Employee & Community Health

What you need to know about sex trafficking

11/7/2019 by Kimberly Beckstrom, APRN, CNP, DNP

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Sex trafficking. There's a widely held belief that, "It doesn't happen here." We have a hard time believing "poor little girls" could be trafficked in our own cities. Yet, statistics tell a different story. 

  • Human trafficking is an emerging global public health problem, most often affecting women and children. 
  • Supply and demand influence human trafficking. It's considered a "low risk" crime by perpetrators because it's so under-recognized. 
  • The profits are high, estimated at $150 billion worldwide. 
  • The United States is the second-largest sex trafficking market in the world, with thousands of cases reported every year. 
  • According to the Minnesota Department of Transportation, the state recorded the nation's third-highest rate of human trafficking in 2015. 

However, many more cases go unreported or unrecognized. Most of these victims aren't being plucked off the street and tied up in a basement somewhere, as is often portrayed in television shows and images. When popular media portrays the minority of cases, it's easy to see how we have a problem identifying victims of sex trafficking. 

What is sex trafficking?

While there is overlap with prostitution, sex trafficking involves a third party who benefits from the sale of sex. These crimes can be hard to prosecute, but state and federal laws are evolving — for the better. The Trafficking Victims' Protection Act of 2000, which has been reauthorized several times, is the primary tool in the U.S. for combating human trafficking. Minnesota's Safe Harbor Law, passed in 2011, removed the criminal status for victims under age 24 engaged in the sale of illegal sex, and instead strengthened penalties for adult buyers exploiting minors. 

What are the risk factors?

Risks for people being sex trafficked include living in poverty, young age, racial or ethnic marginalization, history of abuse or exploitation, intellectual or physical disability, isolation, chemical dependency, lack of a support system, immigration status, fleeing a crisis situation, identifying as LGBTQ, being homeless or a runaway, and/or having criminal record/juvenile delinquency. The National Center for Missing and Exploited Children estimated in 2016 that one in six endangered runaways reported to them were likely sex trafficking victims. 

What are the signs or symptoms?

Victims of trafficking are at risk for a number of physical and behavioral health problems. The trafficked person's "employer" wants them to be healthy, so they do seek care at clinics. However, health care providers, as well as others, often fail to recognize the signs and symptoms of at-risk individuals and miss the opportunity to rescue victims. 

Whether you're a concerned family member, health care provider, friend or neighbor, symptoms that trafficked people have may be vague and non-specific. In a 2008 study, 63% of trafficked individuals complained of 10 or more symptoms including headaches, fatigue, dizzy spells, back pain, memory difficulty, abdominal or pelvic pain, and gynecologic infections. Signs include: 

  • Being visibly anxious.
  • Unwilling to make eye contact. 
  • Dressing inappropriately for their age, setting, or the weather. 
  • Offering stories and explanations that may not add up or seem scripted; a companion may do much of the talking. 
  • Having a pattern of mysterious injuries, sexually transmitted infections and pregnancy terminations. 
  • Displaying tattoos, also called branding, such as a "bar code", "Property of", "Daddy's girl", etc.

Why don't they leave?

A trafficking survivor often can't simply "just leave." They've experienced severe trauma. The perpetrator may control their housing and money, as well as many other tactics to maintain control. Victims may be unaware of their rights and fear prosecution. 

What are the resources for victims?

Resources for victims of sex trafficking include social services. Victims' services advocates may help meet their physical needs, such as clothing, safety and housing, as well as provide emotional and psychological support. Child protective services, if appropriate, also may help. 

What can you do?

If you're concerned about an individual, call the National Human Trafficking Hotline at 1-888-373-7888 or text "BeFree" to 233733. For more information about sex trafficking, visit the National Human Trafficking Hotline's website

Kimberly Beckstrom, APRN, CNP, DNP, is a family medicine nurse practitioner at Employee and Community Health's (ECH) Mayo Family Clinic Northeast. She also has been a sexual assault nurse examiner (SANE) at Saint Marys Hospital Emergency Department in Rochester. Her areas of special interest are women's health and adolescent health and contraception.