Activist Spotlight: Synn Stern on Homelessness, Harm Reduction, and Sex Worker History

L. Synn Stern has been doing outreach work since the 1980’s.  As an ex-sex worker and ex-injection drug user, she has a unique perspective on her work and the lives of her clients. She is now a certified R.N. and works as Health Services Coordinator at the Washington Heights Corner Project, a community space in Washington Heights that provides syringe exchange, counseling, and various support groups among other services. She also helps run the weekly women’s group there. I took some time to talk to her about her past doing sex work, her passion for outreach, and how she was rebirthed into the woman she is today.

What was your experience being homeless for much of your youth in NYC?

I spent a lot of time as one of the hidden homeless; the couch surfer, the office dweller, the sleeper in locker rooms, exploiting the rich, unpoliced resources of college campuses. I spent more time than that frankly homeless; out on the street with nowhere to to stash my blankets and nowhere to wash. NYC is a cruel place for those in need of a public toilet, and the more homeless one looks, the harder they are to find. Although it took me a while to figure out, as long as college was in session, I was able to keep myself together by sleeping in unused campus spaces or befriending legitimate students, eating in their cafeterias (or getting students to steal food for me) and bathing in gym buildings and the like. I lived several relatively undisturbed years in the dance building of a campus under construction. I had my own set of lockers, unlimited access to showers. Fantastic. Between semesters I ran the gamut of out-on-the-street homeless, to sleeping on trains, to living in abandoned buildings, squats, emergency rooms, and tricks’ houses. The usual thing.

How did you get involved in the sex industry? What was it like working then in comparison to how it is now?

I remember sitting in a bar once, very underage, during school hours, and the guy next to me said, “Penny for your thoughts.” I scoffed. Then he said, “Twenty bucks for your thoughts,” and it was that simple. Before that I had not realized that there was any value to what I’d been giving away.

And for the first dozen paid encounters, I felt like Queen Feminist. I felt like I’d invented it. I could not have been prouder. Of course, I was out there a long time, vulnerable, incautious and young enough to experience at lot of pain and shame as well…

The biggest difference between then and now is technology. Cars were bigger and child safety locks had not yet been invented, and there was no such thing as a cell phone, an ATM, or Craigslist. Some changes have been for the better, some for the worse.

You were involved with the pioneer NYC sex workers’ rights org, PONY, around their inception. How did you get involved and what was it like then?

I remember seeing guys wandering around wearing PONY T-shirts. I’d heard of PONY, and was so excited to see all these guys who were political and out. It was some time before I learned that PONY was a brand name of athletic gear, not an advocacy group. I hooked up with WHISPER initially: Women Hurt In Systems of Prostitution Engaged in Revolt. Rather a rescue-ish, anti-prostitution bunch, but it gave me a community and a forum, and an opportunity to think about myself as having a profession.

I don’t quite remember how I got from WHISPER to PONY initially, just that the first meeting I attended was in Veronica Vera’s studio—later her Academy for Boys Who Want to be Girls. It had a doorman. I was still newly and insecurely housed and afraid I would not be allowed in. They served chips and cookies and I was so hungry I was afraid to eat anything because I thought my hunger and poverty would be obvious, and I was ashamed. When the meeting ended, they offered the leftovers to me, but I was too embarrassed to take them.

Some heavy hitters of the sex work movement were there: Annie Sprinkle, Tracy Quan. And for a while I got them involved with doing outreach to our brothers and sisters on the street. By outreach, I basically mean condom distribution to the NYC strolls. A small group would go out with PONY information, sandwiches, condoms, and lube, and try to find sex workers willing to talk to them. PONY meetings at the time included news, product reviews, client reviews, work site discussions, safety tips, and discussions of international events, among other things.

And later Annie Sprinkle gave you one of her Aphrodite awards?

Annie was doing one of her performance pieces at the museum and gave homemade awards to those of us who had been active with PONY the previous year.  [For years, Sprinkle has been giving out Aphrodite awards for ‘sexual service to the community’ to fellow sex workers, activists, and sex educators—ed.] While it was half a joke, I treasure my award. I was proud of it then and I’m proud of it now. I include it in the awards section of my resume, along with the psychiatric nursing award I got in my first nursing school and the award Hunter College gave me for sex education when I got my MPH. But I’m sure the vast majority of people to whom I’ve submitted my resume never notice it.

