Date: September 25, 2013




Sex Trafficking and Exploitation of Minors Serious Problems in the U.S., and Stronger Prevention and Response Efforts Are Needed; Exploited Youth Should Be Treated as Victims, Not Criminals


WASHINGTON -- Commercial sexual exploitation and sex trafficking of minors are serious problems in the United States with long-term adverse consequences for children and society as a whole, and federal agencies should work with state and local partners to raise awareness of these issues and train professionals who work with youths to recognize and assist those who are victimized or at risk, says a new report from the Institute of Medicine and the National Research Council.  Minors who are prostituted or sexually exploited in other ways should be treated as victims rather than arrested and prosecuted as criminals, as they currently are in most states, the report says.


“Commercial sexual exploitation and sex trafficking of minors are often-overlooked forms of child abuse,” said Richard Krugman, co-chair of the committee that wrote the report, and vice chancellor for health affairs and dean of the University of Colorado School of Medicine.  “Our national, state, and local laws and policies should recognize that and provide these children and adolescents with the support they need. Right now, they are often invisible to us, and when we do recognize them, we fail to see them as victims and survivors of abuse and violence.  We hope our report will help open our nation’s eyes to a serious domestic problem in need of solutions.”


Commercial sexual exploitation and sex trafficking of minors refer to a range of crimes, including recruiting or transporting minors for the purpose of sexual exploitation, exploiting them through prostitution, or exploiting them through survival sex (exchanging sexual acts for something of value, such as shelter or food), among other offenses. Young victims and survivors of these crimes face both immediate and long-term social, legal, and health consequences. As directed by its charge, the committee focused its report on exploitation and trafficking of minors who are citizens or lawful permanent residents of the U.S. and its territories, but urged readers and policymakers to consider the broader implications of its recommendations as they apply to all children and adolescents.


Despite the gravity of the problem, there is no reliable estimate of the scope or prevalence of commercial sexual exploitation and sex trafficking of minors, the report says; estimates of the number of prostituted children and adolescents in the U.S., for example, have ranged from 1,400 to 2.4 million. These crimes are overlooked and almost surely underreported because they frequently happen at the margins of society and behind closed doors, and the young people involved often do not recognize themselves as victims of abuse. Those especially vulnerable to exploitation include youths who have been neglected or abused; those in foster care or juvenile detention; lesbian, gay, transgender, and bisexual youth; racial and ethnic minorities; and homeless, runaways, and “thrown-away” children who have been asked or told to leave home.


Efforts to prevent the commercial sexual exploitation and sex trafficking of children in the U.S. are largely absent, the report says, and though efforts to respond to these problems are emerging, they are generally insufficient, uncoordinated, and unevaluated.  Many professionals who interact with youth -- such as teachers, health care providers, and child welfare and law enforcement professionals -- are either unaware that trafficking and exploitation happen in their communities or lack the knowledge and tools to identify and respond to young people who are at risk.


Commercial sexual exploitation and sex trafficking of minors should be understood as acts of abuse and violence, the report says.  All states have statutory rape laws specifying that a child under a certain age cannot legally consent to having sex and must be treated as a victim of a crime.  And federal law on sex trafficking recognizes children as victims.  However, in most states, commercial sexual exploitation and sex trafficking of minors often are viewed through the lens of prostitution laws. As a result, laws allow prostituted minors to be arrested and charged with crimes instead of treating these sexually exploited minors as victims of crimes.  These children and adolescents may be subject to arrest, detention, adjudication or conviction, and commitment or incarceration; they may have permanent records as offenders.


The report calls for all national, state, local, tribal, and territorial jurisdictions to develop laws and policies that redirect young victims and survivors of commercial sexual exploitation under the age of 18 away from arrest and prosecution and toward systems, agencies, and services that are equipped to meet their needs.  A small but growing number of states have enacted “safe harbor” laws designed to send young victims of exploitation to agencies that provide supportive services instead of sending them to the criminal or juvenile justice systems.


