Healthcare – Safe House Project https://www.safehouseproject.org Tue, 23 Sep 2025 14:37:29 +0000 en-US hourly 1 https://wordpress.org/?v=6.9 https://www.safehouseproject.org/wp-content/uploads/2024/07/cropped-Asset-42-32x32.png Healthcare – Safe House Project https://www.safehouseproject.org 32 32 Human Trafficking Survivors and Healthcare https://www.safehouseproject.org/blog/human-trafficking-survivors-and-healthcare/ https://www.safehouseproject.org/blog/human-trafficking-survivors-and-healthcare/#respond Tue, 23 Sep 2025 14:37:29 +0000 https://www.safehouseproject.org/?p=3686 Healthcare settings are among the most frequent points of contact for human trafficking survivors. In fact, 88% of survivors access medical care while being actively exploited, and often multiple times...

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Healthcare settings are among the most frequent points of contact for human trafficking survivors. In fact, 88% of survivors access medical care while being actively exploited, and often multiple times during their trafficking experience. These encounters often happen during routine checkups, care for sickness, or emergency visits. Despite the likelihood and frequency of a trafficking survivor’s interactions with the healthcare system, fewer than 1% of survivors are ever identified.

One of the greatest challenges in addressing these missed opportunities for identification is that most healthcare professionals do not know what human trafficking looks like in their community or in a clinical setting. Without the right training, survivors are regularly treated for injuries or illnesses without any questions being asked about what caused them. Trafficking survivors may interact with providers and other healthcare workers many times without being identified.

When healthcare providers understand what to look for and how to respond to human trafficking, they can transform a standard medical visit into a meaningful point of connection, and even a first step toward freedom.

Recognizing the Survivor in the Room

Trafficking survivors frequently present in clinical settings with a mix of physical, psychological, and behavioral health problems. These signs may not indicate exploitation on their own, but when multiple signs are observed in one patient or alongside unusual behaviors, they warrant further attention and screening.

Physical Health Indicators:

  • Injuries or bruises that are untreated, poorly healed, or in various stages of healing
  • Chronic infections or repeated sexually transmitted infections (STIs)
  • Apparent evidence of rough or violent sexual activity
  • Signs of malnutrition or dehydration
  • Psychomatic symptoms, such as chronic pain with no clear medical cause
  • Fatigue, sleep disturbances, or reported insomnia
  • Frequent or recurring complaints of unexplained pain or discomfort

Mental or Behavioral Health Indicators:

  • Anxiety, depression, or panic symptoms
  • Emotional dysregulation or difficulty managing strong emotions
  • Emotional numbness, withdrawal, or unresponsiveness during visits
  • Nervousness or sensitivity to being asked questions or being touched
  • Irritability, agitation, or being easily overwhelmed
  • Difficulty focusing or maintaining consistency with follow-up care
  • Signs of post-traumatic stress, such as hypervigilance or an exaggerated startle response

Substance Use Indicators:

  • Reports of drug or alcohol use during periods of instability or coercion
  • Substance use patterns that align with emotional stress or a desire to dissociate
  • Difficulty remembering how much or when substances were last used
  • Evidence or disclosure of being coerced or forced into using substances

Social & Environmental Indicators:

  • Being accompanied to the medical visit by someone who answers questions for them or refuses to leave the room
  • Hesitation to speak openly or make eye contact
  • Signs of fear or deferring to another person before responding
  • Lack of access to or control over identification documents or personal belongings
  • No known address or reports of frequent moves, unstable housing, or homelessness
  • Limited or no access to health insurance or consistent medical care

In many cases, survivors do not see themselves as victims of human trafficking, especially if they do not know what trafficking is. They may believe that their experiences are normal or deserved, or even the consequences of their own choices, especially if they were groomed at a young age or manipulated emotionally by a trusted individual. Healthcare providers must understand that trafficking survivors are not likely to use language like “abuse” or “trafficking” to describe their situation. Rather, providers should be aware of the common medical indicators of trafficking victimization and complete a screening process if there is any suspicion of potential exploitation.

