Massage is Legal

Human Trafficking is Not

By Karrie Osborn

The subject makes for uncomfortable conversations, and it’s certainly easier to ignore, but the impact human trafficking has on the massage therapy profession is undeniable.


Massage-parlor and human-trafficking regulations are all too prevalent throughout our profession’s legislative landscape these days. Within the scope of some of these laws, legitimate, law-abiding massage therapists are, by default, lumped into the seedy mix of “massage parlors” and forced to comply with everything from blood tests and background checks to posting human trafficking hotline numbers in their places of business. 

Frustration and anger are the underlying emotions as therapists navigate the unfortunate reality that oftentimes puts them in the same regulatory category as escorts and prostitutes, and makes them suspect for human trafficking violations simply because of their career choice. There is no doubt that our charitable hearts extend to the victims of human trafficking, and there are individuals and entities in our profession who are doing good work advocating for the freedom of these women and children (see Making a Difference, page 86). Whether we are uncomfortable with this reality or not, this is our new normal, and we must decide—collectively and individually—how we address it. 

What We’re Dealing With

Worldwide, human trafficking is said to have more than 20 million victims at any one time,1 with its scope covering everything from forced labor in the wheat fields of Kansas to the enslavement of a 12-year-old in the commercial sex industry in California. Human trafficking is the second largest criminal industry in the world (second only to drug trafficking), and the fastest growing, according to the US Department of Health and Human Services.2 In our profession, it is sex trafficking, under the guise of massage, with which our name is most often associated.

The Polaris Project, one of the leading organizations in the fight against human trafficking, reports that sex trafficking often happens in massage parlors disguised as legitimate massage businesses. “[These parlors] operate as commercial-front brothels claiming to offer legitimate services such as massage, acupuncture, and other therapeutic, health, and spa services,” the group says. And while these illegal massage parlors may actually offer nonsexual services like massage, “they are distinguishable from other legitimate massage businesses in that they provide commercial sex to customers as well.”3 A Polaris Project fact sheet claims that these brothels conceal the commercial sex operation by registering and attempting to behave like legitimate businesses. “Unlike other informal underground brothels, these brothels create a veil of legitimacy by interfacing with, and operating within, normal government and regulatory infrastructures.”4

As a result, sex trafficking, which involves the enslavement of a woman or child to provide commercial sex, is difficult to talk about, not only because of its despicable nature and its apparent ability to hide in plain sight, but because it’s difficult to understand how trafficking differs from other layers of illicit activity going on in illegal businesses claiming to perform massage. 

Wasn’t the conversation difficult enough when we were dealing with the difference between massage therapy businesses and the “massage parlor” across town where women choose to prostitute themselves using massage as their front? Now we must add to the confusion by having yet another criminal activity—sex trafficking—operating under the guise of massage. Which illegal business is offering sexual services from women who are of age and working by choice, and which is harboring and enslaving women and children as victims of sex trafficking? Our words only entangle us further. Why do regulations exist that address the legal protocol for “massage parlors” when they are—whether by offering illicit services or unlicensed massage—inherently illegal establishments to begin with? 

It’s a regulatory catch-22. “Historically, massage parlors have been linked to prostitution, but investigations have proven that many [people] are trafficked and forced into working in these establishments,” says Roger Patrizio, director of the Colorado Institute of Massage Therapy in Colorado Springs and founder of Touching the World, a group that advocates against human trafficking. He says today it is common knowledge that many prostitutes are victims, not criminals.

Elisabet Medina, a case manager who works with survivors of human trafficking in California through the nonprofit advocacy group Opening Doors, says it’s a challenge for law enforcement and those advocating for victims of human trafficking to identify what’s really happening behind those closed doors of the massage parlors. “We can’t tell where prostitution stops and sex trafficking begins,” she says.

 “Distinguishing between victims and prostitutes is an ongoing problem. We walk a fine line. Prostitution can be a gateway to human trafficking, or a symptom of something deeper. When we advocate for clients, we don’t always make the assumption that they are there by choice,” Medina says. “It really is a vicious cycle.” 

Paying the Price

Just as it’s been an effective front for prostitution, massage therapy is a natural cover for criminals involved in sex trafficking—what other legitimate business involves clients disrobing and lying naked on a table? In the field of health care, massage has always been treated differently, partially because of this fact.

Charging legitimate massage therapists up to $3,000 for a business license while other health-care providers pay nothing, forcing them to set up business in warehouse districts, and asking MTs to take blood tests, undergo physical exams, and submit to fingerprinting all illustrate the disparity. And now, two states (with at least 11 more having similar conversations in their legislative halls in 2013)5 require airports, train stations, and other highly trafficked areas, as well as massage businesses, to post human trafficking hotline information in the public’s view. It’s an idea sound in its intent, but some argue its implementation is faulty. 

