Are you aware of any sources specifically evaluating participation in sex work as a causal factor in mental and substance disorders (as opposed to sex work represented more prominently in populations already affected)?
Yes, this study corrected for reports of CSA, lower income, etc. in people who are drug addicts. For those who are additionally sex workers they found:
increased rates of mental and physical health problems (eg, suicide attempts, anxiety, STDs, and bloodborne infections) and use of some health services (eg, emergency department visits for women and mental health services for men)
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482625#SEC2
There aren’t many studies done which correct for mental health issues before someone starts as a sex worker. Even less which achieve a long-term study over a cohort of sex workers where not ~80 % can’t be found anymore for various reasons.
But there are a few on how to protect the Johns sex workers from STDs. I leave the interpretation of this inbalance in research to you.
:-)
If two effects are correlated, then three possible causal relationships are possible.
A first effect may cause the second, or the second may cause the first, or a so-called third variable may cause both.
It is possible that an individual who has been afflicted by certain difficulties is more likely to participate in sex work.
It is also possible that individuals from certain populations are more likely to participate in sex work, and also, due to being associated with the population, are also more likely to be afflicted by certain difficulties.
Both possibilities must be considered as alternative to sex work causing such difficulties, to explain the correlation.
I do know how correlation works. The study above shows that, when you correct for previous mental health issues, for lower socioeconomic status, low income, drug abuse, etc. sex work increases various mental and physical health risks and mortality.
