Commercial Sexual Exploitation of Youth
about this project
The Office of the Governor has funded this project to assess the landscape of prevention and treatment services for victims of minor sex trafficking victims in the state. As the need for these services continues to grow, our team is working to identify potential gaps and determine what supports are needed to serve this vulnerable population. Additional resources can be found directly through our statewide partners: Office of Governor Greg Abbott, Texas Department of Family and Protective Services, and Texas Health and Human Services.
If you or someone you know is a victim of human trafficking, find support through the National Human Trafficking Hotline.
peer reviewed literature

human trafficking victimization among youth who run away from foster care
Authors: Natasha E. Latzman, Deborah A. Gibbs, Rose Feinberg, Marianne N. Kluckman, & Sue Aboul-Hosn
This paper uses administrative data to describe the characteristics and experiences of a population of youth in the child welfare system considered to be at particularly high risk of victimization: youth who have run away from foster care. For most (70%) youth with a HT allegation during runaway status, the first identified trafficking allegation occurred during a foster care runaway episode. Most (67%) youth did not have another HT allegation up to a year later. Implications for research and child welfare policy and programs are discussed. Download here.
Authors: Thimna Klatt, Della Cavner & Vincent Egan
An academic article that examines and describes risk factors for victims of sexual exploitation, and for those who are at risk of involvement. The four factors that significantly predicted sexual exploitation are: running away, poverty, drug and/or alcohol use, and having friends or family members in prostitution. Download here.
Authors: Gail Hornor & Jennifer Sherfield
Academic resource that describes a study supporting the concept that "pediatric healthcare specialists should be better trained to identify and response to sexually exploited children and youth. These professionals should also in turn educate parents on their responsibility and ability to protect their children from sexual exploitation of any kind." Download here.
Authors: Makini Chisolm-Straker Jeremy Sze, Julia Einbond, James White & Hanni Stoklosa
Resource describes a study that "shows that homeless teens with a supportive adult in their life may have lower odds of being exploited through trafficking." Includes data collected from Nov. 2015- Feb. 2017 that support this claim, as well as an overview of other potential factors that may prevent sex trafficking among homeless youth. Download here.
Authors: Jennifer S. Middlelton, Maurice N. Gattis, Laura M. Frey & Dominique Roe-Sepowitz
Academic article that explores the unique vulnerabilities of at-risk youth experiencing homelessness to being sexuality exploited. Describes a convenience survey conducted in Kentucky and Indiana, that found that 41% of homeless youth were victims of sex trafficking. Includes findings that highlight the need for trauma-informed care for LGBTQ youth. Download here.
Author: Annie Corbett
The study design uniquely positioned the voices of survivors as experts in relation to expanding knowledge about the exiting process and in offering recommendations for youth-at-risk, family members, and providers. Contributions include underscoring the importance of bearing witness to youths' stories as part of resiliency/ recovery and valuing the complexities of family relationships/dynamics in the exiting process. Implications for advocacy, research, and practice are discussed. Download here.
Author: Jennifer Cole
This study examined how sex trafficking of male minors may differ or be similar to sex trafficking of female minors. Familial sex trafficking was one of the typical pathways into commercial sexual exploitation for minors. There were some differences in the pathways in sex trafficking by gender. There is a need for greater awareness, training, and resource-building for identifying and appropriately responding to male minors who are trafficked in commercial sex. Download here.
State and National reports

roadmap for texas communities to address child sex trafficking
This roadmap was developed in close collaboration between Meadows Mental Health Policy Instititue and the The Office of the Texas Governors Child Sex Trafficking Team (CSTT), with input from a variety of Child Sex Trafficking (CST) experts and local service providers. The purpose of this document is to provide communities with information, research, emerging practices, models, lessons learned, and resources to end CST. Intended audiences include but are not limited to leaders in law enforcement; schools; community and religious organizations; health care professionals; judges; and state, municipal, and county agencies. Download here.
The intersections of sex trafficking and child welfare bring significant social problems for children in foster care. This document by the US Department of Health and Human Serivices Administration for Children, Youth and Famlies introduces literature that supports child welfare interventions in sex trafficking; outlines the needs of sex trafficking survivors; discusses national coordination efforts to address the problem; informs on screening and assessment tools; meeting the needs of trafficking survivors; and addresses capacity issues for housing for survivors. Download here.
This toolkit serves as a framework and compilation of tools developed by the Ohio Network of Anti-Human Trafficking Coalitions taskforce, the Ohio Human Trafficking Commission and other resources created by federal and grassroots partners. The documents here are intended to support a victim-centered framework to assist survivors in communities. Download here.
