Barriers and Facilitators to Leaving a Trafficker: A Qualitative Analysis of the Accounts of People Who Have Experienced Sex Trafficking

ABSTRACT

There is a growing body of literature on the barriers and facilitators to exiting the commercial sex industry, but little empirical research on how this process may be different for those who have experienced sex trafficking. In this study, we explored the barriers that people who have experienced sex trafficking encountered when they considered leaving their trafficker or leaving the commercial sex industry, as well as facilitators that helped them overcome those barriers. To address these questions, we used qualitative analysis of semi-structured interviews with 158 people who had experienced sex trafficking. Among study participants, the circumstances of leaving a trafficking situation incredibly varied. Most participants faced complex barriers to exiting their trafficking situation and their exit pathways reflected these differences. Despite these barriers, most study participants had left their traffickers. We found that there were two broad ways that study participants left their trafficking situations: either actively or passively. We discuss implications for service providers, law enforcement, and policymakers to help support individual agency and decision-making to better facilitate trafficking exit.

KEYWORDS:

• Sex trafficking
• human trafficking
• exploitation
• sex work
• commercial sex
• commercial sex industry

Introduction

The commercial sex industry is complex and dynamic, and like all marketplaces, it operates on the principles of supply and demand. While almost all individuals who purchase sex do so willingly, there is significant variation in the voluntariness of engagement among those who sell sex. The spectrum of willingness to sell or trade sex in the United States is wide – from individuals working voluntarily to those who sell sex through limited or constrained circumstances to those who are compelled to sell sex under the direction of a pimp or trafficker. In 2000, the Trafficking Victims Protection Act (TVPA) provided the first comprehensive U.S. legal framework for identifying and responding to sex trafficking, which was defined as the “recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age” (22 U.S.C. § 7102(11)(A)). Although the TVPA was passed over 20 years ago, relatively few studies have generated reliable estimates of the prevalence of sex trafficking (Barrick & Pfeffer, 2022). Yet, it is commonly understood that it is a widespread and hidden problem such that those who are identified by law enforcement or service providers represent only a fraction of the actual number of people who have been trafficked for sexual exploitation. For example, while the National Human Trafficking Hotline identified over 8,000 potential sex trafficking situations in 2020 (Polaris, no date), only about 1,600 cases were reported by law enforcement in the Uniform Crime Report (United States Department of Justice, Federal Bureau of Investigation, 2020).

While there is a considerable amount of research exploring individuals’ pathways into engaging in commercial sex, there has been less focus on how individuals navigate exiting the industry. This exit process can be even more complicated when an individual is actively working for a third-party facilitator, pimp, or trafficker. Prior studies exploring the process of exiting prostitution provide helpful insight into the help-seeking and decision making that individuals navigate, including some of the facilitators and barriers to leaving the life (e.g., Ferrari, 2021; Gonzalez et al., 2019; Hickle, 2017). A small subset of this research focuses on the exit process among people who have experienced trafficking (e.g., Ferrari, 2021). These studies most often rely on very small, heterogenous study samples. The current study seeks to advance knowledge on the process of exiting prostitution for people who have experienced sex trafficking within the last five years. We aim to address two primary research questions:

1. Among people who have experienced recent sex trafficking, what are factors that hinder leaving a trafficker and/or leaving the commercial sex industry?

2. Among people who have experienced recent trafficking, what are the factors that facilitate leaving a trafficker and/or leaving the commercial sex industry?

To address these research questions, we rely on a qualitative analysis of semi-structured interviews with 158 adults who have, at some point in the past five years, experienced sex trafficking or otherwise self-identified as having worked for a pimp during that time. Based on the themes identified in this analysis, we provide a series of recommendations to better support individuals who are considering leaving a trafficker, exiting the commercial sex industry, or who are in the process of navigating their exit.

Prior research on exiting the commercial sex industry

A great deal of research has considered the pathways into commercial sex. Early research focused mainly on three precursors to engagement in commercial sex: childhood sexual abuse, running away, and drug use (Brown, 1979; McClanahan et al., 1999; Silbert et al., 1982; Simons & Whitbeck, 1991; Widom & Kuhns, 1996). However, more recent research, while focusing more heavily on commercial childhood sexual exploitation (a term inclusive of prostitution and other forms of sexual exploitation), considers the more nuanced impacts of sustained trauma and exposure to a broader array and a greater cumulative number of adverse childhood experiences (Barnert et al., 2017; Middleton et al., 2022; Naramamore et al., 2015; Reid et al., 2017). There is ample support in the literature that factors such as a history of abuse or neglect, homelessness, running away or being forced out of the home, identifying as lesbian, gay, bisexual, transgender, queer/questioning, or intersex, and having involvement with the child welfare or juvenile justice systems may impact a young person’s vulnerability to commercial sexual exploitation or sex trafficking as a child or as an adult (Barnert et al., 2017; Bigelsen & Vuotto, 2013; Dank et al., 2015; Gibbs et al., 2018; Varma et al., 2015). Despite the considerable volume of literature exploring why and how people first become engaged in commercial sex, there is less emphasis in existing research about pathways out of commercial sex. But, as Payhew and Mossman (2007) attest, many of the same factors that lead people into sex work also act as barriers to exiting.

