1 AN EXPLORATION INTO THE PREVALENCE, RELATED RISK FACTORS, AND AFTERCARE PROGRAMMING AVAILABLE FOR YOUTH, TRANSGENDER YOUTH, AND YOUNG ADULTS WHO ARE UNHOUSED AND COMMERCIALLY SEXUALLY EXPLOITED By Paige E. Anweiler Under the Supervision of Dr. D. Scharie Tavcer An Honours Project submitted in partial fulfillment of the Degree requirements for the degree of Bachelor of Arts - Criminal Justice (Honours) Mount Royal University Date Submitted: April 18, 2024 2 Copyright © 2024 Paige E. Anweiler ALL RIGHTS RESERVED This work is completed in entirety by Paige E. Anweiler. All rights are reserved to the information provided in this document. MOUNT ROYAL UNIVERSITY CALGARY, AB, CANADA 3 Land Acknowledgement This honours project was completed on the traditional territory of Treaty 7 and Métis Nation of Alberta Region 3. Also known as Calgary and the place the Blackfoot call Mohkinstsis. 4 Abstract This integrative literature review allowed for a deeper understanding of the unique challenges that transgender, unhoused, youth and young adults face in Calgary and Edmonton. The association between their distinct experiences and commercial sexual exploitation were explored and identified through a review of academic and gray literature. This resulted in identifying risk factors that were juxtaposed with Maslow’s humanistic theory and McDonald’s survival sex hierarchy to make inferences on the causes and consequences of sexual exploitation of these populations, and how best to support them. The prevalence of commercial sexual exploitation within the transgender, unhoused, youth and young adult population in Canada was discovered to cause harm and the environmental scan of the aftercare programming was evaluated and presented. This evaluation included the extent to which the aftercare programming adheres to inclusivity and trauma-informed care so that in combination with the literature, the goal was to compile knowledge about transgender youth and young adults who are unhoused and sexually exploited, and offer suggestions on how to uplift, support, and foster healing. 5 Acknowledgments Firstly, I would like to show my appreciation for my honours supervisor, Dr. D. Scharie Tavcer. I am incredibly grateful for her dedication, support, and mentorship. She not only improved my research and writing skills but also gave me the opportunity to grow as a person. Dr. Tavcer’s extensive knowledge and academic abilities allowed me to aim higher in my future educational endeavors. I am thankful for her selfless decision to assist me on my journey and the countless hours spent supervising this project. The professors within the criminal justice program at Mount Royal University (MRU) are phenomenal. They have given me the tools to succeed both in and out of the classroom. I would like to specifically express my gratitude to Professor Doug King and Dr. Harpreet Aulakh for their time spent teaching the honours seminar. I learned a tremendous amount and their guidance was instrumental in the completion of this project. Thank you to Madelaine Vanderwerff. Her research and data collection prowess was invaluable. I am so grateful for her support and advice. I would also like to thank Tiffany Doherty for her APA citation support. My mother, father, and brother also deserve my appreciation. I admire and try to emulate their determination, dedication, work ethic, compassion, kindness, and courage in everything I do, especially when conducting this honours project. They have been my biggest cheerleaders and I could not have finished this project without them. To my grandad, grandma D., and grandpa D. thank you for being in my life. Their support and love means the world to me. I also want to thank my friends. Their friendship made the process of completing this project much better and for that I am grateful. Lastly, to the other 2024 MRU criminal justice honours students I am appreciative that we had each other to lean on. They are all so brilliant and I can not wait to see where life takes them. 6 Table of Contents Land Acknowledgement................................................................................................................3 Abstract...........................................................................................................................................4 Acknowledgments.......................................................................................................................... 5 Table of Charts and Figures..........................................................................................................8 An Exploration into the Prevalence, Related Risk Factors, and Aftercare Programming Available for Youth, Transgender Youth, and Young Adults Who are Unhoused and Commercially Sexually Exploited................................................................................................ 9 Focus........................................................................................................................................ 11 Commercial Sexual Exploitation............................................................................................. 13 Global Definition............................................................................................................... 13 Canadian Definition........................................................................................................... 16 Transgender Youth and Young Adults..................................................................................... 17 Unhoused Youth and Young Adults.........................................................................................20 Methodology................................................................................................................................. 27 Descriptive Research............................................................................................................... 27 Integrative Literature Review............................................................................................ 27 Limitations................................................................................................................... 28 Feminist Methodology....................................................................................................... 31 Data Collection........................................................................................................................ 32 Theoretical Framework...............................................................................................................35 Maslow’s Humanistic Theory.................................................................................................. 35 McDonald’s Survival Sex Hierarchy....................................................................................... 40 Limitations of Maslow’s Humanistic Theory.......................................................................... 43 Limitations of McDonald’s Survival Sex Hierarchy............................................................... 45 Harm Caused by Commercial Sexual Exploitation.................................................................. 47 Risk Factors..................................................................................................................................50 Risk and Protective Factors..................................................................................................... 50 Risk Factors for Commercial Sexual Exploitation.................................................................. 50 Prevalence.......................................................................................................................... 53 Risk Factors for Transgender Youth and Young Adults.......................................................... 58 Prevalence.......................................................................................................................... 63 Victimization......................................................................................................................64 Risk Factors for Unhoused Youth and Young Adults.............................................................. 65 Prevalence.......................................................................................................................... 67 Victimization......................................................................................................................68 Combined Risk Factors............................................................................................................68 Connecting Risk Factors to the Theoretical Framework......................................................... 70 7 Environmental Scan.....................................................................................................................75 Design...................................................................................................................................... 75 Survivor-focused Lens....................................................................................................... 76 Trauma-informed Care.......................................................................................................76 Inclusivity.......................................................................................................................... 78 Calgary.....................................................................................................................................79 SafeLink Alberta................................................................................................................79 RESET Society of Calgary................................................................................................ 81 Calgary Communities Against Sexual Abuse....................................................................82 Edmonton.................................................................................................................................83 Sexual Assault Centre of Edmonton.................................................................................. 83 Saffron Centre.................................................................................................................... 84 ACT Alberta.......................................................................................................................85 Conclusion.................................................................................................................................... 90 Discussion..................................................................................................................................... 92 References..................................................................................................................................... 96 Appendix A................................................................................................................................. 124 Appendix B................................................................................................................................. 125 Appendix C................................................................................................................................. 127 Appendix D................................................................................................................................. 128 Appendix E................................................................................................................................. 130 8 Table of Charts and Figures Figure 1: Maslow’s Hierarchy of Needs....................................................................................... 24 Figure 2: Inclusion and Exclusion Criteria................................................................................... 29 Appendix A: Summary of the Harm Caused by Commercial Sexual Exploitation....................124 Appendix B: Summary of the Risk Factors for Commercial Sexual Exploitation by Population.................................................................................................................................... 125 Appendix C: Child and Youth Victims (0 to 17 Years) of Police-Reported Sexual Offences, by Province and Territory, 2012........................................................................................................127 Appendix D: Programs That Support Those Who are Currently or Have Been Sexually Exploited, Which Were Obtained From the 211 Alberta Database............................................. 128 9 An Exploration into the Prevalence, Related Risk Factors, and Aftercare Programming Available for Youth, Transgender Youth, and Young Adults Who are Unhoused and Commercially Sexually Exploited The goal of this honours project was to gain a deeper understanding of the prevalence, and related risk factors for youth, trans youth, and young adults who are unhoused and consequently are commercially sexually exploited. This aim led to the creation of the research question: what are the risk factors as well as effective aftercare programming associated with commercial sexual exploitation for unhoused transgender youth and young adults? To explore this, Maslow’s humanistic theory and its more recent adaptation known as McDonald’s survival sex hierarchy (MSSH) were used as a guiding post to explain the risk factors associated with each population of interest (McDonald & Middleton, 2019). These risk factors can be examined to discern which one of the categories within Maslow’s hierarchy of needs they fit into. These needs were divided into physiological, safety, love and belonging, esteem, self-actualization, and transcendence. This theory showcases the needs that victims of commercial sexual exploitation are trying to fulfill and their correlated degree of importance. Youth and young adults explored in this study, were defined as individuals between the ages of 12 and 24 which mirrors that found encompassed in Canadian legislation. The low end of this age range comes from Canada’s Youth Criminal Justice Act (YCJA). This is the legislative document for youth charged with a criminal offence and applies to children between the ages of 12 and 17 (Youth Criminal Justice Act, SC 2002, c 1, s 2(1), s. 3(1)). Alberta has legislation to support children who have experienced sexual exploitation called the Protection of Sexually Exploited Children Act (PSECA) (Protection of Sexually Exploited Children Act, RSA 2000, c P-30.3). This Act serves children as well as adults up until the age of 24 who have been sexually 10 exploited or who are at risk of being sexually exploited, and who participate in voluntary or involuntary services to support their healing and transition into society after victimization (Government of Alberta Children and Youth Services, 2014; Protection of Sexually Exploited Children Act, RSA 2000, c P-30.3, s 7). Aftercare programs in Alberta were also examined to compare their effectiveness in supporting these populations with a focus on programming within Alberta’s two largest cities, Calgary and Edmonton. The various agencies within these cities work together to provide programs that include mental and physical health, shelter, education, legal assistance, and other needs-based services (Dedase-Escoton et al., 2020; Muraya & Fry, 2016). Aftercare programs are created to assist survivors of sexual exploitation in alleviating their trauma, diversion from the criminal justice system, and increased support for societal reintegration into their communities or families. The definition of youth and young adults was also influenced by the age limits of these programs, which is typically 24 or 25 years of age depending on the aftercare program in Alberta. Extension beyond age 18 happened because services realized many survivors of childhood sexual exploitation needed support (Dedase-Escoton et al., 2020; Government of Alberta Children and Youth Services, 2014; Muraya & Fry, 2016; Protection of Sexually Exploited Children Act, RSA 2000, c P-30.3, s 7). This is to support young adults in the transition from victimization into the rest of society as well as assist in healing the childhood trauma they experienced, that often continues to have a long-lasting impact (Barnert et al., 2017; Clayton et. al., 2014; Dedase-Escoton et al., 2020; Government of Alberta Children and Youth Services, 2014; Hampton & Lieggi, 2020; Jimenez et al., 2015; Muraya & Fry, 2016; O’Brien et al., 2023; Protection of Sexually Exploited Children Act, RSA 2000, c P-30.3, s 7). 11 Focus The focus of this honours project was on the commercial sexual exploitation of unhoused youth, transgender youth, and young adults within Canada. Commercial sexual exploitation of youth under age 18, is the procurement or facilitation of a minor by an adult for the purpose of sexual act(s) and includes the exchange of sex for a need that is deemed essential by the victim, such as money, shelter, nutrition, emotional support, or addictive substances (Czechowski et al., 2022; Hurst, 2021). The Criminal Code of Canada under section 153(1) defines the offence of sexual exploitation as: Every person commits an offence who is in a position of trust or authority towards a young person, who is a person with whom the young person is in a relationship of dependency or who is in a relationship with a young person that is exploitative of the young person, and who a) for a sexual purpose, touches, directly or indirectly, with a part of the body or with an object, any part of the body of the young person; or b) for a sexual purpose, invites, counsels or incites a young person to touch, directly or indirectly, with a part of the body or with an object, the body of any person, including the body of the person who so invites, counsels or incites and the body of the young person. The age of consent in Canada to engage in sexual activity is 16 (Government of Canada, 2023) but it is also considered an offence if the person was 16, 17, or 18 and the perpetrator was in an authority position, offers them care, or the relationship is manipulative in nature (Bellemare, 2008). As outlined in section 153(1.2) of the Criminal Code: 12 A judge may infer that a person is in a relationship with a young person that is exploitative of the young person from the nature and circumstances of the relationship, including a) the age of the young person; b) the age difference between the person and the young person; c) the evolution of the relationship; d) and the degree of control or influence by the person over the young person. In this case, someone 16 years old or older but younger than 18 years old is defined as a young person (Criminal Code, RSC 1985, c C-46, s 153(2)). Section 153(1.1) of the Criminal Code also details the possible punishments for the offence of sexual exploitation. Every person who commits an offence under subsection (1) a) is guilty of an indictable offence and is liable to imprisonment for a term of not more than 14 years and to a minimum punishment of imprisonment for a term of one year; or b) is guilty of an offence punishable on summary conviction and is liable to imprisonment for a term of not more than two years less a day and to a minimum punishment of imprisonment for a term of 90 days. Bill C-36, the Protection of Communities and Exploited Persons Act, legally protects adult sex workers from the criminalization of the sale of their own sexual acts (Bill C-36, (An Act to amend the Criminal Code in response to the Supreme Court of Canada decision in Attorney General of Canada v. Bedford and to Make Consequential Amendments to other Acts, 2nd Sess, 41st Parl, 2014 (as passed by the House of Commons 6 November 2014) legally protects adult 13 sex workers from the criminalization of the sale of their own sexual acts; (Department of Justice Canada, 2023). But in contrast, if people are performing commercial sex acts under duress, coercion, out of monetary necessity, and/or they are age 18 or younger, then voluntary consent is voided (Gerassi, 2015a; Government of Canada, 2023) and the youth are considered to be sexually exploited versus engaged in sex work. In the context of Alberta, section 9 of the PSECA legislation outlines its own offences in relation to child sexual exploitation, as seen here: Any person who: (a) causes a child to be a child in need of protection, or (b) obstructs or interferes with, or attempts to obstruct or interfere with, a director or a police officer exercising any power or performing any duty under this Act There are three potential punishments for this offence outlined in PSECA which can include a fine of $25,000 or less, imprisonment of 24 months or less, or a combination of a fine and custody sentence. Commercial Sexual Exploitation Global Definition Commercial sexual exploitation is defined by the International Labour Office Geneva (2007) as: CSEC is the sexual exploitation by an adult with respect to a child or an adolescent female or male – under 18 years old; accompanied by a payment in money or in kind to the child or adolescent (male or female) or to one or more third parties. (p. 7) 14 This type of sexual exploitation can take many different forms. As outlined by the International Labour Office Geneva (2007), child pornography and physical sexual abuse by way of the sex trade or sex tourism are aspects of commercial sexual exploitation. In addition, commercial sexual exploitation is unique due to the trade that it is characterized by. This transaction is a requirement for commercial sexual exploitation but is not always evident in child trafficking as a whole (United Nations, 2019). While the exchange for sex may include money, it does not need to be of monetary value. Instead, it may be in the form of something the victim requires and is thus valuable to them (Czechowski et al., 2022; Hurst, 2021). These transactions may include housing, food, companionship, education, drugs, or