This source complies key resources and tools, including the Building Child Welfare Response to Child Trafficking Handbook outlined in this publication. The handbook is a critical resource for state child welfare systems and other service provider settings. The goal for this publication and the tools within is to serve as a launching point for other organizations and agencies incorporating trafficking-specific policies and protocols into their work. Download here.
This report covers the prosecution of sex traffickers, protection of the populations at risk for trafficking, and the prevention of human trafficking throughout the world. The Department of State prepared this Report using information from U.S. embassies, government officials, nongovernmental and international organizations, published reports, news articles, academic studies, research trips to every region of the world, and information submitted to tipreport@state.gov. The US data begins on page 484. Download here.
This commissioned survey of over 8000 adult men is a large sampling. From an economics model perspective, the research intentionally exchanges the supply side of the equation, (more frequently studied) with the demand side, but their scope is a decidedly narrow focus. The full report has a number of graphic representations of the data depicting the data, which are very helpful in the interpretation of the data. The survey results reveal an identified gender bias in the research without a broader query of the demand. The biases are men only buy sex from women, and not from men or children. Additionally, no query was made of women who buy sex from men, women, or children. (See page 6 for their explanations.) Of the surveyed men, actively participating frequent buyers represent men with high incomes with an apparent perceived low risk of arrest and low likelihood of prosecution. Several key policy and legislative action items identified as a part of the survey results for addressing the demand, which are listed in the full report. Community action for changing local laws and ordinances to regulate illicit massage businesses in conjunction with reformation of the state laws focusing on the buyers with harsher penalties are among their recommendations. (See page 5.) Download here.
Victims of sex trafficking are found all over the United States, but often times the general public is not aware of how prevalent the problem is inside their home country. Particular factors that increase the likelihood of sexual exploitation include (but are not limited to): poverty, homelessness, previous sexual abuse, substance abuse, mental health concerns, domestic violence, runaway, involvement in Child Welfare and/or Juvenile Justice System, child abuse/neglect, and/or other types of trauma. Exploitation may be initiated by a romantic partner, a family member, an employer, or even a complete stranger. Victims often express some kind of emotional attachment to their exploiter, whether than be romantic or a belief that the exploiter is their only source of protection and/or income. Many victims come in contact with healthcare, law enforcement, and/or child welfare professionals during the period of their exploitation. Such front-line professionals should be better trained and prepared to recognize and respond to victims of sex trafficking. The report includes additional statistics about characteristics and experiences of sex trafficking survivors. This is an excellent starting point for source material on the topic of sex trafficking. Download here.
Human trafficking survivors do not typically find the traditional criminal justice systems punitive outcomes for traffickers to match their views of justice, favoring alternative approaches. Drawing from qualitative interviews with 80 survivors of sex and labor trafficking, this brief documents survivors experiences with and perceptions of alternative practices, including procedural, restorative, and transitional justice. Overall, respondents view restorative and transitional justice concepts as desirable and promising, suggesting that survivors could perceive greater justice if service providers and criminal justice incorporated these alternative forms of justice into their practices. Download here.
This report outlines The Texas Human Trafficking Prevention Task Force team deliverables and activities for 2018. Download here.
This study describes child sex trafficking in three regions across Texas using empirically grounded qualitative and quantitative research methods. It is intended to expand the body and depth of knowledge that can that can help anti-trafficking professionals better identify individuals at risk for, or experiencing, child sex trafficking. Download here.
Resources Identifying CSEY

Commercial sexual exploitation identification tool (CSE-IT)
WestCoast's Commercial Sexual Exploitation-Identification Tool is designed to improve early identification of children who are commercially sexually exploited. The CSE-IT is appropriate for use by any provider serving youth, including child welfare workers, probation officers, mental health clinicians, and first responders. This tool is prominently used by child welfare professionals throughout Texas and largely promoted by our state partners at Office of Texas Governor Greg Abbott, Texas Department of Family and Protective Services, and Texas Juvenile Justice Department.
Download the screening tool through WestCoast's website.
By: Massachusetts General Hospital Human Trafficking Initiative and Massachusetts Medical Society Committee on Violence Intervention and Prevention
Summary: The objectives of this guidebook are to educate health care providers about human trafficking, and to provide resources for patient referral and ongoing professional education. Achieving these objectives will support the larger goals of advancing both health care scholarship in the field, as well as the health care systems evolving contribution to global efforts directed at intervention, and ultimately, prevention of human trafficking. Download here.
