Recognizing the Red Flags of Sex Trafficking

Melissa Mills, BSN

You work in the ED. Tina, a young woman in her early 20’s, has just been brought back to Exam Room 8. You go in to introduce yourself and see that she has come with complaints consistent with a UTI. Tina is lying in bed, appears malnourished, and doesn’t make eye contact. She is with another woman who is around the same age and an older woman who Tina calls “ma’am” and introduces as her friend, Miss Rhonda. You notice that the older woman does most of the talking, and reports that Tina lost her driver’s license a few months ago and hadn’t gotten a new one. She also tells you that she will pay in cash today for any treatment Tina might need.

As you do your admitting assessment, Tina gives you a sketchy health history and says she just doesn’t know about her health when she was younger. You ask the other two women to step outside while you do your physical exam, but Miss Rhonda refuses and says that Tina has no secrets. Tina just looks away.

During your exam, you notice several bruises on Tina’s back, chest, and inner thighs. When you ask how she got the bruises, Tina quietly says that she often falls for no reason. Once you are done with your assessment, you go to leave the room, and Miss Rhonda tells you they don’t have much time and need to be treated quickly.

As you walk out of the room, you wonder to yourself just what the real story is with the patient in Room 8.

Trafficking by the Numbers

Human Trafficking is an umbrella term that includes sex trafficking, forced labor, and domestic servitude. The Department of Homeland Security defines human trafficking as an act that involves the use of force, fraud, or coercion to obtain labor or a commercial sex act. Human trafficking is the fastest growing crime in the world and is often silent, happening in homes and business around the country. Most victims never come forward for fear of the traffickers or the potential for legal consequences.

The International Labour Organization estimates that there are nearly 40.3 million victims of human trafficking around the globe with 75% of these victims being women and girls. Trafficking is a $150 billion industry that not many people want to talk about or recognize. Nurses need to know what sex trafficking is and how to recognize the signs of a potential victim.

Sex Trafficking Defined

Victims of sex trafficking are manipulated or forced to engage in sex acts for money. They might be pushed into sexual acts through the use of manipulation, violence, threats, or even the promise of love and affection. Human Trafficking Search reports that the most common recruitment tactic used is an intimate partner/marriage proposition, followed by familial, posing as a benefactor, job offers, and false promises.

Signs of Sex Trafficking

Nurses are in a unique position to recognize possible victims of sex trafficking. However, studies have reported that as many of 50% of trafficking victims in the U.S. encountered a healthcare professional while in captivity but were not recognized. This statistic is eye-opening and demonstrates the critical need for every nurse to be trained to have a keen awareness of the signs of sex trafficking, which can include a patient who:

Displays signs of physical or sexual abuse
Has another person speaking for them during the visit
Engaged in sexual activity at an early age
Reports having a pregnancy or an abortion at a young age
Has trauma to the genitalia
Presents with advanced health problems that aren’t treated
Has frequent emergency room visits
Displays anger, depression, or anxiety
Has suspicious tattoos or branding
Runs away from home or foster care
Inappropriately dresses for the weather or situation
Reports a high number of sexual partners
Has multiple urinary tract infections
Has been diagnosed with multiple sexually transmitted infections

It’s vital to remember that not all of these signs alone are indicative of sex trafficking. However, when a patient presents with several of these signs during a visit, you should be considering the possibility that something else could be going on in this patient’s life. Let’s revisit Tina’s story from above. Now that you know the signs of sex trafficking, you can quickly see that Tina is a patient you might want to consider as a potential victim of sexual trafficking.

Have you ever encountered a victim of sex trafficking? Did you recognize the signs quickly or did it take awhile? How did you respond? Comment below.

Recognizing the Red Flags of Sex Trafficking

Trafficking by the Numbers

Sex Trafficking Defined

Signs of Sex Trafficking

About Melissa Mills, BSN

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