RECOGNIZING AND ASSISTING 

YOUTH VICTIMS OF DOMESTIC 

SEX TRAFFICKING

Revised May 2016

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

Administration on Children, Youth and Families

Family and Youth Services Bureau
Bought and Sold

RECOGNIZING AND ASSISTING YOUTH VICTIMS OF 

DOMESTIC SEX TRAFFICKING

Domestic minor sex trafficking refers to the 

commercial sexual exploitation of any American 

citizen or legal resident under the age of 18. 

Victims include girls, boys, and transgender 

youth as young as 12—or even younger. They are 

recruited, exploited, and victimized by traffickers 

or pimps within the United States. 

Young people whose bodies are bought and sold 

for sex are not criminals. They are victims

of physical, psychological, and emotional 

violence.

The impact of commercial sexual exploitation on 

young victims is often devastating. They face 

violence, disease, and jail. Before they are even 

old enough to vote, they lose their dignity and 

their freedom. They suffer trauma that may 

never go away. 

Identifying and providing services to young 

victims of commercial sexual exploitation should 

be a top priority of communities and professionals 

serving families across the nation.
This brochure is for youth and family services 

professionals who come in direct contact with 

young people who may be sexually exploited 

or trafficked. By reading it, you’ll learn who is 

most at risk, what to look for, what exploited and 

trafficked young people need, and where you can 

get additional resources and support.

Some Youth Are More at Risk

Victims come from cities, suburbs, and small 

towns across the country, from all races and 

ethnic groups. Still, there are certain factors that 

increase the risks of victimization: 

• a history of abuse and neglect at home, 

particularly sexual abuse 

involvement in the child welfare and juvenile 

justice systems

a history of running away and homelessness 

poor family connections 

• 

• 

• 

Young people experiencing one or more of the 

above factors may be more vulnerable than 

other youth to the coercion of traffickers. Often, 

traffickers manipulate other exploited youth 

to help them recruit teens at runaway shelters, 

group homes, bus stops, shopping malls, or other 

places where vulnerable youth tend to be.1

Where does commercial sexual exploitation of 

minors occur?

• Peep shows or strip clubs

Erotic massage services

Streets (Prostitution)

Online (Pornography)

Escort services

Truck stops

• 

• 

• 

• 

• 

No One Chooses to Be Sexually 

Exploited

Sex trafficking of minors is a form of child abuse. 

It’s important to remember that no one chooses 

to be exploited. Many young victims are lured by 

exploiters and traffickers with the false promise 

of a better life, love, or affection. Later, traffickers 

use violence, threats, and manipulation to control 

their victims psychologically and financially. 

Signs of Sex Trafficking 

Identifying victims can be difficult. Even though 

trafficking doesn’t require movement, some 

victims are moved frequently. They have been told 

by their exploiters to mistrust adults, particularly 

law enforcement. They have been trained to lie 

about their ages or activities. And often, they 

don’t think of themselves as victims. 

1 Hay, M. (2006). Commercial sexual exploitation of children and youth. 

BC Medical Journal, 46(3), 119-122.
However, some signs may include:

• Over-sexualized behavior

Controlling older companion, “boyfriend,” or 

“girlfriend”

Highly controlled or restricted schedule, 

money, or communications

Unidentifiable source of income, large 

amounts of cash, or unexplained source of 

new clothing and personal items

Bruises or other physical signs of abuse

A tattoo that the young person is reluctant to 

explain (for instance, being “branded” with an

exploiter’s name on the neck, chest, or arms)

Gaps in life story or defensiveness in respons

to questions or concerns

Malnourishment

Untreated health and dental problems

• 

• 

• 

• 

• 

• e 

• 

• 

This list is not complete and more questions must 

be asked to determine if sex trafficking has occurred.

What Victims of Sexual Exploitation 

Need

Young victims of sex trafficking have experienced 

intense violence and psychological abuse. They 

need trauma-informed services that prevent them 

from experiencing additional harm to their safety 

and well-being while helping them to recover and 

heal.

A safe and secure environment. For exploited 

and trafficked young people, a major barrier to 

getting help is fear of reprisal from their exploiters. 

When reaching out to victims on the street or in 

other public places, talk to them away from others, 

particularly someone who seems controlling. 

Establish code words or signals they can use to 

let you know when to leave immediately or not 

approach. 

Similarly, during intake into a program and case 

management sessions, talk one-on-one and discuss 

safety issues upfront. Victims often know the best 

ways to keep themselves safe. Service providers 

must build a rapport with the youth in order to 

understand their needs and address emergency 

and basic needs first. 