alcohol (Czechowski et al., 2022; Hurst, 2021; Kattari & Begun, 2017; United Nations, 2019). Many of these items have to do with one's quality of life which gives this phenomenon the name of survival sex when the victims are adults (Czechowski et al., 2022). Commercial sexual exploitation directly involves youth and young adults as they are the ones who are victimized through this act (Labour Office Geneva, 2007). Children - those under 18 years of age - are used for sexual means largely for the purpose of pedophiles’ - adults’ sexual pleasure (Justice Institute of British Columbia, 2002). Victims are usually more susceptible to suggestion, emotionally immature, and reckless because they lack the life experience and/or developmental skills to make healthy decisions (Schwartz, 2015). Therefore, there is a power imbalance from the very beginning of the interaction that is utilized to sexually exploit (International Labour Organization, 2015). In Canada, the age of consent for sexual acts is 16 (Government of Canada, 2023). Therefore, sexual acts with a minor under the age of 16 are prohibited as the child cannot voluntarily consent (Gerassi, 2015a; Government of Canada, 2023). Regardless of this, commercial sexual acts can not be legally performed under force, 15 compulsion, or financial necessity. Thus, commercial sexual exploitation can not be consensual due to the age of the victim as well as its coercive aspect. It is important to note that sex work differs from commercial sexual exploitation. Sex work may be similar to commercial sexual exploitation as it can result in harm to those who engage in this work (Benoit et al., 2017, Navarrete Gil et al., 2021). However, Shirley (n.d.), who is a sex worker, believes that this profession empowers her. She engages in sex work to regain the power and authority that she lost when she was previously victimized and as a way to increase her self-esteem. A sex positivist view on sex work supports this understanding (Gerassi, 2015a). This perspective argues that when sex work is consensual, sex workers should be allowed to decide whether or not to engage in this type of work. This follows the “rights-based approach” that service providers may implement when supporting sex workers, such as SafeLink Alberta’s Shift program (SafeLink Alberta, n.d.b, para. 1). The consent and empowerment piece of sex work is missing in commercial sexual exploitation (Bellemare, 2008; Gerassi, 2015a; Government of Canada, 2023; International Labour Organization, 2015; Lanctot et al., 2021; McDonald & Middleton, 2019; Shirley, n.d.). Youth and young adults involved in commercial sexual exploitation may be forced to face victimization based on the needs that commercial sexual exploitation may fill (Gerassi, 2015a; Government of Canada, 2023; McDonald & Middleton, 2019). Children and youth cannot consent as they may be under the age for consent in Canada, manipulated, coerced, under the authority of their abuser, and/or doing this work out of necessity and survival (Bellemare, 2008; Gerassi, 2015a; Government of Canada, 2023; International Labour Organization, 2015; Lanctot et al., 2021; McDonald & Middleton, 2019). These reasons negate any informed consent resulting in this type of victimization being named commercial sexual exploitation. 16 Canadian Definition The Canadian Centre of Expertise on the Prevention of Sexual Exploitation and Abuse (PSEA), also known as Digna, works to prevent this type of victimization in Canada and internationally (Digna, n.d.a). Digna defined sexual exploitation as “any actual or attempted abuse of a position of vulnerability, differential power, or trust, for sexual purposes, including, but not limited to, profiting monetarily, socially or politically from the sexual exploitation of another” (para. 1). However, the Government of Canada (2017) states that they are “committed to ending the commercial sexual exploitation of children” (para. 1). To assist this effort Canada helped to create and later signed the Optional Protocol to the Convention on the Rights of the Child on the Sale of Children, Child Prostitution and Child Pornography in 2001 (Government of Canada, 2017). The Optional Protocol defined their population of interest as (General Assembly of the United Nations, 2000): a) Sale of children means any act or transaction whereby a child is transferred by any person or group of persons to another for remuneration or any other consideration; b) Child prostitution means the use of a child in sexual activities for remuneration or any other form of consideration; c) Child pornography means any representation, by whatever means, of a child engaged in real or simulated explicit sexual activities or any representation of the sexual parts of a child for primarily sexual purposes. (p. 248) Thus, Canada seems to subscribe to the larger understanding of sexual exploitation instead of commercial sexual exploitation. In other words, Canada has not officially defined commercial sexual exploitation, rather they use the broader definition of sexual exploitation which commercial sexual exploitation would be organized under. In the case of the Optional 17 Protocol commercial sexual exploitation would either fall into the sale of children or child prostitution depending on whether there was a trafficker or not (General Assembly of the United Nations, 2000). Therefore, Canada’s understanding of commercial sexual exploitation seems to overlap with the ideas that were presented by the International Labour Office Geneva (2007) global definition. Transgender Youth and Young Adults Sex and gender are two distinct facets of one’s being. Sex relates to the biological aspects of one's being, such as “anatomy, physiology, genetics, and hormones” (National Institutes of Health, n.d., para. 2). These are aspects that you are born with (National Institutes of Health, n.d.). Thus, there are biological characteristics that are assigned to either male or female and are then used to determine sex. Though this sounds simplistic, biology is more complicated (Hughes, 2002; Morland, 2014; National Institutes of Health, n.d.). There are also individuals who do not fit into the biological criteria for male or female. For example, intersex people may be born with underdeveloped sex characteristics or a combination of male and female sex characteristics. Therefore, their sex is not within the binary of male or female sex (GLAAD, 2022b). Gender is a social construct, whereby one’s culture, experiences, and societal gender roles play a part in creating (National Institutes of Health, n.d.; Torgrimson & Minson, 2005; World Health Organization, n.d.). These same factors can influence the way a person’s gender is expressed to others. Gender is very personal to an individual and can only be known by them (National Institutes of Health, n.d.). Thus, gender is something that the individual identifies with and determines for themselves. There are a multitude of genders and related academic terms to classify one's gender. Some of these terms are: 18 Cisgender refers to someone whose gender identity matches their sex determined at birth. Conversely, transgender is defined by Kattari & Begun (2017) as “people whose gender identity or expression is different, at least part of the time, than the sex assigned to them at birth” (p. 95). In other words, transgender individuals' gender does not align with their biological sex. For instance, women who are transgender were assigned male at birth, and the same notion applies to transgender men (GLAAD, 2022b). Additionally, non-binary individuals do not align with the gender identity of man or woman. The term gender non-conforming hinges on gender expression as these individuals do not follow the social norms regarding masculine and feminine behaviours. Transgender is seen in some academic circles as a broad category that encompasses many gender identities (Goldstein et al, 2017; Newcomb et al., 2019). Therefore, academics consider transgender women, transgender men, non-binary folks (those who do not entirely conform to the binary genders of male and female), and other gender-diverse individuals to be included under the term transgender (Newcomb et al., 2019). For this project, I included this fulsome definition as well as gender-diverse youth to create a comprehensive picture of transgender youth who are targeted and victims of commercial sexual exploitation. The acronym 2SLGBTIQ+ will be used in this paper. 2SLGBTIQ+ represents the many diverse identities that make up the queer community: two-spirit, lesbian, gay, bisexual, transgender, intersex, queer or questioning, and other sexual and gender diverse identities (GLAAD, 2022a; Métis Nation of Ontario, 2022; New Paltz State University of New York, n.d.; Women and Gender Equality Canada, 2022). Two-spirited people have been around for hundreds of years, though the term two-spirit has been used since 1990 (Hunt & Holmes, 2015; Them, 2018; Tran, 2022; Trans Care British Columbia, n.d.). 19 Two-spirit refers to another gender role believed to be common among most, if not all, first peoples of Turtle Island (North America), one that had a proper and accepted place within native societies. This acceptance was rooted in the spiritual teachings that say all life is sacred. (Them, 2018, 0:52-1:13, as cited in The Two Spirit Society of Denver) Two-spirit encompasses many Indigenous identities that can vary based on Indigenous Nations (Métis Nation of Ontario, 2022; Them, 2018). Many nations believe that two-spirited people do not adhere to the binary of men and women as they are their own gender identity and embody “both masculine and feminine spirits” (Indian Health Service, n.d.; Métis Nation of Ontario, 2022; Tran, 2022, para. 4). This is due to the varying spiritual understandings and perspectives, in regard to gender and sexuality, that each Nation holds (Indian Health Service, n.d.; Métis Nation of Ontario, 2022; Them, 2018). They were often valued and held roles of significance within the community such as matchmakers, artists, and healers (Them, 2018; Tran, 2022; Trans Care British Columbia, n.d.). Lesbian refers to a sexual orientation, whereby a woman is attracted to women (GLAAD, 2022a; New Paltz State University of New York, n.d.). A lesbian may also refer to non-men who are attracted to one another (New Paltz State University of New York, n.d.). This attraction may be sexual, “physical, romantic, and/or emotional” (GLAAD, 2022a; Métis Nation of Ontario, 2022; Women and Gender Equality Canada, 2022). Gay is also a sexual orientation and is defined as a person who is attracted to the same gender as themselves (GLAAD, 2022a; New Paltz State University of New York, n.d.; Women and Gender Equality Canada, 2022). Another sexual orientation is bisexual. Individuals who are bisexual are attracted to more than one gender identity. Similar to lesbians, there are multiple types of attraction for gay and bisexual identities (GLAAD, 2022a; Women and Gender Equality Canada, 2022). 20 Queer is often used as an umbrella term (GLAAD, 2022a; Goldberg et al., 2020; Métis Nation of Ontario, 2022; New Paltz State University of New York, n.d.Women and Gender Equality Canada, 2022). Meaning, queer refers to people who are neither cisgender and/or straight. This term was historically used in a disrespectful manner to the 2SLGBTQ+ community and can still cause harm. On the other hand, the word queer has been taken back by the queer community (relatively recently) and given meaning as an identity. The Q can also mean questioning (GLAAD, 2022a; Métis Nation of Ontario, 2022; New Paltz State University of New York, n.d.; Women and Gender Equality Canada, 2022). Questioning refers to someone who may not know, decided on, or “are in the process of exploring their sexual orientation or gender identity” (GLAAD, 2022a; Métis Nation of Ontario, 2022; New Paltz State University of New York, n.d., para. 31; Women and Gender Equality Canada, 2022). Multiple identities make up the 2SLGBTQ+ community that do not have their own letter in the acronym, therefore the + is meant to represent them (GLAAD, 2022a; New Paltz State University of New York, n.d.; Women and Gender Equality Canada, 2022). Unhoused Youth and Young Adults The concept of homelessness has been defined by the Canadian Observatory on Homelessness as “the situation of an individual, family or community without stable, safe, permanent, appropriate housing, or the immediate prospect, means and ability to acquire it” (Gaetz et al., 2012, p. 1). Furthermore, youth homelessness was conceptualized by Gaetz, O’Grady, Kidd, & Schwan (2016): “Youth homelessness” refers to the situation and experience of young people between the ages of 13 and 24 who are living independently of parents and/or caregivers, but do not have the means or ability to acquire a stable, safe or consistent residence. (p. 27) 21 Someone can become homeless for many reasons. Some of them include financial problems, unaffordability of housing, health stressors, unsuitable housing, opioid addiction, and abuse (Statistics Canada, 2023; Turner Strategies, 2018). Homelessness can cover a wide range of living situations (Echenberg & Munn-Rivard, 2020; Gaetz et al., 2012). These include unsheltered/absolute homelessness, emergency sheltered, provincially accommodated, hidden/concealed homelessness, and at-risk of homelessness/relative homelessness: Someone who is unsheltered does not have a home and may be living in an area that was not intended for safe residence. This is also known as absolute homelessness (Echenberg & Munn-Rivard, 2020). Emergency sheltered occurs when someone is inhabiting short-term housing due to a crisis, such as homelessness, natural disaster, or domestic violence (Echenberg & Munn-Rivard, 2020; Gaetz et al., 2012). Provincially accommodated involves shelter that is not permanent and is not reliable (Gaetz et al., 2012). Hidden/concealed homelessness is when someone does not have a home but is living with loved ones or in long-term housing facilities (Echenberg & Munn-Rivard, 2020). Those who are at risk of homelessness/experiencing relative homelessness currently have a home but it may become unattainable due to their financial situation or the home’s health and safety are subpar (Echenberg & Munn-Rivard, 2020; Gaetz et al., 2012). Lastly, homelessness can also be categorized by duration and is listed here from longest to shortest length: chronic, cyclical or episodic, and temporary (Echenberg & Munn-Rivard, 2020). In recent years, the term unhoused has been used in place of homelessness (Abrams, 2023; Lambert, 2022). Being unhoused incorporates the same aspects that were discussed in the definition of homelessness but with further context regarding this experience. Though someone may not have a physical house, they may still have a home (Kerman, 2022). In other words, a 22 person’s home can refer to their support people, memories, and valuable items; all of which you can have without stable and secure housing (Abrams, 2023; Kerman, 2022; Lambert, 2022). Therefore, unhoused differs from homeless as it recognizes this human aspect and puts the focus on fixing the issue of housing, rather than unfairly suggesting that being unhoused is a personal failing (Abrams, 2023). Additionally, those who are homeless have been stigmatized within Canadian society and thus face further hardships (Lambert, 2022). Unhoused is meant to account for the individual as a whole and treat them with dignity. Houselessness may occur for a multitude of causes some of which are abuse in the family, low socio-economic status, or being forced to leave their home based on their gender or sexual identity (Gaetz, O’Grady, Kidd, & Schwan, 2016; Goodyear et al., 2024; Statistics Canada, 2023). McCann & Brown (2019) discuss that “living on the streets, in emergency shelters or temporary accommodation, for example, couch surfing, a vehicle and squatting” are all examples of unhoused situations (p. 2062). Therefore, youth who are unhoused often do not have access to the proper financial resources or familial support that is usually needed to become housed and/or maintain housing (Gaetz, O’Grady, Kidd, & Schwan, 2016; Goodyear et al., 2024; McCann & Brown, 2019; Statistics Canada, 2023). This attribute can decrease a youth’s security and personal safety and is thus, a risk factor for commercial sexual exploitation because they may trade sex to obtain shelter (Clayton et. al., 2014; Cotter, 2021; McCann & Brown, 2019; Saewyc et al., 2013). Studying the population of interest is important because commercial sexual exploitation harms and endangers them and impacts society too (Hurst, 2021). Vulnerable populations, such as unhoused youth, transgender youth, and young adults, face additional challenges such as an association with victimization and mental health issues, unsafe or abusive environments, stigma, 23 and discrimination and are targeted as a result (Clayton et. al., 2014; Gaetz, O’Grady, Kidd, & Schwan, 2016; Jimenez et al., 2015; Kattari & Begun, 2017; Lambert, 2022; Reilly et al., 2022; White Hughto et al., 2016). Based on their circumstances, unhoused individuals require stable housing and financial resources to have the necessities for life met to begin working toward thriving (in areas such as social relationships and education) and not just surviving (Gaetz, O’Grady, Kidd, & Schwan, 2016; Hampton & Lieggi, 2020; McCann & Brown, 2019; Varma et al, 2015). Transgender folks often need access to gender-affirming care and non-discriminatory mental health assistance in addition to basic needs (Greenfield et al., 2021). Sexually exploited youth tend to lack control over their lives and their relatively young age may contribute to emotional immaturity (Schwartz, 2015). Lastly, commercial sexual exploitation creates lasting trauma that affects the victim's physical and emotional well-being (Varma et al, 2015). These identifiable characteristics create unique risk factors that lead to being targeted and therefore are worthy of exploration. Maslow’s humanistic theory, also called Maslow’s hierarchy of needs, is the overarching theoretical framework behind this exploration, in particular with insights gathered on commercial sexual exploitation (Acevedo, 2018; McDonald & Middleton, 2019). In 1943, Abraham H. Maslow birthed the ideas for his theory in his published article “A Theory of Human Motivation” (Madsen & Wilson, 2012), which states that an individual’s actions are driven by their unconscious desire to obtain one or more of their basic needs (McDonald & Middleton, 2019). Madsen & Wilson (2012, p. 1472) describe these needs as (1) physiological, (2) safety (3) belongingness or love, (4) self-esteem, and (5) self-actualization. In 1969, Maslow added transcendence (i.e., spiritual powers) to the hierarchy of needs (Faugère, 2021; Koltko-Rivera, 2006; McDonald & Middleton, 2019; see Figure 1). 