Summary

Commercial sexual exploitation and sex trafficking of minors in the United States are commonly overlooked, misunderstood, and unaddressed forms of child abuse. Their consequences are far-reaching:

•    Victims and survivors of these crimes face immediate and long-term social, legal, and health consequences.

•    Exploiters and traffickers, who often operate undetected or without serious penalties, contribute to and benefit financially from the exploitation and abuse of minors.

•    People who purchase or trade for sex with underage individuals engage in and help fuel demand for exploitation and abuse of minors.

•    Individuals and businesses that look the other way or actively facilitate commercial sexual exploitation and sex trafficking of minors enable and perpetuate these crimes.

•    A nation that is unaware of these problems or disengaged from solutions unwittingly contributes to the ongoing abuse of minors and all but ensures that problems of commercial sexual exploitation and sex trafficking of minors will remain marginalized and misunderstood.

Despite the gravity of commercial sexual exploitation and sex trafficking of minors in the United States, moreover, few professionals and systems responsible for protecting and serving children and adolescents are adequately prepared to prevent, identify, and respond to these problems.

Commercial sexual exploitation and sex trafficking of minors refer to



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Summary Commercial sexual exploitation and sex trafficking of minors in the United States are commonly overlooked, misunderstood, and unaddressed forms of child abuse. Their consequences are far-reaching: • Victims and survivors of these crimes face immediate and long-term social, legal, and health consequences. • Exploiters and traffickers, who often operate undetected or with- out serious penalties, contribute to and benefit financially from the exploitation and abuse of minors. • People who purchase or trade for sex with underage individuals en- gage in and help fuel demand for exploitation and abuse of minors. • Individuals and businesses that look the other way or actively facilitate commercial sexual exploitation and sex trafficking of minors enable and perpetuate these crimes. • A nation that is unaware of these problems or disengaged from solutions unwittingly contributes to the ongoing abuse of minors and all but ensures that problems of commercial sexual exploita- tion and sex trafficking of minors will remain marginalized and misunderstood. Despite the gravity of commercial sexual exploitation and sex traf- ficking of minors in the United States, moreover, few professionals and systems responsible for protecting and serving children and adolescents are adequately prepared to prevent, identify, and respond to these problems. Commercial sexual exploitation and sex trafficking of minors refer to 1

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2 Commercial Sexual Exploitation and Sex Trafficking of Minors a range of crimes of a sexual nature committed against children and ado- lescents, including • recruiting, enticing, harboring, transporting, providing, obtaining, and/or maintaining (acts that constitute trafficking) a minor for the purpose of sexual exploitation; • exploiting a minor through prostitution; • exploiting a minor through survival sex (exchanging sex/sexual acts for money or something of value [e.g., shelter, food, drugs]); • using a minor in pornography; • exploiting a minor through sex tourism, mail order bride trade, and early marriage; and • exploiting a minor by having her or him perform in sexual venues (e.g., peep shows or strip clubs). This report focuses primarily on trafficking for purposes of prostitu- tion, exploitation of a minor through prostitution, and survival sex. Numerous factors—at the individual, community, and systems levels— contribute to a lack of understanding and awareness of commercial sexual exploitation and sex trafficking of minors in the United States. For example, these crimes may be overlooked and underreported because they frequently occur at the margins of society and behind closed doors. Victims often are vulnerable to exploitation. They include children and adolescents who are, or have been, neglected or abused; in foster care or juvenile detention; or homeless, runaways, or so-called thrown-away children (i.e., children and adolescents that are asked or forced to leave home). In addition, the absence of specific policies or protocols related to commercial sexual exploitation and sex trafficking of minors, coupled with a lack of specialized training, makes it difficult for professionals from a range of sectors to identify and assist victims and survivors of these crimes. Further, victims and survivors may be distrustful of law enforcement, may not view themselves as “victims,” or may be too traumatized to report or disclose the crimes committed against them. Most states continue to ar- rest commercially exploited children and adolescents as criminals instead of treating them as victims, and health care providers and educators have not widely adopted screening for commercial sexual exploitation and sex trafficking of minors. Finally, a lack of awareness among individuals who routinely interact with victims and survivors ensures that these crimes are not identified and properly addressed. As a result, there is no reliable estimate of the incidence or prevalence of commercial sexual exploitation and sex trafficking of minors in the United States, and many victims go without help. Although a modest amount of research and noteworthy practices and

