Editor’s Note: Dr. Tasia Isbell (she/her/hers) is a third-year pediatric resident physician in the Leadership in Equity and Advocacy Track at the Boston Combined Residency Program at Boston Children's Hospital and Boston Medical Center. She is passionate about medical education, social determinants of health, and community engagement. She is pursuing a career in general pediatrics post-residency. – Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics
Child and adolescent sex trafficking is a major public health concern in the United States and around the world.
Adverse effects of sex trafficking on the physical and mental health of children and teens have been well documented and include, but are not limited to:
- Post-traumatic stress disorder (PTSD)
- Depression
- Anxiety disorders
- Behavioral problems (eg, oppositional behavior, aggression)
- Sexual assault
- Physical injury
- Infection (sexually transmitted infections, HIV/AIDS, tuberculosis)
- Substance misuse
- Malnutrition
- Unintended pregnancy
Children and teens who experience sex trafficking may present to their pediatricians for medical care but may also need help with a variety of unmet social needs, such as housing and education. It is important to note that children and teens who have experienced sex trafficking often have risk factors that contribute to their vulnerability, including:
- Being unhoused or having run away from home
- History of sexual or physical abuse
- History of neglect
- Familial dysfunction (eg, caregiver substance misuse, intimate partner violence, untreated psychiatric conditions)
- Substance use
- Mental/behavioral health problems
- Learning disabilities
The factors at play in the trafficking of children and teens are complex and require creative trauma-informed public health approaches to address the psychosocial and medical needs of this population.
In an Advocacy Case Study and video abstract entitled, “Integrating Social Care into a Specialized Medical Home for Sex-Trafficked Youth,” which is being early released in Pediatrics, Dr. Anish Raj and colleagues from the Children’s Hospital of Philadelphia and the University of Pennsylvania describe a specialized medical home for sex-trafficked youth called the Adolescent Protection Collaborative (APC) (10.1542/peds.2023-062394). The APC model is the first of its kind to integrate a child abuse pediatrician into a primary care setting alongside adolescent medicine physicians and social workers to address the needs of the “whole patient.” This model recognizes that trafficking does not occur in a vacuum but rather requires pediatricians to address both the unique medical and social needs of sex-trafficked youth.
In reflecting on the APC model, I am inspired to integrate a more comprehensive, trauma-informed approach into my own pediatric practice. Recognizing the intricate interplay of medical and social factors, especially for sex-trafficked youth, we as pediatricians can learn from Dr. Raj and colleagues the importance of prioritizing the whole patient.
