Running Head: SEX TRAFFICKING AND PTSD 1

Sex Trafficking and PTSD in Adolescent Girls in the United States

Jasmine Parker

University of North Florida

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Human sex trafficking is a major public health concern that creates a myriad of problems

that affect many people and communities. Roughly 2.5 million people become victims of human

trafficking, with over 900,000 being minors (International Labour Organization, 2012). As the

number of individuals who purchase sex increases, the demand for workers increases, leading to

the coercion of most to be exploited (Gerassi, 2015). There are components to sex trafficking,

such as the recruitment process. In one study, 47% of trafficked victims reported that they were

brought in by friends who were forced into recruiting by their own trafficker (Curtis et al., 2008).

Deception and exploitation are the underlying concepts of human trafficking that lead to the

development of issues that forever impact an individual’s life. Declining mental health is a big

problem considering the increased chance of acquiring disorders such as post-traumatic stress

disorder.

PTSD can be said to be debilitating because it is characterized by failing to recover from

a traumatic time. For the general population, the chance of developing the disorder after a

traumatic event is between 5% and 24% (Breslau, 2001). Adolescents seem to fall towards the

lower end of that scale due to misdiagnosis. Most are diagnosed with illnesses such as ADHD or

ODD, but the true cause is PTSD (Cook et al., 2003). A significant portion who are accurately

diagnosed attributed the disorder to sexual abuse trauma.

Being a victim of human sex trafficking can be a major determinant of developing PTSD.

Because there is no uniform way of collecting data on a topic no one wants to discuss, the

statistics are inaccurate and insufficient (Macy & Graham, 2012). As a result, researchers fail to

get the most accurate data while studying the link. The purpose of this review is to discover if

there is an association between human sex trafficking and PTSD in adolescent girls aged 13-18
SEX TRAFFICKING AND PTSD 3

in the United States. If adolescent girls are exposed to sex trafficking, then the chance of

developing PTSD is increased.

Human sex trafficking deprives its victims of their freedom and the right to make

decisions. When girls are placed into these situations, they have a limited ability to foresee and

control factors that can negatively impact their health. Research shows that of 204 sex trafficked

victims interviewed, 68 being adolescent girls, 77% presented possible symptoms of PTSD

(Hossain, Zimmerman, Abas, Light, & Watts, 2010). The unsettling feeling of not knowing the

circumstances surrounding the next meal, sleeping patterns, client list, and condom use leads to

more severe mental responses. Furthermore, being a victim of sex trafficking can be detrimental

to one’s self esteem, giving rise to PTSD symptoms before and after the diagnosis. Feelings of

worthlessness can lead to isolation and emotional numbness. One study included 5 women who

were all forced into sex trafficking as teenagers. All 5 victims developed one or more mental

health disorders, with 3 being diagnosed with PTSD (Farley, 2003). One victim stated that she

only felt useful as a place for someone to empty themselves into and tried to escape her emotions

to protect herself (Farley, 2003). When thoughts like such as those begin to set in, the positive

self-confidence a victim once had of themselves is lost and difficult to regain. Additionally,

human sex trafficking has adverse effects on gynecology including early pregnancy and

pregnancy complications, which literature has associated with PTSD. Exams to the pelvic and

abdominal areas are used to identify medical conditions in adolescent girls that can arise from

forced sexual activity such as dysmenorrhea and dyspareunia. Studies have shown that PTSD can

lead to changes in the brain that increase reactivity and pain sensitivity (Ashby & Kaul, 2016).

Although this is true, adolescents with this type of sexual trauma tend to be more likely to

participate in high-risk sexual activity for reasons that have yet to be studied.
SEX TRAFFICKING AND PTSD 4

Sex trafficking seen and unseen is becoming all too ordinary in the United States,

illegitimately grossing millions of dollars per year. As researchers link this sexual trauma to

PTSD, the next challenge becomes finding ways to treat the victims. Researchers have tested

different treatments options, but have struggled to determine their effectiveness. Narrative

exposure therapy, is a psychologist-guided autobiography of the sex trafficking experience in

chronological order. Although unpleasant, talking about the experience can aid the recovery

process by remembering the events so that they can be put into context and distinguish the past

and present. Recent research shows that the completion of at least 10 narrative exposure therapy

sessions helped decrease the PTSD severity scores in 10 women (Robjant, Roberts, & Katona,

2017). Moreover, finding effective treatments should come with gaining a better understanding

of PTSD and how it manifests. When this type of trauma is left unaddressed and untreated, the

chances of an individual to be revictimized or reenact the trauma themselves is increased.

Prevention can be complicated to accomplish when it comes to a traumatic event such as sex

trafficking, which turns the focus towards early intervention. Studies show that having

knowledge of the early signs of PTSD is crucial during early treatment and that adolescents stand

a better of chance of recovering and re-establishing themselves (Beals & Scott, 2012). Knowing

about PTSD has its advantages. An adolescent who has been victimized will not always self-

identify for reasons such as self-blame and is not always easy to recognize without proper

knowledge. Early intervention can prevent adolescents from growing up with chronic PTSD and

help suppress symptoms. The exploration of using more than one type of therapy within a single

intervention could be helpful due to the complexity that each case can bring about.