A 2021 review of existing literature identified 13 studies focused on factors that either facilitate or hinder exit from commercial sex (Ferrari, 2021). An analysis incorporating the factors identified in the included studies organized these factors into those that facilitate exit from prostitution, hinder exit, or that are ambivalent factors that can either serve as facilitators or barriers. Facilitating factors included self-efficacy, spirituality, the desire to help others, social support, the desire to reunite with children, social awareness about sex trafficking, and the availability of economic empowerment and other supportive programming. Hindering factors included shame, labeling and stigma, and low social capital. Ambivalent factors that could either serve as facilitators or hindrances included substance use/addiction, relationships with family, and relationships with people from religious organizations (Ferrari, 2021). Importantly, people who have experienced sex trafficking often have complex circumstances and experience varying levels of both facilitating and hindering factors at different times.

Other research has organized barriers to exiting sex work into categories of individual, relational, structural, and societal factors (e.g., Baker et al., 2010). Additional factors affecting a person’s ability to exit the sex industry include individual factors such as self-destructive behaviors and substance abuse, physical health problems, shame, and lack of knowledge of services (Baker et al., 2004; Brown et al., 2006; Cusick & Hickman, 2005; Gesser, 2022; Murnan, 2021; Tomko et al., 2021). Relational factors impacting exit from the sex industry include limited conventional formal and informal support, strained familial relationships, social isolation, and relationships with pimps or traffickers (Brown et al., 2006; Dalla, 2002; Oselin, 2010; Williamson & Cluse-Tolar, 2002). An additional relational factor that can be particularly complicated for people involved in commercial sex under the control of a third party which may include an intimate partner, a pimp, or trafficker is that some people involved in these exploitative situations may feel a romantic attachment to their exploiter (Bullens & van Horn, 2002; Duncan & Dehart, 2019; Eberhard et al., 2019; Martin & Pierce, 2014). Structural factors include challenges to accessing meaningful employment, meeting basic needs, educational barriers, criminal records, and lack of service availability (Baker et al., 2010; Hammond & McGlone, 2014; Oselin, 2010), while an example of a societal factor is the socially applied stigma associated with sex work (Blakey & Gunn, 2018).

When it comes to the creation of programs and policies to assist people in their exit from commercial sex, there are a number of methodological challenges to determining empirically whether interventions “work.” However, a 2007 review of the literature on models of exiting prostitution (Payhew & Mossman, 2007) identified several best practices for interventions that can support an individual’s exit from prostitution. These included: (1) the availability of holistic intervention services that can address the multiple and complex needs that individuals face upon exit from the sex industry; (2) the flexibility to accommodate a non-linear exit process that may involve individuals changing their mind and making multiple steps toward and away from exit; (3) the facilitation of free choice which give individuals choices and allow them to make their own decisions; (4) case management by one person who can build a relationship with an individual navigating exit from the sex industry and help them access other necessary services in the community; (5) the building of trusting relationships, essential for even being able to explore strategies to leave the life; (6) the provision of adequate resources; (7) public education campaigns that counter any beliefs that those in sex work do not deserve support; (8) outreach strategies to maximize the chances of engaging with those who may be considering exit and who need additional support to do so, and (9) the placement of services in a geographic area (and during hours) that are practical and accessible for those who are engaged in commercial sex (Payhew & Mossman, 2007). There is ample recent literature to support these strategies to help facilitate people’s exit from the sex industry (e.g., Cimino, 2019; Gesser & Shdaimah, 2021; Murnan, 2021; Preble et al., 2015).

The exit process for people who have experienced sex trafficking

It is also worth considering how the exit process may be further complicated for people who have experienced sex trafficking. In the United States, the Trafficking Victims Protection Act (2000) defines sex trafficking as “the recruitment, harboring, transportation, provision, obtaining, patronizing, soliciting or advertising of a person for the purpose of a commercial sex act, in which the commercial sex act is induced by force, fraud, or coercion or in which the person induced to perform such an act has not attained 18 years of age.” The process of exiting prostitution can be very different for a person involved in a situation with a third-party pimp or trafficker than it would be for a person who is not compelled to sell sex and is able to make a decision, as Hickle (2017) described, “to transition from one role to another,” (p. 3).

People who have experienced sex trafficking often must contend with continued ramifications of this experience beyond when they cut ties with a trafficker. There may be longer term and ongoing psychological ramifications resulting from their involvement in sex trafficking, including lasting trauma, fear, and other lingering effects of psychological coercion (Chambers et al., 2022; Gonzalez et al., 2019; Logan et al., 2009). They may also face ongoing financial ramifications as a result of their sex trafficking experience, as it is common for individuals to suffer financial abuse and struggle with outstanding debts, poor credit, and limited financial knowledge as a result (Gatens, 2019). Additionally, people who have experienced sex trafficking may also experience long-term legal ramifications due to their trafficking experience, including arrest records and other criminal justice consequences for prostitution-related offenses that their traffickers forced them to commit (Barnard, 2014; Devaney, 2021). These persisting financial, economic, and legal ramifications also impact decision-making around leaving a trafficker and/or leaving the commercial sex industry altogether.

