(July 2007) Women who have been subjected to trafficking and forced into service, including sex work, are more likely to suffer multiple physical and mental health problems than the general female population, according to a recent study. But once released from such situations, women can show vast improvement after only a month of professional care.

Charlotte Watts, co-author of the report, “Stolen Smiles: A Summary Report on the Physical and Psychological Health Consequences of Women and Adolescents Trafficked in Europe,” discussed the health consequences of trafficking and what could be done to help women recover. Watts spoke at a June 28 presentation in Washington, D.C., sponsored by the Gender-Based Violence Task Force of the Interagency Gender Working Group (IGWG). Watts is the Sigrid Rausing Chair in Gender Violence and Health and head of the newly established multidisciplinary Centre on Gender, Violence and Health at the London School of Hygiene and Tropical Medicine.

The study included 207 women from 14 countries who had been recently released from a trafficking situation. The researchers included trafficked women from four “spheres of marginalization and vulnerability” in their sample, including migrant women, exploited laborers, sex workers, and torture victims.

According to the report, 60 percent of the women interviewed were physically or sexually abused before being trafficked. This figure rose to 95 percent of the women during their trafficking situation.

Upon release, many women suffered severe physical health problems. Within the first two weeks, 57 percent of women reported between 12 and 23 symptoms, with the most common symptoms being headaches, fatigue, dizzy spells, back pain, stomach/abdominal pain, and memory problems. After three to eight weeks of treatment, the incidence decreased significantly to 7 percent.

“The improvements suggest that it is beneficial to give women the time, support and health care they are likely to need before conducting in-depth interviews/interrogations to collect criminal evidence and before asking them to make well-considered decisions,” according to Catherine Zimmerman, another co-author of the report.2

Trafficked women are also at high risk for psychological problems. Upon their entry into a care facility, 56 percent of women reported symptoms of post-traumatic stress disorder and 95 percent reported feeling depressed. These problems appear to be more persistent, as most women did not show improvement until they received medical care for at least 90 days.

While it may not be surprising that trafficked women suffer significant health problems, it is still important to recognize the physical and mental condition of women who enter the legal system once they are released from the trafficking situation. In her presentation, Watts cautioned that a trafficking victim “might be treated as a criminal instead of someone who has faced horrendous physical and mental abuse.”

The report offers several recommendations regarding the health of trafficked women, tailored to states, policymakers, health service providers, and nongovernmental organizations. First and foremost, Watts and her colleagues want each of these groups to recognize the health consequences of trafficking.

They also call for legislation that would provide trafficked women with a full range of health care services, regardless of their legal status in a country. The authors believe that once the women are released from the trafficking situation, a 90-day period of reflection is necessary for the women to receive treatment and recover to a point where they are able to make decisions about cooperating with authorities or returning home.

Finally, they are trying to raise awareness in the legal system by conducting sensitization training and distributing pamphlets on how to appropriately deal with women who have been trafficked. Some of their practical tips include being aware of the women’s state of health; providing essential medical care before interrogation, establishing trust by making male or female officials available, whichever the trafficked women would prefer; and using a credible interpreter who will not compromise the victim or manipulate the answers. 

Sara Maki is a Bixby Intern at the Population Reference Bureau.


  1. Charlotte Watts, “Stolen Smiles: The Physical and Mental Health of Women and Adolescents Trafficked in Europe,” presentation sponsored by the Interagency Gender Working Group (IGWG) Gender-Based Violence Task Force, Washington, D.C., June 28, 2007; and Cathy Zimmerman et al., Stolen Smiles: the Physical and Psychological Health Consequences of Women and Adolescents Trafficked in Europe (London: London School of Hygiene & Tropical Medicine, 2006).
  2. Cathy Zimmerman, Presentation on the Health Consequences Among Women Who Have Been Trafficked and Their Implications for Services and Policy (London: London School of Hygiene & Tropical Medicine, 2006), accessed online at www.lshtm.ac.uk, on June 29, 2007.