The Naughty Nurse Mobile Is Saving Trans Lives in the SF Bay Area

On Tuesday at a van is roaming the Mission. This particular Tuesday is a typical one: The van, known as the Naughty Nurse Mobile, gives seven HIV tests and a few HCV tests, and has a visit from a trans elder, who is a street-based sex worker. Unapologetically, the nurses of the Naughty Nurse Mobile fill gaps in care to make sure that no one is left behind.

Launched in 2017, the Naughty Nurse Mobile is a health clinic-on-wheels for sex workers in San Francisco’s Mission District. A program of Horizons’ grantee partner St. James Infirmary, the mobile clinic functions to bring people together. Nurses not only provide free, on-site HIV and HCV testing, but they also take strolls through popular nightlife areas to pass out “ho bags” and chat with sex workers about the Infirmary’s services. “We’re meeting a lot of people and letting them know we’re available,” describes Toni Newman, Executive Director of St. James. “Our goal with the Naughty Nurse Mobile is to get them in here [to the clinic] to see what their needs are.”

Newman, a trans woman of color and former sex worker, has dramatically bolstered the reach of St. James during her tenure. Not only has she launched innovative outreach strategies, such as the Naughty Nurse Mobile, but she has also hired 16 trans women of color to better retain trans patients of color, who often have distinct, unmet needs. Now, with 23 trans women of color on staff, St. James has become the largest employer of trans women of color in the United States.

Innovation is embedded in the fabric of St. James. Since their founding in 1990, they have adopted innovative strategies to reach the SF Bay Area’s diverse sex worker population, which has few other resources. As a peer-based clinic, St. James is run by the people, for the people. It is staffed by former sex workers, people of color, and transgender people. “Our clients know we get it,” says Newman. “That’s why I think they come back.”

St. James’ trans-specific health clinic, STRIDE, has patients who have been returning for eleven years. The clinic provides hormone therapy and gender-affirming services for transgender sex workers – and was one of the first programs of its kind in San Francisco. Under Newman’s leadership, STRIDE has evolved into a “one-stop shop” for trans sex workers, providing healthcare, therapy, substance abuse counseling, case management, name change services, and housing referrals. 

Newman makes it clear that for sex workers, many of whom have limited access to basic resources, innovation is a necessity. As a former sex worker, she “understand the logistics of survival” and knows that creative approaches are essential for solving complex problems. 

Horizons’ venture philanthropy approach to grantmaking prioritizes solutions like these: innovative, community-derived approaches that are bold and unapologetic. Horizons has been a long-time supporter of St. James with our flagship Community Issues Program because, with every peer-based connection made, St. James is saving lives.