We acknowledge the complex and varied experience of people involved in the commercial sex industry and that there is a spectrum of voluntariness among those who sell sex. This study focuses exclusively on the experiences of those who self-identified as having had a pimp or having been trafficked for sex. This study adds to the growing body of literature on how individuals who have been trafficked navigate leaving the commercial sex industry. While most qualitative research on this topic has utilized fairly small sample sizes, to our knowledge, this is the first qualitative study with a sample of this size (n = 158), and the first study on this topic to utilize respondent-driven sampling (RDS), a method intended to reach more deeply into a target population and to accomplish broader respondent representation.

Methods

This research is part of a larger study aimed at understanding the scope and nature of sex trafficking in one county in the United States. The larger study involved a mixed methods approach, including the use of Multiple Systems Estimation (MSE) to generate a prevalence estimate and then the use of semi-structured interviews with people who had experienced sex trafficking, recruited using respondent-driven sampling. The current study utilizes a subset of the qualitative data gathered through semi-structured interviews that focused on experiences leaving a trafficker and/or the sex industry.

Participatory action research approach

This study was guided by a participatory action research (PAR) approach, which engages community members who are affected by a particular social issue in research on that topic in meaningful and ongoing ways (Reason & Bradbury, 2008; Stringer, 2014). PAR has been recognized for its suitability to working with hidden, marginalized, and stigmatized communities (Jumarali et al., 2021), as projects guided by this approach can be informed by community members’ expertise and perspectives and overcome common sampling challenges with hard-to-reach populations (Gerassi et al., 2017). Particularly salient for this project, PAR projects are also noted for their direct applicability to local concerns or issues in the community.

This study involved a practitioner-researcher partnership, led by a community-based nonprofit organization. This community-based agency convened and facilitated the ongoing involvement of a Survivor Advisory Council (SAC), composed of nine members, who provided ongoing, direct guidance to the project. In addition to providing expertise and input on the study design, methods, and research questions, members of the SAC also served as interviewers for this project. Upon completion of data collection, SAC members participated in the interpretation of findings, the generation of recommendations, and in writing key study deliverables aimed at specific policymaker audiences. This study was approved by Sterling IRB (IRB ID#8984).

Sample

As part of a larger study aimed at estimating the scope of sex trafficking in one United States county, 158 adults who had worked for a pimp or trafficker or who identified as having been trafficked for sex participated in semi-structured interviews. Table 1 summarizes participant characteristics. The vast majority of participants identified as female (94%, n = 149), though the sample included 8 participants who identified as male and one participant who identified as transgender. Our measures of race and ethnicity was open-ended and relied entirely on how participants identified themselves. The sample was racially and ethnically diverse, though did not mirror the racial and ethnic composition of the county from which they were recruited. 48% of participants self-identified as Black or African American (n = 75), followed by 13% (n = 20) who identified as white, and 10% (n = 15) who identified as two or more races. A small number of participants identified as Alaska Native, Native American, or Hawaiian/Pacific Islander (n = 4), and approximately 7% identified as another race. Nine percent of the sample population (n = 17) identified as being Hispanic or Latinx. In contrast, as of 2022, approximately 11% of county participants identified as Black or African American, 42% identified as white, 18% identified as Asian, and 7% identified as two or more races. 24% of the county population identifies as Hispanic or Latino (United States Census Bureau, 2022). At the time of interviews, participants ranged in age from 18 to 64 (M = 35.8). The age that participants were first engaged in commercial sex ranged from 1 to 49 (M = 20.3). Almost half of participants first engaged in commercial sex as minors (48%), while the other half entered the commercial sex industry at age 18 or older.

Table 1. Interviewee characteristics.

Characteristic	range	mean
Age at interview	18–64	35.8
Age first engaged in commercial sex	9–49	20.4
	n	%
Under age 18 when first engaged in commercial sex	71	48.0
Gender
Female	149	94.3
Male	8	5.1
Transgender	1	>1.0
Race
White only	20	12.7
Black or African American only	75	47.5
Native American, Alaskan Native, or Hawaii or Pacific Islander only	4	2.5
Asian only	0	0.0
Other race only	11	6.9
Two or more races	15	9.5
Latinx	17	9.3

To understand the market sector that participants engaged in, we asked an open-ended question in interviews: “How did you normally find work?” The majority of respondents reported engaging in street-based commercial sex (n = 109), but many also used the internet to coordinate exchanges (n = 67). Other venues that participants reported finding work included truck stops (n = 10), bars and casinos (n = 7), brothels (n = 4), and massage parlors (n = 3), among others.

