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Fr. James McTavish — Devastating consequences of sex trafficking on women’s health

Fr. James McTavish — Devastating consequences of sex trafficking on women’s health
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Devastating consequences of sex trafficking on women’s health

On the first of Novem­ber, I cel­e­brat­ed the Holy Mass of All the Saints at a cen­ter for reha­bil­i­ta­tion of female sur­vivors of sex traf­fick­ing. They are being tak­en care of by Reli­gious Sis­ters who have a spe­cif­ic ded­i­ca­tion in this area.1 The Sis­ter in charge com­ment­ed to me that same-sex attrac­tion (SSA) was com­mon­ly observed among such girls, includ­ing sex­u­al­ized behav­ior with the same sex. I was asked how we should con­sid­er this phe­nom­e­non of SSA in this con­text and how best to help these young vic­tims. The expe­ri­ence of vis­it­ing the shel­ter made me reflect on the health consequences—physical, men­tal, and spiritual—of the trau­mat­ic expe­ri­ence these girls have been through.

I would like to answer this pas­toral ques­tion of female SSA, post-sex traf­fick­ing by first look­ing at the broad­er pic­ture of human traf­fick­ing for sex­u­al pur­pos­es and briefly show­ing its dev­as­tat­ing impact on women’s health glob­al­ly. Next, I will share some spe­cif­ic points of Catholic moral teach­ing on pros­ti­tu­tion and human traf­fick­ing before con­sid­er­ing the spe­cif­ic role of health­care work­ers in iden­ti­fy­ing and assist­ing vic­tims of traf­fick­ing. The Reli­gious Sis­ters’ gen­er­al approach in min­is­ter­ing to the vic­tims of sex traf­fick­ing and pros­ti­tu­tion will then be out­lined, before clos­ing with some pas­toral con­sid­er­a­tions regard­ing the expe­ri­ence of SSA in this spe­cif­ic context.

Human Trafficking

Ear­li­er this year Arch­bish­op Bernardi­to Auza deliv­ered a lec­ture titled “The Holy See and the Fight Against Human Traf­fick­ing” (Auza ). He esti­mat­ed that thir­ty-six mil­lion peo­ple were traf­ficked in 2016. Arch­bish­op Auza stat­ed that:

accord­ing to the 2016 Glob­al Report on Traf­fick­ing in Per­sons released two months ago by the UN Office on Drugs and Crime, human traf­fick­ing is a 32 bil­lion dol­lar indus­try, run­ning third behind arms and drug traf­fick­ing. Fifty-one per­cent of the vic­tims are women, 21 per­cent are men, 20 per­cent girls and 8 per­cent boys. (Auza )

 

For women vic­tims of traf­fick­ing, 72 per­cent of them are traf­ficked for sex­u­al exploita­tion. This would mean that glob­al­ly approx­i­mate­ly 13 mil­lion women are sex traf­ficked annually.

The “Traf­fick­ing in Per­sons Report” (TIP report) released by the U.S. Depart­ment of State explains “‘Traf­fick­ing in per­sons’ and ‘human traf­fick­ing’ have been used as umbrel­la terms for the act of recruit­ing, har­bor­ing, trans­port­ing, pro­vid­ing, or obtain­ing a per­son for com­pelled labor or com­mer­cial sex acts through the use of force, fraud, or coer­cion” (U.S. Depart­ment of State , 30). Traf­fick­ing can be for var­i­ous pur­pos­es such as forced labor and organ retrieval, but by far the major­i­ty of vic­tims are traf­ficked for sex­u­al pur­pos­es. The same TIP report defines sex traf­fick­ing in the fol­low­ing way:

When an adult engages in a com­mer­cial sex act, such as pros­ti­tu­tion, as the result of force, threats of force, fraud, coer­cion or any com­bi­na­tion of such means, that per­son is a vic­tim of traf­fick­ing. Under such cir­cum­stances, per­pe­tra­tors involved in recruit­ing, har­bor­ing, entic­ing, trans­port­ing, pro­vid­ing, obtain­ing, patron­iz­ing, solic­it­ing, or main­tain­ing a per­son for that pur­pose are guilty of sex traf­fick­ing of an adult. Sex traf­fick­ing also may occur with­in debt bondage, as indi­vid­u­als are com­pelled to con­tin­ue in pros­ti­tu­tion through the use of unlaw­ful “debt,” pur­port­ed­ly incurred through their trans­porta­tion, recruit­ment, or even their “sale”—which exploiters insist they must pay off before they can be free. An adult’s ini­tial con­sent to par­tic­i­pate in pros­ti­tu­tion is not legal­ly deter­mi­na­tive: if one is there­after held in ser­vice through psy­cho­log­i­cal manip­u­la­tion or phys­i­cal force, he or she is a traf­fick­ing vic­tim and should receive ben­e­fits out­lined in the Paler­mo Pro­to­col and applic­a­ble domes­tic laws. (U.S. Depart­ment of State , 30)

 

Health Consequences2

In the work of Led­er­er and Wet­zel, one vic­tim not­ed the following:

Dur­ing that time I saw 10 to 20 men a day. I did what he said because he got vio­lent when I sassed him. I took all kinds of drugs — even though I didn’t real­ly like most of them. Over the years I had pimps and cus­tomers who hit me, punched me, kicked me, beat me, slashed me with a razor. I had forced unpro­tect­ed sex and got preg­nant three times and had two abor­tions at [a clin­ic]. After­ward, I was back out on the street again. I have so many scars all over my body and so many injuries and so many ill­ness­es. I have hepati­tis C and stom­ach and back pain and a lot of psy­cho­log­i­cal issues. I tried to com­mit sui­cide sev­er­al times. (Led­er­er and Wet­zel , 61)

 

Most female vic­tims of sex traf­fick­ing end up in forced pros­ti­tu­tion and/or the pornog­ra­phy indus­try. Melis­sa Far­ley states that “through­out his­to­ry, regard­less of its legal sta­tus, pros­ti­tu­tion has had a dev­as­tat­ing impact on women’s health” (Far­ley , 1097). This can be seen in the many phys­i­cal and psy­cho­log­i­cal con­se­quences of this destruc­tive lifestyle. Some find­ings include the following:

  • Sex­u­al vio­lence and phys­i­cal assault are the norm for women in all types of prostitution.