24 Figure 1 Maslow’s Hierarchy of Needs Note. This illustration showcases the 1969 version of Maslow’s humanistic theory with the six needs organized in a hierarchical format. This pyramid arrangement is seen in many works that discuss Maslow’s hierarchy of needs. Adapted from Applying a survival sex hierarchy to the commercial sexual exploitation of children: A trauma-informed perspective, by A. R. McDonald, and J. Middleton, 2019, Journal of Public Child Welfare, 13(3) (https://doi.org/10.1080/15548732.2019.1590289). McDonald & Middleton (2019) expanded on his theory by altering it to explain and address commercial sexual exploitation. The revised McDonald’s Survival Sex Hierarchy (MSSH) showcases that the weight attributed to each need varies based on the individual and their circumstances as well as the role that coercion plays in commercial sexual exploitation (McDonald & Middleton, 2019). In other words, each individual will value each need differently depending on what they are lacking in their lives and may choose to exchange sex for something that will fill their need. For instance, a child may engage in commercial sexual exploitation to obtain a good that they place considerable worth on, such as drugs or alcohol (an example of a physiological need). On the other hand, another individual may agree to trade sex in order to feel a sense of love or belonging (i.e., one of Maslow’s needs) from another person. Thus, there are many variations as to why a youth or young adult may be commercially sexually exploited. In either case, consent is voided because children cannot make an informed decision to consent to 25 commercial sexual exploitation (Gerassi, 2015a; Government of Canada, 2023; McDonald & Middleton, 2019). The ideas from Maslow’s humanistic theory align well with the population in this project as each of their intersecting identities may come together to amplify certain basic needs and how they are deprived of these needs. Lacking factors that promote well-being and fill Maslow’s needs as well as inputting characteristics that can have a negative effect on an individual may drive a youth to try to seek out means to create a more beneficial environment, which may be attempted to be produced through commercial sexual exploitation (Carducci, 2020; Clayton et. al., 2014; McCann & Brown, 2019; McDonald & Middleton, 2019; Simons et al., 1981). The action or inaction of addressing these needs and promoting a healing environment for survivors of commercial sexual exploitation in Alberta is uncovered in this project by specifically examining aftercare programming. The environmental scan was able to show whether the aftercare programs of interest were able to tackle the needs of survivors and or if there were possible pitfalls of the services. My project aimed for a deeper understanding of the prevalence, and related risk factors for youth, trans youth, and young adults who are unhoused and are commercially sexually exploited; in an effort to accumulate more academic information on the topic and better support the population in aftercare programs. It examines available voluntary after-care programming in Calgary and Edmonton that targets youth and young adults who are sexually exploited, unhoused, transgender, or a combination of these characteristics. Added to the previously stated research mandate is an analysis of Maslow’s humanistic theory and its influence on commercial sexual exploitation when compared to the specific needs of the research population. Lastly, this 26 honours project concludes with personal commentary on positive program characteristics as well as potential gaps. 27 Methodology Descriptive Research Siedlecki (2020) states that “the purpose of descriptive studies is to describe individuals, events, or conditions by studying them as they are in nature” (p. 8). Descriptive research studies the many aspects of the population(s) of interest, highlight issues or knowledge gaps, and/or discuss geographical differences (Siedlecki, 2020). These facets of descriptive research align with this honours project, because the prevalence, harm, and risk factors that surround those who are unhoused, transgender, youth, young adults, and/or commercially sexually exploited were explored. Additionally, Palys (2007) stresses the importance of accuracy within descriptive research. This idea was shown in the aim of this honours project, which was to accurately understand commercial sexual exploitation and describe how this type of victimization interacts with the populations of interest (Palys, 2007; Siedlecki, 2020). Measures such as an established inclusion and exclusion criteria, predetermined search words/phrases, and accountability for research ethics worked to support the accuracy necessary with presenting descriptive research (see Figure 2). Integrative Literature Review This descriptive research project incorporates an integrative literature review. An integrative literature review is best suited for this research project because its aim of conveying knowledge deficiencies while highlighting future research avenues is included in this paper (Snyder, 2019). This is evident as there is currently a gap in the research regarding supporting those who were victimized by commercial sexual exploitation in Alberta. Moreover, there were not any readily available studies that were found using the predetermined search criteria for this project that analyzed and compared aftercare programs in Calgary and Edmonton for survivors 28 of commercial sexual exploitation, with a particular focus on transgender, unhoused, youth and young adults. This project also identified possible avenues for future success in the analyzed aftercare programming, concerning the population of interest by the completion of an environmental scan. Lastly, Oermann & Knafl (2021) state that integrative literature reviews also have a theoretical component. This aspect will be satisfied in this project because Maslow’s humanistic theory together with McDonald’s survival sex hierarchy were the theoretical frameworks that guided the source analysis and eventual arrangement of this project (McDonald & Middleton, 2019). Limitations. One limitation of an integrative literature review is its reliance on secondary data analysis as there was no primary research creation. This can limit the information that can be added to the larger body of academic knowledge on this topic. Thus, journal articles, reports, and statistics that were produced by other parties were relied on. A predetermined inclusion and exclusion criteria for source acquisition was followed in order to maintain consistency and quality throughout the integrative literature review (see Figure 2). This literature was still valuable as it offered an analysis of academic information that already existed and combined it with criminological theory to determine the phenomenon of commercial sexual exploitation and the efficacy of available aftercare programming for victims; presenting this knowledge in a singular location. 29 Figure 2 Inclusion and Exclusion Criteria Inclusion Criteria Published in peer-reviewed journals Exclusion Criteria Articles published in or before 2013 ● Unless used to obtain a historical background or in conjunction with another more recent source Published in English Annual reports published in or before 2018 ● But information regarding aftercare programs may be obtained from their website, presentations, or testimonials without a date associated Studies that focus on one or more aspects of the research population: transgender, unhoused, youth and young adults who are commercially sexually exploited Does not touch on the research population ● Excludes information solely focused on online sexual exploitation ● Including articles that focus on the targeted research population but use alike terms: survival sex instead of commercial sexual exploitation or homeless instead of unhoused Articles related to Maslow’s humanistic theory ● This may also be referred to as Maslow’s hierarchy of needs Information that is pertinent to theory, risk factors, or harm related to commercial sexual exploitation may be from worldwide sources Canadian-specific information on statistics or prevalence Statistics that are from outside of Canada 30 Secondly, bias and the author’s perspective(s) can also be a limitation to any study. This can affect the literature analyzed as well as how the findings or statistics are presented. To mitigate this limitation pre-determined search words/phrases were implemented during data collection (Snyder, 2019). The search words/phrases outlined above coupled with the inclusion and exclusion criteria decrease bias and increase future research replication through their consistent and exhaustive nature. Moreover, this uniform data collection method lessens the possibility of missing pertinent research as the topics of interest have been previously addressed. This was done in an effort to increase the trustworthiness of this honours project. In addition, ethical practices are safeguarded through accountability to my supervisor Dr. D. Scharie Tavcer, as well as the ethical framework of the author which are influenced by the core principles of The Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans, which include: “respect for persons, concern for welfare, and justice” (Panel on Research Ethics, 2023, para. 8). Lastly, there was limited academic literature about aftercare programming for those who have been sexually exploited, and even less for those who are transgender and unhoused. It is a challenge to compare programming in Calgary and Edmonton that is available for victims of commercial sexual exploitation, specifically in regard to the youth and young adults within the gender-diverse population. This gap is significant as transgender youth and young adults have unique risk factors for commercial sexual exploitation and require specific support based on this aspect of their identity. Transgender individuals have a higher risk of violent victimization and thus, gaining a deeper understanding of their experience is crucial in order to make better non-discriminatory aftercare programs that will address their risk factors for commercial sexual exploitation; which include incorporating their need for gender-affirming care and inclusive 31 mental health access (Greenfield et al., 2021; Hampton & Lieggi, 2020; Jaffray, 2020; Nafekh et al., 2023). Therefore, this project demonstrated the prevalence and scope of risk factors and harms caused by this victimization while being mindful of the intersectional issues with these groups of young people. Feminist Methodology This honours project was also based on a feminist methodological framework. Feminist methodology is quite expansive and does not have one clear-cut definition (Wilson, 2023). Despite this, there are themes that run through research from a feminist lens. One focus of feminist methodology is to benefit women through the research (Methodological frameworks, n.d.). This cornerstone of feminist methodology does not need the research study to be conducted solely on women. It is about attending to the needs and viewpoints of those being studied, from their perspectives, not solely from the hierarchical perspective of the researcher (Harding, 2020; Methodological frameworks, n.d.; Wilson, 2023). Feminist research should show the wide-variety of experiences that those who are oppressed in society face, while being “cognisant of the gendered, historical and political processes involved in the production of knowledge” (Wilson, 2023, p. 87). In addition, Wilson (2023) discusses that “feminist research is grounded in a commitment to equality and social justice” (p. 87). Feminist methodology was utilized within this project to echo and uphold this sentiment. Equality and social justice are necessary to take into consideration when researching those who have a higher propensity toward discrimination, marginalization, and victimization (Harding, 2020; Wilson, 2023). The populations of interest for this project are connected to societal discrimination, stigma, and trauma (Coronel-Villalobos & Saewyc, 2019; Gaetz, O’Grady, Kidd, & Schwan, 2016; Goodyear et al., 2024; McCann & 32 Brown, 2019; McDonald & Middleton, 2019; Nafekh et al., 2023; Reilly et al., 2022; Sanders & Brown, 2015; Varma et al., 2015; White Hughto et al., 2016). Thus, this project is coming from the understanding that greater care must be taken when researching a sensitive topic, such as commercial sexual exploitation, that has caused much harm to the survivor. Feminist methodology also aligns with the descriptive aspect of this project. Since a feature of descriptive research is the accurate disclosure of findings, it is only ethical to collect and present this project in an ethical, moral, and truthful manner; such as the one seen in feminist methodology (Harding, 2020; Palys, 2007; Wilson, 2023). Using a feminist methodology as a guiding force behind this project decreased the likelihood of inadvertently causing harm to survivors of commercial sexual exploitation through the misrepresentation of their experiences. This research project aimed to increase the appreciation for this type of victimization concerning these vulnerable populations from their perspective, through literature and secondary studies. This project may increase public perception as well as add to academic knowledge to hopefully create positive change to benefit transgender, unhoused, youth and young adult survivors of commercial sexual exploitation, even if on a smaller scale (Methodological frameworks, n.d.). In other words, this project looks at commercial sexual exploitation from many angles and draws conclusions on how best to support those who need help the most: the survivors. Data Collection A search used the search words/phrases discussed below to assess the feasibility of researching this topic (Snyder, 2019). This course of action showed that there was abundant research with high validity that would result in a comprehensive and successful integrative literature review. Academic peer-reviewed journal articles and academic textbooks are a large portion of the sources that were utilized for this project. This literature served to obtain 33 knowledge on Maslow’s humanistic theory, the harms of commercial sexual exploitation, risk factors for this population, and effective aftercare program characteristics. The MRU library database and Google Scholar were employed to gather academic literature on the topic. Additionally, the search words/phrases below were used in conjunction with each other (with AND in between) when finding sources on these databases. A non-exhaustive list of the search words/phrases is: “commercial sexual exploitation”, “sexual exploitation”, “survival sex”, “transgender”, “gender diverse”, “unhoused”, “homeless”, “youth”, “children”, “young adults”, “prevalence”, “statistics”, “risk factors”, “harm caused”, “psychological effects”, “physical effects”, “Maslow’s humanistic theory”, “Maslow’s hierarchy of needs”, “adverse childhood experiences”, “trauma-informed care”, “community support”, “psychological support”, “aftercare programming”, and “effectiveness”. Furthermore, the reference list of the acquired literature was considered to see if any of their referenced articles align with the topic and thus, add value through their analysis. Non-academic documents were also studied. These documents included information from Statistics Canada and government reports to obtain statistics about the prevalence of commercial sexual exploitation of transgender, unhoused, youth and young adult populations. Annual reports and websites of aftercare programs were also analyzed to gather an understanding of the programming available in Calgary and Edmonton to determine their effectiveness. The Google search engine was used to find these sources. “Commercial sexual exploitation”, “survival sex”, “child sexual exploitation”, “prevalence”, “statistics”, “ youth”, “children”, “young adult”, “unhoused”, “homeless”, “transgender”, “gender diverse”, “aftercare programming”, “community supports” were some of the words/phrases that were used either together or 34 independently to find non-academic literature. Specific location indicators were also attached, these include: “Canada”, “Alberta”, “Calgary”, and “Edmonton”. Lastly, data collection and analysis did not stop once writing started since research is not a linear process. In fact, many sources were found as new information and viewpoints were discovered during the writing process. Thus, there were instances where data collection reemerged to encourage a fulsome, deep, and accurate knowledge of the topic. These concrete and thought-out data collection steps and methodologies were taken to answer the research question: what are the risk factors and effective aftercare program characteristics associated with commercial sexual exploitation for unhoused transgender youth and young adults? 35 Theoretical Framework Maslow’s Humanistic Theory This project was guided by Maslow’s humanistic theory because it provides insights into the motivations behind an individual who is victimized through commercial sexual exploitation. It connects by outlining the needs that Maslow theorized are necessary and may drive an individual’s actions and choices toward exploitation (Acevedo, 2018; Koltko-Rivera, 2006). Therefore, his theory aligns with the aims of this project by aiding in explaining how certain risk factors such as a lack of money, isolation, or discrimination can lead to unfilled needs like food, shelter, and security for transgender, unhoused, youth and young adults, which increases their likelihood to be sexually exploited (Clayton et. al., 2014; McCann & Brown, 2019; McDonald & Middleton, 2019; Simons et al., 1981). Maslow was a humanistic psychologist who made influential contributions to the psychological field, especially with his humanistic theory (Madsen & Wilson, 2012; Waterman, 2013). Humanistic psychology is the study of human beings by incorporating all aspects of their being, including those that are characteristically subjective, specifically through the lens of self-actualization (Acevedo, 2018; Angyal et al., 1981). In other words, humanistic psychologists believed that people were distinct from one another and this uniqueness should be acknowledged (Acevedo, 2018; Angyal et al., 1981; Mackenzie et al., n.d.). This is seen in commercial sexual exploitation because each child has different risk factors (based on their identity or life experiences) that can lead them to victimization (Clayton et. al., 2014). Therefore, this area of psychology is an important facet of the study of human behaviour, choice, and motivation (Madsen & Wilson, 2012; Waterman, 2013). Maslow’s humanistic theory adheres to the ideals of humanistic psychology by showcasing the (often unconscious) 36 importance of the five basic needs he identified as necessary for everyone’s homeostasis: physiological, safety, belongingness and love, self-esteem, and self-actualization. These contribute to an individual’s actions and thus, their future potential (Carducci, 2020; McDonald & Middleton, 2019). These five needs are separated into two categories: deficiency needs and growth/being needs (Acevedo, 2018; Montag et al., 2020). Deficiency needs encompass physiological, safety, belongingness and love, and self-esteem needs (Acevedo, 2018; Carducci, 2020). When they are not met, These needs motivate individuals to strive to take action to fulfill them (Rowan & Glouberman, 2017; Venter, 2016). In other words, deficiency needs inspire action through their absence (Carducci, 2020). This makes sense because without housing kids are unable to have a safe and reliable place to sleep, the capacity to prioritize their education, or focus on their physical and mental health (Clayton et. al., 2014; Gaetz, O’Grady, Kidd, & Schwan, 2016; Reilly et al., 2022; Greenfield et al., 2021). Thus, being unhoused can affect someone's emotional well-being, social status, and employment opportunities; which may motivate unhoused youth to try to better their situation through commercial sexual exploitation. Firstly, physiological needs are categorized as the lowest-level basic needs at the bottom of the pyramid (Koltko-Rivera, 2006). They are often the needs that are associated with essential aspects of maintaining biological functioning and life (Koltko-Rivera, 2006; Simons et al., 1981), such as “oxygen, food, water, and a relatively constant body temperature” (Simons et al., 1981, p. 1). These are essential to life and thus, come first on the hierarchy because if people lacked these needs they would be forced to attain them for mere survival (Koltko-Rivera, 2006; Simons et al., 1981). 37 Safety is related to the feelings surrounding security, welfare, and personal protection (Koltko-Rivera, 2006; McDonald & Middleton, 2019; Simons et al., 1981). Koltko-Rivera (2006) summarizes that the need for safety is established through “order and law” (p. 303). The concept of “order and law” that Koltko-Rivera (2006) discusses is likely associated with legal socialization (Trinker & Cohn, 2014; Van Petegem et al., 2021). Social conventions and laws are created which are then upheld in an effort to enhance safety and establish expectations within society. Therefore, positive associations with the law and its actors are within this aspect of Maslow’s humanistic theory. As per the hierarchical nature of this theory, individuals do not often pay much attention to this need unless their physiological needs are adequately fulfilled to the point where they can focus on this higher-level need (Carducci, 2020; Madsen & Wilson, 2012). This need is often seen during times of personal or social emergency and crisis (Carducci, 2020; Simons et al., 1987; Venter, 2016). In other words, the need for safety is in line with deficiency needs as they would be felt more when it is gone. For example, someone may strive to ensure this need is obtained when they do not have a house or are experiencing violence. This makes sense as commercial sexual exploitation is associated with those who are unhoused and in transgender youth (who may have been forced to leave their childhood home due to discrimination or abuse) (Clayton et. al., 2014; Goodyear et al., 2024; McCann & Brown, 2019; Varma et al., 2015). Belongingness and love needs are two separate feelings that are closely related (Pinkus, 2020). Love emerges from a closeness with others and that creates an emotional bond. There are many versions of love that come from multiple types of relationships such as romantic, familial, friendship, and professional. Belongingness refers to the aspiration to be welcomed, accepted, and included by others. This need relates to the ways in which people relate to others and their 38 beneficial consequences (Koltko-Rivera, 2006; Pinkus, 2020). Human beings crave these connections because of our social nature (Sanders & Brown, 2015). Unfortunately, unhoused and transgender youth and young adults are often socially isolated (Goodyear et al., 2024; McCann & Brown, 2019). This is likely due to the stigma and discrimination that they face for their living conditions and/or gender identity, and its impact on their relationships (Goodyear et al., 2024; Sanders & Brown, 2015). Self-esteem is characterized as the aspiration to develop a constructive and positive outlook of themselves (Di Domenico & Fournier; 2017; Simons et al., 1981). This need is often achieved through achievements, internal and external accolades, success, and capability. The need for esteem can be achieved in a personal and public forum. In other words, self-esteem may manifest from others holding them in high regard or stem from pride in oneself. Once self-esteem is obtained the individual may gain confidence, self-respect, and self-efficacy (Orth & Robins, 2022; Simons et al., 1981). On the other hand, a lack of self-esteem can cause feelings of shame and low self-worth. (Simons et al., 1981). The last of Maslow’s originally identified needs is self-actualization which is known as a growth/being need (Montag et al., 2020; Carducci, 2020). Growth and being needs come from a place to better oneself. Self-actualization is described as an individual’s desire to become the best version of themselves by striving to obtain their fullest potential (Koltko-Rivera, 2006). As stated by Simons et al. (1987) this need involves doing what an individual was “born to do” (p. 2). This gives the person a sense of purpose and pride as they are implementing and actualizing their passions and strengths into their life. Someone who has reached the level of self-actualization is said to be a healthy person(ality) (Acevedo, 2018; Simons et al., 1987). This showcases the significance Maslow placed on this need. Self-actualization is strived for but 39 difficult to fully achieve due to