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1 THE SEXUAL ABUSE TO PRISON PIPELINE: THE GIRLS’ STORY Human Rights Project for Girls Georgetown Law Center on Poverty and Inequality Ms. Foundation for Women VERTY and INEQU CENTER ON PO ALITY

2 Text here 00 of the report : authors Malika Saada Saar, Human Rights Project for Girls Rebecca Epstein , Georgetown Law Center on Poverty and Inequality Lindsay Rosenthal , Ms. Foundation for Women , Human Rights Project for Girls Yasmin Vafa The authors gratefully wish to acknowledge the following contributors for their substantive assistance to this report: Maheen Kaleem , Human Rights Project for Girls, who appeared at just the right moment, with unbending commitment and vision, to help bring us to the finish line. Julie F. Kay , Human Rights Attorney, whose human rights expertise, guidance and feedback immeasurably strengthened this report in service of America’s most vulnerable girls. , Consultant, Human Rights Project for Girls, whose brilliant research and writing on Shakira Washington girls at the margins laid the foundation for this paper’s development. Teresa Younger , President of the Ms. Foundation for Women, whose leadership in supporting Ms. Fellow- ship during her first months at the Foundation was essential to the completion of this report. And with thanks for their time and effort in reviewing this paper and providing invaluable insight: , ChildFocus Mary Bissell , Georgetown Law Center on Poverty and Inequality Peter Edelman Carmen Perez , Campaign for Youth Justice , YouthFirst! Initiative Liz Ryan , Boston College Law School Francine Sherman Dana Shoenberg , Center for Children’s Law and Policy To obtain a hard copy of this report, please contact: Center for Poverty and Inequality | Georgetown University Law Center 600 New Jersey Avenue NW #461 | Washington, DC 20001 [email protected] www.law.georgetown.edu/go/poverty Download available at Design Ines Hilde , Georgetown Law Photography Front cover photo and photos on pages 4, 6, 27, and 34 by © Richard Ross , www.juvenile-in-justice.com. Back cover photo and photos on pages 21 and 45 by © Rebecca Epstein , www.rebeccaepsteinphotography.com. All photos used by permission.

3 THE SEXUAL ABUSE TO PRISON PIPELINE: THE GIRLS’ STORY Dedicated to the girls The Nature of This Flower Is to Bloom Rebellious. Living. Against the Elemental Crush. A Song of Color Blooming For Deserving Eyes. Blooming Gloriously For its Self. — Alice Walker

4 Text here 00 authors ’ organizations about the Human Rights Project for Girls works to make the lives of US young women and girls a human rights priority. Gendered violence here in the US, like gendered violence abroad, restricts girls’ rights and the realization of their full potential and dignity. As a national organization of human rights lawyers, Rights4Girls addresses the conditions of sexual violence, rape, exploitation, and trafficking here in the United States in the areas of policy, legislation, and law. We advocate for the dignity and personhood of young women and girls – so that every girl may possess the right to be safe and live a life free of violence and exploitation. See more at www.rights4girls.org. The Center on Poverty and Inequality works with policymakers, researchers, practitioners, and advo- cates to develop effective policies and practices that alleviate poverty and inequality in the United States. The Center’s areas of anti-poverty work include national, state, and local policy and program recommen- dations that help marginalized girls, promote effective workforce and education policies and programs for disconnected youth, and develop policy to combat deep poverty. Its strategies are to partner with Adminis- tration agencies and non-profit organizations to host national conferences, produce and widely disseminate in-depth reports, engage in public speaking, and participate in national coalitions and working groups. See more at www.law.georgetown.edu/go/poverty. The Ms. Foundation for Women is the first and largest US women’s foundation. Since our founding in 1972, we have supported grassroots organizations across the country to sustain and amplify the vision and voice of women who area leading change in their communities, particularly low-income women, women of color and young women. We focus on three pillars — women’s health, economic justice and safety — in order to fulfill our mission: to build women’s collective power to realize a nation of justice for all. See more at www.forwomen.org.

5 contents of table Introduction 4 Girls’ Paths of Sexual Abuse into the Juvenile Justice System 6 The Proportion of Girls — Especially Girls of Color — in the Juvenile Justice System is Increasing. 7 Girls in the Juvenile Justice System are Disproportionately 7 Victims of Sexual Violence. Girls’ Behavioral Reaction to Sexual Abuse and Trauma is 9 Criminalized, Reinforcing the Sexual Abuse to Prison Pipeline. The Juvenile Justice System Typically Fails to Address, and 12 Often Exacerbates, Trauma that Caused Girls to Be There. Dismantling the Pipeline: Policy Recommendations to 15 Reduce Traumatized Girls’ Arrest and Incarceration 3 Lived Experience of the Sexual Abuse to Prison Pipeline: 19 Victims of Sex Trafficking Jailed as Offenders. Dismantling the Pipeline: Policy Recommendations to 20 Keep Victims of Sex Trafficking Out of Juvenile Justice Lived Experience of the Sexual Abuse to Prison Pipeline: 22 Detention of Girls Who are Status Offenders. Dismantling the Pipeline: Policy Recommendations to Decrease the Disproportionate Effect of Status Offense 23 Enforcement on Girls In Focus: Dual-System Youth and the Sexual Abuse to 24 Prison Pipeline. Dismantling the Pipeline: Policy Recommendations to Reduce Foster Girls’ Crossing Over into the Juvenile 25 Justice System Child Welfare and the Sexual Abuse to Prison Pipeline: Identifying and Treating Trauma in the Child Welfare System 27 Dismantling the Pipeline: Policy Recommendations to Improve the Child Welfare System’s Response to Girls 29 Conclusion 32

6 4 VIOLENCE AGAINST GIRLS IS A PAINFULLY AMERICAN TALE. IT IS A CRISIS OF NATIONAL PROPORTIONS...

7 introduction Violence against girls is a painfully American tale. It is a crisis of national proportions that cuts across every divide of race, class, and ethnicity. The facts are staggering: one in four American girls will experience some form of sexual violence by the age of 18. Fifteen percent of sexual assault and rape 1 victims are under the age of 12; nearly half of all female rape survivors were 2 victimized before the age of 18. And girls between the ages of 16 and 19 are four times more likely than the general population to be victims of rape, 3 attempted rape, or sexual assault. And in a perverse twist of justice, many girls who experience sexual abuse because of their victimization. are routed into the juvenile justice system Indeed, sexual abuse is one of the primary predictors of girls’ entry into the 4 juvenile justice system. A particularly glaring example is when girls who are 5 victims of sex trafficking are arrested on prostitution charges — punished as perpetrators rather than served and supported as victims and survivors. Once inside, girls encounter a system that is often ill-equipped to identify and treat the violence and trauma that lie at the root of victimized girls’ arrests. More harmful still is the significant risk that the punitive environ- ment will re-trigger girls’ trauma and even subject them to new incidents of sexual victimization, which can exponentially compound the profound harms inflicted by the original abuse. This is the girls’ sexual abuse to prison pipeline. This report exposes the ways in which we criminalize girls — especially girls of color — who have been sexually and physically abused, and it offers policy recommendations to dismantle the abuse to prison pipeline. It illustrates the pipeline with examples, including the detention of girls who are victims of sex trafficking, girls who run away or become truant because of abuse they experience, and girls who cross into juvenile justice from the child welfare system. By illuminating both the problem and potential solutions, we hope to make the first step toward ending the cycle of victimization-to-imprisonment for marginalized girls.

8 6 GIRLS’ PATHS OF SEXUAL ABUSE INTO THE JUVENILE JUSTICE SYSTEM

9 JUVENILE SEXUAL ABUSE INTO THE JUSTICE SYSTEM OF PATHS GIRLS ’ tion of girls’ having violated conventional norms and of girls — especially the proportion 19 in the juvenile justice — of girls color even when that stereotypes of feminine behavior, 20 is increasing . system behavior is caused by trauma. The rate of girls’ involvement in juvenile justice is system girls are the juvenile justice in growing disproportionately at key determinative points of victims sexual disproportionately in the criminal justice process, including the decision violence . 5 to arrest and detain girls. Research reveals that girls who are sent into the 6 Girls of color are particularly affected by this trend. juvenile justice system have typically experienced Although rates of overrepresentation vary significant- 21 overwhelmingly high rates of sexual violence. 7 the national trends are revealing. ly by jurisdiction, African-American girls constitute 14 percent of the Further studies are urgently needed, as virtually no general population nationally but 33.2 percent of national data exists to illuminate incarcerated girls’ 8 Native American girls girls detained and committed. histories of sexual violence. However, several local are also disproportionately involved in the juvenile and regional studies paint an informative portrait 9 they are 1 percent of the general justice system: of incarcerated girls’ histories of abuse. In a 2006 7 youth population but 3.5 percent of detained and 10 committed girls. LGBT/GNC Girls The disproportionate rates of confinement in residen- tial placements for girls of color are most accurately Youth who identify as lesbian, gay, bisexual, trans- gender, or gender non-conforming (LGBT/GNC) revealed when viewed per capita: Native American are overrepresented in the juvenile justice system. girls are in residential placements at a rate of 179 per Although LGBT/GNC youth comprise only 5 to 7 100,000; African-American girls at a rate of 123 per percent of the general population, they represent 100,000; and Latinas at a rate of 47 per 100,000. By 13 to 15 percent of youth who come into contact 12 comparison, 37 per 100,000 of non-Hispanic white with the juvenile justice system. Recent research 11 by the National Council on Crime and Delinquency girls are confined. (NCCD) indicates that LGBT/GNC girls, in partic- According to studies by the Girls Study Group of the ular, are involved in the system at an even higher US Department of Justice’s Office of Juvenile Jus- rate: a survey of 1,400 girls across seven jurisdic- tions found that 40 percent of girls in the juvenile tice and Delinquency Prevention, among others, the justice system are LGBT/GNC (compared to 14 increase in girls’ rate of arrest and incarceration over 13 percent of boys). the last two decades is not a result of their engaging 14 Nor are they in- in criminal activity at higher rates. 15 Although the reason has not been creasingly violent. definitively determined, evidence suggests that one study of girls involved in Oregon’s juvenile justice cause is more aggressive enforcement of non-serious system, for example, 93 percent had experienced offenses that are rooted in the experience of abuse sexual or physical abuse; 76 percent had experienced 16 as illustrated by the recent increase in and trauma, at least one incident of sexual abuse by the age of 13; 17 arrests of girls involved in family-based incidents. and 63 percent had experienced both physical and 22 In fact, the leading cause of arrest for girls are minor sexual abuse. offenses such as misdemeanors, status offenses, out- Similarly, in a 2009 study of delinquent girls in South 18 And the standing warrants, and technical violations. Carolina, 81 percent reported a history of sexual decision to arrest and detain girls in these cases has 23 violence, and 42 percent reported dating violence. been shown often to be based in part on the percep-

10 placement girls in residential by race and ethnicity Rate per american asian hispanic native american african non - hispanic white 100,000 20 40 11 60 80 37 47 100 120 140 160 123 180 179 Y C http://www.childtrends.org/wp-content/uploads/2012/05/88_ available at 5 (2013), ouTh B and hildren C on Tors ndiCa , i eTenTion d uvenile , J ank aTa d rends T hild Adapted from Juvenile_Detention. 8 girls in juvenile justice justice juvenile in boys Girls’ rate of sexual abuse is 4 times higher than boys’ in juvenile justice, and girls’ rate of complex trauma (five or more ACEs) is nearly 31% 7% twice as high. s e x u a l ly a b u s e d s e x u a l ly a b u s e d 45% 24% s f i v e o r m o r e aCe s f i v e o r m o r e aCe Source: Michael T. Baglivio et al., US Dep’t of Justice, Office of Justice Programs, Office of Juvenile Justice & Delinquency Prevention, The Prevalence of http://www.journalofjuvjustice.org/ J. J uv . J ustice 1, 9 (Spring 2014), available at , 3 Adverse Childhood Experiences (ACE) in the Lives of Juvenile Offenders JOJJ0302/JOJJ0302.pdf.

11 ’ OF SEXUAL ABUSE INTO THE PATHS JUVENILE JUSTICE SYSTEM GIRLS Finally, a 1998 study of juvenile-justice-involved girls in The US Attorney General’s Task Force on Children California found that 81 percent of girls had expe- Exposed to Violence has concluded that childhood rienced one or more incident of physical or sexual trauma is associated with involvement in the juvenile 39 For girls more than for boys, this abuse; 56 percent reported one or more forms of sex- justice system. connection is strongly rooted in the experience of sex- ual abuse; and 45 percent reported being beaten or 40 24 And the link appears to continue even ual violence. burned at least once. after girls are released: a recent study has shown But rates of prevalence alone do not fully capture the that sexual abuse is one of the strongest predictors severe extent and multiple incidents of girls’ sexual of whether a girl will be charged again after release; victimization. In the California study, for example, of in fact, it appears to have a greater impact on girls’ the 56 percent of girls who reported sexual abuse re-entry into the system than other risk factors like — which can take many forms — 40 percent of girls 41 behavioral problems and prior justice involvement. reported being raped or sodomized at least once, and Yet, significantly, the experience of sexual abuse did 25 17 percent reported multiple occurrences of abuse. 42 Clearly, sexual not have the same impact on boys. Girls in the Oregon study, meanwhile, reported they abuse has a uniquely defining impact on juvenile had experienced an average of over four forms of justice involvement for girls. 26 severe sexual abuse before the age of 12. 9 Justice-involved girls also are victimized by sexual GIRLS’ EXPERIENCE OF COMPLEX TRAUMA AND violence at an earlier average age, and for a longer MULTIPLE INCIDENTS OF VICTIMIZATION average duration, than other forms of abuse. The Some studies indicate that girls experience com- South Carolina study, for example, found that in plex and multiple forms of trauma at disproportion- contrast to other forms of violence that peaked during ate rates. In a 2014 study of the abuse histories of certain developmental stages, sexual violence was a more than 60,000 youth in Florida’s juvenile justice risk for girls throughout their lives, though particularly system, for example, girls reported having experi- 27 Meanwhile, the California study during adolescence. 31 enced Adverse Childhood Experiences (ACEs) at found that the age at which girls were “most likely” to higher rates than boys in all 10 categories of trauma 32 28 and abuse analyzed. Nearly half of the girls (45.1 and the be fondled or molested was five years old; percent) experienced five or more forms of trauma Oregon study found that the average age at which at and abuse, compared to less than one-third (27.4 least one instance of sexual abuse occurred was just 33 percent) of boys. These findings are consistent with 29 These findings are under seven and a half years old. other research, including a 2010 study of a nationally particularly significant in light of a recent study that representative sample of justice-involved youth, that found that traumatic exposure before high school is show higher rates of complex trauma and multiple 34 an even stronger predictor of girls’ delinquency than forms of victimization among girls. 30 such exposure during high school. Although the precise findings of rates of sexual abuse girls to sexual ’ behavioral reaction vary, all studies find higher rates of victimization for , abuse and trauma is criminalized 35 One local study of delinquent youth, girls than boys. reinforcing to prison the sexual abuse for example, found that the rate of sexual abuse for . pipeline justice-involved girls was over four times higher than The most common crimes for which girls are arrest- And a 2011 literature review found that for boys. ed — including running away, substance abuse, and girls’ dramatically higher rate of sexual abuse was the truancy — are also the most common symptoms of most consistent finding among nineteen studies 43 Indeed, child sexual abuse experts list these abuse. 37 that analyzed the prevalence of trauma by gender. 38 Other recent studies have replicated this finding.

12 girls paths of sexual abuse into the juvenile justice system ’ regional abuse high alarmingly show studies of and local but , vary findings rates the in girls justice system . among juvenile SOUTH CAROLINA OREGON FLORIDA 81% 93% 84% OF GIRLS OF GIRLS OF GIRLS of sexual vi Ctims violen Cally physi or sexually Ce family of vi Ctims Ce violen abused 10 42% 76% 31% OF GIRLS OF GIRLS OF GIRLS dating violen Ce vi Ctims of sexually abused abused sexually 63% 41% OF GIRLS OF GIRLS abused sexually & physi Cally abused Cally physi Source: Michael T. Baglivio et al., US Dep’t of Justice, Source: Dana K. Smith, Leslie D. Leve & Patricia Source: Dana D. Dehart, The Ctr. For Child & Family Office of Justice Programs, Office of Juvenile Justice Chamberlain, Adolescent Girls’ Offending and Health Studies, Poly-victimization Among Girls in the Juvenile The Prevalence of Adverse & Delinquency Prevention, Risking Sexual Behavior: The Predictive Role of Trau- Justice System: Manifestations & Associations to hild c Childhood Experiences (ACE) in the Lives of Juvenile M altreatMent 346, 350 (Nov. 2006). ma, 11 https://www. available at Delinquency 12 (Oct. 2009), uv avail- 1, 9 (Spring 2014), J. J ustice . J , 3 Offenders ncjrs.gov/pdffiles1/nij/grants/228620.pdf. able at http://www.journalofjuvjustice.org/JOJJ0302/ JOJJ0302.pdf.