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Summary 3 programs have emerged, far more needs to be known before it will be possible to adequately understand and respond to commercial sexual ex- ploitation and sex trafficking of minors in the United States. This report is designed to provide a more complete picture of the problems by connect- ing the dots between more established fields of research and practice and the emerging body of work on commercial sexual exploitation and sex trafficking of minors in the United States. This report also aims to provide the scientific underpinnings for future practice, policy, and research efforts and help raise awareness and encourage action on problems of national importance with serious health and safety implications. The report identifies opportunities—through the expansion and enhancement of current efforts and the introduction of new strategies—to advance understanding of and improve the nation’s response to commercial sexual exploitation and sex trafficking of minors. Study Charge In fall 2011, with support from the Department of Justice’s Office of Juvenile Justice and Delinquency Prevention, the Institute of Medicine and the National Research Council formed the Committee on the Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States to conduct a study of these problems as they affect U.S. citizens and lawful permanent residents of the United States under age 18. Based on its review of the evidence, the committee was asked to make recommendations en- compassing strategies for responding to commercial sexual exploitation and sex trafficking of minors in the United States, new legislative approaches, and a research agenda (see Box S-1). Guiding Principles and Overall Conclusions To guide its deliberations, the committee began with three fundamental principles: 1. Commercial sexual exploitation and sex trafficking of minors should be understood as acts of abuse and violence against children and adolescents. 2. Minors who are commercially sexually exploited or trafficked for sexual purposes should not be considered criminals. 3. Identification of victims and survivors and any intervention, above all, should do no further harm to any child or adolescent. These principles are woven throughout the text of this report and are fun- damental to the committee’s recommendations.

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4 Commercial Sexual Exploitation and Sex Trafficking of Minors BOX S-1 Statement of Task The U.S. Department of Justice has requested that the Institute of Medicine and the National Research Council convene a committee of experts to conduct a study on the commercial sexual exploitation and sex trafficking of children who are citizens or lawful permanent residents of the United States. The study will be conducted by a committee of independent experts who will review relevant research and practice-based literatures that will inform future policy and practices within law enforcement, human services, and health care agencies. As part of its work, the committee will examine the following topics: 1.  What is known about the scope and severity of commercial sexual exploi- tation and sex trafficking of U.S. citizens or lawful permanent residents of the United States (under age 18); 2.  Data on causes and consequences for victims and offenders, including the gateways to commercial sexual exploitation and sex trafficking for both populations, as well as the impact of these experiences on future criminal behavior and health outcomes; 3.  xperiences with commercial sexual exploitation and sex trafficking E among populations served by child welfare and juvenile justice systems; 4.  Evidence associated with selected efforts in human services, health care, education, and law enforcement settings to prevent commercial sexual exploitation and sex trafficking of minors and to intervene with victims and offenders; 5.  Identify lessons learned through international, national, state, and local advocacy efforts that contribute to successful intervention and prevention strategies; and 6.  Assess the adequacy of current state and federal laws for addressing the commercial sexual exploitation and sex trafficking of minors and recom- mend new legislative approaches, if necessary, to address this issue. Based on its examination of the preceding topics, the committee will make recommendations in the following areas: 1.  Strategies to respond to commercial sexual exploitation of U.S. minors, including policies and practices for human services, health care agencies, juvenile justice agencies, law enforcement, and the judiciary; 2.  New legislative approaches, if necessary; and 3.  research agenda to guide future studies in this field. A