this high threshold (Acevedo, 2018; Carducci, 2020). This is seen in kids who are unhoused, lack access to necessary gender-affirming care or mental health support, and experience violent victimization (Varma et al., 2015). They do not have the time or resources to work toward self-actualization because they are stuck in “survival mode”, working on accomplishing previous levels on Maslow’s hierarchy of needs (Lanctot et al., 2021, as cited in National Child Trauma Stress Network, n.d., p. 706; Simons et al., 1987). In 1969, Maslow expanded on his original theory by incorporating transcendence (also referred to as self-transcendence) at the top of his hierarchy (Faugère, 2021; Koltko-Rivera, 2006; McDonald & Middleton, 2019; see Figure 1). Koltko-Rivera (2006) stated that transcendence “seeks to further a cause beyond the self and to experience a communion beyond the boundaries of the self through peak experience” (p. 303). Therefore, understanding their role as human beings while taking into account the purpose of others (Koltko-Rivera, 2006; Venter, 2016). Transcendence can manifest in the desire to make connections and seek guidance on a spiritual and/or religious level (Rowan & Glouberman, 2017). Maslow argued that as lower-level needs (those closer to the bottom of the pyramid) were fulfilled, individuals then could begin acquiring higher-level needs (Madsen & Wilson, 2012; see Figure 1). Therefore, the needs were consciously arranged in a pyramid to showcase their hierarchical and connected nature (Simons et al., 1981). This results in its alternative namesake: Maslow’s hierarchy of needs (Madsen & Wilson, 2012; Simons et al., 1981). Carducci (2020) explains that even though these needs are arranged in a hierarchical order, each need only has to be fulfilled to the point where they are no longer a burden. Thus, lower-level needs do not need to be completely achieved before processing onward through the pyramid. Additionally, McDonald & Middleton (2019) illustrated further by stating that the individual may attribute 40 higher importance to particular needs regardless of the order they appear in Maslow’s humanistic theory. McDonald’s Survival Sex Hierarchy McDonald & Middleton (2019) used Maslow’s humanistic theory as a starting point when they created a survival sex hierarchy for children who are survivors of commercial sexual exploitation, known as MSSH model. The MSSH model is incredibly relevant to this paper on commercial sexual exploitation but there were slight modifications made to incorporate the specific risk factors associated with transgender and unhoused youth and young adults. Firstly, the MSSH incorporated a survivor-centered lens and trauma-informed care perspective. This allowed for a new idea to emerge within the theory. While the occurrence of free will was understood to be present within the original theory it did not appreciate the ways in which our choices can be pressured or manipulated. In other words, the MSSH model realizes that choices are not always made voluntarily if they are done out of necessity or fear; which may be the case with commercial sexual exploitation. The roadblocks that may stop someone from fulfilling their needs are referred to as survival threats (these were called psychological threats in Maslow’s humanistic theory). As described by McDonald & Middleton (2019), these are other people who victimize or inadvertently harm the victim of commercial sexual exploitation. The MSSH model incorporates five needs whose importance may vary based on the specific victim. Physiological, safety, love and belonging, esteem, and self-actualization needs are included. McDonald & Middleton (2019) describe the different ways that these needs interact with youth who engage in survival sex, i.e., commercial sexual exploitation. The physiological needs of commercial sexual exploitation survivors are similar to Maslow’s humanistic theory in that they are the aspects that one needs to survive. 41 Safety can refer to youth who engage in commercial sexual exploitation from that motivation to make money that will support themselves. The jobs that youth can realistically acquire often pay minimum wage and may not be enough money to make a living wage. Secondly, trauma and negative emotions may also push someone into this type of victimization as a way to temporarily suppress these feelings. Additionally, a sense of empowerment and control can be achieved through this action. This aspect is further illustrated in children who were victims of long-term sexual abuse, as this can internalize the idea that they are inherently sexual. Love and belonging are notably seen in people who were brought into this type of victimization by a trusted person. The youth may feel a sense of obligation or duty to this person(s) and not make efforts to end the exploitation, even if it is unhealthy. Therefore, there are relationships, such as familial, romantic, or friendship that can tie the youth to commercial sexual exploitation. Lastly, this victimization can occur as a way to feel validated in their gender identity or sexual orientation, largely affecting those in the LGBTQ+ community. Esteem is linked to the monetary materials or costly experiences that engaging in commercial sexual exploitation can provide. This can give the youth a somewhat lavish lifestyle as they may be able to own more valuable possessions, which in turn can make them feel valuable. Similar to the need for safety, power and control are incentives, but in this case, the power is rooted in the status and importance they perceive from the financial advantages. This showcases the effect that self-desire has on survival sex. Lastly, self-actualization is attributed to youth who are aware of the complex aspects of commercial sexual exploitation. Meaning, that they know the possible harms of this behaviour but choose to continue because the positives outweigh the negatives. Aligning with Maslow’s 42 humanistic theory, they believe that commercial sexual exploitation is their life’s calling. They also have the skills to determine someone’s sincerity or truthfulness, which were likely developed to protect their well-being in survival sex. Furthermore, self-actualized youth may also try to justify survival sex or advocate for others to engage in this practice. Addressing Maslow’s needs in aftercare programming will likely decrease the risk of victimization and allow for increased support and successful reintegration into society. The aftercare programming that was analyzed was done so with this in mind. The environmental scan was conducted on six aftercare programs in Calgary and Edmonton. The Calgarian aftercare programs were SafeLink Alberta, RESET Society of Calgary, and Calgary Communities Against Sexual Abuse. In Edmonton, the Sexual Assault Centre of Edmonton, Saffron Centre, and ACT Alberta were of interest. MSSH worked well when conducting the environmental scan on aftercare programming in Alberta, Canada. It was found that there was not a particular focus on gender-diverse people. While they were mentioned, there was no organization I could find that offered specific programs to address the unique risk factors of transgender youth and young adults who are commercially sexually exploited. On the other hand, there was much mention of youth and young adults as well as the risk of victimization that accompanies those who are unhoused. Additionally, most programming dealt with sexual exploitation or assault as a whole rather than the commercial piece. Therefore, further attention and awareness should be given to transgender youth and young adult survivors of commercial sexual exploitation within Alberta’s aftercare programming. Aftercare programming can be connected to MSSH as the data collected showcases the types of needs that transgender, unhoused, youth and young adult survivors of commercial sexual 43 exploitation prioritized (McDonald & Middleton, 2019). These needs can either hinder or create healthy decisions, based on how feasible they are to obtain (Acevedo, 2018; Koltko-Rivera, 2006; Simons et al., 1987). Thus, it can be inferred that when these needs go unmet it harms the individual, leaving them more susceptible to seeking out these needs through unhealthy means, and being targeted for commercial sexual exploitation. In particular, there has been evidence to show that transgender youth and young adults exchange sex for access to, often life-saving, gender-affirming care (Greenfield, 2021; Nafekh et al., 2023). Therefore, their physical and emotional safety is negatively impacted by the harm caused due to commercial sexual exploitation, but their health may also be benefited by prioritizing their gender identity and expression (Coronel-Villalobos & Saewyc, 2019; Jimenez et al., 2015; Nafekh et al., 2023). Resulting in transgender youth and young adults to weigh their options and priorities. Limitations of Maslow’s Humanistic Theory There are some limitations to Maslow’s humanistic theory that must be disclosed. Acevedo (2018) shares that there is little empirical evidence that led Maslow to the creation of this theory. In other words, this theory was deduced from generalizations gathered from a relatively small research population and lacked rigorous testing. Maslow also realized that the pursuit of these needs can result in harmful perfectionism or discouragement rather than the original beneficial objective (Acevedo, 2018, p. 742). This was said to be especially alarming to Maslow in the case of young people attempting to obtain self-actualization. The theory has also been criticized for being ethnocentric as it does not account for cultural distinctions; including the difference in significance placed on certain needs through a multicultural lens (Acevedo, 2018). There did not seem to be much stock placed in the idea that different ethnicities may have contrasting experiences with the hierarchy of needs. Later on in 44 Maslow’s work, he recognized this aspect. He revealed the sample sizes that his findings were based on were not indicative of varying identities. Stating that “he had made generalizations out of his own choice of ‘‘certain kinds of people’’ ‘‘selected with all kinds of builtin biases’’ (Acevedo, 2018, p. 742). This is showcased in the time Maslow spent with the Siksika Nation, one of the four Blackfoot Nations, in 1938 (Feigenbaum & Smith, 2020; Mackenzie et al., n.d.). Here he saw a community that utilized love, respect, restorative justice, collaboration, and equality (Mackenzie et al., n.d.). It is argued that this led him to his idea of self-actualization (Feigenbaum & Smith, 2020; Mackenzie et al., n.d.). Despite learning from the Blackfoot, they were not cited for the knowledge that they imparted to Maslow, likely due to the racist ideas about Indigenous peoples in academia (Mackenzie et al., n.d.). On the other hand, some academics believe that Maslow’s hierarchy of needs was not based on his time with Siksika Nation (Kapisi et al., 2021). Kapisi et al. (2021) argues that Maslow did not fully grasp Blackfoot teachings and was more aligned with eurocentric beliefs. Maslow failed to incorporate the cyclical and interconnectedness of living creatures, as demonstrated by the hierarchical nature of his theory (though he did not create the pyramid that is often associated with this theory). Lastly, he disregarded the ideology that children are self-actualized when they are born. Therefore, there is some debate as to the validity of the claim that Maslow took credit for Blackfoot understanding. Despite these limitations, Maslow’s humanistic theory is still relevant to my study, especially in its MSSH form. This is because it accounts for the barriers (such as financial, relational, or emotional) that may limit someone’s success and happiness, and it gives insight into how and why youth are targeted for commercial sexual exploitation and the motivations of 45 those entangled in this type of victimization (Abulof, 2017; McDonald & Middleton, 2019; Simons et al., 1981). Limitations of McDonald’s Survival Sex Hierarchy Since the MSSH model was derived from Maslow’s humanistic theory, the limitations of Maslow’s theory carry onto the MSSH (McDonald & Middleton, 2019). The MSSH model originated from the ideas Maslow presented. Therefore, the limitations (for example, the concerns in regard to little empirical evidence and ethnocentric lens) that were described for Maslow’s humanistic theory are also applicable for the MSSH model (Acevedo, 2018). At the time of writing this honours project, McDonald & Middleton’s (2019) article had been cited five times which showed that there was relatively little less discourse about the MSSH model. Nevertheless, the theory is beneficial to this project because it directly relates to the lived experiences and motivations of those who are commercially sexually exploited, while incorporating valuable support frameworks for survivors (such as, a survivor-focused lens and trauma-informed care practices). Another limitation of the MSSH model that is specific to this honours project is the MSSH disregarded the role of transcendence in children and youth who are survivors of commercial sexual exploitation (McDonald & Middleton, 2019). This limitation was crucial to rectify in this project due to the specific focus on the transgender population. Therefore, transcendence was added to this project's understanding of the MSSH model. This was important because transphobic discrimination is a risk factor for the commercial sexual exploitation of transgender youth and young adults (McDonald & Middleton, 2019; Nafekh et al., 2023; White Hughto et al., 2016). Therefore, transcendence is crucial to develop an understanding of the role 46 that religion and spirituality may play, if any, in transphobia when looking at the lives and home environment of transgender youth and young adults who are commercially sexually exploited. 47 Harm Caused by Commercial Sexual Exploitation The harm caused to survivors of commercial sexual exploitation is twofold. Whereby, there is the child that is actively being exploited and their future self that will have to deal with the consequences of this trauma (O’Brien et al., 2023; see Appendix A). A large negative impact of this type of victimization is seen in the mental and physical health of survivors (Clayton et. al., 2014; Jimenez et al., 2015). For starters, commercial sexual exploitation is aligned with psychological abuse. This experience can lead to damaging instances of “depression, post-traumatic stress symptoms, dissociation, irritability, suicidal ideation, self-harm, and suicide” (Jimenez et al., 2015, p. 81). Therefore, causing further harm - that may be permanent (for example, suicide) - compared to those who were never victimized (Fedina, et al., 2019; Jimenez et al., 2015). Hampton & Lieggi (2020), found that crimes (in addition to commercial sexual exploitation) were committed against youth. These instances of victimization could be violent or nonviolent; including sexual assaults, physical assaults, and theft (Hampton & Lieggi, 2020; Jimenez et al., 2015). Moreover, addictive substances may also be used as an unhealthy coping mechanism to deal with trauma or as a means of control by the perpetrator; as well as serve as a risk factor in and of itself (Barnert et al., 2017; Jimenez et al., 2015; Varma et al., 2015). Additionally, physical well-being is adversely affected (Fedina, et al., 2019; Jimenez et al., 2015). Medical needs are often neglected during victimization (Jimenez et al., 2015). Ignoring this aspect of one's physical health is especially dangerous in regard to chronic diseases (Jimenez et al., 2015; Varma et al., 2015). For example, diabetes can cause “blindness, kidney failure, heart attacks, stroke and lower limb amputation” if not controlled (World Health Organization, 2023, para. 1). This neglect extends to other areas of physical health if their 48 nutritional needs or sleep are inadequate (Jimenez et al., 2015). Conversely, it has been found that these physical consequences of commercial sexual exploitation may result in youth seeking medical attention often (Varma et al., 2015). In particular, reproductive health and commercial sexual exploitation are connected (Jimenez et al., 2015). Sexually transmitted infections are of great concern as some can result in detrimental health consequences such as infertility, pelvic inflammatory disease, and cancer (Jimenez et al., 2015; Otu et al., 2021). For those who menstruate, unexpected pregnancies can also occur which may result in abortions that are demanded and forced by those who were part of the individuals who exploited the youth (Barnert et al., 2017; Fedina, et al., 2019; Jimenez et al., 2015). Lastly, painful sex due to injuries to sex organs from commercial sexual exploitation (Jimenez et al., 2015). The consequences of commercial sexual exploitation can cause a ripple effect in other areas of the survivors’ life. Survivors often come in contact with institutional systems, such as the criminal justice system (as an offender) and the child welfare system (Barnert et al., 2017; Hampton & Lieggi, 2020; O’Brien et al., 2023). This could be due to the increased levels of police contact and injectable drug use that this victimization is linked to (O’Brien et al., 2023). Clayton et. al. (2014) details that the systems themselves are further exemplified as a risk factor for commercial sexual exploitation, showing their adverse effects. There are also future social ramifications due to commercial sexual exploitation (O’Brien et al., 2023). Many survivors of commercial sexual exploitation have difficulty connecting with others in a healthy way. Thus, their ability to make and maintain relationships is impacted by their past victimization, particularly with romantic interests. An American study conducted on 860 youth, half of whom were victims of commercial sexual exploitation, highlighted this 49 association as those who were victimized were less content and fulfilled by their relationships than youth who had never been victims (O’Brien et al., 2023). 50 Risk Factors Risk and Protective Factors These factors help to gain an understanding of the causes behind the involvement in a certain phenomenon (Public Safety Canada, 2015). Risk factors are defined by Public Safety Canada (2015) as: negative influences in the lives of individuals or a community. These may increase the presence of crime, victimization or fear of crime in a community and may also increase the likelihood that individuals engage in crime or become victims. (para. 8) Conversely, protective factors are: positive influences that can improve the lives of individuals or the safety of a community. These may decrease the likelihood that individuals engage in crime or become victims. Building on existing protective factors makes individuals and communities stronger and better able to counteract risk factors. (para. 9) In the context of this project, risk and protective factors assist in understanding the level of likelihood someone has of becoming a victim of commercial sexual exploitation based on their specific and personal characteristics. Risk Factors for Commercial Sexual Exploitation The Institute of Medicine and National Research Council’s Committee on the Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States has divided risk factors for commercial sexual exploitation into four categories: societal, community, relationship, and individual (Clayton et. al., 2014). Societal risk factors encompass the lack of applicable resources and aftercare programs, insufficient education about commercial sexual exploitation, and the objectification of youth. Community risk factors include pressure and 51 influence from social groups, seclusion from others, being part of a gang, and lack of resources offered for the local community and schools. Relationship risk factors pertain to unhealthy social behaviours and strife within the family. Lastly, individual risk factors comprise childhood trauma and mistreatment, prejudice, and previous involvement in the criminal justice system and/or the foster care system. There are also a myriad of other risk factors or experiences that have been shown to correlate to victimization by way of commercial sexual exploitation. An important aspect to consider is adverse childhood experiences (ACEs). Finkelhor et al. (2015), highlighted the core points of ACEs: The current scale is made up of 10 items. Five of them concern aspects of child maltreatment: physical abuse, psychological abuse, sexual abuse, physical neglect and emotional neglect. Five additional items concern parental or family incapacities: parental loss through divorce, death or abandonment, parental imprisonment, parental mental illness, parental substance abuse, and violence against the mother. (p. 13) Additionally, there has been discussion about including other harmful and stressful childhood experiences in the ACEs scale (Afifi, 2020; Finkelhor et al., 2015). Low socioeconomic status, social isolation, conflict within the community, and bullying and peer victimization have been suggested by some academics to update the existing ACEs criteria. The more ACEs one experiences, the more likely they are to experience adverse health effects, substance abuse, and harmful situations in adulthood (He et al., 2022; Ports et al., 2016; Webster, 2022). Though ACEs are not solely utilized for risk factors related to commercial sexual exploitation, they are still valuable to the overall understanding of this paper. Ports et al. (2016), conducted a study where 7,272 participants - who “were adult members of a large healthcare 52 maintenance organization in southern California seeking routine health checks at an outpatient clinic” (p. 4) - received a 28-answer questionnaire outlining 10 ACEs factors, as well as a yes/no question to discover if the individual has experienced sexual violence over the age of 19. ACEs were shown to have a strong correlation with adult sexual violence. Therefore, it can be inferred that ACEs can be applied to risk factors regarding sexual violence against children, specifically commercial sexual exploitation (see Appendix B). The 2019 GSS also showed that adverse childhood experiences were connected to violent victimization (Cotter, 2021). For example, those who were physically abused under the age of 15 showed violent victimization rates three times greater than those who did not suffer from the same childhood experience. Despite childhood physical abuse being more reported, a greater association was found between sexual childhood abuse and adult violent victimization compared to physical childhood abuse. Other factors such as “childhood experiences of abuse, harsh parenting, neglect, or witnessing violence” were also linked to future violent victimization (Cotter, 2021, p. 11). All these influences can create an environment where the incentive to partake in commercial sexual exploitation is greater as there is a want or need that the victim is hoping to fulfill (Diamond-Welch & Kosloski, 2020; see Appendix B). These risk factors do not stand alone, rather they can be interconnected and influence each other (Clayton et. al., 2014). Meaning, that there can be multiple factors that increase someone's risk of being a victim of commercial sexual exploitation. As this paper was written with a survivor-focused approach, it is important to note that the presence of risk factors does not signify that the victim is responsible for their victimization (Clayton et. al., 2014; McDonald & Middleton, 2019). This paper asserts that the accountability lies with the perpetrators of violence, not the victims. 