The U.S. departments of Justice, Health and Human Services, and Education, working with other partners, should support national, regional, state, and local efforts to raise awareness of these crimes, the report says.  These efforts should include training for professionals and others who routinely interact with minors. Health care and child welfare workers, the education sector, and the private sector have an important role to play in preventing, identifying, and responding to these problems.  Efforts should also include campaigns to raise public awareness and specific strategies for raising awareness among children and adolescents. In addition, in the absence of an exhaustive list of resources for victim and support services, a digital information-sharing platform should be created to deliver reliable, real-time information on how to prevent, identify, and respond to the problem.


Despite the hard work of prosecutors and law enforcement in many jurisdictions, individuals who sexually exploit children and adolescents largely escape accountability, the report says. All jurisdictions should review and strengthen laws that hold exploiters, traffickers, and solicitors accountable for their role. These laws should include a particular emphasis on deterring demand, both through prevention efforts and penalties for those who solicit sex with minors.


In addition, the report recommends that the departments of Justice, Health and Human Services, and Education collaborate and partner with others to implement a national research agenda to advance understanding of this kind of exploitation and develop evidence-informed interventions to prevent youth from becoming victims and to assist those who have been exploited.


“It’s time to direct greater effort to preventing this kind of abuse, identifying young people who have become ensnared in it, and developing effective approaches that can enable them to reclaim their lives,” said committee co-chair Ellen Wright Clayton, Craig-Weaver Professor of Pediatrics and professor of law at Vanderbilt University.


The study was sponsored by the Office of Juvenile Justice and Delinquency Prevention in the U.S. Department of Justice.  Established under the charter of the National Academy of Sciences, the Institute of Medicine and the National Research Council provide independent, objective, evidence-based advice to policymakers, the private sector, and the public.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.  A committee roster follows. 



Jennifer Walsh, Senior Media Relations Officer

Rachel Brody, Media Relations Associate

Office of News and Public Information

202-334-2138; e-mail

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Additional resources:
Report page:


Report Brief:


Pre-publication copies of Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States are available from the National Academies Press on the Internet at or by calling 202-334-3313 or 1-800-624-6242. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).


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Board on Children, Youth and Families


Committee on the Commercial Sexual Exploitation and

Sex Trafficking of Minors in the United States


Richard D. Krugman, M.D. (co-chair)

Vice Chancellor for Health Affairs, and


University of Colorado School of Medicine



Ellen Wright Clayton, J.D., M.D. (co-chair)

Craig-Weaver Professor of Pediatrics,
Professor of Law, and

Center for Biomedical Ethics and Society
Vanderbilt University

Nashville, Tenn.


Tonya Chaffee, M.D., M.P.H.

Medical Director of Child and Adolescent Support

Advocacy and Resource Center

University of California

San Francisco


Angela Diaz, M.D., M.P.H.

Jean C. and James W. Crystal Professor of Adolescent Health

Department of Pediatrics and Preventive Medicine

Mount Sinai School of Medicine

New York City


Abigail English, J.D.


Center for Adolescent Health and the Law

Chapel Hill, N.C.


Barbara Guthrie, Ph.D., R.N., F.A.A.N.

Associate Dean for Academic Affairs, and


Yale University School of Nursing

New Haven, Conn.


Sharon Lambert, Ph.D.

Associate Professor

Department of Psychology

George Washington University

Washington, D.C.


Mark Latonero, Ph.D.


Research Director

Annenberg Center on Communication Leadership and Policy

University of Southern California

Los Angeles


Natalie McClain, Ph.D., R.N., C.P.N.P.

Assistant Professor

William F. Connell School of Nursing

Boston College

Chestnut Hill, Mass.


Callie Marie Rennison, Ph.D.

Associate Professor

School of Public Affairs

University of Colorado



John A. Rich, M.D., M.P.H.

Professor and Chair

Health Management and Policy

School of Public Health

Drexel University



Jonathan Todres, J.D.

Associate Professor of Law

College of Law

Georgia State University



Patti Toth, J.D.

Program Manager

Washington State Criminal Justice Training Commission





Patti G. Simon, M.P.H.

Study Director