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Summary 5 After reviewing the evidence, the committee came to the following overall conclusions: • There is substantial and compelling evidence that commercial sexual exploitation and sex trafficking of minors in the United States are serious problems with immediate and long-term adverse consequences for children and adolescents, as well as for families, communities, and society as a whole. • Efforts to prevent the commercial sexual exploitation and sex trafficking of minors in the United States are essential but largely absent. • Efforts to identify and respond to the commercial sexual exploita- tion and sex trafficking of minors in the United States are emerging, with some noteworthy examples, but efforts to date are largely undersupported, insufficient, uncoordinated, and unevaluated. • Efforts to prevent, identify, and respond to commercial sexual ex- ploitation and sex trafficking of minors in the United States require collaborative approaches that build upon the core capabilities of people and entities from a range of sectors. • Efforts to address commercial sexual exploitation and sex traffick- ing of minors in the United States need to confront demand and the individuals who commit and benefit from these crimes. These conclusions reflect the need for coordinated action to develop effec- tive, multisector efforts to prevent and respond to the commercial sexual exploitation and sex trafficking of children and adolescents in the United States. Recommendations The committee’s recommendations are designed to provide practical strategies for increasing awareness; for advancing understanding; and for supporting efforts to prevent, identify, and respond to commercial sexual exploitation and sex trafficking of minors in the United States. They call for multiple and diverse actions at a variety of levels by a wide range of individuals and governmental and nongovernmental entities. (Box S-2 pro- vides suggested actions that can be taken by a range of actors to support the implementation of the committee’s recommendations.) If acted upon in a coordinated and comprehensive manner, the committee’s recommen- dations can help advance and strengthen the nation’s emerging efforts to prevent, identify, and respond to commercial sexual exploitation and sex trafficking of minors in the United States. Finally, the committee recognizes the numerous challenges related to engaging in new work and committing

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6 Commercial Sexual Exploitation and Sex Trafficking of Minors additional resources to any problem in a time of serious fiscal constraints. Therefore, the committee highlights strategies for leveraging existing re- sources whenever possible. Increase Awareness and Understanding Many professionals and other individuals who interact with youth, such as teachers, health care providers, child welfare professionals, and law enforcement professionals, either are unaware that commercial sexual exploitation and sex trafficking of minors occur in their communities or lack the knowledge and tools to identify and respond to victims, survivors, and minors at risk of being victimized. In not recognizing children and adolescents at risk for commercial sexual exploitation and sex trafficking and the victims/survivors among the young people they serve, professionals fail to connect individuals in need to appropriate and timely services. In addition, minors’ lack of awareness of commercial sexual exploitation and sex trafficking increases their vulnerability to these crimes. A number of efforts now under way are aimed at training service providers and raising public awareness with respect to commercial sexual exploitation and sex trafficking of minors in the United States. Such ef- forts are essential to prevention and identification of and response to these crimes. Broadening the reach of these existing efforts could help increase understanding and recognition of these crimes. Therefore, the committee makes the following recommendation: Recommendation 1: The Department of Justice, the Department of Health and Human Services, and the Department of Education, work- ing with other partners, should increase awareness of commercial sexual exploitation and sex trafficking of minors by supporting the development, implementation, and evaluation of •  ational, regional, state, and local evidence-informed training for n professionals and other individuals who routinely interact with children and adolescents; •  ational, regional, state, and local public awareness campaigns; n and •  pecific strategies for raising awareness among children and s adolescents. All training activities and public awareness campaigns should be carefully designed to engage the public and service providers to act on the behalf of victims and survivors without doing further harm.

