Human Trafficking Definitions and Legal Considerations

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Trigger warning! This page contains information about Human Trafficking, including physical abuse, sexual assault and abuse. There are links to videos which include survivor's first hand accounts of their experiences. All videos on this page are optional for course completion. Please view with caution.

Introduction

"Human Trafficking is the recruitment, transportation, transfer, harbouring or receipt of people through force, fraud or deception, with the aim of exploiting them for profit. Men, women and children of all ages and from all backgrounds can become victims of this crime, which occurs in every region of the world." -United Nations, Office of Drugs and Crime

The United States Department of State describes "trafficking in persons" "human trafficking" and "modern slavery" as interchangeable terms.

Human trafficking is a global public health issue. Recently, researchers, policy makers, and survivors of human trafficking are pushing to

Human trafficking is increasingly understood as a global public health concern that harms individuals, families, and communities by directly and indirectly causing a multitude of adverse physical and mental health outcomes.1 Intersecting with a complex range of social determinants of health (eg, income, migration status, social exclusion),2 human traffick- ing manifests itself through various forms of commercial sexual exploitation and forced labor. Researchers, policy makers, and survivors have promoted reframing human traf- ficking, which is traditionally perceived as a law enforce- ment issue, as a public health issue.

Definitions and Concepts

Below is a list of definitions and concepts within the context of human trafficking. Please refer to this list as needed throughout the Rehabilitation's Role in Human Trafficking Intervention course.

• Coercion is a means of control. It is the act of persuading another person into action by means of threats or force. In context of human trafficking this can include: threats of serious bodily harm, physical restraint, psychological or emotional manipulation, and document confiscation.
• Commercial Sex Act refers to any sexual act or conduct, or sexually explicit performance promised to/given to/or received by any person in exchange for anything of value.
• Debt Bondage (also known as debt slavery, bonded labour, or peonage) is a pledge of services by a debtor (or a person under the debtor's control) to repay know or unknown amount of debt. Examples of these charges can include: fees for transportation, food and boarding, interest on a loan, and fines for missing a quota. Often the terms for debt repayment are not clear which gives the lender control over the debtor. When the services for debt repayment are not clearly defined, the debtor can become trapped in a cycle of debt they cannot pay down and are obligated to provided services indefinitely.
• Force, in the context of human trafficking, is a means of control over victims. The use of monitoring and/or confinement is often used during the early stages of victimization to erode the victim's resistance. Physical forms of force used in human trafficking can include: physical restraint, and physical and sexual assault. This is related to harboring of a victim which involves isolation, confinement, and monitoring.
• Fraud, in the context of human trafficking, involves the false representation or promise of employment, wage, debt agreement, working condition, and relationship status including marriage.
• Human Smuggling is the exchange of fees or services to gain transportation or fraudulent documentation to illegally cross a border into a foreign country.
• Involuntary Servitude (also known as involuntary slavery) refers to a person being coerced into a form of labour against their will to the benefit of another person.
• Obtaining, in the context of human trafficking, is the forced taking or exchange of something to gain control over another person.
• Patronizing, in the context of sex trafficking, is receiving a sexual act or sexually explicit performance.
• Receive
• Recruiting is the proactive targeting of vulnerable persons and the grooming of wanted behaviours by means of fraud and coercion by human traffickers.
• Slavery, in the context of human trafficking, is when a controlled person is forced to provide labour and/or services against their will.
• Soliciting, in the context of sex trafficking, involves the offering a sexual act or sexually explicit performance.
• Transporting includes the movement and arrangement of travel for persons being trafficked.
• Transfer

Human Trafficking versus Human Smuggling

Information in the above table is adapted from the Human Trafficking Fact Sheet created by the US Department of Health and Human Services Office on Trafficking in Person.

	Human Trafficking	Human Smuggling
Consent	Victims are forced, defrauded, or coerced into trafficking If consent was initially offered it is rendered null by exploiting labour, services, or commercial sex	Individuals give consent to being illegally smuggled and involved a transaction of some sort The transaction is mutual and ends at the arrival at the agreed-upon destination
Victim of the crime	committed against an individual	committed against a country
Domestic or Transitional	Victimization can be transnational or domestic Trafficking does not require crossing international or state borders	Smuggling is transnational by definition

Human trafficking is involuntary. The victims are trafficked by force, fraud, and/or coercion to provide labour or services against their will. Human trafficking victims do not have to be moved, relocated, or transported in any way. It can occur in the victim's own town or home. In the United States, any person under the age of 18 who is a victim of sex for profit is automatically considered a trafficking victim.

