Health care professionals beware. It is estimated that more than half of the trafficked victims encounter health care providers during their exploitation. You may have a unique opportunity to identify and assist a trafficking victim by providing access to services, resources and information.
Human trafficking is the business of stealing freedom for profit. In some cases, traffickers’ trick, defraud or physically force victims into providing commercial sex. In others, victims are lied to, assaulted, threatened or manipulated into working under inhumane, illegal or otherwise unacceptable conditions. It is a multi-billion-dollar criminal industry that denies freedom to 24.9 million people around the world.
Myth: It’s always or usually a violent crime.
- Reality: By far the most pervasive myth about human trafficking is that it always – or often – involves kidnapping or otherwise physically forcing someone into a situation. Most human traffickers use psychological means such as, tricking, defrauding, manipulating or threatening victims into providing commercial sex or exploitative labor.
Myth: All human trafficking involves commercial sex.
- Reality: Human trafficking is the use of force, fraud or coercion to get another person to provide labor or commercial sex. Worldwide, experts believe there are more situations of labor trafficking than of sex trafficking. However, there is much wider awareness of sex trafficking in the United States than of labor trafficking.
Myth: Only undocumented foreign nationals get trafficked in the United States.
- Reality: Polaris has worked on thousands of cases of trafficking involving foreign national survivors who are legally living and/or working in the United States. These include survivors of both sex and labor trafficking.
Myth: Human trafficking only happens in illegal or underground industries.
- Reality: Human trafficking cases have been reported and prosecuted in industries including restaurants, cleaning services, construction, factories and more.
Myth: Only women and girls can be victims and survivors of sex trafficking.
- Reality: One study estimates that as many as half of sex trafficking victims and survivors are male. Advocates believe that percentage may be even higher but that male victims are far less likely to be identified. LGBTQ boys and young men are particularly vulnerable to trafficking.
Myth: Human trafficking involves moving, traveling or transporting a person across state or national borders.
- Reality: Human trafficking is often confused with human smuggling, which involves illegal border crossings. In fact, the crime of human trafficking does not require any movement whatsoever. Survivors can be recruited and trafficked in their own home towns, even their own homes.
Myth: All commercial sex is human trafficking.
- Reality: All commercial sex involving a minor is legally considered human trafficking. Commercial sex involving an adult is human trafficking if the person providing commercial sex is doing so against his or her will as a result of force, fraud or coercion.
Myth: If the trafficked person consented to be in their initial situation, then it cannot be human trafficking or against their will because they “knew better.”
- Reality: Initial consent to commercial sex or a labor setting prior to acts of force, fraud, or coercion (or if the victim is a minor in a sex trafficking situation) is not relevant to the crime, nor is payment.
Myth: People being trafficked are physically unable to leave their situations/locked in/held against their will.
- Reality: That is sometimes the case. More often, however, people in trafficking situations stay for reasons that are more complicated. Some lack the basic necessities to physically get out – such as transportation or a safe place to live. Some are afraid for their safety. Some have been so effectively manipulated that they do not identify at that point as being under the control of another person.
Myth: Labor trafficking is only or primarily a problem in developing countries.
- Reality: Labor trafficking occurs in the United States and in other developed countries but is reported at lower rates than sex trafficking.
Myth: Traffickers target victims they don’t know.
- Reality: Many survivors have been trafficked by romantic partners, including spouses, and by family members, including parents.
Women and girls account for 75% of trafficking victims globally.
According to the International Labor Organization, there are 40 million victims of human trafficking at any time – 25% are children!
88 percent of victims had contact with at least one health care professional at some point during the period in which they were being trafficked; however, none were identified.
Almost 41% sex trafficking victims are African American.
Barriers to Identifying
Many times, it is hard to identify a victim of trafficking because there are both professional and victim barriers. The primary barrier in healthcare is a lack of knowledge on the part of the provider. Other barriers include not using trauma-informed care and making assumptions without appropriate follow-up. Unfortunately, prejudice and judgement are exhibited by some providers. Patient barriers include a lack of knowledge related to law; fear of speaking out; and, often language obstacles.
What Can Healthcare Professionals Do?
