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Sex Trafficking - Coggle Diagram
Sex Trafficking
Pertinent Assessment Findings
Unexplained absences from school or work
Poor school or work attendence
Runaway behavior
Boasting about frequent travel to other cities
Inappropriate dress for the current weather
Being sleep deprived
Being malnourished
Showing signs or impairment due to drugs or alcohol
Someone who has been coerced to take part in a crime
May live near or in an exploitive environment such as a farm, fishery, factory, massage parlor, motels, brothels, but sex trafficking can also take place in a home with parents, intimate partners, or other family members.
National Human Trafficking Resource Center indicators: Inconsistent history or a history that appears coaxed. May be difficult to determine if a language barrier is present; resistant to answer questions about injury or incident; avoids eye contact; fearful of touch; no idea of address or general area where they live; no control over their own finances; lacks decision making capacity; accompanied by a controlling companion or family members that refuses to let the patient speak for themselves or be alone for care or insists on being the translator; no ID or the companion has their ID; underage of 18 and involved in a commercial sex act; tattoos or branding signs; multiple sex partners; diminishes bruising or other marks on body; has addiction issues; admits to forced sex encounter or being forced into sex acts
May have physical signs or bruising, abrasions over bony prominences, scratches, loss of memory, fractures and contractures, brittle or fine hair, scabies, GI distress, perineal area pain, bleeding, trouble hearing, chronic head trauma.
Interventions
National Human Trafficking Hotline 1-888-373-7888
Text HELP to 233733 (BEFREE)
Email
help@humantraffickinghotline.org
Once a practitioner identifies a potential trafficked person, it is imperative to establish a private, quiet, safe place to assess the patient further, much like in cases of child or elder abuse.
Do not start a dialogue until you can establish a safe, private, and secure place.
Ask the patient if it is safe to talk now and if it is alright if you are the one in the room or whether they would prefer someone else. Never assume it is safe for the victim; they must confirm that it is safe.
Be alert to your facial expressions, body language, and any nonverbal cues you are exhibiting. Avoid stereotyping and revictimizing the potential victim as they disclose information.
Do not make false promises. Only offer what you can access provide.
If privacy cannot be obtained to interview the suspected victim alone, do not confront the situation. The trafficker may cause the victim serious bodily injury after removing them from the facility if alerted to the fact that the healthcare provider is suspicious of the situation.
Sexual assault kits may need to be obtained. Follow sexual assault collection of evidence protocols in your local area and per institutional policy.
Community/Normalization Considerations
Traffickers do not discriminate based on race, gender, social demographic, immigration status, or economic status.
Vulnerable individuals are people who lack support systems, are runaways, foster children, children in the juvenile system, homeless youth, people who have language or cultural barriers, people with substance abuse issues, undocumented migrant workers, people with disabilities, and people on Native American reservations.
Mental weapons used by the trafficker to exercise power and control over a victim may include threats of harm to children, siblings, or other family members; deportation or return to a traumatizing situation; calls to social services; and physical violence or reminders of past violence for misguided offenses.
Debt bondage, withholding of pay, and maintaining possession of all forms of identifying documents may further lead to an invisible bond or tie to the pimp/trafficker.
Trafficked victims may use a school bus, a public bus, a train, or a taxi.
Much like intimate partner violence, victims usually do not self-identify, self-report, or recognize the fact that they are being manipulated, controlled, stigmatized, or dehumanized.
Traffickers may only seek out healthcare for their victims when they become seriously ill since it presents a risk of discovery.
Traffickers seek out the quickest means of care, and lengthy emergency department waits may lead to their decision to leave with the victim before receiving medical treatment. They may also "hospital shop" for quicker wait times from door to the provider. An accompanying "family member" that is impatient, "in your face," and upset over lengthy delays in overcrowded emergency rooms or clinics may, in fact, be a trafficker. Another indicator is the "spouse" or "boyfriend" that insists on a high-risk patient, such as one with a possible ectopic pregnancy or appendicitis, leaving without being seen, against medical advice, or eloping before care is completed.
Cell phones can be another way the traffickers control the victim. The victim may have arrived alone but is always on her cell phone. The cell phone may be the trafficker's way of " keeping tabs" or listening to everything going on in the room.
Pathophysiology & Etiology
Adverse childhood experiences such as abuse and neglect
Stunted neurodevelopment that result in social, emotional, and cognitive impairments
History of sexual abuse
LGBTQ are higher risk
Homelessness
Children at greatest risk are those working in restaurants, hair and nail salons, nannies or Au pairs, or agricultural settings.
Lack of stable support structure while having accessibility to social media puts children at higher risk for exploitation