Changing the Survivor Narrative in Healthcare

Healthcare providers can play a powerful role in helping trafficking survivors feel safe during medical visits and take advantage of the opportunity to seek help. Even small, intentional actions can change a survivor’s understanding that they will be believed if they speak up, changing their story from continued exploitation to freedom and healing.

  • Addressing Stereotypes & Biases

Providers must prevent their own perceptions about trafficking victims from impacting their ability to see the signs of exploitation in any patient. This is especially important when considering how often trafficking survivors present in healthcare spaces with other primary concerns, such as homelessness, addiction, mental health challenges, behavioral health problems, or sexual health issues.

  • Investing in Training

The signs of human trafficking are often hidden behind other medical complaints. Survivors may seek care for injuries, infections, anxiety, pregnancy, or substance-related concerns, but these symptoms result from ongoing abuse rather than the more common reasons. With targeted and comprehensive education, medical workers can learn to recognize these patterns, ask gentle and non-threatening screening questions, and respond effectively when the signs of exploitation become clearer.

  • Offering Privacy

Many healthcare organizations have existing policies about separating patients from guests or asking standard questions about feeling safe, but these practices should be taken a step further if there is any suspicion of trafficking activity. Many survivors are not allowed to attend medical visits without being accompanied by their trafficker, and they are unlikely to disclose sensitive information even if their trafficker is not in the room. Offering an intentional private moment, even under the pretense of a routine procedure, can be a critical opportunity for a provider to invite self-disclosure and for a survivor to feel safe enough to share.

  • Prioritizing Clarity & Consent

Many survivors of human trafficking experience ongoing violations of their boundaries and agency, including invasive or dehumanizing treatment from people in positions of authority. Medical procedures can feel threatening or triggering, even when they are standard practices or medically necessary. It is critical for providers to present choices during examinations and clear explanations of all procedures and steps, along with asking for consent before physical contact, to help survivors feel more secure during a healthcare visit.

  • Recognizing Trauma Responses

The way a trafficking survivor expresses fear, pain, or distress may look very different from what a healthcare worker expects. Survivors are often forced to control or hide their emotions in order to prevent further harm, and this response can become a habit that appears even in situations that are not exploitative. However, understanding that these behaviors are common trauma responses can help providers respond with empathy instead of frustration.

  • Creating Calm Environments

The sensory experience of a healthcare visit can deeply impact a survivor’s sense of safety, especially when considering the effect of loud noises, intense conversations, and rapidly changing environments on individuals with complex trauma or PTSD. Providers can mitigate this by speaking clearly, making intentional eye contact, and creating space in the conversation for survivors to express their need for a calmer environment. Even small changes, like offering a quiet space to sit or waiting to ask questions until in a more private space, can be significant.

  • Providing Trusted Resources

Many survivors, even if they choose to share about their experiences, may not be ready to take action during a healthcare visit. In all situations, providers should have access to an existing list of vetted resources, including local shelters, advocacy groups, crisis hotlines, or mental health providers, to encourage survivors to consider tangible options without forcing a decision. Providing this information discreetly may equip survivors to hold on to it longer and take action when they are ready.

For many survivors of human trafficking, the healthcare system may be one of the few places where help is accessible. Providers who are willing to look beyond surface-level symptoms and engage patients with care, curiosity, and patience have a unique opportunity to create a transformative moment of safety. Every appointment or encounter, no matter how routine, holds the potential to become a turning point for trafficking survivors living in exploitation.

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Barriers in Healthcare and Ways Providers Can Help Survivors https://www.safehouseproject.org/blog/barriers-in-healthcare-and-ways-providers-can-help-survivors/ https://www.safehouseproject.org/blog/barriers-in-healthcare-and-ways-providers-can-help-survivors/#respond Sun, 19 May 2024 20:29:02 +0000 https://www.safehouseproject.org/?p=1162 <p>The post Barriers in Healthcare and Ways Providers Can Help Survivors first appeared on Safe House Project.</p>

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  • 87% of trafficking victims interact with medical professionals while they are being trafficked. They may be doctors, nurses, EMTs, physical therapists, counselors, etc., but these medical professionals are first responders to the crime of sex trafficking — and often the only responders a victim will ever interact with.
  • 80% of those individuals that seek medical attention go to an emergency room. Medical personnel in emergency rooms are particularly equipped to identify, report, and even prevent sex trafficking simply due to the likelihood of encountering victims and survivors. In particular, forensic nurses who handle sexual assault and abuse cases are key players in the fight to identify victims.
  • Only 1% of these trafficked individuals will ever be identified. In most cities, identification is less than one percent. There are hundreds, if not thousands, of people trafficked in every town across the United States every day. Very few of them will be identified as victims of trafficking, and even fewer will have access to the resources they need to begin recovering.

