TRISTAN'S MOON

And Boys, TOO


An ECPAT-USA discussion paper about the lack of recognition of the commercial sexual exploitation of boys in the United States

rECommEndATions (2013)

  1. Acknowledge the existence of CSE boys and young men, their risk for physical and mental health harm, and their need for services. Include both GBTQ and heterosexual boys with attention to their different circumstances and needs.
  2. Raise awareness among local and federal law-enforcement officers and foster-care agencies that boys in the sex trade are victims whose fear of stigma and rejection exacerbates their denial and prevents them from acknowledging their victimization.
  3. Establish screening and intake systems for CSE boys at runaway and homeless youth centers and social service agencies, and conduct sensitivity training of workers to recognize CSEB and to elicit information from boys and to address shame and stigma.
  4. Support the establishment of male-focused anti-trafficking agencies with staff trained to meet the need to CSE boys. 
  5. When appropriate, encourage agencies and service providers that focus on girls to expand their mandate to include boys, and hire and train male workers.
  6. Encourage collaboration among organizations that already address CSE boys and young men, and to advocate for wider recognition among law enforcement, public health community, policy makers and the public of their existence and harm to CSE boys.
  7. Conduct further research on LGBTQ youth on advantages and disadvantages of gender-specific or co-ed service agencies. 
  8. Conduct research about the health impact of sexual exploitation on boys and young men.
  9. Revise existing statutes to make it easier to prosecute exploiters of children even when there is no pimp or trafficker involved.

This study was designed by Brian Willis, JD, MPH, Health Advisor to ECPAT-USA and carried out by Norene Robert and Brian Willis. The report is written by Sara Ann Friedman, adapted from Norene Roberts’ paper “The Commercial Sexual Exploitation of Boys and Young Men in the United States.”

We are extremely grateful to the 40 informants who took the time to answer survey questions. We are also indebted to the experts who read the draft study and gave substantive content.

Copyright ©ECPAT-USA 2013

And Boys Too

Needed: A Spotlight on Commercial Sexual Exploitation of Boys

Many youth talked at length about the shame, stigma, degradation and loneliness that they felt. They added that being labeled and stigmatized by their family, peers, and society overall, left them with low self-esteem and self-worth, which often resulted in an inability to leave “the life.” Beside the self-loathing that they experienced from participating in CSEC markets, one of the youths’ biggest dislikes was providing sexual services to strangers, and the risk of being raped or killed weighed most on their minds.

The Commercial Sexual Exploitation of Children in New York City, 2008

ExECUTivE sUmmAry

The long-existing commercial sexual exploitation of children (CSEC) in the United States began to gain attention after the enactment of the Trafficking Victims Protection Act of 2000 (TVPA) and its reauthorizations in 2003, 2005, 2008 and 2013. During this period, nearly all the attention of state and local governments, law enforcement, and service providers has been focused on sexually exploited adolescent girls. While there has been some increased awareness about sexually exploited boys in the U.S. over the past several years, most law enforcement and services providers often miss them entirely or view them as too few to be counted or not in need of services. The little notice given to boys primarily identifies them as exploiters, pimps and buyers of sex, or as active and willing participants in sex work, not as victims or survivors of exploitation.1 Discussion of boys as victims or survivors of CSEC is frequently appended to a discussion about commercially sexually exploited girls. A panel discussion about commercial sexual exploitation often ends with these words: “...and boys too.”

While awareness of commercial sexual exploitation of boys (CSEB) has paled next to that of commercial sexual exploitation of girls (CSEG), two important studies in the past 12 years, The Commercial Sexual Exploitation of Children in the U.S., Canada and Mexico by Estes and Weiner (2001) and The Commercial Sexual Exploitation of Children in New York City by Curtis et al. (2008), have estimated that high percentages of commercially sexually exploited children in the U.S. are boys. In order to examine why CSEB receive much less attention and to question the widespread popular assumptions that they are willing participants or even exploiters and not victims, ECPAT-USA has carried out a study to examine available information about CSEB, their participation in CSEC, and services available to them. The study conducted a number of desk reviews that were supplemented by interviews with 40 key service providers and youth agencies.

The research explored several questions relating to the existence and circumstances of CSEB: Do they exist? What are their backgrounds? Who are their exploiters? At what age are they exploited? What are their needs and what services are available to meet those needs? Although many of the answers were inconclusive, several clear findings and messages stood out. Most significantly, responses from service providers clearly indicate that the scope of CSEB is vastly under reported, that commercial sexual exploitation poses very significant risks to their health and their lives; that gay and transgenders are over-represented as a proportion of the sexually exploited boys; and that there is a shortage of services for these boys. The fact that boys and young men may be less likely to be pimped or trafficked highlights the fact that even if there is no third party involved in the commercial transaction, “buyers/exploiters” of sexually exploited children should be prosecuted under anti-trafficking statutes.