If a young person is being placed into a housing 

program, don’t assume that your facility or 

neighborhood shelter is secure. Pimps and other 

exploiters may hang out near homeless youth 

shelters and group homes, aiming to recruit 

new victims. Discuss safety concerns with your 

supervisor or the manager of your local shelter or 

transitional living program. Work to create a facilitywide safety plan for all victims of commercial 

sexual exploitation and relationship violence. The 

plan should include how to respond to internal 

security risks and therapeutic response to these 

incidents. 

Extensive medical and dental care. Victims are 

often prevented by their victimizers from getting 

proper care. Many have injuries from beatings and 

rapes that were never properly treated. They also 

are at extremely high risk for sexually transmitted 

infections and should have a complete medical 

screening as soon as possible. You may want to 

accompany youth to appointments to ensure 

trauma-informed services are provided and that 
1 in 6

endangered runaways 

reported to NCMEC 

in 2014 were likely

sex trafficking victims2

In October 2015, FBI and local law 

enforcement conducted a four-day 

operation in 135 cities nationwide4:

child sex trafficking 

victims were 

recovered

149

150traffickers 

were 

arrested

70% to 90%

of commercially sexually 

exploited youth have 

experienced sexual abuse 

at their homes3

In a 2013 study, The Institute of 

Medicine found that

HOMELESSNESS

is the largest risk factor

for commercial 

sexual exploitation (CSE) 

and sex trafficking of minors.5

youth are comfortable disclosing their experiences 

of exploitation to health care providers.

Mental health services. Victims may have 

mental health problems such as post-traumatic 

stress disorder and complex PTSD. They may also 

have “traumatic bonding” with their exploiters, 

also known as Stockholm syndrome. Find 

professionals trained to deal with depression, 

anxiety, post-traumatic stress, and the impact of 

trauma and physical or sexual abuse. You might 

start by contacting members of the National Child 

Traumatic Stress Network.

An honest, nonjudgmental listener.

Victims of sexual exploitation are often fearful, 

mistrusting, and ashamed. To open up, they need 

someone who can listen to the details of their life 

compassionately and respond without judgment. 

Remember that relationships between victims 

and exploiters are often complex. Never badmouth 

the exploiter or tell the victim to “just leave.” Don’t 

expect the victim to tell you the full, true story 

right away, and never take it personally if they 

lie. You may want to ask a survivor advocate—

someone trained in crisis intervention and 

working with victims of sexual violence—to take 

on this role of listener or to be there when you talk 

to youth about the details of their exploitation.

Culturally appropriate services. Enlist the help 

of others who speak the victim’s language and 

understand his or her culture when providing 

services. Make sure that the organizations you 

refer victims to are culturally competent as well. 

Culturally competent services include the ability to 

meet victims where they are by providing services 

tailored to their needs.

2 The National Center for Missing & Exploited Children (NCMEC) 

3 Guidance to States and Services on Addressing Human Trafficking of Children and 

Youth in the United States

4 Federal Bureau of Investigation (FBI)

5 Institute of Medicine Report
Educational services and vocational and life 

skills training. Exploited youth often need a 

whole host of basic skills to help them make a new 

start. Discuss and plan educational and vocational 

opportunities with youth. Contact your local 

transitional living program, GED, or vocational 

training program. (Transitional living programs 

funded by the Family and Youth Services Bureau 

are listed on the FYSB website.) 

Community ties. Because victims have been 

so isolated from their families, friends, and 

communities, they often feel that going back to 

their exploiters is the only option. Reestablishing 

healthy social connections is crucial. Consider 

creating community connections with faith-based 

and housing organizations, schools and mentors to 

ensure healing and restoration of young victims.

Time. It can take months or even years for young 

people to understand their victimization and 

recognize that help is available. Victims can leave 

their trafficking situations and go back multiple 

times before finally making a permanent break, so 

don’t give up on them. And don’t expect victims to 

suddenly be “fixed.” They might need a very long 

time to begin to heal and establish stable lives for 

themselves. Let them know that you will offer 

support as long as they need it.

Help navigating the legal system. Trafficking 

victims may have criminal records or may be 

asked to testify against their traffickers. You can 

get more information about meeting victims’ 

legal needs from your local Legal Aid Society, the 

American Bar Association or the U.S. Department 

of Justice’s Office for Victims of Crime.

Considerations for Involving Law 

Enforcement and Family

If the young person gives permission, you 

can involve police and family any time. As you 

are building the young person’s treatment plan, 

you may need to include steps that will involve 

the appropriate law enforcement agencies, family 

members, and the courts. Work with family and law 

enforcement to take a victim-centered approach 

that holds exploiters—not victims—accountable. 

Work closely with the young person to 

understand his/her relationship with their family. 

