The Hidden and Misunderstood Problem of Familial Sex Trafficking of Minors in the United States: A Scoping Review of the Literature

Voller VK, Maass KL, Weinfurter EV, Martin L. The Hidden and Misunderstood Problem of Familial Sex Trafficking of Minors in the United States: A Scoping Review of the Literature. Child welfare. 2024;102(2):145-180.

Abstract

This scoping review identified existing evidence on familial sex trafficking of minors in the United States and analyzed the evidence to guide future interventions. Comprehensive searches across six databases found nine relevant articles, revealing a nascent and underfunded body of scholarship. Despite its relevance to human trafficking and child welfare, few articles were published in specialized journals. Further research is urgently needed to develop effective interventions that prevent and disrupt this form of child sexual exploitation.

Headnote

This scoping review identified existing evidence on familial sex trafficking of minors in the United States and analyzed the evidence to guide future interventions. Comprehensive searches across six databases found nine relevant articles, revealing a nascent and underfunded body of scholarship. Despite its relevance to human trafficking and child welfare, few articles were published in specialized journals. Further research is urgently needed to develop effective interventions that prevent and disrupt this form of child sexual exploitation.

Recruitment by a family member was the most common recruitment trategy reported to the National Human Trafficking Hotline in cases of sex trafficking in the United States between 2020 and 2022 (Polaris, 2023a). This phenomenon, which is also known as familial sex trafficking, family-controlled sex trafficking, family-facilitated sex trafficking, or intrafamilial sex trafficking, occurs when a family member is the victim-survivor's trafficker or sells the victim-survivor to a thirdparty trafficker (United States Department of State, 2021). Although there is emergent evidence suggesting overlap between familial sex and familial labor trafficking (International Association of Chiefs of Police, 2024) as well as occurrences of familial trafficking in victim-survivors over the age of 18 years old (e.g. vulnerable adults) (Polaris, 2023b), this scoping review only focuses on familial sex trafficking of minors.

Currently, there are no universal tools to screen for domestic sex trafficking of minors, nor is there a central database to record the prevalence of domestic minor sex trafficking (DMST) in the United States (Armstrong, 2017). Further, many victims of DMST do not report due to fear of retaliation, distrust of law enforcement and health care providers, stigma, barriers to reporting, and other factors (United States Department of Health and Human Services, 2022). As a result, available estimates of incidence and prevalence are likely underreporting the hidden and misunderstood crime.

Familial sex trafficking is similar to DMST, which is defined as "the commercial sexual abuse of children by selling, buying, or trading their sexual service" (Hornor, 2015, p. 88). DMST can include instances of familial sex trafficking however, not all cases of DMST involve a family member. Anecdotal reports suggest that familial sex trafficking occurs more frequently than previously understood, that familial sex trafficking is often intergenerational, and that the prevalence of familial sex trafficking is higher in rural communities and families living in poverty (Cutbush Starseed & McCallum Desselle, 2024, slide 28). Familial sex trafficking is poorly understood due to the complex dynamics associated with family-controlled sex trafficking and the difficulties in its detection and reporting (Verhoeven et al., 2013). Thus, current research on the topic is scarce.

In the past five years, approximately 61% of alleged offenders of sex trafficking and sexual exploitation reported to child protection response in Minnesota were identified as family members or caregivers (Minnesota Department of Human Services, forthcoming). However, despite its estimated scope, familial sex trafficking poses a dilemma for policy makers and other anti-trafficking stakeholders as it challenges the dominant imagery of the "ideal offender" (Christie, 1986, p. 17), who is often portrayed as someone unknown to the victim-survivor; a cisgender man; a person who is very physically aggressive and abusive; and in the context of the United States, a non-citizen or a man of color (Chacén, 2019; Raby & Chazal, 2022; Todres, 2010). The limited research that does exist on familial sex trafficking suggests that, in addition to being directly related to the victim-survivor and thus known, offenders often include cisgender women who employ manipulation and other psychological or emotional violence to control their victim-survivors (Cutbush Starseed & McCallum Desselle, 2024, slide 28; Edwards et al., 2023; Mariaca-Pacheco, 2023; White et al., 2023).

