Human Trafficking: Recognition and Response

Human trafficking is a form of modern slavery involving the use of force, fraud, or coercion to exploit individuals for labor or commercial sex. The Trafficking Victims Protection Act (TVPA) defines severe forms of trafficking as: sex trafficking where a commercial sex act is induced by force, fraud, or coercion, or where the victim is under 18; and labor trafficking involving the recruitment, harboring, or transportation of a person for involuntary servitude or slavery. Trafficking causes severe physical and psychological harm. Victims experience complex trauma with chronic stress activation of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in elevated cortisol levels, disrupted immune function, and altered brain architecture—particularly in the amygdala (hyperactivation leading to hypervigilance) and prefrontal cortex (impaired executive function and decision-making). Stockholm syndrome (trauma bonding) develops as a survival mechanism where the victim forms psychological attachment to the trafficker. Healthcare providers may be the only professionals to encounter trafficking victims in a non-coercive setting, making recognition in emergency departments, clinics, and hospitals critical.