13 PATHS OF SEXUAL ABUSE INTO THE JUVENILE JUSTICE SYSTEM ’ GIRLS CALIFORNIA MULTI-STATE STUDY In the California study, of the girls who had been sexually abused, 32% 81% the abuse was severe OF GIRLS OF GIRLS and often occurred multiple times. sexually maltreated Cally physi or sexually abused 11 39% 56% 40% OF GIRLS OF GIRLS OF GIRLS assaulted raped sexually / abused sexually raped / sodomized on Ce least at 40% 45% 17% OF GIRLS OF GIRLS OF GIRLS physi Cally abused least at beaten or burned Ces multiple oCC urren on Ce 56% OF GIRLS domesti Cally abused Trauma Histories Source: Carly B. Dierkhising et al., Source: Leslie Acoca, Outside/Inside: The Violation of American Girls at Home, on the Streets, and in the Juvenile 561 (1988), elinquency & d riMe c http://leslieacoca.org/images/Outside-In- available at Among Justice-Involved Youth: Findings from the Nation- Justice System , 44 e ur . J. P sychotrauMa - side_-_The_Violation_of_American_Girls_at_Home_-_On_the_Streets_-_and_in_the_Juvenile_Justice_Sys- , 4 al Child Traumatic Stress Network available at http://www.ncbi.nlm.nih. tology (Jul. 2013), tem_by_Leslie_Acoca.pdf. gov/pmc/articles/PMC3714673/.

14 JUSTICE ’ OF SEXUAL ABUSE INTO THE JUVENILE PATHS SYSTEM GIRLS behaviors as warning signs that an adolescent has justice typically system juvenile the 44 exacerbates often and , address to , fails been abused and needs therapeutic intervention. girls trauma caused that to be . there According to a study conducted by the US Depart- ment of Health and Human Services, 46 percent of Although some defend the practice of detaining runaway and homeless youth report being physically victimized girls on the grounds that the system can abused; 38 percent report being emotionally abused, 50 that justifica- provide protection or needed services, and 17 percent report being forced into unwanted tion cannot counterbalance the significant psycholog- 45 sexual activity by a family or household member. ical and physical harms created by commitment. In Research has consistently shown that girls’ problem fact, access to adequate services, if any, is severely behavior, in contrast to that of boys, “commonly limited; worse, the system’s routine processes can 46 relates to an abusive and traumatizing home life.” serve to re-traumatize girls; and, worse still, some Self-reports by female offenders support these report that they experience new incidents of abuse findings, in which girls “are significantly more likely while inside. than males to report that victimization was a key The NCTSN has noted the unique link between 47 factor leading to their offending.” trauma and mental health for girls: “[S]tudies have A National Child Traumatic Stress Network (NCTSN) 12 consistently found that among those who are ex- review of literature on trauma and girls’ delinquency posed to trauma, females are more likely than males emphasizes the causal role that unaddressed trauma 51 to develop mental health problems as a result.” can play in the criminalization of girls: And, consistent with the link between trauma and contact with the juvenile justice system, in 2004 the [Studies] suggest that if trauma is not resolved, NCTSN noted overwhelming rates of trauma and ... result[s may] includ[e] (a) alcohol and drug post-traumatic stress disorder (PTSD) among girls in use, (b) involvement in violent activity, and the system: 70 percent of girls in juvenile justice had (c) development of mental health problems been exposed to some form of trauma and over 65 such as PTSD. For many of these adolescent percent had experienced symptoms of PTSD some- females, there appears to be a link between time in their lives, 48.9 percent of whom were experi- the experience of abuse and neglect, the lack 52 encing those symptoms at the time of the study. of appropriate treatment, and the behaviors 48 that led to arrest. Rates of PTSD and other mental health disorders are 53 For consistently higher in girls than their male peers. Yet despite the body of research showing that the example, one study by the National Center for Mental effect of trauma and abuse drives girls into juvenile Health and Juvenile Justice found that approximately 49 the system itself typically overlooks the justice, 80 percent of females in the juvenile justice system context of abuse when determining whether to arrest met the criteria for at least one mental health disorder, or charge a girl, often with a minor offense. When law 54 Another found that compared to 67 percent of boys. enforcement views girls as perpetrators, and when major depression is four to five times more common their cases are not dismissed or diverted but sent in girls housed in detention and correctional facilities deeper into the justice system, the cost is twofold: than in the general community, compared to twice as girls’ abusers are shielded from accountability, and common in detained boys than the general communi- the trauma that is the underlying cause of the behav- 55 The rate of major depression in detained girls was t y. ior is not addressed. The choice to punish instead 56 29 percent, compared to 11 percent in boys. of support sets in motion a cycle of abuse and imprisonment that has harmful consequences for victims of trauma.

15 girls ’ of sexual abuse into the juvenile justice system paths Trauma Release into community with coping exacerbated trauma symptoms behaviors resume and/or re-entry into Trauma symptoms triggered abusive and/or new incidents of abuse environment to reactions common girls ’ New arrest Entry into trauma and criminalized are occurs and Juvenile cycle repeats exacerbated in involvement by Justice and deepens juvenile the system , justice to of a leading cycle abuse (for prostitution, imprisonment and status offenses, incorrigible behavior, etc.) 13 Sexual Abuse (sex trafficking, abusive home, poorly supervised child welfare placement) Reactive Behavior Unaddressed Trauma, Mental Health, Physical Health Issues - involved youth mental health diagnoses among justice by gender Gender Differences in Mental Health Diagnoses 67% 80% b o y s o f o f g i r l s ealth in the W outh , y ustice J uvenile J and h ental M for . tr c l ’ at , n ocozza J. c osePh & J hufelt l. s ennie J Source: J uvenile J ustice isorders d ealth h ental M s : r esults ith ysteM http://www.ncmhjj.com/wp-content/uploads/2013/07/7.-PrevalenceRPB.pdf. 4 (June 2006), tudy s revalence P available at -s ulti M a froM tate

16 THE GIRLS OF SEXUAL ABUSE INTO JUVENILE JUSTICE SYSTEM ’ PATHS Yet when girls enter the juvenile justice system, mental traditional group care setting became pregnant within health screenings are rarely administered by licensed two years, the same was true for only 26.9 percent of 63 professionals, and follow-up assessments and those who received the intervention. 57 Some studies treatment are frequently inadequate. In addition, the juvenile justice system rarely meets have found that this lack of services exists more often medical needs related to sexual abuse that girls have 58 According to a recent in facilities that serve girls. experienced, including gynecological and obstetric nationwide census conducted by the US Department care. Although the national prevalence of adolescent of Justice’s Office of Juvenile Justice and Delinquency pregnancy among justice-involved girls is unknown, Prevention (OJJDP), only approximately half the youth several local studies have found that a significant in the juvenile justice system are placed in a facility percentage of girls in the juvenile justice system are that provides mental health evaluations of all resi- 64 and the risk for adolescent or have been pregnant, 59 Follow-up care is often insufficient even for dents. pregnancy is increased by childhood trauma and sex- 60 And a significant youth who do receive evaluations. 65 In a survey of girls in the juvenile justice ual abuse. majority of juvenile justice youth (88 percent) resides system, The National Crittenton Foundation found in facilities in which mental health counselors are not that 49 percent of the young mothers in the study 61 licensed professionals. 66 reported a history of sexual abuse. 14 Most juvenile justice facilities are unaccredited and do “I became even more withdrawn and angry. I felt not offer specialized services for pregnant girls who completely disconnected from my family, from have been sexually abused. Nor are they in com- friends; and the counselors inside offered no sup- pliance with standards of pediatric or reproductive port for the real problems I was facing. I felt like health care for incarcerated populations established nobody believed that I could actually do something by the American College of Obstetricians and Gyne- positive with my life — especially the staff inside cologists and other accrediting organizations such the facilities, who treated me like a case number, not like a person. At that time what I needed was as the National Commission on Correctional Health to talk to folks about all I had been through, to 67 In one recent national survey by OJJDP, only Care. feel connected to people — to feel useful, so that I 18 percent of juvenile justice facilities provided the could find my own direction in life. I needed to heal 68 More- basic service of pregnancy testing at entry. from the trauma and to be supported with love and over, pregnant girls in some juvenile justice facilities encouragement.” – NADIYAH SHEREFF report being shackled, hungry, and without access to 69 prenatal and parenting education. Yet mental health services can yield important and In addition to the insufficient treatment of trauma-re- positive results for girls. A study in Florida that exam- lated health needs, conditions in juvenile justice sys- ined girls after release, for example, found that those tems risk re-traumatizing girls. Routine procedures, who received mental health care services were 37 including the use of restraints and strip searches, as percent less likely to re-offend, and another found well as the isolating, punitive environment itself, can that two years after release, girls who were provided be particularly harmful to victims of trauma by trigger - 70 a trauma-based intervention had reduced rates of ing their traumatic stress symptoms. 62 recidivism compared to girls in generic group care. A 2012 Texas Criminal Justice Coalition study of Meanwhile, a recent study in Oregon found that girls incarcerated girls illustrates the issue. In that study, living in out-of-home placements who were provided 46 percent of participants reported that the staff, with a trauma-based intervention were far less likely programs, and treatment in county juvenile justice to become pregnant: while 46.9 percent of girls in the facilities did not help them deal with past trauma in

17 ’ SEXUAL ABUSE INTO THE OF JUVENILE JUSTICE SYSTEM PATHS GIRLS their lives; 4 percent said their time in county facilities delinquency, and establishes State Advisory Groups, did more harm than good in dealing with past trauma. among other provisions. The JJDPA, however, has - State facilities fared only marginally better: 30 per not been reauthorized since 2002. Reauthorization cent of surveyed girls reported that their time in the of the JJDPA is critical to funding services, innova- state secure facility was unhelpful in addressing past tion, and creating new standards that will reflect over trauma. Significantly, 8 percent reported that the state a decade of research and the development of best 71 facility had done them more harm than good. practices to serve the needs of children in the juvenile justice system. Girls in such conditions tend to respond by internaliz- ing their negative experiences, entering into depres- As part of the reauthorization process, we recom- 72 These reactions sion or engaging in self-harm. mend the following changes to the JJDPA to improve 73 According can increase the risk of additional harm. conditions for girls in the juvenile justice system: to the National Child Traumatic Stress Network, • Implement accountability mechanisms to ensure “[m]any characteristics of the detention environment that states to comply with standards and guide- (seclusion, staff insensitivity, loss of privacy) can lines for gender-specific services, including issu- exacerbate negative feelings and feelings of loss of ing annual public reports on progress towards control among girls, resulting in suicide attempts and 15 compliance with standards and guidelines. 74 In addition, some girls experience self-mutilation.” • Increase funds available to incentivize states to new incidents of sexual victimization while in the create gender-specific, trauma-informed preven- 75 Taken together, lack of appropriate care and system. tion and treatment programs and services. re-triggering conditions can lead to a harmful cycle of • Require at least one State Advisory Group trauma that often turns inward. member to have expertise in gender-specific For girls who are sent into the juvenile justice sys- issues, such as sexual abuse and domestic child tem because of behavior based on their reaction to sex trafficking, as well as knowledge of effective trauma – such as running away from home to escape interventions. an abusive caretaker — detention is an unjust and • Require states to employ validated, comprehen- harmful practice. These girls are not a threat to public sive screening and assessments to evaluate 76 Arresting and detaining them effectively pun- safety. all children entering the juvenile justice system ishes girls for being victims, and it fails to provide the for trauma and to develop appropriate treatment services necessary to heal and recover. It is simply an plans and programming in response to identified unacceptable response to child sexual abuse. needs. Require states to screen children at intake for • Dismantling the Pipeline: Policy Recommen- commercial sexual exploitation and divert identi- dations to Reduce Traumatized Girls’ Arrest fied victims away from the juvenile justice system and Incarceration. whenever possible. • Explicitly prioritize funding for the development of Strengthen the JJDPA. programs to train law enforcement officers and Passed in 1974, the Juvenile Justice and Delinquency other juvenile justice system staff to better identify Prevention Act (JJDPA) is the single most comprehen- and respond to trauma. sive federal legislation that governs conditions of con- • Require states to evaluate the effectiveness of finement for youth and delinquency prevention. The juvenile justice programs that address the needs JJDPA sets standards for states’ operation of juvenile of girls; develop plans to remedy identified gaps justice systems, provides federal funding to and deficiencies; and report on progress annually. improve the juvenile justice system and to prevent

18 PATHS ABUSE INTO THE JUVENILE SEXUAL JUSTICE SYSTEM OF GIRLS ’ Require the collection of data on girls in the • • Identify and develop other sources of federal juvenile justice system and their outcomes funding to support the creation of communi- disaggregated and cross tabulated by race and ty-based, gender-responsive, and trauma- informed programming such as the Juvenile ethnicity, including the following information: Accountability Block Grant Program (JABG) → The number of victims of commercial and the NGI Innovation Awards. sexual exploitation involved in the juve- nile justice system. → The conditions of confinement for girls, Fully Enforce — and Strengthen — the Prison Rape Elimination Act. including frequency of solitary confine- The Prison Rape Elimination Act (PREA) is a power - ment or isolation, strip searches, shack- ful tool that can help prevent abuse against girls in ling during childbirth, inappropriate use juvenile justice if effectively enforced. Under the law, of restraints, or other practices that may facilities must screen inmates for a history of sexual exacerbate girls’ trauma. abuse and provide appropriate medical and mental The number of pregnant and parenting → 77 Youth who health care within 14 days of intake. girls in the system and the treatment are victimized while in a facility, meanwhile, must they receive, from pregnancy testing 16 have timely access to emergency medical and crisis through postpartum care and new- 78 PREA standards also limit intervention services. parenting services. procedures that are likely to trigger re-traumatization, such as pat-downs by officers of the opposite sex, Further the Work of OJJDP’s National Girls strip searches, and solitary confinement. And the law Initiative. requires state facilities to collect data on allegations of Promising work has been initiated by the OJJDP, sexual abuse, aggregate the data at least yearly, and which oversees compliance with the JJDPA. Through 79 make that data publicly available. its Girls Study Group and National Girls Initiative (NGI), OJJDP has elevated a focus on girls in the juvenile Although these provisions represent progress, en- justice system. The current Administrator, Robert forcement mechanisms are weak. There is no private Listenbee, has expressed his strong commitment right of action to enforce PREA’s standards. And to improving the juvenile justice system for girls. We while the US Department of Justice may reduce by 5 applaud these efforts and urge that NGI receive the percent federal grant funds to states that fail to certify appropriate funding and support to engage in the compliance, a state can avoid that penalty as long following actions: as the governor “submits an assurance that such 5 percent will be used only for the purpose of enabling • Issue regulations interpreting the JJPDA require- the state to achieve and certify full compliance with ments for the creation and implementation of 80 No deadline has been the standards in future years.” gender-specific policies and programming. 81 imposed for states to come into compliance. • Assist OJJDP in enforcing JJDPA requirements to create and implement gender-specific services. PREA would be a more effective means of preventing Convene a coalition and seek input from broad, • and addressing violence against girls in juvenile justice diverse sources to develop clear guidelines and if amended in the following ways: best practices for gender-responsive program- • Provide for mandatory penalties if states fail to ming and policies. adopt and comply with federal standards within Develop training and technical assistance for • a reasonable period. states seeking to create more gender-responsive programming and policies.

19 SYSTEM GIRLS SEXUAL ABUSE INTO THE JUVENILE JUSTICE ’ PATHS OF Require Facilities to be Accredited for the Provi- Limit the time that a state can offer an assurance • sion of Medical Care. before funding is cut. The National Commission on Correctional Health • Define the required “timely” crisis intervention Care (NCCHC) has promulgated widely accepted services as within 12 hours of a resident’s filing standards for health care in correctional settings. a complaint under the law. Compliance, however, is not mandatory, and many If an assault disclosed at intake occurred shortly • 88 As juvenile justice facilities remain unaccredited. before entering the facility (within a week), reduce a result, compliance with established standards of the maximum allowable timeframe for states to pediatric care is low or non-existent. According to provide victims with access to mental health and the American Academy of Pediatrics Committee on medical services to three days from the current Adolescence, “[D]ata from 2004 showed that overall, 14-day standard. fewer than half of the facilities were compliant with • Require foster homes and congregate care facil- recommended health screening and assessments. ities to comply with PREA and federal standards Few detention facilities met even minimal levels of if they enter into contracts with juvenile justice 82 care, although better care was seen as the length of agencies. 89 Policymakers at the federal, state, stay increased.” 17 and local level should mandate accreditation. Provide Gender-Specific Physical and Mental Health Care In Justice Settings. Provide Comprehensive Reproductive Girls need access to trauma-informed and gen- Health Care. der-specific health care — not only to improve their The juvenile justice system should adopt a coor - wellbeing over the long term, but also to reduce the dinated and integrated approach to reproductive 83 The Multidimensional likelihood of recidivism. health needs in addressing girls’ high rates of sexual 90 Treatment Foster Care model is one approach that Most fundamentally, juvenile justice facili- abuse. has been shown to be effective in reducing recidivism ties should be required to meet the comprehensive 84 Juvenile justice systems should ensure among girls. standards for women’s physical and reproductive 91 that girls’ mental health needs are adequately identi- and adhere health care developed by the NCCHC fied, assessed, and treated while in the system, and to guidelines like those established by the American that girls have access to necessary mental health care College of Obstetricians and Gynecologists (ACOG), when they re-enter their communities. the American Public Health Association, and the Juvenile Detention Alternatives Initiative of the Annie Implement Gender-Specific Health Screening and 92 Consistent with a 2011 report E. Casey Foundation. Assessment. - by ACOG’s Committee on Health Care for Under State and local jurisdictions should require facilities served Women, for example, protocols should include to implement gender-specific health screening at mandatory assessment for pregnancy risk at intake intake. The Girls Health Screen (GHS), developed by and follow-up pregnancy testing as appropriate. The Leslie Acoca of the National Girls Health and Justice shackling of pregnant young women during labor and Institute, is a helpful model to guide the development 93 delivery should be strictly prohibited. of gender-specific medical triage in juvenile justice 85 Currently, it is the only validated health settings. In addition, given the unique reproductive health screening tool tailored specifically to girls in state consequences of trauma and abuse, juvenile justice 86 and it has been effectively implemented in custody, systems should work with specialists to integrate 87 juvenile justice facilities in three California counties. mental health treatment into reproductive health treat- Comprehensive follow-up assessments can help ment and services. inform treatment plans.

