The hidden suffering of countless children and teens in the United States is not just an overseas tragedy—it lives among us in cities, suburbs, and rural towns alike. The issue of human trafficking and exploitation of young people is a pressing and profoundly disturbing crisis that demands the urgent attention of the public, healthcare professionals, educators, policy-makers, and the broader community.
While many people associate human trafficking with distant countries or dramatic kidnappings, the reality is far more nuanced and pervasive, deeply woven into the social fabric of everyday American life. Children and adolescents, especially those in vulnerable situations, are being coerced, manipulated, and exploited for both labor and sex, often under the radar of those who might otherwise help them.
A recent policy statement released by the American Academy of Pediatrics (AAP), published in the July 2025 issue of Pediatrics, calls for a sweeping change in how society recognizes and responds to these heinous acts. The document emphasizes the necessity of a comprehensive public health approach to identify and care for victims of child trafficking and exploitation. Despite significant strides in awareness over the past decade, major gaps remain—particularly in terms of training, education, and resources for healthcare providers and community workers who may be in a position to intervene. The disparities are especially stark in rural communities, where access to specialized training or social services can be extremely limited. This lack of infrastructure contributes to ongoing cycles of trauma and abuse that many children are unable to escape.
Dr. Jordan Greenbaum, a leading author of the policy statement, articulates the importance of collaboration and vigilance in addressing this issue. He describes how trafficked children and teens may appear to live ordinary lives on the surface, participating in jobs such as domestic service, construction labor, and even door-to-door sales. Beneath these seemingly mundane roles, however, lies a far darker truth—these children may be subject to forced criminal activity or sexual exploitation, robbed of their rights and stripped of their dignity. What makes their plight so insidious is that it often hides in plain sight, evading even the most well-meaning adults and professionals who may not know what signs to look for or how to respond safely and effectively.
The AAP’s statement builds on prior clinical recommendations published in 2023, aiming to bridge the divide between policy and practice. One of its central themes is the need for training healthcare professionals to recognize indicators of exploitation using a culturally sensitive, trauma-informed, rights-based approach that prioritizes patient-centered care. Children who are trafficked typically suffer from a range of serious health issues that go beyond the visible injuries. These may include sexually transmitted infections, unwanted pregnancies, malnutrition, substance abuse, post-traumatic stress disorder, and deep psychological trauma. Many victims also present with chronic anxiety, depression, and dissociative symptoms that are often misdiagnosed or dismissed.
The scope of the problem is staggering. On a global scale, it’s estimated that over 3 million children and teens were engaged in forced labor—including commercial sexual exploitation—as recently as 2021. In the United States, the figures among runaway and homeless youth are particularly harrowing. Various studies suggest that between 7% and 26% of these young people experience sex trafficking, while labor trafficking affects anywhere from 5% to 54% of this vulnerable group. These numbers are likely conservative, given the underreporting and fear of disclosure that characterizes these cases. Victims often suffer in silence, too fearful of retribution or too mistrustful of authority to seek help.
The distinction between labor exploitation and labor trafficking is important yet often misunderstood. Labor exploitation occurs when a child is treated unfairly or subjected to unsafe or degrading conditions in a work environment. Labor trafficking, on the other hand, involves the use of force, fraud, or coercion to compel a minor into work, often in dangerous or illegal conditions. Sex trafficking, as defined by U.S. federal law, includes any commercial sex act involving a minor, regardless of whether force, fraud, or coercion can be proven. This definition is crucial because it recognizes the inherent vulnerability of minors, who by law cannot consent to such acts. Child sex trafficking can take place both online and offline, and frequently involves the production and distribution of child sexual abuse materials—another deeply harmful aspect of exploitation that continues to proliferate in the digital age.
The rise of internet accessibility, global instability, and natural disasters has only increased the vulnerability of at-risk youth. Factors such as poverty, family dysfunction, domestic violence, and homelessness serve as catalysts for exploitation. As Dr. Dana Kaplan, co-author of the AAP statement, notes, undocumented youth are at particularly high risk. Their uncertain legal status, coupled with fears of deportation or distrust of government institutions, often makes them hesitant to report abuse or seek help. Many lack the necessary support systems or legal protections to break free from their exploiters, leaving them caught in a web of silence and fear.
