St. James Infirmary

While we’re heartbroken over the closure of St. James Infirmary after serving Sex Workers for nearly 25 years, we’re extremely grateful and relieved that our community partners have agreed to take over our remaining programs and support our phenomenal staff.

Lyon-Martin Community Health Services has been providing clinical care to trans, non-binary, gender non-conforming, and intersex (TGI) communities and cis-gender women for over 40 years, and will be operating SJIs Outreach Program, led by Celestina Pearl.  Founded by righteous activists, and rooted in reproductive justice and self-determination, Lyon-Martin has inspired SJI’s principles and philosophies, and we can’t think of a better organization to house one of our first official health care programs.  Lyon-Martin Executive Director, JM Jaffe, is a former SJI Board member, and a highly capable and trustworthy leader who, along with the entire staff and Board of Directors, will help ensure that this important work continues. Please consider supporting excellent, high-quality, compassionate and trauma-informed medical, gynecological, and mental health care services, including the Naughty Nurse Mobile, by sending your donations to Lyon-Martin.

TGI Justice Project (TGIJP) provides vital services to transgender, non-binary, gender non-conforming, and intersex communities, and is now running Our Trans Home (OTH) Subsidy Program.  The Bobbie Jean Baker House is now closed, but TGIJP has found new homes for all of the residents, while they are enrolled into the OTH Subsidy Program.  With Janetta Johnson’s fierce advocacy, Sharyn Grayson’s graceful leadership, and our beloved Stephany Ashley’s guidance as a member of the Board of Directors, along with TGIJP’s amazing support team, we feel confident that our staff and participants will thrive in their new home.  We’re so proud of the dedicated and brilliant OTH housing staff for their tireless efforts to ensure that their peers are safely housed and treated with dignity and respect, and we applaud their resilience in navigating incredibly challenging working conditions at St. James Infirmary.  Please consider supporting innovative trans-led housing services by sending your donations to TGIJP.

Long-time community partner, and former office-mate, San Francisco Community Health Clinic (SFCHC), will oversee Taimon Booton Navigation Center (TBNC), SJI’s largest peer-led housing program for trans/GNC and sex worker communities.  Founded in 1987 as Asian AIDS Project, the organization provided support to the Asian and Pacific Islander community during the AIDS crisis, eventually launching as Asian & Pacific Islander Wellness Center in 1996.  Since that time, they became a federally qualified health center (FQHC), remaining rooted in API communities while welcoming anyone who needs health care and social support services.  SFCHC now provides medical, mental health, education, and community services, including transgender health care (Trans Thrive), and street-based services.  With a strong organizational foundation and leadership team, and a variety of resources for both participants and staff, we feel confident that TBNC and the extraordinary staff will be supported in their new home.

We truly hope that the City & County of San Francisco continues to prioritize housing services for our most vulnerable community members, and that the crucial work of OTH and TBNC will keep going and expand until homelessness amongst transgender, gender non-conforming and intersex people is something of the past. 

Sadly, SJI’s Harm Reduction Program, one of our original core programs run by and for Sex Workers, will be dissolved on December 29th.  Originally operating “under the radar” during street- and venue-based sessions, and at our weekly drop-in clinic, SJI received supply donations from the community to distribute to participants until we were a sanctioned site under the San Francisco Department of Public Health.  Over the years, the program offered access to harm reduction supplies; overdose prevention education and Narcan; safer sex supplies, hygiene kits and first aid supplies; and food, clothing and other basic needs supplies.  In addition, the program operated a Secondary Syringe Exchange (SSE), with participants distributing harm reduction supplies, collecting used syringes, and conducting peer education.  Community Navigators were also an integral part of the team for the last several years, working hand in hand with SJI on the frontlines at our weekly Syringe Access sites, and connecting participants to additional resources.  On average, the Harm Reduction Program conducted approximately 9,000 encounters annually.  This is a huge loss for the SJI family.    

Thank you to our numerous community partners, allies, supporters, and funders over the last 25 years for helping us create Margo’s magical dream of Sex Worker Health Care in San Francisco, and advocating for the de-criminalization and de-stigmatization of all Sex Workers.  Our endless thanks to the entire SJI staff since we began this unbelievable journey – you have been the backbone and heart of this organization for the past two decades, and we are abundantly grateful for your compassion, dedication, integrity, and professionalism on behalf of your communities and peers.  And, to all of our participants and Sex Workers who we have been honored to serve since 1999 – you are forever part of our souls, and WE LOVE YOU! 

