Skip to main content
SpringerLink
Log in

Review of the Literature on the Intersection of LGBTQ Youth and CSEC: More Than a Monolith

  • Published:
Current Pediatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review article delves into the critical issue of commercial sexual exploitation of children (CSEC), focusing on the intersection of CSEC with LGBTQ youth. It aims to shed light on the unique vulnerabilities faced by sexual minorities (SM) and transgender/gender diverse youth (TGD), challenging the tendency to homogenize the experiences of all sexual and gender minorities.

Recent Findings

The review reveals that LGBTQ youth, especially TGD individuals, are disproportionately affected by CSEC and have unique risk factors, including the causes homelessness, polyvictimization based on sexual and gender identities, and barriers to utilizing shelters and gaining employment. The review also highlights unique areas for potential prevention and resilience that is also unique within subsets of the LGBTQ community, including living authentically, accessing GAC with gender-affirming providers, and finding families of other LGBTQ peers who accept them.

Summary

This comprehensive review underscores the complexity of the intersection between LGBTQ youth and CSEC. By highlighting the unique vulnerabilities of sexual minorities and transgender/gender diverse youth, the review emphasizes the need to move beyond a broad understanding of the LGBTQ experience. It points out the gaps in current literature and the urgent need for targeted research to better comprehend the intricacies of CSEC risk factors and resilience mechanisms within these populations. Ultimately, the review urges for inclusive and targeted interventions to safeguard LGBTQ youth from the devastating impacts of commercial sexual exploitation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

CSE:

Commercial sexual exploitation

CSEC:

Commercial sexual exploitation of children

DMST:

Domestic minor sex trafficking

GAC:

Gender-affirming care

GM:

Gender minority

GMY:

Gender minority youth

GNC:

Gender nonconforming

LGBTQ:

Lesbian, gay, bisexual, transgender, queer, or questioning

MSM:

Men who have sex with men

SM:

Sexual minority

SMY:

Sexual minority youth

TGD:

Transgender and gender diverse

WHO:

World Health Organization

WPATH:

World Professional Association for Transgender Health

WSW:

Women who have sex with women

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Alessi EJ, Greenfield B, Manning D, Dank M. Victimization and resilience among sexual and gender minority homeless youth engaging in survival sex. J Interpers Violence. 2021;36(23-24):11236–59. An interesting qualitative study of LGBTQ youth who have engaged in CSEC that explores both predisposing factors as well as self-identified sources of resilience.

    Article  PubMed  Google Scholar 

  2. Arrington-Sanders R, Alvarenga A, Galai N, Arscott J, Wirtz A, Carr R, et al. Social determinants of transactional sex in a sample of young Black and Latinx sexual minority cisgender men and transgender women. J Adolesc Health. 2022;70(2):275–81. An interesting study focused on gay men and transgender women who identity as Black and Latinx that highlights the intersection of race and LGBTQ communities engagement with sexual exploitation.

    Article  PubMed  Google Scholar 

  3. Barral R, Kelley MA, Harrison ME, Svetaz MV, Efevbera Y, Bhave S, et al. Dismantling inequities in adolescent and young adult health through a sexual and reproductive health justice approach. Semin Reprod Med. 2022;40(01/02):131–45.

    Article  PubMed  Google Scholar 

  4. Basson D, Rosenblatt E, Haley H. Research to action: sexually exploited minors (SEM) needs and strengths. Oakland, CA: West-Coast Children’s Clinic; 2012.

    Google Scholar 

  5. Bounds DT, Otwell CH, Melendez A, Karnik NS, Julion WA. Adapting a family intervention to reduce risk factors for sexual exploitation. Child Adolesc Psychiatry Ment Health. 2020;14:8.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bounds DTPP-BC, Rodrigues SMBSNRN, Milburn NGP. Strengthening families to disrupt intergenerational health inequities with adolescents at risk for commercial sexual exploitation, substance use, and HIV. Am J Public Health. 2023;113(2):S124–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Busza J, Matambanadzo P, Phiri L, Meki B, Cowan FM. HIV prevention in individuals engaged in sex work. Curr Opin Infect Dis. 2023;36(1):1–8.

    Article  PubMed  Google Scholar 

  8. Boswell K, Temples HS, Wright ME. LGBT youth, sex trafficking, and the nurse practitioner’s role. J Pediatr Health Care. 2019;33(5):555–60. This article highlighted ways medical professionals could better support LGBTQ youth engaged in CSEC.