Human smuggling is voluntary. It is the exchange of fees or services to gain transportation or fraudulent documentation to illegally cross a border into a foreign country. Human smuggling does not involve coercion, most people seeking out these services are fleeing violence or poverty.

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Consensual Commercial Sex versus Sex Trafficking

	Consensual Commercial Sex	Sex Trafficking
Consent	All involved individuals give consent Not a violation of the sex worker's human rights	Trafficked individual does not give consent, but is coerced into the sexual act or performance Sex trafficking is a violation of the victim's human rights
Person involved	Sex workers are consenting adults	Victims of sex trafficking can include men, women, and children
Payment for Services	Sex workers earn and keep income	All income or services go to the trafficker, not the victim

"Sex work is consensual. Human trafficking is not. When you conflate the two, and you label all sex workers as victims of human trafficking, it totally takes away from the folks who are being trafficked"

-Julia Baumann

founder and coordinator of Safe Space, a drop-in centre for sex workers in London

Consensual Commercial Sex (also known as sex work) is when a person willingly takes part in the sale of a consensual sexual act or conduct.

Sex Trafficking (also known as Sexual Exploitation) is the sale of nonconsensual sexual acts or conduct through force or coercion.. Victims of sex trafficking include all races, genders, ages, socioeconomic backgrounds, and nationalities.

Human Trafficking

Introduction/Statistics

More than 175 nations have ratified or acceded to the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons (the UN TIP Protocol), which defines trafficking in persons and contains obligations to prevent and combat the crime.

• Trafficking does not require crossing internations or state borders
• Limitations of data on human trafficking

Trafficking Victims Protection Act of 2000 (TVPA), as amended (22 U.S.C. §7102).

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Types of Human Trafficking

The US State Department recognizes two types of human trafficking, and classifies them as federal crimes:

1. Labour trafficking (also known as forced labour) involves the use of force, fraud, and/or coercion to obtain labour from the trafficking victim. Labour trafficking can occur within any industry or sector: agriculture and meat farming, factory work, hospitality industry such as restaurants, hotels, or massage parlors; retail, mines, private home, or drug trafficking operations.
   Two widespread forms of labour trafficking include:
   • Domestic servitude involves a victim performing forced labour in a private residence.
   • Forced child labour involves children being forced or coerced to work. Unfortunately forms of slavery including the sale of children, and debt bondage of children continue to exist across the world. Forced child labour is different from children who are able and choose to legally seek employment and work.
     • Some indicators of forced child labour include (1) when the child appears to be in the custody of a non-family member and their work benefits that person, (2) withholding food, rest, or schooling to a child who is working.
2. Sex trafficking involves the use of force, fraud, and/or coercion to perform a commercial sexual act or conduct. The victim can suffer threats of serious physical or psychological harm, threats to friends or family, or debt bondage. Sex trafficking can occur in any location including physical locations and on the internet. Examples of sexual exploitation can include: prostitution, escort agencies, phone sex lines, stripping on a web cam or internet chat rooms, and pornography. ,
   • Child sex trafficking involves sex trafficking with a person under the age of 18 years. The use of force, fraud, or coercion is irrelevant, children engaging in commercial sex is illegal in most countries around the world.

The United Nations, private and not-for-profit organizations such as Stop the Traffick acknowledge other types of human trafficking to include:

1. Forced marriage occurs when a person is forced into marriage under threats of force, fraud or through coercion. Situations where forced marriage may occur include: as access into a country or access to benefits.
2. Forced criminal activity involves a person carrying out a criminal activity under threats of force, fraud or through coercion. Forced criminality can include: drug distribution, cannabis cultivation, begging, pickpocketing or bag snatching, ATM theft, or the selling of counterfeit goods.
3. Child soldiers involves a child serving as a soldier or to commit a crime to the benefit of the trafficker under threats of force, fraud or through coercion.
4. Organ harvesting and trafficking involves the removal of an organ or body part to sell on the blackmarket. The victim can be cheated out of an agreeabled upon price for the organ, have an organ removed without their knowledge during treatment for another medical condition, or kidnapped and have an organ removed without their consent.

