The famous story of a phone call at the start of the Infirmary is true. Early one morning, COYOTE received a telephone call from a sex worker who had just left court. She wanted to know if the blood draw she got in jail the night before was legal. It was not.
General Counsel to the Department of Public Health put COYOTE in touch with the Director of STD Prevention & Control at the San Francisco Department of Public Health to find out what was going on at DPH and in the jails. In a matter of minutes, Dr. Jeff Klausner offered to meet. Coincidentally, Exotic Dancers Alliance (EDA) Co-Founders, Dawn Passar and Johanna Breyer, had also met Dr. Klausner around that time after their presentation at the San Francisco HIV Planning Council regarding substandard working conditions in the adult entertainment theaters. He had asked if EDA needed anything, to which they replied, “an office.”
Carol Leigh, (aka, Scarlott Harlott), and others from COYOTE met with Dr. Klausner as soon as possible. They brought along Priscilla Alexander’s plan for the St. James Infirmary. Dr. Klausner explained that he was doing what he could with a CDC grant to eradicate syphilis. Testing in the jails seemed logical. To COYOTE, it was anathema.
It was the mid-1990’s. It had only been twenty years since the San Francisco Department of Public Health reversed its policy of quarantining women arrested for prostitution, to force mandatory penicillin injections. (The clients were never arrested, so they never enjoyed similar hospitality). Now sex workers were being convicted for carrying condoms while allegedly “soliciting.” Meanwhile, the Convention and Visitor’s Bureau was passing out condoms in San Francisco’s upscale hotels. The irony was rich.
Despite initial doubts of COYOTE members, Dr. Klausner turned out to be groovy. He loved the model and ultimately, became a partner in St. James Infirmary, and gave us our first office space.
But none of that could have occurred in a vacuum. So much work happened before that fateful call, both in San Francisco and around the world. A tremendous movement came before St. James Infirmary was even conceived.
Priscilla Alexander, whose plan COYOTE and EDA used as a blue print for the Infirmary, had been Margo’s secretary at COYOTE, and worked in Geneva with the World Health Organization, where she was eye-witness to the disastrous nonoxynol-9 studies on sex workers in Africa.
At home in San Francisco, there was the constant drumbeat of HIV prevention, care and treatment. Sex workers, like gay men, were being scapegoated for the spread of a disease, but unlike the gay community, sex workers had no broad-based community support. Residents in the neighborhoods were complaining to their local city Supervisor, Terence Hallinan, about scantily clad women strutting their dimly lit streets at night, claiming they left behind used condoms. Residents complained about exhaust fumes emanating from slowly moving (mainly American made) vehicles, as clients surveyed the scene, and they complained about threat of disease. In response, Hallinan put together the San Francisco Task Force on Prostitution.
Margo had just returned to San Francisco from her years in France. Teri Goodson, an activist and sex worker organizer, joined NOW with the express purpose of changing the organization’s position on “prostitution.” Scarlott Harlott had succeeded in bringing the term sex work into the mainstream. Scarlott kept COYTE alive, founded the Bay Area Sex Worker’s Advocacy Network, and PENET, and was the Director of the Sex Worker’s Film Festival. Exotic Dancers Dawn Passar and Johanna Breyer, successfully challenged strip club owners, the Mitchell Brothers, who had instituted draconian ‘stage fees.’ And the strippers at the Lusty Lady were organizing. Scarlott, “the organizer” Harlott, brought all these women together and convinced Supervisor Hallinan that “the community” should also include those who were being discussed. Hallinan agreed.
First, Task Force members asked City Attorney Louise Renne, for an opinion on a typical police practice at the time: arresting women for standing on, then stepping off street corners. The City Attorney opined that arrest for standing on the sidewalk was unconstitutional. Next, Task Force members pushed the District Attorney to stop using possession of condoms as evidence in solicitation prosecutions. He finally succumbed under pressure, but the practice has continued throughout the state of California.
Then Task Force members questioned the efficacy of police licensing massage parlor workers, only to then enforce prostitution laws against them. Licensing was ultimately transferred to the Department of Public Health, which also handled licensing of swimming pools and spas.
Exotic dancers at the Lusty Lady succeeded in their unionization drive, with the support of EDA and COYOTE. Newly minted union members became the darlings of the local Democratic Party and local elected officials. The support of course was welcomed with open arms, as it were. The Party continues to struggle with decriminalization vs. legalization, and coercion, trafficking, abuse, and its own PTSD in the midst of its me-too moment.
Margo ran for Supervisor in 1996, in an effort to widen the circle of political support. Her positions were published in a broadsheet called, ‘The St. James Informary.’ She had wide support on the City’s left. In a field of 21 candidates vying for 6 open seats, she came in 7th, with over 78,000 City-wide votes.
Dr. Klausner was aware of all that work, so it wasn’t a stretch for him to assemble the necessary pieces to support St. James Infirmary.
In June of 1999, COYOTE and EDA installed Johanna Breyer as the first Executive Director of St. James Infirmary. Dawn Passar, who had been the Outreach Coordinator at the Asian AIDS Project, joined the Infirmary as its first Outreach Coordinator, and Dr. Deborah Cohan became the first Medical Director. “Dr. Chuck” Cloniger was St. James Infirmary’s first Nurse Practitioner, who graciously agreed to stay with the Infirmary for over two decades. St. James Infirmary opened its doors in June 1999 one night a week. By week two, participants seeking services had to arrive early because the line for peer-based, non-judgmental health care was flowing out onto the sidewalk.
Dr. Deb Cohan presented her research from the Infirmary at two International AIDS Conferences, with peer-based research associates, all participants and providers at San Francisco’s St. James Infirmary, including Chuck Cloniger, Alix Lutnick, Johanna Breyer, P. Davidson, A. Herlyn, and others.
Since the founding of St. James Infirmary, it has been directed by Naomi Akers, who oversaw the Infirmary’s first presentation (since Priscilla Alexander) at the World Health Organization, Stephany Ashley, who brought the annual budget to over a million dollars, and presented about St. James Infirmary internationally, and most recently Toni Newman, who was able to secure funding for SJI’s OurTransHome.
In 2019, St. James Infirmary became a proud sponsor of its rich cultural past by becoming fiscal sponsor to the Compton’s Transgender Cultural District, led by Aria Sa’id, and also celebrated its 20 year anniversary. Today, St. James Infirmary still continues to provide services to some of our most vulnerable community members, and fulfill Margo’s final legacy.
What We Believe
There are many factors which affect the working conditions and experiences for all Sex Workers including the political and economic climate, poverty and homelessness, stigmatization, violence, as well as the overwhelming intricacies of the legal, public and social systems. It is the philosophy of St. James Infirmary to build upon existing skills and strengths in order to allow individuals to determine their own goals.
We are fundamentally against the criminalizing of Sex Workers—regardless of our different perspectives on decriminalization or legalization, the collective view of the St. James Infirmary is that incarceration of our community further marginalizes and disenfranchised us, which creates barriers to capacity building, and exacerbates a public health crisis.
We believe in revolution through healthcare. We challenge the conventional healthcare model that divides patients and providers and fosters unhealthy power dynamics. Our peer-based model creates a safe, trusted, and honest environment in which to provide services, and empowers our community to define our own well-being.
We are founded on the principles of harm reduction—St. James Infirmary supports Sex Workers being treated with dignity and respect, in every aspect of their lives