  • Health prob­lems include exhaus­tion, fre­quent viral ill­ness, STDs, vagi­nal infec­tions, back aches, sleep­less­ness, depres­sion, headaches, stom­ach aches, and eat­ing disorders.

  • Post-trau­mat­ic stress dis­or­der is a con­se­quence of pros­ti­tu­tion as are mood dis­or­ders such as dis­so­ci­a­tion and depression.

  • Pros­ti­tut­ed women are at a high­er risk of being mur­dered. (Far­ley , 1087-125)

 

Drug and alco­hol abuse is a com­mon find­ing among pros­ti­tut­ed women. In most it serves as a mech­a­nism to par­tial­ly numb the hor­ror and mis­ery they experience.

The hand­book Car­ing for Traf­ficked Per­sons: Guid­ance for Health Providers reports that “as is the case with vic­tims of tor­ture, indi­vid­u­als who have been traf­ficked are like­ly to sus­tain mul­ti­ple phys­i­cal or psy­cho­log­i­cal injuries and ill­ness­es and report a com­plex set of symp­toms (IOM et al. , 17). Where the vic­tim is a minor (younger than 18 years of age) the TIP report notes that “Sex traf­fick­ing has dev­as­tat­ing con­se­quences for chil­dren, includ­ing long-last­ing phys­i­cal and psy­cho­log­i­cal trau­ma, dis­ease (includ­ing HIV/AIDS), drug addic­tion, unwant­ed preg­nan­cy, mal­nu­tri­tion, social ostracism, and even death” (U.S. Depart­ment of State , 30).

Classification

Var­i­ous clas­si­fi­ca­tions have been used to enu­mer­ate the wide spec­trum of health con­se­quences of pros­ti­tu­tion and sex traf­fick­ing. Led­er­er and Wet­zel report the fol­low­ing cat­e­gories: phys­i­cal health symp­toms; psy­cho­log­i­cal symp­toms; repro­duc­tive issues; vio­lence, abuse, and humil­i­a­tion; and sub­stance abuse (Led­er­er and Wet­zel ). Willis and Levy list the fol­low­ing:3 infec­tious dis­ease, preg­nan­cy, men­tal ill­ness, sub­stance abuse, vio­lence and mal­nu­tri­tion (Willis and Levy ). No attempt will be made here to pro­duce a defin­i­tive review of the myr­i­ad health con­se­quences of sex traf­fick­ing. The point is rather to show the com­plex­i­ty and vast range of dele­te­ri­ous effects of traf­fick­ing for sex­u­al pur­pos­es on the affect­ed indi­vid­ual.4 It is also of note that same-sex attrac­tion post-traf­fick­ing is not mentioned.

To ful­ly con­sid­er the neg­a­tive impact of sex traf­fick­ing on women, we should not over­look the con­se­quences in the wives, part­ners, or girl­friends of the men who buy the bod­ies of traf­ficked women. The sin of the male has far-reach­ing con­se­quences in all his rela­tion­ships with sig­nif­i­cant oth­er women in his life. Not only will he place his, let us say, wife at some med­ical risk (con­sid­er the risk of infec­tion from HIV, for exam­ple), but moral­ly he will be fail­ing to give his wife the puri­ty and qual­i­ty of love that he promised through the sacra­ment of marriage.

Let us now look at some aspects of Catholic Church teaching.

Selected Elements of Catholic Moral Teaching on Prostitution and Human Trafficking

Biblical

Rahab was a woman in the Old Tes­ta­ment who was known to be a pros­ti­tute. How­ev­er, she was open to God’s will and was saved because of her faith­ful help to Israel (see Jo 2:1ff and 6:17ff). The New Tes­ta­ment writ­ers acknowl­edge both her faith (Heb 11:40) and good works (Jas 2:25). She is also men­tioned in the fam­i­ly tree of Jesus (Mt 1:5).

In the New Tes­ta­ment, we know that Jesus him­self was not ashamed to asso­ciate with women of ill repute and fre­quent­ly stepped in to defend and save them (see Lk 7:36–50 and Jn 8:1–11). Jesus even pro­voked the chief priests and the elders of the peo­ple by announc­ing, “Amen, I say to you, tax col­lec­tors and pros­ti­tutes are enter­ing the king­dom of God before you” (Mt 21:31).

Lives of the Saints

Var­i­ous holy men and women did pas­toral work to ease the suf­fer­ing of pros­ti­tut­ed women and attempt­ed to form the con­science of soci­ety about the wrongs of buy­ing the body of anoth­er. Some spe­cif­ic exam­ples may enlight­en us. Blessed Gen­naro Maria Sar­nel­li, an Ital­ian Redemp­torist (1702–44), ded­i­cat­ed him­self to stop­ping the spread of pros­ti­tu­tion in Naples, Italy. Saint Alphon­sus Liguori, founder of the Redemp­torists, and the patron saint of moral the­ol­o­gy in the Catholic Church, wrote a com­men­tary on the con­cern of Gen­naro for women caught up in this predicament:

