Assisting Trafficking Victims Research brief The purpose of this research brief is to review research on the relationship between sexual violence and trafficking (especially, but not limited to, sex trafficking) and shed light on gaps in existing research. The documents reviewed in this brief discuss trafficking, the frequency of sexual violence against trafficking victims, health concerns of victims, and strategies for outreach to victims. Defining trafficking For the purpose of this research brief, human trafficking is defined as “the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of” prostitution and/or labor exploitation (U.S. Department of Health and Human Services, Administration for Children and Families, n.d.). Child trafficking is defined as the recruitment and transport of a minor (with or without force, fraud, or coercion) for the purpose of prostitution and/or labor exploitation. As defined by the United States Trafficking Victims Protection Act of 2000 (TVPA), transportation or physical movement of the victim does not necessarily need to be present in order for the crime to occur; instead, it is the presence of exploitation (force, fraud, or coercion) that indicates whether a trafficking crime has occurred (Victims of Trafficking and Protection Act, 2000). The data discussed in this research brief indicates that trafficking victims are frequently subjected to sexual and physical violence. Physical injuries, gynecological problems, and mental health issues among trafficked persons are common. Global economic and political forces, as well as patriarchal attitudes across societies (i.e., tolerance for trafficking), contribute to trafficking. Much research on sexual violence in the context of trafficking focuses on sex trafficking, with sexually exploited women and female adolescents comprising the bulk of research subjects. Methodological concerns may arise if most research draws heavily from this population, as trafficking victims in other labor sectors who experience sexual violence are underrepresented. This research brief contains reports that focus heavily on sex trafficking, but also provide limited information on sexual violence in the context of the mail-order bride industry and labor sectors. Future research should address this gap by studying the experiences of sexual violence among trafficking victims in diverse labor sectors. While it is highly probable that sexual violence occurs against trafficking victims across labor sectors, additional research can broaden the field’s understanding of such victims. Because of the clandestine nature of human trafficking and the extreme isolation of its victims, accurate statistics on the incidence of trafficking are difficult to find. Thus, the articles in this research brief discuss study samples and reported cases rather than incidents as a whole. The findings in this research brief have several implications for stakeholders and researchers in the field. Stakeholders such as anti-sexual violence advocates, counselors, and health care providers can be made more aware of the relationship between trafficking and sexual violence, and thus can provide improved outreach and services to trafficking victims. Additionally, researchers can use the synthesized data to enhance further research on trafficking victimization, social forces that contribute to trafficking, and physical and psychological impact of trafficking victims. Raymond, J. G., D’Cunha, J., Dzuhayatin, S. R., Hynes, H. P., Rodriguez, Z. R., & Santos, A. (2007). A comparative study of women trafficked in the migration process: Patterns, profiles and health consequences of sexual exploitation in five countries (Indonesia, the Philippines, Thailand, Venezuela and the United States). Retrieved from the Coalition Against Trafficking in Women International: http://action.web.ca/home/catw/attach/ CATW%20Comparative%20Study%202002.pdf Aims:Raymond et al. discuss the dynamics of female migration and the vulnerabilities of migrant women to sexual violence and exploitation. The authors’ studies reveal how trafficking and its associated sexual violence can have negative physical, psychological, and reproductive health consequences for women. Methods: This collection of articles draws upon interviews with 146 women trafficked domestically and internationally in Indonesia, the Philippines, Thailand, Venezuela, and the U.S. The authors examine structural factors that contribute to trafficking (e.g., economic policies, immigration policies, women’s poverty and inequality), as well as the dynamics of sex trafficking, “entertainment” industries, and some mail-order bride venues. Key results: • Variables that contribute to female migration in many countries include gender stereotyping of women in work situations, growing poverty, lack of meaningful employment opportunities, and demand for female migrant labor in destination countries, among others. • In one study, Santos lists six factors in the backgrounds of female trafficking victims from the Philippines that could be applied to other trafficking victims in the study: “(1) poverty and lack of economic opportunities, (2) low educational levels and lack of knowledge about the recruitment process, (3) history of sexual abuse, (4) family pressures, (5) desire for independence and future aspirations, (6) exposure to alleged success stories of others who migrated abroad” (Raymond, D’Cunha, Dzuhayatin, Hynes, Rodriguez, & Santos, 2007). • Study respondents reported high levels of physical, psychological, and sexual violence, as well as control through coerced use of alcohol and drugs. • Health risks associated with trafficking (specifically sex trafficking) include a wide array of physical injuries, sexually transmitted infections, and mental health problems, notably depression. Summary: Raymond et al. highlight the health impact of trafficking on its victims, while framing trafficking in its economic, political, and social context. Application:The authors illustrate why anti-trafficking initiatives must be multitiered efforts to address the poverty, low educational levels, sexism, and demand by men that lie at the root of trafficking of women. In doing so, anti-trafficking and anti-sexual violence advocates will not only reduce trafficking, but also the sexual violence inherent to trafficking. Future research