53 Furthermore, having some of these risk factors does not guarantee that an individual will be entangled in this type of victimization (Burgess et al., 2018; Clayton et. al., 2014). Rather, these risk factors highlight possible correlations; giving deeper background knowledge regarding commercial sexual exploitation and information that can hopefully be used to prevent and support survivors from victimization (Clayton et. al., 2014). Lastly, the reverse of these risk factors can also serve as protective factors that lessen an individual’s likelihood of victimization. Some protective factors include strong and supportive family structures, having access to basic survival needs, and the ability to make safe decisions (Clayton et. al., 2014; Justice Institute of British Columbia, 2002). Prevalence The prevalence of commercial sexual exploitation was difficult to determine due to its underreported nature (Office of Juvenile Justice and Delinquency Prevention, 2014). The dark figure of crime refers to the offences that are not reported to the police and thus, the accuracy and the full extent of the crime are unknown (Cotter, 2021; Scurich & John, 2019). This lack of reporting may be due to the nature of the crime (Clayton et. al., 2014). Commercial sexual exploitation can be hard to recognize because it often occurs in private and/or in areas that are “undesirable” to other members of society. Lack of education and legislation for commercial sexual exploitation was not yet robust enough to support survivors and in turn, understand the extent of this issue. Along with this, trauma, self-blame, or wariness of police may add to this issue of underreporting. Specific statistics regarding commercial sexual exploitation in Canada are virtually nonexistent. Despite this, there was information available to help deduce the scale of commercial sexual exploitation. 54 For starters, the International Labour Organization et al. (2022) estimated that 27.6 million people were victims of forced labour world-wide in 2021. The International Labour Organization (n.d.) stated that: Forced labour can be understood as work that is performed involuntarily and under the menace of any penalty. It refers to situations in which persons are coerced to work through the use of violence or intimidation, or by more subtle means such as manipulated debt, retention of identity papers or threats of denunciation to immigration authorities. [In other words,] the person has not offered himself or herself voluntarily. (para. 1-2) Of the 27.6 million estimation, 11.8 million of those who were victimized are women or girls and 3.3 million were under the age of 18 (International Labour Organization et al., 2022). Victims of forced labour have increased by (roughly) 2.7 million victims between 2016 and 2021. The International Labour Organization et al. (2022) states that “the increase in the number of people in forced labour was driven entirely by forced labour in the private economy, both in forced commercial sexual exploitation and in forced labour in other sectors” (p. 2). In other words, approximately 80% of forced labour occurred in private sectors, whereby 23% of that was through forced commercial sexual exploitation (International Labour Organization et al., 2022). Approximately 6.3 million people globally are entangled in commercial sexual exploitation. Women and girls make up the large majority of this number. Additionally, most of the children who are victims of forced labour are victimized by commercial sexual exploitation. Lastly, commercial sexual exploitation occurs in many economies, but the majority of these instances happen in countries with an income that was associated with those in the upper-middle class or higher (the inverse occurred when population was considered). 55 Canadian police-reported crime statistics can give a baseline for these types of crimes. In 2012, police-reported statistics showed that there were roughly 14,000 minors who were victims of sexual offences in Canada (Cotter & Beaupré, 2014). Child pornography or child prostitution-related offences were identified by police 2,293 times. Furthermore, 1.4 per 100,000 children and youth were victims of sexual exploitation, and luring a child/agreement or arrangement was at a rate of 5.3 per 100,000 children and youth. These offences give insight into the rate of commercial sexual exploitation in 2012, because of their similarities in coercion and transactional elements. Lastly, level 1 sexual assaults made up the majority of sexual offences against children and youth at 72%, which converts to a rate of 148 per 100,000 children and youth. From 2012-2022, those aged 18 to 24 made up 43% of human trafficking victims in Canada and 24% were under 18 years of age (Heidinger, 2023). Of that, trafficking by way of sexual exploitation was the most common form of human trafficking that police discovered. This is supported by the Canadian Human Trafficking Hotline which was created in 2019. Each year the hotline uncovers 251 to 460 instances of human trafficking; totaling 1,500. Sex trafficking was the most disclosed form at 1,209 occurrences. It has also been noted that certain groups such as at-risk youth and those who are impoverished are more likely to be victimized. These vulnerable groups directly relate to this paper’s population of focus. The General Social Survey (GSS) offers self-reported data (every five years) regarding victimization which is different than police-reported official statistics (Cotter, 2021; Statistics Canada 2021). Police-reported statistics can only detail the crime that police have been made aware of, but there are many offences that are not reported to the police (Department of Justice Canada, 2021; Statistics Canada 2021). This is where the importance of the self-reported data 56 that encompasses the GSS emerges. The GSS is able to create a more accurate picture of the amount of people in Canada who are victims of crime by collecting information from the public about their experiences. The 2019 GSS showed that 69% of victimization was non-violent. Nevertheless, 11% of self-reported victimization were sexual assaults, which were the fourth most reported offence category; led by theft of personal property at 37%, physical assault at 17%, and theft of household property at 12%. That same data showed that 30 instances of sexual assault per 100,000 Canadians. It was also shown that Canadians between the ages of 15-24 have higher rates of victimization compared to their middle-aged counterparts. This was also evident in sexual assaults. Those 15 to 24 years of age rate of sexual assaults was 103 per 1000, which was lower compared to the 25 to 34 age group with a sexual assault rate of 50 per 1000. Sexual assault rates are an important indicator of commercial sexual exploitation as they incorporate instances where consent cannot be given voluntarily. Similar to the Canadian statistics, information about commercial sexual exploitation prevalence in Alberta was lacking. Thus, statistics regarding sexual offences, human trafficking, and sexual abuse were utilized in the literature search. In 2012, Canadian police-reported victims of sexual offences who are under the age of 18 were at “a rate of 205 victims for every 100,000 children and youth,” which translated to “approximately 14,000 child and youth” (Cotter & Beaupré, 2014, p. 3). The same data showed that Alberta ranked 11th lowest among the provinces and territories with a rate of 200 per 100,000 youth and children (Cotter & Beaupré, 2014; see Appendix C). In 2022, police-reported cases of human trafficking mostly occurred in census metropolitan areas (CMA) (Heidinger, 2023). Statistics Canada (2022b) details that a CMA: 57 is formed by one or more adjacent municipalities centred on a population centre (known as the core). A CMA must have a total population of at least 100,000, based on data from the current Census of Population Program, of which 50,000 or more must live in the core based on adjusted data from the previous Census of Population Program. (para. 1) Between 2012-2022, Criminal Code cases of human trafficking in CMA’s amounted to 2,362; of that Calgary had 63 Criminal Code instances of human trafficking and Edmonton had 62 cases (Heidinger, 2023, p. 18-19). In comparison, the 2019 GSS showcased similarities to police-reported rates for Calgary and Edmonton for violent self-reported victimization. Calgary had a rate of 120 per 1,000 population (15 years of age or older), compared to 108 per 1,000 population (15 years of age or older) for Edmonton (Cotter, 2021). Therefore, the occurrence of these crimes was relatively similar in Alberta’s two most populated cities. In addition, the Association of Alberta Sexual Assault Services (2020), conducted a survey (from September to June 2019) where 1,496 adult respondents who were Alberta residents over age 18, answered questions regarding sexual abuse, the incident(s) corresponding age, and their ideas and beliefs about sexual abuse. “Forty-five percent of adult Albertans have experienced some type of sexual abuse in their lifetime [and of this] 34% of Albertans were sexually abused under the age of 18 and 28% of Albertans were sexually assaulted as adults” (Association of Alberta Sexual Assault Services, 2020, p. 7). Based on this finding, it has been estimated that around 325,000 children suffered from sexual abuse out of the total population of 955,799 children for Albera in 2019 (Association of Alberta Sexual Assault Services, 2020). Of the 325,000 child victims of sexual abuse, it was determined that approximately 121,723 children were in Calgary and 298,626 children were in Edmonton. 58 Risk Factors for Transgender Youth and Young Adults Transgender identity is a risk factor for commercial sexual exploitation, in and of itself (Clayton et. al., 2014; McDonald & Middleton, 2019; see Appendix B). One reason for this may be the discrimination that transgender youth and young adults face, as discrimination has also been cited as a risk factor for commercial sexual exploitation (Clayton et. al., 2014). Beliefs are influenced by life experiences, education, media, and socialization (Sathyanarayana Rao et al., 2009; Solomon & Kurtz-Costes, 2018). Therefore, it can be inferred that discrimination can also occur for these reasons. In particular, conservative religious beliefs that adhere to cisgender normativity can play an instrumental role in transphobic rhetoric (Campbell et al., 2019). The resulting transphobic beliefs can have a snowball-like effect and lead to systemic oppression; thus, impacting the safety, security, and support of transgender individuals (Nafekh et al., 2023; White Hughto et al., 2016). Another risk factor for commercial sexual exploitation that is unique to transgender individuals is inaccessible gender-affirming care. Nafekh et al. (2023) stated: “gender-affirming care is age-appropriate care, which may involve social, medical, and legal components – such as hormone therapy and name changes on legal documents – to support people in affirming their gender identity” (p. 12). This care also includes respecting one’s pronouns and clothing that validates their gender identity (Nafekh et al., 2023). These supports are often vital to the mental and physical well-being of transgender people (Greenfield, 2021; Nafekh et al., 2023). Despite their importance, access to these services, especially for youth and young adults, may be blocked due to a lack of parent/guardian permission, economic obstacles, or restrictive policies and laws (Nafekh et al., 2023). Transgender youth may participate in commercial sexual exploitation to gain the resources needed to obtain this care through unregulated/unsafe avenues 59 (Coronel-Villalobos & Saewyc, 2019; Nafekh et al., 2023). Thus, decreased barriers and obtainable gender-affirming care are protective factors for transgender youth and young adults (Greenfield, 2021). On January 31, 2024, Alberta’s Premier Danielle Smith announced, through a video on social media, the government's intention to implement new policies that are targeted at transgender youth (Cecco, 2024; Smith, 2024). This proposed policy will limit gender-affirming medical care, athletic involvement for transgender children and youth, and name and/or pronoun changes as well as education regarding sexuality, gender identity, and sexual orientation as parental consent will be needed (Cecco, 2024; Smith, 2024; Toy, 2024; Wilhelm, 2024). During this video, she also announced plans to increase medical support for transgender adults and counselling for transgender youth (Smith, 2024; Wilhelm, 2024). Smith (2024) cited many reasons for this decision. One of her reasons for limiting medical-based gender-affirming care was the idea that children and youth are constantly shifting their perspectives and going through biological changes. Thus, medical interventions based on gender identity for youth should be restricted as a way to support their future self, as these are “adult decisions” and the individual in question could change their mind in the future (Smith, 2024; Wilhelm, 2024, para. 8). Another rationale was that “biologically stronger transgender females” have an advantage in sports over cisgender girls (Smith, 2024, 1:58–2:08). Lastly, Smith (2024) also stated that this proposed policy was created out of care and love for transgender youth. Two aspects of this proposal are of particular interest to this paper. For starters, the new policy would limit gender-affirming care for youth. Gender-confirmation surgeries will be prohibited for those under the age of 17 (Cecco, 2024; Smith, 2024). For context, bottom surgery 60 was already banned for minors (Cecco, 2024). Additionally, in 2022-2023 only eight chest-based surgeries were performed on minors for reasons related to gender dysphoria (Cecco, 2024; Dawson, 2024). Transgender children under the age of 15 will not be able to obtain hormone therapy or puberty blockers, and hormone access for gender identity reasons will only be available to youth 16 or older who have the consent of their parents and psychologist (Cecco, 2024; Smith, 2024). The second attribute of Alberta’s newly introduced legislation is that it would require school teachers to inform and receive consent from the parents or guardians of a child under 16 who wishes to change their name or pronouns, parental consent will not be required for youth 16 and older but parents need to be informed (Cecco, 2024; Smith, 2024; Toy, 2024). Similar legislation regarding parental consent for alternative pronoun usage in schools has been passed in Saskatchewan and New Brunswick. In Saskatchewan, the legislation was challenged in UR Pride Centre for Sexuality and Gender Diversity v Government of Saskatchewan (Education) (Toy, 2024). The court recognized that outing children and invalidating their identity can result in significant negative consequences if they have unsupportive guardians, such as abuse and violence, houselessness, suicidal ideation, and social isolation. Based on these findings, it can be concluded that the ramifications of this aspect of Alberta’s policy plan could heighten a transgender youth’s risk of victimization, in a similar fashion to Saskatchewan. The youth has a possibility of losing their support system, financial support, mental health, or personal safety; all of which are seen in the risk factors associated with commercial sexual exploitation (Clayton et. al., 2014; Diamond-Welch & Kosloski, 2020). In the case of Alberta, Smith (2024) dismissed the risks and harms that are associated with outing students to their parents. This was perceived when she stated: 61 We know that nearly all parents, even those who may disagree with the decision of their children, will love and care for their children no matter what choices they make. However, in the handful of rare situations where one or both of the parents reject or become abusive to a child who identifies as transgender, we have child protection laws that will be strictly enforced. (Smith, 2024, 4:30–4:50) Though child protection laws are positive, they are needed because laws in and of themselves do not prevent child abuse. This is evident as childhood abuse perpetrated by parents occurs. The 2014 GSS found that 33% of respondents, who were Canadians older than 14 years of age, suffered from child maltreatment when they were 14 years old or younger (Burczycka & Conroy, 2017). Burczycka & Conroy (2017) found that “with respect to the most serious instance of physical abuse that they experienced, the majority of victims indicated that a parent or step-parent was responsible (61%)” (p. 4). Furthermore, “more than 9 in 10 (93%) victims of childhood physical and/or sexual abuse did not report the abuse to either police or child protection services before they turned 15” (Burczycka & Conroy, 2017, p. 4). The existence of parental abuse and the low rates of reporting along with the increased risk that transgender youth have for victimization, showcase that laws have yet to stop childhood abuse and are unlikely to cease this form of victimization entirely (Burczycka & Conroy, 2017; Goodyear et al., 2024; McCann & Brown, 2019; Varma et al., 2015). ACEs, which include childhood maltreatment, are a risk factor for commercial sexual exploitation (Finkelhor et al., 2015; He et al., 2022; Ports et al., 2016; Webster, 2022). Therefore, the implementation of this kind of policy may create an environment in which transgender children and youth are at greater risk for commercial sexual exploitation. 62 The Being Safe, Being Me 2019: Results of the Canadian Trans and Non-binary Youth Health Survey (Taylor et al., 2020) illustrated the reality for trans and non-binary youth and sexual exploitation. The survey encompassed youth in Canada who were 14 to 25 years of age and included 1,519 respondents, 281 of which were Albertan youth. The general consensus was that gender-diverse youth in Alberta do not necessarily feel safe or supported (p. 86). ● 58% are not comfortable talking with their health practitioner about their trans and/or gender affirming health care needs; ● 77% have avoided public washrooms for fear of being harassed, being read as trans, or being outed; and ● 66% do not feel safe in school washrooms. These statistics show that the majority of the transgender youth who participated in the survey and reside in Alberta had a relatively high level of fear and apprehension about seeking gender-affirming care services and accessing public and/or school washrooms (Taylor et al., 2020). Still, this data was collected before January 31, 2024, when the Albertian government announced the proposed policy that would affect transgender youth (Smith, 2024; Taylor et al., 2020). With the Alberta government proposing to limit transgender children’s ability to access gender-affirming care services, it may result in further negative emotions in transgender youth concerning their gender-affirming medical needs than the 58% of respondents who already felt uncomfortable in 2019, before the proposed restrictions (Smith, 2024). This relates to one of the risk factors of commercial sexual exploitation, i.e., the lack of accessible gender-affirming care for transgender youth (Coronel-Villalobos & Saewyc, 2019; Greenfield, 2021; Nafekh et al., 2023). 