Dynamics of Human Trafficking

Trafficker

People who deal in human trafficking do so for monetary and financial gain. These crimes go undercounted and unrecognized because they are often difficult to detect.

Trafficker Profiles

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"In 2020, 42% of trafficking victims were brought into trafficking by a member of their own families and 39% were recruited via an intimate partner or a marriage proposition." -The Polaris Project

Both US and international law state that human traffickers can be classified as corporations or other legal entities, or private persons.. According to an extensive review of federal human trafficking prosecution in the United States since TVPA was enacted in 2000 found that the vast majority of prosecuted human traffickers were private persons. The review found that in 2020, the average defendant was a 36yo man, with 81% of all human trafficking case defendants being male. When comparing sex and labour trafficking cases from 2020, men made up 82% of defendants in sex trafficking cases and women made 43% of defendants in labour trafficking cases. This data was found to track with global trends, however there is no one human trafficker's profile type and they could come from any segment of the population. Human traffickers can be foreign nationals or local citizens, family members, spouses/partners, friends, acquaintances, or strangers. They can be individual actors or part of a larger organisation. They can be pimps, gang members, diplomats, or business owners.

The review went on to say that traffickers often know and have a trusting relationship with their victim. Data on sex trafficking cases from 2020, approximately 43% of defendants previously knew their victims. Of these cases: 31% were social media contacts, 21% as a spouse or intimate partner, 13% as a human smuggler, and 10% as a friend or classmate. Data on labour trafficking cases found approximately 57% of defendants previously knew their victims.

At what point a person transitions to a trafficker can be difficult to identify. The review points to the fact that the nature of the coercion used by the trafficker are highly personalised.

Trafficker Recruitment Techniques

Human trafficking recruitment is often based on the deception of innocent, unsuspecting victim. Recruitment techniques commonly used by traffickers include:

• Threats or use of violence
• Manipulation
• Seduction and romance
• Forced pregnancy
• False employment promises
• False promises about education or travel
• Sale by family
• Recruitment of formerly enslaved persons
• Abuse of religious beliefs
• Abduction or kidnapping

In some cases, a former victim of human trafficking will become a trafficker themselves. This is most commonly the case of female victims of sex trafficking.This speaks to the grooming and psychological manipulation victims of human trafficking suffer and endure.

Victim

Human trafficking victims can come from any segment of the population, however traffickers tend to prey upon people with the following vulnerabilities:

• Poverty/economic hardship
• Limited English proficiency
• Lack of lawful immigration status
• lack of stable safe housing
• Lack of a social safety net
• Following a natural disaster, war or political instability
• Limited economic and educational opportunities
• Psychological or emotional vulnerability

Human trafficking victims are often tricked or mislead into trafficking by (1) false romantic intentions, (2) promises of good employment or pay, and (3) a stable life.. They can be of any gender or age, and come from any educational, socio-economic, ethnicity or nationality, or religious background. However, women and girls are at a higher risk of being trafficked for sexual exploitation. Refugees are also often victimised due to dire living situations in refugee encampments.

Health Impact of Human Trafficking

"Polyvictimization, also known as complex trauma, describes the experience of multiple victimizations of different types, such as sexual abuse, physical abuse, bullying, exposure to family violence, and more. This definition emphasizes different kinds of victimization, rather than just multiple episodes of the same kind of victimization, because it signals a generalized vulnerability. Research shows that the impact of polyvictimization is much more powerful than even multiple events of a single type of victimization." - National Children’s Advocacy Center

Physical Health

• Reproductive/Sexual health: frequent treatment of sexually transmitted infections or injuries, multiple unwanted pregnancies, lack of sexual desire or oversexualised behaviours
• Signs of physical abuse: fractures or burns, bruising; signs of concussions, traumatic brain injuries or unexplained memory loss
• Gastrointestinal problems
• Malnutrition
• Changes in sleep: sleeplessness, sleep disturbances, nightmares, and/or insomnia
• Fatigue
• Skin or respiratory problems caused by exposure to agricultural or other chemicals
• Communicable and non-communicable diseases
• Oral health issues, including broken teeth
• Chronic pain
• Tattoos or branding of ownership