In Naples, his zeal on behalf of the pros­ti­tutes was well known; every­one spoke about how much he worked on their behalf. To free them from their shame­ful life, he col­lect­ed alms and preached on this evil in order to lessen the num­ber of pros­ti­tutes. Every feast day he would preach in the busy square oppo­site the Church of S. Mat­teo for this pur­pose. He also per­suad­ed the archbishop’s con­fra­ter­ni­ty to engage in a retreat on this top­ic. As for him­self, he held back noth­ing of his own, even to the point of exhaus­tion, to help these poor women caught in this sin­ful life or those in dan­ger of falling into it. He helped many of them escape from it at his own expense. He looked every­where there might be a chance he would find one of these piti­ful women and free her. There were two for whom he gave spe­cial help for more than two years; he relo­cat­ed them and pro­vid­ed them a place to live and even bought fur­ni­ture for them. Besides these, there were many oth­ers for whom he found places to live. It was for this work that he sought dona­tions in many homes, not only in reli­gious places, but also at some hous­es where he was so unwel­come that he once said he felt like he would die. In all this, he suf­fered insults, doors slammed in his face, and the typ­i­cal risks that come with ask­ing for alms. He also suf­fered a great deal of per­se­cu­tion and per­son­al injury. (Chio­varo , 60–61)

 

St. Alphon­sus spoke fur­ther of the dan­ger Gen­naro exposed him­self to in this mission:

This work caused our Don Gen­naro to often live in mor­tal dan­ger, liable to being killed by the pimps of these poor women. Because of the dan­ger, his par­ents kept try­ing to stop him out of fear of what might befall him, and per­haps the whole fam­i­ly. Nev­er­the­less, he protest­ed that he was ready to suf­fer any con­se­quence and, in fact, would con­sid­er it his good for­tune if, for a work that gives such glo­ry to God, he even had to lose his life! (Chio­varo , 61)

 

Blessed Gen­naro Maria Sar­nel­li died worn out from his labors at 41 years of age. On his tomb­stone part of his epi­taph reads “Repressed the scourge of prostitution.”

Anoth­er saint­ly exam­ple of care for vic­tims of pros­ti­tu­tion is St. Maria Micaela Des­maisieres. She was born to Span­ish nobil­i­ty in 1809. Her father was a high-rank­ing offi­cer in the Span­ish Army and her moth­er was lady-in-wait­ing of the then Span­ish Queen, Maria Luisa de Par­ma. St. Maria Micaela found­ed the con­gre­ga­tion known as the “Sis­ters Ador­ers,” now present in around twen­ty-three coun­tries, who ded­i­cate their lives to Eucharis­tic ado­ra­tion and to min­is­ter­ing to women vic­tims of pros­ti­tu­tion and sex trafficking.

Magisterium

In 1948, Pope Pius XII stat­ed that

The most for­mi­da­ble obsta­cle to your action [against pros­ti­tu­tion] is nei­ther the declared hos­til­i­ty of the ene­mies of God and souls, nor that of the lib­ertines, nor traf­fick­ers in the white slave trade who shame­less­ly enrich them­selves. This hos­til­i­ty is com­plete­ly under­stand­able.… What is odd is that it is nec­es­sary to van­quish the care­less, iron­ic, even indif­fer­ent Chris­tians who believe them­selves to be upright, con­vinced and prac­tic­ing Catholics. (Rey-Mer­met , 120–21)

 

In Gaudi­um et spes we find

what­ev­er is opposed to life itself, such as … pros­ti­tu­tion, the sell­ing of women and chil­dren … are infamies indeed. They poi­son human soci­ety, and they do more harm to those who prac­tice them than to those who suf­fer from the injury. More­over, they are a supreme dis­hon­or to the Cre­ator. (Vat­i­can Coun­cil II , no. 27)

 

The Cat­e­chism declares

Pros­ti­tu­tion does injury to the dig­ni­ty of the per­son who engages in it, reduc­ing the per­son to an instru­ment of sex­u­al plea­sure. The one who pays sins grave­ly against him­self: he vio­lates the chasti­ty to which his Bap­tism pledged him and defiles his body, the tem­ple of the Holy Spir­it. (Cat­e­chism , no. 2355)

 

Pope Francis5

Arch­bish­op Auza tells us:

Car­di­nal Jorge Bergoglio had already been exposed to human traf­fick­ing in Buenos Aires, where he was arch­bish­op for fif­teen years pri­or to his papal elec­tion. In a dai­ly homi­ly, after not­ing that Jesus “stands with our broth­ers and sis­ters who live under slav­ery,” he com­ment­ed, “We have been taught that slav­ery has been abol­ished, but you know what? It’s not true, because in the city of Buenos Aires slav­ery is not abol­ished. In this city slav­ery is present in dif­fer­ent forms.” Soon after his elec­tion, he sent a hand-writ­ten note to his fel­low Argen­tine, Bish­op Marce­lo Sanchez Soron­do, Chan­cel­lor of the Pon­tif­i­cal Acad­e­my of Sci­ences and the Pon­tif­i­cal Acad­e­my for Social Sci­ences, in which he wrote, “I believe it would be good to exam­ine human traf­fick­ing and mod­ern slav­ery. Organ traf­fick­ing could be exam­ined in con­nec­tion with human traf­fick­ing. Many thanks, Fran­cis.” (Auza )

 

Our cur­rent pope has been very pro-active in his advo­ca­cy to denounce sex traf­fick­ing. He has giv­en numer­ous address­es and orga­nized var­i­ous con­fer­ences to exam­ine the prob­lem of human traf­fick­ing and to look for pos­si­ble solu­tions to try to reduce the inci­dence of mod­ern-day slav­ery. In Evan­gelii gaudi­um, his apos­tolic exhor­ta­tion on the procla­ma­tion of the Gospel in today’s world, he devotes a whole para­graph to the theme:

