St. James Infirmary Clinic

The St. James Infirmary, (abbreviated SJI), was founded by members of the sex worker activist community in 1999 and is a peer-based, full spectrum medical and social service organization serving current and former sex workers of all genders and their families. Located in the South of Market district in San Francisco, California, the St. James Infirmary is a public non-profit 501c3. Its services are free and confidential. Named after legendary sex worker rights activist and founder of COYOTE (Call Off Your Old Tired Ethics), Margo St. James, the St. James Infirmary is the first occupational safety and health clinic for sex workers run by sex workers in the United States.

In 1993, the San Francisco Board of Supervisors passed legislation that called for the establishment of the San Francisco Task Force on Prostitution. This Task Force was formed to investigate, “prostitution patterns,” and to “recommend social and legal reforms which would best respond to the City’s needs while using City resources more efficiently”. In 1996, the Task Force issued its final report and determined that the City’s responses to prostitution were not only ineffective, but also harmful. Pertaining to health, safety and services, the report stated that, “programs should include occupational and educational programs, health and other programs for those who continue working as prostitutes, as well as those who wish to transition into other occupations”.

Under “Hold and Treat” laws, persons arrested for prostitution charges would be forcibly tested and treated for sexually transmitted infections. In 1998, Margo St. James, a local sex workers' rights activist and COYOTE member, received a call from a woman in jail who had been arrested for prostitution, who told Margo that while held awaiting charges, her blood had been drawn without the woman’s consent and without her knowledge of what test was being performed. Margo called the Director of STD Control and Prevention of the San Francisco Department of Public Health, Dr. Jeffrey Klausner. Dr. Klausner invited members of the sex worker community for a meeting on the health status of sex industry workers. Before this meeting, Dr. Klausner was aware that the San Francisco Department of Public Health was not “really working with the sex worker population and/or the massage parlor workers. So [he] wanted to initially do some outreach to those populations” (J. Klausner, interview, September 4, 2003). This was the beginning of conversations and alliances to be made that provided the framework for a peer led occupational health and safety clinic for sex workers. The St. James Infirmary was made possible because of the unique vision of sex worker rights activists from COYOTE and the Exotic Dancers Alliance (EDA) and a timely event in the San Francisco County Jail. Via collaboration with the Department of Public Health STD Control and Prevention Section (known as “City Clinic"), University of California San Francisco (UCSF), COYOTE and EDA, in 1999, the first Occupational Health and Safety Clinic run by and for Sex Workers was created.

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