Human Trafficking

  • Human trafficking (HT) is a human rights violation and a public health issue.
  • Survivors of sex trafficking can experience or witness significant violence and psychological manipulation.
  • Survivors are often told by their trafficker to lie about their name, age and circumstances.
  • If a person (especially a child) is potentially in imminent danger a call to local law enforcement would be appropriate.
  • The severe and chronic trauma suffered by survivors of sex trafficking may make it difficult for health care providers to gather a patient’s history in an organized manner.
  • It is important to obtain the patient’s history outside of the presence of anyone who accompanied them to the exam (Greenbaum et al., 2015; Potter & Sharma, 2017).
  • Care Coordination is beginning to be more widely operationalized in Texas. The local children’s advocacy centers are in the primary role (except for Harris County where it is their county CPS). (Office of the Texas Governor, Greg Abbott, n.d.). In the communities where Care Coordination has been initiated, the local CAC typically serves in the primary role as Care Coordinator, except for Harris County, where it is a consortium of county agencies.
  • (DFPS Human Trafficking and Child Exploitation Team)
  • Children at greater risk for trafficking are children who:
    • Run away, are homeless or “throwaway” youth.
    • Have a history of sexual abuse, physical abuse or neglect.
    • Have a history with juvenile justice or child protective services.
  • Possible signs of sexual exploitation and/or trafficking include (Potter & Sharma, 2017):
    • Sexually transmitted infections;
    • Anogenital trauma;
    • Unwanted and unplanned pregnancies;
    • Poor nutrition;
    • Dental caries, broken or missing teeth;
    • Strangulation or suffocation;
    • Drowning;
    • Substance use disorder; and
    • Tattoos or brands.

Identification and Response Resources

  • Additional identification and response resources are available at: www.HEALtrafficking.org
  • A group of nurses with ED experience (www.reclaim611.org) has a 24-hour “help line” for professionals that can assist with navigating cases that present in hospital, clinic, etc.:  833-833-6611
  • The National hotline also has a direct line for the DFPS Statewide intake (SWI) and they will do either a direct hand-off of a caller or send the information to SWI.
  • If you or someone you know has been exploited, call the National Human Trafficking Hotline at 1-888-373-7888 or text HELP to 233-733 (BEFREE) to access help and services. Non-governmental / Confidential / 200+ Languages
  • Report a tip about human trafficking or other potential criminal behavior to law enforcement at iWatchTX.org, by calling 1-844-643-2251 or by downloading the free iWatchTexas.app.

Mandatory Reporting for Suspected Human Trafficking

  • Texas law (Family Code §261.101 and Human Resources Code §48.051) mandates that anyone who suspects a child, a person 65 years or older or an adult with disabilities is being abused, neglected or exploited must report it to law enforcement or DFPS. A health care professional cannot delegate this responsibility to another individual.
  • A person who reports abuse in good faith is immune from civil or criminal liability. DFPS keeps the name of the person making the report confidential. Anyone who fails to report suspected abuse can be held liable for a misdemeanor or felony.
  • Call Texas Abuse Hotline toll-free 24 hours a day, 7 days a week, nationwide, or report with the secure website and get a response within 24 hours:

Possible Questions to Ask Patients who may be Trafficked

  • When health care providers suspect patients may be sex trafficked, they should consider asking the patient questions about:
    • Living conditions.
    • Ability to come and go as they please.
    • Personal safety.
    • Freedom to talk to whomever they please.
    • Employment status.
    • Whether they are forced, or coerced, to do anything including sexual acts, to be safe, have shelter, or to have basic needs met.

Texas Department of Family and Protective Services Role in Sex Trafficking of Children/Youth

  • “The Texas Department of Family and Protective Services takes all forms of maltreatment seriously; however, there is a recognition that victims of human trafficking require different approaches to investigations and service provision than required by other forms of maltreatment.
  • Therefore, in June 2017, DFPS established the Human Trafficking and Child Exploitation (HTCE) division to establish a systemic approach to human trafficking. The HTCE division supports the DFPS mission to promote safe and healthy families and protect children and vulnerable adults from abuse, neglect and exploitation, through the development of policy, practices and identification services that are:
    • Survivor informed,
    • Trauma responsive,
    • Person centered, and
    • Evidenced-based where possible.
  • DFPS will investigate allegations of sex trafficking when the alleged perpetrator is a traditional caregiver, an adult living in the child/youth’s home, or when a child/youth in DFPS conservatorship is identified or suspected of being a victim of sex trafficking” (DFPS, 2018).

Commercial Sexual Exploitation—Identification Tool (CSE-IT)

  • CSE-IT helps professionals identify potential survivors of commercial sex trafficking for youth 10 years or older.
  • For more information on Westcoast Children’s Clinic (2016) or the CSE-IT.

National Human Trafficking Hotline

  • Phone: (888) 373-7888
  • Online hotline
  • Toll-free 24-hour hotline:
    • Assists caller to connect to reporting agencies, if necessary.
    • Takes tips about potential human trafficking (sex and/or labor trafficking) situations.
    • Connects caller to referrals.