To our knowledge, there has not been an analysis of the popular and public policy discourse about nuclear family units in the context of sex trafficking. A background review on anti-trafficking public policy in the United States and our review of academic literature on the topic identified four contexts in which the term "family" appears. First, the importance of "family re-integration" was often mentioned as a component of rehabilitative and support services for victim-survivors post-trafficking by a stranger (for example, see Juabsamai & Taylor, 2018; Meshkovska et al., 2021). These papers discussed the significance of supporting victim-survivors of sex trafficking in reestablishing relationships with their biological families after their separation and exploitation. Across these sources, family re-integration was framed as a critical step, but not the only step, for victim-survivor recovery and healing. Secondly, families were presented as a tactic used by traffickers to manipulate their victim-survivors, e.g. paying a ransom, or threatening to injure or kill a family member (for example, see Toney-Butler et al., 2023). In addition to these academic sources, popular films like Taken (2008) and The Sound of Freedom (2023) depict harrowing accounts of highly organized international sex traffickers demanding an exorbitant amount of ransom from the families of their victim-survivors. Third, numerous studies found that history of domestic violence (e.g., physical or verbal) within the family unit of the victim-survivor could be a risk factor for further exploitation and abuse, including sex trafficking and familial sex trafficking (for example, see Kyriakakis et al., 2012; Sanborn & Giardino, 2015). Lastly, strong familial bonds are described as a protective factor against sex trafficking and other forms of abuse and exploitation (Franchino-Olsen, 2021; McNeal & Walker, 2016). Cases of familial sex trafficking of minors challenge the perspective of the nuclear family being a protective factor against sex trafficking and, instead, highlight instances in which a child's family and home are not safe.

Currently, there is limited policy attention to familial sex trafficking at the federal and state level. For example, our analysis of the 66 page National Plan to Combat Human Trafficking published in December 2021 by the White House revealed that the terms "family" and "familial" were only mentioned five times and in the context of family re-integration post-trafficking, the involvement of families in paying ransoms to traffickers, and family violence as a risk factor for run-away youth. Nowhere in the 66-page document was familial sex trafficking mentioned.

At the state level, several states have begun to acknowledge the significance and scope of familial sex trafficking. For example, in February 2024, the Minnesota Department of Health and Human Services held a webinar titled "Intrafamilial Trafficking: Improving Services and Response for Children and Families" with over 230 multisectorial attendees (S. Ladd, personal communication, February 22, 2024). Additionally, in 2022, the Kentucky Cabinet for Health and Family Services and Dr. Jordan Greenbaum, the director of the Global Child Health and Well Being Initiative at the International Center for Missing and Exploited Children, created a screening tool and conducted a subsequent study to increase identification of familial sex trafficking across the state (Khoury & Lawson, 2024, slides 30-34). Lastly, in 2018 the Louisiana Child and Youth Trafficking Collaborative Accessibility Initiative launched a new multi-year program with a special focus on familial sex trafficking (Courville & Andrepont, 2024, slides 41-49). Despite these advances, jurisdiction varies between states (Cutbrush Starseed & McCallum Desselle, 2024, slide 24). For instance, in several states, "child welfare jurisdiction includes cases of familial trafficking and third-party trafficking (i.e. all trafficking cases) [...] In other states, child welfare jurisdiction includes cases of family trafficking only" (2024, slide 24).

As a result, there is inconsistency in how cases of familial sex trafficking are managed between states. For example, in states where child welfare agencies only have jurisdiction for familial sex trafficking, instances of familial sex trafficking that involve a third party may not be identified. These discrepancies can result in gaps in service provision for victim-survivors and can create further barriers to identifying, reporting, and prosecuting cases of familial sex trafficking. This lack of coherent and comprehensive state and federal policy to address familial sex trafficking is concerning given the estimated scope of the problem.