    Article  PubMed  Google Scholar 

  9. Chohaney ML. Minor and adult domestic sex trafficking risk factors in Ohio. J Soc Soc Work Res. 2016;7(1):117–41.

    Article  Google Scholar 

  10. Cole T. Mental health difficulties and children at risk of exclusion from schools in England. Report. 2015. Retrieved from https://citeseerx.ist.psu.edu/viewdoc/download. Accessed July 2023

  11. Deal C, Doshi RD, Gonzales G. Gender minority youth experiencing homelessness and corresponding health disparities. J Adolesc Health. 2023;72(5):763–9. https://doi.org/10.1016/j.jadohealth.2022.11.229.

    Article  PubMed  Google Scholar 

  12. Diaz A, Arden M, Blaustein S, Nucci-Sack A, Sanders L, Steever J. Using school-based health programs to prevent human trafficking: the Mount Sinai experience. Annals of Global Health. 2021;87(1):1–7. This article describes an innovative approach of using school-based health programs to increase adolescent access to healthcare including reproductive care.

    Article  Google Scholar 

  13. Eastwood EA, Nace AJ, Hirshfield S, Birnbaum JM. Young transgender women of color: homelessness, poverty, childhood sexual abuse and implications for HIV care. AIDS Behav. 2021;25(Suppl 1):96–106.

    Article  PubMed  Google Scholar 

  14. Ertl S, Bokor B, Tuchman L, Miller E, Kappel R, Deye K. Healthcare needs and utilization patterns of sex-trafficked youth: missed opportunities at a children’s hospital. Child Care Health Dev. 2020;46(4):422–8.

    Article  PubMed  Google Scholar 

  15. Fisher MR, Turner C, McFarland W, Breslow AS, Wilson EC, Arayasirikul S. Through a different lens: occupational health of sex-working young trans women. Transgend Health. 2023;8(2):200–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Franchino-Olsen H. Vulnerabilities relevant for commercial sexual exploitation of children/domestic minor sex trafficking: a systematic review of risk factors. Trauma Violence Abuse. 2021;22(1):99–111.

    Article  PubMed  Google Scholar 

  17. Goldman S, Goyal D. Knowledge regarding child victims of commercial sexual exploitation and the feasibility of using a smartphone application: a pilot study. J Forensic Nurs. 2019;15(2):103–9.

    Article  PubMed  Google Scholar 

  18. Greenbaum VJ. Commercial sexual exploitation and sex trafficking of children in the United States. Curr Probl Pediatr Adolesc Health Care. 2014;44(9):245–69. https://doi.org/10.1016/j.cppeds.2014.07.001.

    Article  PubMed  Google Scholar 

  19. Greenbaum J. A public health approach to global child sex trafficking. In: Fielding JE, editor. Annual Review of Public Health, vol. 412020. p. 481–97. This article offers a good overview of CSEC and CSEC prevention through a public health lens with attention both to the magnitude of the problem as well as suggested solutions.

  20. Greenbaum J, Kaplan D, Young J. Council child abuse N, council immigrant child family H. Exploitation, labor and sex trafficking of children and adolescents: health care needs of patients. Pediatrics. 2023;151(1). This article offers a useful overview of human trafficking of children with time dedicated to specific high risk groups including LGBTQ and migrant children.

  21. Greenbaum J, Stoklosa H, Murphy L. The public health impact of coronavirus disease on human trafficking. Front Public Health. 2020;29(8).

  22. Greenfield B, Alessi EJ, Manning D, Dato C, Dank M. Learning to endure: a qualitative examination of the protective factors of homeless transgender and gender expansive youth engaged in survival sex. Int J Transgend Health. 2021;22(3):316–29. This article offers interesting and important insights into areas of resilience for transgender and gender expansive youth engaged in CSEC.

    Article  PubMed  Google Scholar 

  23. Hampton MD, Lieggi M. Commercial sexual exploitation of youth in the United States: a qualitative systematic review. Trauma Violence Abuse. 2020;21(1):57–70.

    Article  PubMed  Google Scholar 

  24. Hill BJ, Motley DN, Rosentel K, VandeVusse A, Fuller C, Bowers SME, et al. Employment as HIV prevention: an employment support intervention for adolescent men who have sex with men and adolescent transgender women of color. Jaids-J Acquir Immune Defic Syndr. 2022;91(1):31–8.

