Social Determinants of Health With Sex Trafficking Survivors in the United States: A Grounded Theory

Sex trafficking survivors experience complex trauma compounded by structural inequities that shape their access to safety, health, and recovery. This grounded theory study explored how social determinants of health (SDOH) influence the lived experiences of sex trafficking survivors in the United States and the perspectives of counselors working with this population. Using a constructivist grounded theory design, we conducted in‐depth interviews with 20 participants (10 survivors, 10 counselors). Findings revealed six interconnected domains (i.e., financial disempowerment and recovery, education, trauma‐informed health care, environmental vulnerability, spiritual harm and healing, and relational trauma and reconnection) that extend traditional SDOH frameworks by integrating trauma histories, systemic oppression, and relational context. Survivors emphasized the need for holistic, trauma‐informed, and culturally responsive systems of care that promote safety, agency, and stable community support. The resulting theory centers survivor voice and offers counseling‐specific implications for practice, training, advocacy, and policy.