Executive Summary

The Office of the Texas Governor’s Child Sex Trafficking Team (CSTT) is engaged in comprehensive statewide efforts to end commercial sexual exploitation of youth and to heal victims. The CSTT’s core mission is to protect youth from sexual exploitation, help victims heal and recover, and bring justice to those who exploit children.1 In 2019, the Office of the Governor provided funding for the Texas Center for Child and Family Studies (the Center) and the Texas Network of Youth Services (TNOYS) to collaboratively conduct a statewide scan of available service capacity for meeting the comprehensive needs of commercially sexually exploited youth (CSEY). This scan was commissioned in order to gather data that can be used to support capacity building for specialized CSEY services in Texas.

Background and Problem Statement

Defining Sex TraffickingAs defined by federal law, sex trafficking is “the recruitment, harboring, transporting, provision, obtaining, patronizing or soliciting of a person for the purposes of a commercial sex act, in which the commercial sex act is induced, through the use of force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age.” Federal law further defines a commercial sex act as “any sex act on account of which anything of value is given to or received by any person.”2An important component of this definition is that, for minors under age 18, a commercial sex act does not have to involve force, fraud, or coercion to be defined as trafficking. The Trafficking Victims Protection Act of 2000 (reauthorized in 2003, 2005, 2008, and 2013) defines minors who are involved in any kind of commercial sex act as victims of a crime. It also establishes that any adult who benefits from a relationship with a minor involved in commercial sex is defined as a human trafficker.

Scope and Prevalence of CSEY

The true prevalence of CSEY in state and national populations is exceedingly difficult to estimate because trafficking victims are a hidden population.11 For many complex reasons, CSEY victims do not or cannot report their exploitation to authorities, so the victims who come to the attention of law enforcement or other protection systems are likely the tip of the iceberg in relation to the actual number of victims and survivors. Similarly, there are no viable research based estimates, since victims and survivors may not disclose their experiences to researchers for many reasons, such as stigma, fear of legal consequences, or fear for personal safety.

The National Human Trafficking Hotline tracks statistics of trafficking cases reported to the hotline across the U.S. In 2018, there were 7,859 cases of sex trafficking reported.12 Reported cases occurred in all 50 states. Since this number only includes cases reported to the national hotline, it can be assumed that the true number of CSEY victims in the United States is vastly higher, and the number of youth who are at-risk of trafficking is higher still.

Risk Factors for Trafficking

Society’s most vulnerable children and young adults are targeted for sex trafficking. Though children and youth of any background can become CSEY victims, those who have additional vulnerabilities created by their circumstances are at greater risk. Some of the strongest risk factors for CSEY victimization include past emotional or sexual abuse, episodes of homelessness, runaway episodes, identifying as LGBTQ, involvement with the child welfare system, or having a caseworker from any agency or organization.

Homeless or runaway youth are at particularly high risk. According to the National Center for Missing and Exploited Children, of the more than 23,500 endangered runaways reported in 2019, one in six were likely victims of child sex trafficking.18 Foster youth are also especially vulnerable to CSEY due to the heightened vulnerabilities associated with maltreatment trauma, family separation, and unstable living situations. Youth who are LGBTQ are at much higher risk of CSEY than other youth. The 2019 UT Austin study found that among at-risk cisgender heterosexual youth participating in the study, 18 percent of females and 7 percent of males were victims of sex trafficking, compared to 25 percent of at-risk LGBTQ youth.

Barriers to Leaving Trafficking

Youth sex trafficking situations are not always violent overtly forceful, and yet the barriers to getting out of trafficking can still be overwhelming. Trafficking victims can form emotional bonds with their traffickers that can make it difficult to leave. Known as trauma bonds or Stockholm Syndrome, these bonds are “the result of a complex interaction of abusive control dynamics, exploitation of power imbalances, and intermittent positive and negative behavior.”20Trafficked youth may believe that they receive love or friendship from their traffickers, which may influence whether they try to leave. According to the National Human Trafficking Hotline, some trafficking victims “have been so effectively manipulated that they do not identify at that point as being under the control of another person.”

Research suggests that fear is also a common reason why victims may remain in their trafficking circumstances. Common fears include arrest, stigma or judgment, not being able to be economically self-sufficient, and/or violence from traffickers. In addition to being a risk factor for trafficking, poverty is also a barrier to exiting. A 2018 research study about factors associated with exits from trafficking states that individuals “are driven by necessity to ensure their own survival, including illegal or degrading means if no other avenues are available.” Many CSEY youth may believe that commercial sex is their only means of survival.

