Human trafficking is not the same as human smuggling. Human smuggling is consensual, whereas trafficking is done against a person’s will (Rothman, 2017). There are three common types of human trafficking: the sex trade, forced labor, and domestic servitude. The economic sectors that profit most from human trafficking are agriculture, restaurants, manufacturing, domestic work, entertainment, hospitality, and the commercial sex industry. Trafficking can occur between countries or in areas within a country (Eccleston, 2013). It can happen to anyone of any gender, race, or age (NHTH, 2017).
Source: DHS, 2022.
Human trafficking will continue as long as there is demand for its victims. Healthcare providers may be one of the only channels through which a victim is identified. Proper staff training can lead to potential identification and intervention. Your ability to assess a victim and knowledge of the resources to assist a victim can turn a very bad situation into a positive outcome. Victims who are in a clinic or emergency department (ED) may rely on you to ask the right questions at the right time. It is possible a healthcare provider is the only other human contact they may experience in months or years, depending on their situation.
With the abuser pretending to act protective and caring, it can be easy for you to overlook a victim if you are not trained in what to look for, or if the abuser does not allow adequate time or conversation with the victim. Healthcare providers must be sensitive and methodical in approaching a victim if they suspect something is “off” about the situation. Having a screening tool, or training on appropriate questions to ask the victim and abuser, can open dialogue and uncover possible victimization.
Sex trafficking is the most prevalent form of human trafficking in the United States (Gorman & Hatkevich, 2016). Sex trafficking is a high profit and low risk business where the commodity—the human being’s body—can be sold repeatedly (Roe-Sepowitz et al., 2013). Unfortunately, sex trafficking is a problem in the United States because there is a high demand for child pornography and prostitution (Clause & Lawler, 2013). Commercial sexual exploitation includes prostitution, pornography, live sex shows, stripping, personal sexual servitude, escort services, mail order brides, military prostitution, and sex tourism (Gorman & Harkevich, 2016). Children and teenagers are at risk for any of these.
Recruitment of victims in the United States comes from shopping malls, junior high and high schools, foster homes, group homes, courthouses, restaurants and bars, bus stations, concerts, parks, libraries, and social networking websites (Gorman & Harkevich, 2016). Parents should be aware that one of the most common ways that traffickers access children is now through the use of social media sites like Facebook (Clause & Lawler, 2013).
Once the victims are found, they may be transported to where the trafficker has a high demand or they may stay close to the area where they were targeted. The use of internet advertising has taken the sex industry to a global operation (Clause & Lawler, 2013).
The Trafficking Victims Protection Act (TVPA) defines the crime of sex trafficking as the “recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act where such an 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” (Roe-Sepowitz et al., 2013). Many people would not be able to recognize a sex slave even if living in the same community (Clause & Lawler, 2013). For this reason, proper training of healthcare workers is essential in reducing this crime.
Victims of sex trafficking will be “groomed” in stages by the abuser (see below). Traffickers look for victims who are vulnerable by using acts of kindness to groom them into submission (Clause & Lawler, 2013).
Source: Long, 2014.
There are two ways an abuser will pimp* a victim of sex trafficking. Finesse pimping uses kindness and psychological games to attract young vulnerable victims. Guerilla pimping involves the use of violence and intimidation to force the victim into submission. Finesse pimping is used more with children and guerilla pimping is used more against adults (Clause & Lawler, 2013).
*Pimping: the commodification of people, often against their will, for the purpose of sexual exploitation.
Vulnerable youth can be easily targeted by the abuser with the use of promises, psychological manipulation, provision of drugs and alcohol, or violence. The abuser will first try to establish a trusting environment by wooing the victim with what seems like a loving and caring relationship. Pimps will invest a lot of time and effort into forming a bond with their victim by initially buying gifts, showing affection, or providing a place to stay (Roe-Sepowitz et al., 2013).
With sex trafficking, the general public usually does not realize that the victims working the streets do not keep any of the money they receive for sex. All money, including tips, must be given to their pimp. Victims of sex trafficking may be forced to perform multiple sex acts with 10 to 20 customers every day (Hodge, 2014). Drugs play a large role in sex trafficking. Drugs are often used as a way for the victim to cope with the trauma; alternately, some victims enter this lifestyle to support a drug habit (Roe-Sepowitz et al., 2013).