I have always been dis­tressed at the lot of those who are vic­tims of var­i­ous kinds of human traf­fick­ing. How I wish that all of us would hear God’s cry: “Where is your broth­er?” (Gen 4:9). Where is your broth­er or sis­ter who is enslaved? Where is the broth­er and sis­ter whom you are killing each day in clan­des­tine ware­hous­es, in rings of pros­ti­tu­tion, in chil­dren used for beg­ging, in exploit­ing undoc­u­ment­ed labour. Let us not look the oth­er way. There is greater com­plic­i­ty than we think. The issue involves every­one! This infa­mous net­work of crime is now well estab­lished in our cities, and many peo­ple have blood on their hands as a result of their com­fort­able and silent com­plic­i­ty. (Fran­cis , no. 211)

 

In an East­er Sun­day address, Pope Fran­cis said,

Peace in the whole world, still divid­ed by greed look­ing for easy gain, wound­ed by the self­ish­ness which threat­ens human life and the fam­i­ly, self­ish­ness that con­tin­ues in human traf­fick­ing, the most exten­sive form of slav­ery in this twen­ty-first cen­tu­ry; human traf­fick­ing is the most exten­sive form of slav­ery in this twen­ty-first cen­tu­ry! (Fran­cis )

 

More recent­ly the pope addressed the par­tic­i­pants of Reli­gious in Europe Net­work­ing Against Traf­fick­ing and Exploita­tion (RENATE). The group was in Rome for their 2nd Euro­pean Assem­bly with the theme “End­ing Traf­fick­ing Begins with Us.” The pon­tiff, talk­ing about wounds in the world, said

One of the most trou­bling of those open wounds is the trade in human beings, a mod­ern form of slav­ery, which vio­lates the God-giv­en dig­ni­ty of so many of our broth­ers and sis­ters and con­sti­tutes a true crime against human­i­ty. While much has been accom­plished in acknowl­edg­ing its grav­i­ty and extent, much more needs to be done on the lev­el of rais­ing pub­lic con­scious­ness and effect­ing a bet­ter coor­di­na­tion of efforts by gov­ern­ments, the judi­cia­ry, law-enforce­ment offi­cials and social work­ers. (Fran­cis )

 

Hav­ing briefly out­lined some per­ti­nent aspects of Catholic moral teach­ing on pros­ti­tu­tion and sex traf­fick­ing, we now con­sid­er the role of health­care work­ers in assist­ing vic­tims of trafficking.

Specific Role of Healthcare Professionals

In one study, 88 per­cent of traf­fick­ing vic­tims report­ed access­ing health­care facil­i­ties dur­ing their expe­ri­ence of being traf­ficked and, of these, 63 per­cent were seen at an emer­gency depart­ment (Led­er­er and Wet­zel , 77). In the ini­tial inter­view some red flags that may indi­cate a sit­u­a­tion of traf­fick­ing are:

  • Some­one else is speak­ing for the patient

  • Patient is not aware of his or her loca­tion, the cur­rent date, or time

  • Patient exhibits fear, anx­i­ety, PTSD, sub­mis­sion, or tension

  • Patient shows signs of phys­i­cal or sex­u­al abuse, med­ical neglect, or torture

  • Patient is reluc­tant to explain his or her injury

  • Patient reports an unusu­al­ly high num­bers of sex­u­al partners

  • Patient does not have appro­pri­ate cloth­ing for the weath­er or venue

  • Patient uses lan­guage com­mon in the com­mer­cial sex industry

  • Patient is under the age of 18 and is involved in the com­mer­cial sex industry

  • Tat­toos may be present (or oth­er forms of brand­ing that say “For sale,” “Prop­er­ty of …,”) (Nation­al Human Traf­fick­ing Resource Cen­ter , 1)

 

Addi­tion­al help­ful reminders for health­care staff are giv­en in the hand­book Car­ing for Traf­ficked Per­sons: Guide­lines for Health Providers:

  1. To con­sid­er each con­sul­ta­tion as an oppor­tu­ni­ty for improv­ing the health of the traf­ficked person.

  2. The safe­ty of traf­ficked per­sons, self and staff is paramount.

  3. Pro­vide good care and avoid dis­crim­i­na­tion. Any prej­u­dice or dis­dain on the part of the health­care work­er should not inter­fere with good care.

  4. Be pre­pared with refer­ral infor­ma­tion and con­tact details for trust­ed sup­port per­sons. It is help­ful if health­care work­ers are famil­iar with the pro­to­col in their hos­pi­tal of what to do if they sus­pect that the patient is a vic­tim of trafficking.

  5. Know­ing the vast range of neg­a­tive health con­se­quences of sex traf­fick­ing neces­si­tates the per­for­mance of a com­pre­hen­sive health assess­ment. (IOM et al. , 27–29)

 

Addi­tion­al ques­tions maybe appropriate:

  • Head/eyes/ears/nose/throat: Any his­to­ry of head trau­ma? Exam­ine the skull for bruis­es, depres­sions or healed lac­er­a­tions. Fre­quent headaches? Any pha­ryn­geal trau­ma (lac­er­a­tions, tears)?

  • Neck: Any his­to­ry of strangulation?

  • Car­dio­vas­cu­lar: Any trau­ma to the chest?

  • Res­pi­ra­to­ry: Pos­si­ble expo­sure to TB? (Liv­ing con­di­tions? Num­ber of peo­ple shar­ing one bed­room? Ventilation?)

  • Gas­troin­testi­nal: Abdom­i­nal trauma?

  • Gen­i­touri­nary: Forced sex, or sex­u­al trau­ma that includes for­eign objects? Enure­sis or enco­pre­sis (a poten­tial result of sex­u­al abuse)?

  • Mus­cu­loskele­tal: Repet­i­tive and non-repet­i­tive work-relat­ed injuries? Frac­tures? His­to­ry of phys­i­cal abuse such as burns? Contractures?

  • Neurological/behavioral: Seizure activ­i­ty (may also need to con­sid­er pseu­do-seizures)? Sleep dis­or­ders (inabil­i­ty to fall asleep, fre­quent awak­en­ings, night­mares)? Any his­to­ry of head trauma?