As awareness continues to grow about familial sex trafficking- including its adverse mental and physical health sequelae on victimsurvivors and social and economic consequences (Krushas & Kulig, 2023; see Table 1)-there is a growing call for additional research on this complex issue to better understand its scope, identify key risk factors, and create innovative interventions to prevent and disrupt the oftentimes intergenerational cycle of familial sex trafficking. This scoping review is unique as currently there is no structured review of the literature on familial sex trafficking, an understudied form of sex trafficking in the United States. Therefore, with the goal of setting the stage for future research and informing interventions and policies, we conducted a comprehensive analysis of the literature on familial sex trafficking within the United States to bridge this critical gap and contribute to a more comprehensive and nuanced understanding of this hidden and misunderstood problem.

Methods

This scoping review had two objectives: (1) identify extant evidence on familial trafficking in the United States; and (2) analyze this literature to inform future research and best practices to aid program intervention and policy development. The scoping review protocol was registered with Open Societies Foundation (OSF) on September 23,2023.

Inclusion/Exclusion Criteria

Because our goal was to understand familial sex trafficking within the context of the United States, eligible studies must have discussed familial sex trafficking that occurred within the United States to be included for analysis. Studies were excluded if they only included instances of familial sex trafficking outside of the United States, were not published in English, were published before 2000, or if they were not published in a peer-reviewed journal. We did not conduct a search of the grey literature.

Search Strategy

The librarian team member (EW) led the development and execution of the search strategy and literature identification. The search strategy was piloted with a combination of the concepts of family and trafficking, and pilot results were reviewed by the team in order to further refine the search query. The final search strategy looked for the term traffick· within five words of any of the terms family, familial, or intrafamilial. Complete search strategies are available in Appendix A. The final searches were conducted on October 5, 2023, in six databases: Scopus, Medline (Ovid), PsycINFO (Ovid), Sociological Abstracts, Social Services Abstracts, and Criminal Justice Database. Additionally, the reference lists of included studies were screened to identify potentially relevant articles. Covidence, a web-based collaboration software platform designed to support the production of systematic and other literature reviews, was used to remove duplicates and to manage the screening and extraction processes.

Data Abstraction

The study team (KM and VV) collected data from each article using a standardized abstraction form developed within the Covidence software program in November 2023. Fields in the form were derived from the project's aim and primary research questions. Data items captured by each field included article details (e.g., author, date, journal), study aim, study sample (e.g., number of participants, who participated), study design (e.g., qualitative or quantitative), data collection method (e.g., interviews or survey), study location (e.g., rural or urban), key findings, limitations, and gaps. Table 2 outlines all of the data items we extracted from the articles that met inclusion/exclusion criteria. Although the majority of the fields used apriori categorical variables (e.g., study design, study method, sample size, study location) the findings, limitations, and cited gaps in the literature were populated by hand with emergent themes that appeared in the review of the literature (Arksey & O'Malley, 2005). Two study team members (KM and VV) abstracted data from all included articles. Abstracted items were compared and conflicts were resolved through an iterative process between the two study team members.

Data Synthesis and Analysis

Through the iterative process of systematically enumerating findings from the abstraction form, the study team developed a dataset of information about the extant literature on familial trafficking in the United States, including project foci, key findings, research questions, and stated gaps in current knowledge from the reviewed documents. Table 3 presents a high-level summary of the findings across the reviewed literature. In order to synthesize the large amount of data into a cohesive set of results, one study team member (VV) conducted a content analysis of all the identified articles to identify key themes. This same research team member (VV) then created a document which contained all themes and a different study team member (KM) then reviewed the documents and employed a summative content analysis process to tally themes. Results were shared with the last author (LM) for a final high level review of the content.

Results

Systematic Searches

Database searches identified 1319 peer reviewed documents from the six databases that were searched. Of those, 319 were duplicates and subsequently removed. Of the remaining 1000 documents, only 55 met the criteria for full text review to assess for eligibility. Of the 55 articles assessed, only 16 met all of the inclusion criteria and were subsequently analyzed. An additional six articles were located manually and added to the review for a total of 22 articles.