That’s awesome! So what were some of the tools and resources you used to preserve and change your life?

I always read and often wrote. I let someone tell me that “really tough people feel nothing,” and I believed him, and decided I didn’t want to be tough. I took the expression “living well is the best revenge” to heart after some sad years moping about my early abuse. I had a big vocabulary, white skin and good teeth, good diction, good posture, and a loving if imperfect family which gave me adequate nutrition, vaccinations, and a healthy start. I lived in a racist, classist city in a racist, classist time. I was invisible to a certain type of law enforcement who assumes addicts and prostitutes are a certain color and talk a certain way. I was white and abusing the privilege. And that kept me out of jail, and mostly out of the grasp of law enforcement. When I graduated from college (SUNY Purchase, BA in Literature 1983), because you don’t get a diploma until sometime later in the mail, I had to get a bursar’s note to prove it to my father who had no idea what I’d been doing. But all my time on the street, I still had a family I could return to if things got really bad. And I often, if briefly, did.

And yes, dope too helped keep me going. It numbed me, fed me, warmed me, loved me, and kept me from killing myself just long enough to live through it all and get myself clean. I thought I wanted to be an artist until the AIDS crisis came along and made people like me employable for exactly the sort of history one would normally hide from an employer: a history of drug use, of sex work, a knowledge of the streets. And an early boyfriend had been a medic. We used shooting galleries and shared works. Who didn’t? What other choice was there? But he impressed upon me the importance of sterilizing our equipment and trying to inject correctly. I owe him my relatively un-scarred veins and my HIV-free status.

What was it like experiencing the beginning of the AIDS epidemic?

The massive dying started around 1981 and did not really stop until 1996, when we finally got anti-retroviral medications to work.

Unthinkable now. Comparisons to the Plague do not exaggerate. The stigma was such that Japan’s anonymous test site was in Hawaii. The fear was such that hospitalized patients would be largely left alone and their foods trays dumped outside their doors. Nurses refused to treat people assumed to be infected. Morticians refused to bury them. Parents refused to permit their children to attend school with them. People were afraid to get tested for fear of being fired, or kicked out of their apartments, and many were. I lost most of my network. So many dead friends….

It was years before we were able to get people to move from thinking about “risk groups”—”faggots,” “junkies,” ” hookers,” Haitians—to “risk behaviors.”

Syringe exchange programs did not exist in those years, and I was newly clean, working at Odyssey House (a long-term residential drug treatment program), sick to my stomach 5 days per week until it occurred to me that my illness was philosophical rather than physical, and I left to find an employer who would let me do my idea of decent, healing work.

What was problematic about working at a more mainstream drug treatment program?

Odyssey House, like almost every other mainstream drug treatment program in the USA is based on the 12 steps of Alcoholics Anonymous. Not a terrible thing in itself, but when you combine it with the fact that the first step is getting people to admit that they are powerless over their drug use, and that they have a “progressive, incurable disease,” add to it the fact that the vast majority of people who enter treatment do not complete it and most of the people who leave treatment do so in their first few days—I watched far too many people enter treatment and leave it, learning only that they have an incurable disease over which they are powerless. Nothing more.

And for those that stayed, residential treatment programs at that time still practiced the “break them down, then re-build them” model developed (mainly for men) in the 1970’s. Strict hierarchy, head shaving, diaper wearing, “encounter” sessions, public shaming—all the norm. Of course, many people left at the broken stage… For those few who remained on to complete treatment, after having spent a year or more learning to function in a specialized environment with its own specific language and norms, they needed far more help learning at adjust and function in the regular world than the treatment program was giving them. Heavy on care. Way too light on aftercare. So they either stayed on to become program staff, or they went back to a world they no longer knew how to live in and relapsed. Seeing this over and over again, and realizing that, for the program, the only success was total abstinence, and that anything short of that they blamed on the failure of the client, not—for instance—their own lack of “re-entry” or aftercare support, was deeply disturbing.