Sex trafficking in the United States is an epidemic that shows no signs of slowing down. Hundreds of thousands of individuals are trafficked and exploited every day in the United States. Of the one percent that is identified, 80% will be revictimized by the same or a new trafficker. Only five percent of those survivors who leave sex trafficking will have access to the resources they need to find freedom, healing, and hope for a future.

These numbers demonstrate the tremendous need for identification training in healthcare settings. The chances are high that a victim of sex trafficking will encounter at least one medical professional while being exploited, and survivors regularly report that there were dozens of opportunities for a nurse or a doctor to recognize the signs. When these signs are missed or ignored, victims are denied an opportunity to be seen and helped to freedom.

For medical professionals, the first step is to learn the signs of sex trafficking and how victims may present in their specific fields of expertise. For ER nurses, for example, victims of trafficking may present as a sexual assault case. For pediatricians, victims may appear as quiet, fearful children too small for their age. Dentists may notice an ongoing lack of oral hygiene, and OBGYNs may notice a consistent pattern of sexual trauma or sexually transmitted infections. Unfortunately, some victims of sex trafficking may present with no unusual symptoms and receive care without their doctor ever suspecting that they are being exploited.

In all of these cases, medical professionals must first be trained on the signs and symptoms of sex trafficking. Secondly, they must understand how to ask questions in a way that encourages survivors to share more information about the violence they experience. Third, they must be prepared to offer the appropriate support and resources to the survivor. For minor survivors, these resources may look very different than those for adult survivors, and all cases should be handled with trauma-informed methods. Healthcare professionals must be equipped to investigate and refer suspected cases of sex trafficking in every area of patient care to ensure that another opportunity for identification and freedom is not missed.

The medical needs of survivors of trafficking can last for a lifetime. While this is particularly important for primary care doctors to understand, it also has significant implications for a survivor’s ability to obtain healthcare services.

The survivors that are able to live in a safe home program often have access to medical care even if they do not have health insurance. Many safe homes partner with generous medical professionals, who donate their time and expertise to care for these individuals. Unfortunately, survivors outside of safe homes, even those who have graduated from programs, often struggle to find providers that accept their insurance.

On top of that challenge, most insurance will not cover treatment they deem unnecessary, which includes many of the treatments associated with sex trafficking. Since research and legislation is currently so minimal concerning the long-term effects of a trafficking experience on a survivor’s body and mind, insurance companies do not consider many of the chronic conditions survivors have as related to their experience and refuse to cover treatment related to those conditions. This problem leaves survivors without medical care they need to live, with many being unable to work or participate in other activities.

The truth of the healthcare for survivors problem is that hundreds of thousands of victims of trafficking are going unnoticed, and those that are noticed are often left without the care they need. There is an immense need for basic training for all medical professionals to help address the immediate need for identification, but much of the change will come from legislative and institutional change. Insurance companies, hospitals and clinics, and state governments need to accept the challenge to begin tearing down walls. Without extensive change through intentional action, hundreds of thousands of survivors of sex trafficking will continue to be forbidden access to the care they desperately need to rebuild their futures in healing, hope, and freedom.

For additional resources for healthcare professionals, visit:

https://www.safehouseproject.org/resources
https://healtrafficking.org/resources/pearr-tool/

Safe House Project

At Safe House Project, we are committed to helping survivors reclaim their lives. If you or someone you know needs assistance, don’t hesitate to reach out. You can support our mission to end human trafficking by making a donation today. Together, we can make a difference and offer hope to those who need it most.

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