Human Trafficking and Exploitation: The Texas Requirement _______________________________________
• Does someone, other than family, who behaves in a controlling manner, accompany the patient? Traffickers attempt to guard and control most every aspect of the victim’s life, while maintaining isolation from family, friends, and other common forms of human interac- tion. • Are there inconsistencies in answers to basic questions (e.g., name, age, address)? • Does the patient speak English? If not, has he or she recently been brought to this country, and from where? Many victims of human trafficking have recently been trafficked from other countries. As discussed, common sending countries/regions include Eastern Europe, Asia, Latin America, Africa, India, and Russia. • If the patient is accompanied by someone other than a family member, who does the talking, and why? Attempt to interview and examine the patient sepa- rately and alone, using an interpreter if necessary. Probe in a sensitive manner for detailed information on the situation and relationship. • Does the patient show signs of psychosocial stress (e.g., appears withdrawn, submissive, fearful, anxious, depressed)? Can the individual account for this? • Are there visible signs of physical abuse (e.g., bruises, lacerations, scars)? How does the individual explain these? • Does the patient lack a passport or other immigration and identification documentation (e.g., driver’s license, social security number, visa)? If so, what explanation is given? To control victims’ movements, traffickers often take away passports and any legal identification docu- ments. • What is the patient’s home and work situation? Basic questions about what they eat, where they live and sleep, who else lives with them, and what work they do can be revealing. For example, “Can you leave your work or job situation if you wish?” or “When you are not working, can you come and go as you please?” • Is the explanation given for the clinical visit consistent with the patient’s presentation and clinical findings? • Does the victim appear fearful when asked questions about citizenship, country of origin, immigration status, or residence? This may indicate a fear of deporta- tion. • If the victim is a minor, is s/he in school? Living with parents or relatives? If not, what reasons are given for these circumstances? If answers to these questions indicate that an individual may be a victim of human trafficking, one should contact the National Human Trafficking Hotline at 1-888-373-7888. Under the child abuse laws, practitioners who are mandated reporters and who are suspicious that a minor is being abused should immedi- ately report the abuse to the Texas Department of Family and
Protective Services (DFPS). For more information regarding specific states’ reporting requirements, please visit https:// www.littleleague.org/player-safety/child-protection-program/ state-specific-information-child-abuse. In addition, older and dependent adults may be victims of abuse, exploitation, or trafficking. Because these individuals may be especially vulnerable due to reliance on others for care and support, state law requires that any person who suspects such mistreatment must report it immediately to the DFPS. Recognizing and reporting suspected abuse is essential to pro- tecting the safety and dignity of older and dependent adults. SCREENING QUESTIONS Examples of questions to screen for human trafficking include [105; 106; 107]: • Can you tell me about your living situation? • Has anyone ever threatened you with violence if you attempted to leave? • Does anyone force/require you to have sexual inter- course for your work? • Has anyone ever threatened your family if you attempted to leave? • Does anyone make you feel scared at work? • Are you free to come and go as you wish? • Does your home have bars on windows, blocked win- dows/doors, or security cameras? • How many hours do you work? • Have you ever worked without receiving payment you thought you would get? • Do you owe your employer money? • Do you have to ask permission to eat, sleep, use the bathroom, or go to the doctor? The Polaris Project has developed a flow chart for the assess- ment of potential trafficking victims, available at https:// www.traffickingresourcecenter.org/sites/default/files/Assess- ment%20Tool%20-%20Medical%20Professionals.pdf. Again, if a person is thought to be a victim, healthcare providers should follow workplace protocols and/or contact the National Human Trafficking Hotline at 1-888-373-7888 for next steps. INTERVIEWING TRAFFICKED VICTIMS: BEST PRACTICE GUIDELINES Service providers should repeatedly weigh the risks and benefits of various actions when interviewing human trafficking victims [70; 108; 109]. Survivor safety is of utmost importance, and a private conversation should be sought, if at all possible. It may be necessary to be discrete or nonchalant when requesting to speak with the victim alone, as angering the trafficker may result in negative consequences for the victim. If the agency has a policy to always speak to patients alone, this may be easier to explain. Other strategies to separate a possible victim from a companion include stating the need for a private exam or
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MDTX2026
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