Is it punishment or good practice to insist MTs post the human trafficking hotline number? Is it harmful to business, or the right thing to do? Patrizio understands the sensitivity to this issue. “A business owner or employee may feel like they are being implicated in this crime industry [by having to post the hotline],” he says. “I can understand that this may seem unfair because most massage therapists proudly demonstrate the highest ethical and professional standards as they day-in and day-out make people’s lives a little bit easier and a lot healthier. But personally, I believe the simple posting of a hotline number will raise more awareness with our clients and colleagues to this vast problem of modern-day slavery. And if this leads to just one girl seeing this number, calling it, and finding a new life, it is most purposeful. If it leads to more individuals recognizing this problem and getting involved as a modern-day abolitionist or keeping an alert eye out, then again, well worth it.”

Patrizio says he also understands the frustration. “I believe that most trained massage therapists remain disturbed by the public’s perceived association we have with massage parlors, though this commonality is only through the shared name of ‘massage,’” he says. “We may always have unethical sexual behavior linked to our industry, and in our society at large, but I do feel with more diligence in massage therapy legislation and unified leadership, we can say no to prostitution under the guise of massage therapy, and get that name ‘massage’ out of parlors and illicit massage businesses across the country.” 

Stop Regulating, Start Enforcing

With all the regulations impacting the massage and bodywork profession today, some are asking, “When is it enough?” 

“The state regulation of massage therapists can serve as a tool for law enforcement,” says Jean Robinson, director of government relations for Associated Bodywork & Massage Professionals. “State-licensed massage therapists have been vetted by the state. Their education has been verified, they have passed an entry-level exam, and in most cases, they have passed a background check. They are professionals.” 

In a perfect world, Robinson says, local law enforcement would stop by local businesses advertising or offering massage therapy and check that the therapists are all licensed. “If they come across an illicit business offering massage and the practitioner is not licensed, the person is breaking the law. The business should be shut down at the local level, and the person claiming to be offering massage should be reported to the state board and prosecuted.”

This basic enforcement of existing laws does not happen enough, Robinson says. Instead of funding an enforcement effort, many states are now considering regulating massage businesses as well as the individual. “It creates another regulation for law-abiding massage therapists to follow and pay for, while criminals continue to operate unscathed.

“Laws are only as good as their enforcement,” Robinson says. And while many might think that state massage regulatory boards can solve the problem, Robinson reminds us that these boards can only discipline the licensee or fine those practicing without a license. “They have no other legal authority,” she explains. “Boards need law enforcement to deal with the criminals.” 

New York massage therapist Joanne Crovets has tried for years to do the right thing and get enforcement to work. “When I got into this profession nearly 20 years ago, this subject [of illegal massage businesses] was a thorn in my side.” Admittedly, she says, it still is. “This is a nearly impossible nut to crack if they don’t enforce their own laws,” she says of state regulatory boards. “They enacted all these laws and then the laws are not followed.”

She notes that within three blocks of her home, there are at least five businesses purporting to offer therapeutic massage that are operating illegally. But when she called the authorities, she was told they didn’t have the manpower to check them out. “It is so frustrating,” she says. “I would seek out these illegal places and report them on my own, without pay, if I thought there would be a result.” Unfortunately, she’s seen that’s not the case.

Others are pushing for enforcement as well. Unlike other human trafficking support groups, Opening Doors does not advocate for a certain bill or regulation, Medina says, but rather advocates for law enforcement. “If [enforcement] is made a priority for elected officials, then it will become a priority for law enforcement. It’s only done through public outcry,” she says.

“Enforcement is not a matter of will, it’s a matter of resources,” Medina says. “Prior to 2008, vice units were regulating massage parlors, along with county code enforcement officers, the sheriff’s department, and local law enforcement.” Erika Gonzalez, a program director of immigration legal services at Opening Doors, says many agencies lost their vice departments, which once oversaw much of this enforcement, after the economic downturn in 2008. Staff resources are short, they say, leaving massage parlors to fall through the cracks. As a result, since 2008, the number of these massage parlors has grown exponentially, almost tripling in the last four years, according to Medina. 

Medina paints the picture of regulatory failure that’s occurred in Sacramento, where there is one person responsible for handling the oversight of all massage establishments, which includes approximately 150 applications a week. “They barely have time to do the background check, let alone go in and visit each establishment.”

Gonzalez says current massage parlor laws are already strong. “We don’t see a need to change the law. Our approach is really to collaborate and work as a collective with law enforcement.”

What Can You Do?

While massage and bodywork schools can certainly be part of the answer by having checks and balances within their own system to ensure credibility and prevent the illegal sale of transcripts, advocates say much of the change we can effect within our profession will come from the individual massage therapist and bodyworker.

“We’re encouraging massage therapists to come alongside us, and we’re asking them to be educated about human trafficking and be our eyes and ears in the community about what’s going on,” Medina says. 

“The more that legitimate massage therapists can come forward and defend their profession, the more helpful it is to both victims of human trafficking and to legitimate massage therapists,” Gonzalez adds.

Patrizio agrees that there is much a massage therapist can do. “I do not pretend to have the answers, but I know for certain that simply accepting criminal activity and injustice, because it has always gone on, is not the answer,” he says. “Saying no to injustice can be the first step for creating positive and lasting change.” 