    Article  Google Scholar 

  25. Hill BJ, Motley DN, Rosentel K, VandeVusse A, Garofalo R, Kuhns LM, et al. Work2Prevent, an employment intervention program as HIV prevention for young men who have sex with men and transgender youth of color (phase 3): protocol for a single-arm community-based trial to assess feasibility and acceptability in a real-world setting. JMIR Res Protoc. 2020;9(9):e18051.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Hill BJ, Motley DN, Rosentel K, VandeVusse A, Garofalo R, Schneider JA, et al. An employment intervention program (Work2Prevent) for young men who have sex with men and transgender youth of color (phase 1): protocol for determining essential intervention components using qualitative interviews and focus groups. JMIR Res Protoc. 2020;9(8):e16384.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hill BJ, Motley DN, Rosentel K, VandeVusse A, Garofalo R, Schneider JA, et al. An employment intervention program (Work2Prevent) for young men who have sex with men and transgender youth of color (phase 2): protocol for a single-arm mixed methods pilot test to assess feasibility and acceptability. JMIR Res Protoc. 2020;9(8):e16401.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hogan KA, Roe-Sepowitz D. LGBTQ+ homeless young adults and sex trafficking vulnerability. J Human Traffick. 2020; https://doi.org/10.1080/23322705.2020.1841985.

  29. Hounmenou C, O’Grady C. A review and critique of the US responses to the commercial sexual exploitation of children. Children Youth Services Rev. 2019;98:188–98.

    Article  Google Scholar 

  30. Hurst IA, Abdoo DC, Harpin S, Leonard J, Adelgais K. Confidential screening for sex trafficking among minors in a pediatric emergency department. Pediatrics. 2021;147(3)

  31. Hurst TE. Prevention of child sexual exploitation: insights from adult survivors. J Interpersonal Violence. 2021;36(13-14):NP7350–72.

    Article  Google Scholar 

  32. James D, Khadr S. New challenges in child protection. The child protection practice manual: training practitioners how to safeguard children. 2016;14:11.

  33. Martin L, Rider GN, Johnston-Goodstar K, Menanteau B, Palmer C, McMorris BJ. Prevalence of trading sex among high school students in Minnesota: demographics, relevant adverse experiences, and health-related statuses. J Adolesc Health. 2021;68(5):1011–3.

    Article  PubMed  Google Scholar 

  34. McCann E, Brown M. Homelessness among youth who identify as LGBTQ+: a systematic review. J Clin Nurs. 2019;28(11-12):2061–72.

    Article  PubMed  Google Scholar 

  35. Moore JL, Goldberg AP, Barron C. Substance use in a domestic minor sex trafficking patient population. Pediatr Emerg Care. 2021;37(4):E159–62.

    Article  PubMed  Google Scholar 

  36. Moore JL, Houck C, Barron CE, Goldberg AP. Patients referred for domestic minor sex trafficking: a comparison of confirmed and suspected youth. J Pediatr Adolesc Gynecol. 2019;32(6):628–32. This article focused on high risk male youth seen in a child abuse clinic to uncover shared characteristics among those engaged or suspected to be engaged in CSEC.

    Article  PubMed  Google Scholar 

  37. Moore J, Fitzgerald M, Owens T, Slingsby B, Barron C, Goldberg A. Domestic minor sex trafficking: a case series of male pediatric patients. J Interpers Violence. 2021;36(23-24):11728–42.

    Article  PubMed  Google Scholar 

  38. Moynihan M, Mitchell K, Pitcher C, Havaei F, Ferguson M, Saewyc E. A systematic review of the state of the literature on sexually exploited boys internationally. Child Abuse Negl. 2018;76:440–51. https://doi.org/10.1016/j.chiabu.2017.12.003.

    Article  PubMed  Google Scholar 

  39. Newcomb ME, Hill R, Buehler K, Ryan DT, Whitton SW, Mustanski B. High burden of mental health problems, substance use, violence, and related psychosocial factors in transgender, non-binary, and gender diverse youth and young adults. Arch Sex Behav. 2020;49:645–59.

    Article  PubMed  Google Scholar 

  40. Noor MN, Bryant J, de Wit J, Holt M. Resourcefulness of homeless young people who practise sex work in Pakistan: a qualitative study. Sex Health. 2021;18(5):378–84. This article added to a small but important body of work focused on areas of resilience and strength among homeless youth and young adults engaged in sex work.