Johanna Breyer, MSW, Founding Executive Director

Charles Cloniger, MS, FNP, Founding Clinical Director

Patsy Chan, Board of Directors

Elizabeth Faber, Board of Directors

Notes from the Naughty Nurse Mobile 9/13/23

~ with SJI Founders and Directors

We love you, we are you, we support you, and we are so incredibly grateful for the opportunity to have served the sex worker, trans, drug user, and unhoused communities for almost a quarter of a century.

By now you may have heard that St. James Infirmary (SJI) will be closing over the next 6-9 months. Our housing, outreach, and syringe access programs are still in operation, and we hope to avoid any service disruption during the transition to new organizations. Unfortunately, there were circumstances beyond the control or knowledge of some of us. The co-directorship model initiated in 2020 was suddenly disbanded by the Board of Directors in March 2023 and SJI was faced with leadership and fiscal compliance issues. Our core programs struggled with various internal and external challenges, such as: COVID service interruptions and difficulties recovering programmatically as a result; lack of administrative support; inability to offer competitive salaries for key program positions; and changing needs among the community served. While our outreach and harm reduction programs are well-utilized, sex workers now have more options and go elsewhere for medical care and HIV/STI testing services. For example, in 2015 there were over 300 visits with SJI medical providers, and by 2022 there were only 8 visits for the entire year. Our HIV testing program together with the outreach program conducted over 1,000 tests in 2019, but less than 50 tests to date in 2023. Sadly, our critical mental health services concluded last month due to lack of competitive salaries. Our holistic care services and support groups were also funded under the mental health services program. In essence, we are no longer operating an “Infirmary” at this time.

It breaks our hearts to know that at this point there is nothing we or anyone else can do to “save“ the organization. We are now focused on ensuring our remaining programs and services continue with the support of community partners. Those of us who have been on the frontlines serving sex workers for decades are the blood, sweat, tears, heart, and spirit of St. James Infirmary, and will always be dedicated to the well-being of our communities as voiced by the communities.

St. James Infirmary, along with many passionate and dedicated allies, have accomplished so much towards fulfilling the needs and desires of our people for almost 25 years, including:

• street-based and venue-based sex worker outreach and supplies for safer working conditions

• weekly clinics for sex workers including medical services, hormone therapy for trans participants (STRIDE), HIV/STI testing, holistic services, food, and clothing

• mental health services

• syringe access and harm reduction services

• peer counseling and social support

• innovative trans-led housing programs for trans/GNC and sex worker communities

• trainings for medical students at UCSF, community service providers, and hundreds of sex workers

• frequent parties, celebrations, street fairs, marches, conferences, and shared meals

• the first San Francisco Marcha de Lxs Putxs

• Mujeres TransLatinas en Acción: our well-attended weekly gathering for Transgender Latinas

• local and state-wide policy initiatives on behalf of sex worker and trans communities

• serving as special consultants to WHO, UNAIDS, UN High Commission on HIV and The Law, Human Rights Watch, and many other organizations around the globe

• publishing and presenting ground-breaking research on sex workers

• award-winning humanizing media campaign “Someone You Know Is A Sex Worker,” among others

• and much, much more

Again, we love you, we are you, we support you! We look forward to all the different ways we will continue to connect, fight and build community in new and better ways!

In continued solidarity,

St. James Infirmary Founders and Directors:

Carmen Alicea, RN, LVN, Founding Clinical Nurse

Cary Escovedo, former HIV Services Manager

Celestina Pearl, LVN, Sex Worker Outreach Director

Charles Cloniger, MS, FNP, Founding Clinical Director

Corrie Varga, LMFT, former Mental Health Services Director

Dawn Passar, MFA, Founding Outreach Coordinator

Dr. Jeffrey D. Klausner, MD, Big Daddy

Johanna Breyer, MSW, Founding Executive Director, former Board Member

Juba Kalamka, MFA, Community Healthcare Services Director

Naomi Akers, MPH, former Executive Director, former Board Member