Based on our research and responses from service providers, ECPAT-USA proposes a number of recommendations. Two immediate needs are clear: first, to raise awareness about the scope of CSEB and second, to expand research about which boys are vulnerable to sexual exploitation and how to meet their needs.

inTrodUCTion: Why This sTUdy

Attention to commercial sexual exploitation of children (CSEC) in the U.S. has increased significantly with passage of the Trafficking Victims Protection Act (TVPA) and its subsequent reauthorizations. Since the Act’s original passage in 2000, U.S. federal law defines anyone under 18 years of age who is “induced to perform a commercial sex act” as a victim of human trafficking, not as a criminal. In addition, beginning in 2010, the annual Trafficking in Persons Report published by the U.S. Department of State Trafficking in Persons Office has acknowledged CSEC in the U.S. Understandably, most of the focus of law enforcement, government, media, policy makers, service providers, researchers, and funders has been on commercial sexual exploitation of girls (CSEG). Commercially sexually exploited boys (CSEB), on the other hand, who may be considered too few to be counted or not in need of help or services, have registered as a barely visible blip on the radar. The little attention paid to boys has focused on them as exploiters, pimps and buyers of sexual services or as active participants in sex work—not as victims or survivors.2 Most service providers who were interviewed for this report in 2010-11, acknowledge the existence of CSEB yet only provide services to CSEG or are unwilling or unable to help boys.

The John Jay College and the Center for Court Innovation study The Commercial Sexual Exploitation of Children in New York City in 2008 estimated that as high as 50% of the commercially sexually exploited children in the U.S. are boys. The 2001 study by Estes and Weiner cited above also estimated that a large percentage of the CSE population is boys. ECPAT-USA undertook a study to shine a spotlight on boys by questioning these common assumptions and by further exploring available information about the role of boys and young men as victims of CSEC.

mEThodology

Despite strong anecdotal information, the absence of empirical data makes it difficult to challenge or look beyond appearances suggesting that boys engaged in prostitution are willing participants or exploiters themselves. Based on the two studies cited above, the ECPAT-USA study surveyed a number of published and unpublished literature reviews on the topic, supplementing and measuring them against interviews with 40 key informants, mainly providers or services to sexually exploited children and youth agencies. The questionnaire is in the Appendix of this report. The study was also shared for comments with key experts who work with sexually exploited boys in the field before it was published and distributed.


ECPAT-USA’s study explored the following questions:

  • What is the extent of CSEB in the United States?
  • Why are boys vulnerable to sexual exploitation?
  • Who are their exploiters—are they under the control of pimps/traffickers? What in their age of entry into “the life,” their race and ethnicity?
  • What is their sexual orientation and gender identity?
  • What are the long-term health outcomes of their exploitation?
  • What is their relationship to law enforcement?
  • What are their needs and what services are available?
  • And finally, the emerging evidence provided a reasonable answer to the question: Why are CSE boys so frequently ignored?

Contributing factors to why CsE boys and young men are not getting identified or served.

  • The unwillingness of boys to self-identify as sexually exploited due to shame and stigma about being gay or being perceived as gay by family and community. 
  • A lack of screening and intake by law enforcement and social services agencies rooted in the belief that boys are not victims of CSE. 
  • Limited outreach by anti-trafficking organizations to areas, venues and tracks known for male prostitution. 
  • Oversimplification of the reality that boys are not generally pimped hides the needs and misinforms
    potential services. 

Findings

Modest but clear findings surfaced: that the scope of CSEB is vastly under reported and much more needs to be done to identify sexually exploited boys as young people in need of protection; to raise awareness about the impact of CSEB; and to provide specialized services for them.

male sex workers seen as having more agency and choice.

The invisibility of men and boys in scholarly discussions of the global sex trade was analyzed through a sample of 166 recent articles published in social science journals. Most failed to acknowledge the existence of male sex workers at all. When male sex workers were discussed, they were assigned considerably more agency than female sex workers, the chief danger ascribed to them was HIV rather than violence, and the question of their sexual orientation was always addressed, whereas female sex workers were always assumed heterosexual. The results are discussed in the context of world system theory, Orientalism, and heteronormativity.

Source: Dennis, J. (2008). Women are Victims, Men Make Choices: The Invisibility of Men and Boys in the Global Sex Trade. Gender Issues, 25(1). 

Based on the desk review and interviews, several noteworthy findings emerged to varying degrees among the key informants. Some were predictable, others surprising. Although the study did not use the situation of girls as a baseline, comparisons are likely and logical, and similarities and differences in gender behavior and experience and treatment also surfaced.

