nantly women and girls who have been trafficked for sexual exploitation. However clinicians also work with a number of men who have suffered sexual exploitation, including some who were used by paedophile networks. HBF also works with victims of trafficking for domestic servitude and other forms of forced labour including cannabis farming, street hawking, fertility exploitation, construction work/labouring, catering, DVD production and selling and garage work/car washing11. Far fewer men than women are referred for HBF’s services, but that may be more an indication of the kinds of cases that are identified and referred to us rather than a reflection of the proportion of males to females who have been trafficked in the UK. The exploitation of men and boys is an important area for further research as not enough is known about the experiences of male victims. There are concerns that men and boys are less likely to self-identify, or to be identified by others and referred for HBF’s clinical services.12 Table 1 below shows that the total number of client referrals to HBF from 01/01/2010 to 13/5/2013 was 1,982. Of these, the total number of potential trafficking cases was 291.13 The potential trafficking cases are broken down by gender and forms of exploitation. All of these people were either taken on for initial assessment because they had physical and/or psychological symptoms and needs which HBF could assist with, or they were provided with onward referral to other services.14 It should be noted that clients may be referred who are not identified as victims of trafficking until they have been in HBF’s care for some time and that these cases are not included in Table 1. HBF’s use of case study extracts Case study extracts in this chapter are taken from over 45 trafficking cases, spanning 2005-2012. They provide direct insights into the experiences of victims of trafficking referred to HBF, and the specific challenges faced by clinicians and other professionals who work with them. They 11 Trafficking in organs, tissues and cells and trafficking in human beings for the purpose of the removal of organs Rape as a Method of Torture Female Male Total Trafficking (Sexual Exploitation) 184 6 190 Trafficking (Labour Exploitation) 46 19 65 Both Labour and Sexual Exploitation 33 3 36 Total number of referrals of victims of trafficking 263 28 291 Total number of clients referred overall 1015 967 1982 should be considered as illustrative of particular points raised in the accompanying text. Throughout the paper, several references may be made to the same case in order to illustrate different clinical issues. The case study extracts reflect HBF’s day-to-day work, including initial assessment, addressing practical needs, clinical assessment, medico-legal documentation and therapeutic work for victims’ sustained recovery. They are drawn from clinical notes recorded by clinicians and other professionals within therapy session records and/or during the course of preparing medico-legal letters and reports. Each case study extract has been altered to ensure that client confidentiality is protected without disturbing the relevance or meaning of its content. All the names of victims of trafficking have been changed; pseudonyms are regionally appropriate for the case but do not necessarily reflect the ethnic/religious/tribal affiliation of the individuals concerned. Many case study extracts cite the region of the world which victims come from, rather than their specific country of origin. Countries are named only in cases where the individual concerned is otherwise completely unidentifiable and the context requires it. References to gender (“he”, “she”) have been avoided whenever victims of trafficking are referred to in general terms because all aspects of trafficking exploitation apply to men and women, girls and boys. However, the case study extracts do accurately portray the gender of the person concerned. 13 - a prima facie The case study extracts illustrate clinical matters which have been observed in many other trafficking cases by HBF clinicians and so represent issues that HBF considers are important to raise. 14 51