CHILD DEVELOPMENT PERSPECTIVES The Impact of Trafficking on Children: Psychological and Social Policy Perspectives

Child trafficking and commercial sexual exploitation (CSE) are egregious crimes, extreme forms of child maltreatment, and major violations of children’s human rights. Although empirical research is sorely lacking on the impact of such crimes on children’s developmental well-being, numerous reports describe the physical and emotional trauma, humiliation, vio­ lence, degradation associated with treatment as a com­ modity, and unrelenting fear and abuse. This paper provides an overview of the impact of trafficking and CSE on children and the practical implications of related research in the areas of child maltreatment and victim­ ization. Findings suggest that trafficking and CSE present grave risks to the physical, psychological, spiritual, and social–emotional development of young victims. Impli­ cations for psychology and social policy, in terms of prevention and psychosocial rehabilitation for children who have been victimized, are also presented. KEYWORDS—child trafficking; commercial sexual exploi­ tation; psychosocial rehabilitation; international psychology Human trafficking and commercial sexual exploitation (CSE) are major social problems. Children are routinely sold like commodities in a multibillion dollar industry that operates with near impunity (International Labour Organization—International Programme on the Elimination of Child Labour [ILO-IPEC], 2001; United Nations Office of Drugs and Crime [UNODC], The author would like to express her sincere appreciation to Steve Reznick and the anonymous reviewers for their insightful comments and suggestions. Correspondence concerning this article should be addressed to Yvonne Rafferty, Department of Psychology, Pace University, 41 Park Row, New York, NY 10038; e-mail: [email protected]. # 2008, Copyright the Author(s) Journal compilation # 2008, Society for Research in Child Development 2006). CSE is the most widely recognized form of child traffick­ ing, and because heterosexual prostitution remains the largest and most profitable form of CSE, girls are primarily affected (International Organization for Migration [IOM], 2007). Two million girls ages 5–15 are initiated into the commercial sex industry each year (United Nations Population Fund [UNFPA], 2000). An increasing number of boys are also trafficked for pedophile abuse, sexual tourism, child pornography, and pros­ titution (IOM, 2007; Lillywhite & Skidmore, 2006). Children trafficked into one form of labor are often subsequently sold into another, as with girls who are recruited to work in factories or domestic work but who are subsequently sold into brothels. Abuse and exploitation of children who have been trafficked often go unreported, and the crimes that are reported rarely result in the prosecution of perpetrators. Traffickers, pimps, and buyers generally remain free and unpunished, whereas children are often prosecuted for illegal border crossings, being undocumented migrants, and crimes associated with prostitu­ tion (Child Rights International Network [CRIN], 2005). Because they are rarely identified as victims, the support ser­ vices they desperately need are rarely provided (Farr, 2005). Although researchers have identified several factors that place children at risk for child trafficking, they are often merely listed with no theoretical framework to guide research. The ecological perspective (Bronfenbrenner, 1986) is a possible framework to conceptualize risk factors associated with child trafficking because it emphasizes the relationship between people and their environment, rather than examining the characteristics of either in isolation. When applied to child trafficking, this framework could focus on child and family risk factors (e.g., victims are disproportionately female, between the ages of 12 and 16, ethnic minorities, those lacking educa­ tion and vocational skills, and from marginalized social groups with fewer personal resources), characteristics of the commu­ nity (socially isolated rural areas characterized by extreme poverty and economic inequality), and broader contextual variables (e.g., gender inequality and discrimination and unrelenting demand factors; Chase & Statham, 2005; Rafferty, 2007). Attitudinal factors are also linked with CSE (e.g., the Volume 2, Number 1, Pages 13–18 14 j Yvonne Rafferty belief that sexual intercourse with virgins reduces risks associated with HIV/AIDS; Lalor, 2004). DEVELOPMENTAL IMPACTS OF CHILD TRAFFICKING Traffickers use psychological manipulations and coercive methods to maintain control over their victims and to make their escape virtually impossible by destroying their physical and psychological defenses. Reported methods include physi­ cal, sexual, and psychological violence; isolation; deployment in areas unknown to them; dependence on alcohol or drugs; controlled access to food and water; and monitoring through the use of weapons, cameras, and dogs (IOM, 2007; Zimmerman et al., 2003). Children who experience CSE confront all the dangers associated with sexual abuse; they are also subjected to routine beatings and abuse by traffickers, employers, pimps, madams, and customers. It is the extent and persistence of the psychological and physical abuse and the coercive, deceitful, and exploitative relationship with the traffickers that distin­ guish trafficking from other maltreatment. Although empirical research (i.e., rigorous academic re­ search) on the impact of trafficking on children is lacking, numerous accounts suggest that the emotional and physical trauma and unrelenting abuse and fear present a grave risk to physical, psychological, spiritual, and social–emotional devel­ opment (Bertone, 2000; End Child Prostitution and Trafficking International [ECPAT], 2005, 2006a; ILO-IPEC, 2001; Scarpa, 2005). Case studies of victims suggest that CSE is ‘‘the most physically and emotionally damaging for the victim because of the persistent physical, sexual and psychological abuse that accompanies it on a daily basis’’ (IOM, 2007, p. 25). Some children die as a result of abuse and exploitation; others disappear (Mitchels, 2004; UNODC, 2006). In addition to these case studies and