Procedure

Participants were recruited using RDS, which is useful for sampling hard-to-reach populations as the recruitment process is designed to use the social networks connecting members of the target population (Crawford et al., 2018). Recruitment for this study began with a number of seed participants who were paid $50 for their participation in a semi-structured interview. At the conclusion of the interview, each seed participant was given a coupon with three unique referral codes to share with other people in their social networks who met the eligibility criteria for the study. They were informed that they would receive an additional $25 for each person they referred who completed an interview. Individuals who recruited the maximum number of three people were given an additional $25. Those recruited participants were then able to recruit others from their social networks to participate and so on. While similar, RDS is distinct from snowball sampling in that it uses an incentivized process that also limits the number of recruits by each participant to capture broad representation across the study population. Our final sample included 71 seed participants and 87 subsequent recruits.

Referral coupons included a QR code linked to a toll-free number associated with the study, which was staffed by research team members who could screen callers for inclusion in the study. Participants were eligible for the study if they indicated that they were at least 18 years old, had traded sex for money or something of value within the last five years in the county, and had given some or all of the money earned from a commercial sex exchange to a third party.

Interviews were conducted between September 2021 and March 2022. Although the initial plan was to hold all interviews in a face-to-face modality, to observe COVID protocols and increase flexibility for participants, we offered the option of conducting interviews via Zoom. The vast majority of participants opted for face-to-face interviews; fewer than ten participants chose to participate virtually. Interviews lasted between 30–60 minutes.

To maintain participant anonymity, consent was collected verbally. Interviewers either read or played a video of the informed consent form to participants and offered a written copy of the consent information as well as a document with study information and contact information for study team members. Face-to-face interviews took place in a community-based service provider’s office. Interviews followed a semi-structured interview format and were recorded with participant permission. All participants consented to audio recording. Recorded interviews were transcribed using an automated transcription service. A team member reviewed the transcripts for accuracy and redacted any identifying information.

Data analysis

The de-identified transcripts were analyzed using QSR NVivo, a qualitative coding software. A coding system was established based on (1) describing the nature of sex trafficking exploitation of participants and (2) better understanding recruitment and entry into and exit from commercial sex, networks of victims and traffickers, and experiences with law enforcement and service providers. Research team members met regularly to review and revise the codebook. To ensure interrater reliability, before individual coding began, all research team members involved in the qualitative analysis coded several interviews simultaneously, met to discuss any discrepancies and to establish processes for areas of disagreement. Once coding was complete, the research team developed analytic memos for each code to explore each theme in depth.

Results

Among study participants, the circumstances of leaving a trafficking situation – whether to work under a different trafficker, to continue sex work on their own, or to exit the commercial sex industry altogether – were incredibly varied. Most participants faced complex and difficult barriers to exiting their trafficking situation and the ways in which they were able to move away from their traffickers reflected these differences in experience. Despite these barriers, most study participants had left their traffickers – and most had also stopped sex work altogether by the time they were interviewed for this study. Our interview protocol included questions related to how and when study participants were able to leave traffickers. We found that there were two broad ways that study participants left their trafficking situations: either proactively, because they made a deliberate choice and were seeking to leave or escape their trafficker, or passively, because of a change in circumstances.

Barriers to exit

Study participants discussed various physical and situational barriers to exiting a trafficking situation or leaving a trafficker. The six most commonly reported barriers to exiting trafficking were (1) violence or threats of violence against the victim; (2) threats of violence against their loved ones; (3) lack of other personal relationships, lack of a place to go, or both; (4) the trafficker’s possession of the victim’s documents, other valued possessions, or money; (5) physical restraint or lack of permission to leave; and (6) romantic attachment to the trafficker.

Violence or threats of violence

Among the most common barriers to leaving a trafficker was the use of violence or threats of violence that compelled study respondents to stay in the trafficking situation. Many respondents reported physical and sexual victimization at the hands of the trafficker, and though there was variation in what was reported, the abuse described was typically severe, and included rape and physical assault, some so severe that it resulted in permanent disfigurement. One respondent described the ongoing violence and threats to her physical safety that she endured: “He [trafficker] would become very violent. He would, you know, break my things, damage my property. He would slap me, punch me, choke me, spit on me. Throw stuff on me … He would [break] into my house. All types of stuff,” (Woman, 26).

The threat of being killed was very real for participants. One interviewee described her experience when she did once try to leave.

I left once. And then it was like, when he caught me, it was bad. I was going to die, you know, slapping my face with a pistol. He told me he had killed me … I remember I was out for a few days … and then when I woke up … my lip was up to my nose and my face was all messed up. I couldn’t see good … I didn’t think about leaving [again]. I might, you know, tell somebody else, you know, don’t get involved with this. But I didn’t think about leaving. I just did what I was fucking told. (Woman, 60)

Even if participants had not experienced assault themselves, for some, observing violence against others served as a powerful deterrent to trying to leave. As one participant described,

The other girls, they pretty much got beat up and I saw it and watched it and heard about it and I didn’t want that to happen to me … Most of those girls’ stories where they were trying to leave … They wanted to go back home now that they didn’t have the freedom that they thought they would, and I didn’t want that to happen to me. So, I was like … if I try to leave, he’s going to beat me up and I don’t want to get beat up. (Woman, 29)

As respondents describe experiences with direct or indirect victimization diminished feelings of autonomy and impacted decisions about leaving traffickers.

