Vol 23, 2014 Annals of Health Law 82
HEALTH CONSEQUENCES OF SEX TRAFFICKING
infections is a particularly strong signal that should immediately raise the
possibility of a trafficking situation in the minds of healthcare providers.
Because of the overwhelming rate of substance abuse ( 84.3%) that
survivors reported, signs of alcohol and/or drug abuse could also be a
significant warning sign when observed in patients who require
reproductive health services at a young age, appear to be controlled by
another person, or also exhibit the physical and psychological symptoms
Clinics and other abortion providers should be especially attentive to
warning signs particularly with regard to younger patients. Multiple
abortions and evidence of coercion (such as the presence of a significantly
older or controlling “boyfriend,” or the physical and psychological
symptoms discussed above) in these patients should prompt the healthcare
provider to seek more information about the patient’s situation. More than
half ( 52.9%) of survivors (N= 34) indicated that at least one abortion was
partly or wholly forced on them, making this concern especially grave.
These warning signs are not intended to be exhaustive or authoritative,
but they build on and refine the suggestions of prior research. 54 To be sure,
there are myriad other physical and psychological symptoms that could
alert medical staff to the possibility that a patient is a victim of trafficking
and many other contexts in which victims seek medical services.
Nonetheless, the symptoms and service contexts most mentioned by
survivors should prove particularly relevant to the problem of victim
identification by medical professionals and may also lead to conversations
that could later assist prosecutors because of their likely admissibility under
the Federal Rules of Evidence.
B. Protocols for Identifying Victims and Catalyzing Rescues
Interaction between medical care providers and victims is an
extraordinarily delicate situation. Because some victims may come alone,
the health provider has an opportunity, if trust level and other
considerations allow, to ask questions about the possible victim’s situation
and to provide her with resources like contact information for rescue and
other services. Existing literature and this study both provide some
guidance for carefully making the most of these opportunities.
54. See, e.g., Isaac et al., supra note 52, at 9-10; T.K. Logan et al., Understanding
Human Trafficking in the United States, 10 VIOLENCE, TRAUMA, & ABUSE 3, 19-20 (2009);
Jeffrey Barrows & Reginald Finger, Human Trafficking and the Healthcare Professional,
101 S. MED. J., 521, 522-23 (2008); Cole, supra note 21, at 468; Patricia A. Crane & Melissa
Moreno, Human Trafficking: What is the Role of Health Care Provider?, 2 J. APPLIED RES.
ON CHILD 1, 6-7 (2011).