20 ’ of sexual abuse into paths the juvenile justice system girls discipline : girls school , violence , and the school to prison pipeline including being suspended, expelled, or referred to Sasha was raped as a high school student. When 100 law enforcement. news of the rape was circulated in social media, she was ridiculed by her classmates, making it In Norman, Oklahoma, for example, after rumors impossible for her to feel safe at school. Sasha spread about the rape of three female students by a immediately became truant. For six months, Sa- male peer, the school reportedly did not act to stop sha’s mother unsuccessfully appealed to school the repeated harassment of the victims. In fact, district administrators to transfer Sasha to a safer when one of the rape victims swung a heavy book school environment. In an effort to ensure that bag at a student who stated “I hear you like being Sasha still received her education, her mother 101 raped in the ass,” she was suspended along with attempted to home school her, but the school dis- 102 the student who harassed her. trict threatened to refer Sasha to the child welfare system for keeping her out of school. Because of More research should be conducted to study the her extensive, unaddressed trauma and fear for her rates at which girls experience sexual violence in own safety, Sasha refused to go to school and ulti- school and how schools handle these incidents, 103 mately dropped out. After two years out of school including the services they provide to the victims. and without receiving trauma-related services, she Meanwhile, school districts should abandon was arrested on petty theft charges. Only after her 104 zero-tolerance disciplinary policies for victims arrest was Sasha referred to a therapist who iden- of sexual violence on campus and consider wheth- tified her trauma as the cause of her truancy. With er a given violation of school policy was caused the assistance of an educational advocate, Sasha by the initial trauma of sexual victimization. As applied and was accepted to an alternative school 18 stated by the Illinois State Board of Education that provided a small therapeutic setting and a Ensuring Success in School Task Force, “When 98 second chance at graduation. there is a relationship between the survivor’s Sasha’s story illustrates a common problem. When behavior and the survivor’s experience of violence schools fail to support girls who are victimized by — for example, when students engage in gender-based violence and harassment on campus, acts of self-defense — schools need to be flexible 105 girls no longer feel safe and as a result may disen- and modify punishment appropriately.” This gage, become truant, or exhibit challenging behav- recommendation reflects the need to recognize iors that are rooted in the trauma they have experi- the link between girls’ reactive behaviors and 99 enced. Yet instead of being viewed as victims of underlying initial trauma and train staff to respond sexual violence, these girls are often disciplined, accordingly. Include Trauma-Related Health Treatment in Although juvenile justice systems often operate with Re-entry/Aftercare Plans. limited financial and case management resources to As described above, sexual abuse is a unique pre- address issues that may arise after release, Medic- 94 The period immediately dictor of recidivism for girls. aid and CHIP funds can be used to finance some after release is when girls are at the highest risk of trauma-related health and mental health services, as 96 recidivism and serious harm. The original underlying At a minimum, states should require detailed below. abuse, for example, may resume; or girls may deal juvenile justice systems to assist youth in enrolling in with unresolved trauma by using coping strategies health care coverage before release to eliminate un- that increase girls’ risk of re-entry, such as substance necessary administrative barriers to accessing mental 97 abuse or running away. To lessen this risk, re-entry health and trauma services during this critical time. planning should include an attempt to connect Ideally, every girl released from the juvenile justice girls with trauma-related health resources in the system should have a community provider identified 95 community. as part of her aftercare treatment plan.

21 girls of sexual abuse into the juvenile justice system paths ’ lived experience of the sexual abuse to prison pipeline : sex trafficking of victims as offenders jailed “Suffering, isolated, tired and helpless at the age of 15, the concrete box that represented my cell in Zenoff Hall, the girls’ section the largest of the juvenile facility in Las Vegas, Nevada, seemed no less invasive than the horror of the streets. As much of a real physical confinement as it was, it wasn’t all too different than the mental confinement I endured from my pimp. I was interrogated for hours on end, reminded that my opinions didn’t matter, and locked in like a dog in a kennel. Unless I was saying the answers to the questions that they wanted to hear, my voice was irrelevant. Skip ahead a few years later, I endured it again in California, only that time experiencing my seventeenth birthday within the juvenile hall walls. Both times I was faced with charges of solicitation and/or prostitution, a crime that as a minor who wasn’t of legal age to consent to sex, couldn’t seriously be charged to commit. But yet, there I was, facing them. To my agony, I comprehended this as yet another system that failed me ... I was re-traumatized every day in detention while having to be watched, fully nude, while I showered. No one assessed me or ever even asked me what got me there, no rehabilitation ser - 106 vices were offered. I just sat locked in a box while being interrogated and talked-down to.” — Withelma “T” Ortiz Walker Pettigrew 19 One of the grimmest examples of the sexual abuse- A few states have adopted legislation or regulations to prison pipeline is the detention of girls who are to allow child welfare to respond to child sex traffick- 110 But even when child welfare systems bought and sold for sex. ing victims. can respond to child sex trafficking, too often they Child sex trafficking* is child sexual abuse. And 111 do not. it is abuse that is often layered over pre-existing In the worst cases, where children are poorly cared trauma: children who have been sexually abused for, the child welfare system inadvertently plays a are especially vulnerable to traffickers. Yet many part in making girls vulnerable to exploitation. When jurisdictions still view victims of child sex trafficking girls who grow up in the child welfare system — as perpetrators. These girls are arrested on charges especially children who have been placed in of prostitution even though they are too young to 108 multiple homes — live without stability or safe, legally consent to sex. supportive family attachments, it can render them Although child welfare agencies are charged with vulnerable to the manipulation of traffickers who the task of responding to child sexual abuse cases 112 Indeed, some promise to love and care for them. and have often had previous interactions with traffickers purposely troll for youth in certain group exploited youth, they do not — and in many states, homes because they are aware of this vulnerability. cannot — function as an alternative to incarcera- As one report in California stated: tion unless the trafficker is a parent or “caretaker,” 109 As a result, trafficked as defined by state law. Exploiters know where foster care group children, who are victims of statutory rape or child homes are and they directly recruit girls from abuse, are sent into the juvenile justice system these settings — they prey on the kids they — imprisoned as a direct consequence of their know are the most vulnerable. Exploiters victimization. also use coercion and threats to force these * Domestic Minor Sex Trafficking: Hearing before the H. Subcomm. on Crime, Terrorism & Homeland Security of the H. Comm. on the Judiciary , 111th Cong. 4 (Sept. 15, 2010) (testimony of Ernie Allen, President & CEO, Nat’l Ctr. for Missing & Exploited Children).

22 girls paths sexual abuse into the juvenile justice system ’ of young girls to recruit other youth living in the tution-related offenses, or other acts related to 113 group home. their sexual exploitation. We know too little about the lives of trafficked girls Such laws would be consistent with state laws that and the experiences of girls in child welfare. More declare minors to be legally incapable of consenting research is urgently needed to learn how many to sex, as well as federal law, which defines any act American girls are trafficked each year, as well as of commercial sex with a person under the age of 115 the percentage of trafficked girls in child welfare, 18 as a severe form of trafficking in persons. given their significant abuse histories and unique Enact Effective and Universal Safe Harbor vulnerability. Laws. States that continue to allow the arrest and de- Recently enacted legislation may help the child tention of children on prostitution charges should welfare system support girls in their care who are enact safe harbor or immunity laws to ensure that trafficked or at-risk and help them avoid crossing trafficked youth are treated as victims, not perpe- over into juvenile justice: the Preventing Sex Traf- trators. Several states have adopted these laws. ficking and Strengthening Families Act. This law re- The provisions of existing safe harbor laws vary, quires states to identify, document, and determine 20 but all strive to direct child victims of sex trafficking appropriate services for children in the child welfare into appropriate treatment services and divert them system who are victims of sex trafficking or at risk from juvenile justice involvement. of becoming victims. It also allows them to track child victims of sex trafficking under the Adoption To be fully effective, safe harbor statutes should at and Foster Care Analysis and Reporting System minimum include the following elements: - before and during their time in foster care. Impor • Funding mechanism and/or partnership tantly, the law also requires the child welfare system with child welfare system to ensure provision to report children who are missing from foster care of comprehensive services to victims and placements to law enforcement and the National appropriate alternatives to arrest, detention, Center for Missing and Exploited Children within 114 and prosecution; Further guidance is needed to assist 24 hours. Eligibility of all minors under the age of 18; • states in collecting data from the child welfare and Eligibility of all victims of sex trafficking, • juvenile justice systems, identifying and develop- regardless of whether they enter the system ing appropriate screening tools, and ensuring that on prostitution charges; services are gender-specific, trauma-informed, and • Immunity from arrest and prosecution when the culturally competent. charging offense is directly related to the child’s Dismantling the Pipeline: Policy exploitation and victimization; and Recommendations to Keep Victims of • Fully funded court diversion programs when Sex Trafficking Out of Juvenile Justice. immunity is not an option. Diversion programs avoid detention and instead End the Arrest and Detention of Youth for Prostitution. provide child victims with essential services. Victims State laws and delinquency codes should avoid acquiring records and instead may receive define children under the age of 18 who engage specialized and individualized treatment, including per se in commercial sex acts as victims of traffick- family support services, essential life skills train- ing, and they should prohibit the arrest, detention, ing, and assistance with job placement, as well as and prosecution of children for prostitution, prosti- housing, education, and vocational skills.

23 girls of sexual abuse into paths the juvenile justice system ’ 21 ending by girls against violence ending demand As with all markets, even illicit ones, sex trafficking ecutions of child-sex buyers and redirect 117 is driven by both supply and demand. To date, resources to scale up operations against most enforcement efforts at the federal and state buyers rather than criminalizing victims; levels focus on the victims and the traffickers. Instruct federal and state anti-trafficking • 118 Laws that criminalize the act of sex with minors task forces throughout the country to target are too rarely enforced in the context of child sex buyers of child sex in their operations; and trafficking. In many cases, child-sex buyers escape with little or no accountability, despite the traumat- Encourage the use of federal anti-trafficking • ic effect of their acts on the victims. To help put statutes and state laws that criminalize an end to the commercial sexual exploitation of sex with minors to prosecute buyers of un- children, advocates and lawmakers should: derage girls. Educate the public on the role of buyers in • A targeted strike against demand from both perpetuating systematic violence against a cultural and legal standpoint would weaken underage girls and other vulnerable youth; the market for commercially sexually exploited youth and help combat this form of gender- Increase training of law enforcement and • based violence. prosecutors on investigations and pros-

24 girls of sexual abuse into the juvenile justice system paths ’ : pipeline prison to abuse lived of the sexual experience offenses status for girls detention of “I was locked up ten different times within a two year period. Inside juvie I met other girls like myself who were there for prostitution, running away, and truancy. All of us were from the same neighborhoods, poor families, and seemed to have the same disposition of trauma, anger mixed with hopelessness. We were not violent girls. We were girls who were hurting. Being confined to a tiny cement room was one of the hardest things I have ever had to experience. Being locked up all I could do was reflect on my life but it didn’t seem to help. I became even more withdrawn and angry.” — Nadiyah Shereff 22 Status offenses can often be seen more compre- Status offenses such as truancy, running away, or hensively when viewed in the context of trauma. curfew violations are acts that are unlawful only The root cause for committing status offenses is when committed by youth. Unlike juvenile delin- often tied to abuse, such as running away from an quent offenses, the acts are defined by the perpe- 119 abusive home or failing to attend school because trator’s age. 124 For exam- a trafficker is forcing a girl to “work.” Girls are disproportionately involved in the juvenile ple, as recently stated in a brief prepared for the justice system for status offenses at critical stages National Child Traumatic Stress Network: “Youth of the process, including petitions, which initiate a who have experienced chronic trauma do not be- case; detention; and judicial dispositions that result lieve that the adults around them can or will protect in out-of-home placement at residential centers, them, and sometimes they are right. What is inter - 120 In 2011, foster homes, or correctional facilities. preted as delinquent behavior or pointless acting for example, girls accounted for 28 percent of all out is often their attempt to assume the burden of petitioned delinquency cases, but 41 percent of 125 taking care of themselves.” 121 Strikingly, girls petitioned status offense cases. comprised only 16 percent of the overall detained Consistently, girls are disproportionately affected population in 2011, but almost 40 percent of by the enforcement of the status offense of running 122 126 Over the past twenty years, girls have Finally, girls youth detained for status offenses. away. accounted for approximately 60 percent of runaway accounted for 40 percent of status offense cases 127 It is the only petitioned offense in recent that resulted in out-of-home placement in 2011, cases. years other than prostitution for which the majority although they were just 12 percent of youth receiv- 123 128 Yet running away is of youth offenders are girls. ing such dispositions overall. 129 which contrib- often a response to sexual abuse,

25 girls ’ sexual abuse into the juvenile justice system paths of utes to a harmful cycle: when girls with a history of Because girls are disproportionately charged with sexual abuse run away, they are more likely to be and detained for status offenses, closing this loop- 130 or engage in oth- commercially sexually exploited hole would particularly benefit girls. We recommend er behavior that increases their risk of involvement that all states adopt legislation closing the VCO in the juvenile justice system. Research indicates loophole, and that the federal government provide that, in turn, when a girl returns home after release, incentives for them to do so in a reauthorized and if the juvenile justice system failed to address the strengthened JJDPA. underlying abuse, she remains at high risk of sub- Provide Law Enforcement Training on Gender 131 sequent sexual victimization throughout her life. Bias and Gender Stereotyping to Decrease Girls’ Contact with the Justice System. Despite the link to sexual abuse, of all status offens- The disproportionate effect of the enforcement of es, runaway cases have most consistently resulted status offenses on girls is part of a broader trend in detention and out-of-home placement adjudica- 132 sometimes referred to as “net widening,” in which Greater attention tion over the past two decades. law enforcement policies and practices arrest, should be directed at the trauma underlying these detain, and incarcerate more youth for less serious minor offenses and away from detention. 136 Net widening has resulted in an in- offenses. 23 Dismantling the Pipeline: Policy Recom- crease in girls’ involvement with the juvenile justice 137 mendations to Decrease the Disproportion- system over the past twenty years. ate Effect of Status Offense Enforcement But girls who commit low-level violations and who on Girls. do not pose a risk to public safety do not belong in Close the Valid Court Order Loophole. 138 — especially those whose be- the justice system The Juvenile Justice and Delinquency Prevention havior stems from sexual abuse. Training is required Act (JJDPA) prohibits youth from being incarcerated to understand implicit and structural gender and 133 In 1980, however, Congress for status offenses. racial bias that results in the disproportionate rates created a loophole in that ban: the Valid Court of girls entering the system, and to better recognize Order (VCO) exception. The VCO exception allows trauma. The National Child Traumatic Stress Net- children to be detained if they violate court orders work has produced several resources on recogniz- that prohibit them from committing enumerated ing trauma in the juvenile justice system, including status offenses. For example, if a court issues an bench cards to help judges recognize and respond order that forbids a girl from running away, she can 139 and a brief on to the impact of trauma on children be sent into the juvenile justice system under the 140 trauma among girls in the juvenile justice system. VCO exception if she later does so. Similar guidance should be expanded and deep- ened to include information about the effect of The VCO exception undercuts the JJDPA’s core gender bias and stereotyping on public systems’ requirement that youth should not be detained perceptions of and responses to girls’ behavior, as for status offenses. In 2010, in recognition of the well as ways to ensure that trauma assessments problem, the National Council of Juvenile and are integrated into treatment plans. Family Court Judges, which had originally advocat- ed for the exception, called for the phaseout of the 134 Some states have voluntarily chosen to do VCO. 135 so, but they remain in the minority.