Existence and scope of commercial sexual exploitation of boys


The most significant finding was the unexpectedly large number of boys who are CSE. Without exception, the key informants noted that CSEB and young men exist in their communities; none said they did not. The fact that the majority of U.S. research on boys has focused on runaway and homeless youth, who may or may not engage in CSE and who are almost never tracked or even asked in intake interviews appears to indicate that research has failed to focus specifically on CSEB but rather views it within the context of the homelessness and street life.

Researchers in the 2008 study The Commercial Sexual Exploitation of Children in New York City by John Jay College and the Center for Court Innovation reported their own surprise at the large number of boys who showed up to be interviewed for their “self-reporting” study, which was not looking for gender differences. Even though boys had been previously mentioned by some policy makers, practitioners and researchers, this study did not focus on them as a significant segment of the market or on their unique sets of problems. The report said: “While we might argue about the relative proportion of boys versus girls in the sex market, there can be little doubt that boys are far more numerous...than is commonly acknowledged. Policy makers and practitioners who are concerned about the growth of CSEC markets need to account for and respond to all of the youth that are swept into it, yet there is scant discussion about boys, and no services for them at all.”3

high rates of sexual abuse in the home predicts sexual victimization on the street.

Path analysis was used to investigate the impact of childhood sexual abuse on later sexual victimization among 372 homeless and runaway youth in Seattle. Young people were interviewed directly on the streets and in shelters by outreach workers in youth service agencies. High rates of both childhood sexual abuse and street sexual victimization were reported, with females experiencing much greater rates compared with their male counterparts. Early sexual abuse in the home increased the likelihood of later sexual victimization on the streets indirectly by increasing the amount of time at risk, deviant peer affiliations, participating in deviant subsistence strategies, and engaging in survival sex. These findings suggest that exposure to dysfunctional and disorganized homes place youth on trajectories for early independence. Subsequently, street life and participation in high-risk behaviors increases their probability of sexual victimization.

Source: Tyler, K. A., Hoyt, D. R., Whitbeck, L. B., & Cauce, A. (2001). The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth. Journal of Research on Adolescence (Blackwell Publishing Limited), 11(2).

  

Why boys and young men are vulnerable to commercial sexual exploitation.

As they do with many girls, both the literature and key informants indicate that boys enter the sex trade in order to meet their basic needs, including for money, shelter, food, drugs, clothing and transportation.4

Common to girls as well, the literature finds boys and young men to have high rates of previous physical and sexual abuse5 and a lack of family support,6 leaving them vulnerable and at high risk for exploitation. Most are either runaways or “throwaways,” having been thrown out of the house for varied reasons. Key informants cited boys and young men turning to sex work to obtain drugs and/or turning to drugs to cope with sexual exploitation. Some also mentioned the market demand for boys, and one cited looking for love, a need that is shown to be very common with girls and young women.

sexual orientation and gender identity

For many boys there is also a strong link between meeting basic needs and their sexual orientation or gender identity. Many boys reported that they are thrown out of their house for being gay, bi-sexual or transgender. Finding themselves on the street leaves them at high risk for sexual exploitation in attempting to meet their basic needs. It is worth noting that although the data of self-identification connotes an overrepresentation of gay, bi-sexual, transsexual and questioning (GBTQ) youth, compared to national numbers, the same research suggests the majority are heterosexual.7


At the same time, the LGBTQ population of CSEC is not insignificant and needs to be recognized. Although major overlap exists among all CSE youth, the experiences of transgendered youth are often unique. Lumping CSE transgendered youth in with CSE heterosexual or even gay boys and young men obfuscates, even denies the distinctive experiences of this population8 and serves no one.

The exploiters

From the little that is known about traffickers and sexual exploiters of boys, recruitment approaches vary. For the most part, boys appear to be largely recruited by friends and peers and do not commonly have “pimps.” The 2008 study on CSEC in New York City suggested the term “market facilitator” better represented the “language to describe pimps, [and] youth seemed far more willing to discuss their relationship with them.”9 The majority of buyers are men, mostly white and middle or upper class, professional and married, although some are women. They find boys in many of the same places as girls: on the street,10 on the internet,11 call services and in clubs and bars.12 Boys are also bought and sold in male-specific venues, such as gay bars, and male transit areas, including truck stops and conventions14 as well as on Internet sites such as rentboy.com and the male escort section of backpage.com.

