Research In Action
Research In Action
Moderator’s Note: Child sex trafficking remains a complex and unaddressed form of youth violence. Carmelle Tsai Wallace, MD, MPH, a former Pediatric Emergency Medicine Fellow at Children’s Hospital of Philadelphia (CHOP), and Cynthia Mollen, MD, MSCE, Chief of the Division of Emergency Medicine at CHOP, have authored a blog post exploring this multifaceted topic. Their post dispels popular myths about child sex trafficking and provides recommendations for how healthcare providers and researchers can take action.
An abbreviated version of Dr. Wallace and Dr. Mollen’s blog post is included below. Click here to read the full blog on CHOP PolicyLab’s website.
In the last decade, the issue of sex trafficking has garnered increased attention in the mainstream media, as well as among academic and corporate sectors. According to the International Labour Organization, there are more modern slaves (including victims of forced labor and human trafficking) now than at any other time in human history.
Rightfully so, people are taking notice. As public awareness grows, it is important for those in health care to have an accurate understanding of child sex trafficking and its various forms, and to help clarify the myths surrounding the issue.
Myth #1: Child Trafficking Survivors are Kidnapped and Locked Up
Owing to movies and media portrayals, public perception is often that trafficked children are under lock and key, kidnapped and sold across international borders, and never see the light of day. But this is only one form of child trafficking.
An equally insidious and arguably more pervasive form occurs daily. These children and adolescents are in our schools, social service systems and health care facilities. These are children who are engaging in all forms of transactional, commercial and even survival sex. They are not necessarily living under the physical roof of their trafficker, and may even be living at home. Nevertheless, they experience coercion and control that result in complex mental, emotional and physical trauma.
According to U.S. federal law, any person under the age of 18 involved in a commercial sex act is a victim of trafficking. This includes all transactional sex for food, shelter, and clothing, and even children that some may consider “prostitutes.” The complexities of coercion and control by traffickers are convoluted. Victims may refer to their traffickers as romantic partners, and may not necessarily see or name what is occurring as exploitation or trafficking.
In some cases, children may even be trafficked by a family member. Survivors have shared that even their own parents have been the one to exploit them. When trafficking victims present to a health care setting, they may actually be with a family member (who may or may not be the trafficker), or with a trafficker pretending to be a family member.
Myth #2: Child Sex Trafficking Survivors Never Present to Health Care Facilities
Actually, when surveyed, more than 80% of trafficking survivors report having seen a health care provider. Less is known about trafficked minors, but we can extrapolate that they are likewise being seen in pediatric emergency departments, primary care offices and dental offices.
Myth #3: Child Sex Trafficking Survivors Will Be Scared or Traumatized If You Talk to Them About Trafficking
To gain some insight into this myth, we interviewed young adults who had been trafficked as minors about their experiences with the health care system and their thoughts around screening (Wallace et al). What we found surprised us. These young people told us over and over that they do want health care providers and professionals to speak with them about what is going on in their lives. They want to be spoken to compassionately but directly, and they told us it’s okay to ask if they’re trading sex for services, money or a place to stay. It is important to recognize that they may not always disclose truthfully, and that these patients may even be challenging to care for in a health care setting. However, it is crucial not to be deterred, to have a high index of suspicion for children who are at risk, and to show them that the health care system is a safe place where they can be open and honest and disclose when they feel ready.