    Article  PubMed  Google Scholar 

  41. Ormiston CK. LGBTQ youth homelessness: why we need to protect our LGBTQ youth. LGBT Health. 2022;9(4):217–21.

    Article  PubMed  Google Scholar 

  42. Panda P, Garg A. Modern-day slavery in our health care system: an advocacy journey. Pediatrics., 144. 2019;(4)

  43. Panda P, Garg A, Lee S, Sehgal AR. Barriers to the access and utilization of healthcare for trafficked youth in the United States. Child Abuse Negl. 2021;121:105259.

    Article  PubMed  Google Scholar 

  44. Reid GM, Holt MK, Bowman CE, Espelage DL, Green JG. Perceived social support and mental health among first-year college students with histories of bullying victimization. J Child Family Stud. 2016;25:3331–41.

    Article  Google Scholar 

  45. Rhoades H, Rusow JA, Bond D, Lanteigne A, Fulginiti A, Goldbach JT. Homelessness, mental health and suicidality among LGBTQ youth accessing crisis services. Child Psychiatry Hum Dev. 2018;49:643–51.

    Article  PubMed  Google Scholar 

  46. Srivastava A, Rusow JA, Holguin M, Semborski S, Onasch-Vera L, Wilson N, et al. Exchange and survival sex, dating apps, gender identity, and sexual orientation among homeless youth in Los Angeles. J Prim Prev. 2019;40(5):561–8. This article explored online sexual exploitation trends among youth differentiated by gender and sexual identities.

    Article  PubMed  Google Scholar 

  47. Talbott JMV, Dutcher JS, Pougnier CA, Calvin SL, Roe-Sepowitz D, Kling JM. Review of published curriculum on sex trafficking for undergraduate medical trainees. Am J Prev Med. 2020;58(4):604–11. This review article explored literature supporting the importance of medical trainees education on CSEC as a means to better identify and serve these pediatric patients.

    Article  PubMed  Google Scholar 

  48. Hottes TS, Bogaert L, Rhodes AE, Brennan DJ, Gesink D. Lifetime prevalence of suicide attempts among sexual minority adults by study sampling strategies: a systematic review and meta-analysis. Am J Public Health. 2016;2016:106.

    Google Scholar 

  49. Trevor Project. Homelessness and housing instability among LGBTQ youth. Thetrevorproject.org. Published Feb 3, 2022. .

  50. Trinidad AC. Double-edged sisterhoods: transgender identity, peer groups and the commercial sexual exploitation of transgender girls. J Child Sex Abus. 2022;31(8):948–66. This article focused on transgender youth experiences with trafficking and the complicated role transgender mentors play in the lives of transgender youth engaged in CSE.

    Article  PubMed  Google Scholar 

  51. Van Ouytsel J, Walrave M, Ponnet K. An exploratory study of transactional sexting among high school students. J Adolesc Health. 2020;66(4):510–3. This article explored online sexual exploitation trends among youth differentiated by gender and sexual identity.

    Article  PubMed  Google Scholar 

  52. Wallace C, Greenbaum J, Albright K. Global perspectives on the health and social impacts of child trafficking. Pediatrics. 2022;150(4)

  53. Whaling KM, der Sarkissian A, Sharkey J, Akoni LC. Featured counter-trafficking program: resiliency interventions for sexual exploitation (RISE). Child Abuse Negl. 2020;100:104139. This article described a program focused on female and LGB/TGN youth to support them through a multidisciplinary team approach.

    Article  PubMed  Google Scholar 

  54. Wood LCN. Child modern slavery, trafficking and health: a practical review of factors contributing to children’s vulnerability and the potential impacts of severe exploitation on health. Bmj Paediatr Open. 2020;4(1)

Download references

Funding

No funding was secured for this study.

Author information

Authors and Affiliations

  1. Seattle Children’s Hospital, Seattle, WA, USA

    Emily Georges

  2. University of Washington, Seattle, WA, USA

    Emily Georges

  3. Department of Pediatrics, 4500 Sand Point Way, Suite 240, NE, Seattle, WA, 98105, USA

    Emily Georges

Authors
  1. Emily Georges
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emily Georges.

Ethics declarations

Conflict of Interest

The author has no conflicts of interest to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Georges, E. Review of the Literature on the Intersection of LGBTQ Youth and CSEC: More Than a Monolith. Curr Pediatr Rep 11, 105–115 (2023). https://doi.org/10.1007/s40124-023-00302-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40124-023-00302-6

Keywords

Search

Navigation