Angela Diaz: Hi, my name is Angela Diaz, and I would like to talk about trauma in particular, 

sexual trauma. Sex trafficking usually happens when a young person is used by a 

third party sexually for gains. It could be financial gains. And what happen with 

this is that a young person, and this is domestic. Sex trafficking in the U.S. 

happens in every single state under the history of Columbia. Sometimes when 

people hear sex trafficking, they think about other countries or people being 

brought to the U.S., I'm talking about our own kids.

Angela Diaz: Domestic sex trafficking happens all the time. And this young people are 

approached and groomed by traffickers. And then they could just be seeing the 

young person in the street and so, "You are so beautiful," and start talking with 

them and offer to buy them a hamburger or something and just start chatting 

with them, and eventually they may say, "I want to be your boyfriend." And 

then when they try to develop that relationship, one day they will say, "If you 

really love me, you should have sex with my friend." And if the young person 

does it, then that continues to increase with different type of people that they 

are having sex with. And this person, this boyfriend is being paid or has some 

gains from this interaction of the young person.

Angela Diaz: And sex trafficking can be through a trafficker, it could be through sometimes a 

gang, maybe involving sex trafficking and sometimes it's an individuals and 

sometimes it's a gang. Sometimes the families maybe trafficking the young 

person and having gains such as money or drugs or something like that. There 

are a number of things that put young people at risk for sex traffic. The most 

immediate, the proximal risk to sex trafficking of young people in the U.S. is 

being homeless or having unstable home.

Angela Diaz: Another risk is having a history of abuse, especially sexual abuse. Young people 

who are gay, lesbian, and transgender are at a higher risk to be sex-trafficked. 

Young people who are system-involved such as foster care or the criminal 

justice system also are more likely to be sex-trafficked. So these things are 

complex, but we need to understand that there are multiple risk. Some are 

individuals, some are family, some are community, some are more societal. But 

they're at sometimes because we ask them directly if they ever exchange sex 

either for shelter, for money, for food, for drugs, we find out if they are 

engaging in any of those behaviors.

Angela Diaz: Also, sometimes if you see a young person that comes to the clinic sort of that is 

not dressed according to the temperature for example, or they have certain 

tattoos in the neck that says, "That his car," or something that sort of identify 

them as property of somebody else, you sort of think that there is a possibility 

of them, then you ask the young person directly.

Angela Diaz: Something else to be very aware, sometimes the trafficker and may come with 

the victim and they want ... When you are taking a history, you should always 

see any patient, any teenager should be always seen at least for part of the 

history by themselves. But especially when you suspect that they are being sextrafficked because the trafficker tend to take over, they want to be giving all the 
history because they don't want the young person to say anything that may 

compromise them.

Angela Diaz: So we always say to everyone, the way that we work here is that at some point 

we ask the parents or the friends, whoever comes with a young person to wait 

outside and we will continue the conversation and do the physical exam. So we 

have that opportunity to work with the young person and ask any question that 

we may need to ask and give the young person the opportunity to share 

anything that they need to share.

Angela Diaz: But we know that they're not just going to pack up and leave. It's complex. They 

may be afraid of the trafficker, they may not know what to do, where to go, so 

we have to start that conversation and we really encourage them to keep 

coming and every time they come we continue the conversation and continue 

to give them another dose of mental health.

Angela Diaz: But they are not going to be able to leave the life unless they have outside in the 

community connections. Whether it's connection to family, they have a place to 

live, they have a place to let's say get money to eat or ... They need to survive. 

The need to do that. Those, you need to start working with them as they 

prepare to leave the life to what system of care are they going to come to, what 

resources in the community are going to be available to them? And only after 

that ... And sometimes it takes like six tries or more for them to try to leave, for 

them to then stay out and be able to get reconnected. They need to be 

reconnected to society and to the different elements of society. That is very 

important.

Angela Diaz: So we provide these trauma-informed services to these young people who had 

been sex-trafficked, but we also work with a different system in their behalf. 

Sometimes they are brought by police, sometimes they're referred to us by 

court. I guess I said through, FBI, Homeland Security and sometimes just other 

services. But we're also very involved in advocacy. We have many different 

groups in New York. People work together because these young people were 

not only been victimized in the trafficking, but they also were being arrested, 

they used to end up with a criminal record and they used to be re-victimized by 

the different system.

Angela Diaz: And after a lot of advocacy, New York actually changed the law. And now they 

see any young person as a victim rather than a criminal. A victim who needs 

services, who need to be connected, who need to really be helped. And this 

have been really, really important. And this is key because young people are 

much more likely now to even disclose and they know that they can be helped 

and we can work with The Child Welfare System, Child Protection, everyone, the 

different type of system to really help this young person do well rather than 

consider them a criminal and making it harder for them to leave the life.