Establishing But-For Causation and Evidence-Based Future Restitution Under the TVPRA

1. Introduction

United States v. Coulter is a published decision from the United States Court of Appeals for the Tenth Circuit, handed down on April 15, 2025. In this appeal, Germaine Coulter was convicted of child sex trafficking and conspiracy to commit child sex trafficking. The primary issue on appeal was whether the district court properly ordered restitution under the Trafficking Victims Protection Reauthorization Act (TVPRA), specifically whether the government had shown that Coulter’s actions were the “but-for” cause of the victims’ injuries and whether the amount and duration of future therapy and medication costs awarded were supported by the evidence. Coulter challenged both the causation and the quantum of the restitution award. The appellate court affirmed, clarifying the standards for causation and the scope of future-oriented restitution awards under federal law.

2. Summary of the Judgment

• Coulter was sentenced to 360 months in prison on two counts of child sex trafficking and conspiracy to commit child sex trafficking. He was ordered to pay $386,000 in restitution to two victims for psychological treatment and medication.

• The district court required the government to prove that Coulter’s conduct was the but-for and proximate cause of the victims’ losses, and it concluded that pre-existing trauma did not break the causal link.

• An expert psychologist, Dr. Missar, recommended lifetime therapy, psychiatric treatment, medication, lost wages, and educational support. The district court credited the expert’s diagnosis and treatment plan but limited future therapy and medication to ten years—rather than a lifetime—to avoid undue speculation.

• Coulter appealed both the causation finding and the ten-year cap on restitution. The Tenth Circuit affirmed in full, holding (1) the government met its burden of showing but-for causation under the TVPRA and (2) the district court did not abuse its discretion in capping future treatment at ten years based on the record.

3. Analysis

3.1 Precedents Cited

United States v. Anthony I (942 F.3d 955, 10th Cir. 2019): Held that restitution under the TVPRA requires proof that the defendant’s conduct was both the but-for and proximate cause of a victim’s losses.
United States v. Anthony II (22 F.4th 943, 10th Cir. 2022): Reaffirmed Anthony I and applied it to vacate a restitution award where the expert “lumped together” losses from multiple traffickers without disaggregating harm attributable to each defendant.
18 U.S.C. § 2259 (Trafficking Victims Protection Reauthorization Act): Governs restitution for victims of sex trafficking, including future costs “reasonably projected” as a proximate result of the offense.
18 U.S.C. § 3664: Outlines the procedures and standards (preponderance of the evidence) for determining restitution in federal court.

3.2 Legal Reasoning

A. But-For and Proximate Causation
Under Anthony I and Anthony II, restitution for losses under the TVPRA requires the government to prove by a preponderance of the evidence that the defendant’s conduct was the “but-for” cause (i.e., without the defendant’s actions, the victim would not have suffered that loss) and the proximate cause of the victim’s injury. Coulter argued that pre-existing trauma (childhood molestation; other family tragedies) severed the causal chain. The court held that so long as Coulter’s sex-trafficking conduct was a but-for and proximate cause of the victims’ PTSD, depression, and related treatment needs, restitution was appropriate—even if the victims had past traumas from other sources.

B. Evidence Supporting Restitution Amount and Duration
The district court received uncontroverted expert testimony from Dr. Missar, who diagnosed both victims with PTSD, persistent depressive disorders, and other trauma-related conditions traceable to Coulter’s trafficking. Although Dr. Missar recommended a lifetime of therapy, medication, and lost-wage compensation, the court was entitled to apply its discretion in fashioning a restitution award. Citing the need to avoid “overly speculative” projections, the district court limited future treatment to ten years—mirroring the expert’s recommendation for a decade of group therapy—while preserving two years of intensive individual therapy and psychiatric care.

C. Abuse of Discretion Standard
The Tenth Circuit reviews a restitution order’s legality de novo, factual findings for clear error, and the amount awarded for abuse of discretion. Here, no abuse was found: the court adhered to governing law, made findings grounded in the record, and tailored the award to actual, proved losses.

3.3 Impact

This decision confirms that victims of sex trafficking need not be “blank slates” free of prior trauma to obtain restitution; courts must focus on the causal contribution of the defendant’s criminal conduct.
It reinforces the principle that experts’ lifetime-treatment recommendations may be trimmed when the evidence would otherwise permit speculative awards.
Future restitution proceedings under the TVPRA must carefully disaggregate harm caused by the defendant, quantify losses by a preponderance of the evidence, and avoid unbounded awards detached from record proof.
District judges are reminded of their gatekeeping and fact-finding roles: expert opinions guide but do not dictate the precise scope or duration of restitution.

4. Complex Concepts Simplified

But-For Causation: A legal test asking whether the harm would have occurred “but for” the defendant’s actions. If the answer is no, the requirement is met.
Proximate Cause: A legal link showing that the defendant’s conduct was a substantial factor in bringing about the victim’s harm, without which the harm would not have occurred in the way it did.
Restitution vs. Compensation: Restitution orders defendants to pay victims directly for losses caused by the crime, including future expenses like therapy and medication.
Preponderance of the Evidence: The civil-standard of proof used in restitution hearings—victims must show that it is more likely than not that the losses occurred and were caused by the defendant.
Speculative Award: An award lacking sufficient factual support or grounded only in conjecture, which courts must guard against when projecting long-term future costs.

5. Conclusion

United States v. Coulter crystallizes the requirements for ordering restitution under the TVPRA: the government must prove by a preponderance of the evidence that the defendant’s sex-trafficking conduct was the but-for and proximate cause of a victim’s psychological and financial losses. Moreover, while expert testimony can map out a victim’s anticipated lifetime needs, district courts retain discretion to shape restitution awards—capping or tailoring them—so they remain tethered to concrete evidence and avoid speculation. This decision will serve as a critical guidepost for future trafficking restitution proceedings, striking a balance between full recovery for survivors and disciplined judicial oversight.