Staff physician The Hospital for Sick Children Toronto, Ontario, Canada
Background: Child sex trafficking is a form of human trafficking for the purpose of sexual exploitation. It constitutes child maltreatment and a growing public health concern in Canada. Child sex trafficking is associated with adverse medical and mental health effects, requiring a comprehensive continuum of pediatric healthcare. Research examining clinical profiles and practice approaches for this population is limited. In response to a high demand for care and gaps in service, The Hospital for Sick Children launched Lotus Health, Canada’s first pediatric healthcare program specializing in child sex trafficking. Our multidisciplinary model of evidence-guided healthcare uses a trauma-informed, strengths-based, systems of care framework. Objective: The objectives of this study were to: 1) describe an innovative model of specialized pediatric healthcare for children who have experienced sex trafficking and those at risk; and 2) examine the sociodemographic, medical, sexual health, mental health, and service characteristics of children referred for healthcare services following a concern of sex trafficking. Design/Methods: A retrospective chart review was conducted of the initial 100 children referred to Lotus Health and seen in clinic at least one time. Sociodemographic, clinical, and service data were systematically extracted from health records using a standardized data collection form. Descriptive statistics were calculated for categorical and continuous variables. Results: The sample (N=100) ranged in age from 12 to 18 years (M=14.9) and were mostly females from diverse racial backgrounds. There were 960 clinical encounters between September 2019 and April 2022. The most frequently requested services were sexual and reproductive healthcare and mental health support. Compared to the general population of children in Canada, the sample was found to have disproportionately high rates of physical injuries, pregnancies, sexually transmitted infections, gynecological problems, disordered eating, neurological concerns, neurodevelopmental disabilities, mental health disorders, suicidality, and substance use.
Conclusion(s): This study offers evidence of the highly complex clinical profiles of children exposed to sex trafficking and the need for specialized pediatric healthcare services. Findings advance the state of empirical and clinical knowledge in a Canadian context and provide an avenue toward improving health and safety outcomes for this vulnerable population of children.