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Summary 7 Training Activities Training activities need to target and reach a range of audiences in a variety of settings (e.g., urban and rural; tribal lands and states). Specific audiences include, but are not limited to, • parents and caregivers, • teachers and other school personnel, • students, • physicians and other health care providers, • child welfare professionals, • community- and faith-based organizations, • law enforcement personnel, • attorneys in juvenile and criminal courts, • judges in juvenile and criminal courts, • mental health professionals, and • social workers. Training activities also need to be ongoing to ensure that training lev- els are sustained among professionals in fields that experience high rates of turnover and/or transfers. To be maximally effective, efforts to address the commercial sexual exploitation and sex trafficking of minors should build on the core capacities of various people and entities. Therefore, the Office of Juvenile Justice and Delinquency Prevention will need to work in partnership with the Departments of Education and Health and Hu- man Services to engage relevant sectors in developing, implementing, and evaluating training activities that use evidence-based methods to promote learning. Broad engagement will help ensure that the necessary training is available, accessible, and acceptable for multiple audiences. Further, each sector will need to be consulted to determine the best methods for providing the training, recognizing that needs may vary, for example, between focused task forces and rural providers and between law enforcement personnel and health care providers. Strategies might include leveraging existing programs and expanding current efforts within the Departments of Justice, Education, and Health and Human Services to provide a range of training opportuni- ties for an array of professionals. Public Awareness Campaigns A lack of public awareness about all aspects of commercial sexual exploitation and sex trafficking of minors in the United States is a signifi- cant barrier to preventing, identifying, and responding to these crimes. Public awareness campaigns addressing these problems need to be devel-

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8 Commercial Sexual Exploitation and Sex Trafficking of Minors oped, including special efforts to increase awareness among children and adolescents to help them avoid becoming victims. The Office of Juvenile Justice and Delinquency Prevention and the Departments of Education and Health and Human Services could partner with the commercial sector, foundations, and nongovernmental organizations, including journalists and other media that reach the public, to leverage resources and to reach the broadest possible audience. Strengthen the Law’s Response Minors who are victims of commercial sexual exploitation and sex traf- ficking in the United States often are arrested and treated as perpetrators under state criminal and juvenile delinquency laws that make a wide variety of sexual offenses illegal. Although victims themselves, these children and adolescents may be subject to arrest, detention, adjudication or conviction, commitment or incarceration, and having permanent records as offend- ers. A small but growing number of states have enacted laws—sometimes referred to as “safe harbor” laws—designed to redirect young victims of commercial sexual exploitation and sex trafficking from the criminal or juvenile justice system to the child welfare system or other agencies to receive supportive services. While recognizing that additional time and research are needed to assess the effectiveness of specific state laws, the committee believes that the core principle underlying these safe harbor laws—that children and adolescents who are survivors of sexual exploita- tion and sex trafficking must be treated as victims, not criminals—should be advanced without delay. Therefore, the committee makes the following recommendation: Recommendation 2: All national, state, local, tribal, and territorial ju- risdictions should develop laws and policies that redirect young victims and survivors of commercial sexual exploitation and sex trafficking from arrest and prosecution as criminals or adjudication as delinquents to systems, agencies, and services that are equipped to meet their needs. Such laws should apply to all children and adolescents under age 18. In addition, despite laws in every state that enable the prosecution of in- dividuals who purchase sex with a minor, function as exploiters/traffickers, or otherwise sexually exploit children and adolescents, and despite the hard work of prosecutors and law enforcement in many jurisdictions, individuals who sexually exploit children and adolescents have largely escaped account- ability. Understanding the need for a strong legal response to perpetrators of commercial sexual exploitation and sex trafficking, the committee makes the following recommendation:

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Summary 9 Recommendation 3: All national, state, local, tribal, and territorial jurisdictions should review, strengthen, and implement laws that hold exploiters, traffickers, and solicitors accountable for their role in com- mercial sexual exploitation and sex trafficking of minors. These laws should include a particular emphasis on deterring demand. New laws (e.g., safe harbor and strict liability laws) and emerging law enforcement strategies (e.g., wiretapping and other enhanced investigation techniques) warrant additional examination and evaluation. In addition to reviewing, strengthening, and implementing laws that respond to victims/ survivors and exploiters after crimes have occurred, the committee urges state, local, tribal, and territorial jurisdictions to consider how laws can be used to help prevent commercial sexual exploitation and sex trafficking of minors. Strengthen Research to Advance Understanding and to Support the Development of Prevention and Intervention Strategies The committee’s review of commercial sexual exploitation and sex trafficking of minors in the United States was constrained by the extremely limited evidence base related to these crimes, particularly in the areas of prevention and intervention strategies. In addition, the committee found considerable variability in the quality of current research in these areas. Therefore, the committee makes the following recommendation: Recommendation 4: The Department of Justice, the Department of Health and Human Services, and the Department of Education should collaborate and partner with others to implement a national research agenda focused on •  dvancing knowledge and understanding of commercial sexual a exploitation and sex trafficking of minors in the United States; •  eveloping effective, child- and adolescent-centered, multisector d interventions designed to prevent children and adolescents from becoming victims or exploiters and to assist those who have been exploited; and •  eveloping strategies and methodologies for evaluating the ef- d fectiveness of prevention and intervention laws, policies, and programs.