  • Nutri­tion: Any nutri­tion­al defi­cien­cies (food intake, con­tent)? Dis­or­dered eat­ing (e.g., anorex­ia or bulim­ic behavior)?

  • Der­ma­to­log­i­cal: Burns (e.g., cig­a­rette burns, scalds from hot water)?

 

Areas of spe­cif­ic con­cern include men­tal health and sex­u­al and repro­duc­tive health. A thor­ough eval­u­a­tion and work up of these areas is often indi­cat­ed. Where med­ical evi­dence will be used in pos­si­ble assault/rape cas­es or for crim­i­nal pro­ceed­ings against traf­fick­ers, a spe­cial­ized foren­sic exam may be need­ed and should be con­duct­ed by suit­ably trained per­sons.6

It may be use­ful for health­care per­son­nel to receive suit­able train­ing to iden­ti­fy vic­tims of sex traf­fick­ing, and how to treat them, at the begin­ning of their pro­fes­sion­al train­ing, not just when they are in the field.7

Trauma in Carers

The neg­a­tive effects of sex traf­fick­ing may extend to the health­care staff car­ing for the vic­tims. This vic­ar­i­ous trau­ma (also known as com­pas­sion fatigue or sec­ondary trau­mat­ic stress):

refers to the neg­a­tive reac­tions that can occur when pro­fes­sion­als repeat­ed­ly wit­ness or hear about vic­tims’ dif­fi­cult expe­ri­ences of trau­ma, vio­lence, and abuse. The signs of vic­ar­i­ous trau­ma resem­ble post-trau­mat­ic stress dis­or­der, and can include emo­tion­al, behav­ioral, and phys­i­cal symp­toms, such as anx­i­ety, depres­sion, dis­turbed sleep, change in appetite, irri­tabil­i­ty, night­mares, loss of empa­thy, and numb­ness. (U.S. Depart­ment of State , 38)

 

IOM et al. report that “it is not unusu­al for peo­ple work­ing with traf­ficked per­sons to expe­ri­ence emo­tions of anger, pain, frus­tra­tion, sad­ness, shock, hor­ror and dis­tress. The work could also affect ener­gy lev­els and cause dis­turbed sleep, somat­ic com­plaints and hyper-arousal” (IOM et al. , 97).

Hav­ing con­sid­ered some salient fea­tures of the role of health­care work­ers in iden­ti­fy­ing and treat­ing vic­tims of sex traf­fick­ing, we now turn to an in-depth descrip­tion of the Sis­ters’ gen­er­al approach in min­is­ter­ing to the vic­tims of sex traf­fick­ing and prostitution.

Ministry to Victims of Sex Trafficking and Prostitution8

The infor­ma­tion in the fol­low­ing sec­tions, pre­sent­ed in ques­tion-and-answer style, was obtained in an inter­view with one of the Sis­ters involved in the ministry.

How are the victims of sex trafficking and prostitution identified?

The young women can be referred by gov­ern­men­tal agen­cies, such as the Depart­ment of Social Wel­fare and Devel­op­ment, or non-gov­ern­men­tal agen­cies, such as the Inter­na­tion­al Jus­tice Mis­sion. They can also be referred through the “drop in” cen­ter (see the “Drop in” wel­come house section).

How are they housed?

The young women are housed in one of three sep­a­rate facil­i­ties: the “drop in” cen­ter (a form of tem­po­rary shel­ter), the “recov­ery” (reha­bil­i­ta­tion) cen­ter, and the “after-care” cen­ter, depend­ing on their needs and stages of recovery.

 

“Drop in” welcome house9

The wel­come house has open doors so the women can come and go as they please. They are not bound to reside here but can rest, eat, and stay overnight for as long as they want. Help is giv­en includ­ing: sup­port groups for shar­ing, coun­selling, and rec­ol­lec­tions. Assis­tance is offered to help them find oth­er job oppor­tu­ni­ties. Med­ical exam­i­na­tions are also available.

 

Recovery center

The recov­ery cen­ter offers the young women a live-in expe­ri­ence from six months up to one year for the first stage of inten­sive pro­cess­ing involv­ing coun­selling, psy­cho-spir­i­tu­al inner jour­ney­ing, and phys­i­cal pro­cess­ing to assist in release of pent-up neg­a­tive emo­tions such as anger. The spir­i­tu­al aspects of heal­ing are described in more detail in the fol­low­ing paragraphs.

Med­ical exam­i­na­tions are car­ried out.

Fol­low­ing the peri­od of per­son­al heal­ing, attempts are then made to try to recon­nect the young women with their fam­i­ly. The fam­i­ly need to be vet­ted as there are cas­es when they are the ones ask­ing the young woman to return to pros­ti­tu­tion as a source of the fam­i­ly livelihood.

Assis­tance is giv­en when need­ed to help the young women pre­pare to give tes­ti­monies in court against traf­fick­ing rings.

Lat­er in their recov­ery process they can have class­es in a home-school­ing con­text. They may also be giv­en lead­er­ship roles in the cen­ter to assist in the care of the new­ly admit­ted girls even becom­ing a role mod­el for them. In exe­cut­ing their respon­si­bil­i­ties, the lead­ers can also be assessed [to see] if they [are] ready to pass to the next stage called after care.

 

After-care center

From the recov­ery cen­ter the young women can pass to the after-care cen­ter. This focus­es on the tran­si­tion stage, help­ing them rein­te­grate into soci­ety. The sched­ule is less struc­tured and empha­sis is giv­en to help the young women con­struc­tive­ly plan their future: such as tak­ing on oth­er work or going to study in col­lege. They are also mon­i­tored when they return to their fam­i­ly or com­mu­ni­ty. Con­tin­u­ous for­ma­tion is also offered.