Age of entry, race and ethnicity

In other categories, such as the age boys enter the life and their race and ethnicity, anecdotal information suggests that boys can enter the life at a similar or even younger age than girls, between 11 and 13 years for boys and young men compared to 12 and 14 years for girls.14

According to the few key informants who noted race and ethnicity of the boys and young men they have seen, they appeared consistent with regions of the country: Hispanic on the West Coast, African American on East Coast, and Caucasian in the Midwest.

health outcomes

health of homeless youth engaged in prostitution at risk for later medical problems

All initial visits (n=620) of runaway/homeless youths to an outpatient medical clinic over a 12-month period (July 1988 – June 1989) were analyzed. Of these visits, 467 made by youth not involved in prostitution were compared with 153 visits by youth who were involved. According to the data from an adolescent risk profile interview, homeless youth involved in prostitution are at greater risk for a wide variety of medical problems and health-compromising behaviors, including drug abuse, suicide, and depression. The implications for public health and social policy are discussed.

Source: Yates GL, Mackenzie RG, Pennbridge, J. & Swofford, A. (1991). A risk profile comparison of homeless youth involved in prostitution and homeless youth not involved. Journal of Adolescent Health

Overall, the mental, physical, and emotional health outcomes of the CSE boys are by all accounts, dismal with increased chances of further sexual assault at the hands of a stranger.15 Key informants and desk reviews are in agreement about the disproportionately high rates of illicit drug use among CSE boys,16 including alcohol and amphetamines as well as marijuana, cocaine, ecstasy and heroine, sometimes forced on them by their pimps/traffickers in cases where a pimp or trafficker is involved. CSE boys are also reported to suffer from HIV and other STIs, Hepatitis C, depression, PTSD, anxiety and increased rate of suicide attempts.17 All but one key informant said that the most serious health threat was HIV and other STIs. They also said that boys were able to access healthcare services—except when they were controlled by exploiters—through free clinics, LGBTQ and refugee health centers.

Boys also endure a high level of injuries often resulting from violence, such as abscesses, broken jaws, flesh wounds, stabbings, burns, bruises and scars. Two key informants said that clients reported that injuries had come from buyers/exploiters while other respondents stated they did not know who had injured their clients. One key informant reported that a CSE boy she had worked with had been stabbed by a buyer/exploiter. Several key informants speculated that many CSE boys and young men who are homeless or street-involved also endure violence from peers. Six key informants had worked with clients who had been forcibly raped by buyers/exploiters. One key informant reported that she had worked with several CSE boys and young men who had committed suicide. Two additional service providers reported that CSE clients had spoken of CSE male friends who had committed suicide. One key informant reported that she has known CSE boys and young men who have been murdered and also CSE boys and young men who had murdered “buyers/exploiters.”

Key informants were divided evenly on whether boys disclose to medical personnel that they have been CSE. Many who do disclose their exploitation also report that the medical care they receive frequently serves runaway and homeless youth.

law enforcement and government agency involvement

Boys and young men represent a small percent of minors who enter the criminal justice system on prostitution charges.18 They are rarely identified as people arrested for prostitution or victims of human trafficking by law enforcement agencies—whether local, state or federal. Law enforcement officers do not refer boys to agencies. They look specifically for “the stereotypical girl” victim. Several key informants said that law enforcement believes that boys are not pimped and therefore not in need of services. Whether a young person has to be sold by a third party such as a pimp, trafficker or “market facilitator” in order to be identified as a victim of trafficking under U.S. law remains an unsettled question.

Key informants pointed out their belief that law enforcement has very little understanding of CSE boys. For example, when filing human trafficking reports, they would often ask: “Why couldn’t he get away? He’s a boy.” One informant said she was forced to explain to law enforcement professionals before filing a report that boys and young men can be bought and sold just like girls.

Key informants also said that the juvenile justice system lacks understanding of CSE boys. While many are arrested on other charges, they are rarely screened for CSE. Girls, on the other hand, are more often screened for CSE and referred to agencies. One service provider reported that no boys have been referred to her agency in contrast to many girls. Many said that the juvenile justice system as well as child protective services need better training for CSEC.

services needed, services provided

Although key informants without exception said they believed that CSE boys and young men existed in their community, only a small minority is willing and able to serve them. One FBI staff person called an agency to house seven CSE boys found in a sting. The spokesperson of the agency, which serves girls, said she did not know where those boys went and knew of no agencies in her area that serve boys.

social service agencies need to acknowledge the risk of sexual exploitation

The article argues that it is necessary for social workers to recognize that boys are at risk for sexual exploitation. Social service providers must examine why they tend to ignore male sexual exploitation, how these attitudes lead to exploitation, and how sexual abuse affects young men later in life. Boys tend to enter into prostitution either as a means of escaping abuse at home, or as a result of early life experiences that lead them to prostitution. Characteristics of sexually exploited boys are listed, as are characteristics of young men at risk for exploitation. Cultural, societal and ethnic factors are considered.

