Recognizing and Caring for Sex Trafficking Victims

Elizabeth Woods, MD
Elizabeth A. Berdan, MD, MS
Mary Bridge Children’s Hospital

The Commercial Sexual Exploitation of Children (CSEC) is a problem in all our Washington communities.  Research from the Urban Institute identified an underground commercial sex economy here in Washington and uncovered a circuit that runs between Everett, Seattle, and Tacoma with connections to Portland, northern California, and Las Vegas. There is no community immune to its dangers. You are seeing victims/survivors in your practice. Are you prepared to recognize them?

The Problem

Did you know that 12 years old is the average age of entry into trafficking?  Most victims are US residents, and many teens being trafficked do not consider themselves victims. Trafficked victims report accessing healthcare on multiple occasions but say this part of their history was never asked or addressed. Anyone can be a trafficker–man, woman, friend, foe, public servant, mother, father.

Contrary to popular opinion, these children are not stolen from parking lots; they are carefully groomed in relationships with people they know or by online predators.  They may be manipulated with the exchange of sex for money, clothing, food, shelter, drugs, and lifestyle options previously not available to them. They may think they are in control or they may feel hopeless, helpless, and ruined.

A call to action

Educate yourself and your colleagues. Develop hospital and clinic protocols. The goal is not to obtain a disclosure of trafficking, rather to establish a trusting, non-judgmental relationship. Allow the patient to be in control. Avoid the rescue fantasy. It is so easy to want to save these children and DO something. The best thing you can do is to understand your community resources, and to establish a long-term care plan.


For each patient you suspect as a victim of trafficking, provide the number to the National Human Trafficking Hotline 1-888-373-7888 or tell patients to text “BeFree” (233733). This number can provide 24/7 assistance and local resources ( Stolen Youth ( is a Washington state resource to locate services in your area and assist with identifying after-care options. If a child or teen is in danger you are required by law to notify the Department of Children, Youth and Families (DCYF) as well as law enforcement.  Lastly, be an advocate for healthy conversations regarding sex, internet supervision, parent-monitored social media, and cell phone controls.

If our encounters are compassionate, we demonstrate we care, and we have resources to offer, we have an opportunity to make an important difference in someone’s life. Someone may not open up on the first encounter, and they may not choose to disclose to you. This is about guiding the patient along their chosen path.

Free CME courses to help you learn how to recognize victims of sex trafficking are offered by Physicians Against Trafficking of Humans part of the American Medical Women’s Association (PATH-AMWA). Learn more by contacting the Child Abuse Intervention Department at Mary Bridge Children’s Hospital at 253-403-1478. You may also reach out for access to screening protocols. We are happy to collaborate!