Emotional/Psychological Health

• Unable to concentrate or provide basic information including age, address or time
• Substance abuse
• Self-harm and suicidal ideation
• Depression, anxiety, panic attacks
• Fear of being alone, distrust and fear of strangers
• Guilt, shame, and/or self-blame
• Post-traumatic stress disorder
• Eating Disorders
• Suspicious behaviour: appears nervous or avoids eye contact; seems overly fearful, submissive, tense, or paranoid
• Has a lack of autonomy or independence. Person will defer to another before giving information, no control over identification documents
• Cultural, linguistic barriers and isolation
• Withholds information. The person can be unwilling to answer questions about their health, gives confusing or contradicting information

Victims of human trafficking suffer physical, mental, emotional, and psychological injuries. They loose their independence and autonomy. Their quality of life is hugely and devastatingly effected. A study by Hossain et al interviewed more than 200 victims of sex trafficking and assessed for mental health and quality of life. They found 55% had high levels of depression symptoms, 48% had high levels of anxiety symptoms, and 77% were potentially suffering from PTSD.

Trafficking Victim Identification and Assessment

• Where are you most likely to interact with a trafficked person?
  • Clinical settings in which trafficked persons may be encountered.
  • Application for rehabilitation professionals
• Identifying a trafficked person
  • the potential indicators of trafficking in persons
  • provider challenges to identification and response
  • challenges/opportunities when interfacing with trafficked persons
• Interacting with a trafficked person
  • Patient-centered
  • the role of trauma-informed care in trust-building and Communication.
  • provides samples of appropriate language to assist with identification.
  • the importance of the use of professional interpreters
  • provides strategies to have private conversations with potential trafficked persons.
  • Survivor barriers to disclosure
• Safety concerns
  • measures to keep oneself and patients safe.
  • describes the importance of appropriate documentation

Response and Follow Up

Intervention

• describes the importance of the healthcare provider role in intervention and response.
• includes a discussion of the importance of organizational Protocols.
• includes a discussion of mandated reporter obligations

Referrals

• describes the importance of survivor-centered, multidisciplinary referrals within the health care organization and with community partners.
• includes a discussion on the importance of building a trusted local network of resources
• includes a discussion of the implications of law enforcement involvement.

Resources

• provides information on how to contact your community, local, and/or state resources.
• National Human Trafficking Hotline number and text number along with any local hotlines.

Resources

• https://www.unodc.org/documents/human-trafficking/First-Aid-Kit/First_Aid_Kit_-_Booklet_eng.pdf

Screening Tools for Health Care Practitioners

source: https://www.hhs.texas.gov/services/safety/texas-human-trafficking-resource-center

Commercial Sexual Exploitation-Identification Tool (CSE-IT)

CSE-IT is a research-based screening tool that helps improve early identification of commercially sexually exploited youth. West Coast Children’s Clinic developed this tool, which is currently used in Texas and other states and across various sectors.

Learn more about CSE-IT on the Office of the Texas Governor Child Sex Trafficking Team website and on the West Coast Children's Center website.

Short Child Sex Trafficking Screen for the Health care Setting

Dr. Jordan Greenbaum with The Institute on Healthcare and Human Trafficking developed this validated screening tool for assessing teenagers seeking health care in the United States.

Adult Human Trafficking Screening Tool and Guide

Administration for Children and Families designed this survivor-centered, trauma-informed and culturally appropriate screening tool and guide. It can help health care providers in various sectors assess adult patients or clients for signs of potential exploitation or risk of being exploited.

Learn more about the Adult Human Trafficking Screening Tool and Guide on the U.S. Office on Trafficking In Persons website.

Trafficking Victim Identification Tool and Manual

Vera Institute for Justice developed this tool and manual, which are intended primarily for victim service agency staff and other social service providers who are screening potential adult and child trafficking victims. Law enforcement, health care and shelter workers will also find it helpful in improving trafficking victim identification, especially in conjunction with appropriate training or mentoring.

Learn more and download the tool on the Vera Institute for Justice website.