Module 1 Study Guide

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 transitioning

• 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 poor 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

• disabled

• 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+