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10 Commercial Sexual Exploitation and Sex Trafficking of Minors A Shift from Counting Generally to Counting Specifically Many research efforts to date have focused on collecting prevalence data on commercial sexual exploitation and sex trafficking of minors in the United States. Based on difficulties entailed in measuring crime in gen- eral and in measuring commercial sexual exploitation and sex trafficking of minors specifically, however, the committee concluded that it would not be useful to devote substantial resources to refining estimates of the problems’ overall prevalence. At the same time, more needs to be known about the prevalence of these crimes among and the associated needs of certain vulnerable populations, including but not limited to boys; lesbian, gay, bisexual, and transgender (LGBT) youth; homeless youth; rural youth; systems-involved youth; and racial and ethnic minority populations, includ- ing Native Americans. Many of these children and adolescents have specific risk factors and needs that have not yet been adequately recognized or examined. Priority Areas for Research In addition to emphasizing the importance of addressing the needs of vulnerable youth, the committee suggests the following priority areas for immediate examination: • development of evidence-based prevention strategies; • identification of risk and protective factors; • development and evaluation of short- and long-term intervention needs and strategies; • gender- and ethnic-responsive delivery of services (including physi- cal health, mental health, legal, housing, and education) and sup- port to difficult-to-reach populations; • comprehensive, multisector approaches; and • demand and its reduction. Publication and Dissemination of Research Findings Developing and implementing a national research agenda with clearly defined priority areas could help build an evidence base for understand- ing and identifying promising and best practices for the prevention and identification of and response to commercial sexual exploitation and sex trafficking of minors in the United States. Broad dissemination of the re- search findings through publication in the peer-reviewed literature would help build a much-needed critically reviewed evidence base to inform future programs, policies, and practices.

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Summary 11 Support Multisector and Interagency Collaboration Commercial sexual exploitation and sex trafficking of minors are com- plex problems that cannot be fully understood or addressed effectively through any one sector, discipline, or area of practice alone. An adequate response to the problems will require participation from numerous indi- viduals and entities, including victim and support service providers, health and mental health care providers, legislators, law enforcement personnel, prosecutors, public defenders, educators, and the commercial sector. An adequate response will also require ongoing collaboration among many individuals and entities. Models for multisector and interagency collaboration exist for crimes that share related and overlapping characteristics with commercial sexual exploitation and sex trafficking of minors in the United States (e.g., child abuse, domestic violence, sexual assault). Task forces also provide a model for collaboration among sectors and across agencies, but they are too few in number, are distributed unevenly across the country, and lack needed evalu- ation. Thus, specific guidelines and technical assistance will be necessary to facilitate effective multisector and interagency collaboration on these problems and to support the development of new efforts throughout the country. Therefore, the committee makes the following recommendation: Recommendation 5: The Coordinating Council on Juvenile Justice and Delinquency Prevention, in collaboration and partnership with national, state, local, tribal, and territorial governmental and nongov- ernmental entities, should develop guidelines on and provide techni- cal assistance to support multisector collaboration and information sharing. Guidelines and technical assistance could help individuals and entities ensure that their multisector approaches create a structure and/or a network of participants that is efficient, conducive to collaboration, and responsive to the needs of all partners and to the young people with whom they inter- act. Guidance might be provided on • identifying and engaging essential partners; • developing memoranda of understanding and/or formal agreements on roles and responsibilities; • establishing data- and information-sharing protocols; and • creating formalized channels of communication. Multisector approaches will necessarily take a variety of forms and include a range of partners based on need, the availability of resources, and