63 Furthermore, Smith’s (2024) video outlined that school staff may be required to inform parents of their child’s transgender identity, if this proposed policy moves forward. Taylor et al.’s (2020) findings showed that transgender students were previously fearful of accessing the washroom due to the possibility of being outed or experiencing bullying. Thus, Alberta’s intention to implement this policy may heighten this fear due to discriminatory and adverse consequences that outing someone as transgender may create (Smith’s, 2024; Taylor et al., 2020; Toy, 2024). One of these outcomes could be the risk factor of homelessness from transphobic abuse or beliefs that may exist in the family of the gender-diverse youth (Clayton et. al., 2014; Goodyear et al., 2024; McCann & Brown, 2019; Varma et al., 2015). Therefore, it can be inferred that the legislation proposed by Smith (2024) will only increase youth’s apprehension seeking medical support, worry about the possibility of being outed or discriminated against, and apprehension living as their authentic gender identity (Taylor et al., 2020). It is important to note that the policy publicized by Premier Danielle Smith has only been proposed and has not yet been implemented during the writing of the paper (Cecco, 2024; Smith, 2024; Toy, 2024). Regardless, its existence showcases the targeted and institutionalized attempts to dehumanize and dismiss transgender youth. Therefore, these discriminatory acts can interact with other risk factors and create a unique set of reasons why a transgender youth or young adult may be victimized through commercial sexual exploitation (Clayton et. al., 2014; McDonald & Middleton, 2019; see Appendix B). Prevalence In 2021, Canada began differentiating between sex and gender on the Census and was the first country to make this data about transgender and non-binary individuals available (Statistics Canada, 2022a). This allowed for further inclusion as well as available information regarding the 64 prevalence of the transgender population in Canada. The 2021 census showed that there were 100,815 transgender and non-binary people in Canada. Of that number, 12,480 individuals resided in Alberta. Among those aged 15-34, 0.74% of Alberta’s population were transgender or non-binary. It was also found that non-binary people tended to live in urban Canadian areas. Within an Albertan context, 4.5% of non-binary people in Canada who were 15 or older lived in Calgary and 4.5% resided in Edmonton. This is compared to the largest percentage of 15.3% in Toronto, Ontario. In Canada, one in 300 people who are 15 years of age or older are transgender or non-binary. It was found that younger people were overwhelmingly more likely to be transgender or non-binary. For context, those born between 1997 and 2006 had the highest population, and the amount decreased by generation. This decline reasonably has to do with reporting and acceptance. Governmental and societal recognition of the 2SLGBTQ+ population has grown and thus, younger individuals may feel more comfortable reporting their identity. Furthermore, young adults aged 20-24 have the greatest amount of gender diversity (and it is the second age grouping among 11, with the youngest starting at 15). This age range included 0.85% or nearly 1 in 100 of its population were transgender or non-binary. To put this into perspective, the oldest age range (65 years of age or older) had a gender-diverse population of 1 in 700. Victimization Coronel-Villalobos & Saewyc (2019) analyzed the 2014 Canadian Trans Youth Health Survey to determine the prevalence and risk factors of transgender youth who are victims of commercial sexual exploitation. 656 youth and young adults aged 14 to 25 answered the survey. Gender diversity was seen as 276 (42.5%) participants were transmasculine, 107 transfeminine (16.5%), and 266 (41%) non-binary. The survey showed that the act of trading sex for goods 65 (commercial sexual exploitation) was seen in 66 (10.1%) respondents. Gender diversity was seen in these 66 people as 37.9% were transmasculine, 22.7% transfeminine, and 39.4% non-binary. It was found there was no difference based on gender (transwomen, transmen, or non-binary individuals) for commercial sexual exploitation. However, previous research focusing on cisgender individuals (male or female sex characteristics) has shown that women and girls have a greater likelihood of victimization (Allan, 2023; Chettiar, 2010; Gerassi, 2015b). Moreover, self-reported data from the Survey of Safety in Public and Private Spaces (SSPPS) showed that by the age of 15, transgender individuals are more likely to experience violent victimization in Canada (Jaffray, 2020). Nonconsensual/inappropriate sexual conduct, both in-person and virtually, was also higher for transgender people compared to cisgender individuals. Transgender Canadians were more likely to face workplace discrimination, negative mental health, suicidal thoughts, and rely on substances (alcohol or drugs) to deal with the trauma they experience. It was difficult to find statistics on the commercial sexual exploitation of transgender youth and young adults, particularly in Alberta. The small sample size of transgender and non-binary people contributed to this. For example, the Association of Alberta Sexual Assault Services (2020) did not include transgender individuals in their findings because they made up less than one percent of participants. Additionally, Canadian physical and sexual assault statistics for transgender people in 2018 could not be analyzed due to the smaller sample size (Jaffray, 2020). Risk Factors for Unhoused Youth and Young Adults Along the same vein as transgender victims of commercial sexual exploitation, unhoused youth and young adults are at higher risk for victimization (Clayton et. al., 2014; Cotter, 2021; 66 Saewyc, 2013). Being unhoused can have many social consequences (Gaetz, O’Grady, Kidd, & Schwan, 2016; see Appendix B). For example, it is often hard for unhoused youth to find employment or maintain their education, due to the stigma and logistics surrounding their living situations (Gaetz, O’Grady, Kidd, & Schwan, 2016; Reilly et al., 2022). Therefore, already lacking financial funds can be depleted further. Additionally, loss of connection with family and childhood abuse are also a contributor to homelessness for youth. The resulting isolation that unhoused people experience can cause further hardships such as feelings of loneliness as well as negative impacts on mental and physical well-being (Sanders & Brown, 2015). Violent victimization is also common within the unhoused population (Cotter, 2021). With a particular focus on youth, leaving home at a young age (under 16) increases the likelihood of multiple unhoused stints, and thus, results are associated with victimization (such as sexual assault) once unhoused (Gaetz, O’Grady, Kidd, & Schwan, 2016). Ports et al. (2016), shows an association between childhood sexual abuse and adult sexual violence. Therefore, the trauma that results from being unhoused and its correlated risk, such as violence, can have long-lasting consequences (Ports et al., 2016; Centre for Substance Abuse Treatment (US), 2014). Highlighting the importance of supporting young adults to heal from the abuse they experienced as children in an effort to stop further violence, especially (for this paper) in the form of commercial sexual exploitation. Lastly, substance use and addiction have been correlated with both houselessness and commercial sexual exploitation. Data from the 2014 Canadian Trans Youth Health Survey showed that the consumption of injectable and/or illegal drugs was more likely to exchange sex for other goods (Coronel-Villalobos & Saewyc, 2019). Drug use is common among houseless youth and young adults and drugs or alcohol may be consumed as a means of coping (Gomez et 67 al., 2010; Kirst & Erickson, 2013). “Previous research has shown that 40-71% of street-involved youth abuse alcohol and/or other drugs” (Kirst & Erickson, 2013, 186). This can then increase their risk for commercial sexual exploitation if they are exchanging sex for addictive substances or for money to obtain them (Chettiar, 2010; McDonald & Middleton, 2019; Native Women’s Association of Canada, 2014; Varma et al., 2015). Youth drug use is also harmful as it can increase their risk of contracting the human immunodeficiency virus (HIV) (Public Health Agency of Canada, 2014). Therefore, drug use and commercial sexual exploitation are linked (see Appendix B). Prevalence In 2016, The State of Homelessness in Canada estimated that approximately 235,000 people were homeless. Depending on the study used, 18.7% to 20% of Canada’s homeless population are individuals aged 13 to 24 (Gaetz, Dej, Richter, & Redman, 2016; Gaetz, O’Grady, Kidd, & Schwan, 2016, as cited in Gaetz et al., 2014). In other terms, each year there are approximately 35,000-40,000 homeless youth (Gaetz, O’Grady, Kidd, & Schwan, 2016). The 2016 Without a Home: The National Youth Homelessness Study consisted of 1,103 participants. It was found that 40.1% of participants were homeless for the first time at 15 years of age or younger. Housing instability was also a large factor as 75.9% were homeless more than once and 36.9% had 6 or more bouts of homelessness. The likelihood of multiple homelessness occurrences increased if the youths’ first instance of homelessness occurred before the age of 16. The 2018 Alberta Point-in-Time Homelessness Count Technical Report discovered that 5,735 people were homeless in Alberta. The greatest homeless population in Alberta was Calgary with 2,911 people, followed by Edmonton with 1,971 people. More recently, the approximate homeless population in 2022 was 2,782 in Calgary and 2,519 in Edmonton 68 (Homelessness Hub, n.d.a; Homelessness Hub, n.d.b). This is somewhat consistent with the overall population difference as Calgary had 325,997 more people than Edmonton in 2022. Victimization Homelessness is correlated with violent victimization (Cotter, 2021). Self-reported data from the GSS in 2019 showed that this association increased when the episode(s) of homelessness occurred relatively recently. This is evident as violent victimization is three times more likely for those who have been homeless compared to those who have not, but violent victimization increases to being five times more likely for those who were homeless in the last five years (3% of respondents) in comparison to people who have never been homeless. Youth also experience this link between houselessness and violent victimization (Gaetz, O’Grady, Kidd, & Schwan, 2016). According to 2016 Without a Home: The National Youth Homelessness Study, “only 7.6% of Canadians report being the victim of a violent crime, compared with 59.6% of homeless youth who report violent victimization, including high rates of sexual assault” (Gaetz, O’Grady, Kidd, & Schwan, 2016, p. 100). Additionally, Saewyc et al. (2013), reported that “among street-involved and homeless youth in North America, an estimated 1 in 3 report sexual exploitation” (p. 148). The prevalence is similar for youth outside large cities, as unhoused and street-involved youth have exchanged sex for other goods at a rate of 1 in 3 (Saewyc et al., 2013). These statistics showcase the disproportionate, rampant, and somewhat normalized sexual abuse and exploitation of unhoused youth. Combined Risk Factors Unhoused youth and young adults who are transgender are vulnerable to commercial sexual exploitation (Clayton et. al., 2014; see Appendix B). The 2018 SSPPS found that 2SLGBTQ+ people's risk of becoming houseless is double those who are not queer, and financial 69 insecurity is also more common in the 2SLGBTQ+ community (Prokopenko & Kevins, 2022). Transgender youth and young adults may be kicked out of their parent's or guardian's home or runaway due to backlash from their gender identity (Goodyear et al., 2024; McCann & Brown, 2019; Varma et al., 2015). Thus, discriminatory beliefs, specifically transphobia, are a risk factor as well. Furthermore, maintaining stable housing can be difficult for gender-diverse people (Nelson et al., 2023). Transgender people have reported discrimination by landlords and homeless shelter staff, and instances of losing housing due to transphobia have been identified (Abramovich, 2014; Kattari & Begun, 2017; Nelson et al., 2023). Homeless shelters and other support programs (for example, addiction treatment programs) often separate their clients by men and women, which can further impact gender-diverse people as they may have to decide to invalidate their gender or not receive assistance (Kattari & Begun, 2017). Thus, transgender individuals face specific barriers to obtaining housing. The collision of transgender identity and being unhoused heightens someone’s risk for commercial sexual exploitation. The 2016 Without a home: The national youth homelessness survey noted that 1.8% of respondents were transgender, 2.5% non-binary, and 1.8% two-spirit, but only 0.5% of Canada’s population is transgender (Gaetz, O’Grady, Kidd, & Schwan, 2016). Showcasing that transgender youth were overrepresented in the unhoused population due to the difference between the two populations Additionally, specific risk factors for both transgender and unhoused youth can co-exist (Coronel-Villalobos & Saewyc, 2019). Based on data from 2014, “participants were over 4 times more likely to trade sex if they had run away from home, or obtained trans-related hormones from illicit sources” (Coronel-Villalobos & Saewyc, 2019, p. S6). 70 Commercial sexual exploitation has been linked to poor mental health (Clayton et. al., 2014; Jimenez et al., 2015). Both transgender and unhoused youth and young adults have higher possibilities of mental distress (Gaetz, O’Grady, Kidd, & Schwan, 2016; Newcomb et al., 2019; Veale et al., 2017). Anxiety, depression, and suicide were evident in these groups. Both transgender and unhoused youth and young adults face these hardships based on the way they live, thus their likelihood of mental health issues and as a result victimization increases (Clayton et. al., 2014; Gaetz, O’Grady, Kidd, & Schwan, 2016; Veale et al., 2017). Therefore, accessible and inclusive mental health support is also a vital protective factor against commercial sexual exploitation (Clayton et. al., 2014; Greenfield et al., 2021) It is also important to note that other characteristics play a role in commercial sexual exploitation (Coronel-Villalobos & Saewyc, 2019). Most notably, people of colour were more likely to be victimized than their white peers. Therefore, it can be inferred that discrimination based on race is also a risk factor. Indigenous people also had an increased risk of exploitation through commercial sex, which is likely caused by the lasting trauma from colonialism and attempted assimilation (Chettiar, 2010; Native Women’s Association of Canada, 2014; Sharma et al., 2021). Moreover, Sharma et al. (2021) states that “Two-spirit youth are over-represented among Indigenous street-involved and homeless youth in Vancouver, and are more likely to report sexual exploitation than street-involved heterosexual Indigenous youth” (p. 5, 7, as cited in Saewyc et al., 2008). This showcases the increase in risk and harm associated with the intersection of vulnerable identities (see Appendix B). Connecting Risk Factors to the Theoretical Framework McDonald’s survival sex hierarchy can be seen in the types of goods that are exchanged for sex through commercial sexual exploitation (McDonald and Middleton, 2019). Food, 71 housing, companionship, and addictive substances are some of the items that are traded for sex (Czechowski et al., 2022; Hurst, 2021; Kattari & Begun, 2017; McDonald and Middleton, 2019; United Nations, 2019). Maslow’s physiological needs are perceived in the form of food (McDonald and Middleton, 2019; Koltko-Rivera, 2006; Simons et al., 1981). Exchanging sexual acts for sustenance may be identified as a necessary evil by the victim in order to attain the basic nourishment needed to stay alive. Housing is directly linked to one’s safety (Clayton et. al., 2014; Cotter, 2021; Gaetz, O’Grady, Kidd, & Schwan, 2016; McDonald and Middleton, 2019; Saewyc et al., 2013). Without housing, nothing is physically enclosing/protecting the person or giving an impression of privacy/security. Therefore, housing is integral to one's safety and those who are unhoused may enter into commercial sexual exploitation to obtain it (Clayton et. al., 2014; McDonald and Middleton, 2019). Companionship is also closely related to Malsow’s need of belongingness and love (Koltko-Rivera, 2006; McDonald and Middleton, 2019; Pinkus, 2020). This form of companionship, however abusive, may disguise itself as genuine and for a moment fulfill this need (McDonald and Middleton, 2019). From an outsider's perspective, it is apparent that the perpetrators of commercial sexual exploitation are using the child (International Labour Office Geneva, 2007; International Labour Organization, 2015). On the other hand, it can be inferred that the need of belongingness and love could be accomplished for the time being, because - for a relatively short moment - the victim is not alone (Clayton et. al., 2014; McCann & Brown, 2019; McDonald & Middleton, 2019; Simons et al., 1981). This is seen in the unhoused youth and young adult population. They experience much stigma and isolation and thus may crave comfort in the form of commercial sexual exploitation (Gaetz, O’Grady, Kidd, & Schwan, 2016; Reilly et al., 2022; Sanders & Brown, 2015). This one of Maslow’s needs is also evident in queer youth as 72 they may partake in commercial sexual exploitation to feel accepted by others, especially due to the discrimination they face (ACT Alberta, 2023; Clayton et. al., 2014; Goodyear et al., 2024; Kattari & Begun, 2017; McCann & Brown, 2019; McDonald and Middleton, 2019; Varma et al., 2015). Lastly, someone who is in the throes of substance abuse and misuse may consider drugs and alcohol to be of considerable worth (McDonald and Middleton, 2019; Varma et al., 2015). Addictive substances can temporarily hinder the negative emotions surrounding past trauma or their present abuse (Barnert et al., 2017; Jimenez et al., 2015; McDonald and Middleton, 2019; Gomez et al., 2010; Kirst & Erickson, 2013; Varma et al., 2015). These substances may also suppress feelings of guilt and shame, allowing for the survivor's self-esteem to heighten for a moment (Barnert et al., 2017; Jimenez et al., 2015; McDonald and Middleton, 2019; Varma et al., 2015). Therefore, fulfilling Maslow’s need for self-esteem. This is especially seen in survivors of commercial sexual exploitation as they are correlated with these negative coping mechanisms. Self-actualization does not have strong evidence within this literature review. As McDonald and Middleton (2019) discussed, self-actualization is related to survivors who know the harms of commercial sexual exploitation, decide to partake anyway, and believe that engaging in this type of victimization is part of who they are. There was little evidence, besides McDonald and Middleton’s (2019) article that supported the notion that survivors’ view commercial sexual exploitation as their life’s purpose. Instead, it seemed that an environment where commercial sexual exploitation occurred was due to risk factors and desires that increased the youth or young adult propensity for victimization and thus violence (Cotter, 2021; Clayton et. al., 2014; Diamond-Welch & Kosloski, 2020; Finkelhor et al., 2015; Ports et al., 2016). 73 Some of these risk factors were to be expected and neatly fit within Maslow’s humanistic theory. In particular, the lack of financial resources and incorporation of adverse childhood experiences are logically connected to this type of victimization, especially for unhoused youth and young adults (Afifi, 2020; Clayton et. al., 2014; Diamond-Welch & Kosloski, 2020; Finkelhor et al., 2015; Gaetz, O’Grady, Kidd, & Schwan, 2016; Goodyear et al., 2024; Ports et al., 2016; Statistics Canada, 2023). On the other hand, transgender youth and young adults had the most unique risk factors compared to the risk factors of commercial sexual exploitation as a whole and unhoused youth and young adults. Transgender youth and young adults' risk factors aligned most with Maslow’s need of transcendence and safety. Transcendence is seen through the risk factor of transphobic discrimination (Clayton et. al., 2014; Nafekh et al., 2023; White Hughto et al., 2016). Campbell et al. (2019), discuss that conservative religious beliefs often align with transphobic beliefs. Therefore, spiritual and religious elements may negatively affect transgender people. While there was little evidence to show that transgender youth and young adults try to obtain transcendence, it can be argued that it still impacts them. As others try to obtain transcendence, possibly through religion, they may misconstrue the sentiments of Maslow’s theory - believing in something greater than themselves as well as understanding your purpose and the purpose of others - and thus, develop and spout transphobic ideology (Campbell et al., 2019; Koltko-Rivera, 2006; Rowan & Glouberman, 2017; Venter, 2016). Transphobic discrimination can also impact one's safety, because transgender youth may be abused or lose their residence due to the prejudice that exists in their family (Goodyear et al., 2024; McCann & Brown, 2019; Varma et al., 2015). The lack of safety is also evident concerning inaccessible gender-affirming care and anti-transgender legislation (Greenfield et al., 2021; 74 Hampton & Lieggi, 2020; Jaffray, 2020; Nafekh et al., 2023; Toy, 2024). Both of these risk factors can cause substantial physical and mental harm to transgender people and thus, may push them toward victimization to obtain the care they desire or have some perception of safety. Understanding these risk factors and how they correlate to commercial sexual exploitation may, optimistically, increase empathy and thus assist survivors of this victimization as well as uplift vulnerable groups in society 75 Environmental Scan An environmental scan is defined by Thomas Edison State University (n.d.) as “the process of gathering information about events and their relationships within an organization's internal and external environments” (para. 1). Rathi et al. (2017), discusses that this analysis tool, which is usually based on criteria that is of value to the organization, can be used to uncover trends and possible gaps. Design Six organizations that assist survivors of commercial sexual exploitation were analyzed through this environmental scan. These organizations service Alberta’s sexual violence survivors (three aftercare programs in Calgary and three aftercare programs in Edmonton). Some of these organizations do not specifically mention commercial sexual exploitation, but they do assist similar types of victimization, such as sexual assault, sexual violence, or sex trafficking. This environmental scan utilized a mixture of annual reports and website information that was gathered based on the availability of knowledge sources from each specific aftercare program. Three main components were used to evaluate the aftercare programs: survivor-focused lens, trauma-informed care, and inclusivity. The first two criteria were taken from the ideas outlined in the MSSH model and the last was implemented due to the risk factor of discrimination that was previously discussed (Clayton et. al., 2014; McDonald & Middleton, 2019). These evaluation criteria are quite subjective. In addition, each aftercare program evaluation process differed due to the accessible availability of information for each program as well as the way it was interpreted by the author. Therefore, much detail will be included behind the rationale for each criterion. 