Identifying Human Trafficking in Adults

Identifying human trafficking in adults

  • a) Sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age; or
  • b) Labor Trafficking. The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for subjection to involuntary servitude, peonage, debt bondage, or slavery. (22 USC 7102(9))

Who is the victim?

  • Victims of this crime may be men, women, transgender persons, adults, minors, U.S. citizens, legal permanent residents, or foreign nationals. Any person under the age of 18 who engages in commercial sex acts, regardless of the use of force, fraud, or coercion, is a victim of human trafficking, even if they appear to consent to the commercial sex act.


  • In the United States, some of the most highly vulnerable populations include undocumented workers, runaway and homeless youth, individuals with substance abuse or addiction issues, and low-income individuals; however, individuals across all income and education levels can be trafficked. Regardless of background, the common denominator is some form of vulnerability

The 4 P’s of human trafficking

Protection, Prevention, Prosecution, Partnership

Signs of a trafficked victim:

  • Malnourished
  • Showing Signs of physical injuries
  • Avoiding eye contact, social interaction with authority figures/Law enforcement
  • Seeming to adhere to scripted or rehearsed responses in social interactions
  • Lacking Official Identification Documents
  • TVPA Trafficking and violence prevention act
  • Submissive or fearful
  • Inability to speak for self or alone
  • Living with employer
  • Multiple people in cramped spaces
  • Human trafficking does not require restraint or abuse

It may seem to be consensual but by looking at these signs and paying attention, you can make a good determination if it is trafficking or not.

What you need to know

  • Psychological violence is integral to all forms of trafficking exploitation; physical and sexual violence are also prevalent
  • Human traffickers have been known to brand their victims to control their Trafficked people may live for years under the control of their traffickers, and the impact on their physical and mental health can be profound and enduring over them. Common tattoos include barcodes, crowns, names, etc.
  • Trafficked people are likely to have had pre-trafficking vulnerabilities (including poverty, destitution, experiences of war/community violence, domestic violence, adverse childhood events, disabilities, and learning difficulties) which can create cumulative harm
  • Stay curious in any consultation; ask appropriate, sensitive questions; create an environment where the patient can feel comfortable to talk openly; and apply “trauma informed” methods of working. Follow local safeguarding policies if you are concerned about a patient

Potential pre-trafficking vulnerabilities

  • Poor socioeconomic status
  • Lack of educational and work opportunities
  • History of rape/sexual assault
  • Loss of family
  • Community or gender based violence
  • Background of state persecution/torture
  • Health conditions, learning difficulties, or disability
  • Natural disasters and times of crisis, including pandemics

Why trafficked people find disclosure difficult

Methods used by traffickers to control and subjugate are designed to prevent escape and disclosure, and include violence and fear, threats to family, deception, perpetuation of “debt bondage,”.

Other barriers to detailed disclosure of what has happened in the past or is happening now may include

  • Lack of understanding or recognition of themselves as victims
  • Limited knowledge of the language spoken in the host country
  • Fear of, and lack of, trust of authorities
  • Fear of having to recount a traumatic history with accompanying shame, distress, and risk of re-traumatization
  • Lack of the autonomy and agency needed to seek help after long periods of being controlled
  • Inability to afford healthcare or transport
  • Lack of knowledge of services available to them
  • Difficulties in registering with health services

How do trafficked adults present?

Trafficked adults might present to many services, particularly to maternity services, general practice, emergency departments, or sexual health clinics. They could present with one or more of a wide range of physical and/or mental health conditions. However, they may suffer from a loss of agency and autonomy, making it difficult for them to ask for help.

Ill health may be linked to previous abuse, pre-existing mental or physical disability, poverty, and/or the consequences of poor healthcare in the country of origin as well as from the conditions endured during exploitation in the country of current residence or during the journey to that country.

Physical injuries, psychological problems, and illnesses may not always be obvious or visible, and may not be easy for individuals to disclose, making identification of potential victims a complex process. Additionally, traffickers may provide stories for their victims and instruct them on what to say.

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