Community leader and trans activist Cecilia Gentili is crushing the stigma against sex work.
In a partnership with Callen-Lorde Community Health Center, which has outposts in Manhattan, the Bronx, and Brooklyn, Gentili has launched COIN, or “Cecilia’s Occupational Inclusion Network,” a free health clinic to help sex workers have a safe and supportive relationship with their doctors. The program is named after the advocate and is an ode to her past experiences engaging in sex work.
“When we had a customer or a client, we would say to each other, ‘Go and get your coin, girl!'” Gentili, a transgender woman and founder of Trans Equity Consulting, told Gay City News. “It was so significant and descriptive of the work that we do.”
The clinic, which is funded through June, will offer primary medical care, sexual health, HIV treatment, and prevention — including PrEP services — as well as trans health services and reproductive health services. With nearly 30 patients enrolled in the program, the clinic is still in its infancy, but medical providers and advocates alike said they are filling a significant gap in the healthcare industry. All too often, sex workers experience discrimination from doctors, which makes it difficult to address their health needs and increases the likelihood they will go without routine care.
“Because sex workers are so stigmatized, it’s hard to get comprehensive health care,” said Dr. Zil Goldstein, a medical provider at COIN. “People are excited to have their healthcare in an affirming environment.”
Gentili knows this issue all too well. For years, she hid her occupation from doctors to avoid mistreatment.
“I didn’t know how they would react,” Gentili recalled. “When you have a clear understanding that the medical provider that you are seeing happens to be a person sensitive to your experience and is going to understand who you are, and how that plays a relationship with your body, the medical experience becomes much more easier.”
Last year, Gentili took direct action to confront the injustices facing transgender individuals in the healthcare system. She joined Tanya Asapansa-Johnson Walker and the Human Rights Campaign in a lawsuit against the Trump administration’s rule eliminating nondiscrimination protections on the basis of gender identity under the Affordable Care Act.
For many patients, Goldstein said this clinic will represent the first time a provider has viewed their medical care holistically and does not “pigeonhole” them into sexual health services. Because staffers understand the nuances of the sex work industry, they understand that an online sex worker’s needs can differ from someone who engages with clients in person.
The facility supports workers across the sex trade, including those who engage in camming, escorting, stripping, BDSM, and all other forms of sex work. Health officials are defining sex work as any form of “being sexual (or the idea of being sexual) in exchange for money, gifts, safety, drugs, hormones, or survival needs such as housing, food, clothes, or immigration and documentation — whether you get to keep the money/goods/service/or someone else profits from these acts.”
To protect patients’ privacy, charts will not indicate that they are enrolled in the sex worker program. If there is a request to release medical records to law enforcement, the clinic said they would “disclose the least amount of information necessary.” On the COIN website, Callen-Lorde expresses support for the comprehensive decriminalization of sex work.
Patients will receive care regardless of their income or insurance status. For those with insurance coverage, Callen-Lorde will bill the insurance company — and any co-pays or deductibles will be paid by the COIN Clinic. Patients at the COIN Clinic will not be charged for any medications, labs, or care, according to the clinic’s website.
The opening of the clinic coincides with robust advocacy surrounding the rights of of sex workers in the state. This year, advocates successfully repealed a loitering law known as a ban on “Walking While Trans,” a now-gutted policy that police officers used to disproportionately target transgender women of color. That legislation also seals all prior convictions and records under the statute.
As someone from multiple marginalized groups, Gentili said the clinic’s launch is a testament to her journey and the progress made to advance sex worker rights.
“I’m a sex worker. I’m a trans woman. I lived in this country undocumented,” she said. “I never had an expectation in life to have a clinic named after me. It’s overwhelming. Beautifully overwhelming.”
Those who would like to schedule an appointment at the clinic can call 212-271-8134.
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