Human Trafficking Indicators for Healthcare Providers

Eighty-eight percent of sex trafficking survivors report accessing healthcare services while being trafficked while only 6% of healthcare professionals report treating a human trafficking victim [1]. Understanding a handful of basic indicators will help you as a healthcare provider increase your ability to recognize potential trafficking situations and report it accordingly.

You have a unique opportunity to recognize indicators of trafficking that the public would likely miss. As a healthcare provider you may see portions of the body that are generally covered where tattoos or signs of abuse may hide, you may also have a longer opportunity for a conversation with your patient that will allow you to ask more questions and in turn recognize more indicators.


Sex Trafficking Indicators for Healthcare Providers

One indicator is rarely enough to determine trafficking so if you start to think your patient may be being trafficked start looking for as many indicators as you can. This will be helpful in your leadership’s decision to report.

1.Burns, cuts, bruises, or other signs of abuse. While these signs may be obvious in some situations abuse may be more hidden, such as bruising at the back of the head where one’s hair hides it. Remember these victims are a product being sold so some traffickers may prioritize keeping their victims face bruise free while others do not care.

2. Tattoos – used as brands. Not all traffickers use a tattoo to brand their victims, however, many do. This may be of a crown, something that indicates they are for sale or their trafficker’s name.

3. Victim will avoid eye contact, especially with male providers.

4. Inappropriate clothing for their age or the weather. This indicator is more prevalent in bigger cities and less common in more rural areas.

5. Unable to give basic information. This may include their address, birthday, or any other basic information.

6. Accompanied by someone that seems controlling. This may be the trafficker, or it may be another female, referred to as the “Bottom.” This person may answer questions for the victim, not really allowing them to speak, they may also have control of the victim’s personal belongings.

7. The victim may appear malnourished or sleep deprived.

8. They may come across as depressed, nervous, anxious, and afraid.

9. There may be signs of substance abuse. Some traffickers use substances as means of control as they also become their victim’s dealer, while others do not let their victims touch drugs.

10. Their story of injury or sickness will sound scripted and inconsistent. Victims are often given a script as well as limits on what they can and cannot say. If you begin to ask a question outside what they can say the story will become inconsistent. Because of this the victim may become hostile.

11. Victims may report an unusually high number of sexual partners. They may have multiple recurring STI’s or pregnancy tests.

12. A victim may refuse medical attention if they become uncomfortable or feel it is taking too long and is beginning to interfere with their ability to make the money they are supposed to make that day.



Language for Healthcare Providers to Listen For:

Trafficking has its own language associated with it, listening for the words listed below combined with indicators from above will help identify potential trafficking situations.

The Life

The Game











Pimp Circle

Loose Bitch





Best Practices for Healthcare Providers

If you have a patient, you believe may be in a potential trafficking situation there are a few best practices to keep in mind.

1.Do not react with shock and judgement.

2. Meet them where they are and take care of basic needs first. When was the last time they ate or slept? Can you create space for those things to happen?

3. Communicate well to build rapport and trust with the patient.

4. If you can get the patient alone, do so. This may be the best thing the COVID-19 pandemic gave us, being alone in an appointment is now more common and easily understandable.

5. Do not be afraid to ask questions – even if they begin to become hostile, this will still give you more to work with.

6. Be conscious of your language – no one likes to be called a victim. Most often trafficking victims are not even aware of what trafficking is, so asking them if they are being trafficked may be ineffective. It is also easier for someone who has experienced abuse to admit to the abuse they have seen versus what they have experienced. Asking “have you seen violence done to someone else?” May be more effective than “Have you experienced violence?”

7. Schedule a follow-up appointment – even if you must make up a reason. This just creates another touchpoint with the potential victim.

8. Educate and explain resources available. It is very easy for a caregiver to fall into a rescue mentality especially in this type of situation. You must accept that the only role you may play is letting a potential victim know there are resources available to them.

9. Know your mandatory reporting requirements if the potential victim is a minor. Know your health systems policy for reporting situations like these and follow the steps accordingly.



The Life Story interviewed survivors of trafficking about their experience with a lot of different professional sectors. This short video of survivors talking about their experience with the healthcare industry is eye opening. Check it out, learn the indicators, and do your part in improving a potential victim’s experience.



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[1] Lederer, L. J., & Wetzel, C. A. (2014). The Health Consequences of Sex Trafficking and Their Implications for Identifying Victims in Healthcare Facilities. Annals of Health Law, 23, 61–91.