Consequences of Trafficking

There are many potential short-and long-term consequences of sex trafficking, including PTSD, complex trauma, physical injury, mental health problems, difficulty in relationships with others, and sexually-transmitted infections. Research finds that PTSD is the most common mental health diagnosis among trafficking victims, followed by depression. Although violence is not always involved in youth sex trafficking, it is prevalent and can be life-threatening. Violence may be perpetrated by traffickers or buyers.

Sex trafficking also has an economic impact on the broader society. Research has estimated that in Texas there are $83,125 in associated economic costs for every CSEY victim.26Mental and physical health costs, public health system burdens, and law enforcement expenses are all components of this calculation. Based on this cost per victim, it is estimated that youth sex trafficking has cost the state of Texas about $6.6 billion to date.

Service Needs of Trafficking Victims

Mental health needs are high among CSEY victims. As PTSD and other related conditions are common in this population, it is essential for professionals to take a trauma-informed approach in their treatment. Medical treatment, housing, and employment are other common needs among trafficking victims. Utilizing a harm-reduction approach is also important for CSEY victims who use drugs. A harm-reduction approach “incorporates a spectrum of strategies from safer use, to managed use, to abstinence to meet drug users ‘where they’re at,’ addressing conditions of use along with the use itself.”27Regardless of the approach or treatment modality utilized, it is important to treat each youth who has experienced trafficking as a whole person, not just a victim. A 2018 qualitative research study asked 13 child sex trafficking survivors about what would have been helpful to them during the time they were involved in trafficking. The four responses that were most prevalent among participants were active listening, encouragement, non-judgment, and “don’t leave when we push you away.”

To ensure restoration and healing of victims of sex trafficking, assistance for CSEY victims must include trauma-informed, culturally-sensitive, non-judgmental approaches to medical care, residential services, mental health treatment, education and training, legal assistance, advocacy, and safety planning.

Efforts to Address Commercial Sexual Exploitation of Youth in Texas

Office of the Texas Governor

The Office of the Governor’s Child Sex Trafficking Team (CSTT) is engaged in comprehensive statewide efforts to end commercial sexual exploitation of youth and to heal victims. The CSTT’s mission is to “build sustainable capacity, enhance expertise, promote policies, and create new and leverage existing collaborations to: protect children from sexual exploitation, help the public recognize signs of sexual exploitation, help victims recover, support healing, and bring justice to those who exploit children.” The CSTT works toward these goals by developing public awareness campaigns, supporting prevention services, bringing together cross-system stakeholders, and building the capacity of communities to provide a full continuum of residential and community-based services for victims and survivors throughout the state.

Office of the Texas Attorney General

Attorney General of Texas Ken Paxton formed the Human Trafficking and Transnational/Organized Crime Section (HTTOC) in 2016.30This initiative is focused on combatting human trafficking in Texas. The HTTOC has undertaken various anti-trafficking efforts, including being involved in the closure of Backpage.com, the largest purveyor of escort ads in the United States. HTTOC has also created training materials and assists in the prosecution of criminal trafficking cases.

Study Objectives

In order to gather empirical data to better understand the state’s capacity to provide and expand community services for the CSEY population, the Texas Center for Child and Family Studies (the Center) and the Texas Network of Youth Services (TNOYS) partnered with The Office of the Governor’s Child Sex Trafficking Team(CSTT) to answer these research questions:

1.What specialized CSEYservices are currently being provided in the state? What is the nature and scope of specialized service availability?
•This question addressed specialized program types, overall and unused capacity, agency characteristics, screening and assessment patterns, intervention modalities used, and interest in serving additional clients.

2.What are the opportunities for capacity to be developed among community organizations not currently providing specialized CSEY services?
•This question addressed screening and assessment patterns in non-specialized agencies, risk levels of populations served, and interest in expanding service arrays to include specialized CSEY programming.

3.What are the barriers to increasing the state’s capacity of specialized CSEYservices?


Data CollectionThe study objectives were carried out through a statewide survey of providers likely to be offering services to victims of CSEY in Texas.

The survey was developed by the project leads from the Center and TNOYS based on ongoing planning meetings with the steering committee. Once completed and put into the online Survey Monkey platform, the survey was pilot tested internally by the steering committee, and with external stakeholders from the membership of TNOYS and the Texas Alliance of Child and Family Services(TACFS). Multiple rounds of revisions resulted from pilot testing, and the final version of the survey was approved by the steering committee in September 2019.

