Lofton moved to New York City in 1977 and immersed herself in poetry. She also became a member of a gay organization named United Lesbians of Color for Change Inc. She wrote, performed and eventually published her poetry during the height of the Slam Poetry movement in New York. Lofton took the name "Sapphire" because of its one-time cultural association with the image of a "belligerent black woman," and also because she said she could more easily picture that name on a book cover than her birth name.
Sapphire self-published the collection of poems Meditations on the Rainbow in 1987. As Cheryl Clarke notes, Sapphire's 1994 book of poems, American Dreams is often erroneously referred to as her first book. One critic referred to it as "one of the strongest debut collections of the 1990s".
Her first novel, Push, was unpublished before being discovered by literary agent Charlotte Sheedy, whose interest created demand and eventually led to a bidding war. Sapphire submitted the first 100 pages of Push to a publisher auction in 1995 and the highest bidder offered her $500,000 to finish the novel. The book was published in 1996 by Vintage Publishing and has since sold hundreds of thousands of copies. Sapphire noted in an interview with William Powers that "she noticed Push for sale in one of the Penn Station bookstores, and that moment it struck her she was no longer a creature of the tiny world of art magazines and homeless-shelters from which she came". The novel brought Sapphire praise and much controversy for its graphic account of a young woman growing up in a cycle of incest and abuse.
A film based on her novel premiered at the Sundance Film Festival in January 2009. It was renamed Precious to avoid confusion with the 2009 action film Push. The cast included Gabourey Sidibe, Mo'Nique, who won the Academy Award for her portrayal of Precious' mother Mary, Mariah Carey, and Lenny Kravitz. Sapphire herself appears briefly in the film as a daycare worker.
Sapphire's writing was the subject of an academic symposium at Arizona State University in 2007. In 2009 she was the recipient of a Fellow Award in Literature from United States Artists.
Sapphire currently lives and works in New York City.
She has recently released a companion novel to "Push" that focuses on Precious's son, titled "The Kid".
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