St. James Infirmary

For the St. James Infirmary (SJI), this past year has been immensely challenging. But it’s a challenge we have met with passion and determination. The COVID19 pandemic has critically affected the sex worker, transgender/gender non-conforming (TGNC), impoverished, homeless, and drug-using communities that SJI  serves. We are seeing more need than we have ever seen in the organization's history. Since the start of the pandemic, SJI has served 10,200 clients through engagement with outreach, clinic, and mental health services, a Transgender housing program, syringe access sites, and the “STRIDE” Transgender healthcare program. That is nearly double the number of clients typically served. Along with direct service, SJI maintains its mission of meeting the needs of people engaged in the sex trade through advocacyand social justice, and continues to prioritize advocacy for sex workers. Current advocacy efforts are focused on SB357, which would end abusive profiling of women of color--especially trans women of color--accused of “loitering with intent to commit prostitution.” SJI has additionally joined coalitions advocating  for increased access to housing (not shelters), and for drug user health and well-being, including ending the violent war on drugs, removing police from hospitals and other public health services, and creating safe consumption sites for drug users in San Francisco. In addition to pivoting direct services in response to the pandemic, we’ve made major changes inside the organization: the internal leadership structure of SJI has shifted over the past year. 

In alignment with SJI’s foundation as a peer-based occupational health and safety clinic for sex workers of all genders, a co-leadership model is a natural next step. Starting in November 2020, SJI program directors, with the support of the Board of Directors, began restructuring the organization based on knowledge sourced from the Nonviolent Global Liberation movement founded by Miki Kashtan. We are now a Co-Directorship, made up of 10 program directors who work collaboratively on conflict engagement and organizational decisions made using the advice process. SJI has also initiated a racial equity audit and begun the process of further training and consideration of  how to best facilitate the leadership of BIPOC community members.

In March 2020, in response to the COVID-19 pandemic, SJI made major shifts in the ways and types of services it offers . Mental health and clinical services transitioned to online virtual meetings, over-the-phone offerings, and socially distanced outdoor sessions, and the clinic has continued to provide urgent and trauma-related care, linkage to HIV+ care services, and clinical services like STI testing and treatment and hormones. SJI’s outreach team kicked into full gear, creating a home delivery service for current and former sex workers to ensure that necessities for survival, including food and PPE, are plentiful. Via SJI’s street outreach van, groceries have been delivered twice a week along with meals, masks and hand sanitizer, condoms and lube, hygiene products, wound care supplies and safer drug use supplies. These same supplies have been delivered to strip clubs and massage parlors, as well as neighborhoods where street-based sex workers work in San Franciso. As the overdose crisis intensified during this pandemic year, we responded with increased services for people who use drugs. We hired a new Director of Harm Reduction; more than doubled our distribution of Narcan in early 2021; and added a fourth syringe access site, in collaboration with the Hope Center, which offers a free clinic and many additional resources for women, trans, and gender nonconforming people.

Our community-based health services provide aid to many marginalized communities. Mujeres TransLatinas En Accion offers support to TransLatina sex workers each week. SJI’s partnership with Openhouse features a group for senior TGNC people. We have also joined the fight against COVID-19 by providing the vaccine ourselves. SJI has provided vaccines to over 70 current and former sex workers and their family members. SJI program participants state that they would rather come to SJI for services because they know they will not be judged or lectured about their sex work activities.

The staff and volunteers of SJI have been working tirelessly to champion our community and this year we lost our most storied champion, founder, Margo St. James. The recent memorial for her has sparked an intergenerational push to further the movement to decriminalize sex work, and to offer dignity and well-being to all sex workers. St. James Infirmary’s staff and volunteers hope to see this in our lifetime! We will continue to provide excellent, free, peer-based harm reduction services to our community for as long as it takes. 

Thank you to our participants, staff, volunteers, funders and supporters.