Child sex trafficking and commercial sexual exploitation of children are major public health issues in the United States. Health care providers are often the only professionals to interact with trafficking victims and they are in a position to see things that others will not.
Research informs us that victims have an average of nine Health Care Provider encounters while in captivity and are rarely identified as victims of sex trafficking. Below are red flags that medical professionals can use to help identify a potential victim.
Red Flags in Medical Setting for Minor Victims 🚩
- Patient presents inappropriately dressed for age, weather.
- Child (or adult with the child) lies about the child’s age.
- Child presents with an adult who does all the talking.
- Child appears submissive, passive, and gives little eye contact.
- Adult does not want the child to be left alone with the health care professionals.
- Child is depressed, frightened, or anxious.
- History does not make sense or correlate with injuries.
- While able to answer initial questions, child or adult is not able to answer follow-ups or adequately describe where they live, go to school, work, etc.
- General signs of abuse/neglect present.
- Child or adult with them presents a questionable identity claiming to be the new wife or boyfriend/girlfriend relationship, visiting cousin, a family friend, a relative.
- Payment in cash rather than insurance.
- Minimizing health concerns or other risk factors.
- Vague medical history.
- Failure to make previous follow-up appointments.
- Distrust of law enforcement or anything that appears related to “the system.”
- Child may be openly hostile, refuse to answer questions, give an attitude.
Medical Specific Red Flags 🚩
- Bald patches where hair was pulled out
- Lacerations or bruises
- Scars, ligature marks, or bite marks
- Burns (cigarette or otherwise)
- Partial dentures where teeth were forcibly knocked out or in
- Stab marks
- Malnutrition, dehydration, exhaustion, stunted growth
- Dizziness, headaches, memory loss from traumatic brain injury
- Untreated disease
- Dental/visual problems
- Chronic back pain, muscle strains, cardiovascular and respiratory issues related to exposure to chemicals, serious industrial injury
- Persistent or untreated STIs or UTIs
- Vaginal or rectal trauma
- Multiple pregnancies/repeated abortions or miscarriages
- Pelvic Inflammatory Disorder
Emerging evidence suggests that a high percentage of child victims of sex trafficking in the United States seek medical attention, and they do so in a variety of settings. Most visit emergency rooms and about 35% go to outpatient facilities. (“Sex trafficking in the United States: Challenges for the healthcare provider;” V.J. Greenbaum, 2017).
Health issues seen in trafficking victims include but are not limited to the following:
- Sexually transmitted diseases, HIV/AIDS, pelvic pain, rectal trauma and urinary difficulties from working in the sex industry.
- Pregnancy, resulting from rape or prostitution
- Infertility from chronic untreated sexually transmitted infections or botched or unsafe abortions.
- Malnourishment and serious dental problems. These are especially acute with child trafficking victims who often suffer from retarded growth and poorly formed or rotted teeth.
- Bruises, scars and other signs of physical abuse and torture. Sex-industry victims are often beaten in areas that won’t damage their outward appearance, like the lower back.
- Substance abuse problems or addictions either from being coerced into drug use by their traffickers or by turning to substance abuse to help cope with or mentally escape their desperate situations.
- Psychological trauma from daily mental abuse and torture including depression, stress-related disorders, disorientation, confusion, phobias, and panic attacks.
- Feelings of helplessness, shame humiliation, shock, denial or disbelief.
(Indicators from the U.S. Department of Health and Human Services)
If you think you have come in contact with a victim of human trafficking, call the Human Trafficking Hotline Number at 1-888-373-7888. This hotline will help you determine if you have encountered victims of human trafficking, will identify local resources available in your community to help victims, and will help you coordinate with local social service organizations to help protect and serve victims so they can begin the process of restoring their lives.