reports, research on child maltreatment can shed light on the plight of children who are trafficked. These studies suggest a strong link between child maltreatment and maladaptive physical and psychological out­ comes (Bottoms & Quas, 2006). The following sections highlight the impact on children who are trafficked, including educational deprivation, physical health problems, and emotional and behavioral issues. The sections also review related research on child maltreatment and victimization. Findings suggest that developmental theory, and particularly complex trauma theory (Briere & Spinazolla, 2005; Cook et al., 2005), may provide a useful theoretical framework to guide our understanding of how trafficking affects children. Children who have been exposed to complex trauma, such as prolonged physical abuse, sexual abuse, emotional abuse and neglect, violence, and torture, are at increased risk for a number of symptoms and behavioral characteristics, including attachment, biological integrity, emotional regulation, dissociative adaptations, behav­ ior, cognitive functioning, and self-concept. Educational Deprivation Children who are trafficked are robbed of the few educational opportunities available to them and, thus, a chance to improve their future economic situation. Related research has identi­ fied adverse outcomes of educational deprivation among victims of neglect (psychological and emotional) and abuse (physical and sexual). Outcomes include developmental de­ lays, language and cognitive difficulties, deficits in verbal and memory skills, poorer academic performance, and grade reten­ tion (e.g., Eckenrode, Laird, & Doris, 1993; Friedrich, Einbender, & Luecke, 1983; Gaudin, 1999; Kendall-Tackett & Eckenrode, 1996). Physical Health Problems Victims of child trafficking experience inhumane living con­ ditions, inadequate diet and hygiene, beatings and abuse, neglect, and denial of their basic human rights to health care and protection, resulting in lasting health problems (ECPAT, 2006a; ILO-IPEC, 2001). Victims of CSE are further threatened by unsafe sexual practices, heightening risks of unwanted pregnancies, unsafe abortions, complications from frequent high-risk pregnancies, and sexually transmitted diseases, including HIV/AIDS (ECPAT, 2006b; Mitchels, 2004; UNFPA, 2000). HIV/AIDS and other sexually transmitted diseases are prevalent among children who have been trafficked (ECPAT, 2005; Scarpa, 2005). Related research has also identified a number of adverse health outcomes for children who have been abused, maltreated, and victimized (Malinosky-Rummell & Hansen, 1993; Sneddon, 2003). Emotional Well-Being The experiences associated with trafficking can lead to lasting psychological challenges. Children experience physical and emotional trauma associated with removal from their families, homes, and communities; their subsequent encounters involve substantial harm through physical, emotional, and sexual abuse (Mitchels, 2004). Although empirical studies have not assessed the psychological impact of child trafficking, case studies have reported adverse emotional effects among trafficked children, including depression, hopelessness, guilt, shame, flashbacks, nightmares, loss of confidence, lower self-esteem, and anxiety (ECPAT, 2006a). The negative messages they routinely receive can influence their sense of worth, leading to feelings of selfblame (ECPAT, 2006a). Empirical research on child maltreatment has identified numerous adverse consequences for victims. Psychological abuse associated with ongoing threats, isolation, and witnessing the abuse of others negatively affects self-concept, personal goals, and relationships with others, and seriously jeopardizes emotional well-being (Hart & Brassard, 1987; Sneddon, 2003). Emotional and physical neglect are associated with social and emotional withdrawal (Bousha & Twentyman, 1984), behavioral problems (Watts-English, Forston, Gibler, Hooper, Child Development Perspectives, Volume 2, Number 1, Pages 13–18 Child Trafficking j 15 & DeBellis, 2006), and lower self-esteem, confidence, and assertiveness (Egeland, Sroufe, & Erickson, 1983). Children who experience physical and sexual abuse are more likely to experience adverse emotional outcomes, including anxiety and depression, lower self-esteem, social isolation, symptoms of posttraumatic stress disorder (PTSD), substance abuse, and suicide (Dykman et al., 1997; Kaufman, 1991; Nelson et al., 2002; Sneddon, 2003). Sexually abused children can suffer severe psychological ramifications, such as PTSD and depression (Browne & Finkelhor, 1986; Kendall-Tackett, Williams, & Finkelhor, 2001). Finally, multiple experiences of victimization during childhood increase risk for mental illness (Read, 1997) and psychiatric difficulties in adults who were victimized as children (Edwards, Holden, Felitti, & Anda, 2003; Horwitz, Widom, Loughlin, & White, 2001; Widom, 1999). Behavioral Outcomes Adverse behavioral outcomes, including attachment difficul­ ties, mistrust of adults, antisocial behaviors, and difficulties relating to others, have been reported among children who were trafficked (ECPAT, 2006a). Although empirical studies have not been conducted, several reports suggest that CSE is a risk factor for sexualized behavior, and that some adolescents may turn to prostitution or other sexual activity because they feel worthless, that their lives have been spoiled, and that they have nothing left to lose (ECPAT, 2006a). Mitchels (2004) reports that some younger children resort to self-harm to regain a sense of control through pain, whereas older children detach them­ selves from the harsh realities they have endured by abusing alcohol or drugs. Research has linked hostile and aggressive behavior in children who were physically abused to the aggressive manner in which they are treated (Kaplan, Pelcovitz, & Labruna, 1999; Prino & Peyrot, 1994). Children who were physically or sexually abused experience suicidal behaviors, emotional problems, and difficulties relating to their peers (Sneddon, 2003). They are also at greater risk for substance abuse (Arellano, 1996). Adults who were neglected as children are at increased risk for violence, antisocial behavior, and related problems (Widom & White,