I don't know anyone on OnlyFans, but I know a few women who do "Just Chatting" Twitch streams and the psychological toll on them is huge. Having to give people constant attention, answer every question or at least acknowledge it, and provide a sort of faux-friendship in exchange for money is a really strange arrangement. Just yesterday a long-term supporter of one woman I know "confessed their love" to her, and will probably unsubscribe because she won't reciprocate.

Another interesting but sad fact is that a lot of those streamers have significant others, but they hide it from the audience because they believe they'll get more engagement.

Sure the same thing might happen in regular businesses, but the interactions are either shorter (eg cashier) or at least it's acknowledged as being entirely professional.