76 Survivor-focused Lens The main stakeholders for the purpose of this environmental scan were the participants of the aftercare programming of interest (i.e., survivors) (Rathi et al., 2017). Therefore, a survivor-focused lens was crucial. Brandt et al. (2021), showcased the importance of a survivor lens when trying to address human trafficking in Alberta. Within this survivor-centered approach, participants should have choice and control within their healing journey. Additionally, the terminology used to refer to the participants within the program was also a crucial aspect (Sexual Assault Kit Initiative, n.d.). Victim serves a purpose as it is often used in the law and criminal justice procedures. Outside of this context, the term survivor is necessary (McDonald & Middleton, 2019; Schwark & Bohner, 2019; Sexual Assault Kit Initiative, n.d.). It was preferred in terms of this environmental scan as it is more empowering and uplifting. The word survivor showcases that they lived through something difficult and can still thrive despite it, rather than be consumed by their victimization. Lastly, feedback, comments, and concerns from participants should be taken into consideration and valued by the program. Survivors are who the aftercare programs are meant to support and help. Therefore, their voice should be of utmost importance to ensure that the aims of the program are meeting its outcome. Trauma-informed Care To understand trauma-informed care, trauma must be defined first. The definition of trauma can vary (Menschner & Maul, 2016). A commonly used definition of trauma was established by the Substance Abuse and Mental Health Services Administration's (SAMHSA) Trauma and Justice Strategic Initiative (2014, p. 7), 77 Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being. (as cited in Menschner & Maul, 2016, p. 2) Adverse childhood experiences are traumatic (Forkey et al., 2021). Since these experiences are a risk factor for commercial sexual exploitation, it was imperative to discuss trauma-informed care. Trauma-informed care is a program model that values collaboration (Forkey et al., 2021). All parties that are involved in the participant’s life (such as their clinicians and family) work in tandem with one another to best support the participant, in this case, the survivor of commercial sexual exploitation. To deliver the best care possible there should be an open and honest exchange (Menschner & Maul, 2016). Therefore, the trauma that the participant has experienced in the past is taken into account when determining the proper course of action. This is important as past trauma can be influential in one’s healing journey (Champine et al., 2022). The Centres for Disease Control and Prevention’s (CDC) Office of Readiness and Response with the SAMHSA’s National Center for Trauma-Informed Care created “six guiding principles to a trauma-informed approach” (CDC, 2020, para. 1). 1. Safety 2. Trustworthiness and transparency 3. Peer support 4. Collaboration and mutuality 5. Empowerment and choice 6. Cultural, historical, and gender issues 78 The participant is empowered through choice, respect, and honesty (CDC, 2020; Champine et al., 2022; Forkey et al., 2021; Menschner & Maul, 2016). Champine et al. (2022) and Menschner & Maul (2016), further showcase the importance of being trauma-informed in order to not create adverse effects through re-traumatization. Trauma-informed care does not blame the victim but rather tries to work toward healing them from their experiences (Menschner & Maul, 2016). Thus, working toward establishing both mental and physical safety as well as developing resilience to traumatic experiences (Champine et al., 2022; Forkey et al., 2021; SAMHSA Trauma and Justice Strategic Initiative, 2014). Trauma-informed care practices are important to evaluate the level of support that survivors of commercial sexual exploitation receive. Aftercare programs that specifically use the term trauma-informed care are noted. In addition, programs that use trauma-informed care practices that implemented the six guiding principles were also analyzed, whether or not trauma-informed care was stated. Inclusivity Inclusivity was also integral to the success of aftercare programs. This was especially seen in the populations of interest. As previously discussed, discrimination is a risk factor for commercial sexual exploitation (Clayton et. al., 2014). Therefore, language that aligns with transphobia, classism, ageism, and racism will only serve to further harm survivors. For example, aftercare programs that stick to the gender binary of men and women, while using she/her and he/him pronouns exclusivity to refer to survivors is an example of exclusionary practices. A welcoming and accepting culture within the aftercare program will be of benefit to survivors of commercial sexual exploitation and thus was included in this environmental scan criteria. 79 Secondly, the mere mention of transgender, unhoused, youth and young adults in addition to the appearance or absence of specific steps to support their unique needs attributed to the program's inclusivity. Therefore, statistics related to transgender, unhoused, and youth and young adult participants will be important in this scan. Information regarding class, ethnicity, disability, gender, sexual orientation, and other identities will also be noted in this category. Participant safety can be concluded from the way in which aftercare programs display their data and run their programs. Calgary SafeLink Alberta Safelink Alberta offers support for those who engage in sexual intercourse and use substances (Ostberg, 2022). This is done to increase health and safety surrounding these activities. A large facet of their programs and educational initiatives revolve around safe consumption of substances, harm reduction, sexually transmitted infections, and sex work. The closest aftercare program that they offer to support survivors of commercial sexual exploitation was Shift (SafeLink Alberta, n.d.b). This program assists adult sex workers. Though sex work is completely different from commercial sexual exploitation, young adults who are the population of interest in this project, would be able to access their services. Some of their services include mental health support referrals, testing and remedies for sexually transmitted infections, financial support, and access to accessibly priced birth control. This program is not survivor-focused, but this was not applicable in this case. They have a “rights-based approach” (SafeLink Alberta, n.d.b, para. 1). Whereby, the decision to engage in sex work is honoured. Trauma-informed care was mentioned within Safelink’s framework for supporting sex workers (SafeLink, 2024). They believe that 80 Any practice supporting sex workers must be trauma informed. Some trauma informed practices include: treat every client as though they could be engaged in sex work (default to a nonjudgemental approach to sex work and be conscious of the statements you make and the language you use - don’t assume that the person before you is not engaged in sex work); understand your own biases towards sex work and educate yourself about how stigma and discrimination affect sex workers; and accept sex work as a legitimate occupation. (p. 43) Despite this, Shift centers and supports their participants by meeting them “where they are at, whether they want to continue sex work, safely transition, or anything in-between” (SafeLink Alberta, n.d.b, para. 1). This gives the participants choice over next steps. Additionally, Shift offers information on how to work safely, such as ““Bad Date” reporting, safer working strategies (date screening, condom negotiation)”; which will likely mitigate the risk of victimization while engaging in sex work (SafeLink Alberta, n.d.b, para. 2). Inclusivity was also evident in the SafeLink organization. Shift recognizes that other factors can lead to sex work, such as low socio-economic status or exploitation (SafeLink Alberta, n.d.b). Therefore, they encompass and address many scenarios that can lead to sex work (HIV Community Link, 2022; SafeLink Alberta, n.d.a). Transgender sex workers are also specifically included in their programming with access to a transgender sex worker peer support group (SafeLink Alberta, n.d.a). Therefore, most of their language was gender-inclusive, because they used non-gendered language such as participants or adults (Ostberg, 2022; SafeLink Alberta, n.d.b; SafeLink Alberta, n.d.a). Cultural inclusivity was also seen in the 2021-2022 Annual Report as reference was also made to the use of “cultural practices” as well as the Indigenous community (Ostberg, 2022, para. 9, 14). 81 RESET Society of Calgary RESET Society of Calgary specifically supports survivors of sexual exploitation, who are girls or women who are 16 years of age or older (RESET Society of Calgary, n.d.b). They also support women who are sexually exploited and by extension their children. RESET stands for exploitation, intervention, and transition. Thus, they focus on helping survivors leave the cycle of sexual exploitation. They call this service the EXIT program (RESET Society of Calgary, n.d.c). It offers housing, mental and physical health support, financial help, legal assistance, and skill building (RESET Society of Calgary, n.d.a; RESET Society of Calgary, n.d.c). This program has three phases that build off one another to support leaving sexual exploitation for the long term (RESET Society of Calgary, n.d.a). It begins with a focus on immediate safety, then education and skills development, followed by autonomy and working toward achieving their goals. The survivor-focused lens was directly referenced in their 2022 Annual Report stating that their support is “survivor-led, trauma-informed, built on trust, and there for life” (p. 3). Increasing survivors' skills regarding agency and independence is also important to a survivor-focused lens to have control over their choices and lives (RESET Society of Calgary, n.d.a). Despite this, the word victim was used more than survivor in the 2022 Annual Report. Trauma-informed care was also mentioned. This was notably seen in their trauma-informed counselling services. They appreciate the impact of trauma and have staff that follow trauma-informed practices (RESET Society of Calgary, n.d.d). Gender inclusivity was not evident in this aftercare program as women and girls were the only survivors who could access their services (RESET Society of Calgary, n.d.c). Furthermore, there was no direct mention of transgender women in the 2022 Annual Report. On the other 82 hand, information regarding unhoused and Indigenous participants was included, which increased their inclusive nature. Calgary Communities Against Sexual Abuse Calgary Communities Against Sexual Abuse (CCASA) works to prevent and educate about this type of victimization while offering support to survivors (CCASA, n.d.c). They offer four programs for survivors: “phone, text, chat [lines], Calgary sexual assault response team, police and court education and support team, and counselling services (CCASA, n.d.b). The program that will mostly closely support survivors of commercial sexual exploitation was likely their counselling services, but the other programs could be of some assistance depending on their life circumstances. Therefore, all of these supports are applicable. The 2022 Annual Report utilizes the term survivors more than victims. Moreover, the word victim was only used when referring to programming. Therefore, this language was quite empowering in nature. Survivor choice was also seen as service providers and survivors working together to determine the best course of action (CCASA, n.d.b). Though trauma-informed care was not specifically mentioned on the CCASA website and 2022 Annual Report, their services are rooted in “a trauma-specialized approach that recognizes you are the expert of your own experiences, and we work with you to provide the best support for you” (CCASA, n.d.b, para. 2). Inclusivity was evident within CCASA (CCASA, n.d.a). The youth support group, part of their counselling supports, in. They also included a land acknowledgement as we outlined their anti-racism and truth and reconciliation practices within their 2022 Annual Report. Financial stressors were briefly mentioned once in regard to their increase due to COVID. Lastly, it was noted that their counselling service is currently creating a program for the queer community. 83 Edmonton Sexual Assault Centre of Edmonton The Sexual Assault Centre of Edmonton offers support for those who are survivors of sexual assaults as well as educational programs (Sexual Assault Centre of Edmonton, n.d.d). These programs include the client care program, adult counselling, child and youth counselling, group counselling, police and court support, public education, and institutional support, community and agency development. All of which could be beneficial to survivors of commercial sexual exploitation, especially in regard to their mental health. A survivor-focus lens was implied but not stated in their materials. Consent, respect, and privacy are at the forefront of the client’s rights (Sexual Assault Centre of Edmonton, n.d.e). Additionally, a person-centered approach was one of many approaches that may be utilized in counselling. It requires the counsellor to accept the client for who they are and build a professional relationship. Lastly, the term client was used most for referring to the survivors that they assist. Trauma-informed care was seen as another approach that a counsellor can choose to use with a client. Therefore, it was not required but up to the discretion of the counsellor to use the approach that they feel will be of the most benefit. This organization has a diversity and inclusion program where they partner with other Canadian organizations (Sexual Assault Centre of Edmonton, n.d.a). This was done to reduce the barriers that exist for vulnerable populations when accessing support services. To showcase non-binary and transgender inclusion reflectQT, a group counselling program, was created (Sexual Assault Centre of Edmonton, n.d.b; Sexual Assault Centre of Edmonton, n.d.d). It is specifically for the queer population. Moreover, the feminist approach to counselling is, by nature, welcoming to any gender (Sexual Assault Centre of Edmonton, n.d.e). The Sexual 84 Assault Centre of Edmonton (n.d.c) states that they “support people who have experienced sexual violence no matter the circumstances surrounding the abuse” (para. 16). They use the example of sex workers but it can also be inferred that survivors of commercial sexual exploitation could fit this definition for support services. Saffron Centre The Saffron Centre supports survivors of sexual violence (Saffron Centre, n.d.c). They offer counselling to support survivors’ mental health, educational resources, and assistance with the process of navigating the criminal justice system. The Saffron Centre differs from the other two Edmonton aftercare programs as they are located in Sherwood Park, but they do offer support for those in Edmonton (Saffron Centre, n.d.a; Saffron Centre, n.d.c). In the 2022-2023 Annual Report the terms victim and survivor are used equally; being that they are each used once when in relation to their programming. Client was the most commonly used term. In conjunction with the philosophy of a survivor-focused lens, they started working toward lessening barriers for those trying to access their services (though this survivor-focus was not specifically mentioned). The majority of their counselling clients made progress in their healing journey. This document also makes much mention of trauma-informed care and/or trauma in general. The term trauma-informed care was specifically noted in their justice system supports. It was also found that “100% of clients felt their counsellor understood the impact the sexual abuse/assault had on them” (Saffron Centre, n.d.a, p. 8). In terms of inclusivity, youth participants were specified (Saffron Centre, n.d.a). There was no mention of transgender or unhoused individuals. Though there was not much mention in their 2022-2023 Annual Report, their website offers the phone numbers of helplines that 85 specifically support youth, transgender, and Indigenous peoples as well as a land acknowledgment (Saffron Centre, n.d.b; Saffron Centre, n.d.d). ACT Alberta ACT Alberta seeks to create a safe environment for survivors of human trafficking (ACT Alberta, n.d.d). For this project, their support regarding sex trafficking will be of focus. Their aims are to prevent this type of victimization, assist those who are survivors, seek legal consequences for offenders, and work with others (ACT Alberta, n.d.b). Some of their programs offer assistance to survivors as well as training for members of the community. Support for survivors may include assistance at court, paperwork support, and referrals to other agencies. A survivor-focused lens was partly seen as they use a “rights based victim-centered approach” (ACT Alberta, n.d.b, p. 4). The specifics regarding this victim-centered approach are not expanded upon. A potential negative for this criterion was that the term victim was deployed much more than the word survivor in the 2021-2022 Annual Report, but these terms do seem to be used interchangeably or with one another on their web pages (ACT Alberta, n.d.a; ACT Alberta, n.d.b; ACT Alberta, n.d.; ACT Alberta, n.d.d). This likely lessens the negative connotations associated with the term victim when looking at their website. Trauma-informed care was stated by ACT Alberta but the ways in which it is implemented are not thoroughly described (ACT Alberta, n.d.a; ACT Alberta, n.d.d). One way that it is likely implemented is through trauma counselling (ACT Alberta, n.d.b). Act Alberta recognizes that sex trafficking largely affects women and girls, but they also realize that there are other survivors of sex trafficking (ACT Alberta, n.d.c). The organization is queer-inclusive as it recognizes the unique barriers they face to access resources (ACT Alberta, 2023). In addition, they acknowledge that youth who are unhoused and/or run away from their 86 home are preyed on by traffickers. These abusers can offer the love that 2SLGBTQ+ youth may not receive at home and thus, are manipulated (consciously or unconsciously on the part of the survivor) into sex trafficking. They also explicitly state that they “respect and serve individuals and stakeholders from all backgrounds, abilities, religions, sexual orientations, and genders” as well as mention poverty (ACT Alberta, n.d.b, p. 4; ACT Alberta, n.d.c). Overall, the programs in Calgary and Edmonton were quite comparable. The ways in which the aftercare programming seemed to excel was by centering the participants. The large majority of the programming had a survivor-focused lens and all supported the needs of their participants (ACT Alberta, n.d.b; CCASA, n.d.a; RESET Society of Calgary, n.d.a; Saffron Centre, n.d.a; Sexual Assault Centre of Edmonton, n.d.d). In terms of language, it varied among the aftercare programs. In general, more organizations used the term survivor than that of victim. Despite this, Act Alberta used the term victim more in their 2021-2022 Annual Report than survivor. Client, participant, and phrases that talked about the behaviour they were engaged in or at the receiving end of (otherwise known as survivors) were also used to refer to those within the programs (ACT Alberta, n.d.b; CCASA, n.d.a; Ostberg, 2022; RESET Society of Calgary, n.d.a; Saffron Centre, n.d.a; Sexual Assault Centre of Edmonton, n.d.d). In all the aftercare programs the participants were the focus of the organizations’ work and benefit. Similarly, most of the programs mentioned or had principles of trauma-informed care practices. The only program where these principles seemed to be up to the provider’s discretion was the Sexual Assault Centre of Edmonton, but it was still mentioned and utilized (Sexual Assault Centre of Edmonton, n.d.e). These programs were all voluntary, meaning participants chose to partake in their services (ACT Alberta, n.d.b; CCASA, n.d.a; Ostberg, 2022; RESET Society of Calgary, n.d.a; Saffron Centre, n.d.a; Sexual Assault Centre of Edmonton, n.d.d). 