26 girls ’ of sexual abuse into the juvenile justice system paths in focus : dual - system youth pipeline the sexual abuse to prison and 144 Youth who have been involved in both the juvenile A Los Angeles report, half of dual-system youth. for example, found that of the first-time juvenile of- justice and child welfare systems — known as fenders studied who were also involved in the child crossover, dual-system, or dually involved chil- 141 — are some of the most vulnerable children welfare system, 37 percent were female, although dren 142 and they are disproportionately in state custody, girls comprised only 24 percent of first-time offend- 145 143 girls comprise one-fifth to one-quarter of female: ers who were not involved in child welfare. the juvenile justice population, but one-third to one- Girls are disproportionately represented in the dually involved youth population. 24 Youth in Juvenile Dually Involved Youth: Justice: 1/5 to 1/3 to 1/2 are Girls. 1/4 are girls. . of m ulTi -s YsTem Y ouTh : s TrenGTheninG The C onneCTion B eTween C hild w elfare r for J uvenile s ourCe : d enise h J usTiCe Tr eform , a ddressinG ., C niv u eorGeTown ., G l a T e The erz n eeds http://cjjr.georgetown.edu/wp-content/uploads/2015/03/MultiSystemYouth_March2012.pdf. available at 1 (Mar. 2012), usTiCe J uvenile and J

27 girls of sexual abuse into the juvenile justice system paths ’ Research by the National Council on Crime and Dismantling the Pipeline: Policy Recom- Delinquency (NCCD), meanwhile, found that mendations to Reduce Foster Girls’ Cross- - gender non-conforming girls are especially vulner ing Over Into the Juvenile Justice System. able to juvenile justice involvement after contact Implement screenings upon entry into the • 146 (NCCD’s findings with the child welfare system. child welfare system to identify a history are consistent with several studies that indicate of trauma. that LGB girls and GNC youth are particularly at • Develop cross-system collaboration between risk of juvenile justice involvement and face distinct the juvenile justice and child welfare systems. 147 ) safety risks in public systems. Implement models like CYPM, adding gender- responsive components to improve services The consequences of crossing into the juvenile and outcomes for dually involved girls. justice system are significant. The risk of recidivism • Limit providers’ referrals to law enforcement to is higher for foster care youth than for their peers. 161 manage challenging behaviors. One study of dual-system youth, conducted two years after release from juvenile justice, found that 70 percent had re-entered the justice system, compared to 34 percent of their peers who had 25 152 not had contact with the child welfare system. Meanwhile, a significant percentage of dual- of girls crossover pathway for the system youth languish in the juvenile justice sys- color tem for a longer time than their non-child- The crossover pathway is especially significant for welfare-involved counterparts, and they are African-American youth, who are involved in the more likely to be involved in the criminal justice child welfare system at 2.26 times their represen- 153 system as adults. 148 tation in the general population of children and, once there, are disproportionately likely to become Collaboration between the juvenile justice and 149 involved in the juvenile justice system. A study of child welfare systems can help prevent crossover. one county found that 27 percent of African-Amer - Inter-agency cooperation can improve the de- ican girls in juvenile detention had an open child velopment of treatment plans and better inform welfare case compared to 7 percent of youth 150 judges in deciding whether to detain girls or overall and 13 percent of African-American boys. 154 Research shows that children of color in the To that end, divert them from juvenile justice. child welfare system face disparities in outcomes some jurisdictions have begun screening for child compared to white youth. They are less likely to welfare involvement at the time of arrest. A helpful be reunited with families, more likely to be placed model is the Crossover Youth Practice Model in congregate care settings, less likely to exit child (CYPM), developed by the Center for Juvenile welfare with a permanent family, and face worse Justice Reform at Georgetown University. CYPM long-term outcomes in academic achievement, 151 health, and other areas than their white peers. is a dual-system approach that works to reduce foster youth involvement in the juvenile justice system, out-of-home-placements, congregate care placement, and pre-adjudication detention, as well as increase families’ participation in the 155 decision-making process.

28 girls ’ of sexual abuse into the juvenile justice system paths Girls who have experienced abuse often engage these trauma-rooted behaviors without resorting to in challenging and, at times, defiant and disruptive calling the police except in extreme circumstances. behavior, which is a common response to trauma. Meanwhile, child welfare agencies should be re- When foster families and caregivers are not ade- quired regularly to collect data on provider referrals quately trained to address these behaviors, they to law enforcement based on behavior while in their sometimes call law enforcement to control the care or otherwise related to placement. Such data, 162 But as described above, the children in their care. which should be publicly available, should be ana- juvenile justice process is likely to be significantly lyzed to develop policies and practices to improve harmful and risk re-traumatizing these youth. To providers’ handling of crisis situations and end avoid this cycle, providers who apply for contracts unnecessary shunting of child welfare youth into the to work with vulnerable children should be required juvenile justice system. to demonstrate that they are qualified to address 26 the role of group homes enforcement law of role the Youth in foster care sometimes enter the ju- Poorly supervised group homes and other congre- gate care facilities that do not implement specialized venile justice system because their residential protections and trauma-informed treatment supports placements do not adequately address the be- havioral challenges common among girls who can play a significant role in the sexual abuse to have experienced severe abuse, and instead prison pipeline. According to one study, girls with a rely on law enforcement to control the behavior history of sexual abuse are more likely to be placed 159 156 of youth in their custody. in a group home or congregate care facility. At least one-third of Place- arrests for crossover youth are related to their ment in congregate care, in turn, doubles the risk of juvenile justice involvement for girls – though it does child welfare placement. In most cases, the 157 arrest is the result of an incident that occurred not have the same effect on boys. Preliminary 160 within the youth’s group home. research suggests that the reason for this increased risk of juvenile justice involvement for girls is unsafe living conditions in congregate care, including a higher risk of sexual abuse and physical abuse by 158 staff and other youth. This abuse may lead girls in these placements to develop coping strategies that increase their risk of justice involvement, as de- scribed in this report.

29 27 CHILD WELFARE AND THE SEXUAL ABUSE TO PRISON PIPELINE: IDENTIFYING AND TREATING TRAUMA IN THE CHILD WELFARE SYSTEM

30 child and the sexual abuse to prison pipeline welfare Child welfare systems can act as a leading force abuse, violence, or neglect. Some jurisdictions have in helping prevent and respond to girls’ trauma. made important progress by implementing trauma- Although it is challenging for underfunded and informed care. But these efforts are not yet suffi- overburdened child welfare systems to fully accom- ciently uniform or widespread. States can do more modate the needs of girls struggling with complex to improve systems’ identification and assessment of needs, failing to do so carries consequences that trauma and abuse, enhance the provision of services, are significant and enduring. and build stronger partnerships with other public sys- tems that play key roles in serving traumatized girls, - Histories of sexual abuse appear to be vastly under including schools and the mental health field. Accord- reported in the system, given the surprisingly low rate ing to research by the National Child Traumatic Stress (9 percent) of child welfare cases that are initiated Network (NCTSN), significant work lies ahead: 163 One reason for based on sexual abuse allegations. the low rate may be that child welfare cases focus on Despite the extraordinary number of children the actions of the caretaker. This practice excludes in foster care who have experienced traumatic incidents in which girls are sexually abused by others. events and are exhibiting traumatic stress symp- To address the needs of all girls who are victims of toms, and the growing body of science about sexual abuse, regardless of the perpetrator, the child efficacious treatments for child traumatic stress, 28 welfare system should screen all youth for a history of few child welfare agencies across the nation sexual abuse at entry, irrespective of the reason their integrate trauma knowledge into their practices, case was initiated. policy, training, performance standards, or as- sessment and have evidence-based trauma-spe- Each year, approximately 190,000 girls live in foster cific interventions available in their community or care, but little research has been collected on their their service continuum, including mental health 164 In one histories of sexual abuse or their outcomes. 170 contract portfolios. of the few studies to examine the issue, 54 percent of 165 foster care girls reported a history of sexual abuse. In a 2005 study conducted in 11 geographically di- In addition, girls who had experienced sexual abuse verse jurisdictions, NCTSN conducted interviews with fared worse in the system than other girls in foster staff who serve traumatized youth, including the child care: they changed placements twice as often; they welfare system, dependency and family courts, foster were more likely to have been placed in a restrictive care agencies, mental health agencies, and schools, placement or congregate care setting (64 percent vs. and found the following: 166 they were more likely to exhibit mental 35 percent); Child welfare workers seldom receive in-depth • 167 and health symptoms (37 percent vs. 18 percent); information about a child’s trauma history when they were almost twice as likely to have been involved a child is first referred to them by another agency in the juvenile justice system (41 percent vs. 24 or system. 168 Another study similarly found that sex- percent). Many agencies do not conduct a standardized • ual abuse significantly increased the risk of multiple post-traumatic stress assessment with a child 169 Meanwhile, placements and adoption disruptions. who has experienced maltreatment and has been as previously mentioned, sex trafficking of girls in referred to the child welfare system. foster care is clearly an issue, though its prevalence Fewer than half of those interviewed trained staff • is unknown. on available evidence-based treatments for child The primary mission of the child welfare system, of traumatic stress. course, is to care for children who have experienced

31 child sexual abuse to prison pipeline the welfare and Implement system-wide gender-responsive pro- • Over a third of those interviewed conducted no • tocols for trauma screening and assessment of staff trainings on assessment of child trauma. girls to identify urgent needs relating to violence • About a third of those interviewed said that they and abuse. never make referrals to a treatment provider or Administer an immediate and thorough assess- • placement based on use of evidence-based 171 ment when abuse is identified by a qualified practices; another third said they rarely did so. mental health professional. In light of the substantial harms inflicted by sexual Implement mechanisms to ensure that all care- • abuse, it is critical to ensure that child welfare systems givers receive updated results of mental health fully assess children’s histories of trauma and abuse assessments to ensure appropriate treatment. and develop comprehensive supports, protocols, and • Coordinate meetings with girls’ teams of pro- protections when incidents of abuse are disclosed fessionals and other caregivers to discuss the about youth in their care. Although it will be complex assessment as the baseline for developing an and challenging work that will require collaboration effective treatment plan consistent with practices among the health system, child welfare system, and developed by the National Child Traumatic Stress juvenile justice system, as well as a recognition of the Network, including referrals out of the system to significant overlap in the populations of children they 29 provide appropriate services where necessary. serve, this urgent issue must be addressed to better Use culturally appropriate, evidence-based • serve girls and steer them away from the juvenile assessment tools and treatment plans to 172 justice system. address traumatic stress and associated mental health symptoms. Dismantling the Pipeline: Policy Recommen- Increase federal child welfare funding to support • dations to Improve the Child Welfare System’s the most effective strategies for girls and Response to Girls. their families and create federal standards for Improve the Child Welfare System’s Identification gender-specific child welfare practices. of Victims of Abuse and Implement a Gender-Re- The two primary sources of federal financing for child sponsive Approach to Victims of Abuse. welfare services, Title IV-E and Title IV-B of the Social Develop and implement high-quality trainings • 175 are significantly underfunded. Con- Security Act, for staff on how to prevent, identify, assess, and gress should increase funding to these programs to respond to children who enter the system with better serve children. As part of this effort, it should a history of sexual abuse, including commercial incentivize states to decrease overreliance on group sexual exploitation. Promising training has been homes that are unstable and that fail to address girls’ developed by the National Child Traumatic Stress complex needs; instead, it should emphasize placing 173 Network. more youth in family-like settings and therapeutic Extensively train foster parents and kinship care- • foster care and providing services at home, con- givers on the risks of sex trafficking and how to sistent with research that shows these methods so mitigate them. For those girls who already have a 176 Finally, it should serve foster youth most effectively. history of being trafficked, and who may continue incentivize states to provide front-line child welfare to maintain a connection to their former traffick- workers with professional training on best practices in ers, specially trained foster homes should be trauma-informed approaches. considered, akin to therapeutic foster placements and specialized foster placements for pregnant 174 and parenting teens.

32 pipeline child welfare prison to abuse sexual and the Use Medicaid Funds to Improve Quality Use Medicaid to Connect Child-Welfare-Involved Care and Trauma-Related Services for Children with Integrated Health Care Practices. Girls in Child Welfare. For a variety of reasons — including periods of Medicaid is currently underutilized as a tool to help homelessness and running away, frequent place- youth who have experienced trauma. Medicaid funds ment changes, and involvement in the juvenile justice can be better used to cover the cost of certain trau- system — girls in foster care often lack consistent ma-related services needed by abused and neglect- access to the coordinated health services they need ed girls in state custody, including multi-systemic to recover from trauma and abuse. therapy and functional family therapy, two of the most Through the Affordable Care Act, the Center for commonly recommended evidence-based treatment Medicare and Medicaid Innovation (CMMI) has 177 services for system-involved youth. invested in integrated care models that “emphasize a Improve the Use of Medicaid to Cover the Cost of person-centered, continuous, coordinated and com- Trauma-Related Care. 184 These prehensive care” approach to health care. Federal law requires Medicaid agencies to assess and models provide critical trauma-informed primary care improve the delivery of services for children in foster for people with complex medical needs, including 178 A 2013 guidance letter issued by the US De- care. 185 children in the child welfare system. 30 partment of Health and Human Services (HHS) offers An example of an integrated care model is the medi- assistance to states to use Medicaid more effectively cal home. Medical homes are comprised of interdisci- to cover the cost of trauma-related care, as well as plinary teams of providers who develop individualized, design Medicaid treatment strategies for children and 186 179 for people with chronic health coordinated plans Recommend- youth who have experienced trauma. 187 The medical home model is especially conditions. ed strategies include using Medicaid funds to cover well-suited for girls who have suffered abuse, be- evidence-based screening and assessment practices, cause they address needs holistically, including men- as well as home and community-based services for tal and physical health and social service needs. They children exposed to trauma. can also serve mobile or hard-to-reach populations. Fully Utilize Medicaid’s Early Periodic Screening, The American Pediatric Association has developed Diagnostic and Treatment Benefit (EPSDT). tools to help medical providers understand how The EPSDT applies to children enrolled in Medicaid, this model can address the health needs of children particularly those who have experienced trauma and 188 including training on medical exposed to violence, require specialized health services as a result. This issues associated with violence exposure, screening benefit covers services that physicians determine are tools, and methods to engage families in violence medically necessary “to correct or ameliorate any 189 prevention. 180 even if physical and mental illness or conditions,” the conditions are not included in the state’s Medicaid Invest in Creating Safe and Supportive 181 As such, it can cover many services that are plan. Group Homes with Specialized Services for Teenage Girls. commonly needed by children in state custody who Although family preservation is often a desirable - have experienced trauma, such as cognitive behavior outcome, there will always be girls for whom staying al therapy, crisis management services, peer support, 182 in a family or relative placement is not a safe op- family therapy, and targeted case management. tion because of intra-familial abuse or other harmful - Many states do not maximize use of this benefit, par 183 environmental factors. Currently, there are not enough ticularly for children with mental health needs.

33 sexual pipeline child welfare and the abuse to prison family foster care options or adoptive parents to youth, and children with disabilities. Child welfare serve all children who need them. Identification of agencies and courts should prohibit refusals to serve and investment in group homes that provide quality, youth based on their immutable characteristics and specialized services to youth should be increased, ban the practice of cherry-picking the most coopera- while group homes that do not should be phased tive youth, which tends to exclude children who have out. Youth themselves should be consulted in making experienced the most severe abuse and are in great- these assessments and help identify improvements to est need of services, increasing their risk of juvenile better meet their needs. justice involvement. Prohibit Child Welfare Agencies and Providers from To complement these efforts, child welfare systems Discharging Runaway Girls. should ensure that effective and meaningful com- Currently, child welfare systems can discharge youth plaint procedures are in place to allow girls to seek who are on runaway status, and providers are not protection and immediate placement changes when always required to hold beds for runaway youth, they feel unsafe. Federal standards of abuse or which contributes to placement instability and service maltreatment of children in foster care are too limited disruption after a runaway child is located. Yet chronic to adequately address girls’ experiences and con- episodes of running away are often indicative of vio- 190 as revealed in a qualitative study on girls’ cerns, 31 lence and abuse, which, if untreated, increase these 191 At a reports of abuse in foster care placements. youths’ risk of harm and arrest. While these cases minimum, all service providers should be required may be challenging to manage, effective strategies to demonstrate comprehensive child abuse preven- should be developed to continue to serve these vul- tion practices before receiving accreditation or grant nerable girls. funding. For group homes, these practices should be similar in scope to the PREA standards for juvenile Require Continuing Crisis De-escalation Training for All Providers in the Child Welfare System to Help justice facilities. Staff Effectively Manage Trauma-rooted Behavior. Implement Policies that Improve Responses to Providing regular training and ongoing professional the Behavior of Foster Youth Who Have Experi- development support to front-line staff is critical to en- enced Trauma and Abuse. suring the well-being of youth in custody and ending In recognition of the challenging trauma-rooted the abuse to prison pipeline. behaviors that child welfare children often exhibit, the system contracts with specialized providers that can provide therapeutic interventions and help chil- dren heal. When these providers fail to manage the trauma-related behavioral challenges they have been hired to handle, they should not punish the girls in their care by calling on law enforcement except as a last resort, as detailed above. Implement “No Eject, No Reject” Policies to Prevent Discrimination and Guard Against “Cherry-picking” of Youth Among Child Welfare Providers. Under-funding and a shortage of beds leaves certain groups of children at particular risk, including older youth, pregnant and parenting youth, LGBT/GNC

34 32 CONCLUSION

35 conclusion Girls’ high rates of sexual abuse and their increased involvement in the juvenile justice system is not a coincidence. There is a direct correlation. Research has illuminated the link between girls’ trauma and the ever-widening law enforcement net in which girls are caught, most often on minor offenses. There is much work to do. We still do not know enough about this pipeline for girls. Research typically ex- cludes girls from study samples, data is often not disaggregated by gender, race, and ethnicity, and public agencies do not collect information about trauma and gender-specific issues. The real and distinct lives of girls, especially when their lives play out at the intersection of race and gender, remain invisible. And when we lack the most basic information about girls’ unique needs and what 33 is happening in their lives, especially against the backdrop of high rates of sexual violence, the battle to develop effective strategies for their health is an uphill one. We must take action to learn more about the systemic criminalization of victimized girls, who are disproportionately girls of color. In the context of the emerging and significant debate on the criminalization of boys of color, our report is a definitive call to recognize the harm that is girls’ experience. We hope that this report will fuel new conversations and a sense of urgency to recognize and remedy the unjust and injurious response to victims and survivors of sexual abuse. CONCLUSION

