Welcome to COIN – a free healthcare program for sex workers in an affirming, supportive environment.
COIN (Cecilia’s Occupational Inclusion Network), a health program for sex workers, provides free care in an affirming, supportive environment.
The COIN Clinic is open to anybody who identifies as a sex worker and self-attestation is the only requirement for enrollment. COIN patients have access to primary care, sexual health, behavioral health, dental, pharmacy, and any other services received at Callen-Lorde. For uninsured patients, COIN works to cover the cost of care and assists in obtaining coverage when possible. Insured patients in the program can have their copays and deductibles covered. Additionally, all COIN patients can receive specialized case management and access a support group for sex workers that meets twice a month.
COIN patients can utilize Walk-In hours at Callen-Lorde Chelsea every Friday from 10am-3pm or can be scheduled at any Callen-Lorde location. Intake and appointments can be made by calling the COIN line at (212) 271-8134 or the main call center at (212) 271-7200.
As we continue to mourn the death of our namesake and inspiration Cecilia Gentili, Callen-Lorde wants to assure everyone that the COIN program will continue to provide free, competent, affirming health care to sex workers.
Learn more about COIN Confessions, a support group for sex workers and people involved in the sex trade industry. Join us for community building and a confidential space to discuss topics such as health, safety, legality, financial management, and social issues here.
Frequently Asked Questions
What is Callen-Lorde’s philosophy toward sex work?
Callen-Lorde firmly and without reservation supports the health, rights, and dignity of sex workers. We are opposed to laws that disproportionately regulate and criminalize bodily autonomy, sexuality and sexual and reproductive health and rights. We support the total decriminalization of sex work as an important step to protect and respect the human rights of all sex workers. We recognize sex work as meaningful and valuable work that provides economic opportunity for people selling and trading sex. We affirm that sex workers are not criminals to be stigmatized, but rather, members of an often exploited and under-protected working class. We stand in solidarity with sex workers demanding rights, the recognition of sex workers’ agency, decision-making capacity, and safe working conditions. We honor the different experiences that people may have with regards to the level of consent and control they experience around participating in the sex industry. We understand the gray area between sex work and sex trafficking and want our services to be available to anyone in the sex industry, regardless of their level of agency in their work. We pledge to promote the rights of sex workers and to create a safe space for sex workers to obtain healthcare without judgment, fear, or stigmatization.
How do you define “sex work”?
Callen-Lorde uses the Youth Women’s Empowerment Network of sex trade, which defines it 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”. This means we support people engaged in any form of sexual labor, be it camming, escorting, stripping, BDSM, and all other forms of sex work. In a nutshell, if you tell us you are a sex worker of any kind, you are welcome in this program.
What will be written in my chart?
In order to maintain the confidentiality and safety of our patients, we will not be indicating in your chart that you have been enrolled in the sex worker program but instead it will indicate that you have been enrolled in the COIN program.
We realize many sex workers have concerns about what is documented in their medical chart. Our providers will work with you to make sure you are comfortable with everything that gets written down or recorded during your visit.
What if my chart is subpoenaed?
When any patient’s chart at Callen-Lorde is subpoenaed, there are several steps that are taken to protect confidentiality of records. When any request is made to disclose information by a law enforcement official a lawyer and/or the Compliance and Privacy Officers review the subpoena prior to any disclosure of records. This is to ensure all proper channels have been followed by requesting a subpoena, and that we are able to disclose the least amount of information necessary to law enforcement. Whatever records are disclosed to law enforcement will be reported to the patient. Unless specifically requested, only basic information will be disclosed.
Explain how this is free. Like free for real?
All patients of Callen-Lorde are treated regardless of ability to pay. When patients do not have insurance, we have an income-based sliding fee scale for care. The COIN Clinic has additional coverage so you will NOT BE CHARGED for any medications, labs, or care at Callen-Lorde (including copays/deductibles etc). If you have insurance, we will first bill care to your insurance. Any fees your insurance does not cover, (co-pays/deductibles, etc.) will be charged to the COIN Clinic and you will not be billed.
We recommend that all patients meet with one of our insurance navigators to discuss your health insurance options. Although your care will be free at Callen-Lorde, any care received outside of Callen-Lorde such as specialty or emergency care, cannot be covered. Our Insurance Navigators can help you to decide what health insurance option might be right for you.
It is also important to note that at this time, the funding is temporary, and we are unaware how long it will last. If our program changes and we are no longer able to completely cover your care at Callen-Lorde, you will be alerted before further care is rendered.
But what if I get a bill?
If you are enrolled in the COIN Clinic, you should not receive a bill from Callen-Lorde. If you are mistakenly sent a bill for care, such as medications or lab bills (that we ordered for you) please call 212-271-7253 to speak to a Billing Specialist.
What training have my provider and support staff had?
Callen-Lorde partnered with Trans Equity Consulting to work with us on this program. The entire staff of Callen-Lorde has been trained on working with people in the sex trades and our providers (both medical and mental health) have received additional specific training on the best way to care for sex workers. Finally, Callen-Lorde convened 8 focus groups of all gender identities to help us inform this program. These recommendations were implemented to all aspects of the program and shared with the staff of the program.
I have some feedback about the program, where can I send it?
As this is new program at Callen-Lorde, we very much welcome your feedback. You can email feedback directly to fbrigham@callen-lorde.org or, you can call the patient experience department at 212-937-4836. Finally, if you would like to get involved more directly with the program, you can apply to join our Community Advisory Board (CAB). The application for this is on our website at https://callen-lorde.org/community-advisory-board/.
What is the history of the COIN program and legacy of Cecilia?
COIN is the manifestation of Cecilia’s dream and although it is difficult to imagine doing this work without her, we are humbled and honored to keep this vital lifeline open in her name. In honoring Cecilia’s passionate advocacy, Callen-Lorde stands ready to reinforce our efforts to support the full decriminalization of sex work in New York. We are here to support you, hold you in your grief, and continue providing free and competent health care for sex workers.
What steps can I take to contribute to harm reduction efforts?
Save a Life: Carry Narcan, Use Drug Testing Strips
Naloxone, also known as its brand name Narcan, is a safe and effective medication used to counteract the effects of an opioid overdose. It can reverse the effects of opioids like heroin, morphine, fentanyl, prescription pain medications, and other synthetic opioids. Using naloxone is as easy as three simple steps: peel the packaging, place the device in one nostril, and press the plunger. Anyone can use or administer naloxone, and it is a safe way to completely reverse an opioid overdose.
Fentanyl is a powerful synthetic opioid that can be deadly, even in very small amounts. Xylazine is a dangerous tranquilizer that, like Fentanyl, is found mixed with other drugs in NYC. Drug testing strips can help detect the presence of fentanyl or xylazine in drugs.
Free naloxone kits and fentanyl and xylazine test strips are available at Callen-Lorde and many other community-based organizations and pharmacies throughout New York State. For more information on kits, strips, or trainings, visit nyc.gov/naloxone or https://oasas.ny.gov/prevent-overdose