Understanding the psychological and physical injury that is the result of sex trafficking can be

beneficial when it comes to preparing care and support resources.

SEX TRAFFICKING AND PTSD 5

The purpose of this review was to determine if there is an association human sex

trafficking and PTSD in adolescent girls aged 13-18 in the United States. With the minimal

studies that have been done, most researchers would support the statement that if adolescent girls

are exposed to sex trafficking, their chances of developing PTSD will increase. The studies show

the association with statistics from case series, case controls, and reviews including published

literature. Even though adolescent girls are being sexually exploited in the United States, most

Americans are turning a blind eye based on the belief that sex trafficking only occurs in other

countries. Due to lack of education, the difference between a prostitute and a sex trafficked

victim is unclear. Girls exposed to this type of environment are at a higher risk of getting PTSD,

along with multiple other mental health disorders than girls who do not become victims. Public

health practitioners can use the results of my review to start considering conducting more

research to see what types of treatment programs are the most effective and efficient. In the past,

the conversation has been about law enforcement issues, often leaving out the journey to

recovery of the survivor. Media, as an integral part of society, can be utilized to bring the

necessary attention to the health needs of victims and survivors. Resources can be used to

implement distinctive health services that are readily available. More funding can be put towards

not only developing health services, but designing them to be long-term and effective.
SEX TRAFFICKING AND PTSD 6

The purpose of this review was to determine if there is an association human sex

trafficking and PTSD in adolescent girls aged 13-18 in the United States. With the minimal

studies that have been done, most researchers would support the statement that if adolescent girls

are exposed to sex trafficking, their chances of developing PTSD will increase. The studies show

the association with statistics from case series, case controls, and reviews including published

literature. Even though adolescent girls are being sexually exploited in the United States, most

Americans are turning a blind eye based on the belief that sex trafficking only occurs in other

countries. Due to lack of education, the difference between a prostitute and a sex trafficked

victim is unclear. Girls exposed to this type of environment are at a higher risk of getting PTSD,

along with multiple other mental health disorders than girls who do not become victims. Public

health practitioners can use the results of my review to start considering conducting more

research to see what types of treatment programs are the most effective and efficient. In the past,

the conversation has been about law enforcement issues, often leaving out the journey to

recovery of the survivor. Media, as an integral part of society, can be utilized to bring the

necessary attention to the health needs of victims and survivors. Resources can be used to

implement distinctive health services that are readily available. More funding can be put towards

not only developing health services, but designing them to be long-term and effective.
SEX TRAFFICKING AND PTSD 7

1. Johnson, K. (2017). The DSM-5 Definition of PTSD. Journal of Legal Nurse Consulting, 28(3), 25-29.

2. Gerassi, L. (2015). From Exploitation to Industry: Definitions, Risks, and Consequences of Domestic

Sexual Exploitation and Sex Work Among Women and Girls. Journal of Human Behavior in The

Social Environment, 25(6), 591-605

3. Miller-Perrin, C., & Wurtele, S. K. (2017). Sex Trafficking and the Commercial Sexual Exploitation of

Children. Women & Therapy, 40(1/2), 123. doi:10.1080/02703149.2016.1210963

4. Beals, K. R., & Scott, D. A. (2012). Neglect, Physical and Sexual Abuse: A Look at Posttraumatic

Stress Disorder in Children and Adolescents. Michigan Journal of Counseling: Research, Theory, And

Practice, 39(1), 31-38.

5. Ashby, B. D., & Kaul, P. (2016). Mini-Review: Post-traumatic Stress Disorder After Sexual Abuse in

Adolescent Girls. Journal of Pediatric and Adolescent Gynecology, 29531-536. doi:

10.1016/j.jpag.2016.01.127

6. Hossain, M., Zimmerman, C., Abas, M., Light, M., & Watts, C. (2010). The Relationship of Trauma to

Mental Disorders Among Trafficked and Sexually Exploited Girls and Women. American Journal of

Public Health,100(12), 2442-2449. doi:10.2105/ajph.2009.173229

7. Farley, M. (2003). Prostitution, trafficking, and traumatic stress. New York: Routledge.

8. Robjant, K., Roberts, J., & Katona, C. (2017). Treating Posttraumatic Stress Disorder in Female

Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective Audit. Frontiers in

Psychiatry, 8, 63.

9. Macy, R. J., & Graham, L. M. (2012). Identifying domestic and international sex-trafficking victims

during human service provision. Trauma, Violence, & Abuse, 13(2), 59–76.

doi:10.1177/1524838012440340

10. Breslau, N. (2001). The epidemiology of posttraumatic stress disorder: What is the extent of the

problem? Journal of Clinical Psychiatry, 2001; 62, Suppl 17:16-22

11. Simon, P., Krugman, R. D., Clayton, E. W., National Research Council, (U.S.), & Institute of

Medicine, (U.S.). (2013). Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors

in the United States. Washington, D.C.: National Academies Press .

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