Threats of violence against loved ones

Study respondents commonly reported that traffickers would use threats of violence against their parents, children, or other loved ones to prevent them from leaving. One participant described,

If I ever leave him … he’d go to my mom’s house and shoot … and kill my mom, dad, and son and crazy stuff like that. I couldn’t … I literally had to stay there. Should I leave? And then get my mom and them, or just stay and risk it out so my family is safe? (Woman, 26)

Some respondents described how traffickers would learn where their families lived. At least one participant described this as an intentional act during the grooming stage, when they still trusted the trafficker – before they exhibited any signs of violence or control. Sometimes threats would be made against a child that a respondent shared with their trafficker, which was obviously complicated. Participants also noted that they observed the trafficker carry and display weapons, which served as a powerful barrier to trying to leave.

Romantic attachment to trafficker

Consistent with what has been established in prior literature, respondents frequently described feeling like they were in love with their traffickers, especially early on in their relationships. In response to a question about whether anything could have made a participant leave her trafficker sooner, she replied, “I think I was just in love,” (Woman, 58). A common narrative among participants who described romantic attachments to their traffickers was that the relationship with the trafficker began gently, sometimes following the same pattern of a more typical romantic relationship, later followed by the use of violence and other methods of coercion to compel sexual exploitation. One participant provided a vivid description of how this occurred to her when she was 15 years old.

Well, at first he was my boyfriend, of course. And then we were both young and he knew I was at a vulnerable state ‘cause I had lost my son, at a young age, he died from SIDS … And then I ended up falling in love with him … .So then I was just with him, like all the time and then eventually he just turned me out. (Woman, 24)

Social isolation and lack of a place to go

Our interview protocol included a question about why participants did not leave a trafficking situation earlier than they did. Many respondents stated that they did not have anywhere to go. Participants frequently discussed troubled or nonexistent relationships with their families. Some participants expressed shame about facing their families because their loved ones knew they had been involved in commercial sex. Among those with troubled relationships with their families, some of those relationships were strained even prior to the trafficking experience and may have served as a risk factor for involvement in commercial sex in the first place. For others, isolation from their families was a result of their trafficking experience. Some participants described having their personal cell phones confiscated and not being allowed to visit family. One participant described how she had to plead with her trafficker to use a phone to connect with her family.

I didn’t have a phone. I didn’t have, you know, nothing, you know, and every now and again, I [would] be like, “Can I call my mom and just see how my kids [are] doing?” And it’s like, “Okay, but don’t be, you know, talking too much or telling her nothing,” you know, and sometimes he just take the phone and hang up. (Woman, 60)

In those cases, the trafficker used isolation as a method of control.

Trafficker’s possession of money or important possessions

A common reason that participants gave for not leaving the trafficking situation sooner than they did was that the trafficker had possession of important documents or other beloved possessions. Almost always, the trafficker also had the money that the individual had made selling sex. Demonstrating the coercive nature of this form of financial and emotional control, one participant described,

I knew I could leave. I just didn’t [have] nowhere to go. I was free to leave, but they made sure they had control of everything. So if I left, I had nothing to take with me. So I would have to come back. So I was free to leave. They wouldn’t care ‘cause they know I’m gonna be right back. Both of them kept all my money in their bank account. So when I left, I left with nothing. (Woman, 27)

Other participants described their trafficker keeping their money, identification cards, or even their children’s social security cards or other important documents. For some participants, this would not be the first time they would lose all of their belongings by fleeing an abusive partner or trafficker, and the few possessions they had were precious to them. As described by one respondent, “He took my purse and, like, all my clothes and shoes and everything. So I had to, like, keep starting over,” (Woman, 23).

Physical restraint or lack of permission to leave

Less commonly reported was the use of physical restraints, in the form of locked doors or constant surveillance, which prevented some participants from being able to leave their trafficking situation. As one participant described,

The first guy would bolt the doors. He would bolt doors and he would literally lock the doors and keep me in my room. Or if I wanted to go out somewhere, to the store or something, he would say no – that I couldn’t do anything. It was actually really scary. I had no idea that that was going to happen. (Woman, 20).

Proactive attempts to leave

Among the study participants who took a proactive approach to leaving, several themes emerged. It was overwhelmingly common for an event to trigger the decision (or imperative) to leave. Among our study participants, these events included experiencing extreme violence, becoming pregnant, or simply having and recognizing a window of opportunity to get away. When describing how they left, studying respondents described relying on both formal services (e.g., service providers or law enforcement) and informal supports (e.g., friends, family, sometimes even sex buyers). Rarely, respondents described incapacitating their traffickers to facilitate an escape from them.

Triggers for exit

Extreme violence

It was common for participants to describe experiencing ongoing violence or threats of violence from their traffickers. But when asked specifically about what made them leave the trafficking situation when they did, many participants described more extreme, brutal acts of violence that served as the impetus for leaving. Several participants described fearing death. As one participant described,

I was scared for my life. I mean, we fought all the time, but this particular night I like got the shit beat out of me, so bad. I thought I was near death. I thought this was the night I was going to die. I’ve never felt like that about any time we fought. I mean, I was scared of course, and yeah, in pain, but it never felt like, “Oh my god, is this the fucking moment?” … I called my mom, like hysterical. Like, “Mom, please, anything. Please help me get home. I will never deal with this man again.” And they got me home … I knew from that moment I could never be around this guy again, because he is going to kill me eventually. He wants to. And if I make him mad enough, he will. (Woman, 27)

Participants who described experiences with severe violence often reported that they went to a hospital to address their injuries, which may have also facilitated the physical distance and time that they needed to consider leaving a trafficker.

