Anyone who says crime doesn’t pay clearly hasn’t read the International Labour Office’s report on human trafficking, which estimates that forced labor alone generates about $150 billion a year. And that’s just one aspect of buying and selling humans. The problem is actually much bigger and complicated than most of us realize because we don’t like thinking about how slavery never really ended. It just got smarter and quieter. I wanted to learn more about it all, so I talked to Dr. Whipple, a pediatrician who often works with victims of human/sex trafficking, Dr. Williamson, a University of Toledo professor and human trafficking expert, and Dr. Gates, who co-chairs the Research and Data Committee of the San Diego County Advisory Council on Human Trafficking. This is what I’ve learned:

Human Trafficking In The U.S. Is A Complex Operation Affecting Countless American Women

It’s tempting to think of human trafficking in the U.S. as a bunch of foreign women being smuggled into the country in shipping containers from abroad. Because then, the problem isn’t with America. It’s with international crime syndicates ran by burly gangsters with eye-patches and funny accents. You can’t be expected to fix and therefore care about that problem. You’re good! Have a glass of wine!

Unfortunately, according to Dr. Williamson: “[We] estimate there are 100,000 American teens who are caught up in sex trafficking, and about 300,000 who are at risk. That is the scope of the problem. Of that, about 17,000 are foreign victims.”

Not only is human trafficking a very domestic problem in the U.S., it’s usually the work of small organizations loosely connected to each other. “Mostly it’s mom and pop shops … Like a chain, each link is a particular job, so you have bottoms, who are basically assistant managers to the sex trafficker. They’re usually a woman involved in prostitution herself or the sex trade. Then you have the watchers and connectors who drive the kids around, girls and boys … We have connectors who hang out in different neighborhoods looking for runaways, and they connect them to human traffickers.”

Because of this, removing one link from the chain does little to nothing to disrupt the entire operation. It often doesn’t even affect anyone beyond a few city blocks. In fact, in the majority of cases, U.S. human traffickers are very small groups within city gangs themselves, not even entire gangs, independent of the group as a whole and often controlling no more than 4 or 5 victims at a time.

The Majority Of Human Traffickers Use Psychological Manipulation Instead Of Violence

So who are the people at risk of becoming victims of human traffickers? Well, primarily it’s runaways, the homeless, kids from the LGBT community, kids of color etc. It’s not that we don’t notice when these people go missing (although that is a whole other can of worms that we don’t have time to open). It’s just that… all those people are uniquely vulnerable. Many have gone through horrible trauma and are willing to trust people who show them even an ounce of human kindness. Enter human traffickers.

“There is gorilla pimping and finesse pimping,” Dr. Williamson explains.

“Gorillas jump out of the car, snatch you, beat you, you never know them. They force you to become a prostitute against your will. That happens of course but we more often see finesse pimps, manipulators … Finesse pimps tell their victims they are their bfs, that they love them, they ASK them to please do this for them. They groom them for a long period of time until they are ready for prostitution. They get to know their victim, their likes, dislikes, family and friends etc.”

Dr. Gates concurs: “We talked to 54 traffickers and 450 of their victims. The traffickers estimated they used gorilla pimping and violence in about 3% of the cases. The survivors estimated it at about 12%, so probably less than 10% resorted to force.”

That’s why recruiters are most likely to be a young person, no older than 16-17. Adult women can also be recruiters if they set themselves up as mother figures that make their victims feel safe. These people don’t operate out of dark alleys or isolated bus stations or secret lairs shaped like skulls. They work in broad daylight outside juvenile court or probation offices or even the mall.

“A common story from traffickers would be them recruiting from places like mall etc., looking for someone less than confident,” Dr. Gates explains.

“Then they would approach her, look her in the eye and give her a compliment. If she averted her eyes bashfully, they stroke up a conversation like can I buy you lunch, will you be here tomorrow or next week. The first meeting is usually followed by more meetings, dates, meals, purchases that flatter her etc.”

In the end, though, the grooming process rarely ends with 24/7 trafficking.

There Is Such A Thing As Part-Time Slavery

“Part time trafficking is very common,” Dr. Williamson explains. “This is how smart traffickers do it. If they can make everything look as normal as possible, if kids keep going to school and events etc. and then on the weekend say they’re spending the weekend camping or with a gf or bf, nothing suspicious, then the trafficker can use them for months, maybe even years.”

Nabbing kids off the street happens too of course but it’s not common because it isn’t smart. Once you kidnap a child, there’ll be someone looking for them, they become a hot product, Liam Neeson might come after you etc. You will only be able to make money off them for a short time. As a trafficker, you want a situation where nobody is suspicious that anything is wrong and then you can make money for a long time.

“The most common story would be that of 17yo Tyra [composite character],” Dr. Gates told me. “She was finishing her senior year in HS and her bf groomed her into having sex with men for money, and this guy was loved by her family and friends and was trusted by all of them. And he convinced Tyra that they were business partners. In reality, she had little control over what happened with her, with the money, with the clients, and over time this grew into a form of trafficking. All while he was trafficking her, Tyra went to school, she was going with friends to parties.”

“Many people knew about her having sex for money and thought it was cool. They didn’t see it as trafficking. It was only after her parents found out that she could get away.”

Sadly, escaping your captors doesn’t immediately fix the problem.

We Are Not Doing Enough To Address This Problem

Doctors and nurses are in a unique position to spot victims of human trafficking because hospitals/clinics are one of the few places a trafficker will sometimes take the victim to. The problem is, a doctor cannot legally detain anyone and, even worse, some doctors don’t want to get involved in trafficking cases because it takes too much time and ends up costing them money.

“There are healthcare providers who don’t want to get involved,” Dr. Whipple says.

“You have to go to court. As a physician if you get involved you may have to testify, which can mean a loss of 6-8k in income that day, which doesn’t count as expenses. The court doesn’t make it easy. Testifying is a huge financial impact. It’s also hard to cancel patient appointments so some doctors don’t want to go to court. It’s all bullshit.”

Fortunately, more and more laws have been passed that force healthcare providers to look for and report signs of human trafficking. But the problem still isn’t being fought to the fullest extent of the law. Until 2000, there was no law protecting underage victims of human trafficking across state lines. According to Dr. Gates: “Up until a couple of years ago, girls under 18, particularly African Americans, were arrested for this sort of thing. It was assumed they were willingly involved in prostitution crimes.”

But now, if you are under 18 and are caught up in human trafficking, you are a victim, but that only passed recently. It’s called the Safe Harbor law but, for example, Ohio didn’t have a law like this until 2012.

What a lot of communities are doing right lately are taskforces. Dr. Williamson explains: “If you call the police about a suspected victim, the police won’t rush out there because it’s not a high-profile call, no one is bleeding out or in immediate danger.”

“But when you call the taskforce and give them all the information, they will begin an investigation … But we don’t have enough taskforces that do active investigations, going around with pictures of the victim etc. They aren’t doing enough active searches.”

That’s why experts like Dr. Williamson see people like a 12-year-old trafficking victim who grew up to become a heroin addict due to PTSD and depression. How do we stop this from happening? You can call your representatives, get involved in anti-trafficking organizations, and above else do your research. This is a massive problem, so it won’t disappear overnight, but change is possible if only enough people get involved.