Trafficking in Children
Under Michigan law, any child who has been recruited, enticed, harbored, transported, provided, or obtained for commercial sexual activity, a sexually explicit performance, or the production of pornography, is a victim of sex trafficking. Although traffickers often use force, threats, violence, false promises, manipulation, lies, and other physical or psychological methods to control their victims, a child need only be sexually exploited to be considered a victim of sex trafficking in Michigan (HHS, 2017a).
There are times when traffickers of children take advantage of the parents’ extreme poverty. Parents may sell children to traffickers in order to pay off debts or gain income, or they may be deceived into thinking this will be a better life for their children (Wikipedia, 2017). Sadly, research has shown that 91% of domestic sex trafficking victims experienced some sort of abuse in their home (Gorman & Hatkevich, 2016). The internet and social media have made recruiting easier (Roe-Sepowitz et al., 2013). The average age at which a girl first becomes exploited into prostitution is 12 to 14 years, and boys make up almost half of the victim population (Roe-Sepowitz et al., 2013).
The MDHHS’ Human Trafficking of Children Protocol
(available from http://www.michigan.gov/documents/dhs/HumanTraffickingProtocol_440356_7.pdf)
This protocol was developed in consultation with state and local law enforcement, juvenile justice, healthcare providers, education agencies, and organizations with experience in dealing with at-risk youth. The protocol was developed to guide professionals in identifying and assisting children who are victims of human trafficking. The protocol focuses on the needs of victims, with the overriding intention of protecting the interests of children and maintaining their safety in the community.
All caseworkers and applicable contracted service providers must review the MDHHS Human Trafficking of Children Protocol and be aware of the signs/behaviors that indicate that a child may be a human trafficking victim.
Source: HHS, 2017a.
Because children are easier to exploit, Michigan law now offers them greater protections, effectively shielding them from prosecution for acts they committed while in the care of their traffickers. In January 2015, several changes in the law went into effect that impact how law enforcement, the court and the Michigan Department of Health and Human Services (MDHHS) respond to child trafficking cases. Perhaps most important, any child who is sexually exploited for commercial purposes is now recognized as a victim of human trafficking, regardless of his or her ability to prove the existence of force, fraud, or coercion. By creating a presumption of coercion in sex trafficking cases involving children, Michigan law shields these children from prosecution for committing commercial sex acts (HHS, 2017b).
Forced labor is another type of human trafficking. In the United States, the Trafficking Victims Protection Act of 2000 (TVPA) defines labor trafficking as “the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage or slavery” (NHTRC, 2016). Peonage is the act of paying off debt through work (DHS, 2017a). Debt bondage is where the victim is forced in bonded labor to work to pay off a debt, loan, or other obligation (Eccleston, 2013).
Children as Victims of Labor Trafficking
Under Michigan law, any child who has been recruited, enticed, harbored, transported, provided or obtained for forced labor is a victim of labor trafficking. Labor trafficking can include, but is not limited to, domestic servitude, forced labor in restaurants or salons, forced agricultural labor or debt bondage. Michigan law includes a provision that allows the identification of child victims of labor trafficking, regardless of the presence of force, fraud or coercion, keeping these children in line with sex trafficking victims (HHS, 2017a).
Areas most prone to forced labor include domestic work, agriculture, construction, manufacturing, and hospitality (Eccleston, 2013). Forced labor is often difficult to detect. Forced labor in the private economy generates $150 billion in illegal profits per year, with migrant workers and indigenous people being particularly vulnerable (ILO, 2017). Illegal immigrants can become confined to forced labor if the abuser confiscates their passport or identification documents and uses the threat of their exposure as an illegal to the authorities (Eccleston, 2013).
Traffickers target those with low literacy and education levels and those living at or below the poverty line (Gorman & Hatkevich, 2016). Nearly 21 million people are victims of forced labor, with 11.4 million women and girls and 9.5 million men and boys (ILO, 2017). Women and children are highly trafficked in labor arenas because of their relative lack of power, social marginalization, and overall status as compared to men (OTIP, 2017).