While reviewing whether the studies identified in our search strategy (described below) met our inclusion and exclusion criteria, we identified some (п = 27) that focused on familial trafficking that occurred outside of the United States; although these studies were excluded from our present analysis, we retained a list of studies on familial trafficking that occurred outside of the United States since this is a new area of research, which is presented in Appendix B. However, these were not analyzed.

Of the 22 articles that originally met the inclusion criteria, only nine articles explicitly focused on familial sex trafficking. The other thirteen articles focused more broadly on sex trafficking and included familial sex trafficking only as an emergent theme. Due to the lack of depth of detail about familial trafficking, we excluded these thirteen articles from our analysis of themes. Due to the lack of scholarship on familial trafficking, we provide an overview of some article information from these excluded articles in Appendix C.

The study team conducted an in-depth analysis of data from the nine articles that explicitly focused on familial sex trafficking. This allowed for a more precise analysis of the existing information and current gaps in knowledge about familial sex trafficking. Furthermore, limiting the scope of the review to only the nine articles focusing explicitly on familial sex trafficking allowed for a richer and more poignant qualitative analysis of the literature.

Quantitative Data Items: Study Overview of Articles Focused on Sex Trafficking (N = 9)

The nine articles that explicitly focused on familial sex trafficking were written between 2015 and 2023 and included data collected between 2011 and 2021 (See Figure 2).

Table 3 presents a high-level summary of the extant literature on familial sex trafficking in the United States. Only four fields- public policy, criminal justice and legal studies, family studies, and human trafficking-and six journals were represented in the studies meeting the inclusion criteria for this review. The fields of public policy and human rights only contributed one article each. Additionally, there were no articles in journals related to public health or child welfare, despite the fields being positioned to analyze the community and population health effects of familial sex trafficking and its impact on children, families, and communities that are vulnerable.

Only two of the nine studies received funding (Edwards et al., 2022; Reid et al., 2015). Of the two studies that were funded, one received funding from a professional organization or society (Reid et al., 2015) and one received funding from a state agency (Edwards et al., 2022). None of the studies in this review received federal funding.

Of the nine articles, various research designs, methods, and samples were employed. Two of the articles conducted in-depth interviews and surveys with justice professionals who were 18 years of age or older at the time of the study and identified as cisgender (Allert, 2021; Allert, 2022). Four of the studies (Edwards, 2022; Reid, 2015; Sprang, 2018; White, 2023) included retrospective chart reviews of victim-survivors who were minors at the time of the exploitation. Although these four articles did control for gender and compared prevalence rates of familial sex trafficking between cisgender male and female adolescents in urban and rural areas, none of the four articles using retrospective medical chart review looked at cases of transgender youth or controlled for other categorical variables like race, ethnicity, or socioeconomic class. Lastly, four articles employed a study design using in-depth interviews. Horning and colleagues (2023) conducted in-depth interviews with 24 people identified as sex market facilitators who had experienced familial sex trafficking as an adolescent and now lived in an urban region of New York State. Mariaca-Pacheco and colleagues (2023) conducted in-depth interviews with ten victim-survivors of familial sex trafficking who experienced the abuse as children but were now adults. The sample in Mariaca-Pacheco and colleagues (2023) included nine cisgender and one transgender participant. And finally, Raphael (2020) conducted in depth interviews with four victim-survivors of familial sex trafficking who identified as cisgender.

Although the nine studies had a range of study goals and objectives, the study team observed that many of the articles shared three goals in common: (1) identifying the relationship between the child or adolescent victim-survivor and the perpetrator (Allert, 2021; Allert, 2022; Cole & Sprang, 2018; Mariaca-Pacheco et al., 2023; Reid et al., 2015; White et al., 2023); (2) identifying risk factors for familial sex trafficking (Cole & Sprang, 2015; Edwards, 2022; Raphael, 2020; White et al., 2023); and (3) identifying barriers to reporting cases of familial sex trafficking (Allert, 2021; Allert 2022; Raphael, 2020). The study team noted that to-date only one of the extant articles about familial sex trafficking examined the unique recruitment mechanisms that perpetrators of familial sex trafficking use to groom victimsurvivors (Horning et al., 2023).

