Recognizing victims

Identifying human trafficking victims: How physicians can help

For victims of human trafficking, a physician visit can be a life-changing event that sets into motion the process of escaping a captive situation.

For victims of human trafficking, a physician visit can be a life-changing event that sets into motion the process of escaping a captive situation.

Human trafficking is a form of modern-day slavery in which victims are forced or coerced into submission by a trafficker for the purpose of engaging in commercial sex acts or other work against their will.

“Physicians are one of the key groups that can actively find, see and identify these victims while they’re still in the process of being victimized,” says Alan Janssen, DO, the medical director at the emergency department of Genesys Regional Medical Center.

Most sex trafficking survivors received medical treatment at some point while they were being trafficked, according to a 2014 study. About 88 percent of victims saw a healthcare provider and 63 percent sought treatment at a hospital or emergency room.

Dr. Janssen has taken a leadership role in educating health care providers about human trafficking. His hospital has received a state grant to run a pilot program to train medical professionals how to best treat and identify victims. Dr. Janssen also helped develop the Human Trafficking Victim Identification Toolkit for Physicians and Other Medical Professionals. 

Understanding human trafficking

To identify victims, it helps to know some basic information about human trafficking.

Human trafficking happens in every state in America. Cases are often underreported, according to the National Human Trafficking Hotline. In 2016, over 7,500 human trafficking cases were reported in the U.S.

Red flags and how to spot them

It wasn’t until the staff at Dr. Janssen’s hospital became educated on trafficking red flags that they started to see cases.

“Little things would trigger something for people to say, ‘Hey, I wonder if that’s a human trafficking case,” Dr. Janssen says.

To recognize a victim of human trafficking, it’s often necessary to look for inconsistencies in a patient’s history.

“The only way you’re going to get to the bottom of identifying these people is to take the time to do a thorough history and physical,” Dr. Janssen says.


The toolkit Dr. Janssen helped develop lists red flag indicators for physicians to look for, including:

  • Stated age older than appearance
  • Frequent or forced abortions
  • Accompanying individual insists on providing translation, refuses to leave exam room or answers for the patient
  • Scripted or mechanically recited history
  • Tattoos or marks that may indicate ownership (names, brands, logos)
  • Evidence of physical violence
  • Delayed presentation of medical care
  • Burn marks
  • Frequent change of location or domicile

For the full list, refer to the toolkit.

The National Human Trafficking Resource Center also has a comprehensive list of the physical, mental, social and developmental health indicators of human trafficking.

How to help victims

Because human trafficking victims might not come back for a follow-up appointment, it’s important for the issue to be on a physician’s radar so they can act quickly and appropriately. In these cases, a physician’s actions can mean the difference between life and death, Dr. Janssen says.

“Helping a trafficking victim is just as important as taking care of a heart attack,” he says. “As soon as you can, you need to give the time and energy and focus to that patient that you would to any other high-level patient in your department.”

Dr. Janssen suggests physicians develop a strategy for addressing trafficking cases in advance so they’ll be better prepared to handle them.

Because most physicians haven’t had a lot of training, Dr. Janssen says the best option for them is to call the National Human Trafficking Hotline at (888) 373-7888 if they think they have identified a victim. The hotline can help direct them to resources in their area that support victims, and the physician can share those resources with the victim.

It’s important to understand that not all victims will feel ready to ask for help from medical professionals or law enforcement. In these cases, giving victims support resources will hopefully plant a seed that help is available should they change their mind after leaving a physician’s care.

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