“Commercial sexual exploitation and sex trafficking of minors not only are illegal activities, but also result in immediate and long-term physical, mental, and emotional harm to victims and survivors.”
Commercial sexual exploitation and sex trafficking of minors in the United States are frequently overlooked, misunderstood, and unaddressed domestic problems. In the past decade, they have received increasing attention from advocates, the media, academics, and policy makers. However, much of this attention has focused internationally. This international focus has overshadowed the reality that commercial sexual exploitation and sex trafficking of minors also occur every day within the United States.
Commercial sexual exploitation and sex trafficking of minors not only are illegal activities, but also result in immediate and long-term physical, mental, and emotional harm to victims and survivors. A nation that is unaware of these problems or disengaged from solving them unwittingly contributes to the ongoing abuse of minors and all but ensures that these crimes will remain marginalized and misunderstood.
In September 2013, the Institute of Medicine (IOM) and the National Research Council (NRC) of the National Academies published the report Confronting
Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States [1]. The purpose of that report is
- to increase awareness and understanding of the crucial problem of commercial sexual exploitation and sex trafficking of minors in the United States;
- to examine emerging strategies for preventing and identifying these crimes, for assisting and supporting victims and survivors, and for addressing exploiters and traffickers; and
- to offer a path forward through recommendations designed to increase awareness and understanding and to support efforts to prevent, identify, and respond to these crimes.
The IOM/NRC report includes chapters on specific sectors with a role to play in addressing the problem. Because the report is lengthy and broad in its reach, the IOM/NRC, with the support of the U.S. Department of Justice Office of Juvenile Justice and Delinquency Prevention, decided to develop a series of guides offering a more concise and focused perspective on the problem and emerging solutions for several of these sectors.
The intended audience for this guide is health care professionals, such as physicians, nurses, advanced practice nurses, physician assistants, mental health professionals, and dentists, who see children and adolescents for prevention and treatment of injury, illness, and disease. At any of these encounters—in settings that include, among others, emergency departments, urgent care, primary care clinics, adolescent medicine clinics, school clinics, shelters, specialty clinics (obstetrics/gynecology, psychiatry), community health centers, health department clinics, free-standing Title X clinics, Planned Parenthood, and dental clinics [2]—these health care professionals can have an opportunity to identify and assist young people who are victims of commercial sexual exploitation and sex trafficking [3, 4, 5, 6, 7, 8].
Ideally, these professionals would be involved in efforts focused on the prevention of victimization by these crimes and work to identify and provide treatment/referral for victims and survivors. Yet despite the potential opportunities for intervention, health care professionals often overlook or fail to identify these youth. The result can be missed opportunities for intervention and the continued perpetration of these crimes. This guide is intended to raise awareness of these opportunities so that health care professionals will be better equipped to fulfill their important role in preventing, recognizing, and responding to commercial sexual exploitation and sex trafficking among the youth in their care.
Following this introduction, Section 2 provides definitions of relevant terms, a set of guiding principles, a summary of what is known about the extent of the problem, and an overview of risk factors and consequences.
Section 3 reviews barriers to the ability of health care professionals to identify victims and survivors of these crimes, as well as some promising opportunities for overcoming these barriers.
Section 4 describes some ways in which health care professionals are responding to these crimes. It also summarizes multisector, collaborative strategies in which the health care sector plays a role.
Finally, Section 5 presents strategies for making progress in identifying, preventing, and responding to these crimes, based on the recommendations offered in the IOM/NRC report.