87 Therefore, the participants seemed to have much choice and decision-making power within these programs. Many included mental health support and discussed traumatic experiences in relation to victimization and healing. There was not a large focus on gender-diverse survivors. Only The Sexual Assault Centre of Edmonton’s reflectQT and SafeLink Alberta’s sex worker group meeting specifically services transgender people (SafeLink Alberta, n.d.a; Sexual Assault Centre of Edmonton, n.d.b; Sexual Assault Centre of Edmonton, n.d.d). Despite this, there was a blog post regarding queer people from ACT Alberta as well as a one-line mention of a possible future program from CCASA in its 2022 Annual Report (ACT Alberta, 2023). The other programs did not include any mention outside of transgender folks. In fact, the RESET Society of Calgary only spoke of female survivors, with no mention of transgender women (RESET Society of Calgary, n.d.a). As a whole, 2SLGBTIQ+ supports and/or informational resources seemed to take lesser prominence in the details they choose to publicly share. Therefore, there was a relatively small amount of support for transgender survivors of sexual-related crimes. The Shift program from SafeLink was specifically created for adult sex workers and was the only program specifically dedicated to adults (SafeLink Alberta, n.d.b). The rest of the aftercare programs supported youth and young adults in some way. The REST Society of Calgary assists women and girls over the age of 16 as well as their children (RESET Society of Calgary, n.d.b). The 2022 CCASA Annual Report showed that their support for children and youth lies mainly with education workshops as a preventative measure. Child and youth counselling is offered by the Sexual Assault Centre of Edmonton (Sexual Assault Centre of Edmonton, n.d.d). The Saffron Centre also supported youth and published the number of youth that they assisted in their 2022-2023 Annual Report. ACT Alberta’s resources for youth were 88 harder to decipher as they did not break down the ages of those who use their services. Thus, ACT Alberta did not mention any specific aftercare programming for youth but they did speak to the hardships that 2SLGBTQ+ youth may encounter (ACT Alberta, 2023). As per their 2021-2022 Annual Report, one of their donors was Youth & Philanthropy Initiatives Canada, so it is likely that they offer support to youth and young adults. Concerning those who are unhoused, the only aftercare program that incorporated housing into their framework was the RESET Society of Calgary (RESET Society of Calgary, n.d.a). ACT Alberta did mention the increased risk of being a trafficking victim that unhoused youth have (ACT Alberta, 2023). They further cemented this point by anchoring it into the role that discrimination against the 2SLGBTQ+ community faces, particularly in their risk factors for becoming unhoused. Another prominent downside of the aftercare programming analyzed was that noticeable was that there was no specific programming for survivors of commercial sexual exploitation in Calgary or Edmonton. Though there were programs who supported those who were sexually exploited or made reference to aspects of survival sex, the aftercare programs that were analyzed did not discuss the unique needs of survivors of commercial sexual exploitations. Most of these programs dealt with supporting survivors of the broader umbrella of sexual crimes (aside from SafeLink’s Shift program). Therefore, further attention and awareness should be given to unhoused, transgender, youth and young adult survivors of commercial sexual exploitation within Alberta’s aftercare programming, because of the unique risk factors and harms that they experience. The aftercare programs that were analyzed through the environmental scan were only a small sample. There are many other services across Alberta that offer support to those who are at 89 risk for or survivors of sexual exploitation (see Appendix D). Residential treatment centres also assist this population and work toward healing the trauma that they experienced (Brown et al., 2018; Hodgdon et al., 2013; Tyler et al., 2019). The trauma of those undergoing residential treatment can stem from a large variety of experiences, one of which being sexual abuse (Hodgdon et al., 2013). The Canadian Mental Health Association (n.d.) states that “residential treatment is the most intensive form of treatment for children and youth” (para. 1). These programs are implemented to support and address the needs of the individual, and usually incorporate a mental health treatment component (Canadian Mental Health Association, n.d.; Tyler et al., 2019). Tyler et al. (2019) suggests that in order to increase the perception of safety and trust in the survivor during the program, residential treatment centres should be guided by trauma-informed care principles. These residential treatment centres are part of the support that is available to survivors of commercial sexual exploitation in Alberta. A few of these facilities are: ● The Little Warriors Be Brave Ranch (Little Warriors, n.d.) ● Trellis Society’s Eleanor’s House (Trellis Society, n.d.) ● McMan’s Manhattan Place (McMan Calgary & Area, n.d.) ● Wood’s Homes (Wood’s Homes, n.d.a; Wood’s Homes, n.d.b) All of the organizations above support youth and children who have experienced trauma, with the first two specifically focusing their services on survivors of sexual exploitation and abuse (Little Warriors, n.d.; McMan Calgary & Area, n.d.; Trellis Society, n.d.; Wood’s Homes, n.d.a; Wood’s Homes, n.d.b). Therefore, there are other types of services available for survivors of commercial sexual exploitation, than the six that were thoroughly examined in this project. 90 Conclusion The research question: what are the risk factors and effective aftercare program characteristics associated with commercial sexual exploitation for unhoused transgender youth and young adults? was able to be answered through the completion of this project. This descriptive research project was guided by an integrative literature review and feminist methodology. This project found that commercial sexual exploitation intrinsically involves children and youth survivors (Labour Office Geneva, 2007). Thus, this type of victimization and by extension this project was focused on this age group and the transition into adulthood. Masow’s humanistic theory was seen to have some merit in regard to the risk factors for commercial sexual exploitation that accompany those who are unhoused, transgender, youth and young adults. This was especially seen in the categories of physiological, safety, esteem, and love and belonging (Carducci, 2020; McDonald & Middleton, 2019). Though, there was little to no support found, for any of the populations of interest, that the need of self-actualization and transcendence were motivations for youth and young adults to engage in commercial sexual exploitation. The MSSH model was crucial to the project through its addition of a survivor-focused lens, trauma-informed care perspective, and realization that choices are not always made voluntarily if they are committed due to necessity or fear (McDonald and Middleton, 2019). Self-reported and police-reported data regarding sexual exploitation, sexual assault, and violent victimization was necessary to paint a picture of the scope of commercial sexual exploitation. This was due to the small amount of data concerning actual Canadian statistics for the scope of commercial sexual exploitation. This type of victimization disproportionately affects those who already face discrimination and stigma in society such as unhoused, transgender, 91 Indigenous, youth and young adults (ACT Alberta, 2023; Chettiar, 2010; Clayton et. al., 2014; Coronel-Villalobos & Saewyc, 2019; Cotter, 2021; Gaetz, O’Grady, Kidd, & Schwan, 2016; Goodyear et al., 2024; Jaffray, 2020; McDonald & Middleton, 2019; Native Women’s Association of Canada, 2014; Saewyc et al., 2013; Sharma et al., 2021). There were also risk factors specific to the populations of interest (see Appendix B). These risk factors revolved around identity and situational characteristics. The harm caused by commercial sexual exploitation was found to be both physical and emotional (Clayton et. al., 2014; Hampton & Lieggi, 2020; Jimenez et al., 2015; O’Brien et al., 2023). This can result in immediate and long-lasting consequences to the life of a survivor (see Appendix A). To determine whether this harm was being accurately addressed in Calgary and Edmonton, an environmental scan was conducted. The environmental scan of aftercare programming was successful as it yielded interesting results. The most prominent was that specific aftercare programming for the commercial aspect of sexual exploitation as well as some aftercare programs were lacking in inclusivity. 92 Discussion Commercial sexual exploitation is an important area of study because of the survivors that it adversely affects. This was seen through its prevalence, the harm it causes, and the risk factors that may lead to this harm. In addition, it was crucial to understand the support services available for survivors to develop an idea as to whether more could be done for those who are harmed. The fact that commercial sexual exploitation has harmed one individual is cause enough to work toward gaining accurate knowledge and ensuring that measures are in place to help survivors, especially those with vulnerabilities and increased risk of violence. The prevalence of commercial sexual exploitation in Canada was difficult to ascertain. Canada does not appear to collect and present statistics that detail the scope of this type of victimization. Still, there was also a relatively large amount of literature on the criminological phenomenon of commercial sexual exploitation. The study of commercial sexual exploitation seems to be an emerging field that has largely expanded in the last ten years or so. Thus, there was fulsome information about the harm caused by commercial sexual exploitation and the risk factors that it is associated with. Despite this amount of information, most of the studies looked at a narrow research population. Therefore, it was necessary to bridge this gap and work to create a project that highlighted the intersection of transgender, unhoused, youth, and young adults. Continued future study that looks at this issue would be beneficial toward the accumulation of knowledge. Official statistics together with the focus that literature has shown on commercial sexual exploitation allows for further speculation. It can be inferred that commercial sexual exploitation is more prevalent and impactful than initially realized. Nevertheless, the statistics do not highlight this sentiment. This is a problem as accurate numbers regarding the scope of this type 93 of victimization are not accessible. The lack of statistics may result in decreased awareness, attention, and funding for commercial sexual exploitation survivors; which can hinder their healing and not work toward decreasing this prevalence. Therefore, Canadian statistics should work to create a framework to capture this gap. In addition to police-reported statistics on sexual exploitation offences, self-reported means of data collection may be implemented to try to limit the dark figure of crime. For this to work, terms should be clearly defined and explained (as done in this project) to limit the possible confusion between commercial sexual exploitation, survival sex, and sex work. Understanding the harm caused by commercial sexual exploitation and then trying to convey these negative consequences to others (maybe in the form of educational initiatives) may start to raise society's appreciation for this type of victimization and the internal stigma that is sometimes felt by survivors of negative childhood experiences (Lanctot et al., 2021, as cited in National Child Trauma Stress Network, n.d.). This hopefully, increases the attention necessary to create supportive services for survivors. Along a similar vein, recognizing these risk factors of commercial sexual exploitation may allow governments and support services to have the necessary information to work toward lessening their effects, possibly through social services. Therefore, this information is a powerful educational tool that can be used to bring about social change that will likely benefit survivors of commercial sexual exploitation. It seems as if the aftercare programs that were analyzed in the environmental scan refer participants to other organizations for financial or housing resources and are quite separate from one another. Though this is positive, it is likely that many referrals may become overwhelming for survivors. A California-based study conducted by Placzek et al. (2021), found that one personal-level barrier to accessing social services is “competing priorities” (p. 6). In other words, 94 they found that people may have many negative situations accumulating at once and are forced to choose the most important issue to tackle. Consequently, a more streamlined or congregated effort may be of benefit. A system that connects the survivor to multiple organizations at once (with their consent), while offering support in terms of applying and reaching out to aftercare programs may be of benefit. Thus, survivors may not have to choose what facet to focus on, rather they can receive support easier for multiple levels of harm. Overall, the aftercare programs in Calgary and Edmonton were quite comparable. None of the programs specifically mentioned survivors of commercial sexual exploitation. Most programming dealt with sexual exploitation or assault (with one focused on sex work) rather than the commercial piece of sexual exploitation. Therefore, further attention and awareness should be given to transgender youth and young adult survivors of commercial sexual exploitation within Alberta’s aftercare programming. These findings may be a beneficial source of knowledge for aftercare programs that support survivors of commercial sexual exploitation, as it may result in changes to programs or additions to existing services to better support and address the risk factors as well as the harm caused to unhoused, transgender, youth and young adult survivors of commercial sexual exploitation in Alberta. Thus, environmental scans of aftercare programs should be conducted regularly to ensure that survivors receive effective and respectful support. Though this project mentions the combination of the population of interest and some aspects of intersectionality in regard to risk factors, further study could be conducted into other aspects of one's identity and its influence on commercial sexual exploitation. Another interesting addition to this project could be in the incorporation of primary research. Interviewing and/or surveying survivors of commercial sexual exploitation would improve this project by giving the research a more first-hand and comprehensive understanding of the harms caused and correlated 95 risk factors, in particular. The environmental scan that was conducted could be further developed and expanded. It could be enlarged by the number of aftercare programs that are analyzed, the location of these programs to include rural communities or other provinces and territories, and/or increase the criteria associated with the evaluation. Lastly, this project did not look much into and make commentary on preventing commercial sexual exploitation. Therefore, future academic focus could be on limiting the causes of commercial sexual exploitation and thus survivors. 96 References Abramovich, A. (2014, June 13). 1 in 3 transgender youth will be rejected by a shelter on account of their gender identity/expression. Homelessness Hub. 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Gender and health. https://www.who.int/health-topics/gender#tab=tab_1 Youth Criminal Justice Act, SC 2002, c 1 124 Appendix A Summary of the Harm Caused by Commercial Sexual Exploitation Note. This figure showcases a summary of the harm caused that was found to be correlated to commercial sexual exploitation. Adapted from Commercial sexual exploitation and sex trafficking of children and adolescents: A narrative review, by E. Barnert, Z. Iqbal, J. Bruce, A. Anoshiravani, G. Kolhatkar, and J Greenbaum, 2017, Academic Pediatrics, 17(8) (https://doi.org/10.1016/j.acap.2017.07.009); An ecological analysis of risk factors for runaway behavior among individuals exposed to commercial sexual exploitation, by L. Fedina, T. Perdue, C. L. Bright, and C. Williamson, 2019, Journal of Child & Adolescent Trauma, 12(2) (https://doi.org/10.1007/s40653-018-0229-5); Commercial sexual exploitation of youth in the United States: A qualitative systematic review. M. D. Hampton, and M. Lieggi, 2020, Trauma, Violence, & Abuse, 21(1), (https://doi.org/10.1177/1524838017742168); Aspects of abuse: Commercial sexual exploitation of children, by M. Jimenez, A. M. Jackson, and K. Deye, 2015, Current Problems in Pediatric and Adolescent Health Care, 45(3) (https://doi.org/10.1016/j.cppeds.2015.02.003); Commercial sexual exploitation outcomes in a community sample of youth, by J. E. O’Brien, T. Jensen, K. Mitchell, and K. White, 2023, Journal of Adolescent Health, 72(1), (https://doi.org/10.1016/j.jadohealth.2022.08.028); Refocusing on sexually transmitted infections (STIs) to improve reproductive health: A call to further action, by A. Otu, G. Danhoundo, I. Toskin, V. Govender, and S. Yaya, 2021, Reproductive Health, 18(242) (https://doi.org/10.1186/s12978-021-01296-4); Characteristics of child commercial sexual exploitation and sex trafficking victims presenting for medical care in the United States, by S. Varma, S. Gillespie, C. McCracken, and V. J. Greenbaum, 2015, Child Abuse and Neglect, 44 (https://doi.org/10.1016/j.chiabu.2015.04.004). 125 Appendix B Summary of the Risk Factors for Commercial Sexual Exploitation by Population Note: This illustration shows a condensed version of the risk factors for commercial sexual exploitation that were discussed in this paper. Adapted from Survival sex work involvement among street-involved youth who use drugs in a Canadian setting, by J. Chettiar, K. Shannon, E. Wood, R. Zhang, and T. Kerr, 2010, Journal of Public Health, 32(3) (https://doi.org/10.1093/pubmed/fdp126); Confronting commercial sexual exploitation and sex trafficking of minors in the United States: A guide for providers of victim support services, by E. W. Clayton, R. D. Krugman, T. Chaffee, A. Diaz, A. English, B. Guthrie, S. Lambert, M. Latonero, N. McClain, C. M. Rennison, J. A. Rich, J. Todres, and P. 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Pachankis, 2016, Social Science and Medicine, 147 (https://doi.org/10.1016/j.socscimed.2015.11.010). 127 Appendix C Child and Youth Victims (0 to 17 Years) of Police-Reported Sexual Offences, by Province and Territory, 2012 Note. This graph shows the 2012 numbers of police-reported children and youth (ages 0-17) victims of sexual offences in Canada, which was organized by province or territory. Reprinted from Police-reported sexual offences against children and youth in Canada, 2012, by A. Cotter and P. Beaupré, 2014, Statistics Canada, Catalogue No. 85-002-X, p. 8 (https://www150.statcan.gc.ca/n1/pub/85-002-x/2014001/article/14008-eng.htm). Copyright 2014 by the Minister of Industry. Reproduced and distributed on an "as is" basis with the permission of Statistics Canada. 128 Appendix D Programs That Support Those Who are Currently or Have Been Sexually Exploited, Which Were Obtained From the 211 Alberta Database Program Location(s) Government of Alberta Ministry of Children and Family Services ● Protection of Sexually Exploited Children Across Alberta: Barrhead, Slave Lake, Whitecourt, Westlock, Glenevis, Athabasca, High Prairie, Stony Plain, Spruce Grove, St Albert, Edmonton, Atikameg, Edson, Fort Saskatchewan, Drayton Valley, Valleyview, Sherwood Park, Leduc, Lac La Biche, Goodfish Lake, Wetaskiwin, Red Earth Creek, Saddle Lake, Hinton, Maskwacis, Camrose, Vegreville, Peace River, St Paul, Rocky Mountain House, Grande Prairie, Fairview, Kehewin, Red Deer, Bonnyville, Grande Cache, Stettler, Cold Lake, Olds, Fort McMurray, Lloydminster, Wainwright, Drumheller, Calgary, Airdrie, Strathmore, High Level, high river, Brooks, Blairmore, Lethbridge, Taber, Medicine Hat United Way of the Alberta Capital Region ● Empower U Edmonton, Alberta CEASE: Centre to End All Sexual Exploitation ● Trauma Recovery Program ● Safer Way Out ● Bursaries ● Public Awareness and Education ● Building Blocks for Families and Women - Coaching for Success ● Victim Advocacy Support - Project STAR ● Empower U Edmonton, Alberta REACH: Edmonton Council for Safe Communities ● Community Neighbourhood Organizing Initiatives Edmonton, Alberta Canadian Centre for Child Protection Inc. Across Canada 129 ● Cybertip.ca Lloydminster Sexual Assault Services Incorporated ● Public Education Lloydminster, Alberta Youth Unlimited ● Streetlight Calgary, Alberta Trellis ● Hera Program ● Eleanor’s House Calgary, Alberta McMan Youth, Family and Community Services Association of Calgary ● Collaborative Outreach Preventing Exploitation Program Calgary, Alberta HER Victory Society of Calgary ● Intervention, Housing, and Day Program Sexually Exploited Women Calgary, Alberta Save the Children Canada ● Programs for Indigenous Children and Youth Across Canada and Globally ● Headquarters: Toronto, Ontario Note. This table showcases the programs found on 211 Alberta with the search parameters of programs within Alberta, with a maximum distance of 10000 kilometers, and “sexual exploitation” as a keyword. Adapted from Searching for “sexual exploitation”, by 211 Alberta, n.d. (https://ab.211.ca/results/?searchLocation=Alberta&latitude=54.63050249382342&longitude=-114.9268772571529 &sd=0&ss=Distance&searchTerms=%22sexual+exploitation%22+&exct=0&topicPath=https://ab.211.ca/results/?se archLocation=Alberta&latitude=54.63050249382342&longitude=-114.9268772571529&sd=0&ss=Distance&search Terms=%22sexual+exploitation%22+&exct=0&topicPath=); See where we work, by Save the Children Canada, n.d. (https://www.savethechildren.ca/what-we-do/where-we-work/). 130 Appendix E Note. This is the revised version of the poster presented on March 26, 2024, at MRU’s University-wide Poster Presentations during MRU Research and Scholarship Days.