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Lisa Black


Health care providers can work with community partners to offer evidence-based medical screening, treatment and holistic services to individuals who have experienced labor or sex trafficking and exploitation.

Itasca, IL--The American Academy of Pediatrics has updated a clinical report, “Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients,” to help physicians recognize and assist children and teens who are subjected to or at risk for trafficking or exploitation.

The clinical report, published in the January 2023 Pediatrics (published online Dec. 19) indicates that measures undertaken to control viral spread during the COVID-19 pandemic – while critical for public health – also may have led to unintended consequences that increased the risks of trafficking and exploitation.

“During COVID-related lockdowns and travel restrictions, children and families were isolated and many suffered income loss, which can increase their vulnerability to exploiters and traffickers,” said Jordan Greenbaum, MD lead author of the report, written by the Council on Child Abuse and Neglect and Council on Immigrant Child and Family Health.

“What is especially challenging for healthcare professionals is that individuals experiencing trafficking or exploitation may not perceive themselves as being exploited or may be reluctant to disclose their situation to medical staff. This makes it difficult to recognize children and adolescents in need. The AAP advises that all pediatric care providers and staff adopt a trauma-informed, culturally responsive approach without judgment or pressure in working with this vulnerable population.”

Child sex trafficking is considered a subset of forced labor, with global estimates of approximately 3.3 million children and adolescents experiencing forced labor in 2021, according to the International Labour Organization. Of those, approximately 1.7 million children and teens were subjected to commercial sexual exploitation. Reliable national prevalence data for child labor and sex trafficking in the United States are not yet available, according to the clinical report.

Those at high risk of being exploited for labor or sex include children and adolescents with unstable housing, or who are missing from care, unaccompanied immigrant youth, minors belonging to marginalized groups (e.g., LGBTQ+; BIPOC) and those coming from families experiencing violence, mental illness, or substance use disorders. Children and adolescents living in resource-poor communities and/or in areas where exploitation is common are at increased risk, as well.

The report summarizes potential red flags for trafficking and exploitation, discusses screening tools, and provides detailed information for medical evaluation and aftercare.

“Physicians can play a vital role in offering critical services to vulnerable and exploited children and adolescents,” Dr. Greenbaum said. “An important first step is to develop trusting, respectful relationships with patients who need to feel safe and supported.”

For an embargoed copy of the clinical report or interview with an author, contact AAP Public Affairs.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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