Qualitative Themes

Theme 1: Exploring Demographic Characteristics of VictimSurvivors and the Relationship Between Victim-Survivor and Perpetrator

Six of the nine reviewed articles sought to ascertain the characteristics of victim-survivors and perpetrators and the relationship between the victim-survivors and perpetrators (Allert, 2021; Allert, 2022; Cole & Sprang, 2018; Mariaca-Pacheco et al., 2023; Reid et al., 2015; White et al., 2023). Across several studies, it was found that victim-survivors of familial trafficking tend to be younger and have a higher number of sexual transactions than victim-survivors of non-familial cases of sex trafficking (Edwards et al., 2022; Reid et al., 2015; White et al., 2023). Although the literature was inconclusive about the specific characteristics of the perpetrator, several studies (Reid et al., 2015; Sprang & Cole, 2018; White et al., 2023) pointed towards there being a greater likelihood of the perpetrator being a parent or step-parent. Additionally, these studies pointed toward other family members including aunts, uncles, grandparents, and in some cases other adolescents-such as cousins and siblings-being the perpetrators.

The study team observed that one of the major limitations within the reviewed articles that aimed to examine the relationship between the victim-survivor and the perpetrator was the fact that those studies did not explore whether or not the perpetrators themselves had been victim-survivors of familial sex trafficking at some point in their lifetime. The extent to which this was explored in the literature is limited to Raphael (2020) who found in her interviews with victim-survivors of familial sex trafficking that two of her interviewees believed that their parents were involved in the commercial sex industry as adolescents and may have been trafficked themselves.

Theme 2: Common Study Aim Analyzing Risk Factors or Vulnerabilities for Families Engaged in Familial Sex Trafficking

In addition to exploring the demographic characteristics of victim-survivors and the relationship between victim-survivors and perpetrators, seven of the articles reviewed sought to identify risk factors or vulnerabilities associated with involvement in familial sex trafficking (Allert, 2021; Allert, 2022; Cole & Sprang, 2018; Horning, 2023; Raphael, 2020; Reid et al., 2015; White, 2023). These risk factors included substance abuse of parents (Allert; 2022; Cole & Sprang, 2018; Raphael, 2020; White, 2023), other forms of violence in the household (Allert, 2021; Allert, 2022; Reid et al., 2015), housing instability (Allert, 2022), and exposure to other criminal activity in the home and community (Allert, 2021; Allert, 2022; Reid et al., 2015). The study team noted that one of the reviewed papers suggested that familial risk factors or vulnerabilities may be intergenerational and the result of trauma, discrimination, and "structural disadvantage" or systemic inequities, such as poverty and structural racism which limit if not deny certain individuals and communities access to opportunities and services (Horning et al., 2023, р. 2).

For example, Horning and colleagues (2023) found that the theme of neighborhood poverty and structural inequality were present in all 24 of the interviews with former sex market facilitators of familial sex trafficking. These results suggest that socioeconomic inequality may contribute to families and communities being more vulnerable to participating in this form of sex trafficking. Horning and colleagues (2023) write that, "structural and intersectional pressures play a role in the push/pull factors influencing family pimping and contribute to continued childhood trauma and strained relationships" (p. 3).

Theme 3: Barriers to Detection, Reporting, and Prosecution

Five of the reviewed articles highlighted the numerous challenges that exist in research and reporting of familial sex trafficking cases (Allert, 2021; Allert, 2022; Edwards et al., 2022; Pacheco et al., 2023; Reid et al., 2015). Specifically, these articles highlighted that oftentimes familial sex trafficking is miscategorized as child sexual abuse or neglect, which carries less penalty than trafficking cases. Additionally, these articles pointed towards the challenges of detecting cases of familial sex trafficking as clinical staff, law enforcement agencies, and other direct service providers lack the knowledge and tools necessary to detect it. Although the studies included in this review provide compelling evidence for the miscategorization of these cases, more research is needed on the potential scope of the miscategorization and on documenting the numerous challenges that exist to reporting.