- Provide human trafficking education to all staff
- Create protocols on how to identify and assist victims
- Teach providers the questions to ask – approach without judgement
- Instruct providers to insist on privacy with the patient to inquire further
- Help providers understand the true needs of a person being trafficked
- Know the at-risk populations
- history of childhood abuse
- runaway teens
- persons with disabilities
- undocumented immigrants
- racial and ethnic minorities
- Hang posters about human trafficking and resources
- Let patients know they are in a safe place
Healthcare facilities need to not only know how to identify but also provide access of specialized care to these victims using an intradisciplinary approach. Victims of trafficking have a large list of needs ranging from healthcare to housing and most importantly, safety.
Learning More Can Help
Are you or someone you know being trafficked? Is human trafficking happening in your community? Recognizing potential red flags and knowing the indicators of human trafficking is a key step in identifying more victims and helping them find the assistance they need.
Bear in mind that not all indicators will be present in all situations. The type of trafficking and the content or environment are all important to consider.
Common Work and Living Conditions: The individual(s) in question
- Is not free to leave or come and go at will
- Is under 18 and is providing commercial sex acts
- Is in the commercial sex industry and has a pimp/manager
- Is unpaid, paid very little, or paid only through tips
- Works excessively long and/or unusual hours
- Is not allowed breaks or suffers under unusual restrictions at work
- Owes a large debt and is unable to pay it off
- Was recruited through false promises concerning the nature and conditions of his/her work
- High security measures exist in the work and/or living locations (e.g. opaque windows, boarded up windows, bars on windows, barbed wire, security cameras, etc.)
- Is living and working on site
- Experiences verbal or physical abuse by their supervisor
- Is not given proper safety equipment
- Is not paid directly
- Is forced to meet daily quotas
Poor Mental Health or Abnormal Behavior
- Is fearful, anxious, depressed, submissive, tense, or nervous/paranoid
- Exhibits unusually fearful or anxious behavior after bringing up law enforcement or immigration officials
- Shows signs of substance use or addiction
Poor Physical Health
- Shows signs of poor hygiene, malnourishment, and/or fatigue
- Shows signs of physical and/or sexual abuse, physical restraint, confinement, or torture
Lack of Control
- Has few or no personal possessions
- Is frequently monitored
- Is not in control of their own money, financial records, or bank account
- Is not in control of their own identification documents (ID or passport)
- Is not allowed or able to speak for themselves (a third party may insist on being present and/or translating)
- Claims of just visiting and inability to clarify where they are staying/address
- Lack of knowledge of whereabouts and/or do not know what city he/she is in
- Appear to have lost sense of time
- Shares scripted, confusing, or inconsistent stories
- Protects the person who may be hurting them or minimizes abuse
This list is not exhaustive and represents only a selection of possible indicators. The red flags in this list may not be present in all trafficking cases. Each individual indicator should be taken in context, not be considered in isolation, nor should be taken as “proof” that human trafficking is occurring. Additionally, cultural differences should also be considered.
To request help or report suspected human trafficking, call the National Human Trafficking Hotline at 1-888-373-7888 or text “help” to BeFree (233733).
Rollins, R., PhD, Gribble, A., Barrett, S., and Powell, C. (2019). AMA Journal of Ethics. Retrieved from https://journalofethics.ama-assn.org/article/who-your-waiting-room-health-care-professionals-culturally-responsive-and-trauma-informed-first/2017-01
Futures without violence (2019). Retrieved from https://www.futureswithoutviolence.org/human-trafficking/?gclid=CjwKCAjw7MzkBRAGEiwAkOXexKiCVfJF7R93tZ4R_4V5W7KziJzjsy_wl7qN58pdcKQ9qzJAFEBhvRoCHwUQAvD_BwE
US Institute of Against Human Trafficking (2019). Retrieved from https://usiaht.org/news/?gclid=CjwKCAjw7MzkBRAGEiwAkOXexCMTS_yhsVmDXORSfHYCNskJ6jYjM3cBGWiLerFfyHAkANjslqxmLhoCkFwQAvD_BwE
Retrieved (2019) from: https://polarisproject.org/human-trafficking-myths-and-facts