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12 Commercial Sexual Exploitation and Sex Trafficking of Minors the social and legal context in which the approaches take shape. All efforts will need to be evaluated to identify promising practices and effective strat- egies for collaboration among sectors and across agencies, understanding that collaborations are most effective when all the participants understand and use evidence-based approaches. Create a Digital Information-Sharing Platform One of the most significant barriers to action by systems, agencies, and individuals to prevent, identify, and respond to commercial sexual exploita- tion and sex trafficking of minors is a lack of reliable, timely information. While a number of organizations maintain lists of services available to child and adolescent victims of commercial sexual exploitation and sex traffick- ing, the committee was unable to identify an exhaustive list of national-, state-, local-, and tribal-level resources for victim and support services. The limited information that is available is diffuse and unvetted. Challenges in locating essential information on commercial sexual exploitation and sex trafficking present very real obstacles for children and adolescents who seek to access services and for professionals and caregivers who try to help them. Therefore, the committee makes the following recommendation: Recommendation 6: The Office of Juvenile Justice and Delinquency Prevention should create and maintain a digital information-sharing platform to deliver reliable, real-time information on how to prevent, identify, and respond to commercial sexual exploitation and sex traf- ficking of minors in the United States. To make this information-sharing platform maximally effective, the Of- fice of Juvenile Justice and Delinquency Prevention should partner with an independent, unbiased entity with robust technological capabilities to create and maintain a platform that can continuously adapt to next-generation technologies.

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Summary 13 BOX S-2 Summary of Key Implementation Strategies for the Committee’s Recommendations Congress •  uthorize and appropriate funds for demonstration and pilot projects A designed to cultivate sustainable multisector collaboration to prevent, identify, and respond to commercial sexual exploitation and sex trafficking of minors in the United States. Require demonstration and pilot projects to include work with particularly vulnerable populations, such as lesbian, gay, bisexual, and transgender (LGBT) children and adolescents; racial and ethnic minority populations (including Native Americans); homeless/ runaway children and adolescents; rural children and adolescents; and multisystem-involved children and adolescents. (Recommendation 4) •  equire the implementation, enforcement, and evaluation of laws, poli- R cies, and practices designed to prevent, identify, and respond to commer- cial sexual exploitation and sex trafficking of minors in the United States through federal legislation. (Recommendations 2 and 3) State Legislatures •  irect states to conduct needs assessments to inform appropriate plan- D ning, implementation, evaluation, and resource allocation for strategies designed to prevent, identify, and respond to commercial sexual exploi- tation and sex trafficking of minors in the United States. (Recommenda- tion 4) •  irect states to review and amend, as appropriate, state laws addressing D commercial sexual exploitation and sex trafficking of minors in the United States to ensure that exploited and trafficked children and adolescents are treated as victims/survivors, not criminals, and to promote reduction of demand. (Recommendations 2 and 3) Administration for Children and Families •  evelop and disseminate an annual Domestic Trafficking in Persons D report. Require states to submit reports annually on specific prevention, protection, prosecution, and partnership activities for inclusion in this report. (Recommendations 1 and 6) National Institute of Mental Health and National Institute of Child Health and Human Development •  upport research on the root causes and prevention of commercial sex- S ual exploitation and sex trafficking of minors in the United States, includ- ing commercial sexual exploitation and sex trafficking of boys, risk and protective factors for all children and adolescents, short- and long-term intervention needs and strategies, and the delivery of services and sup- port to difficult-to-reach populations. (Recommendation 4) continued

