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Indicators for Human Trafficking for the Health Care Provider

Hannah Halbreich, MSW, LICSW

March 15, 2024



What are the comprehensive indicators for human trafficking, and specifically, what signs should healthcare professionals be vigilant for in cases of sex and labor trafficking?


When an individual enters your clinic or when you're working with them in a healthcare setting, it's important to recognize potential indicators of human trafficking. These can include scripted or inconsistent stories. We understand that trauma can affect mental health and memory, leading to inconsistencies in their narratives or sounding rehearsed. They may also be hesitant or unwilling to answer questions, particularly about their address, employment, or any injuries they may have. Additionally, they might be uncomfortable explaining how they acquired a particular illness or injury. They may not know their current location, the addresses where they work, or the state they're in, and might provide limited details about their employment situation.

An individual may be accompanied by someone who appears to be monitoring them closely. The trafficker may even try to enter the examination room or control the conversation on behalf of the individual. 

Observing their behavior and physical cues, such as body language or avoiding eye contact, is crucial as they might indicate fear or nervousness, especially if they feel they are being watched. They may also seem unaware of their current location or living situation.

Sex Trafficking Indicators

As healthcare providers, it's essential to be vigilant for indicators of both sex trafficking and labor trafficking when individuals seek treatment. For sex trafficking, red flags may include a history of running away from home or school truancy. Patients may possess valuables like cell phones without a clear source of acquisition. If minors are involved, they may have significantly older partners. Conducting a thorough examination, including a body scan, can reveal tattoos associated with gangs or other signs of gang affiliation. Noticing repeated high-risk sexual behavior, such as frequent STDs or reproductive issues in women, warrants further investigation.

In a medical setting, recognizing health indicators of sex trafficking is critical, as healthcare professionals may be their only point of contact outside the trafficking environment. Signs may include a lack of recent medical care, recurring STDs, or a high number of sexual partners. It's crucial to ask probing questions and provide support. Research indicates that many victims seek treatment in specialized clinics, with pregnancies being commonly reported. Regular screening for health concerns is imperative.

Labor Trafficking

Shifting the focus to labor trafficking, patients may disclose being underpaid, receiving inadequate wages or tips, or having restricted access to their documents. Living where they work or struggling with debts can heighten vulnerability. Physical manifestations such as malnutrition, dehydration, gastrointestinal problems, and poor dental health could indicate labor trafficking. Additionally, survivors often exhibit mental health challenges like anxiety, depression, paranoia, and PTSD. Observing their demeanor and communication skills can offer valuable insights into their psychological well-being.

This Ask the Expert is an edited excerpt from the course Working with Survivors of Human Trafficking for Health Care Providers by Hannah Halbreich, MSW, LICSW

hannah halbreich

Hannah Halbreich, MSW, LICSW

Hannah Halbreich is a Licensed Independent Clinical Social Worker in Washington D.C., where she specializes in managing programs and providing counseling to individuals and families challenged by trauma, victimization, and discrimination.  Hannah has expertise in working with survivors of sexual and gender-based violence, human trafficking, and conflict-related trauma. She is presently a Trafficking Specialist at the Office on Trafficking in Persons at the Department of Health and Human Services, and she also provides individual counseling to adults with a range of social-emotional issues and diagnoses at the TrueYou Center, a mental health practice in D.C.

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