The survey was emailed by the Office of the Governor’s Child Sex Trafficking Team to a distribution list compiled from multiple sources: TNOYS membership, the membership of the TACFS, organizations affiliated with the Polaris Project, CSTT grantee organizations, and licensed providers contracted with Residential Child Care Licensing(RCCL) at the Texas Department of Health and Human Services. The research team from TNOYS and the Center compiled the distribution lists from these separate entities into a single list of emails that then de-duplicated. The final unduplicated list was provided to the CSTT, who distributed the survey link via email. The survey was sent to 502 unique agencies.


The final analytic sample reflects 125 unduplicated responses. The survey link was sent to 502 unique agencies, so the sample reflects a response rate of 25 percent. Of the 125 agencies who responded to the survey, 39 agencies reported that they are currently providing specialized CSEY services, while 86 agencies are not currently providing specialized services.

Findings are reported below for all respondents, respondents providing specialized CSEY services, and respondents not providing specialized CSEY services.

All Responding Agencies

As shown in Figure 1, agencies that responded to the survey provide services across the state, and the distribution of responding agencies roughly aligns with the child populations of the HHSC/DFPS service regions.40This is a positive indication that the survey responses are representative of the statewide population of community service provider agencies.

The most common program type operated by respondents is child placing agency (CPA), as shown in Figure 2.4142 Program types in the “other” category were described in an open-ended comment box. The most common responses were general residential operation (GRO)(7 responses), advocacy (2 responses), counseling (3 responses), health care (2 responses), and education (2 responses).

Agencies Currently Providing Specialized CSEY Services

Program Types

Among survey respondents, 39 agencies(31%) currently provide specialized CSEY programming within their service array. This does not mean all of the services each agency offers are specialized for CSEY, but rather at least one service type or program offered within the agency is specialized.

As shown in Figure 4, the most common specialized service type among respondents is behavioral health, followed by advocacy, child placing agencies, and emergency shelters. Write-in responses from the “other” category include referrals, prevention, child care, assessment, and GROs.While the survey did not quantify the relationships of specialized programs and other services offered within agencies, it is likely that services such as behavioral health and medical services are embedded in other program types, rather than stand-alone programs.

Agencies Not Currently Providing Specialized CSEY Services

Screening, Victim Identification, and Assessment

Among all responding agencies, 86 (69%) are not currently providing any specialized programs for CSEY. This does not mean that these agencies do not have CSEY victims among their clients, only that they have no specialized programming to specifically serveCSEY. In fact, 35 percent of agencies not offering specialized services have identified CSEY victims among their clients(see Figure 9), and the majority of these (60%) retained the victims in their care.

Survey findings also show that youth-serving agencies without specialized programming are working with high-risk populations. Among the 49agencies (57%) who reported that they have not identified any CSEY victims among their clients, 25 reported that more than half of their clients have three or more risk factors for CSEY.


As with all research, this study has limitations that should be considered when examining the findings. A key limitation of this study is the unknown generalizability of the survey findings to the full population of child and youth serving providers throughout the state. Participation in the study was voluntary, and those who responded may not be fully representative of those who did not. It is possible, for example, that responding agencies are more invested in CSEY issues, have more interest in serving the CSEY population, or just have stronger opinions on the topic. Findings should be interpreted with caution because of this limitation. This is especially true for findings regarding agencies who currently provide specialized CSEY services, since only 39 total responses were received for this subgroup. Findings on specific program types warrant even more caution, since these have even fewer responses from which to generalize (for example, there are only six RTCs specialized for CSEY in the data).

Discussion and Recommendations

This study produced findings to support capacity building for specialized CSEY services in Texas. A few of the most relevant findings are highlighted below.

  • Screening rates could be improved. Among all respondents, only a quarter use the CSE-IT tool to screen for CSEY among their clients. Among specialized programs, half use the CSE-IT, although this low rate could simply reflect that clients are being referred to specialized programs after having been confirmed as victims by the referring entities. Among agencies not offering specialized services, only 12 percent use the CSE-IT, and nearly 80 percent don’t use any CSEY screening tools at all, even though these agencies are serving high-risk populations. Though some agencies who do not use the CSE-IT reported using other tools to screen for CSEY, the most common method they reported using is agency intake form, which may not be as effective as a validated instrument like the CSE-IT. The relatively low usage rate of the CSE-IT may result in under-identification of trafficked youth.
  • Agencies offering specialized CSEY programming are funding services through many sources. As shown in Figure 5, there is substantial variation in primary funding source for CSEY programs. This variation exists between different program types(for example, the primary funding sources are different for CPAs compared to emergency shelters), and also within program types (for example, among the six specialized RTCs, three are funded primarily by DFPS, two are funded primarily by private philanthropic organizations, and one is funded primarily by the Office of the Governor). This highlights the importance of ensuring adequate funding from all potential sources, as well as the work agencies do to sufficiently fund services for this population.

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