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Diversity, Inclusion, and Human Trafficking
sex
the body we have
assigned gender
what we were told we were at birth
gender identity
how we see ourselves
gender expression
how we communicate our gender
perceived gender
how others see us
legal gender
what the government says
orientation
who we are attracted to
reasons trans people seek providers
gender-affirming hrt
surgical interventions
gender dysphoria and re-medical tranitioning
general mental health care
general medical care
obstacles and detours
family/social support
financial
legal gender name on health insurance records
treatment from all levels of staff
assuming everything has to do with being trans
facing gender archetypes and stereotypes
“outing” and fear of violence
naming legal information out loud
sharing sex-specific results and questions
concerns in small towns and big cities alike
safety, “passing,” and privilege
ways to communicate with patients
“what name would you like me to use?”
“what pronoun would you like me to use?”
be compassionate and transparent when you need to learn more
awearness care
if you slip up on a name or pronoun, correct it and keep going
taking care of the body pt has, while respecting their identity
know pt responses may be based on ppr past care
ways to take care of pt body while respect identity
learn current meds and why their on them
is there anything else that I as your provider should know?
transwomen and prostate health, transmen and breast cancer
on legal document like consent forms and such, can a pt used their preferred name
no, it must be their government name; approach them respectfully and explain what is needed of them
transition
the process of changing one’s gender from the sex assigned at birth to one’s gender identity; may include “coming out”, changing one’s name and/or sex on legal documents, assessing hormone therapy, and possibly assessing medically necessary surgical procedures
gender non-conforming
a person who has, or is perceived to have, gender characteristics and/or behaviors that do not conform to traditional or societal expectations
transgender
umbrella term that can be used to describe people whose gender identity and/or expression is different from their sex assigned at birth
human trafficking
a form a modern-day slavery that used various forms manipulation to entrap and keep victims
types of abuse used
physical
sexual
psychological
methods of manipulation
force
fraud
coercion
ways to force victims
physical restraint
physical harm
beatings
why and when is force used
to control; used especially in the early stages to break down resistance
ways to fraud victims
false promises regarding:
wages
working conditions
love/marriage
debt agreements
ways to coerce victims
threats of serious harm/physical restraint
document confiscation
shame/fear-inducing threats to share info or pictures with others or report to authorities
forms of trafficking
sex
labor
debt bondage
organ
trafficking entry age
females: 12-14
males: 11-13
largest trafficking day of the year
Super Bowl
targets of trafficking
victims of child abuse/neglect
children in foster care
disables
children in juvenile system
lesbian, gay, bisexual, and transgender
homeless youth
undocumented immigrants
communities of color
trafficker demographic
2/3 men
women - “madam”
criminal backgrounds
business owner, intimate partner, family member, or parent
commonly exploited industries
landlords
travel services
hospitality services
visa/passport services
advertising agencies
recruitment agencies
transportation services
financial services
victim identification
3rd party does speaking
lack of knowledge of hobbies or social activities
unsure of city or state
no insurance - pays cash
clothing not appropriate for setting or season
coached/coaxed communication
reluctant to answer simple questions
obsessed with cell phone
lack of identification
marking/tattoos for branding
common trafficking tattoos
barcodes
dollar sign
crown
initials
injury indications for trafficking victims
cuts/bruises
marks under clothes
repetitive motion injuries
accidental worksite injuries
inconsistency in clinical presentation of injury and hx given
jaw/neck strain - possible indicator
untreated medical conditions for trafficking victims
diabetes
htn
cancer
prolonged infections
skin rash
anemia
malnutrition
mental/emotional issues for trafficking victims
panic/fear
phobias
depression/flat affect
anxiety
sleep deprivation
memory loss
PSTD
combative behaviors
self inflicted injury
substance/alcohol abuse
signs of withdraw (drugs/ETOH)
gynecological symptoms/hx
high number of sex partners
gynecological trauma
rectal trauma
sexually related infections
uti, recurrent unplanned pregnancies
unsafe, frequent abortions
role of provider
assessment
know the laws in your state
referral/reporting - children/adult
develop pt-centered plan
build trust
ways to build trust with a victim
respect autonomy
provide medical care
educate on trafficking and options
empowerment
principals to consider in trauma-informed care
trustworthy/transparency
empowered voice/choice
peer support
cultural/historical/gender issues
trafficking victim needs
basic services
financial assistance
housing
vocational services
legal services
immigration services
employment
trafficking supportive resources
local organizations
churches/faith-based organizations
family crisis centers
homeless shelters
HIPAA barriers for intevention
pt permission
HIPAA exclusions
mandated reporting
imminent danger to pt/staff
victim barriers to intervention
fears police and consequences of being identified as criminal not victim
condition to fear and not trust anyone
emotions or financial indebtedness
fears traffickers will retaliate
lack of support system or legal support
ashamed of choices and how they’ll be perceived by family, friends, and community
may feel there is no other option
5 different generations and years they were born
traditionalist: 1928-1945
baby boomers: 1945-1965
gen x: 1966-1976
millennials (gen y): 1977-1994
gen z: 1995+