Source: Lillywhite, R., & Skidmore, P. (2006). Boys are not sexually exploited? A challenge to practitioners. Child Abuse Review, 15(5).

 

Of the 40 informants contacted, 18 reported they would serve boys. Of 37 who have provided traffic-specific services, 15 said they are willing and able to serve CSEB and 10 already have provided services to boys. Looking only at organizations specifically focused on commercially sexually exploited children, the numbers are even lower: Only four out of 25 will serve boys and only two organizations have provided services to more than five CSEB.

Reasons for the unwillingness or inability to serve boys include:
  • Programs are already filled or over capacity with girls 
  • Boys are not identified and/or referred by law enforcement, other social service organizations, public 
  • and/or agency outreach, nor do they self-refer 
  • They rarely receive referrals for or calls from boys and do not see a significant need 
  • They feel ill-prepared and need more training regarding CSE boys 
  • Boys and young men are heretofore reported not to be pimped. Therefore, entering prostitution through different pathways they may have different needs The agency has a gender-specific curriculum that is focused on girls 

Organizations serving LGBTQ and runaway and homeless youth meet some boys’ needs, but are not CSEC- specific. Similarly, although some female-specific CSEC agencies will serve transgendered youth who identify as female, many will not.

Like young women, boys cite job training and housing (emergency, transitional and long-term) to allow them to leave “the life.” In a 2008 Canadian study, residential and supportive services were stated as a need by 84% of CSE young men.19  Such services include: housing, counseling, a CSEC-specific program, male CSE survivor outreach workers, school-based prevention, drop-in centers for street-involved youth, better service coverage and coordination among agencies.

ConClUsion: Why Boys ArE ovErlookEd

Given that CSE boys are present in all communities where there are girls and that they suffer similar outcomes, why is there so little contact with the anti-trafficking community and CSEC service providers? Desk reviews and key informants confirm that CSE boys are surrounded by a culture that is both hetero-centric and homophobic; it is a culture that portrays girls as vulnerable, weak and victims and men as strong, powerful and perpetrators.

Until the last two decades, research framed CSE boys and young men as deviants with a desire for quick sex and money.20 Although this belief is not accepted in the human trafficking community, it appears to persist in the wider culture. One key informant conversation with law enforcement officer typified this attitude as the officer referred to a 15-year old male found in a motel trafficking sting as a “sex addict” and to another who was “just doing it for the money.”

shame, stigma and homophobia

The presumption that the majority of boys who are CSE are bisexual, gay or transgendered is belied by further evidence that the majority are actually heterosexual or “straight” but who do not acknowledge their status. This results not only in the likelihood of skewed statistics but also in the refusal to seek help and the adamant denial of exploitation by boys themselves.

Rooted in a culture that amplifies feelings of shame and self-loathing, this fear is very common to CSE boys and often leads to their re-identifying themselves as “hustlers” to give the illusion of control and power.21 This is much like some exploited girls who claim that selling sex gives them power and embrace terms for themselves that minimize their vulnerabilities.

Among the service providers that do not work with boys and young men, the most common response is that they do not receive calls about CSE boys, which only seems to reaffirm the common and misguided belief that boys do not need services. But their failure to screen or assess boys at intake is not evidence that CSE boys do not exist. If no one is looking, then it should not be surprising that they are not being found. Just as the chained foreign-born young female victim dominated (and continues to dominate) ideas of what a sex trafficking victim looks like, the pimped young American girl continues to dominate our ideas of what a domestic sex trafficking victim looks like.

A lacking focus on male tracks and male outreach workers

Very few key informants from trafficking-specific CSEC organizations with street outreach said that they worked in areas of “tracks” known for male prostitutes—although they know where these areas are and believe that they are where outreach workers should look. They agreed that efforts would be more successful by using male outreach workers. When asked if money fell from the sky, what would she do to expand her organization to serve boys and young men, one service provider said: “The first thing I would do is hire male survivors who know where to look.”

rECommEndATions

1. Acknowledge the existence of CSE boys and young men, their risk for physical and mental health harm, and their need for services. Include both GBTQ and heterosexual boys with attention to their different circumstances and needs 

2. Raise awareness among local and federal law-enforcement officers and foster-care agencies that boys in the sex trade are victims whose fear of stigma and rejection exacerbates their denial and prevents them from acknowledging their victimization. 

3. Establish screening and intake systems for CSE boys at runaway and homeless youth centers and social service agencies, and conduct sensitivity training of workers to recognize CSEB and to elicit information from boys and to address shame and stigma. 

