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, 2017). 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).
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 of income. 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 (Department of Homeland Security, 2017).
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 (Office On Trafficking in Persons, 2017).
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, 2017).
Sex Trafficking Case: Molly
National Human Trafficking Resource Center, 2017)
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. According to the NHTRC:
State child welfare agencies are required to report instances of sex trafficking to law enforcement and provide information regarding sex trafficking victims or at-risk youth to the U.S. Department of Health and Human Services, who will in turn report these numbers to Congress. (NHTRC, 2017)