36 34 ENDNOTES

37 endnotes ojstatbb/ezacjrp/asp/glossary.asp (last visited May 24, 2015). , Sexual 1. David Finkelhor, Gerald Hotaling, I.A. Lewis & Christine Smith ’ artney Abuse in a National Survey of Adult Men and Women: Prevalence, Merican a ative , n elinquency & d riMe c on ouncil c l at , n h hristoPher c 9. eglect , 14 hild http:// available at 3 (Mar.2008), ysteM Characteristics, and Risk Factors s ustice c J uvenile J the and outh y 1, 19-28 a & n buse , b tatistics us d eP ’ t of J ustice (1990); ureau of J ustice Sex Offenses and www.juvenile.utah.gov/DMC/Available%20Studies/2008%20Focus%20 , s (Jan. 1997). Native%20American%20Youth-NCCD.pdf; n at ’ l c ouncil on c riMe & Offenders eneWed W hite h ouse c ouncil on W oMen & g irls , r aPe and s exual a ssault : a r 2. d elinquency , c enter for g irls & W oMen , g etting the f acts s traight about https://www.whitehouse.gov/ ction 1 (Jan. 2014), available at ysteM s 7 (Feb. 2009), http://www. available at c all to a g irls in the J uvenile J ustice sites/default/files/docs/sexual_assault_report_1-21-14.pdf. nccdglobal.org/sites/default/files/publication_pdf/fact-sheet-girls- ffice ustice , o ustice see also in-juvenile-justice.pdf; of P rograMs , . on c hildren and f aMilies , J c regon o 3. c allie M arie r ennison , us d eP ’ t of J oMM : c urvey s ictiMization v riMe c ational : ysteM s ustice J uvenile J s ’ riMinal o in ontact c inority M isProPortionate d , n tatistics s ustice J of ureau b regon 1999-2000 With http:// available at t ePort r ssessMent a and dentification i rends 1993-2000 , Table 20-26 (May 2012), v ictiMization 2000, c hanges www.oregon.gov/oya/dmcsummit/2014/Materials/OregonDMCReport- http://www.bjs.gov/content/pub/pdf/ available at 2, at 6 (June 2001), 2012FINAL.pdf cv00.pdf. note 8 ; Annie E. Casey Found., kids count Data 4. , Emily G. Marston, Mike A. Russell, Ingrid Obsuth & Gillian K. Watson 10. Sickmund , supra available , Child Population by Race and Age Group (2013) , Dealing With Double Jeopardy: Mental Health Disorders Among Center g , ontexts : c irls elinquent d in , http://datacenter.kidscount.org/data/tables/8446-child-popu- at Girls in the Juvenile Justice System , a and r elationshiPs daPtation 105, 122 (Shari Miller, Leslie D. Leve & lation-by-race-and-age-group?loc=1&loct=1#detailed/1/any/fal Marina Nicole Placella, Patricia K. Kerig eds., 2012); Selby M. Conrad, se/36/13,66,67,68,69,70,71,12|/17077,17078 (last updated Feb. Tolou-Shams, Christie J. Rizzo & Larry K. Brown, Gender Differences 2015). c hild t rends in Recidivism Rates for Juvenile Justice Youth: The Impact of Sexual d ata b ank , J uvenile d etention 5, available at http://www. 11. . & h uM . b ehav l 4, 305, 309-310 (Aug. 2014) (“Child- childtrends.org/wp-content/uploads/2012/05/88_Juvenile_Detention. 38 Abuse, aW hood sexual abuse (CSA) is a potent risk factor for delinquency and pdf (last updated Sep. 2013). Per capita rates of youth involved in subsequent juvenile justice involvement, especially for young women juvenile justice can more clearly reveal disproportionate rates than the percentage proportion of youth involved with the justice system. (Chesney–Lind, 1997; Gavazzi et al., 2006; Hubbard & Pratt, 2002).”); According to the Office of Juvenile Justice and Delinquency Prevention, Girls in the Juvenile Justice System: Stephanie Hawkins Anderson, 35 See : irls g elinquent d in , The Causes and Correlates of Girls’ Involvement the latter method can mask disparities. us d eP ’ t of J ustice ffice , o elinquency of ustice P rograMs , o ffice of J uvenile J ustice & d J P revention , c ontexts , r elationshiPs , and a daPtation , supra at 44. 6-7, ontact c inority isProPortionate http://www.ojjdp.gov/ d M available at 5. f rancine t. s herMan , r ichard a. M endel & a ngela i rvine , a nnie e. c asey to mpg/litreviews/Disproportionate_Minority_Contact.pdf (last visited May f ound ., M aking d etention r eforM W ork for g irls : a g uide J uvenile 25, 2015). d etention r eforM 5-6 (Apr. 2013), available at http://www.aecf.org/m/ , a ndrea J. r itchie , d ean s Pade 12. c atherine h anssens , a isha c. M oodie -M ills resourcedoc/AECF-MakingDetentionReformWorkforGirls-2013.pdf; rvashi irls eforM r etention ., d ound f asey e. c nnie , a herMan t. s rancine f : & u and v aid , a r oadMaP for c hange : f ederal P olicy r ecoMMendations for g c hallenges and s olutions 10 (2005) available at a ddressing 37 hiv With http://www.aecf.org/m/ living eoPle P and eoPle lgbt P of riMinalization c the (May 2014), https://web.law.columbia.edu/sites/default/ resourcedoc/AECF-DetentionReformAndGirls-2005.pdf. available at Poor data collection on Latina youth in the juvenile justice system has 6. files/microsites/gender-sexuality/files/roadmap_for_change_full_re- made it difficult to quantify their representation in national statistics. port.pdf. Because many jurisdictions do not fully disaggregate data by race and Angela Irvine, Time to Expand the Lens on Girls in the Juvenile Justice 13. nccd b ethnicity, the proportion of Latina youth involved in the system tends (Mar. 26, 2015), http://www.nccdglobal.org/ log System , to be under-identified and likely inflates the numbers of white youth. blog/time-to-expand-the-lens-on-girls-in-the-juvenile-justice-system; at LGBT/GNC Youth in Juvenile Justice Angela Irvine, See n , NCCD Blog (Mar. ’ l c ouncil on Asian youth are similarly inaccurately identified. acial , r elinquency & d riMe c J ustice riMinal the in arities us c 13, 2015), http://www.nccdglobal.org/blog/lgbtgnc-youth-in-juve- isP d thnic e and http://www.nccdglobal.org/sites/default/files/ available at , ysteM s nile-justice. 14. M argaret z ahn , s tePhanie h publication_pdf/created-equal.pdf (last visited May 31, 2015); , J anet c hiancone & a riel W hitWorth , us see aWkins nforMation Reform Trends: Counting Latino Youth , J uvenile J i ustice d eP 3 elinquency ’ d irls g nderstanding : u rouP also tudy s irls , g ustice J of t ’ g (Oct. 2008), available at https://www.ncjrs.gov/pdffiles1/ojjdp/223434. , http://jjie.org/hub/racial-ethnic-fairness/reform-trends/ (last xchange e pdf; Am. Bar Ass’n & Nat’l Bar Ass’n, visited May 25, 2015). Justice By Gender: The Lack of airness f ustice J uvenile J for nstitute i urns b ayWood W. h he t 7. quity , Appropriate Prevention, Diversion, and Treatment Alternatives for Girls e and M oMen in the Juvenile Justice System , 9 W Unbalanced Juvenile Justice, 2011 detention rates for all youth of . & M ary J. W & L. 1, 73, 79 color per 100,000 youth http://scholarship.law.wm.edu/cgi/viewcontent. available at (2002), , http://data.burnsinstitute.org/#compari- son=2&placement=1&races=2,3,4,5,6&offenses=5,2,8,1,9,11,10&- cgi?article=1182&context=wmjowl; Anne L. Stahl & Phyllis Coontz, year=2011&view=map (last visited May 25, 2015). Juvenile Assault Arrestees and Their Incidents: Same and Opposite 8. Melissa Sickmund, Anthony (T.J.) Sladky, Wei Kang & Charles Puz- irls Gender Relationships and , elationshiPs , r ontexts : c , in g elinquent d Easy Access to a supra note 4 (“[O]ur analyses lend support to prior claims , zanchera, US Dep’t of Justice, Nat’l Ctr. for Juv. Justice, daPtation the Census of Juveniles in Residential Placement: 1997-2013, http:// that the increases we see in juveniles entering the justice system may be partially due to changes in laws and police protocol. Variations in www.ojjdp.gov/ojstatbb/ezacjrp/ (last visited May 24, 2015); a e. nnie c enter f ound ., kids count d ata c asey , Child Population by Race and gendered patterns of simple assault arrests may reflect changes in the http://datacenter.kidscount.org/data/tables/8446- Age Group (2013), way that police respond to behaviors that always existed, as well as changes in public tolerance toward those behaviors.”). child-population-by-race-and-age-group?loc=1&loct=1#detailed/1/ z argaret M 15. b , eld c .f arry , b teffensMeier s arrell , d any/false/36/13,66,67,68,69,70,71,12|/17077,17078 (last updated ruMbaugh usan , s ahn P Feb. 2015). For these purposes, detention is defined as being held c. enise , d ayne nn a llison , a iller M ody , J ind -l hesney c eda , M orash M erry M ottfredson eP : rouP g tudy s irls , g ustice J of t ’ , us d ruttschnitt k in a residential juvenile facility before arraignment or adjudication or andace g & c by g irls ’ d nderstanding elinquency , v iolence awaiting placement or transfer. Commitment refers to youth who are t eenage g irls : t rends and u assigned to live in residential placements after adjudication. c available at 6-7 (May 2008), https://www.ncjrs.gov/pdffiles1/ ontext Melis- See sa Sickmund, Anthony (T.J.) Sladky, Wei Kang & Charles Puzzanchera, ojjdp/218905.pdf. , Glossary , e asy a ccess note 14, at 3-4; Schwartz, US Dep’t of Justice, Nat’l Ctr. for Juv. Justice 16. z ahn , See also note 4 at 20-21; supra supra supra Kerig, note 4, at 121, 134-135; Am. Bar Ass’n & Nat’l Bar Ass’n, J , the c ensus of to uveniles in r esidential P laceMent http://www.ojjdp.gov/

38 endnotes a Justice By Gender: The Lack of Appropriate Prevention, Diversion, and http:// available at 4, 217, 224-225 (Dec. 2014), rauMa t dolescent www.ncbi.nlm.nih.gov/pmc/articles/PMC4286894/ (“Study results supra , Treatment Alternatives for Girls in the Juvenile Justice System point to a prospective predictive relationship between previous trauma note 14. Jennifer Schwartz & Darrell Steffensmeier, event exposure and future delinquency for pre-high school entry girls Stability and Change in 17. only. For older girls, results suggest that previous trauma experi- Girls’ Delinquency and the Gender Gap: Trends in Violence and Alcohol irls d elinquent g in : , ences were predictive of future trauma experiences, but not future Offending Across Multiple Sources of Evidence , supra note 4, at 5-6 (“Policy shifts , r and delinquency. c a ontext elationshiPs daPtation 31. toward stretched definitions of what constitutes law-violating behavior The Adverse Childhood Experiences (ACEs) study conducted by Dr. ... leads to enhanced sanctioning for aggressive conduct among youth Felitti with Kaiser Permanente and the Centers for Disease Control overall but even more so among girls who tend to commit the milder, revealed that the higher a child’s ACE score – that is, the greater ahn note less serious forms of physical attacks or threats.”); z , supra then number of adverse childhood experiences, including sexual and physical abuse — the greater her risk of mental and physical health 15, at 6 (“Because arrests for assault increased without corresponding problems throughout her life. V.J. Felitti et Relationship of Childhood al., increases in arrests for homicide or robbery, these analysts attribute Abuse and Household Dysfunction to Many of the Leading Causes of the increases in assault arrests to changes in law enforcement policies, Death in Adults: The Adverse Childhood Experiences Study a M . such as responses to domestic violence, rather than to actual increases , 14 ournal of reventive M edicine 4, 245 (1998). The ten categories of P J in assaults”). , d etention r eforM ACES used in recent studies of youth in the juvenile justice system and g irls : c s hallenges and s olutions , supra note herMan 18. , M include emotional abuse, physical abuse, sexual abuse, emotional aking d etention r eforM 5, at 29-34; ork for g irls : a g uide to s herMan W , supra J uvenile neglect, physical neglect, family violence, household substance abuse, d etention r eforM note 5, at 7. Blind Discretion: Girls of Color & Delinquency in the Juve- 19. household mental illness, parental separation or divorce, and having an Jyoti Nanda, incarcerated household member. The experience of childhood trauma nile Justice System , 59 UCLA L. r ev . 1502, 1529-1530 (2012); Tina has been proven to lead to many negative long-term health conse- Status Offenders in the Juvenile Court: L. Freiburger & Alison S. Burke, , The Effects of Gender, Race, and Ethnicity on the Adjudication Decision quences and juvenile justice involvement. See, e.g ., Michael T. Baglivio J & J uvenile y ustice 4, 352, 354 (2011); Patricia K. Kerig outh v 9 iolence et al., US Dep’t of Justice, Office of Justice Programs, Office of Juvenile in d elinquent irls & Stephen P. Becker, : , Justice & Delinquency Prevention, The Prevalence of Adverse Child- g Trauma and Girls Delinquency 36 c J. , r elationshiPs , a daPtations , supra note 4, at 120; see also ontexts oa - c . uv J of hood Experience (ACE) in the Lives of Juvenile Offenders , 3 s , sos P roJect , e Merging i ssues P olicy eries , i ssue http://www.journalofjuvjustice. available at 2, 11 (Spring 2014), ustice J lition for J uvenile J ustice . 1 http://juvjustice.org/sites/default/files/ available at 3-4 (2013), o n org/JOJJ0302/JOJJ0302.pdf (“ACES not only increase the chances resource-files/SOS%20Project%20-%20Girls,%20Status%20Offens- of involvement in the juvenile justice system but the risk of re-offense. A focused effort on early identification of ACEs, and intervention for es%20and%20the%20Need%20for%20a%20Less%20Punitive%20 and%20More%20Empowering%20Approach.pdf. ACEs with a goal of improving youth life circumstances and preventing , M aking d etention r eforM : a g uide to J ork uvenile d 20. s herMan criminal behavior may reduce likelihood and costs related to juvenile etention W M argaret z ahn , s tePhanie h aWkins , J anet r eforM , criminal activities.”). supra note 5, at 19; a riel & W hitWorth , us d eP ’ t of J ustice , g irls s tudy g rouP : hiancone c 32. Baglivio, The Prevalence of Adverse Childhood Experience (ACE) in the irls , supra note 31, at 9 (Fig. 1). u nderstanding g Lives of Juvenile Offenders ’ d elinquency , supra note 14, at 3; Dana K. Smith, Responding Adolescent Girls’ Offending and Leslie D. Leve & Patricia Chamberlain, ; Id. 33. See also Karen Baynes-Dunning & Karen Worthington, overty c hild 11 Health Risking Sexual Behavior: The Predictive Role of Trauma, to the Needs of Adolescent Girls in Foster Care , XX g eo . J. P 4, 346,346-347 (Nov. 2006). altreatMent l. & P ol ’ y 2, 324 (2013), available at http://karenworthington.com/ M M 21. riel , us hitWorth W a & hiancone c anet , J aWkins h uploads/2/8/3/9/2839680/adolescent_girls_in_foster_care.pdf (an- , s ahn z argaret tePhanie tudy ustice g alyzing the three primary data sets on child maltreatment and finding J f o t ’ eP d rouP : u nderstanding s g irls ’ d , g , supra irls elinquency that sexual abuse was the driving factor of girls experiencing higher Trauma and Girls’ note 14, at 4; Patricia K. Kerig & Stephen P. Becker, irls : c ontext , r elationshiPs a nd a daPtation , overall maltreatment rates as compared to their male peers). Delinquency , in d elinquent g supra 34. note 4, at 121-134. The Florida study replicated the finding of several other studies, Adolescent Girls’ including Erin M. Espinosa, Jon R. Sorenson, & Molly A. Lopez, 22. Dana K. Smith, Leslie D. Leve & Patricia Chamberlain, Youth Offending and Health Risking Sexual Behavior: The Predictive Role of Pathways to Placement: The Influence of Gender, Mental Health Need and Trauma on Confinement in the Juvenile Justice System , 42 J. y outh Trauma, supra note 20, at 350. dolescent & a , P 1824, 1830 (2013); Julian D. Ford et al., . Poly-Vic- ev d 23. d ana d. d ehart , t he c tr . for c hild & f aMily s tudies oly - victiMization timization and Risk of Posttraumatic, Depressive, and Substance Use irls a Mong g in the J uvenile to ssociations a & anifestations : M ysteM s ustice J d Disorders and Involvement in Delinquency in a National Sample of available at https://www.ncjrs.gov/pdffiles1/ elinquency 12 (Oct. 2009), ealth d Adolescents , 46 J. a dolescent h nij/grants/228620.pdf. ehart , 545, 548 (2010); supra note 23, at 11-12. Leslie Acoca, Outside/Inside: The Violation of American Girls at Home, 24. note 4, at 134 (citing Abram 2002; Belknap and Holsinger on the Streets, and in the Juvenile Justice System, supra Kerig, 35. 44 c riMe & d elin - 2006; Dembo 1998; Ford 2008; Johansson and Kempf-Leonard 2009; http://leslieacoca.org/images/ ), available at 4, 561, 566 (1988 quency Kerig 2009, 2010; Lawyer 2006; McCabe 2002; Taylor 2008; Wood Outside-Inside_-_The_Violation_of_American_Girls_at_Home_-_On_ the_Streets_-_and_in_the_Juvenile_Justice_System_by_Leslie_Aco- 2002; Yoshinaga 2004). 36. Other forms of abuse occurred in less disproportionate rates. Baglivio, ca.pdf. note 31, at 4. 25. Id . at 567. supra Chaos And Trauma In The Lives 37. Kerig, supra note 4, at 134. 26. Patricia Chamberlain & Kevin J. Moore, See Of Adolescent Females With Antisocial Behavior And Delinquency , 6 38. Trauma Histories Among Justice-In- Carly B. Dierkhising et al., ournal J 1, 79, at 92 (2002). rauMa t and , , M altreatMent a of volved Youth: Findings from the National Child Traumatic Stress Net- ggression note 23, at 32. http://www. available at (Jul. 2013), sychotrauMatology . J. P ur e d , 4 27. work ana D. Dehart , supra 28. ejpt.net/index.php/ejpt to http://www.ncbi.nlm.nih.gov/pmc/articles/ note 24, at 567. supra Acoca, PMC3714673/ (last visited May 18 2015); Selby M. Conrad, Nicole note 26, at 92. supra Chamberlain, 29. 30. Placella, Marina Tolou-Shams, Christie J. Rizzo, and Larry K. Brown, Mary C. Marsiglio, Krista M. Chronister, Brandon Gibson & Leslie D. Examining the Link Between Traumatic Events and Delinquency Leve, Gender Differences in Recidivism Rates for Juvenile Justice Youth: The note 4, at 310. supra , Impact of Sexual Abuse . 7 Among Juvenile Delinquent Girls: A Longitudinal Study and J. c hild