What is the Sisters’ approach to healing these patients?

The gen­er­al approach is holis­tic and con­sid­ers the fol­low­ing dimen­sions: phys­i­cal, psy­cho­log­i­cal, and spir­i­tu­al. The process of pos­si­ble recov­ery is patient and grad­ual, rec­og­niz­ing that there should be a process of heal­ing and that it takes time (often years). The approach is also hope­ful, know­ing that although the heal­ing process can be involved, demand­ing, and chal­leng­ing, for the women and those help­ing, the ide­al goal is the full rein­te­gra­tion into soci­ety. The rela­tion­ship with the fam­i­ly of ori­gin is also tak­en into consideration.

Is there a role for prayer/spirituality?

Yes, a very impor­tant role! Spir­i­tu­al ses­sions are an essen­tial part of the recov­ery process and include prayer, shar­ing, Mass and rec­ol­lec­tions. The sacra­ment of rec­on­cil­i­a­tion is also offered. These young women, many of whom are deeply wound­ed, can only be healed with the assis­tance of God’s grace.

Many of them also come to the cen­ter not real­ly know­ing Christ. They know of him, from a reli­gious upbring­ing, but what real­ly helps them is to know him in a more per­son­al way: to expe­ri­ence his love in their bro­ken­ness and wound­ed­ness. Once they devel­op a rela­tion­ship with the Cre­ator and start to see some­thing good about them­selves, the heal­ing can more eas­i­ly occur.

Are there specific interventions/situations to be avoided?

The recov­ery process has to be inte­gral and holis­tic. The spir­i­tu­al recov­ery needs to be inte­grat­ed with sol­id human for­ma­tion and psy­cho­log­i­cal sup­port. The spir­i­tu­al and human need to heal hand-in-hand. A dan­ger to be avoid­ed is a reha­bil­i­ta­tion that would be “exces­sive­ly” spir­i­tu­al, and not tak­ing into full con­sid­er­a­tion the com­plex­i­ty of the wound­ed­ness of the per­son. The wounds do not only affect the spir­it of the per­son! The women also need to be in touch with their human feel­ings and bro­ken­ness to ensure an even­tu­al holis­tic recov­ery process.

Are there any generalizable observations?

There are three that can be men­tioned here. The first is that the cen­ters need to cre­ate an atmos­phere where the young women feel loved, accept­ed and not judged for what has hap­pened to them. The sec­ond is to note the great chal­lenge in assist­ing the women in acquir­ing a new set of gospel-inspired val­ues. Often cer­tain wrong val­ues have become “nor­mal.” For exam­ple, many do not know the wrong­ness of abor­tion. Their val­ues have often become dis­tort­ed. Anoth­er exam­ple is that they may have been led to believe that the inces­tu­ous abuse they incurred in their fam­i­ly of ori­gin, pri­or to the expe­ri­ence of being pros­ti­tut­ed, was just a form of “play­ing.” This work of try­ing to evan­ge­lize their pre-con­ceived val­ues is very chal­leng­ing as some wrong val­ues seem to be deeply ingrained. Final­ly, it is not uncom­mon for a woman to aban­don the recov­ery process and to return to that for­mer way of life. Some­times they have to again hit “rock bot­tom” and sur­ren­der to the Lord again before return­ing once more to reha­bil­i­ta­tion. It is an expe­ri­ence sim­i­lar to that of the prodi­gal son who lost every­thing before “com­ing to his sens­es” and decid­ing to return to the Father (see Lk 15:17). Those car­ing have to be full of patience, not scan­dal­ized by human fragili­ty, and always ready to offer the heal­ing rem­e­dy of God’s mercy.

Any predictors of successful outcomes?

Two key pre­dic­tors are open­ness and fam­i­ly sup­port. The open­ness of the young woman is an essen­tial fea­ture of the recov­ery process. The more open they are to the inter­ven­tion process the more like­ly they will make a whole­some recovery.

A sol­id fam­i­ly foun­da­tion also helps in the recov­ery process. Some­times the fam­i­ly was pre­vi­ous­ly intact but a trau­mat­ic life event even­tu­al­ly led to the young woman being pros­ti­tut­ed. Dur­ing recov­ery, if they had at least some expe­ri­ence of being loved in a fam­i­ly envi­ron­ment before­hand, it great­ly assists the heal­ing process.

Any predictors of poor outcomes?

Well, real­ly, the oppo­site to those pre­vi­ous­ly men­tioned. If the young woman is closed, it is not easy for the assis­tance or heal­ing grace to enter deeply into the heart and life of the wound­ed woman. The woman needs to be able to open up about her expe­ri­ences. And if the woman has no expe­ri­ence of love in the fam­i­ly, it makes recov­ery more dif­fi­cult, as does hav­ing no cur­rent lov­ing fam­i­ly to return to for sup­port. Final­ly, co-exist­ing per­son­al­i­ty dis­or­ders may com­pli­cate the heal­ing process.

We now return to the pas­toral issue of SSA in these young women.

Same-Sex Attraction in Females Post-Sex Trafficking10

In the reha­bil­i­ta­tion cen­ter (men­tioned in the Intro­duc­tion sec­tion), it is observed that SSA is com­mon in women who have been vic­tims of sex traf­fick­ing. To pas­toral­ly assist such young women, it is help­ful to estab­lish a base­line of whether they had same-sex feel­ings or expe­ri­ences pri­or to their traf­fick­ing experience.

