Florida: Human Trafficking for PTs and PTAsPage 5 of 10

3. Recognizing Possible Victims and Traffickers

There is no such thing as a willing child prostitute.

Roe-Sepowitz, et al., 2015

Those at highest risk of any form of human trafficking are the vulnerable populations such as those with low socioeconomic status or children who experience abuse at home. While these are the most common, human trafficking does not discriminate.

Abuse can be emotional, physical, or sexual, and it can arise from emotional neglect, physical neglect, and family violence. All are prevalent among trafficked youths. Sexual abuse is the strongest predictor of human trafficking for both boys and girls. Those who have experienced sexual abuse in the home may be looking for a way to escape to a better life, only to find themselves manipulated into a trafficking situation.

Lack of caregiver protection from abuse in the home increases the likelihood of a child's seeking protection from someone outside the home. Exposure to family violence is also an increased risk for human trafficking. Abusers will cultivate relationships with these young children or teens and they soon become victims. Trafficking of boys more commonly relies on emotional and sexual abuse (Reid et al., 2017).

Runaway and homeless youths—male, female, and transgender—are at particularly high risk for becoming victims. Research suggests that lesbian, gay, bisexual, or transgender (LGBTQ) youths can be up to 5 times more likely than heterosexual youths to be victims of trafficking; their increased susceptibility comes from the feelings of rejection and alienation often felt by LGBTQ youth (NCSSLE, 2020a).

The National Center on Safe Supportive Learning Environments offers this list of possible risk factors associated with child trafficking:

  • Lack of personal safety
  • Isolation
  • Emotional distress
  • Homelessness
  • Poverty
  • Family dysfunction
  • Substance abuse
  • Mental illness
  • Learning disabilities
  • Developmental delay
  • Childhood sexual abuse
  • Promotion of sexual exploitation by family members or peers
  • Lack of social support (NCSSLE, 2020a)

Traffickers will specifically target runaway or "throwaway" teens who are having trouble at home. They are seen as easy targets because they are looking for shelter yet may not be old enough to legally get a job by which to earn money. It is common for these teens to trade sex so as to meet basic survival needs of food, shelter, and clothes (Roe-Sepowitz et al, 2015).

Those at risk for labor trafficking often come from unstable and economically devastated locales, including areas that have recently experienced hurricanes, floods, or earthquakes. Traffickers frequently prey on vulnerable populations characterized by oppression, high rates of illiteracy, little social mobility, and few economic opportunities (USDS, 2019).

A graphic illustrating that human trafficking can happen to anyone.

Source: DHS, 2017.

Barriers to Identifying Victims

Nurses play an important role in keeping children safe from traffickers. Traffickers often identify themselves as a loving family member, boyfriend, or employer who is just trying to help, and their victims may be fearful of police or authority figures, which makes it difficult to intervene. Victims may be using drugs as a coping mechanism and worried they will be charged as a criminal for drug usage or possession. They may also be worried that their families will be put at risk by their abuser if they try to escape (Eccleston, 2013).

Many victims develop traumatic bonding, or "Stockholm syndrome," which is a cognitive distortion wherein positive feelings develop between captors and their hostages. This bond is a survival mechanism and helps the victim cope with captivity (OTIP, 2012). Identification of victims is made more difficult by the fact that there is no single profile that identifies a trafficker.

Misidentification is an ongoing barrier to protecting these victims. The control exerted over children is rarely visible as the young victims appear to be independent. Even child sex trafficking victims who are controlled by violence and fear may appear to be acting on their own (Shared Hope International, 2017).

Identifying Traffickers

Traffickers and pimps may be identified by healthcare workers by the following behaviors: traffickers may be jealous, controlling, and violent; significantly older than female companions; promising things too good to be true; and encouraging victims to engage in illegal activities to achieve their dreams. They will buy expensive gifts or own expensive items and act vague about their source. The pimp will be pushy or demanding about sex and encourage inappropriate sexual behavior from the victim. Traffickers are usually open about financial matters but make victims feel responsible for their own financial stability (Shared Hope International, 2017).

These are all behaviors clinicians can recognize if the abuser is with the victim during a medical visit. It is crucial to understand that these behaviors indicate the level of control traffickers exert over victims.

Traffickers elude detection. The hidden nature of human trafficking requires law enforcement to be innovative and adaptive with investigative techniques. A person convicted of sex trafficking a minor faces serious federal penalties that include a mandatory minimum sentence of 10 years' imprisonment. Law officers might decide to charge juvenile victims with delinquency in order to keep the child safe; however, this detention does not offer specialized services for the children and may not be safe. Many times, children return to the abuser when released because of the unique bonding that occurs between victims and their traffickers (OTIP, 2012).


Even though demand is the root cause of the commercial exploitation ofchildren, law enforcement frequently overlooks buyers in the crime of child sex trafficking (Shared Hope International, 2017). Keeping victims isolated is a tactic abusers use to keep them from getting help. Abusers will restrict activities and watch, escort, or guard the victims. When victims do come into contact with medical professionals or others, traffickers may give them scripted answers or a cover story (OTIP, 2012).

Sex trafficking Case: Molly
(National Trafficking Resource Center, 2016)

Molly comes to a clinic for an HIV screening. Her intake paperwork says she is 19 but the nurse mentions that she seems far younger. Molly explains to the nurse she is "mature for my age" and "very experienced." She has a tattoo of the name "Li'l G" on one arm. During the exam she constantly receives texts on her cell phone. She answers a phone call and says "Daddy, don't worry, I'll be done soon."

Molly tells the nurse that it was her boyfriend, who is worried about her. The nurse continues to believe that Molly is younger than she says due to her immature physical development and the discrepancy between her reported age and education level.

Why do you think a patient would lie about her age?

Her trafficker, presenting as her boyfriend, may have given her a scripted story to protect him from liability. Many victims try to protect themselves due to fear of their trafficker and lie to avoid triggering mandatory reporting to the state.

Note: Virtually all states mandate reporting by healthcare professionals (and many others) of instances of sex trafficking of minors as sex trafficking is considered a form of child abuse.

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