Summary: This toolkit covers how to use child sex trafficking screening tools, appropriate questions to ask when screening survivors in the field, and other protocol for agencies who work with CST survivors. Download here.
By: Center for the Human Rights of Children, Loyola University Chicago
Provides a quick overview of the primary components included within the definition of human trafficking. It should not be used as the only method to determine if trafficking exists. However, this less comprehensive tool can provide an initial determination of the situation and guidance for moving forward.
Some service providers may use this tool exclusively, especially if the agency is not fully trained or prepared to provide more intensive case management for child trafficking victims. These agencies should refer the client to a trafficking-informed agency if trafficking is initially suspected and especially if the agency does not have the resources or training to serve the immediate and long-term needs of the client. Download here.
By: Vera Institute of Justice
Summary: This manual is intended primarily for victim service agency staff and other social service providers, who will administer the Trafficking Victim Identification Tool (TVIT) to clients who are potential trafficking victims. The manual content is based on results of research conducted by the Vera Institute of Justice, which collaborated with leading legal and victim services agencies in the United States, to produce the validated screening tool and best practices for identifying trafficked persons, and on other expert sources in government and non-governmental agencies. Veras research found that the TVIT instrument is highly reliable in predicting both labor and sex trafficking in women and men and among foreign- and U.S. born victims. The screening tool can be used in its short version (consisting of 16 core questions, plus questions specific to migration for the foreign-born) without loss of predictive ability, or in its longer form, depending upon the situation and purpose of screening. Download here.
By: Covenant House, New York
Summary: Because of the reluctance of young people to disclose their sex trafficking experiences, the Covenant House created this document to better identify trafficking victims in their care. The Applied Developmental Psychology Department at Fordham University helped the Covenant House develop and scientifically validate a screening tool to better identify trafficking victims among their youth. All results and recommendations from this process are found in this source. Download here.
By: Gretchen L. Zimmerman. PSY.D., Cynthia G. Olsen. M.D., and Michael E. Bosworth, D.O.
Summary: Helping patients change behavior is an important role for family physicians. Change interventions are especially useful in addressing lifestyle modification for disease prevention, long-term disease management and addictions. Understanding patient readiness to make change, appreciating barriers to change, and helping patients anticipate relapse can improve patient satisfaction during the change process. This article reviews the Transtheoretical Model of Change, also known as the Stages of Change model, and discusses its application to the family practice setting, although many of the recommendations offered are applicable to child welfare and serving survivors of child sex trafficking. They review the Readiness to Change Ruler and the Agenda-Setting Chart to show how these tools are implanted in the field. Download here.
By: Administration for Children & Families: Office on Trafficking in Persons & the National Human Trafficking Training and Technical Assistance Center
Summary: This Toolkit is a collection of new and existing resources that build organizational capacity to collaborate with and support staff, volunteers, and consultants who identify as survivor leaders. It is appropriate for use by anti-trafficking organizations, coalitions, task forces, volunteer programs, and other organizations who wish to improve collaboration with those impacted by human trafficking. Download here.
By: V. Jordan Greenbaum, M .D., Michelle S. Livings, M .P.H., Betty S. Lai, Ph.D., Laurel Edinburgh, M.S.N., A.P.R.N., Peggy Baikie, D.N.P., R.N., Sophia R. Grant, M .D., Jamie Kondis, M.D. Hillary W. Petska, M .D., M.P.H., Mary Jo Bowman, M .D., Lori Legano, M .D., Oriaku Kas-Osoka, M .D., and Shannon Self-Brown, Ph.D.
Summary: This studys purpose was to estimate the prevalence of child sex trafficking (CST) among patients seeking care in multiple healthcare settings and to evaluate a short screening tool to identify victims in a healthcare setting. A slightly modified version of a six-item screening tool shows promise in identifying victims of CST in a variety of healthcare set- tings primarily involving high-risk youth. Identification of exploited children by HCPs is critical for prevention and intervention efforts. The frequency of CST victims presenting for healthcare confirms the need for widespread training of clinicians regarding commercial sexual exploitation. Download here.
By: Jaclyn D. Houston-Kolnik, Nathan R. Todd, and Midge Wilson
Summary: This study presents the Sex Trafficking Attitudes Scale (STAS), assessing cognitive, behavioral, and affective attitudes toward the sex trafficking of women and girls. Results showed support for convergent validity as the subscales were associated with related measures. The STAS holds promise to expand research and inform efforts to support trafficking survivors. Download here.
