The adult entertainment community is still in mourning, grappling with the profound loss of Kagney Linn Karter, whose life last week tragically ended too soon when she committed suicide in Ohio. Just 36 years old at the time of her death, Karter’s struggles with mental health issues are an urgent reminder to us all that many of our industry’s stars face often-unspoken struggles hidden from the public’s view of their adult industry fame.

Mental health struggles in our high-pressure industry are a complex tapestry, with many factors influencing the wellbeing of stars. Understanding these challenges is crucial as we seek to support and protect our colleagues and friends in an industry that is frequently misunderstood and stigmatized.

What’s at the root of these struggles, and why are we losing to many stars to suicide? It can’t be narrowed down to any one issue, because Individuals working in this industry face a unique set of mental health challenges that can surface due to a variety of factors. The nature of their work, societal stigma, and personal experiences all contribute to the mental health issues they may encounter.

Stigma and Social Isolation

Workers in the adult entertainment industry often face societal judgment and stigma. This can lead to feelings of shame, guilt, or low self-esteem, which are detrimental to mental health.

That stigma in turn can lead to social isolation. Many stars are ostracized by family, friends, or society at large, and the nature of the work can make personal relationships more difficult. Although men often dream about dating a porn star, the fact is that few can actually handle the reality of these relationships. All of these strained personal relationships can lead to issues with trust, jealousy, and intimacy, further impacting mental health.

Stress and Anxiety

Although the industry offers a lot of personal freedom for its talent, it also is known for its unpredictability and lack of job security. This fact induces significant stress and anxiety about the future, which in turn can lead to a lot of difficult sleepless nights. It doesn’t help that the modern industry’s business models are quite reliant on dynamic technologies that often require regular adjustments to one’s knowledge, skills and approach. Plus, competition is fierce for fan attention.

For hired performers, there is considerable pressure to meet certain physical and performance standards. Given this truth, and the fact that adult stars literally are their own product, it’s not hard to understand how constantly living in this state can lead to anxiety and body image issues, all of which can further erode a star’s mental health.

Just as occurs in the music and mainstream movie business, some stars who live under constant scrutiny might turn to drugs or alcohol as a way to cope with the stigma, anxieties and pressures of the industry. Substance abuse and self-medicating can further complicate mental health issues, creating a vicious cycle of dependency and mental health deterioration that can be quite difficult to break.

Trauma and PTSD

Some adult stars may have experienced traumatic events in their past, including sexual assault and devastating past or current family issues. Sometimes too the trauma arrives within the context of their work. Such experiences can lead to post-traumatic stress disorder (PTSD) and other trauma-related mental health issues.

The nature of adult industry work can also blur personal and professional boundaries, leading to situations that may feel exploitative or abusive. While most fans are respectful, there are still plenty who feel it’s appropriate to hurl hate, venom and aggression at adult talent, especially at women. While there are many studios and content producers that follow a strict code of ethics, there are some as well that seem to delight in being abusive with their hired performers.

Mental Health Disorders and Insufficient Support

The combination of stigma, stress, and isolation can significantly increase the risk of depression and anxiety disorders among those working in adult entertainment, and often these conditions go completely untreated. Constant scrutiny and the need to maintain a specific body image can lead to body dysmorphic disorder, where there’s an obsessive focus on perceived flaws in appearance.

Outside of Pineapple Support, there is a significant lack of mental health support and resources specifically tailored to the needs of those in the adult entertainment industry. Even where support is available, costs can get in the way, as can the stigma surrounding the profession. Additionally, some organizations that claim to care about the wellbeing of adult talent specifically are just religious organizations in disguise.

Also, since most stars in the United States are independent, very few get health insurance provided to them from an employer, as is common for workers in other industries. This leaves them reliant on insurance acquired through HealthCare.gov, and plans found on the Exchange are often expensive and significantly less adequate than plans offered through employment.

Online Harassment and Cyberbullying

Sadly it is common for workers in the adult entertainment business to be subjected to online harassment, doxxing, and cyberbullying, all of which can have severe impacts on mental health, leading to increased risk of self-harm or suicidal ideation. Porn star August Ames tragically committed suicide in 2017 after becoming the target of bullies both from within and outside the industry. Similar industry bullying occurred as well before the deaths of stars like Kacey Jordan, Melissa Hill, Dakota Skye and Shelley Lubben.

Options for Help Do Exist

If you’re an industry performer and struggle with your mental health, you do have some options. First is the aforementioned Pineapple Support, which is specifically tailored for adult industry talent. Quite a few mental health apps have also emerged in recent years, including services like BetterHelp, CalMerry, ReGain, Brightside and Sesame, to name a few. These services usually don’t accept insurance, but often can provide financial assistance or a sliding scale billing approach that’s based on your income.

If you’re lucky enough to have medical insurance through the Affordable Care Act (often referred to as “Obamacare”) Marketplace, all of these plans are required to cover mental health and substance use disorder services as essential health benefits. This coverage includes behavioral health treatment, such as psychotherapy and counseling, as well as inpatient services for these disorders. All plans must comply with these and other essential health benefit standards, so don’t fail to take advantage of your benefits, which must include at a minimum:

• Behavioral health treatment, like psychotherapy and counseling.
• Mental and behavioral health inpatient services.
• Substance use disorder treatment.

These benefits are required to be on par with medical and surgical benefits, so your deductibles and out-of-pocket maximums will affect what you receive. Pre-existing mental and behavioral health conditions are covered, and spending limits aren’t allowed.

For anyone who might be struggling with suicidal thoughts, reach out to a mental health professional or to call a crisis line for support. In the United States, the National Suicide Prevention Lifeline can be reached at 1-800-273-TALK (1-800-273-8255) and offers 24/7 free and confidential support. For those more comfortable with texting, they can text “HELLO” to 741741 to communicate with a trained crisis counselor.

The good news is there’s growing awareness of the mental health challenges faced by our industry’s stars, cam models and creators. Still, there is a long way to go before we can celebrate as an industry any meaningful progress on this difficult, tragic and complex imperative.