1. US Department of State, “Trafficking in Persons Report, June 2012,” accessed December 2012, 

2. US Department of Health and Human Services, accessed December 2012,

3. Polaris Project, “Asian Massage Parlors in the United States,” accessed December 2012,

4. Ibid.

5. Registered massage therapists (RMTs) will be exempt from Colorado’s new posting requirements; California posting regulations will exempt those therapists certified by the California Massage Therapy Council (CAMTC). Florida has just signed a human trafficking regulation, which requires the place of business, and anyone working within, to provide valid government documentation and identification. Other states considering regulation tied to human trafficking include Louisiana, Maryland, Minnesota, Nebraska, New Jersey, Ohio, Oklahoma, Tennessee, Texas, Vermont, and Washington.


Signs of Human Trafficking

According to the Polaris Project, one of the leading organizations in the fight against human trafficking, “Women found in brothels disguised as massage businesses typically live on-site where they are confined and coerced into providing commercial sex to 6–10 men a day, seven days a week.” The group estimates there are more than 5,000 of these fake massage businesses nationwide.1 Here are some telltale signs of illicit activity:

• All-male clientele arrive late into the night.

• Windows and doors are barred.

• Women “working” there have long fingernails, and may not wear appropriate attire.

• Interior doors are locked so people must be given access into back rooms.

• Security cameras monitor area activity.

• Windows are blacked out.



Polaris Project, accessed December 2012,

Posters May Be Required in Your Business

If you live in a state that requires, or is considering requiring, massage businesses to post human trafficking hotline information, here are a few suggestions.

While you must adhere to the law, which may detail everything from paper size to the size of the font to be used for these posters, there is nothing that says you have to put it on neon paper with arrows drawing attention to it. Put it on pretty paper instead, and frame it like your business license or other items hanging on your back wall.

As human trafficking groups remind us, there is nothing wrong with educating the public about the issue, and if asked, you can tell clients about human trafficking and how you advocate for its victims by being proactive in your own profession. Follow the law and have your “what does that mean” elevator speech ready when clients ask. 

You are not that, and that is not you, so be confident and prepared with your explanation.

(Members of Associated Bodywork & Massage Professionals will be given notification when they are impacted by these bills and given direction on how to proceed.)


Making a Difference

It was 10 years ago when Roger Patrizio, director of the Colorado Institute of Massage Therapy, first became aware of the human trafficking issue and realized that children around the world, some as young as 4 years old, were being housed in filthy brothels for the purpose of sexual exploitation. “I felt compelled to do something about this, and owning a massage school brought me the opportunity to establish a nonprofit through our company resources.” In 2004, he created Touching the World, a nonprofit meant to raise awareness surrounding human trafficking and lend financial support to regional organizations that are rescuing and rehabilitating trafficking victims. His school’s community service massage program helps fund the work.

While Touching the World collaborates mostly with local human trafficking groups, it has also lent its support to national and international groups when it can. Patrizio says progress has been made in the fight against human trafficking, and will continue to be made as grassroots efforts by modern-day abolitionists take hold. “I would encourage those who feel led to stand up, look in your community for organizations that are already tackling this issue, and get involved … One person doing a lot is a beginning, but many people doing a little will accomplish great things. Together, we can, and are, making a difference.” 

Patrizio looks forward to the day his nonprofit closes its doors for good. “Our greatest success would be when we are no longer needed. In the meantime, we will continue to raise awareness, encourage others to stand up and fight injustice, and support the worldwide network of human trafficking organizations that are rescuing and rehabilitating victims.”

For more information
about Touching
the World, go to

 Tips for Your Business and Personal Safety

Human trafficking impacts the massage and bodywork profession from many angles. Here are some ways to keep yourself safe and put distance between you and the massage-parlor businesses that are hijacking your name.

Operate legally by having all your proper licensure, credentials, and continuing education. Display your license proudly.

Be smart with your business name. The words you choose should reflect nothing but professionalism. Avoid choosing something that is too cute.

If you employ others, screen them well. Get background checks and school transcripts if you’re in an unlicensed state.

Advocate for victims of human trafficking. 

Make good personal choices. Like your business name, your appearance should reflect nothing but professionalism.

Have a plan if you do offsite massage work. Call a colleague before and after your session to check in; if called to a hotel, let the front desk know what room you are visiting and your expected departure time. (You can read more on good outcall procedures in the article “Outcall Service and Safety” in the Successful Business Handbook, available in the Members section of

Have policies in place for when situations arise. If a client becomes inappropriate during a session, what will you do? And what do you define as inappropriate? Role-play these difficult situations with a colleague so that you have the confidence to carry out your policies if need be.

Choose your advertising venues, and your advertising messages, carefully. or Craigslist are not the best choices for massage therapists and can certainly bring some unwanted callers.

Screen new callers thoroughly. Have a script ready so you aren’t caught off guard.

Educate the public whenever you can about healthy touch and trained therapists, and how “massage parlors” and massage therapy are two very different businesses. 

Speak out on the importance of enforcing the regulations that are already in place, and advocate for officials to provide the resources to make enforcement a top priority.