The health care system is reportedly struggling to address the needs of child sex trafficking victims, but a new report from Northeastern University recommends ways to better address the needs of minors in need.
A new report from a team of Northeastern University experts sheds light on the under-discussed and under-researched issue of minor sex trafficking victims and their interactions with the American health care system.
Sex trafficking, or commercial sexual exploitation, of minors is a major public safety and health issue in the U.S., but this is the first report to take a comprehensive look at the health needs of victims, says Amy Farrell, professor and director of criminology and criminal justice at Northeastern University.
Every year, hundreds of cases related to the commercial sexual exploitation of minors, or child sex trafficking, are reported in Massachusetts alone. That is likely an undercount, Farrell says.
Historically, health systems in the U.S. have focused on identifying victims, but the resistance of minor sex trafficking victims to even seek health care makes that an ongoing challenge. This report aims to address that, laying out the dire health needs of victims while recommending ways for health care providers to better address those needs.
“Exploitation impacts health care needs so not only should doctors and nurses be identifying and then referring victims to services, they should be using the information about exploitation to actually provide better health care,” Farrell says. “Providing quality health care requires understanding a person’s exploitation history or risk for exploitation because exploitation has impacts on health.”
The report is based on a nationwide study conducted by an interdisciplinary team of health care experts, criminologists, clinicians, psychologists and sociologists that also included Northeastern’s Carlos Cuevas, a professor of criminology and criminal justice, Alisa Lincoln, professor of health sciences and sociology and doctoral students Amelia Wagner and Sarah Lockwood. University of New Hampshire, Boston University and the Research Triangle Institute were also partners on the report.
Based on a national survey of over 500 young people who are experiencing or have experienced exploitation and in-depth interviews, the report pinpoints the significant amount of health needs faced by minor sex trafficking victims.
“Young people that are being commercially sexually exploited are at very high risk of STDs,” Farrell says. “But we also found things like individuals needing to seek abortion medical care and then maybe having medical complications as a result of that abortion medical care [and] individuals experiencing violence during exploitation where they had broken bones or they have injuries to all different areas of their bodies.”
Minor sex trafficking victims often also have chronic stomach pain stemming from stress and malnutrition, along with the kind of chronic headaches associated with post-traumatic stress.
What Farrell and her team found is that despite all of these health concerns, young people who are being commercially sexually exploited often will not get health care. They might go to an emergency room or health clinic if there is an immediate need, but they are less likely to go to a doctor.
“They know health is important, but they really struggle to get health care because of stigma and shame and discrimination that they’ve experienced, particularly during exploitation when they were seeking health care from emergency rooms and clinics where they were treated with real derision by health care providers for what was perceived as either their voluntary engagement in substance use or their voluntary engagement in commercial sex even though they were minors and being exploited,” Farrell says.
For that reason, the most significant recommendation from the report is a need to reimagine the relationship health care providers have with young victims of sex trafficking. It has to start with reimagining how pediatric care is provided in the U.S., Farrell explains.
“Sometimes pediatricians actually model relationships that are similar to exploitive relationships,” Farrell says. “‘You give me something, I give you something. I’m the authority, I tell you what to do,’ as opposed to giving children the ability to actually start being agents in their own health care and thinking about health providers as someone you could trust.”
“That’s beneficial to all kids, not just for kids who are exploited,” she adds. “Seeing that relationship as agency building as opposed to just health serving, that requires more time, more resources for pediatricians.”
However, addressing the urgent health needs of this vulnerable population also requires training health care providers to not only identify the signs of exploitation –– like addiction –– but to address immediate health needs of a young person who is being exploited, like access to birth control, STD testing and vaccines, Farrell advises.
Once there are enough doctors who are trained to work with exploitation victims, improving health care navigation is “a critical element” of ensuring victims actually get help.
“Training the right doctors and training the right clinics is that immediate part in the middle,” Farrell says. “That has to happen so that we get providers that understand the relationship between exploitation and health and understand exploitation. Then getting people to those providers is really important.”