Between November 2017 and January 2018, at least five adult performers died due to alleged drug overdoses or by suicide—a pattern which many in the industry say they’ve never witnessed before. Now, female performers are calling out for more mental health resources within the adult entertainment industry, while creating their own support groups for sex workers.

Award-winning adult star Shyla Stylez, 35, was found unresponsive in her mother’s house on November 9. Yuri Luv, 31, died in her sleep in early December due to an accidental overdose of the prescription opioid hydrocodone, as reported by the Los Angeles County Coroner. August Ames, 23, was reportedly found asphyxiated from hanging in a park near her home in California on December 5, just days after she was harassed on social media.

In January, 20-year-old Olivia Nova was found dead in a private property in Las Vegas. She died of complications from alcohol abuse, as revealed through an autopsy report carried by the Clark County Coroner’s Office in Las Vegas. On January 7, 23-year-old Olivia Lua, known as Olivia Voltaire, also passed away after she overdosed on a combination of drugs and alcohol at a California rehab facility.

In the immediate aftermath, industry advocates released a statement calling for performers to seek professional counselling if they need it, and to be aware of online sexual violence and harassment. “We ask that our community practice compassion, sympathy, and empathy with one another because there is so much outside of our industry working against us,” reads the Adult Performer Advocacy Committee (APAC) statement.

Months after the string of deaths, performers and activists say the long-term fight for sex-friendly mental health support is far from over, as stigma continues to stand in the way.

Los Angeles-based psychotherapist Kate Loree specializes in alternative sexuality issues. Loree has worked with adult industry performers who say they often receive death threats online, and some are mistreated when family or friends find out about their work. While it may be easier for performers who have been harassed on social media to delete their accounts, for most, their profiles are a valuable asset to their business and the reason for landing a new gig.

“I think in our culture we don’t want to blame ourselves; we want to think that it’s the porn industry that does this to these girls. We don’t want to look at ourselves, we don’t want to think we are killing these girls,” said Loree.

Loree says agencies and production companies should provide online resources for beginners to assist their performers with mental health. “The porn performers I talk to—a lot of them get rape threats and death threats daily, and so part of the orientation would be teaching them to manage their boundaries on social media and with our culture.”

Vixen models wearing commemorative August Ames T-shirts. Image via Instagram

Many groups do offer mentorship programs and mental health support resources intended for adult performers, such as APAC. However, Kelly Pierce, adult performer and board member of the Adult Performer Actors Guild (APAG), told Rolling Stone that while the guild offers outreach to members, the multi-billion dollar industry needs a well-established mental health support system.

Ela Darling, performer and co-founder of VrTube.xx, believes the issue stems from the stigmatization that adult actors are “dirty” and “unhealthy” because of how they appear on film. Darling told VICE that performers may face discrimination if they decide to leave porn in pursuit of another career. In November 2016, 38-year-old teacher Resa Woodward was forced out of her classroom by district officials in Texas after they received an anonymous tip that she worked as an adult film performer over 20 years ago.

“People will watch our porn all day long and actually shame and stigmatize us. Dating is really hard—there are plenty of people who are happy to fuck you, but they don’t want to meet you,” said Darling.

There was no shortage of mental health services at this year’s Adult Entertainment Expo in Las Vegas, where organizations promoted their sex-friendly resources for adult performers. Kevin Moore, Ames’s husband and producer of the porn production company, Evil Angel, also used his speech at the Adult Video News (AVN) awards to announce The August Project, an initiative serving as a support system for adult performers, in memory of his wife. In an earlier blog post, Moore blamed cyberbullying and online harassment for Ames’s death, and called on the adult industry for more discussions surrounding mental health.

“[Viewers are] talking to these girls like they’re not real people... They’re just characters they get to jack off to, and I really want to change that perspective." —Miss Leya

“The performer community does not have adequate access to mental health services. While Mercedes did have professional support that cared about her, it was unnecessarily hard for her to find someone who would treat her,” Moore said in his post.

British performer, Miss Leya, who is also the creator of the performer hotline, Pineapple Support, originally founded the hotline service after learning about the five performer suicides at this years’ awards shows. Miss Leya has already recruited therapists in Australia, UK, Spain and the US to work with performers through Pineapple Support.

“[Viewers are] talking to these girls like they’re not real people,” Leya told VICE. “They’re just characters they get to jack off to, and I really want to change that perspective.”

Moving forward, the industry is witnessing an increase of sex worker-friendly mental health projects and support groups. While STI testing in the porn industry is now regulated by the Performer Availability Screening Services (PASS), Nikki Hearts also told Rolling Stone how performers, both contract and freelance, still lack health insurance or benefits from their employers.

In an article she wrote for Merry Jane, Heart said if there were an instantly accessible sex-friendly mental health care centre to provide performers with therapists, her friends and fellow porn actors wouldn’t have to suffer from depression and addiction alone. She has also opened up her home for those seeking support within the industry.

“I’m one of the few people who went to therapy and is willing to share that advice,” said Heart.

Organizations like The Cupcake Girls and the APAC, however, are expanding their programs to provide performers with referrals to external, sex-friendly care providers, such as therapists, doctors, and financial aid counsellors.

“We’re not OK with people passing away like this. All the five women who passed away, we could’ve helped them, we absolutely could’ve provided therapy, we could’ve provided mental health support,” said Joy Hoover, founder and president of sex worker advocacy group, The Cupcake Girls. Hoover’s organization currently operates out of Las Vegas and Oregon and specializes in connecting all genres of sex workers to community support centres. The group is now in the midst of opening their Community Driven Holistic Resource Center, a secluded space that will provide mental and physical support centres for performers and group partners in Las Vegas.

Adult actress and chair of APAC, Tasha Reign, also hopes to increase the number of performer newcomer support groups. She’s also in support of raising the entry level into porn from 18 to 21, and to regulate more industry-wide programs related to overall health and sexual consent.

While some performer-based developments are in the works, Reign thinks the necessary resources aren’t being supplied to performers and sex workers.

Reign remarks that globally known organizations, such as the Free Speech Coalition, the US trade association of the adult entertainment industry, and MindGeek, which owns many globally recognized porn sites like YouPorn and Pornhub, should provide performers with more resources in regards to mental health and sexual harassment.

“There are things that are happening, but I just feel like there needs to be more,” Reign told VICE. “I feel like they really owe it to step it up to the plate.”

FSC is currently working to identify the types of distress performers are experiencing, whether it be emotional, psychological, or economically, and connect them to sex worker-friendly support centres. The FSC was originally created as an industry defense organization over 25 years ago, and now oversees the PASS Program.

“It can be a battlefield of people who are on a daily basis telling you that you’re worthless,” said Stabile. “This isn’t an industry problem, it’s a societal problem and we need to learn that our words have actions, that sex workers are people, [and] that these things aren’t without consequences.”

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