Under the skin of OnlyFans

Don't you have skin in this, too? I would expect that you would want to protect your content in much the same way a film studio protects their content when it pops up on 3rd party sites. I don't know if you're being obtuse with your wording here, but whether or not your customers realized that you can't physically remove content from others sites directly is beside the point when there are well known legal options.

For various reasons I happen to know personally many (>10) women who've created an OnlyFans or otherwise participate in online sex work. I know these people well enough that we discuss things like our mental health state / conditions. One commonality that I have found is that many of the women who start an OF are already suffering from a mental health condition that has as a symptom hypersexuality or a need for attention / attention-seeking behaviors. One of the more common diagnosed mental health issues these women have is bipolar disorder, where in their manic states they experience hypersexuality.

One perspective is that online sex work provides a monetarily lucrative outlet for urges these women have to cope with regardless of their participation online. On the other hand, the consequences for online sex work to your "regular" life are much more far-reaching vs expressing these urges with individuals in person.

Of a bigger concern to me is that my conversations with these women have indicated that participating in OnlyFans actually deepens their trauma and mental health issues and may exacerbate their attention-seeking behaviors. Many of them have a traumatic past which directly ties into their relationships with men and sex, and participating in OF reinforces the outcomes of that trauma rather than providing them a pathway to reforge how they structure relationships with men and how they think about sex in their lives. Being involved in online sex work can be deeply traumatizing for the workers, and it is tied directly into the fact that they're both selling attention while seeking attention, and the facsimile but not the reality of a human emotional connection.

I don't know what the answer is, but I really wish that in the US we had universal healthcare including for mental healthcare. There are whole generations of women who are deeply traumatized by their upbringing and the lack of strong male role models in their lives. The epidemic of single motherhood across demographic boundaries within the US has massively contributed to our current mental healthcare crisis, and lack of a father figure that is a /good/ father heavily contributes to broken relationship models with men for these women.

On the other hand it's also weird to me to see progressive elements talk of normalizing such a personal commodification -- perhaps like some progressives, I am not sure there is as big a difference as we'd like to believe between selling one's spring days to be a cog in any commercial operation and selling participation in sexual gratification. But nobody talks of normalizing or glorifying the former! On the other hand, no one stigmatizes being a cog in a commercial operation. Maybe what's going on is that it's hard to argue for the dignity of removing personalized stigma without overcorrecting.

So the solution is probably conversations (like this one) elaborating on the dynamics of the ways it can go wrong. No one's freedom to choose or dignity if they choose sex work is hurt by clear-eyed explanations of the hazards.

Losing your health by working 40+ hours a week is much worse than the baseline.

As far as the extraction of value not being exploitative, this argument simply applies to literally every condition of exploitation, and it is very possible to be employed without having a dominant superior. It would be good for you to arrive to a better definition of exploitation, otherwise plainly most relationships of employment do involve some sort of exploitation.