Healthcare providers are in a unique position to recognize signs of trafficking and exploitation, but many lack the training or institutional support to respond effectively. A child presenting with signs of chronic abuse, recurrent sexually transmitted infections, anxiety, or unexplained injuries may be experiencing trafficking, but without adequate guidance, the red flags are often missed. Even worse, some children may be penalized for behaviors or symptoms directly resulting from their trauma—such as drug use or running away—rather than being offered compassionate care and support. The AAP underscores the importance of avoiding re-traumatization and instead recommends an approach grounded in dignity, empathy, and medical ethics.
Beyond medical intervention, there is a critical need for community-based solutions. Schools, churches, nonprofit organizations, and law enforcement agencies all have a role to play in prevention and recovery. Public awareness campaigns, youth empowerment programs, and trauma-informed training for educators and law enforcement officers can go a long way in building a safety net for at-risk youth. Prevention must also include broader socio-economic reforms aimed at reducing poverty, improving access to housing, and addressing systemic inequities that leave certain populations more exposed to abuse.
The stigma associated with trafficking also presents a barrier to recovery. Many victims feel intense shame or blame themselves for their experiences, particularly if they were manipulated by someone they trusted. Traffickers often use psychological tactics such as gaslighting, love bombing, or threats against family members to maintain control. As a result, survivors may not identify themselves as victims or may even resist assistance out of fear or loyalty to their abusers. Understanding this complex psychological landscape is essential to designing effective recovery and rehabilitation programs.
The digital landscape poses additional challenges. With the proliferation of social media, messaging apps, and encrypted platforms, traffickers now have easier access to potential victims and can groom children without ever meeting them in person. Sextortion, the practice of threatening to release sexual images unless a child complies with demands, is on the rise and often serves as a gateway to further exploitation. Law enforcement agencies are frequently outpaced by technology, and without the cooperation of tech companies, investigations can be slow or ineffective. Stronger regulation of digital platforms, combined with education on online safety, is necessary to protect children from virtual lures that lead to real-world harm.
Efforts to combat trafficking must also address the long-term needs of survivors. Emergency shelters, medical treatment, and legal aid are critical in the immediate aftermath, but true recovery requires sustained, wraparound services. This includes mental health counseling, educational support, vocational training, and stable housing. Survivors often face legal complications, such as expungement of criminal records for acts committed under coercion. Advocacy groups have long pushed for policy reforms that recognize the unique circumstances of trafficked children, ensuring that the law does not further victimize them.
International cooperation is also essential, as trafficking often involves cross-border networks. The movement of children between countries—whether through smuggling, coercion, or deception—requires coordination between immigration officials, child welfare agencies, and law enforcement at all levels. Comprehensive immigration reform that includes protections for child victims can help dismantle the pathways traffickers exploit while offering safe harbor to those in need.
One of the most critical components of combating trafficking is sustained investment in research and data collection. Accurate statistics are difficult to obtain due to the clandestine nature of trafficking, yet without data, it is impossible to measure progress or identify emerging trends. Funding must be directed toward longitudinal studies that examine risk factors, successful interventions, and survivor outcomes over time. Only by understanding the full scope of the problem can society respond with strategies that are both effective and humane.
In the end, the fight against human trafficking and the exploitation of children is not just a matter of policy—it is a moral imperative. Every child deserves a life free from fear, abuse, and exploitation. The AAP’s policy statement is a call to action for everyone involved in the lives of children—from parents and teachers to healthcare providers and legislators. It demands that society recognize these children not as criminals or delinquents but as victims of unimaginable cruelty who deserve compassion, care, and justice.
While the path forward is complex and filled with challenges, there is hope in coordinated, evidence-based action. By empowering professionals, supporting survivors, reforming policies, and raising public awareness, we can begin to dismantle the systems that allow trafficking to flourish. This is not a task for one organization or agency alone—it requires the collective will of a society that values the rights and dignity of every child. Only then can we begin to restore what has been taken and build a future where exploitation has no place.