4. Support the establishment of male-focused anti-trafficking agencies with staff trained to meet the need to CSE boys. 

5. When appropriate, encourage agencies and service providers that focus on girls to expand their mandate to include boys, and hire and train male workers 

6. Encourage collaboration among organizations that already address CSE boys and young men, and to advocate for wider recognition among law enforcement, public health community, policy makers and the public of their existence and harm to CSE boys 

7. Conduct further research on LGBTQ youth on advantages and disadvantages of gender-specific or co-ed service agencies. 

8. Conduct research about the health impact of sexual exploitation on boys and young men. 

9. Revise existing statutes to make it easier to prosecute exploiters of children even when there is no pimp or trafficker involved.

FOOTNOTES:

  1. For an example see: Cates, J. (1989). Adolescent Male Prostitution by Choice. Child & Adolescent Social Work Journal, 6(2), 151-156. For further analysis see: Dennis, J. (2008). Women are Victims, Men Make Choices: The Invisibility of Men and Boys and young men in the Global Sex Trade. Gender Issues, 25(1), 11-25.
  2. ??
  3. Curtis, R., Terry, K., Dank, M., Dombrowski, K., & Khan, B. 2008. THE COMMERCIAL EXPLOITATION OF CHILDREN IN NEW YORK CITY, VOLUME ONE,  The CSEC Population in New York City: Size, Characteristics, and Needs. New York: Center for Court Innovation and John Jay College of Criminal Justice p. 115.
  4. Estes, R. J, &. Weiner N. A. (2001). The Commercial Sexual Exploitation of Children In the U. S., Canada and Mexico. PA: University of Pennsylvania School of Social Work, Center for the Study of Youth Policy. Kipke, M., S. O’Conner, R. Palmer, and R. MacKenzie. 1995. Street Youth in Los Angeles: Profile of a Group at High Risk for Human Immunodeficiency Virus Infection. Archives of Pediatric Adolescent Medicine. 149: 513-519.
  5. Curtis, R., Terry, K., Dank, M., Dombrowski, K., & Khan, B. 2008. The Commercial Sexual Exploitation of Children in New York City, Volume One, The CSEC Population in New York City: Size, Characteristics, and Needs. New York: Center for Court Innovation and John Jay College of Criminal Justice. Kaye, K. (2007). Sex and the Unspoken in Male Street Prostitution. Journal of Homosexuality. 53, (1 & 2).
  6. Curtis, R., Terry, K., Dank, M., Dombrowski, K., & Khan, B. 2008. The Commercial Sexual Exploitation of Children in New York City, Volume One, The CSEC Population in New York City: Size, Characteristics, and Needs. New York: Center for Court Innovation and JohnJayCollege of Criminal Justice. Kaye, K. (2007). Sex and the Unspoken in Male Street Prostitution. Journal of Homosexuality. 53, (1 & 2).United States Department of Justice. (2010). The National Strategy for Child Exploitation Prevention and Interdiction: A Report to Congress. Washington DC: Author.
  7. Caukins, S. E., & Coombs, N. R. (1976). The Psychodynamics of Male Prostitution. American Journal of Psychotherapy, 30(3), 441-451Kaye, K. (2007). Sex and the Unspoken in Male Street Prostitution. Journal of Homosexuality. 53, (1 & 2).
  8. Estes, R. J, &. Weiner N. A. (2001).The Commercial Sexual Exploitation of Children In the U. S., Canada and Mexico. PA: University of Pennsylvania School of Social Work, Center for the Study of Youth Policy.
  9. Estes, R. J, &. Weiner N. A. (2001).The Commercial Sexual Exploitation of Children In the U. S., Canada and Mexico. PA: University of Pennsylvania School of Social Work, Center for the Study of Youth Policy.
  10. Tyler, K., Whitbeck, L., Hoyt, D., & Cauce, A. (2004). Risk factors for sexual victimization among male and female homeless and runaway youth. Journal of Interpersonal Violence, 19(5), 503-520.Whitbeck, L., Hoyt, D., Yonder, K., Cause, A. & Paradise, M. (2001). Deviant Behavior and Victimization Among Homeless and Runaway Adolescents. Journal of Interpersonal Violence. 16: 1175 - 1204.
  11. Edwards, J.M., Iritani, B.J., & Hallfors, D.D. (2005). Prevalence and correlates of exchanging sex for drugs or money among adolescents in the United States. Sexually Transmitted Infections. 82(5): 354‐358.
  12. Greene, J., Ennett, S., & Ringwalt, C. (1999). Prevalence and correlates of survival sex among runaway and homeless youth. American Journal of Public Health, 89(9), 1406-9.Yates GL, Mackenzie RG, Pennbridge, J. & Swofford, A. (1991). A risk profile comparison of homeless youth involved in prostitution and homeless youth not involved. Journal of Adolescent Health, 12(7), 545-8. Edwards, J.M., Iritani, B.J., & Hallfors, D.D. (2005). Prevalence and correlates of exchanging sex for drugs or money among adolescents in the United States. Sexually Transmitted Infections. 82(5): 354‐358.
  13. Curtis, R., Terry, K., Dank, M., Dombrowski, K., & Khan, B. 2008. The Commercial Sexual Exploitation of Children in New York City, Volume One, The CSEC Population in New York City: Size, Characteristics, and Needs. New York: Center for Court Innovation and John Jay College of Criminal Justice. Finn, M., Sims Blackwell, B., Jackson, L., Wolk, J & Oakley, M. B. (2009). Evaluation of the Demonstration Project to Address Commercial Sexual Exploitation of Children in Atlanta-Fulton County. GA: Georgia State University. Muslim, A., Labriola, M., & Rempel, M. (2008) Commercial Sexual Exploitation of Children in New York City, Volume Two: Formative Evaluation: The New York City Demonstration. New York: Center for Court Innovation and John Jay College of Criminal Justice.
  14. McIntyre, Susan (2004) Under the Radar: The Sexual Exploitation of Young Men, 71.
  15. Caukins, Sivan E. and Neil R. Coombs, (1976) The Psychodynamics of Male Prostitution. American Journal of Psychotherapy, July 30 (3), 441-451.
  16. Estes, R. J, &. Weiner N. A. (2001).The Commercial Sexual Exploitation of Children In the U. S., Canada and Mexico. PA: University of Pennsylvania School of Social Work, Center for the Study of Youth Policy.