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14 Commercial Sexual Exploitation and Sex Trafficking of Minors BOX S-2 Continued National Institute of Justice •  upport research on laws, policies, and practices that reduce demand for S commercial sexual exploitation and sex trafficking of minors in the United States and on the individuals who commit and benefit from these crimes. (Recommendation 4) Office of Safe and Healthy Schools and Institute of Education Sciences •  rovide technical assistance to school districts for conducting school P needs assessments on the prevention and identification of and response to commercial sexual exploitation and sex trafficking of minors within the school district, at individual schools, and in the immediate commu- nity. Produce and disseminate needs assessment reports that serve as benchmarks against which future gains can be measured. •  upport research to evaluate implementation strategies for meeting S needs identified in these school assessments. (Recommendation 4) National, State, and Local Bar Associations •  xamine and report on the impact of existing and emerging federal, E state, and local laws addressing commercial sexual exploitation and sex trafficking of minors in the United States. Particular attention needs to be focused on new laws that redirect young victims and survivors of com- mercial sexual exploitation and sex trafficking from arrest and prosecution as criminals or adjudication as delinquents to systems, agencies, and services equipped to meet their needs. (Recommendations 2 and 3) •  upport laws, policies, and practices that reduce demand for commercial S sexual exploitation and sex trafficking of minors in the United States, and punish the individuals who commit and benefit from these crimes. (Rec- ommendation 4) •  onduct reviews of laws, policies, and practices in consultation with other C law-related professional organizations, including associations of prosecu- tors and law enforcement, and publish the results of these reviews every 3 years to support the development and refinement of laws and policies. (Recommendations 2 and 3) Academic and Research Institutions •  stablish formal relationships with victim and support service providers, E especially nongovernmental organizations, to develop studies, to collect

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Summary 15 data, and to evaluate the effectiveness of prevention and intervention activities. (Recommendation 4) •  rovide guidance and technical assistance to the Office of Juvenile Jus- P tice and Delinquency Prevention on the delivery of reliable, real-time information about how to prevent, identify, and respond to commercial sexual exploitation and sex trafficking of minors in the United States. (Recommendation 5) Foundations and Nongovernmental Organizations •  upport and disseminate national, regional, state, and local public aware- S ness campaigns, including specific strategies for raising awareness among children and adolescents. (Recommendation 1) •  evelop, support, and evaluate effective prevention and victim and sup- D port service strategies for underage victims and survivors of commercial sexual exploitation and sex trafficking. (Recommendation 4) •  upport the development and maintenance of a digital information- S sharing platform that can deliver reliable, timely information about how to prevent, identify, and respond to commercial sexual exploitation and sex trafficking of minors in the United States. (Recommendation 5) Commercial Sector •  rovide technical expertise to the Office of Juvenile Justice and Delin- P quency Prevention on the development and maintenance of a digital information-sharing platform that can deliver reliable, real-time informa- tion about how to prevent, identify, and respond to commercial sexual exploitation and sex trafficking of minors in the United States. (Recom- mendation 5) •  everage core capacities (e.g., big data, new media) to create and dis- L seminate national, regional, state, and local public awareness campaigns, including specific strategies for raising awareness among children and adolescents. (Recommendation 1) •  everage core capacities to support prevention, identification, and re- L sponse efforts of law enforcement, social services, and other governmen- tal and nongovernmental organizations working to address commercial sexual exploitation and sex trafficking of minors in the United States. (Recommendation 1)

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16 Commercial Sexual Exploitation and Sex Trafficking of Minors Conclusion This report aims to provide a comprehensive review of current knowl- edge about and approaches for addressing commercial sexual exploitation and sex trafficking of minors in the United States. The report demonstrates that, with the exception of several noteworthy efforts, the United States is in the very early stages of recognizing, understanding, and developing solu- tions for these problems. Fortunately, the release of the report occurs at an opportune time, amid growing attention to and calls for action to respond to commercial sexual exploitation and sex trafficking of minors in the United States at all levels—from the grassroots to the Executive Office of the White House. The committee’s intent is for this report to provide a clear path forward by offering recommendations designed to increase awareness, to advance understanding, and to support efforts to prevent and respond to the com- mercial sexual exploitation and sex trafficking of the nation’s children. Failure to act to prevent, identify, and respond to these problems would all but ensure that children and adolescents in the United States will continue to be overlooked and suffer needlessly and that exploiters will continue to perpetrate abuses without suitable consequences. The human cost of the status quo is simply unacceptable.