Complexities of disclosure: Supporting Canadian youth with sex trafficking experiences in healthcare settings

Background: Sex trafficking is one of the most lucrative global crimes, disproportionately affecting youth aged 16-24. In Canada, 69 % of individuals involved in police-reported trafficking incidents are under 25, yet disclosure in healthcare settings remains rare despite frequent medical care utilization. This discussion paper examines the complexities of disclosure in Canadian health and mental health settings, emphasizing how youth's intersectional identities and relationship to state systems shape disclosure outcomes and access to care. Objective: This paper critically examines how existing scholarship conceptualizes disclosure among youth with sex trafficking experiences in healthcare and mental health settings. By interrogating disclosure processes through a structural lens, this paper aims to advance social work practice, inform policy development, and promote equitable health and human rights for trafficked youth in Canada. Method and results: Applying an intersectionality framework, this paper explores how factors such as gender, race, immigration status, and socioeconomic background interact with state policies, institutional surveillance, and systemic biases to either deter or facilitate disclosure. It highlights how mandatory reporting laws, risk-averse institutional cultures, and inadequate traumainformed approaches create barriers that discourage youth from seeking support. Conclusion: This paper offers actionable recommendations for healthcare providers and organizations to take accountability for their role in the disclosure process. Urging practitioners to move beyond conditional trauma-informed care and actively collaborate with youth to foster safer, more equitable pathways to disclosure and support. By addressing structural barriers and centering youth agency, healthcare systems can better respond to the needs of youth with trafficking experiences.