BiBliogrAPhy

Cates, J. (1989). Adolescent Male Prostitution by Choice. Child & Adolescent Social Work Journal, 6(2), 151-156. Caukins, S. E., &
Coombs, N. R. (1976). The Psychodynamics of Male Prostitution. American Journal of Psychotherapy, 30(3), 441-451.

Curtis, R., Terry, K., Dank, M., Dombrowski, K., & Khan, B. 2008. The Commercial Sexual Exploitation of Children in New York City, Volume One, The CSEC Population in New York City: Size, Characteristics, and Needs. New York: Center for Court Innovation and John Jay College of Criminal Justice, 58-59.

Dennis, J. (2008). Women are Victims, Men Make Choices: The Invisibility of Men and Boys and young men in the Global Sex Trade. Gender Issues, 25(1), 11-25.

Edwards, J.M., Iritani, B.J., & Hallfors, D.D. (2005). Prevalence and correlates of exchanging sex for drugs or money among adolescents in the United States. Sexually Transmitted Infections. 82(5): 354358.

Estes, R. J, &. Weiner N. A. (2001).The Commercial Sexual Exploitation of Children In the U. S., Canada and Mexico. PA: University of Pennsylvania School of Social Work, Center for the Study of Youth Policy.

Finn, M., Sims Blackwell, B., Jackson, L., Wolk, J & Oakley, M. B. (2009). Evaluation of the Demonstration Project to Address Commercial Sexual Exploitation of Children in Atlanta-Fulton County. GA: Georgia State University.

Gragg, F., Petta, I., Bernstein, H., Karla, E. & Quinn, L. (2007). New York Prevalence Study of Commercially Sexually Exploited Children. New York: New York State Office of Children and Family Services.

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Kaye, K. (2007). Sex and the Unspoken in Male Street Prostitution. Journal of Homosexuality. 53, (1 & 2).

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McIntyre, S. 2005. Under the Radar: The Commercial Sexual Exploitation of Young Men.

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Remefedi, G. (1987). Adolescent Homosexuality: Psychosocial and Medical Implications. Pediatrics. 79 (3): 331-337. Tyler, K. A., Hoyt, D. R., Whitbeck, L. B., & Cauce, A. (2001). The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth. Journal of Research on Adolescence (Blackwell Publishing Limited), 11(2), 151.

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Whitbeck, L., Hoyt, D., Yonder, K., Cause, A. & Paradise, M. (2001). Deviant Behavior and Victimization Among Homeless and Runaway Adolescents. Journal of Interpersonal Violence. 16: 1175-1204.

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Questionnaire for CSEC Providers

APPEndix

ECPAT-USA is collecting information about services that are available to commercially sexually exploited adolescent males as well as their unmet needs and health and social problems. To collect this information we are contacting organizations, such as yours, that provide services to commercially sexually exploited youth.

Please Do Not fill out this questionnaire. We would prefer to speak with you. This document serves as a guide to inform you about the types of questions we will be asking.

If your organization does not serve boys/young men directly we are still interested in any insights/information you may have on these issues.

We expect the interview to take between 20-40 minutes.

