U.S. is a hub of human trafficking, along with Mexico and Honduras, and children are increasingly vulnerable due to a variety of societal factors
ITASCA, IL—The American Academy of Pediatrics calls for increased awareness, public policies, training and education about children and teens who are exploited and trafficked for labor and sex in the United States.
An AAP policy statement, “Human Trafficking and Exploitation of Children and Adolescents,” published in the July 2025 Pediatrics, recommends using a public health approach to identify and care for young people who have experienced trafficking and its many adverse health effects. The statement, published online June 23, observes that a lack of support for training and resources remains a significant challenge, particularly in rural communities.
“These children live among us, sometimes working in jobs such as domestic help, construction work, and door-to-door sales. They may be involved in illicit activities, including commercial sex and forced criminality,” said Jordan Greenbaum, MD, a lead author of the statement. “What we know is that besides more research and advocacy, there is a need for community members to work collaboratively to provide safety, medical attention and other basic services to these vulnerable kids.”
The AAP Council on Child Abuse and Neglect and AAP Section on Global Health wrote the policy statement, which serves as a companion piece to clinical recommendations published in 2023. Policy statements and clinical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.
The AAP recommends training health care providers to recognize possible signs of exploitation and to intervene using a culturally responsive, trauma-informed, rights-based, and patient-centered approach.
Children who have been trafficked are at higher risk of traumatic injuries, either work-related or inflicted; sexually transmitted infections; unwanted pregnancy and associated complications; malnutrition, dehydration, exposure; substance misuse; post-traumatic stress disorder; depression and anxiety disorders.
Globally, more than 3 million children and adolescents were involved in forced labor (including commercial sex) in 2021. Among runaway and homeless youth in the US, rates of sex trafficking range from about 7%-26%, and labor trafficking from 5-54%. Child labor exploitation occurs when a child is treated unfairly in the context of work; labor trafficking involves a person using force, fraud, or coercion to compel the minor to work.
According to U.S. federal law, child sex trafficking involves commercial sex acts (sexual activity for which there is an exchange of something of value) with individuals younger than 18 years and does not require demonstration of force, fraud or coercion. It may occur on or offline and includes the production and distribution of child sexual abuse materials.
Child trafficking and exploitation are associated with numerous risk factors involving the child, family and peers, community and society at large. Vulnerability is exacerbated with global pandemics, climate change and environmental disasters, and with increased internet accessibility.
“Poverty, family violence and homelessness are just a few factors that increase vulnerability to exploitation and trafficking," said Dana Kaplan, MD, FAAP, co-author of the statement. “Undocumented youths represent another group at high risk for exploitation; many may be too fearful or uncertain to disclose, seek help, or engage with authorities due to concerns about safety, mistrust, or potential legal consequences.”
“Many of these children experience significant physical and mental health issues,” said Dr. Greenbaum. “There are many ways we can help, starting with professional education, increased awareness and advocacy for victim services.”
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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.