Working at Odyssey had been salvation for me in the beginning—all the structure I needed as a newly clean person but I got to go home at night and get a paycheck too. The awareness that they were probably damaging as many if not more people than they were helping was one I just could not face, until I was literally sickened with it.

What made you want to do clinical work?

Well, there were the usual reasons: I wanted to help people, I wanted to “give back.” I loved working at the exchange(s) but it frustrated me to watch people get treated badly by health professionals or die of preventable things: pneumonia, overdose, miscarriages, going septic from cellulitis and missed injections. I wanted my clients to get good, loving, informed care, and if no one else was doing it for them I would learn to do it myself. I was afraid that getting my license would mean that I would have to change the way I worked. And to some degree it has. Having a license means having a license to protect. But it also has given me some more power and credibility. I don’t regret it. And it was exciting to go back to school in my 40s and realize I actually had a brain and could learn “real” things.

You once wrote a harm reduction manual for street working sex workers. What’s the story behind that?

In 1990 I attended the 1st International Conference for the Reduction of Drug-Related Harm in Liverpool, and the crew who had organized the conference invited me to come do a training for their drug treatment staff. The manual, which was initially produced as that training’s handout, was written while I was living in Rotterdam, The Netherlands—a new expat, newly in love and reveling in the experience of exploring that country’s unique, rational drug policy. The manual was what I would have wanted had such a thing been available to me as a new street sex worker, and was the culmination of all my years of street experience and foolish mistakes.

I’d written scholarly papers and health education manuals before—for instance, a self-injecting guide for women—but that street sex work manual is the work for which I’m best known. It has been translated into multiple languages, and is still being used, totally or in part, by many agencies across the world. I doubt I would have had the insight or security to produce such a thing without the love I found in Rotterdam, or the distance I got there from my NYC past.

Do you think your life experience gives you a different approach and perspective on this sort of work?

I don’t believe in one-size-fits-all approaches to education or care, and I don’t believe that you have to have shared someone’s experience in order to provide them with appropriate, individualized service, but you do have to be willing to imagine what their experience is in order to provide education or care that fits. I have seen too many compassionate, well-meaning but otherwise clueless people give advice that is so inappropriate as to be laughable. For instance, the MD who on rounds, suggested our anemic, homeless, pregnant client get several servings of rare meat per week. I’m sure she might have loved to. But how? Better, if more antisocial, to suggest she steal raisins.

I once listened to a nutritionist give the most educational and inspired advice to a hypertensive pregnant teen. Rather than telling her to “reduce sodium,” she sat down with her and first drew up a list of foods she normally ate from the fast food restaurants she frequented, and then helped her pick the lowest salt, lowest fat choices from among them—e.g. “extra crispy just means extra fried and extra fat.”

Harm reduction is everyday thinking in every field except drug treatment. Think seatbelts and traffic signals and designated drivers. Think of the dentist who encourages their patients to chew gum when they can’t brush or to eat popcorn to remind them to floss. Think rock climbing classes and safety harnesses. Yet teaching someone to inject in the direction of blood flow, or to pay their bills before they go out on a binge is still considered so radical it borders on inappropriate. This nutritionist embodied the expression “meet them where they’re at,” and I try to model my work with others after her good example.

Recently, you and your friend and coworker Nik did a spoken word performance about drug policy for the Red Umbrella Diaries. Can you tell me a bit about that?

I had written an article for The International Journal of Drug Policy in 1992 about my experiences as an American working in Rotterdam. The performance piece is loosely based on that—combining my experiences in NYC in the pre-syringe exchange era and Rotterdam’s enlightened approach to drugs with Nik Krempasky’s experiences as a new nurse and health educator. It was about spinning a story together—part personal, and part political—about the changing landscape of sex work and drugs, and how public health policy interacts with these two cultural taboos. I used to do a lot of performing and public speaking—both academic and artistic—but at the time I did that piece, after my nursing school imposed a cone of silence, I was really out-of-practice and really nervous. But Nik was a joy to work with, and the audience tittered in appropriate places. I look forward to having a chance to do it again. We keep meaning to record it as a podcast for the Harm Reduction Coalition, but have not gotten around to it yet. It is available as a podcast through the Red Umbrella Project.