Pregnancy

Less frequently, participants described leaving their trafficker and the commercial sex industry because they became pregnant. Among participants who discussed pregnancy as a critical turning point for them, some expressed that they wanted to provide their child with a different environment and a different life. As one participant described, “I got pregnant with [my daughter]. I left to make it better for me and her,” (Woman, 24). For other participants, becoming pregnant complicated their circumstances but was not something that they directly connected with their decision to leave a trafficker or the commercial sex industry. This was particularly true for participants for whom their baby’s father was the trafficker.

Sheer opportunity

Several participants described leaving simply because they found an opportunity to safely get away. Some respondents actively planned for this opportune moment – some planned in coordination with other individuals who worked under the same trafficker. Of those who planned in advance, some respondents described secretly saving money, hiding their belongings where they could retrieve them, or coordinating in advance with other people who could help. Other respondents did not plan strategically but just left when a short window of opportunity presented. One participant described leaving with the help of a good Samaritan after her trafficker left her in a hotel room but took her clothes to prevent her from leaving.

When I left, I just had to get out of there … the lady next door, she was there and … she gave me some clothes. ‘Cause I had nothing. He took all my clothes, everything. I had nothing. I was thankful that that lady was there and she opened up the door and she gave me those sweats and sweater and those flip flops. And I just took off walking. (Woman, 34)

As this quote demonstrates, sometimes, despite significant barriers to leaving, participants left or escaped a trafficking situation simply because they identified a moment of opportunity.

Strategies for proactive exit

When participants left trafficking situations proactively, they generally described doing so using either formal or informal help-seeking processes. More rarely, participants described actively incapacitating their trafficker to facilitate an escape.

Use of informal supports

Overwhelmingly, interviewees described relying on informal supports to leave their trafficker – most commonly family members or friends. While some participants did not want their family members to know that they were involved in commercial sex, some were able to disclose enough about their situation, their need for help, and the tangible type of help that would help them leave such as a ride from a specific place at a specific time, purchasing a bus or train ticket, or picking up a bag of belongings. Frequently, the support that respondents described asking for was transportation away from a trafficker, often to a different city or state. Also frequent, survivors wanted to ensure they would have a temporary place to live when they left their trafficker. Less commonly, interviewees relied on other people that they did not know well or at all, such as sex buyers or good Samaritans, to help them leave a trafficking situation.

Use of formal services

Less common than the use of informal support networks to facilitate leaving their trafficker, some participants described utilizing formal services such as community-based service providers or law enforcement. Importantly, participants needed to know about the agencies and the services they offered in order to rely upon them during the act of leaving a trafficker or in the critical period of stabilization afterward. Some participants described that they needed to know they could count on services beyond short-term crisis response or emergency housing. One respondent described how she might have left her trafficking situation earlier if she had a better understanding of the resources available and the assurance that they would be available right when she made the decision to leave. Specifically, she said it might have been helpful to know about resources “that weren’t just temporary, like for a night or being put on a waitlist. Because I think those are the only things I have ever heard of or found,” (Woman, 30).

Rarely, respondents reported relying on law enforcement to help leave a trafficking situation. For these respondents, the act of calling the police often followed a physical or sexual assault. As one participant shared, “[The trafficker] beat me so severely that my head swelled up and I couldn’t take it anymore. And I turned him in to the police that time,” (Woman, 48). It is important to note that a majority of respondents did not feel that turning to law enforcement for help was a viable option due to prior negative or mixed experiences with police.

Incapacitation of the trafficker

A final strategy, described by just a few participants, involved incapacitating a trafficker so that they could leave. These respondents described intentionally giving the trafficker excessive amounts of alcohol or drugs so that they would pass out or be otherwise heavily incapacitated, enabling the respondent to physically escape. As described by one respondent,

I secretly texted [my girlfriend]. I took his phone one time, and secretly texted her and he got mad … that was a whole thing. She was my best friend. She totally was like, “You need to stop. You need to get out of this situation.” And I said, “Yes, I do.” And so one day when he fell asleep, I kind of took my Seroquel that iw as taking and he had it on his dresser. And I kind of put it in his water, and he knocked out. And then I walked out. Grabbed his keys and walked out. (Woman, 20)

Passive, circumstantial leaving

Sometimes, the way that respondents described leaving their trafficker was not a purposeful, planned event. Many interviewees reported leaving their traffickers by virtue of changing circumstances. These circumstances most frequently involved incarceration of either the trafficker or survivor, the death of the trafficker, or an active decision by a trafficker to terminate their relationship.