The information you share with us is confidential:

  • We will not identify your organization: we will only list organizations by the city and state in which you are located. 
  • We are not requesting personal information on any of your clients and Do Not want the names of any of your clients. 
  • This project is focused on adolescent males who are 17 years old and younger and young adult males age 18-22. 
  • We are looking for general information and trends that you have observed regarding the youth that your agency serves as well as any observations you can share with us.
  1. Name of agency: 
  2. Location: a. city b. state: 
  3. Website: 
  4. Name and title of organization contact: 
  5. Is your organization focused primarily on serving youth who have been commercially
  6. sexually exploited? If not, what is the primary focus of your organization? If so, do you serve
  7. domestic or international survivors or both? 
  8. Do you provide services to males? 
  • A. If no, Has your organization considered serving boys and young men? Why or why not? Are there any other organizations in your community that provides services to males? If so, do you have a contact name and number or email at the agency? End of survey.
    B. If yes, continue to number 7.
    For the next questions, you can approximate if you do not have the exact numbers: 
  1. How many youth did you provide services to in 2010? 
  2. What are the ages of the youth you serve? 
  3. In 2010 how many of the youth you served were male and under 18 years old?
  4. In 2010 how many of the youth you served were male and between the ages of 18 and 22?
  5. In 2010 how many of the youth you served were transgendered and under 18 years old? 
  6. In 2010 how many of the youth you served were transgendered and between the ages of 18 and 22? 


From this point forward we will be using the terms boy, young man, male, etc. to include everyone who identifies as male, however, if any of your responses are specific to transgendered youth please let us know.

Also, we will be using the term “commercial sexual exploitation” or “exploitation” (often referred to as CSE or CSEC) to mean any commercial or transactional sex acts and/or sex work and/or prostitution and/ or survival sex, which involves a child or youth.

Background/General questions:

  1. Do you have any reports or data on CSE boys and young men? If yes, could you share it with us? 
  2. How do you come in contact with CSE boys and young men? Are any of these youth ever
    referred to you by other agencies or by the police? If so, which agencies? 
  3. What are the reasons you think males under 18 are sexually exploited? 
  4. Of these reasons, can you rate them in order of the most to least common reason? 
  5. At what age do boys and young men in your community first become sexually exploited? 
  6. Can you tell me about the ethnicity of the males you serve? Have you noticed an over or under representation of any ethnic or racial group among the youth you serve? 
  7. Have you observed any common themes in these youth lives/histories? For example, have you observed that most of these boys are runaways and/or street youth? Or are many coming from foster care? Or have
    you observed commonalities in histories of abuse? Etc. 
  8. Have you observed any differences between the boys and young men in your program compared to the girls and young women in your program? For example, are boys and young men more or less likely to be involved with the police and criminal justice system? Or are they more or less likely to seek services? Etc. 

Exploiters:

  1. Can you tell me what you have observed about who, if anyone, sells these boys and young men for exploitation? Do you think they are pimped? If applicable, are they sold or exploited by other homeless or street youth and/or exploited by street families? 
  2. Now can you tell me about the people who exploit these boys and young men by paying for them? For example: Are they men? Women? Where do they find the boys? Where do they take them? 

Health Outcomes:

  1. What are the common infectious diseases you see in these boys and young men, such as HIV or STIs? 
  2. Have you observed any common chronic diseases you in these boys and young men, such as asthma or diabetes? 
  3. Have you observed any common mental health problems in these boys and young men? 
  4. Have you observed any common drug(s) that these boys and young men use? 
  1. Have you observed any common injuries from violence among these boys and young men? 
  2. What percentage of these boys and young men do you estimate are forcibly raped? 
  3. Do you know of any SE boy/young man who has committed suicide? If so, can you tell me
    what happened? 
  4. Do you know of any SE boy/young man who was murdered? If so, can you tell me what happened? 
  5. What do you think is the most serious health problem these boys and young men face and why? 
  6. Where do these boys and young men go for medical services? 
  7. What are the problems these boys and young men have in getting medical services? 
  8. Do you think that these boys and young men tell doctors that they have been sexually exploited?
    If yes, how do doctors respond? If no, why not? 

What is needed?

  1. What is needed to prevent other boys and young men from being CSE? 
  2. What services or programs are available to boys and young men who are CSE and what are needed? 
  3. What policies or laws do you think are needed to address the CSE of boys and young men? 
  4. Is there anything else you would like to add to what we have discussed? 
  5. Can you recommend any other organization or individual at your organization or another
    organization I should contact? 

Thank you for your time.

We exist because we believe that children everywhere are entitled to the fundamental right to live free from all forms of commercial sexual exploitation, including child prostitution, child pornography, and trafficking for sexual purposes.

30 Third Ave., Suite 800A, Brooklyn, NY 11217, 718-935-9192
email: ecpat@ecpatusa.org; www.ecpatusa.org

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