39 endnotes 54. Jennie L. Shufelt & Joseph J. Cocozza et al ., us d eP ’ t of J ustice , o ffice of J , J Robert L. Listenbee 39. r ., , n at ’ l c tr . for M ental h ealth & ustice J P rograMs , o ffice of J uvenile J ustice & d elinquency P revention , r ePort of ustice J uvenile J the in isorders d ealth h ental M With outh , y ustice J uvenile the avail- 4 (June 2006), tudy s revalence P tate -s ulti M e froM esults : r ysteM s xPosed to v iolence a a ttorney g eneral ’ s n ational t ask f orce o n c hildren able at 21 (Dec. 12, 2012), available at http://www.justice.gov/defendingc- http://www.ncmhjj.com/wp-content/uploads/2013/07/7.-Prev- hildhood/cev-rpt-full.pdf.(“The vast majority of children involved in the alenceRPB.pdf. note 4, at 45 (citing Costello 2003, 2006). supra juvenile justice system have survived exposure to violence and are Anderson, 55. Id. living with the trauma of those experiences.”). 56. Smith, supra note 20, at 350; see also Anderson, Girls in the Juvenile , herson P c s. M arla & k edlak J. s ndrea a 57. us d 40. eP ’ t of J ustice , o ffice of J J e - Justice System: The Causes and Correlates of Girls’ Involvement , revention P elinquency & d ustice d uvenile , in of ffice , o J ustice P rograMs froM the s urvey of y outh in r esidential and eeds s n s ’ outh y linquent g irls : c ontexts , r elationshiPs , and a daPtation , supra note, 4 at 44. ervices : f indings 8 (Apr. 2010), Conrad, supra note 4, at 309-10. P laceMent 41. available at https://www.ncjrs.gov/pdffiles1/ ojjdp/227728.pdf. (“Childhood sexual abuse (CSA) is a potent risk factor for delinquen- 42. Id. 58. cy and subsequent juvenile justice involvement, especially for young Emily G. Marston et al., Dealing with Double Jeopardy: Mental Health in , Disorders Among Girls in the Juvenile Justice System d elinquent women (Chesney–Lind, 1997; Gavazzi et al., 2006; Hubbard & Pratt, a and , elationshiPs , r ontexts : c irls note 4, at 44. g 2002)”); see also Anderson, supra note 4, at 106 (citing supra , daPtation J and , c oal ffenses o . for J uvenile tatus ustice , sos P roJect g irls , s Acoca (1999), Vermeiren (2006)). 43. See note 57, at 2 (Apr. 2010), supra , edlak s eed for a l ess P and M ore e MPoWering a PProach , supra unitive note the n https://www.ncjrs. available at 59. gov/pdffiles1/ojjdp/227728.pdf; s arah h ockenberry , M elissa 19, at 3. see also & nthony s ladky , n at ickMund l c tr . Tip Sheet: Warning Signs of Possible Sexual Abuse in a Child’s Behav- a 44. s for J uv . J ustice , s ervice P rovisions ’ s by acilities f Perated o and ublicly P oW n it toP s , iors nlocked u and ocked l of uMber n by ! , http://www.stopitnow.org/ohc-content/tip-sheet-7 , tate (last visited May 25, 2015). available at http://www.ojjdp.gov/pubs/241134.pdf. 2010 (2013), 45. n at ’ l c oal . 1 (June 2008), the h oMeless , f act s heet : h oMeless y outh (analysis of OJJDP’s Juveniles in Residential Facility Census (2010)). for s edlak , supra note 57, at 8. 60. See available at http://www.nationalhomeless.org/factsheets/youth.pdf (cit- ing US Dep’t of Health & Human Servs., National Evaluation of Runaway . at 9. Id 61. c ducate , elinquency & d riMe c on ouncil ncarcerate l ’ at , n coca a eslie l 62. ? and Homeless Youth (1997)). i or e 37 c ountry 45 (Nov. 2000), ysteMs s ustice J uvenile J uval d and lorida f n i irls g 46. Kerig, supra note 4, at 121 (citing R. Dembo et al., Gender Differences - http://leslieacoca.org/images/Educate_or_Incarcer available at in Service Needs Among Youth Entering a Juvenile Assessment Center: , 2 191, 121 (1995)). ate_-_Girls_in_the_Florida_and_Duval_County_Juvenile_Justice_Sys- A Replication Study ealthcare J. c orr . h tems_by_Leslie_Acoca.pdf; Patricia Chamberlain, Leslie D. Leve & 47. Anderson, supra note 4, at 44 (citing Dixon 2004, Breslau 1991; Cauff- Multidimensional Treatment Foster Care for Girls in David S. DeGarmo, man 1998; Hoyt and Scherer 1998; Rivera and Widon 1990)). 48. , 75 Juvenile Justice: Two-Year Follow up of a Randomized Clinical Trial Marianne Hennessey, Julian D. Ford, Karen Mahoney, Susan J. Ko & . sychol P linical & c onsulting J. c a http:// available at 1, 192-193 (2007), Christine Siegfried , n at ’ l c hild t rauMatic s tress n etWork , t rauMa Mong the www.ncbi.nlm.nih.gov/pmc/articles/PMC1995088/. uvenile J ustice s g irls in ysteM 4 (2004), available at http://www. J nctsn.org/nctsn_assets/pdfs/edu_materials/trauma_among_girls_in_ 63. Pregnancy David C.R. Kerr, Leslie D. Leve, & Patricia Chamberlain, jjsys.pdf. Rates Among Juvenile Justice Girls in Two RCTS of Multidimensional ontexts : c irls g elinquent d . E.g , 77 J. Consulting & Clinical Psychol. 3, 588 49. Treatment Foster Care note supra , daPtation a and elationshiPs r J of us d eP ’ t P rograMs , 4.; Margaret Zahn et al., (June 2009). of J ustice , o ffice ustice & d elinquency P revention , c auses and a orrelates & avoira r aWanda , l atino P anessa v See 64. ngela o ffice of J uvenile riMe c on ouncil c l ’ at , n olf W J ustice c irls elinquency (Apr. 2010), available at https://www.ncjrs.gov/ in the g of and d elinquency , a r allying d ry for c hange : c harting a n eW d irection c esPonse r s ’ lorida f of tate s ustice J uvenile 51 (July ysteM s J pdffiles1/ojjdp/226358.pdf. the in irls g to available at 2006), , Justice for Girls: Are We Making Progress Francine T. Sherman, See 50. http://www.nccdglobal.org/sites/default/files/publi- ev 1584, 1602-1612 (2012), available at http://lawdigi- cation_pdf/cry-for-change.pdf (finding that approximately one-third of 59 ucla l. r talcommons.bc.edu/cgi/viewcontent.cgi?article=1870&context=lsfp; their sample experienced a pregnancy); Cindy S. Lederman, Gayle A. See also s st r tate Dakof, Maria A. Larrea, & Hua Li, Characteristics of Adolescent Female u ePort r aPPing , J ysteMs s esPonse l ’ nt i oPe h hared s M 14 (2015), http://issuu.com/julianbach/docs/just_re- in Juvenile Detention , 27 i nt 321, 326 (2004) (find- sychiatry available at l ’ . J.l. & P ing that 32 percent of their sample had ever been pregnant); R. Alan sponse_mapping_report_digita?e=5039581/12008488 (“States Williams, & Helen M. Hollis, Health Beliefs and Reported Symptoms assert several reasons for considering alternatives to immunity laws. dolescent a 24 J. Among a Sample of Incarcerated Adolescent Females Many feel they do not have safe placement alternatives to detention. In , 1, 21, 24 (1999) (finding that 37 percent had been pregnant); states where child protective services is unable to investigate juvenile h ealth sex trafficking because laws bringing these cases within their mandate Leslie Acoca, Are Those Cookies for Me or My Baby? Understanding J are not in place, a juvenile justice response may be the only system Detained and Incarcerated Teen Mothers and Their Children , 55 uv . option available to intervene in the minor’s exploitation. In states that 65, 67 (2004) (finding that in a study of 1,000 girls in & f aM . Ct . J. employ a diversion response, the option to charge trafficked children California, 29 percent had been pregnant at least once; 16 percent with delinquency for prostitution offenses allows the court to mandate were pregnant while incarcerated; the average age of delivery was - 14; 23 percent had a miscarriage and 29 percent had been placed in participation in a trauma-informed diversion program that may encour physical restraints). age victims overcoming trauma bonds to be more cooperative in their treatment plan. However, while detention may guarantee separation 65. Jennie G. Noll & Chad E. Shenk, Teen Birth Rates in Sexually , 131 P from traffickers, it does not necessarily guarantee safety and rarely ediatrics 4, 1181, 1185 (Apr. Abused and Neglected Females http://pediatrics.aappublications.org/content/ offers trauma-informed services.”) 2013), available at early/2013/03/18/peds.2012-3072.full.pdf+html (“The current set supra note 48, at 4. , ennessey h 51. Id. 52. of results indicates that maltreatment, specifically sexual abuse and See note 4, at 120, 134 (“One reason to hypothesize that Kerig, supra neglect during adolescence, significantly increased the risk of teen 53. PTSD is differentially related to girls’ delinquency is that PTSD, in gen- childbirth by 2.74-fold and 3.14-fold, respectively.”). eral, is a gender-linked disorder. Across samples and ages, a well-rep- - 66. t he n at ’ l c rittenton f ound ., s uMMary of r esults : c rittenton a dverse c hild licated finding is that women and girls are more likely to be diagnosed hood e xPeriences (ace) P ilot 6 (Oct. 24, 2012), available at http://www. nationalcrittenton.org/wp-content/uploads/2015/03/ACEresults.pdf. with PTSD than men and boys, even in the context of exposure to the same traumatic event (citing Tolin and Foa (2006).”).

40 endnotes 78. P rison r aPe e liMination a ct J uvenile f acility s tandards , 28 C.F.R. § 115.382 See Am. Acad. of Pediatrics, Comm. on Adolescence, 67. Policy Statement: ediatrics (2012) (Access to emergency medical and mental health services); 28 P , 128 Health Care for Youth in the Juvenile Justice System C.F.R. § 115.383. (Ongoing medical and mental health care for sexual http://pediatrics.aappublications. available at 1219, 1223 (2011), org/content/128/6/1219.full.pdf+html; Catherine A. Gallagher, Adam abuse victims and abusers). 79. Prison Rape Elimination Act, 42 USC. § 15603(a)(1) (2012) (“The A National Overview of Reproductive Health Dobrin, & Anne S Douds, Care Services for Girls in Juvenile Justice Residential Facilities Bureau of Justice Statistics of the Department of Justice shall carry out, , 17 oll ealth i ’ oMen W ssues h 217 (2007); On shackling, see for each calendar year, a comprehensive statistical review and analysis M of . a . c s PREA Essentials: g bstetricians nderserved u for are c o see also of the incidence and effects of prison rape.”); ealth h on oMMittee , c ynecologists and ostP artuM i ncarcerated W oMen W , http://www. enter c esource Prea r ational n , Data Collection and Review oMen , h ealth care for P regnant and P . n prearesourcecenter.org/training-technical-assistance/prea-essentials and a dolescent reaff’d . 511, at 3 (Nov. 2011, o f P oMM , c eMales . o (last visited May 25, 2015). 2013), available at http://www.acog.org/-/media/Committee-Opinions/ ational c n , Audit and Compliance 80. Committee-on-Health-Care-for-Underserved-Women/co511.pdf?d- esource Prea r enter , http://www. prearesourcecenter.org/faq/audit-and-compliance (Last Updated Mar. mc=1&ts=20150526T0232572323 (“Despite progress, 36 states and the Immigration and Customs Enforcement agency of the Department 14, 2013). Frequently Asked Questions , n at ’ l Prea r esource 81. enter , “Is there of Homeland Security, which detains individuals who are in violation c See a limit to the number of years that a state can submit an Assurance of civil immigration laws pending deportation, fail to limit the use of without a reduction in Department of Justice (DOJ) grant funding?”, restraints on pregnant women during transportation, labor and delivery, http://www.prearesourcecenter.org/faq#n2233 (Last available at and postpartum recuperation.”). uvenile J or f edicaid ., M egs l tate s of onference c l ’ n nvolved -i ustice at J 68. updated May 16, 2014) (“During the initial three year audit cycle, which c hildren : J uvenile J ustice g uidebook for l egislatures 7, available at http:// ends on August 19, 2016, DOJ is not imposing a specific date by which www.ncsl.org/documents/cj/jjguidebook-medicaid.pdf. states that submit Assurances throughout that audit cycle must come Are Those Cookies for Me or My Baby? Understanding Leslie Acoca, 69. into compliance with the National PREA Standards or face a reduction Detained and Incarcerated Teen Mothers and Their Children supra note , in DOJ grant funding. If necessary, additional guidance will be provided 64, at 68-72. by DOJ as the end of the initial three year audit cycle approaches.”). s ervice nforMed -i rauMa t a nvisioning e Maxine Harris & Roger D. Fallot, 70. 82. Frequently Asked Questions: Applicability of Standards to Individual 38 s t ysteM : a v ital , http://www. enter c esource Prea r l ’ at n ervice s P aradigM s hift , in u sing rauMa t heory to d esign Settings , (Items 6 and 7), prearesourcecenter.org/faq (Item 6 Last Updated Jul. 9, 2013) (Item 7 s ysteMs 3, 3 (Maxine Harris & Roger D. Fallot, eds., 2001). Last Updated Feb. 7, 2013). 71. t ex . c riMinal J ustice c oal ., g irls ustice J uvenile J exas t the in xPeriences ’ e Can Better Mental ysteM 5 (Oct. 2012), available at http://www.texascjc.org/sites/ E. Michael Foster, Amir Qaseem & Tim Connor, See 83. s default/files/uploads/Girls%20Experiences%20in%20the%20TX%20 Health Services Reduce the Risk of Juvenile Justice System Involve- M ealth ment? 94 859 (2004); Stephen P. Becker, Patricia K. . h ub . J. P a JJ%20System%20%28Oct%202012%29.pdf. Girls in the Juvenile Justice System: Kerig, Ji-Young Lim & Rebecca N. Ezechukwu, Predictors of Recidivism Stephanie Hawkins Anderson, 72. The Causes and Correlates of Girls’ Involvement : among Delinquent Youth: Interrelations Among Ethnicity, Gender, Age, in d , elinquent g irls ontexts , r elationshiPs , and a daPtation , supra note 4, at 44 (“Girls tend hild J. c , 5 Mental Health Problems, and Posttraumatic Stress & a doles - c see also coca supra note 62, at 45. a , 2, 145 (2012); rauMa t cent to endure more trauma internally (e.g. depression, suicidal ideation/ behaviors, disordered eating) before they respond overtly”) (internal Patricia Chamberlain, Leslie D. Leve & David S. DeGarmo, Multidimen- 84. citations omitted)). sional Treatment Foster Care for Girls in the Juvenile Justice System: supra h ennessey , note 48, at 5. 73. 2-Year Follow-up of a Randomized Clinical Trial , supra note 62, at 190. 74. s tress n etWork , k. k & J ulian d. f ord , n at ’ l c hild t 85. Mana Golzari, Cynthia J. Mollen & Leslie Acoca, The Girls’ Health rauMatic erig atricia Id .; P Screen Pilot Study: A Screening Instrument for Girls in the Juvenile rauMa available at 7 (2014), a Mong g irls t in the J uvenile J ustice s ysteM oc http://www.nctsn.org/sites/default/files/assets/pdfs/trauma_among_ Detention System 480-483 (2014); ork . W , 11 s ased -b vidence J. e J , g irls h ealth The Girls Health Screen and Leslie Acoca, ustice i nstitute , girls_in_the_jj_system_2014.pdf. available at http://www.girlshealthandjustice.org/programs/girls- 75. For analysis of substantiated cases of sexual assault in juvenile excen l and coca a see also health-screen/ (last visited May 25, 2015); nyder & M elissa s ickMund , us d eP t of ’ justice facilities see h oW ard n. s , eveloPMent uvenile of the d available (2009), ePort r echnical : t creen s elinquency & d ustice J J of ffice , o rograMs P ustice J of ffice , o ustice J g irls ’ h ealth o uvenile , J revention P http://stoneleighfoundation.org/sites/default/files/GHS2%20Techni- at http://www. available at (2006), ictiMs v and ffenders ojjdp.gov/ojstatbb/nr2006/downloads/chapter7.pdf; For survey data on cal%20Report%20For%20Web.pdf. a llen b eck , d sexual assault in juvenile justice facilities see c antor , 86. The screen, which takes between 11 and 13 minutes to administer, avid can identify health conditions that typical intake exams may miss, as h artge , & ohn t iM s Mith , us d eP ’ t of J ustice , o ffice of J ustice P rograMs , J s J of ureau b tatistics , s exual v ictiMization in J uvenile ustice acilities r ePorted it is administered privately via a computerized questionnaire, written f y out h 2012 (June 2013), available at http://www.bjs.gov/content/ at a fourth grade reading level, and available in English and Spanish. by pub/pdf/svjfry12.pdf. Girls may also choose to have the questions read to them through . P olicy f ound ., k ids d oing t iMe for headphones. Based on a triage model, the screen identifies health 76. M ark l evin & d erek c ohen , t ex . P ub the o hat ’ s not a c riMe : W needs according to a color-coded urgency scale, which allows medical ver -i ncarceration of s tatus -o ffenders 2 (Mar. file:///C:/Users/MaheenKaleem/Downloads/ 2014), available at providers to quickly and easily pinpoint urgent conditions requiring immediate treatment, such active suicidal ideation, lack of required Kids_Doing_Time_for_Whats_Not_a_Crime__The_OverIncarcera- medication, or incidents of sexual assault experienced just before tion_of_Status_Offenders.pdf (“This stemmed from the overuse of in- entering the facility. All girls receive physical exams and referrals when carceration to handle nonviolent, minor offenses like running away and and ustice J truancy. Such punishments have proven to be costlier than alternatives, h irls g , Girls Health Screen concerns are identified. ealth a eslie l ; note 85 are largely ineffective at (and, in some cases, counterproductive to) nitiative , supra , i leet f an v Manda a & tePhens s essica , J coca overage uvenile enhancing public safety, and are detrimental to the youth’s develop- t he k aiser f aMily f ound ., h ealth c and c are for y outh in the J J ustice , sos P roJect J irls , s tatus o ffenses s ysteM : t he r ole of M , edicaid and chiP 11 (May 2014), available ustice ment.”); See c oal . for J uvenile g a ess P unitive and M ore e MPoWering a PProach , supra note http://kaiserfamilyfoundation.files.wordpress.com/2014/05/8591- at n the and l for eed health-coverage-and-care-for-youth-in-the-juvenile-justice-system.pdf. 19, at 3 (“Girls are being incarcerated for their own protection, not a , coca note 86, at 11. 87. because of any safety threat they pose to the community.”). supra 88. Id. 77. at 5. , 28 C.F.R. rison r aPe e liMination a P (Prea) J uvenile f acility s tandards ct § 115.381 (2012) Medical and mental health screenings; history of sexual abuse.

