This systematic review investigates the psychological factors influencing individuals’ decisions to engage in sex work and evaluates the impact of such professional involvement on personal sexual relationships. Core psychological constructs, including self-esteem, motivation, social stigma, and bodily autonomy, are analyzed across diverse sex work contexts, such as street-based work, escort services, and digital platforms. The review elucidates both intrinsic motivational dynamics and extrinsic societal structures that shape sex workers’ identities, with particular focus on how their occupational roles affect their capacity for intimacy and sexual fulfillment in private spheres. Findings reveal a complex interplay of empowerment and vulnerability, emphasizing the need for sophisticated psychological frameworks that move beyond reductive or moralistic perspectives on sex work.