Discussion

Cases of familial sex trafficking of minors challenge the understanding of a nuclear family as a protective factor against sex trafficking. Familial sex trafficking questions the commonly accepted belief that a child's or adolescent's home and strong familial ties are the best protective factors for victimization from trafficking as it points to instances in which family members themselves are involved in abuse and exploitation. Thus, family and home are not unequivocally safe places. The experience of familial sex trafficking raises the importance of expanding interventions and strategies that seek to prevent vulnerabilities for individual victim-survivors to also consider what interventions and strategies could prevent entire family units from being susceptible to engaging in this exploitative behavior.

Despite being identified by the Polaris Project's human trafficking hotline as the most common recruitment strategy for sex trafficking (Polaris Project, 2023a), familial sex trafficking is extremely understudied in the United States. After a comprehensive search of the extent literature using key search terms (N = 1000) we identified 22 articles that met the broad parameters of our inclusion/exclusion criteria, nine of which contained enough detail to warrant a full analysis. Our review found that few studies received funding and those that did were smaller grants from professional associations. We found no published articles on familial sex trafficking that were supported by a large or federal grant. This is a significant gap in funder priorities. Articles were published in journals that represent only four fields. Three articles were in a journal related to family studies, which makes sense given the topic. But notably, none involved journals that specialize in child welfare or public health.

The nine articles we identified explored important themes, such as relationships between the familial perpetrator and victim-survivor and specific vulnerabilities for family perpetration of trafficking. But so much more exploration is needed to fully understand familial sex trafficking. This is especially critical to address since family relationships and family unification (when possible) is often seen as an important goal in post-trafficking recovery. Further, there is much more to learn about the specific risks for families and intergenerational trafficking. This nascent literature suggests that the anti-trafficking field may benefit from a focus on familial risk factors to help prevent familial trafficking. Familial trafficking is both similar to other forms of family-based abuse and neglect, and also different. Much more research is needed to disentangle the similarities and differences. Finally, our review highlights significant barriers to identification of familial trafficking that the field should begin to explore.

In addition to the nine articles included for full analysis in our study, our review identified two additional groupings of articles that nearly met our inclusion criteria and are important to mention. First, a group of 13 articles mentioned familial trafficking in the United States but did not provide in-depth content about the nature, extent or experience of familial trafficking and thus were not analyzed here. Second, 27 articles described familial trafficking in countries or regions outside of the United States. These were excluded from our review because we sought to understand familial trafficking in the specific context of the United States. Similarly, cultural context and expected familial obligations vary across regions and continents. A cursory read of the papers from an international context suggests that additional themes were present in the international literature, including international adoption, child marriage, selling children to pay family debts, and human organ trafficking.

Limitations of the Review

Although the study team sought to address any threat to external and internal validity of this scoping review, several limitations to this scoping review do exist, including publication bias, bias in study selection, and limits in the search strategy. Each of these limitations are discussed below.

Publication Bias

This scoping review did not include any grey literature or unpublished literature on the topic of familial sex trafficking of minors. As the results from this scoping review suggest, this subfield within human trafficking is nascent, yet quickly growing. Our review may have missed conference proceedings, technical reports, and other grey or unpublished literature relevant to the review that was not formally published in a peer-reviewed academic journal. Future scoping reviews may consider searching for additional grey and unpublished literature on the topic.