needs: Raymond et al. focus most of their attention on sex trafficking, with only brief attention to sexual violence against trafficked women in other labor sectors. While sex trafficking victims make up a disproportionate percentage of female trafficking victims, victims from mail-order bride and labor sectors (e.g., agriculture) should also be the focus of more research. Schauer, E. J., & Wheaton, E. M. (2006). Sex trafficking into the United States: A literature review. Criminal Justice Review, 31, 146-169. doi:10.1177/0734016806290136 Aims: This article reviews the current body of research on sex trafficking into the U.S., highlighting gaps in research and commonly observed factors related to sex trafficking. Methods: Schauer and Wheaton review the current research literature on trafficking for the purpose of sexual exploitation in the U.S. Key results: • Much research on sex trafficking is imprecise because little agreement exists among anti-trafficking organizations and researchers on the operational definition of “trafficking” and related terms. • Statistics on the prevalence of sex trafficking are imprecise for six reasons: (1) sex trafficking is clandestine, and only a fraction of traffickers are arrested and prosecuted, (2) trafficking victims are mobile and thus difficult to count, (3) authorities do not use precise, operational definitions of “trafficking,” (4) governmental corruption in source countries inhibits accurate reporting, (5) local authorities often do not recognize sex trafficking, and (6) for political expediency, governments suppress information on the true extent of sex trafficking. • Political and economic instability, globalization, marginalization of women from mainstream careers, and economic differences between industrialized and non-industrialized countries are cited as possible root causes for sex trafficking. • New laws must operate under a trafficking paradigm recognizing trafficked women as victims and traffickers as criminals, rather than a prostitution paradigm assuming complicity on the part of the trafficked woman and framing her as a criminal. • Qualitative research is needed to (1) develop clear definitions of sex trafficking and related terms, (2) provide quantitative empirical analysis and data to the field, and (3) understand and address the needs of sex trafficking victims. Summary: Recognizing that sex trafficking is a form of sexual violence against women, Schauer and Wheaton acknowledge the misogyny of sex trafficking and its negative impact on women, children, and society. The authors shed light on important root causes of female migration, which contribute to females’ vulnerability to trafficking and associated sexual violence. Application: This review points out methodological issues and gaps in research that may be important to trafficking researchers. Additionally, law enforcement professionals may benefit from the article’s observations about law enforcement sex trafficking paradigms and recognition of local trafficking. Finally, anti-trafficking and anti-sexual violence advocates may benefit from knowing that the scope of sex trafficking is likely underrepresented due to methodological concerns in trafficking research. Future research needs: Schauer and Wheaton highlight the need for common terminology and accurate statistics in sex trafficking research, so as to allow for more meaningful discussions of the issue among researchers and policymakers. The authors’ discussion of methodological problems in sex trafficking research suggests that research on sexual violence in trafficking may be incomplete, as it is difficult to study representative populations of sexually assaulted trafficking victims. While the article stresses the need for comprehensive, multifaceted responses to sex trafficking, it says little about the role of health care providers and their capacity to intervene with or treat sex trafficking victims. Furthermore, the article features little discussion on the impact of sex trafficking (and its inherent sexual violence) on trafficking victims’ health and on public health. Shared Hope International. (2007). Demand: A comparative examination of sex tourism and trafficking in Jamaica, Japan, the Netherlands, and the United States. Retrieved from http://www.sharedhope.org/Portals/0/ Documents/DEMAND.pdf Aims: Shared Hope International (SHI) observes common features in global sex trafficking and commercial sexual exploitation using sex trafficking in Japan, Jamaica, the Netherlands, and the U.S. as case studies. This report discusses the physical violence, sexual violence, and coercion inherent to sex trafficking and commercial sexual exploitation, and offers country-specific recommendations for addressing these problems. Methods: SHI carried out field research with individuals involved in sex trafficking (i.e., trafficking victims, journalists, non-governmental organizations, or NGOs, and legal analysts) and drew upon the body of research on global sex trafficking to produce this report. Key results: • Sex trafficking and sex tourism markets are intertwined to form a single market that exploits trafficked females. A “culture of tolerance” for commercial sex exists in all four of the countries studied. • Failure by law enforcement and governments to correctly identify trafficking victims facilitates sex trafficking and prevents victims from receiving appropriate services. • In the four countries studied, criminal markets for trafficking victims exist under the guise of legal commercial sex venues. Institutions (e.g., businesses, governments) and individuals (e.g., pimps, traffickers, pornographers, corrupt officials) facilitate and benefit from sex trafficking and sex tourism. • Technology facilitates sex trafficking and commercial sexual exploitation in three of the four countries studied. Telephone and internet communication create opportunities for advertising and solicitation of commercial sex and pornography. Summary: SHI sheds light on the complex systems of traffickers, criminal markets, and legitimate institutions that facilitate sex trafficking and emerge out of cultures that tolerate sex trafficking and sexual violence. Effective responses to sex trafficking and its inherent sexual violence must address the layers of demand, criminal involvement, and institutional involvement that foster