Some of the girls actu­al­ly did have SSA pri­or to traf­fick­ing. They explained that their same-sex feel­ings seemed to orig­i­nate fol­low­ing their expe­ri­ence of child­hood abuse at the hands of males. It is well known that such abuse may con­tribute to the devel­op­ment of lat­er SSA (McTavish , 3–4). Fol­low­ing abuse, anti-male sen­ti­ments may devel­op, includ­ing fear, mis­trust, and a gen­er­al feel­ing of being unsafe around males. One girl shared that she ini­tial­ly had an inter­est in boys, but this dis­ap­peared after her expe­ri­ence of abuse, such that lat­er she became more con­fi­dent shar­ing only with oth­er girls. All these anti-male feel­ings were com­pound­ed when these girls sub­se­quent­ly became vic­tims of sex traf­fick­ing. Abuse alone pro­duces a deep wound­ed­ness in the psy­che of a young per­son, and how much more pro­found will the wound­ed­ness be after the expe­ri­ence of being traf­ficked. Deep wounds are not healed overnight, and the recov­ery process is usu­al­ly long and complex.

Some girls, with or with­out a pre­vi­ous his­to­ry of abuse, were known to have devel­oped same-sex feel­ings only after the expe­ri­ence of being traf­ficked. On review­ing the gen­er­al lit­er­a­ture sur­round­ing sex traf­fick­ing, this author can find no men­tion of SSA in females post-expo­sure to sex traf­fick­ing. The com­pre­hen­sive and high­ly influ­en­tial “Glob­al report on Traf­fick­ing in Per­sons” pro­duced annu­al­ly by the UN Office on Drugs and Crime does not make any ref­er­ence to this phe­nom­e­non, although the group of per­sons who are LGBT is men­tioned var­i­ous times and is sin­gled out for spe­cial con­cern.11

Same-sex feel­ings devel­op­ing post-traf­fick­ing could be part­ly explained by the process out­lined above where the woman los­es trust and con­fi­dence with males and feels safer deposit­ing her feel­ings and heart in the arms of anoth­er female. In such cas­es the SSA could be tran­sient or pass­ing as the trau­ma heals. Often young females may have pass­ing attrac­tions or “crush­es” on oth­er girls. The late John Har­vey, founder of Courage, the Roman Catholic min­istry for per­sons with SSA, advised

The ado­les­cent girl often con­fus­es a “crush” she has on an old­er girl or a female teacher as a form of homo­sex­u­al­i­ty. She should be shown that she is sim­ply going through a stage of strong admi­ra­tion and needs to take care not to make an idol out of anoth­er per­son. Mean­while, she must con­tin­ue to seek friends with­in her peer group and learn to form good human rela­tion­ships with both sex­es. (Har­vey , 34–35)

 

Such girls in reha­bil­i­ta­tion, expe­ri­enc­ing same-sex feel­ings after being traf­ficked, may be seek­ing to ful­fill legit­i­mate needs for affec­tion and atten­tion from oth­er females, but need to learn how to do so in healthy, non-erot­ic ways. In a word, they need to “relearn” the virtue of chasti­ty. The Cat­e­chism defines chasti­ty as “the suc­cess­ful inte­gra­tion of sex­u­al­i­ty with­in the per­son and thus the inner uni­ty of man in his bod­i­ly and spir­i­tu­al being … The virtue of chasti­ty there­fore involves the integri­ty of the per­son and the inte­gral­i­ty of the gift” (Cat­e­chism , no. 2337). This will be espe­cial­ly chal­leng­ing for them as the expo­sure to the sex­u­al­ized world of traf­fick­ing may also make them more liable to sex­u­al expo­sure and even exper­i­men­ta­tion when in reha­bil­i­ta­tion.12 Part of their recov­ery process is not only to process their expe­ri­ence of sex­u­al abuse but also to re-learn healthy ways of relat­ing to both sex­es. This is real­ly a train­ing in chasti­ty, which for all is a chal­lenge, but more so when these girls have been vic­tims of gross bound­ary vio­la­tions from sex trafficking.

A wide­ly accept­ed sec­u­lar view is to encour­age young per­sons with same-sex feel­ings to “come out.” This view how­ev­er is found­ed on an erro­neous cul­tur­al inter­pre­ta­tion that all sex­u­al feel­ings are equal­ly valid and should be pro­mot­ed and encour­aged. It is high­ly inap­pro­pri­ate when deal­ing with SSA post-sex traf­fick­ing as what we are like­ly deal­ing with may be a type of “pseu­do-les­bian­ism” post-trau­ma. The focus should be on “com­ing out” of the trau­ma. There is no appar­ent lit­er­a­ture on how best to reha­bil­i­tate a girl with SSA post-sex traf­fick­ing. Per­haps the next best thing is to glean what we can from expe­ri­ences of recov­ery from SSA in non-traf­ficked women. Janelle Hall­man, an expe­ri­enced ther­a­pist, tells us that the reha­bil­i­ta­tion of a woman with SSA

will be a lengthy process in which she reclaims, piece by piece, her heart and soul, which have been housed or deposit­ed in the oth­er woman. She must sal­vage the threads of her true self and reknit them around new per­cep­tions, impres­sions and beliefs that arise out of a cor­rec­tive expe­ri­ence of love, sup­port and accep­tance. (Hall­man , 114)

 

With ther­a­py and coun­sel­ing the girl may be able to come to terms with the trau­ma expe­ri­enced. Sex­u­al behav­ior should be dis­cour­aged, with either sex, in the vul­ner­a­ble stages of recov­ery. Chasti­ty and re-inte­gra­tion of the per­son are noble goals for which to live and strive.

Some healthy con­tact with males may be ben­e­fi­cial in the recov­ery process; at least to show that some males can show them respect and not all need to be mis­trust­ed. How­ev­er, care should be tak­en in expos­ing these very vul­ner­a­ble girls to male con­tact as the Sis­ters informed me that there is a dan­ger that the girls can eas­i­ly fall for a male who shows them even the slight­est inter­est and attention.

