Objectives. To describe the prevalence of sex trading by gender and by associations with mental health concerns and protective factors. Methods. We used data from 9th and 11th graders who completed the 2019 Minnesota Student Survey. The analytic sample (n = 67 806) included transgender and gender-diverse (TGD) youths and cisgender youths who reported trading sex. Data on 7 mental health measures and 4 school-related and health care–related protective factors were collected. Results. The prevalence of sex trading (5.9%) was 5 times higher among TGD students than cisgender students (1.2%). In addition, the prevalence of all mental health concerns was high among TGD students who traded sex (e.g., 75.9% reported a lifetime suicide attempt, as compared with 45.9% of cisgender students who traded sex). Fewer statistical differences were found across protective factors. When TGD students who traded sex were compared according to sex assigned at birth, no statistically significant differences were found. Conclusions. Our findings support strong calls for increased competence regarding gender and sex trading or exploitation in clinical and school-based settings to decrease health disparities among TGD youths. Public Health Implications. In this study, we have presented unique prevalence estimates of mental health disparities among TGD students in the United States who trade sex. Our results indicate that TGD students who trade sex are at risk for mental health symptoms and that sensitivity to both gender and sex trading or exploitation will be critical to meeting the needs of this group in clinical as well as school-based settings.

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Background: Human trafficking for sexual exploitation (referred to as sex trafficking) is a complex global challenge that causes harm and violates human rights. Most research has focused on victim-level harms and experiences, with limited understanding of the networks and business functions of trafficking operations. Empirical evidence is lacking on how to disrupt trafficking operations because it is difficult to study; it is hidden and dangerous, spans academic disciplinary boundaries, and necessitates ways of knowing that include lived experience. Collaborative approaches are needed, but there is limited research on methods to best build transdisciplinary teams. Aim: The aim of this study was to understand how to form a community-engaged transdisciplinary research team that combines qualitative and operations research with a survivor-centered advisory group. Methods: We conducted a qualitative meta-study of our team that is seeking to mathematically model sex trafficking operations. Data were collected from the minutes of 16 team meetings and a survey of 13 team members. Results: Analysis of meeting minutes surfaced four themes related to content and style of communication, one related to value statements, and one capturing intentional team building efforts. Survey results highlighted respect, trust, integrity, openness and asking and answering questions as key aspects of team building. Results show that an action research approach to team building, focused on trust and communication, fostered effective collaboration among social scientists, operations researchers, and survivors of trafficking. Conclusion: Team building, shared language, and trust are essential, yet often neglected, elements of team science. This meta-study provides important methodological insights on community engaged transdisciplinary team formation to tackle vexing social challenges.

One of the major challenges associated with applying operations research (OR) models to disrupting human trafficking networks is a limited amount of reliable data sources readily available for public use, since operations are intentionally hidden to prevent detection, and data from known operations are often incomplete. To help address this data gap, we propose a network generator for domestic sex trafficking networks by integrating OR concepts and qualitative research. Multiple sources have been triangulated to ensure that networks produced by the generator are realistic, including law enforcement case file analysis, interviews with domain experts, and a survivor-centered advisory group with first-hand knowledge of sex trafficking.The output models the relationships between traffickers, so-called "bottoms", and victims. This generator allows operations researchers to access realistic sex trafficking network structures in a responsible manner that does not disclose identifiable details of the people involved. We demonstrate the use of output networks in exploring policy recommendations from max flow network interdiction with restructuring. To do so, we propose a novel conceptualization of flow as the ability of a trafficker to control their victims. Our results show the importance of understanding