41 endnotes 4) implement special enrollment procedures, such as by requir - 89. Am. Acad. of Pediatrics, Comm. on Adolescence, See Policy Statement: ing juvenile justice staff to fill out Medicaid applications for every note 67, at Health Care for Youth in the Juvenile Justice System supra youth leaving custody. 1228. Telephone Interview with Educational Advocate (Jan. 27, 2015). 98. . at 1231-1232; 90. Anita G. Hufft, Id See also Supporting Psychosocial 99. . J. Adaptation for the Pregnant Adolescent in Corrections 29 Mcn a M , z ahn , supra note 15, at 12. to P revent t een urs t he n at ’ M l c aMP aign 100. n at ’ atern n . l W oMen ’ s l aW c tr 122-127 (2004); hild ., t and arassMent ix: h itle t of eneration g . c ext n he P b ased on s ex 2 (June 2012), available at http://www.nwlc.org/ , otential P oWer b dolescent a for aign aMP c eorgia & g regnancy P nPlanned & u ullying to P revent h n ’ ss . a M a sites/default/files/pdfs/nwlcharassbullying_titleixfactsheet.pdf; elP M e to s ucceed : a g uide for s uPPorting y outh in f oster c are niv u of ., h t een P regnancy , exual s and , easing , t ullying : b Ways all h ostile available at http://thenationalcampaign.org/sites/de- ound . f duc e oMen . W h in s chool 37-38 (2001), available at http://www.aauw.org/ fault/files/resource-primary-download/help-me-succeed.pdf. arassMent . 91. n at ’ l c oMM ’ n for c orr . h ealth c are , s tandards files/2013/02/hostile-hallways-bullying-teasing-and-sexual-harass- uvenile J in ervs s ealth h for oMM etention onfineMent f acilities (2004); n at ’ l c & c ’ n on c orr . h ealth ment-in-school.pdf (On student’s self-reported reactions to the high d . in J ails (2008); n at ’ l c oMM ’ n on c orr . prevalence of sexual harassment in school). c are , s tandards for h ealth s ervs h for available at (2008), risons P in . ervs s ealth tandards , s are c ealth h 101. Rebecca Chance, A Demand for Justice in Norman OK After Three . oll . c M a http://www.ncchc.org/standards-resources; on shackling, see Students Were Raped and Bullied Out of School , t he f lounce , (Dec. 4, , c oMMittee on h ealth c are for u nder - of o bstetricians and g ynecologists 2014), http://theflounce.com/demand-justice-norman-ok-three-stu- W for P regnant & P ostP artuM i ncarcerated oMen & care served W oMen , h ealth dents-raped-bullied-school/. note 67, at 3. supra , eMales f a dolescent Hundreds of Students Protest Norman High School Over Rebecca Klein, 102. , s tate s tandards for P regnancy -r elated h ealth ivil 92. a (Nov. 24, 2014),http:// ost P uffington h M . c l iberties u nion Alleged Bullying of Rape Victims , www.huffingtonpost.com/2014/11/24/norman-high-school- c are and a bortion for W oMen in P rison , available at https://www.aclu. - org/maps/state-standards-pregnancy-related-health-care-and-abor protest_n_6214222.html. 103. u See generally a M . a ss ’ n tion-women-prison-map#NATstandards (last visited May 25, 2015); of niv . W oMen e duc . f ound ., h ostile h all Ways : d etention see lternatives i asey nitiative , a g uide to a f e. c nnie ound ., J uvenile b ullying , t easing , and s exual h arassMent in s chool , supra note 100; a uvenile J enters c , Sexual Violence Prevention Strategies also d ontrol c isease d for (2014), ssessMent a acility f etention d uvenile : J eforM r etention and available at http://www.aecf.org/m/resourcedoc/aecf-juveniledetention- , http://www.cdc.gov/violenceprevention/sexualviolence/ revention P 39 prevention.html (last visited May 30, 2015). facilityassessment-2014.pdf#page=103. 104. 93. a M . c oll . of o bstetricians Zero-tolerance policies refer to school disciplinary policies that assign and g ynecologists , c oMMittee on h ealth c are for artuM regnant P for care specific, predetermined punishments to certain behaviors regardless of ncarcerated i ostP & P u nderserved W oMen , h ealth the context in which the behavior occurred. Advocates have criticized W oMen & a dolescent f eMales , c oMM . o P . n o . 511, supra note 67; a nnie ound uide e. c asey f ., J uvenile uvenile J to these policies for being overly harsh reactions to student misbehavior , a g nitiative i lternatives a etention d supra d uvenile r eforM : J etention f acility a ssessMent , etention note 92, that have not necessarily resulted in deterrence or reduction in violent d egan & M occanfuso b hristoPher c or illegal activity on school campuses. at 175. uhfeld k a 1-2 olerance t ero z to Christie J. Rizzo Marina Tolou-Shams, Nicole Placella, Selby M. Conrad, 94. lternatives onPunitive , n ased -b vidence , e & Larry K. Brown, (Mar. 2011), available at http://www.childtrends.org/wp-content/up- Gender Differences in Recidivism Rates for Juvenile Justice Youth: The Impact of Sexual Abuse supra note 4, at 309-310. , loads/2011/03/Child_Trends-2011_03_01_RB_AltToZeroTolerance. in d elinquent g irls : c ontexts , r elationshiPs , 95. See Emily G. Marston et al ., pdf. . s ePort r inal , f orce f ask t chool ll and a daPtation , supra 105. i note, at 114 (“Collaboration between juvenile tate b d . of e duc . e nsuring s uccess in s sseMbly a http:// available at 32 (June 2010), eneral g justice and community mental health systems may be a necessity, in to the i llinois order to supply sufficient numbers of clinical professionals who can povertylaw.org/sites/default/files/webfiles/final-essa-task-force-report- effectively address the treatment needs of incarcerated adolescent with-appendix%20(1).pdf. 106. Hearing: Innocence for Sale: Domestic Minor Sex Trafficking, Before the female populations . . . [T]o maintain treatment gains made in the juvenile justice facility, empirically supported aftercare programs are Subcomm. On Crime, Terrorism, Homeland Sec., and Investigations, necessary to facilitate these high-risk adolescent females’ successful H. Comm. On the Judiciary , 113th Cong. (Mar. 26, 2014) (testimony reentry into the community.”). by Withelma “T” Ortiz Walker Pettigrew), available at (http://judiciary. 42 U.S.C. § 1396d(h)(1) (2012). 96. house.gov/_cache/files/2ad6a4b5-09d7-41c1-90dd-44dec1dbfc69/ The MacArthur Foundation has outlined several strategies states can ortiz-pettigrew-testimony.pdf. 97. & M elissa s noW , s hared h oPe employ to accomplish this goal. s arabeth z eMel , k iMM M ooney , d iane J us - See l inda s Mith , s aMantha v ardaMan 107. . s ’ Merica : a rafficking t ex s hild c oMestic d on ePort r l cad a l ’ at ., n ound f rthur a ac t. M atharine c and ohn , J audouin b atie & k tice ’ at n he , t nternational i tate for http://sharedhope.org/ available at 30-32 (2009), hildren c rostituted P s h uvenile J for overage c ealth h to ccess a acilitating , f olicy P ealth J ustice i nvolved y outh 7 (Dec. 2013), available at http://www.nashp.org/ wp-content/uploads/2012/09/SHI_National_Report_on_DMST_2009. pdf; M elissa f sites/default/files/Facilitating_Access_to_Health_Care_Coverage.pdf. , P rostitution , t rafficking , and c ultural a Mnesia : W hat W e arley s of usiness b the For example, states may do the following: unning r xPloitation e exual M ust n ot k noW in o rder t o k eeP 1) suspend, rather than terminate, Medicaid eligibility to enable http://www.prostitutionresearch. available at 102-103 (2006), s Moothly com/Farley%202006%20-%20Prosituttion,%20Trafficking%20 coverage to be reinstated as quickly as possible on release from and%20Cultural%20Amnesia.pdf; Victims of sexual abuse are also a juvenile justice facility; 2) implement “continuous eligibility,” which allows children who 28 times more likely to be arrested for prostitution as adults than enter and leave a juvenile detention facility within a 12-month their peers. Francine T. Sherman & Lisa Goldblatt Grace, The System Response to the Commercial Sexual Exploitation of Girls , in J uvenile period to maintain eligibility upon reentry into the community; olicy J : a dvancing r esearch , P ustice and P ractice 336 (Francine T. Sherman 3) adopt a policy of “presumptive eligibility,” which permits qualified providers to make temporary eligibility determinations of t & Francine H. Jacobs eds., 2011) (citing c athy s Patz W idoM , us d eP ’ c exual J ustice , o ffice of J ustice P rograMs , v ictiMs of for Medicaid before a final determination has been made by the hildhood s — a buse c Medicaid agency thereby enabling youth to immediately access ater c riMinal l onsequences 5 (March 1995), available at https://ncjrs. gov/pdffiles/abuse.pdf.). health services without waiting for official approval; or 108. Francine T. Sherman, Justice for Girls, Are We Making Progress? , supra note 50, at 1611 (2012). If an adult engages in sexual activity with