The task of assist­ing in the reha­bil­i­ta­tion of girls who have been sex traf­ficked is a chal­leng­ing and daunt­ing one. These girls bring with them many deep wounds from abuse and traf­fick­ing that are not easy to min­is­ter to. How­ev­er, God’s grace is not lack­ing, and I com­mend the Sis­ters for their ded­i­ca­tion to their ardu­ous, but noble and hope­ful­ly reward­ing, charism. I enjoyed cel­e­brat­ing that Eucharist on Novem­ber 1, the Feast of all the Saints. In the Mass, each girl had come dressed as their favorite saint. It was a sight to behold, not only to see vic­tims of sex traf­fick­ing, but also to see the next gen­er­a­tion of pos­si­ble saints: Saint Philom­e­na, Saint Maria Goret­ti, Saint Tere­sa of Cal­cut­ta, and Saint Thérèse of Lisieux in the making.

Biography

Fr. James McTavish, FMVD, M.D., is cur­rent­ly the Branch Respon­si­ble (Provin­cial) of the Ver­bum Dei male mis­sion­ar­ies in the Philip­pines. He may be con­tact­ed at ku.oc.oohay@dvmfhsivatcmsemaj.

Notes

1.Some per­ti­nent details such as the name of the con­gre­ga­tion will be omit­ted. The world of sex traf­fick­ing is fraught with dan­gers for the vic­tims and for those who attempt to assist them. The loca­tion of the shel­ter is kept hid­den as sex traf­fick­ers seek out the girls to re-coerce them back into the life of sex work, or threat­en and attempt to intim­i­date them from tes­ti­fy­ing in future court cas­es against traf­fick­ing rings.

2.Health con­sid­er­a­tions can extend to an appraisal of the victim’s med­ical con­di­tion pre- and post-traf­fick­ing as well as dur­ing the actu­al expe­ri­ence of being traf­ficked. For exam­ple, traf­fick­ing vic­tims may come from a con­text of impov­er­ish­ment and may have some degree of mal­nu­tri­tion before being trafficked.

3.The authors are look­ing at child vic­tims of prostitution.

4.The Chris­t­ian Med­ical and Den­tal Asso­ci­a­tions (n.d.) have pro­duced some very help­ful and infor­ma­tive mod­ules of con­tin­u­ing med­ical edu­ca­tion on human traf­fick­ing includ­ing those on the phys­i­cal and men­tal-health con­se­quences of human traf­fick­ing in gen­er­al (not specif­i­cal­ly on sex traf­fick­ing although these are implic­it­ly included).

5.In his lec­ture “The Holy See and the Fight Against Human Traf­fick­ing,” at Ford­ham Uni­ver­si­ty, Arch­bish­op Bernardi­to Auza pro­vides a detailed and insight­ful list of the var­i­ous endeav­ors of Pope Fran­cis to com­bat sex traf­fick­ing (Auza ).

6.If evi­dence of injuries needs to be doc­u­ment­ed, it should be born in mind that the tak­ing of pho­tos should be explained to min­i­mize risk of pro­vok­ing trau­mat­ic mem­o­ries of any pre­vi­ous forced pornog­ra­phy experience.

7.This sug­ges­tion can also apply to priests and reli­gious. Each year, my com­mu­ni­ty, the Ver­bum Dei mis­sion­ar­ies, offers a one-day mod­ule on pros­ti­tu­tion and sex traf­fick­ing to novices (most­ly young reli­gious men and women at the begin­ning of their voca­tion). The group of novices num­bers around 70, from 20 or so dif­fer­ent con­gre­ga­tions and var­i­ous, main­ly Asian, nation­al­i­ties. It is usu­al­ly a very enrich­ing exchange, espe­cial­ly see­ing how each charism can con­tribute in a spe­cif­ic way to com­bat these chal­leng­ing realities.

8.Many coun­tries have laws and pro­vi­sions to lim­it the extent of sex traf­fick­ing. How­ev­er, these laws not always imple­ment­ed. Where the gov­ern­ment does not do its part, the Church can­not sit idly by and do noth­ing. Pope Emer­i­tus Bene­dict XVI remind­ed us of this: “As I have had occa­sion to say, it is not the prop­er task of the Church to engage in the polit­i­cal work of bring­ing about the most just soci­ety pos­si­ble; nonethe­less she can­not and must not remain on the side­lines in the strug­gle for jus­tice” (Bene­dict ).

9.Advo­ca­cy and out­reach pro­grams are under­tak­en in bars and on the streets to inform the young women about the drop in cen­ter and the ser­vices offered there includ­ing med­ical assistance.

10.For a deep­er under­stand­ing of same-sex attrac­tion accord­ing to Catholic Church teach­ing, var­i­ous doc­u­ments can be con­sult­ed. Sug­gest­ed read­ing includes Homo­sex­u­al­i­ty and Hope by the Catholic Med­ical Asso­ci­a­tion (); Same sex attrac­tion: Catholic teach­ing and pas­toral prac­tice by Rev. Fr. John F. Har­vey (); “Chasti­ty and homo­sex­u­al­i­ty: Com­bat­ing the scourge of HIV and AIDS” (McTavish, ); as well as “Spir­i­tu­al accom­pa­ni­ment of per­sons with same-sex attrac­tion” (McTavish, ) in the Linacre Quar­ter­ly spe­cial issue on same-sex attrac­tion (Win­ter 2015).

11.There is lit­er­a­ture read­i­ly avail­able on sex traf­fick­ing of LGBT indi­vid­u­als (see “Sex Traf­fick­ing of LGBT Indi­vid­u­als” by Mar­tinez and Kelle 2003, for example).

12.There are some cas­es of these girls also engag­ing in inap­pro­pri­ate behav­ior with oth­er young males. This is under­stand­able, although not advis­able, as the girls’ con­cepts of healthy bound­aries has been dam­aged by the expe­ri­ence of sex traf­fick­ing mak­ing it dif­fi­cult for them to engage in healthy, non-sex­u­al rela­tion­ships with others.

References

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