Bias in Study Selection

Although our study team employed mechanisms to ensure that our analysis of the reviewed articles was objective and free of bias-such as having two independent team members review each of the articles at the title and abstract review, abstract screening and full-text phases and using the Covidence software program to blind the independent reviews-the inclusion and exclusion of articles may have been influenced subjectively by reviewers. Additionally, one of the strengths of this scoping review is the nature of the interdisciplinary team. The two team members (VV and KM) who conducted the extracted data from the included articles are from the social sciences and engineering. This interdisciplinary approach helped reduce bias that could be present from reviewers within a single disciplinary background. Future scoping reviews on this topic should continue to employ mechanisms to ensure that bias is minimized as much as possible.

Limits in the Search Strategy

The study team conducted a preliminary review of the literature in August 2023 to identify key terms pertinent to this review. However, due to the exploratory nature of this topic, it is possible that this scoping review missed other key terms that are related to familial sex trafficking. Future scoping reviews on this topic should use the preliminary key word search identified in the methods section as a reference point when building out their key term search.

Limitations of the Literature

Methodological Limitations

Limited Primary Data Collection from Victim-Survivors and Traffickers

Only two of the reviewed studies directly interviewed victimsurvivors of familial sex trafficking about their experiences being groomed and recruited into, victimized by, and exiting familial sex trafficking (Mariaca-Pacheco et al., 2023; Raphael, 2020). These studies show the importance of talking directly with victim-survivors about their experiences as the cases analyzed in Mariaca-Pacheco and colleagues (2023) and Raphael (2020) demonstrate the diverse range of experiences of victim-survivors as well as the unique grooming and recruitment tactics used by familial perpetrators. In addition, Horning and colleagues (2023) interviewed familial sex market facilitators and their experiences in being groomed into becoming traffickers within their nuclear family units. This study demonstrated that many sex market facilitators experienced "structural disadvantage" (p. 1) and grew up in families and communities experiencing poverty and discrimination. Furthermore, Horning and colleagues (2023) found that familial sex trafficking was often intergenerational and that sex market facilitators had family members who had been involved in the criminal activity for many years. It is imperative that future research on the topic of familial sex trafficking prioritize centering the voices of those with lived expertise to (a) better elucidate the various sociostructural factors that made that individual and their family vulnerable to the crime, (b) document any additional barriers that the victim-survivor faced when seeking help and social services, and (c) highlight any potential strategies to facilitate a survivor-victim to exiting instances of familial sex trafficking,

Small Sample Sizes

With the exception of Edwards and colleagues (2022), the studies analyzed in this scoping review had small sample sizes. The two studies that directly interviewed victim-survivors had four (Raphael, 2020) and ten (Mariaca-Pacheco, 2023) participants. One study included interviews with 24 sex market facilitators who had experienced familial sex trafficking as an adolescent (Horning et al., 2023). The other two studies that conducted in-depth interviews or surveys with justice professionals had a range of 35 to 68 participants (Allert, 2021; Allert; 2022). The other three studies that employed retrospective chart review included 19, 31, and 38 participants (Reid et al., 2015; Sprang & Cole, 2018; White et al., 2023).

Need to Control for Sociodemographic Variables to Elucidate the Sociostructural Factors

About half of the reviewed studies (п = 4) explored various sociodemographic characteristics of the victim-survivor, including race and ethnicity, gender, and geographic location of the crime (Mariaca-Pacheco et al., 2023; Reid et al., 2015; Sprang & Cole, 2018; White et al., 2023). Interestingly, the study team noted that none of the reviewed studies examined the poverty level of the household at the time of the crime, although two of the studies that interviewed direct service providers and justice professionals cited poverty as a risk factor for familial sex trafficking (Allert, 2021; Allert, 2022). Furthermore, the study team observed that only one article mentioned structural inequality and systemic racism as drivers of familial sex trafficking (Horning et al.; 2023).

Recommendations for Research and Practice

More research is urgently needed to better understand the unique dynamics of familial sex trafficking as well as its scope and prevalence in the United States. Although there are indications that familial sex trafficking does occur across the United States, our scoping review only found nine published articles on the topic, indicating that research on the topic is currently limited. All of the authors in the nine extant articles called for additional research on familial sex trafficking to better under its scope, prevalence, and the community risk factors as well as the unique recruitment strategies used by perpetrators. Furthermore, the authors suggested that future research specifically focus on how this crime may intersect with other forms of violence, multiple types of human trafficking, and other forms of child abuse.

