Anya CharnaudTrigger warning: This article may contain thoughts, concepts and stories you may find distressing. No identifiable information is given.
What is sexual exploitation?
Adult sexual exploitation can be considered as actual or attempted abuse of a position of vulnerability, power, or trust, for sexual purposes, including profiting monetarily, socially or politically from sexual acts to which the adult has not freely consented. Sexual exploitation takes many forms including, but not limited to, rape (which can include non-consensual rape by a partner), sexual assault, being manipulated or tricked into performing sexual acts for another’s gain, being forced to watch or take part in pornography and being trafficked for the purpose of sexual exploitation. Sexual exploitation can occur both online and offline and is linked to the abuse of technology and digital devices. For children and teenagers under the age of 18 years, Child Sexual Exploitation (CSE) is a form of child abuse. Children can NEVER consent to their own exploitation, even if they cannot see themselves as victims of abuse.
Individuals of any age, gender, sexuality, nationality, ability, disability and any other status can become victims of sexual exploitation. Whilst vulnerability may be increased by individual factors such as age, developmental level, mental health problems, learning difficulties and/or addictions, often major pressures in the context of people’s lives heighten risks of exploitation such as severe financial stress or poverty, lack of opportunity and work options, broken social and family protective structures and isolation (including language and cultural isolation).
Trafficking for sexual exploitation is the most reported form of trafficking across the world (77%). It is a form of gender-based violence, affecting predominantly (but not only) women and girls. Women are often the trafficking perpetrators too. In the UK, thousands of people are victims of trafficking for sexual exploitation, both British nationals and individuals from many other nations. It is present across the UK, and not just confined to the big cities. Victims of trafficking for sexual exploitation have been found in rural village locations too. Individuals trafficked for other primary purposes such as labour or criminal exploitation may also experience sexual exploitation.
What I have learnt through supporting victims and survivors
I first provided healthcare support to victims of trafficking for sexual exploitation 11 years ago, witnessing first hand the dire conditions a number of international women had been forced to stay and provide sexual services in, unable to leave primarily due to deeply frightening threats against themselves and their families should they do so, as well as fears about their immigration status and how they might be treated by UK authorities. The women I met had symptoms of stress and trauma. It was understandably hard for us to develop trust in order to provide support, recognising that trust in other people is so damaged through trafficking experiences. Trafficking for sexual exploitation can utilise many layers of lies and manipulation in order to recruit and relocate individuals. For example, there can be adverts in local papers or on the internet that invite applicants to come and work in the UK as nannies, domestic staff, or the hospitality industry, then people take out loans and agree to pay them back from their salaries. This then becomes debt bondage. The bogus job then falls through and the traffickers then force the applicant into sexual exploitation to pay back the escalating debt. For others, a seemingly loving and attentive boyfriend or partner may manipulate or force them into sexual exploitation, the close relationship adding to the complication of trafficking. For some families and communities, high levels of shame and stigma around sexual activity outside of marriage and sex work (even when abusive) creates a huge division between the victim and their family and may lead to that individual being rejected from their home and communities.
The health and public health risks of sexual exploitation can be high including psychological and physical violence, injury to bodily organs with potential long term effects on reproductive health, sexually transmitted infections, pregnancy and abortion in environments without information, free choice and health support, malnutrition, drug and alcohol misuse (often as a coping mechanism, or forced use for compliance), sleep deprivation, stress and trauma. For children especially, sexual abuse and exploitation can have profound impacts on healthy development and learning.
Working with victims of trafficking for sexual exploitation also helped me recognise that many victims do attend healthcare settings. This may be the case if a victim is unable to work and make money, leading to perpetrators attempting to control access to the treatment required to enable the individual to work again. The clinical team I worked with at the time specialised in supporting the sex worker community, including signposting to support regarding safety, legal or immigration needs, as well as supplying condoms and other protective equipment. For some victims of trafficking, the sex worker clinic also seemed to be a safer place to seek help than mainstream health services.
As professionals it is so important to have an understanding of these victims lived experience, how they may have come to be in this setting. We are aware there is a high chance at some point they will present to a health care service. So to have a good understanding of what someone might be experiencing can help us understand how to help them. A trauma-informed response doesn’t look like a heroic rescue, because pushing and forcing our agenda (no matter how well-intentioned) can be seen by that person as coercing and controlling. Another thing to survive. But to plant the seed suggesting that you’re an individual worthy of dignity and care, that what is happening is not ok, that we know this is going on, and that healthcare settings can be a place of safety. As healthcare professionals, it is hard not to give a direct solution when presented with someone’s suffering…. However, if we without judgment, and our own agenda, pass on information to give someone a sense of known safety then that is part of our work. Exploitation is a public health matter and it’s important we weave knowledge of this into our practice so that we are part of tackling this like other public health issues.
VITA provides practical and effective training that equips frontline health professionals with transferable consultation skills to identify, support and safeguarding victims and survivors. To find out more, book a session or arrange a session for your team, have a look at our website – https://www.vita-training.com/.