Specific Clues of Concern (The Actions and Language of Trafficking)
There is a “Language of Trafficking” that is known to the victims and their perpetrators18,37 Developing an awareness of clues, language and behaviors will allow the healthcare provider to assess a possible trafficking situation. Developing an element of trust, building rapport and creating a safe environment is important. Asking open-ended questions allows for a good flow of dialogue with the patient. For example:
How did you find our facility/clinic?
Who brought you here today?
Tell me about where you live.
Who inspired your tattoo?
Where did you go to get your tattoo?
Traffickers, and even the victims, have a specific language that may be witnessed by those rendering treatment to a victim. Any of the following phrases or words should cause the healthcare provider to consider a “trafficking” possibility.
The word a victim is required to call their pimp/trafficker.37
(as in guerilla warfare) A trafficker or pimp that resorts to violence to control a victim.
The trafficker that uses a false romance; a false promise of money, clothing or other gifts; or false hope of marriage to lure victims. Often referred to as “boyfriend.” This is especially relevant in the control of very young sex victims.
Younger victims frequent a certain prostitution area.37.
Victims that are forced to prostitute themselves in a truck stop area.
A carving, tattoo, or mark on a victim that implies ownership by a pimp/gang/trafficker. The tattoo may say “Daddy,” “Property of”… or even “For sale.”
An amount a pimp charges the victim to leave captivity. The fee is exorbitant to discourage the victim from leaving, so most victims never leave.37.
The amount of money the trafficker expects each night from the victim. If quotas go unmet, the victim may be beaten, starved, tortured or made to work exorbitant hours until the expected amount has been delivered. Generally, the set amount is between $300 to $2,000.37.
A series of places where prostitutes/victims get moved. Keeping them in unfamiliar surroundings increases their vulnerability and facilitates the trafficker’s control over the individual.
The time and location where the sex act is to take place. The buyer or “john” meet them at this predetermined site.
The Life or The Game:
Sex trafficking victims refer to their situation as “being in the life.” This title implies that “the game” is fun and an easy way to make a living.
A victim who is chosen by the pimp or trafficker to “handle” the other victims. The bottom may be required to entice others into servitude by posing as a student, a concerned friend or a mother-figure.13.
Includes deprivation of sleep, isolation, intimidation, gang rape, holding victim’s children hostage, sodomy, starvation, and it is designed to gain control over the victim. This usually occurs in the beginning of captivity.
Legend: Has a cover story to advert suspicion but detail may be inconsistent.
According to the National Human Trafficking Resource Center (NHTRC) and hotline, “general indicators” or “red flags” of human trafficking may include but not be limited to the following with some modifications:13
Inconsistent history or a history that appears coaxed. May be difficult to determine if a language barrier is present.
Resistant to answer questions about the injury or incident.
Avoids eye contact, is nervous and fearful of touch.
No idea of address or general area where they live.
No control over their finances and lacks decision-making capacity.
Accompanied by a controlling companion or family member that refuses to let the patient speak for themselves, be alone for care and insists on being the translator.
Exhibits bizarre, hostile behavior and is resistant to care and assistance. May have initially consented but changes mind after asked to undress for an exam.
No identification or the companion has it in their possession.
Under age 18 and involved in a commercial sex act.
Tattoos or branding signs. Markings may say "daddy" OR "for sale," which implies ownership or read as an advertisement for a product.
Multiple sex partners. This may be easier to ascertain during a medical exam.
Inappropriate attire for the environmental conditions of the area suggesting poor care for the individual or possibly just arriving from another area of the world.
Attempt to reason away bruises or ligature marks by claiming a bruising or rare blood disorder.
Silent, afraid to speak, cringes at the sound of a loud voice.
Uses trafficking "lingo" such as "the life" or other words common in the commercial sex industry.
Struggles with addiction, including opioids.
Admits to a forced sexual encounter or being forced into sex acts.
The state of Nevada has a high rate of drug use and trafficking and their Attorney General has addressed this issue. The Nevada Attorney General, Aaron Ford, has a website that lists the following as warning signs of human trafficking:18,37.
Small children working in a family restaurant.
Person lacking any personal possessions.
Barriers such as fence or bars that restrict person from leaving the work area.