This seems a bit one-sided to me. I think shifting all the responsibility onto those who do not want to see the content isn't the way to go.

Running your own clean relay is probably unrealistic for people who aren't super techy, and becomes something that is either quarantined away, or has to be constantly curated.

Blocking anyone who posts something you don't like is a tiring task, and seems silly.

I like onyx vixen's clean posts, but I don't want to see her naked. The nsfw filter on Amethyst makes this work, and she is pretty respectful in using it.

I think respect is what it comes down to. Nostr is new, and people are bumping into the boundaries through exploration. A sense of propriety will evolve naturally. Sex workers will come to understand that they should label nsfw content as such. There will always be exceptions, but that is much easier to account for.