You may want to discuss with them the possibility 

of informing family members if you believe 

their involvement would aid the young person’s 

recovery. However, it is important to involve the 

youth while making these decisions. If possible, 

please work with a multidisciplinary team to 

ensure a victim-centered approach while dealing 

with law enforcement. This team can include 

mental health providers and legal and victim 

advocates.
If the young person does not give permission,

what you do may depend on his or her age. If you 

are a “mandated reporter,” you may be legally 

required to inform the police about a victim who 

is a minor if you have enough information for local 

law enforcement to file a report. Remember to 

develop a plan before contacting law enforcement 

to ensure a trauma-informed approach will be 

used while working with law enforcement. For 

older youth who don’t want law enforcement to 

get involved, it may be hard to get police or the 

courts to help. However, youth still can receive 

services and assistance from your organization. 

If contacting family is part of the agreed-upon 

treatment plan or a condition for a youth to 

receive services from your agency, getting in 

touch with family members who could aid the 

young person’s recovery may still be necessary. 

Explain what information will be shared with the 

family. If you have only had a short relationship 

with the young person or he or she will only stay 

in your shelter for a few days, you might choose 

not to contact family or to wait until you have a 

stronger relationship with the victim and he or 

she has committed to a treatment plan.

Final Thoughts on Aiding Young 

Victims of Sex Trafficking

When working with a trafficked or exploited 

young person, don’t go it alone. The complete 

healing of a young survivor of trafficking requires 

collaboration. Be sure to communicate with your 

supervisor or program manager as well as with 

law enforcement, victims services professionals, 

and medical and mental health practitioners. Local 

task forces can provide additional support and 

increase capacity to serve victims.

Some Terms Used in Sex Trafficking

When working with victims of sexual exploitation, it helps to understand the language they may 

use. Definitions here are taken and adapted from “Domestic Sex Trafficking: The Criminal 

Operations of the American Pimp” by Polaris Project and “Renting Lacy: A Story of America’s 

Prostituted Children” by Linda Smith (via Shared Hope International).

Bottom: One of a group of victims under the control of an exploiter or pimp, the bottom helps 

the trafficker exert control over other victims.

Daddy: The term a pimp will often require his victim to call him.

Dates, johns, tricks: Pays or trades something of value for sex.

Facilitators: People or businesses that enable traffickers to exploit victims. Includes taxi 

drivers, hotel owners, and newspapers or websites where traffickers advertise.

Family or folk: Group of victims under the control of one exploiter or pimp.

The life: The experience of being used as a victim in prostitution.

Trafficker: (also known as pimp) Someone who receives money or something of value for the 

sexual exploitation of another person. 

Stroll or track: Places where street prostitution occurs.

Wife in law: Women or girls under the control of one pimp.
If you feel unprepared to help sexually exploited 

youth, consider finding training. The National 

Human Trafficking Resource Center offers 

training, online resources, and technical support 

to local communities.

Learn More

Reports

"Child Welfare and Human Trafficking," 

Child Welfare Information Gateway

“Commercial Sexual Exploitation of Children: What 

Do We Know and What Do We Do About It?” 

(PDF, 293KB), National Institute of Justice

“Confronting Commercial Sexual Exploitation and 

Sex Trafficking of Minors in the United States,” 

Institute of Medicine and National Research 

Council

“Guidance to States and Services on Addressing 

Human Trafficking of Children and Youth in the 

United States,” Administration on Children, Youth 

and Families, U.S. Department of Health and 

Human Services

“Study of HHS Programs Serving Human 

Trafficking Victims,” Office of the Assistant 

Secretary for Planning and Evaluation, U.S. 

Department of Health and Human Services

Resource Centers

National Human Trafficking Resource Center 

National Center for Missing & Exploited Children

Federal Bureau of Investigation’s Innocence Lost 

Initiative 

National Child Traumatic Stress Network

Get Help or Report the Exploitation 

of a Young Person

National Human Trafficking Hotline 

1-888-373-7888

Or text BeFree (233733)

Children of the Night 24-Hour Hotline 

1-800-551-1300

National Domestic Violence Hotline

1-800-799-SAFE

National Runaway Safeline 

1-800-RUNAWAY

Rape, Abuse, & Incest National Network, or 

RAINN 

1-800-656-HOPE

National Center for Missing & Exploited 

Children

1-800-THE-LOST (1-800-843-5678)

Bought and Sold: Recognizing and assisting 

youth victims of domestic sex trafficking 

was developed for the Family and Youth Services 

Bureau; Administration on Children, Youth and 

Families; Administration for Children and Families; 

U.S. Department of Health and Human Services by 

JBS International, Inc., under a contract to manage 

the National Clearinghouse on Families & Youth 

(NCFY).

For more information, please contact NCFY.

NCFY 

5515 Security Lane, Suite 800

North Bethesda, MD 20852

Phone: (301) 608-8098

Fax: (301) 587-4352

Email: ncfy@acf.hhs.gov