By: Makini Chisolm-Straker, Jeremy Sze, Julia Einbond, James White, Hanni Stoklosa
Summary: The aim of this study was to develop a sensitive, brief, and user-friendly trafficking screening tool for homeless young adults. This study validated a new screening tool: the Quick Youth Indicators for Trafficking (QYIT). QYIT allows providers to screen for trafficking among homeless young adults. QYIT is the first highly sensitive, comprehensive trafficking screening tool that is truly brief and does not require a trafficking expert to administer. Use of QYIT at appropriate agencies will enable social service providers to systematically detect and serve homeless young adults who have labor and/or sex trafficking experiences. Download here.
By: Center for the Human Rights of Children Loyola University Chicago
The Comprehensive Screening and Safety Tool (CSST) should be employed after the Rapid Screening Tool (RST) for Child Trafficking if trafficking is suspected or conformed. The tool documents the scope, nature, severity, and impact of suspected cases of trafficking, assesses the childs safety, and helps to develop appropriate plans of action for case management and legal purposes. Download here.
STate and National Laws
TEXAS CHILD SEX TRAFFICKING LEGISLATIVE HISTORY
Legislative policy for child sex trafficking has a short, although robust history in Texas. The first mention of child sex trafficking in Texas legislation was in 2003. Texas was 1 of 2 states to have a specific statute for CSEY. In 2003, being arrested for trafficking was a 2nd degree felony and a 1st degree felony for CSEY under age 14. The laws in the beginning were new, and therefore limited in scope.
The 80th Texas Legislative Session in 2007 ushered in a dynamic year for CSEY policies. House Bill 1121 paved the way for harsher laws for those benefitting from trafficking, specified elements necessary for conviction, and required certain agencies to post CSEY hotline number for public view. Advocacy efforts in 2007 elevated the age for being convicted with a 1st degree felony from 14 years to 18 years. By increasing the age of conviction, the legislature decriminalized young survivors of CSEY.

A pivotal year for child sex trafficking legislation was 2011 during the 82nd Session. In this year, the legislature recategorized prostitution to decriminalize it for youth under 18 years old. In other words, kids under 17 could not be charged with prostitution according to Senate Bill 24. This decision followed a case study of a 13-year-old girl arrested for prostitution in Houston. After the case made it to the Texas Supreme Court, it was decided that a child under the age of 14 could not be charged for prostitution. The laws were moving away from penalizing survivors of sex trafficking to working with them on a path to recovery. Additionally, this session saw trafficking officially designated as a form of child abuse. In the same year, the legislature separated labor and sex trafficking; created mandatory sex trafficking registration for traffickers; and increased compelling a minor to 2nd degree felony.

The 83rd Legislature enhanced regulations for CSEY in 2013 by passing Senate Bill 92 and House Bill 8. These bills added trafficking to Crime Victim Compensation fund and heightened punishment for soliciting a child for prostitution to a
2nd degree felony. Lastly, the Trafficked Persons Program offers deferred adjudication and dismissal in the juvenile justice system to protect CSEY survivors judicial records.
Based on recommendations from the task force, the 84th Legislature recommended that there be a designated office to meet the states needs for combatting CSEY. As a result, two laws were passed announcing that the governors office would oversee the efforts to address CSEY. Nearly $5.5 million in funding was earmarked to OOG for grants and operational expenses for efforts to dismantle CSEY in Texas. In addition to this effort, CSEY prevention efforts were increased through legislation to help improve identification and to support law enforcement. Law enforcement received funds for specialized personnel including prosecutors, investigators, and analysists.
National Laws

the frederick douglas trafficking prevention and reauthorization act of 2018: 115th Congress
HR 2200: This bill includes authorizing the Department of Health and Human Services (HHS) to award grants to local educational agencies to establish programs to educate children on the dangers of human trafficking, implementing provisions to ensure that government spending is not used to support human trafficking, and authorizing funding for the National Human Trafficking Hotline. Learn more.
First Enacted in 2000 this bill created the national framework for the federal response to human trafficking. It has been reauthorized and updated five times and is centered on prevention, prosecution, and protection in terms of fighting sex trafficking and labor trafficking. Learn more.
S.1311: This legislation reauthorizes the Justice Department's Domestic Trafficking Victims Fund which provides more than $5 million a year to serve victims of human trafficking. Learn more.
S.1312: This law reauthorizes several grant programs within the Departments of Justice (DOJ), Health and Human Services (HHS), Labor (DOL), and State (DOS) that combat human trafficking. Learn more.