Despite the efforts of survivors and advocates, there are still a lot of common misconceptions about sex trafficking.

As a social worker at the Mount Sinai Adolescent Health Center, I work with many young people who have experienced sexual abuse and exploitation. Here are 5 things I think everyone should know about sex trafficking, because to prevent—and ultimately end—sexual exploitation, we first need to understand it.

1. It happens in the United States. A lot.

Sex trafficking is when someone uses force, coercion or an abuse of power to exploit someone for commercial sex acts. A victim of trafficking doesn’t even need to leave their house, let alone the country, to be trafficked. One of my former patients, Sarah*, was trafficked when she didn’t have enough money to pay for college, and her “boyfriend” offered her a job as a waitress. Instead of taking her to a restaurant, he took her to a client’s home.

Despite common assumptions that human traffickers smuggle their victims into the country, most people who are trafficked in the United States are not brought into the country for that purpose. Instead, they already live here. Young people who are homeless, undocumented, LGBTQ+, abused at home, or otherwise vulnerable are at particular risk.

At least 10,000 to 20,000 children are sexually exploited or trafficked in the USA. Most likely, these numbers are drastic underestimates.

2. Victims are not usually “chained to the bed.”

Many people less familiar with trafficking imagine victims locked in a room or tied to a bed. But usually, the situation is more complicated than that. It’s easy to underestimate the power of emotional abuse and coercion. Traffickers emotionally chip away at their victims’ sense of self. They convince their victims that they are “dirty,” unlovable, and couldn’t survive without them. Victims of trafficking may feel completely dependent on their trafficker or be trying to win their love and affection.

Traffickers often try to isolate their victims, sometimes restricting phone access or stealing passports, visas, or other forms of ID. It’s also common for them to control their victims’ flow of money. This means that people being trafficked often don’t have access to enough money to leave. Many don’t know where they will go or how they will survive if they leave their exploiter.

This isn’t to say that traffickers never lock doors or otherwise physically restrain their victims. That definitely happens. But concentrating only on those cases can make survivors with different experiences feel invalidated, like they weren’t “really” trafficked or didn’t have it “that bad.” This limited understanding also makes it less likely that friends, family, educators, doctors, hotel staff, and others will recognize the signs of trafficking and be able to help young people being trafficked.

3. Traffickers know what they’re doing.

There is a (sad, disgusting) science to coercing young people into “the life.” Traffickers have studied and practiced their recruitment methods. They know to target young people who are financially and/or emotionally vulnerable. Traffickers wait outside of group homes and homeless shelter to woo young people, who have often already been through trauma and are looking for the love and validation they have not received. Often, traffickers will use expensive gifts to impress their targets and make them feel special. These young people often have no support network and are quite vulnerable. Traffickers exploit these circumstances, gaining their victims’ trust before coercing them into sex work.

After grooming them, traffickers often use other tactics to make their victims feel scared, ashamed and dependent on them for basic physical and emotional needs.

4. Victims will not out themselves if they just have the chance.

Being trafficked is heavily stigmatized. Health care providers, law enforcement and social workers can’t expect victims and survivors to out themselves to people they’ve just met. It takes time to develop trust before they’re willing to open up. Providers and other professionals need to approach young people with compassion and understanding—never judgment.

The trafficking survivors we see at the Mount Sinai Adolescent Health Center usually don’t come in because they’re being trafficked. Instead, they come in for STI testing or birth control. Some of them have headaches, belly aches or other physical pains that have no knowable cause. These are somatic pains, caused by trauma and stress. We can educate survivors about how their body is reacting to trauma, and help them organize themselves—but only if they trust us enough to talk about their trauma. The message we send them is we are here, no matter what. We make sure they know that the MSAHC is a safe place, where they won’t be judged. Many of them are only able to come in sporadically, and many are still in “the life.” We don’t tell them “don’t do that”—instead, we give them resources and support to make their own decisions. They are in control.

5. Survivors are strong, and they heal.

As we’ve discussed before, pity doesn’t help survivors. Solidarity does. Survivors are more than their trauma—they are complex individuals just like everyone else, with their own interests, goals and dreams. Healing from trauma is a complicated and difficult process. But it is possible, and there are treatments that work. Survivors are not alone. At the Mount Sinai Adolescent Health Center, we use evidence-based interventions like Trauma Focused Cognitive Behavioral Therapy, which help survivors learn coping skills and give them space to heal.

If you have been trafficked or suspect someone is being trafficked, you can call the National Human Trafficking Hotline at 1-888-373-7888. If you are 10-22 years old and in NYC, you can make a free appointment at the Mount Sinai Adolescent Health Center for comprehensive healthcare, including trauma-informed primary care, sexual and reproductive health, and mental health services.

*Name changed to protect identity


Rachel Colon, LCSW is a primary care social worker at the Center and has over 10 years of experience working with survivors of domestic violence.

The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.