A common way that respondents reported leaving their traffickers was that the opportunity arose when the trafficker was incarcerated. There were mixed feelings among those who left their trafficker in this way. Some were glad to be able to escape their trafficking situations. Others felt deeply committed to the trafficker or romantically attached to them and struggled with the separation. Among these respondents, some described how it took some time to realize that the situation was not what they wanted – and then they either cut ties with the trafficker or completely left the sex trade. One participant described her experience: “He ended up going to prison for an extended period of time. And that actually helped me a lot because I was kind of forced to move on,” (Woman, 26).

Infrequently, interviewees described being arrested and spending time in jail or prison while they were still be trafficked as a point at which they cut ties with their trafficker – or their trafficker cut ties with them. One interviewee said, “I got tired of being beat up and forced to have sex and being broke even though I was out there hoeing all day, and I just couldn’t take it anymore. So I eventually went to jail and got away from him,” (Woman, 33). Another participant (Woman, 27) described actively trying to get arrested just to facilitate her escape from a trafficker.

Infrequently, participants described leaving their trafficking situation because their trafficker died. One interviewee expressed that, “I would hate to say that if [trafficker] didn’t pass away, I would’ve been stuck forever like that to this day. I couldn’t imagine that. I was just lucky,” (Woman, 45). Also uncommon, some participants described scenarios in which the trafficker cut ties with them, either because they were getting older, their looks had changed, or because they weren’t getting along with other people who worked under that trafficker.

Discussion

The purpose of this study was to explore the barriers that people who have experienced sex trafficking encountered when they considered leaving their trafficker or leaving the commercial sex industry, as well as facilitators that helped them overcome those barriers. To address these questions, we used qualitative analysis of semi-structured interviews with 158 people with lived experience of sex trafficking. This study identified several common barriers that individuals who experience sex trafficking may face in trying to navigate an exit from their trafficking situation. We also identified common ways that, despite these barriers, participants persisted in making that exit. The findings from this study have direct and actionable implications for service providers, law enforcement, and policymakers.

Of paramount importance is that service providers should prioritize capacity and availability for crisis calls and be prepared for the specialized requirements of responding to a crisis call. Familiarity with a framework providing guidance for the practice of crisis intervention (e.g., Roberts and Ottens (2005) Seven Stage Crisis Intervention Model) may prove critical for supporting someone in crisis who is considering leaving their trafficker. The moments of opportunity when a person experiencing sex trafficking has the ability and the means to leave their trafficker are often fleeting. These individuals need assurance that when that opportunity presents, they can find community-based support. If they reach out for help but are directed to leave a message or are put on a waiting list, the window of opportunity for intervention may pass. In addition to ensuring the availability of immediate crisis services, people experiencing sex trafficking want to know that their near-term needs can also be met: that they will have some form of stable housing, and ideally, a source of income as they move through the days and weeks following their exit as they work toward stabilization. It is also important that these services be available even if individuals do not self-identify as having experienced human trafficking (Munro-Kramer et al., 2020), or do not wish to participate in an invasive screening to qualify as having experienced trafficking. Funding partners should loosen restrictions that require trafficking qualifications so that there is no expectation or need for individuals to justify or prove their qualification for trafficking-related services. This may mean partnering with a broader range of relevant, trauma-informed community partners so that help is more widely available and accessible, no matter what initial background is provided. This also means that community-based organizations offering physical and mental health services must be accessible, high-quality, and that providers should be trained in trauma-informed practices, which should be used universally, without a client confirming their victimization experiences.

It is also important that service providers establish relationships with emergency room and other healthcare providers. Our study findings are consistent with prior research that finds that people who experience sex trafficking indicate making contact with healthcare systems and providers during their trafficking experience (Baldwin et al., 2011; Chisolm-Straker et al., 2021; Price et al., 2021). As our findings indicate, not only did interviewees in this study make contact with these systems and providers, that contact often happened at the critical moment of considering leaving their trafficker.

The results of this study have important implications for law enforcement. First and foremost, for people experiencing sex trafficking who are engaged in street-based sex work, police officers can serve as a critical lifeline to safety. However, many participants in this study reported having negative or mixed prior experiences with law enforcement, so their trust in police officers suffered, a finding consistent with prior work on law enforcement response to human trafficking (see, for example, Farrell et al., 2019; Farrell & Pfeffer, 2014). One of the most important things law enforcement officers can do is provide consistent messaging that they are a legitimate and trustworthy resource for people who are experiencing trafficking. One of the ways they can solidify this messaging is by continuing to provide resources that a person engaged in commercial sex, whether or not they are experiencing trafficking, can access if they want to exit the sex industry. Even if individuals discard these resources several times, they might receive them at the right time – when they are considering an exit from the industry. At a minimum, law enforcement officers should approach individuals engaged in commercial sex respectfully at all times, even if approaching them for a legal infraction. Many interviewees in this project described having contact with law enforcement during calls for service that were classified as physical assault or domestic violence cases. Taking an approach to use universal trafficking screening or universal resource provision for victims in these types of cases would also help ensure that people who may be experiencing trafficking are made aware of local resources than can help.

