Abigail Judge, PhD, a national expert on human trafficking and a clinical psychologist in the Department of Psychiatry, and Shadi Kourosh, MD, MPH, Director of Dermatology in the Community Health Program at Mass General, have teamed up to increase awareness of human trafficking and to provide resources to dermatologists care for this vulnerable population. As a result of their efforts, the American Academy of Dermatology has created an Ad Hoc Task Force on Dermatologic Resources for the Intervention and Prevention of Human Trafficking and has developed the medical and educational resources to help dermatologists provide timely support and advocacy for those who are trafficked.
Drs. Judge and Kouroush recently received an American Academy of Dermatology (AAD) Presidential Citation in recognition of their dedication and leadership on the Ad Hoc Task Force.
Increasing Awareness Among Dermatologists
Dermatologists are uniquely positioned to aid in efforts to assist those experiencing trafficking given their training to recognize and diagnose relevant signs on the skin and to assist patients with certain aspects of care and recovery, including the treatment of dermatologic diseases, scars, and tattoos.
More than 27 million people are trafficked worldwide, according to the WHO; previous studies indicate that approximately 50% to 80% of human trafficking victims are seen through the medical system at some point without being identified as a victim. Health care providers may not be aware of what to look for, or they may not be able to openly ask questions for fear of putting the victim at risk if their exploiter is present during the visit. However, dermatologists are uniquely positioned to recognize some of the physical signs of human trafficking include rashes related to sexually transmitted infections, traumatic injuries caused by abuse or self-harm, and tattoos.
Dr. Judge works with different types of healthcare providers to improve the medical care of trafficking victims. She notes that although guidelines for recognizing affected patients and response protocols in health care settings have been described, survivors’ ongoing engagement in health care services continues to be very challenging. Their long-term care is compromised by high rates of disengagement, premature termination, and attrition.
A set of resources created by the Ad Hoc Task Force on Dermatologic Resources for the Intervention and Prevention of Human Trafficking specifically address the complex issues inherent in caring for this patient population.
NAVIGATING THE ENCOUNTER WHEN YOU SUSPECT TRAFFICKING
The meaning of support should be determined by the patient him/her/their self given the severe coercion and manipulation that defines exploitation. In few other areas of medicine is trauma-informed care more critical than when interacting with this patient population. The dermatologist’s goal is not to obtain a disclosure about trafficking, but to build rapport, provide trauma-informed care, and potentially obtain enough information so that they can respond to the individual’s needs, as appropriate.
- Approach encounter in a trauma-informed manner
- Be aware of potential signs of trafficking and exploitation that indicate a need for further assessment
- Understand that patients are unlikely to identify as victims of trafficking due to the traumatizing effects of exploitation
HOW TO HANDLE A PATIENT ENCOUNTER WHEN YOU SUSPECT TRAFFICKING
In this video, Abigail Judge, PhD, a national expert on trafficking from the Department of Psychiatry at Massachusetts General Hospital and Harvard Medical School, speaks with Rachel Niemiec, DNP, FNP-C, former nurse examiner and trafficking survivor advocate, on principles of trauma-informed care and pearls for navigating a visit where trafficking is suspected.
Navigating the encounter when you suspect trafficking
Read More
Judge AM. Uncharted Waters: Developing Mental Health Services for Survivors of Domestic Human Sex Trafficking. Harv Rev Psychiatry. 2018 Sep/Oct;26(5):287-297.
Pollock S, Ferree S, Cronin M, Judge AM, Berson DS, Friedman PM, Grimes PE, Murase JE, Freeman EE, Rao M, Malik S, Balk R, Miller J, Cronin TA Jr, Kourosh AS. Dermatology’s role in the fight against human trafficking: A report from the AAD Ad Hoc Task Force and call to action. J Am Acad Dermatol. 2024 Feb;90(2):339-341.
In The News
Abigail Judge, PhD is a clinical psychologist in the Department of Psychiatry, an instructor in Psychology at Harvard Medical School, and the founder of MGH Connect. Her clinical work at MGH focuses on women affected by commercial sexual exploitation. She leads an outpatient psychotherapy clinic for this population and is currently piloting low threshold services for women with opioid use disorder experiencing sexual exploitation and sex trafficking at the MGH Substance Use Disorder Bridge Clinic.
