Reflecting on our last year, there is no question the past 12 months have 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, Our Mujeres TransLatinas En Accion group, 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 campaigning for 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.

For more than two decades, SJI has led the way in offering direct services in response to crises of criminalization, stigma, and impoverishment--and we continue to do so. The “Our Trans Home” transitional housing program serves a particularly crucial need. San Francisco has long been a refuge for Transgender and Gender Non-Conforming people (TGNC). However, trans homelessness has been an ongoing crisis. Due to the nontraditional nature of sex work, and the systemic discrimination against TGNC people in housing, employment, and healthcare, TGNC people are unable to access employment benefits, which contributes greatly to housing insecurity. TGNC people are 18 times more likely to experience homelessness and experience increased discrimination, harassment, and violence when trying to access shelters and housing services. In January of 2020, SJI opened its first transitional housing program for transgender and gender non-conforming adults, the Bobbie Jean Baker House. This housing program is the first of its kind, providing trans-specific cultural competence, an all-trans staff who are majority trans women, and majority people of color. The transitional home prioritizes houseless TGNC individuals who are BIPOC, disabled, elders, HIV+, and/or current or former sex workers. The Our Trans Home housing program serves 80 TGNC people with rental assistance, housing navigation services, and transitional housing and houses 15 people at a time at the transitional home.

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.

We want to reach through and beyond our in-person interactions, creating virtual spaces of connection when we can’t get together in person. So, SJI has launched “Dear Sex Workers, We Love You,” an online series for sex workers that includes a “sex work and parenting” support group, mindfulness meditation, advice on money management and taxes, an art therapy group, and more. The isolation of sex workers has always been a struggle, but the pandemic showed that we need each other more than ever. Our online series is just one attempt to break the isolation.

The staff and volunteers of SJI have been working tirelessly to champion our community and this year we lost our most storied champion, and 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 change in our lifetime and we will continue to provide excellent, free, peer-based harm reduction services to our community for as long as it takes.