10 Signs of Human Trafficking in Hospitals and How to Recognize Them in Pediatric Care

Key Takeaways

• 88% of human trafficking victims pass through the healthcare system during their captivity, and health providers are in a prime position to identify the signs of abuse.
• Pediatric victims may have difficulty advocating for themselves, and health professionals may need to rely on their knowledge and skills to uncover the physical, developmental, and psychological signs of human trafficking in hospitals.
• Continuing education provides critical training for healthcare providers that empowers them to identify and advocate for young victims of human trafficking.

Content Warning: Human Trafficking // This article discusses human trafficking, a topic that may be upsetting or disturbing for some readers. Readers are encouraged to take the necessary steps for their emotional safety.

It’s estimated that 100,000-300,000 children are victims of sex trafficking in the United States today, with an average age of 12-13. Many of these young people fly under the radar, but healthcare workers are in a unique position to make a difference.

88% of people who are trafficked interact with healthcare institutions during their captivity, and highly trained health professionals can identify the subtle signs and symptoms. Continuing education is the first, best line of defense, and courses like Human Trafficking for Healthcare Providers—and Analysis of Cases position doctors and nurses to break the cycle of abuse.

How can you make a difference for your pediatric patients? Here are ten signs of human trafficking in hospitals to watch for in children and teens.

1.   Unexplained Injury Patterns

Much like with child maltreatment, an injury assessment that doesn’t align with the initial story told by a patient or caregiver is a big red flag. These injuries may be atypical or sexual in nature, and because of the power dynamics involved, a possible victim may be reluctant to share.

Injuries such as bruises in various stages of healing can represent ongoing exposure to abuse. These often appear different in color, and new bruises can even be layered on top of old ones. The location and pattern of trauma can also be concerning. For instance, unexplained bilateral injuries to the upper arms or ankles could be evidence of someone being restrained.

The size and shape of the injury may also lay out a narrative of abuse for healthcare providers. Small circular burns could be related to cigarettes, while long linear injury patterns are often a sign of being hit with an object intentionally.

2.   Exhaustion

In a developed nation like the United States, young victims rarely fit stereotypical profiles of human trafficking. It’s estimated that 31% of victims are trafficked by a family member, and these children often have innocuous daytime school routines while being abused at night.

This can lead to sleep deprivation, fatigue, and ultimately exhaustion. It’s important to remember that not all trafficking is sex trafficking. Although less common for young victims, labor trafficking accounts for 77% of all incidents worldwide. Healthcare workers in areas with vulnerable industries, such as low-wage manufacturing or seasonal work, should be especially aware of unexplained exhaustion in young patients.

3.   Sexual Health Concerns

Seeking medical treatment for sexual health complaints could indicate someone is a victim of human trafficking. STIs, repeated pregnancies, genital trauma, or other signs of potential sexual assault in a young person may point to a systemic pattern of abuse. All health professionals should be trained to identify and act on the evidence of sexual assault and ensure clinicians trained in evidence collection are consulted for further inquiry and assessment.

4.   Inconsistent Stories

A child’s account of their injuries or history may conflict with other information being collected. Whether these inconsistencies are identified through your assessment or by evaluating information from any adults presenting with the patient, healthcare workers should be guided by a simple diagnostic principle:

If it doesn’t make sense, it’s probably not true.

When coming across inconsistencies, it’s important not to call out those misalignments directly. Continue to collect information aimed at helping the potential victim and work toward developing a clearer picture.

5.   Lack of Autonomy

One of the most common signs of human trafficking in hospitals is a child who’s given an abnormal lack of autonomy by a parent or guardian. If you notice the child is not being allowed to speak for themselves or appears to be coached through answering your questions, this could be evidence of an abusive relationship.

Signs should extend beyond being shy and translate to a lack of autonomy in their care. Similarly, if in an attempt to engage the patient privately, you meet resistance even after explaining the rationale, this could also be a warning sign.

6.   Abnormal Affect

If a child appears withdrawn or emotionally blunted in their response to your questions about the events leading up to their visit, it could be evidence of abuse. In these instances, a young person may exhibit symptoms of PTSD or extreme anxiety, and healthcare workers may need to engage with interprofessional strategies to provide support.

On the other end of the spectrum, the child who is a victim of abuse may exhibit hypervigilance. This heightened sense of awareness or elevated state of alarm can also be a symptom of post-traumatic stress response.

7.   Sexual Knowledge Not Appropriate for Age

While human trafficking encompasses both sex and labor trafficking, sex trafficking is much more common in children. With such exposure, a child victim of human trafficking can demonstrate awareness of sexual activity that is unexpected and inappropriate for their age. Discovering this in conversation organically can be challenging, but engaging in clear and purposeful questioning when able to speak privately may reveal evidence of abuse.

8.   Regressive Behaviors

Sudden regressive changes in behavior, like bed wetting and thumb sucking, can be indications of possible trauma. These symptoms may be observed and reported by people close to the child who are unaware of criminal abuse. While unlikely to be reported as the reason for seeking medical attention, regressive behaviors could provide additional context for suspicious observations.

9.   Missed Developmental Milestones

Chronic neglect, maltreatment, and trauma exposure can often result in a change from what is considered normal linguistic, social, and cognitive development. In cases of abuse, pediatric human trafficking victims may consistently demonstrate delayed maturation for age-appropriate emotional milestones. Of course, there may be many reasons why a child is exhibiting delayed development, and healthcare professionals will need to contextualize these issues with the patient’s overall history.

10.   Untreated Chronic Conditions

Children being trafficked are often lacking in routine preventative care for chronic conditions like asthma or diabetes. This may be because care is simply not prioritized by those trafficking them, or avoiding exposure to health professionals mitigates their perceived risk of being caught.

Encountering a child whose chronic conditions are being left untreated at a minimum represents neglect and should be escalated to the local resources for child protection. However, healthcare workers should also be vigilant for deeper signs of abuse for the duration of a hospital stay.

Becoming an Ally for Pediatric Victims of Human Trafficking

Human trafficking is a devastating crime, and children are among its most vulnerable victims. Healthcare workers in pediatric environments represent a first line of defense for their young patients, and continuing education is a foundational tool for empowering them to identify the signs of human trafficking in hospitals.

Premiere is committed to equipping health professionals with the skills and training they need to spot the signs of pediatric human trafficking. Courses like Human Trafficking for Healthcare Providers—an Analysis of Cases outline the key characteristics of abuse, dispel common myths, and explain best practices and obligations for mandatory reporters.

All of Premiere’s award-winning courses are developed by industry experts and deliver engaging online content for meeting your professional obligations and developing your career.

FAQs

What are the signs of human trafficking in healthcare?

Ambiguous or unexplainable narratives surrounding injuries, exhaustion, regressive behaviors, a lack of autonomy, or untreated chronic conditions may all indicate a child is a victim of human trafficking.

What should a healthcare provider do if they suspect trafficking?

Healthcare workers should avoid direct confrontation in order to gather as much information as possible. When human trafficking appears probable, they should immediately notify appropriate specialists and child protection resources.

What is the role of a nurse in human trafficking?

Nurses are frontline workers who are in a position to screen young patients for evidence of human trafficking, provide care, and notify authorities.