A final implication for law enforcement is that while the criminal legal system and criminal legal system actors can help facilitate a person’s exit from trafficking, criminal legal system involvement can also impede their social reintegration and successful rebuilding of their lives. Consistent with emerging work on the decarceration of people affected by commercial sexual exploitation (e.g., Abrams et al., 2020) we find it is essential to create avenues for law enforcement to offer people assistance with exiting a trafficking situation that do not burden them with collateral consequences stemming from arrests or other engagement with the system.

Our study found that for some participants, jail represented one of the only known sources of safe respite from their trafficker, the streets, or both. We do not advocate that arresting people who have experienced trafficking is a helpful strategy to facilitate escape. However, we acknowledge this point of contact as an important opportunity for trafficking screening and providing information about resources and services available in the community. There is a need for an alternative option for safe respite outside of the criminal justice system. Additionally, while our study found that arresting a pimp or trafficker can help facilitate a person’s opportunity to exit a trafficking situation, it needs to be for longer than a couple of days, which just does not seem to be enough time for a person to completely cut ties with their trafficker if they were not already planning to leave.

This study supports the idea that stronger support networks in our communities that address initial risk for trafficking such as programs targeting housing, family supports, and substance abuse disorders, not only enable people to exit sex work, but prevent them from getting involved in the first place. Proactive service provision that addresses risk factors should be accessible to community members even without experiencing sexual exploitation or any form of sexual exploitation.

Limitations

As this work was part of a bigger study focused on a broad array of issues, our analysis is limited to responses from a few open-ended questions about barriers and facilitators to leaving a trafficking situation, and therefore we cannot report with specificity the exact percentage of participants who have fully exited the commercial sex industry without returning or the details of participants’ experiences leaving a trafficker, such as when it happened or how many traffickers they had worked for. Due to the nonlinear process of exiting the sex industry, some participants could describe prior experiences with leaving while still involved in the sex industry. Despite the lack of measures of current circumstance, we believe these narratives worthy of telling and helpful in unraveling the complex nature of leaving a commercial sex situation, whether or not a person is currently working under the control or direction of a third-party pimp or trafficker.

Future research

There is a great deal of research on recruitment into sex trafficking, which is important for informing prevention efforts. However, there is little empirical data on exit, the other end of the spectrum. Additional research is needed to support the development of effective intervention efforts and ensure adequate support services are available.

This study found that people experiencing trafficking overwhelmingly relied upon their informal support networks for help, rather than turning to formal services for help, such as law enforcement or community-based service providers. However, our interview instrument did not explicitly include measures to capture why participants made those choices. More research is needed to understand how people who are experiencing trafficking decide to seek help and how they decide who can help them. Additionally, future research may consider how much prior experience with formal sources of help (e.g., law enforcement and community-based service providers) impact the decision-making of people experiencing sex trafficking. More research is also necessary to better understand how communities can support the friends and family who provide that informal help to people experiencing sex trafficking and ensure that informal supports have the tools necessary to help those coming to them for help.

It is also worthwhile to better understand the process of escape or exit from sex trafficking from the perspective of informal supports, such as friends or family members, that help facilitate an individual’s exit. How did they stay accessible and reachable to their friend or family member during the trafficking situation, how did they learn what that person needed in order to exit their trafficking situation, and how did they manage to provide that assistance safely? This study indicates that there is much we can do to improve formal sources of help for people seeking to exit a trafficking situation, and that these efforts could be better understood by examining the decision-making of those exiting trafficking and the experiences of those friends and family who are able to help them.

Conclusion

Based on the qualitative accounts of 158 people with lived experience of sex trafficking, we identified six common barriers to exiting a trafficking situation. These included: (1) violence of threats of violence against the survivor; (2) threats of violence against their loved ones; (3) lack of other personal relationships, lack of a place to go, or both; (4) their trafficker had possession of their valued documents, possessions or money; (5) physical restraint or lack of permission to leave; and (6) romantic attachment to the trafficker.

Our analysis further identified that there were two broad ways that study participants left their trafficking situations: either actively or passively because of a change in circumstances. Proactive attempts to leave were commonly precipitated by an event (e.g., an incident of extreme violence, becoming pregnant, or recognizing a moment of opportunity to escape) and respondents described relying on both formal and informal sources of help during the leaving process. Rarely, respondents described incapacitating traffickers to facilitate their escape. Passive, circumstantial leaving often involved incarceration of either the trafficker or the survivor, the death of a trafficker, or an active decision by the trafficker to terminate their relationship. This study provides actionable implications for service providers, law enforcement, and policymakers, including the critical nature of prioritizing response during crisis calls, being prepared to provide longer-term support services, showing persistence in the provision of information about community-based resources, taking a universally respectful approach to policing the sex industry, and supporting stronger networks in our communities that address the factors that places people at risk for involvement in commercial sex in the first place.

Acknowledgments

We would like to thank the members of our Survivor Advisory Council, who provided critical input at all stages of the project and helped generate the recommendations for policy and practice presented here: Sawan Vaden, Charity Harmon, Antoinette Smith, Makayla Hines, Ashley Green, Breana Baker, Dominique Roseborough, April Grayson, and Kayla Baumann. This project would not have been possible without them.

Disclosure statement

No potential conflict of interest was reported by the author(s).