The research that does exist relies heavily upon retrospective medical and legal chart review as well as interviews with direct service providers, law enforcement agents, and other professional staff. Only three articles included interviews with victim-survivors or family members engaged in familial sex trafficking. Thus, the research community ought to prioritize longitudinal studies to examine the trajectories of victims of familial sex trafficking, including their experiences before, during, and after exploitation, to inform effective intervention strategies.

Additionally, future research should consider conducting socioecological studies focused on entire family units to better understand the unique pathways to whole family system involvement-including a family history of familial sex trafficking-in this illicit crime. Studies should also examine contextual factors that may cause families to be more susceptible to familial trafficking. By further examining the dynamics of familial sex trafficking, researchers will be able to identify key factors contributing to this form of exploitation, including families' vulnerabilities and pathways to exploitation. This research can help guide prevention and intervention to reduce victimization.

Interdisciplinary workforce development and training is needed to better support direct service providers, law enforcement agents, and other anti-trafficking stakeholders to support victim-survivors of familial sex trafficking. In the reviewed articles that conducted interviews with direct service providers, law enforcement agents, and other anti-trafficking stakeholders, many mentioned the difficulty in detecting and responding to cases of familial sex trafficking in the communities they serve. An important challenge identified by these stakeholders was the lack of information and knowledge they have about the topic. Workforce development programs should be created and implemented to provide professionals in relevant fields, such as social work, law enforcement, and health care, with specialized training on identifying and responding to cases of familial sex trafficking. These programs should offer comprehensive education on the nuances of familial sex trafficking, including recognizing signs of exploitation, understanding the complexities of familial involvement, and implementing trauma-informed approaches to support victim-survivors and other impacted parties. By providing professionals with the knowledge and skills needed to address familial sex trafficking, these programs can enhance the capacity of frontline responders to intervene promptly and provide appropriate assistance to victim-survivors.

As noted in several of the reviewed articles, appropriately responding to cases of familial sex trafficking involves collaboration across several different agencies and sectors. Interdisciplinary collaboration among practitioners is essential for developing holistic and trauma-informed approaches to addressing familial sex trafficking. By bringing together professionals from diverse fields, including law enforcement, social services, and victim advocates, collaborative efforts can foster a comprehensive response to familial sex trafficking that addresses the complex needs of victim-survivors and families.

Screening tools and protocols must be improved to allow for the early detection and disruption of familial sex trafficking. Although screening tools and protocols alone cannot prevent or disrupt familial sex trafficking, there is a critical need for improved screening tools and protocols within various settings to identify and intervene in instances familial sex trafficking. These screening tools and protocols should be specifically tailored to the unique dynamics of familial sex trafficking and designed to detect indicators of exploitation, such as coercion, control, and manipulation within familial relationships. Implementing screening protocols in settings frequented by minors, such as schools, health care facilities, and community organizations, can assist in early detection of familial sex trafficking. By improving screening efforts, health care professionals, law enforcement agents, direct service providers, and other anti-trafficking stakeholders and professionals can ensure that victim-survivors receive the necessary support and services to leave exploitative situations and access pathways to safety and recovery.

Conclusion

In this scoping review, we identified a small body of literature on familial trafficking. Far more funding and research is needed to truly understand, prevent, and intervene in cases of familial sex trafficking. Results suggest that numerous barriers exist to detecting the of familial sex trafficking of minors. Furthermore, results from this review found that many challenges exist to efficiently and effectively prosecuting cases of familial sex trafficking of minors in the United States. These results underscore the urgent need for more research and comprehensive policy interventions aimed at addressing this hidden and misunderstood form of commercial child sexual exploitation.

Footnote

* An asterisk mark denotes articles that were located through citation searching.

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