, $600,000 a year in cash may have been key to their lifestyle.

While it is extremely dangerous psychologically and medically, the truth is that high-priced prostitution is rampant in America and available in every city. Millions of American men with families and professions are customers. And not every prostitute is devastated psychologically by the experience.

As one lawyer and prostitute put it to me when she was in my office for psychotherapy, “I suppose that there is some scatter effect, in terms of making it more complicated to have a boyfriend and make sex intimate with him, but I don’t know if it’s more complicated than getting back home from working as a police officer or pediatric neurosurgeon or gynecologist. Lots of professions are incredibly complicated, emotionally.”

The fact is that some women are—whether pathologically or not (which is a longer discussion)—“able” to separate sex from meaningful and ongoing emotional connections and to charge for it. Because their behavior is against the law in most states, they can also make a great deal of money doing so, if they are also attractive.

I take no moral position on the matter, which may be why I have been able to help a number of these women find their true motivations for such work, see the real and substantial psychological risks and make clearer decisions about whether to continue with it.

Finally, in a world that allows third trimester abortions, because women demand the right to control their own bodies, and a world in which a large number of lawmakers have hired prostitutes, it is time to legalize prostitution, put in place safeguards to help protect those who participate in it, and, of course, tax it.