sex trafficking. Application: NGOs, law enforcement officials, and other international stakeholders may find this report useful in understanding how sex trafficking is intertwined with sex tourism markets, legitimate institutions, and criminal elements, as well as why global law enforcement and governmental bodies have not always been successful in addressing sex trafficking. Future research needs: This report discusses several facets of global sex trafficking, including cultural influences, technology, law enforcement responses, and categories of buyers of sexual services. Research into these facets of trafficking could provide the field with a more complete picture of sexual violence in sex trafficking, trafficking dynamics, and appropriate responses. Zimmerman, C. (2003). The health risks and consequences of trafficking in women and adolescents: Findings from a European study. Retrieved from the Organization of American States http://www.oas.org/atip/ Global%20Reports/Zimmerman%20TIP%20 HEALTH.pdf Aims: This report looks at health risks and health care issues surrounding trafficked women. Zimmerman discusses barriers to health services that trafficking victims face, as well as means by which service providers can address the holistic health needs of trafficked women. Methods: This report draws upon a review of trafficking research, interviews with trafficked women in eight European and Asian countries, and interviews with members of law enforcement, governmental, health, and NGO sectors. Key results: • The women in the study often had limited information or misinformation about health before being trafficked and seldom had access to health care in transit or post-trafficking. Barriers to providing health services to trafficked women include meeting victims’ complex service needs, accessing victims in safe ways, and overcoming language and cultural barriers. • Health care professionals are most likely to establish contact with trafficked women through programs and services aimed at victims of sexual exploitation and those in labor sectors that employ trafficked women. • Health services can best serve women who have been trafficked by providing holistic care and integrating health services with other forms of assistance (i.e., social services, legal services). • The majority of the women interviewed reported being physically hurt during their trafficking experience, with various physical injuries and physical health problems reported. All of the women interviewed reported being sexually assaulted, and gynecological problems were the most commonly reported health issue. Also, several respondents reported negative mental health symptoms (e.g., low self esteem, melancholy, fatigue, and thoughts of suicide). Summary: This report illustrates how sexual violence, in conjunction with other forms of violence, has a profound impact on the health of trafficking victims. Zimmerman describes barriers to health services that trafficked women may encounter, as well as how health care professionals can effectively serve this population. Application: This report may assist health care professionals gain insight into ways that the health sector can coordinate outreach and services to trafficking victims. Additionally, it can help other stakeholders understand the importance of incorporating health care professionals in anti-trafficking, anti-sexual violence collaborative efforts. Future Research Needs: Much of the research on sexual violence against trafficking victims focuses on women recruited into prostitution. However, this report reminds readers that trafficked women in labor sectors other than the sex industry are vulnerable to sexual violence. Future research should address the health care needs of sexually victimized trafficking victims in other labor sectors. Conclusion As this research brief demonstrates, many of the trafficking victims studied were subjected to sexual and physical violence, suggesting that sexual violence is a problem among women who have been trafficked. More research is needed to understand the experiences of men and children who are trafficked. The four documents in this research brief bring several important facts on sexual violence and trafficking to light. • First, sex trafficking victims are heavily represented in research on trafficking. While this is an important population to study and aid, the voices of other sexually assaulted trafficking victims are underrepresented in research and need to be heard in future studies. Research on sexual violence against trafficking victims in other labor sectors can help stakeholders recognize vulnerable populations and serve their needs more effectively. • Second, sexual violence in the context of trafficking is an important health issue for trafficking victims. Service providers who aid trafficking victims should be mindful of the multiple health problems and health risks faced by survivors of sexual exploitation and chronic sexual violence. • Finally, the roots of trafficking are multifaceted, with economic, structural, and social factors contributing to migration and trafficking. To prevent trafficking, stakeholders must address the poverty, political instability, and sexism that create risk factors for trafficking victimization. References Raymond, J. G., D’Cunha, J., Dzuhayatin, S. R., Hynes, H. P., Rodriguez, Z. R., & Santos, A. (2007). A comparative study of women trafficked in the migration process: Patterns, profiles and health consequences of sexual exploitation in five countries (Indonesia, the Philippines, Thailand, Venezuela and the United States). Retrieved from the Coalition Against Trafficking in Women International: U.S. Department of Health and Human Services, Administration for Children and Families. (n.d.). Fact sheet: Human trafficking. Retrieved August 8, 2012, from http://www.acf.hhs.gov/trafficking/about/fact_human.html Victims of Trafficking and Protection Act, Pub.L.No. 106–386, Stat. 114 STAT. 1464 (2000). Retrieved from the U.S. Department of State: http://www.uscis.gov/ilink/docView/PUBLAW/HTML/PUBLAW/0-0-0-22532.html National Sexual Violence Resoure Center 2012. All rights reserved. This document was supported by Cooperateive AGreement #5VF1CE001751-03 from the Centers for Disease control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the officail views of the CDC.