42 endnotes 121. someone under the statutorily defined age of consent, it is considered h ockenberry , supra note 120, at 12, 71 (“Males were involved in 72% statutory rape. In most states, the age of consent is at least 16. of the delinquency cases handled by juvenile courts in 2011”) and g lobal onsent of M arriage and s ex for the 50 71(“Males accounted for 59% of the total petitioned status offense ge a egal , l nitiative i ustice J c for nited (2011), caseload in 2011.”). u s https://globaljusticeinitiative.files. available at tates wordpress.com/2011/12/united-states-age-of-consent-table11.pdf. 122. Melissa Sickmund, Anthony (T.J.) Sladky, Wei Kang & Charles However, only a handful of states have legislation with provisions that Puzzanchera, US Dep’t of Justice, Nat’l Ctr. for Juvenile Justice, Easy ensure that minors are immune from prosecution for prostitution or Access to the Census of Juveniles in Residential Placement, Offense prostitution-related offenses, leaving most children vulnerable to arrests Profile of Detained Residents by Sex and Race/Ethnicity for United , J u st on prostitution or prostitution-related charges. hared oPe i s ’ l h States 2011 , available at http://www.ojjdp.gov/ojstatbb/ezacjrp/asp/ nt , supra note 50, at 11. r esPonse M aPPing r Offense_Detained.asp (In 2011, girls were only 16.2% of detained ePort urvey er s residents, but were 36.8% of youth detained for a status offense). rotective P hild c ffecting a actors : f aWs l - s tate , s l ’ nt i oPe h s 109. hared c oMMercial s exual e xPloitation of M inors c ases (2014), Id. (In 2011, girls were only 12.3% of total number of juveniles commit- 123. vices i nvolveMent in http://sharedhope.org/wp-content/uploads/2014/06/ available at ted to residential placements, but they were 40.3% of youth committed Shared-Hope-State-law-survey_CPSInvolvement_through-8.1.pdf. for a status offense). rvine i ngela a , & endel a. M ichard , r herMan t. s or . f dMin ., a ervs s uMan h and aMilies ealth h of t ’ eP s d ; U Id. 110. & f , hildren c , 124. Id . at 3-4. See also f rancine , s tate s tatutes : c urrent t hrough J une for g irls : a g uide W eforM r ork etention d aking ., M ound f asey e. c nnie hild W elfare i nforMation g ateW ay c a 2, available at https://www.childwelfare.gov/pubPDFs/define. to J uvenile d etention r eforM 2014 supra ., duc e of t ’ eP us d note 5, at 11-12; , t uMan , h tudents s ealthy h and afe s of ffice o pdf (Seven states define human trafficking as a form of sexual abuse chools s s ’ Merica a in rafficking 5-8 (2015), available at in their child welfare laws and four states define human trafficking as a https://safesupportivelearning.ed.gov/sites/ of eP t us d default/files/HumanTraffickinginAmericasSchools.pdf; ’ e duc ., form of physical abuse). http://files.eric.ed.gov/ available at , chools s ree -f rug d and afe s of ffice o iscussion : a d toP s raffic , t rograMs P aMily f about asey & c l ’ nt i oPe h hared 111. s reventing J uvenile s ex fulltext/ED498514.pdf (2007). t rafficking c hild W elfare and J udicial s trategies for P 125. l s ue b urrell , n at ’ c tr . for c hild and t rauMatic s tress , t rauMa and the e nvi - and h elPing i ts s urvivors 18-21 (2014), available at http://sharedhope. i 3 (2013), http://www. of c are org/wp-content/uploads/2014/08/Traffic-Stop-FINAL.pdf. nstitutions available at uvenile J in ronMent 112. Hearing: Innocence for Sale: Domestic Minor Sex Trafficking, Before the njjn.org/uploads/digital-library/NCTSN_trauma-and-environment-of-ju- 40 Subcomm. On Crime, Terrorism, Homeland Sec., and Investigations, venile-care-institutions_Sue-Burrell_September-2013.pdf. era H. Comm. On the Judiciary n , 113th Cong. (Mar. 26, 2014) (testimony 126. h ockenberry , supra note 120, at 71; See also , s ydney M c k inney - i , v c of J ustice , s tatus o ffense r eforM stitute enter , r una Way y outh : a r esearch by Withelma “T” Ortiz Walker Pettigrew), supra note 106 (“Like me, b any youth in foster care becomes accustomed to adapting to multiple 1-2 (May 28, 2014), available a rief t http://www.statusoffensereform. org/wp-content/uploads/2014/05/Running-Away_Final.pdf. moves from home to home which allows us to easily then adapt when ffense o tatus , s ustice J of nstitute i , v inney k c M ydney s 127. era , enter c eforM r traffickers/pimps/exploiters move us multiple times, from hotel to hotel, esearch r Way y outh : a r una b rief , supra note 126 at 1-2. city to city, and/or state to state. For myself, as unfortunate as it is to 128. Francine T. Sherman, supra say, the most consistent relationship I ever had in care was with my Justice for Girls: Are We Making Progress ?, note 50, at 12 (“In 2009, girls made up 55 percent of youth arrested pimp and his family.”). c ate W alker , c alifornia c hild 113. elfare k ouncil , e nding the c oMMercial for running away; prostitution was the only other crime for which girls W xPloitation of c hildren : a c all for a M ultisysteM c ollaboration in note 119, at 1. supra made up the majority of arrests.”); alifornia e c ’ s available at 18-19 (2013), 129. J ody M. g reene , et al ., us d eP http://www.youthlaw.org/fileadmin/ncyl/ t of h ealth and h uMan ervs ., a dMin . o n youthlaw/publications/Ending-CSEC-A-Call-for-Multi-System_Collabo- oMeless h : dolescents a buse Mong c hildren , y outh , and f aMilies , s exual a a , ration-in-CA.pdf. http:// P revalence , c orrelates available at and s equelae ES-2 (2002), www.acf.hhs.gov/sites/default/files/opre/sex_abuse_hmless.pdf; 114. Preventing Sex Trafficking and Strengthening Families Act, P.L. 113- Kimberly A. Tyler, Dan R. Hoyt & Les B. Whitbeck, 183 (2014). The Effects of Early 22 U.S. C. § 7102(9)(A) (2015). 115. Sexual Abuse on Later Sexual Victimization Among Female Homeless J. i At least 28 states that have passed legislation that seeks to treat vic- 116. and Runaway Adolescents , 15 246 (Mar. nterPersonal v iolence http://digitalcommons.unl.edu/cgi/viewcontent. available at 2000), tims of domestic child sex trafficking as victims and divert them away n from the juvenile justice system. uMan ., h egs l tate s of cgi?article=1031&context=sociologyfacpub; Kimberly A. Tyler, Kellie J. onference c l ’ at Hagewen & Lisa A. Melander, Risk Factors for Running Away Among t rafficking o vervieW , http://www.ncsl.org/research/civil-and-criminal-jus- y a General Population Sample of Males and Females tice/human-trafficking-overview.aspx#Safe Harbor (last visited May outh & s oc ’ y , 43 26, 2015). At least 5 states have pending legislation. At the time of the 583, 598 (Jun. 2011); Sanna J. Thompson, Kimberly Bender & Jihye writing of this paper, at least two of the states with pending legislation Family Factors as Predictors of Depression Among Runaway Kim, s oc . W Youth: Do Males and Females Differ? 28 c hild & a dolescent have passed safe harbor bills. s hared h oPe i nt ’ l , J u st r esPonse M aPPing ork 35, 44-45 (2011). note 50, at 8. r ePort , supra , eforM r http://shared- o tatus , s ustice J of nstitute i era available at 4 (2014), ustice J eManding , d l ’ nt i enter oPe h hared s , v inney k c M ydney s 130. ffense c 117. : a r supra hope.org/wp-content/uploads/2014/08/Demanding_Justice_Re- note 126, at 2. , rief b esearch r outh y Way una Lisa Thrane, Kevin Yoder & Xiaojin Chen, port_2014.pdf. 131. The Influence of Running 118. 18 U.S. C. § 1591 (2012). Indeed, the courts have held that “[t]he , 26 Away on the Risk of Female Sexual Assault in the Subsequent Year iolence unambiguous text of §1591 makes no distinction between suppliers v & v ictiMs 825 (2011). for . tr c l ’ at and purchasers of commercial sex acts with children.” United States v. s , , n ustice J uvenile J 132. uzzanchera arah h ockenberry & c harles P stiMates Jungers, 702 F.3d 1066, 1072 (8th Cir. 2013). tatistics 2011, c haPter 4: n ational e s of P etitioned J uvenile c ourt ases c ffense o tatus s , tatus s uvenile ., J duc . e ub P for . iv d n ’ ss a ar . b M , a endall r. k essica J note 120, at 81, 85. 119. supra See 42 U.S.C. §§ 5633(a)(11)-(13), (22) (2012). ffenses : t reatMent and e arly i ntervention o echnical a ssistance b ulletin n o . 133. , t eautho r uPPorting s esolution , r udges f . J t . c aM and http://www.americanbar.org/content/dam/ available at 29, 1 (2007), . uv J of ouncil c l ’ at n 134. - , http:// rization of JJdP a ct aba/migrated/publiced/tab29.authcheckdam.pdf. and e liMination of vco e xcePtion available at www.ncjfcj.org/sites/default/files/vcoresolution3-10.pdf; arah ockenberry & c harles h P uzzanchera , n s 120. at ’ l c tr . for J uvenile J ustice , See also e ational New Report Finds Incarceration for ‘Status Offenses’ Still Gary Gately, J uvenile c ourt s tatistics 2011, c haPter 4: n etitioned P of stiMates available at (Apr. 10, 2015), http:// s tatus o ffense c ases , 71 (2011), nforMation http://www.ncjj.org/pdf/ e xchange Widespread, J uvenile J ustice i jjie.org/new-report-finds-incarceration-for-status-offenses-still-wide- jcsreports/jcs2011.pdf.; supra s ickMund , note 8.

43 endnotes at 34 (comparing the child welfare and non-child welfare samples, the spread/108565/ (recommending against detention for status offense child welfare sample was more likely to be female, younger, African behaviors). For a history of the valid court order exception, see Barry C. Field, Violent Girls or Relabeled Status Offenders?: An Alternative American and Hispanic. Thirty seven percent of the crossover sample , 55 riMe was female, compared to 24% of non-child welfare youth). elinquency 243, 243-246 (2009). & d c Interpretation of the Data Irvine, According to the Office of Juvenile Justice and Delinquency Prevention, 135. 146. (“While 14% of gender-conforming girls in the 13 note supra us 27 states plus the District of Columbia still use the VCO exception. juvenile justice system were previously removed from their homes by P rograMs , o ffice d J uvenile J ustice & d e - eP ’ t of J ustice social workers, 40% of GNC girls were previously removed. While 6% , o ffice of J ustice of of gender-conforming girls in the juvenile justice system were placed in , http://www.ojjdp.gov/compliance/FY2013-FY%20 revention P linquency group homes because someone was hurting them, 24% of GNC girls see also c oal . for J uvenile J ustice , sos P roJect , 2014VCO-state.pdf; ational o available at 8 (2015), urvey s http://www. : a n ffenses tatus had this experience.”). s esbian , juvjustice.org/sites/default/files/resource-files/Status%20Offenses%20 : l nJustice i idden 147. , h See, e.g., k. M aJd , J. M arksaMer , and c. r eyes ay g in J uvenile c ourts 94 (Fall 2009), outh y -%20A%20National%20Survey%20-FINAL%20-%20WEB.pdf. ransgender t and isexual , b Jennifer Schwartz & Darrell Steffensmeier, Stability and Change in 136. http://www.equityproject.org/pdfs/hidden_injustice.pdf; available at Girls’ Delinquency and the Gender Gap: Trends in Violence and Alcohol Criminal-Justice and Hannah Brückner and Kathryn E. W. Himmelstein, irls Offending Across Multiple Sources of Evidence , School Sanctions Against Nonheterosexual Youth: A National Longitu- elinquent d g : in a and available at 49-57 (2011), ediatrics P elationshiPs , r ontext http://pediatrics. note 4, at 5 (“Policy shifts supra , daPtation dinal Study , 127 c toward stretched definitions of what constitutes law-violating behavior . aappublications.org/content/early/2010/12/06/peds.2009-2306.full. pdf+html (first published online on Dec. 6, 2010). . . leads to enhanced sanctioning for aggressive conduct among youth ohn J 148. a overall but even more so among girls who tend to commit the milder, there s , i hange c for odels ., M ound f rthur a ac t. M atherine d. & c M l etWeen c hild W elfare and d isProPortionate b inority c ontact in J uvenile ink less serious forms of physical attacks or threats.”) (internal citations ustice ? 2 (Dec. 2011), available at http://www.naco.org/programs/ omitted). One example of net-widening is ending the practice of J csd/Documents/Criminal%20Justice/Juvenile%20Justice%20Page/ “up-charging,” in which girls who have committed a status offense are Dual%20Status%20Youth/06%20Knowledge_Brief_Is_There_a_Link_ instead charged with misdemeanor offenses to evade the restrictions of between_Child_Welfare_and_Disproportionate_Minority_Contact_in_ the JJDPA. Barry C. Feld, Violent Girls or Relabeled Status Offenders?: Juvenile_Justice.pdf. An Alternative Interpretation of the Data , supra note 134, at 253. 41 for note 134, at 253. ractice P outh y rossover , c eforM r ustice J uvenile J . tr ., c niv u eorgetoWn g 149. 137. Feld, supra erig M http://cjjr.georgetown.edu/wp-content/ odel 138. See generally k 93 (2010), , supra note 74. available at l at ’ l c hild t rauMatic s tress n etWork & n at ’ n c ouncil 139. . t . c aM f nd . a uv J of uploads/2014/12/cypm.pdf (listing characteristics of crossover youth c udge ench , nctsn b udges J , available at J nforMed -i rauMa t the for ard and stating that two studies found that “African American youth are http://www.nctsn.org/sites/default/files/assets/pdfs/judge_bench_ overrepresented in the crossover numbers relative to the general cards_final.pdf (last visted May 27, 2015); see also Resources for population, child welfare referrals, and juvenile justice referrals”); see for & J h enise d osePh P. r u yan tr . erz J uvenile J ustice niv Justice Professionals, Law Enforcement and First Responders, For , g eorgetoWn ., c M ultisysteM a PProaches in c hild W elfare and J uvenile J ustice l ’ at n , Juvenile Justice Professionals/Law Enforcement/First Responders r eforM , b uilding xPloring , e Wain , http://www.nctsn.org/category/products/ etWork n tress s rauMatic t hild c r. s anay & J l. s ichelle M (2008); aeturn and haracteristics c t. juvenile-justice-professionalslaw-enforcementfirst-responders (last atherine d. & c ohn J (2009); ounty c laMeda a in outh y 241.1 of utcoMes o s for M ac a rthur f ound ., M odels c hange , i visited May 27, 2015). there a l ink b etWeen c hild W elfare t hild c l ’ tress at , n ord d. f ulian & J erig k. k atricia P 140. note 148, n etWork , rauMatic and d isProPortionate M inority c ontact in J uvenile J ustice ?, supra s irls g Mong a rauMa t at 3. note 74. supra , ysteM s ustice J uvenile J the in 150. J ohn d. & c atherine t. M ac a a Many children are involved in both the juvenile justice and child welfare there 141. rthur s , i hange c for odels ., M ound f hild c etWeen b ink systems; these children are known by a variety of terms, including l uvenile J in ontact c inority M isProPortionate d and elfare W J ustice ? supra note 148, at 3. “crossover,” “dual system,” “dual- involved,” or “dually-adjudicated” 151. youth. The broadest term for these children is “crossover youth,” which Patrick McCarthy, Annie E. Casey Found., The Alliance for Racial Equity in Child Welfare — Yesterday, Today and Tomorrow, in Disparities and refers to all youth who have experienced child abuse or maltreatment Disproportionality in Child Welfare: Analysis of the Research v (Dec. and engaged in delinquency, whether or not they are ever known to 2011), http://www.cssp.org/publications/child-welfare/ child protective services or the juvenile justice system According to available at that definition, “crossover youth” would encompass all children who alliance/Disparities-and-Disproportionality-in-Child-Welfare_An-Analy- al ., niv u eorgetoWn ., g sis-of-the-Research-December-2011.pdf. et erz h enise d enter the abuse-to-prison-pipeline. eeds n the ddressing , a eforM r ustice J uvenile J for . tr c erz note 141, at 17. supra , h 152. ysteM -s ulti M of y or trengthening the c onnection b etWeen c hild W elfare and J uvenile . f tr c esource r l outh ’ at n ennedy f . k obert r 153. : s J uvenile J ustice , M odels for to c r esource c tr . P’ shiP , f c onversation hange c ollaboration h oW http://cjjr.georgetown.edu/wp-content/ available at 1 (2012), . ust J roM elfare W hild c uploads/2015/03/MultiSystemYouth_March2012.pdf. MProve i to ogether t ork W an c gencies a ustice J uvenile J and d Child Welfare and Juvenile Justice: http://www. available at 3 (May 8, 2014), outh y tatus s ual Shay Bilchik & Judge Michael Nash, for utcoMes o 142. modelsforchange.net/publications/539. 17-18 Two Sides of the Same Coin, Juvenile and Family Justice Today d See e.g., 154. , v educing , r ustice J of nstitute i era oss r iMothy t & http://cjjr.georgetown.edu/pdfs/Fall%2008%20 available at (Fall 2008), onger c ylan oster NCJFCJ%20Today%20feature.pdf. roJect P of act MP i he : t ecisions d etention d uvenile J in ias b are c f the Id. supra , erz h at 17; note 141, at 2 (stating that majority are male but 143. c onfirM (June 2001), available at http://www.vera.org/sites/default/ supra the proportion of females among cross-over youth is much higher than note 141, files/resources/downloads/Foster_care_bias.pdf; h erz , at 23-24. proportion of females in general delinquency). , c , supra note 141, at 16-17. erz h 144. eforM . rossover y outh P ractice ., c niv u eorgetoWn ustice J r uvenile J for g 155. tr 145. note 149, at 4-5. Joseph P. Ryan & Denise C. Herz, Crossover Youth and Juvenile Justice supra , odel M 156. Tonya Edmond, Wendy Auslander, Diane E. Elze, Curtis McMillen & Processing in Los Angeles County, Ctr. for Families, Children & The Courts Research Update 4 (Dec. 2008), available at http://www.courts. Ron Thompson, Differences Between Sexually Abused and Non-Sex- 11 83 ually Abused Adolescent Girls in Foster Care, ca.gov/documents/AB129-CrossoverResearchUpdate.pdf. See also J. c buse hild s ex a Kerig, supra note 4, at 134; Jennifer L. Woolard, Crossing Over: Girls at (2002). Sara Goodkind, Jefferey J. Shook, Kevin H. Kim, Ryan T. Pohlig & David , the Intersection of Juvenile Justice, Criminal Justice, and Child Welfare 157. in J. Herring, From Child Welfare to Juvenile Justice: Race, Gender, and elationshiPs supra elinquent g irls : c ontext , r d , and a daPtation , note 4,

44 endnotes 173. See uvenile J ust . 249, 264. System Experiences rauMa y , 11 raining t outh t elfare W hild , c etWork n tress s rauMatic t hild c l ’ at n v iolence & J note 162. supra (2013), oolkit t (Jul. 2013) (“Analyses of placement sample indicate that congregate The Administration of Children and Families issued guidance encourag- care placement is associated with an increased likelihood of justice 174. of ealth ing states to train foster parents on child trafficking. h us d t ’ eP involvement. These analyses reveal an even more pronounced gender hildren , y outh and and aMilies (acyf), g uidance h uMan s ervs ., a dMin . f or difference with regard to its effects; congregate care doubles the c f a ddressing h uMan t to of c hildren and y outh likelihood of juvenile justice involvement for girls but has very little s tates and s ervices rafficking on s effect on that of boys.”). available at (2013), tates https://www.acf.hhs.gov/sites/ nited u the in default/files/cb/acyf_human_trafficking_guidance.pdf (last visited May Care or Madelyn Freundlich, Rosemary J. Avery & Deborah Padgett, 158. 27, 2015); Some states have instituted trainings.. For example, the Scare: The Safety of Youth in Congregate Care in New York City , 31 eglect & n Connecticut Department of Children and Families Human Anti-Traffick- a hild c 2 173, 184 (Feb. 2007). buse u eorgetoWn g see also note 141, at 20.; supra Herz, 159. ing Response Team partners with two non-profits, Love 146 and My for tr J uvenile . c . niv supra outh r eforM , c rossover P ractice M odel , ustice note 149, at 89 y Life My Choice, to host trainings for law enforcement, service providers, J group home providers, foster parents, kinship caregivers , others who (citing the absence of de-escalation techniques and procedures in con- gregate care placements and reliance on law enforcement to resolve may interact with foster youth or children vulnerable to trafficking. See , incidence; inexperienced staff; and absence of appropriate behavioral onn . d c ’ t of c hildren and esPonse r rafficking -t nti a uMan . hart (h aM f eP ) , http://www.ct.gov/dcf/cwp/view.asp?a=4743&Q=562246 eaM modification techniques for the population at hand as a possible t ove , https://love146.org/ (last visited (last visited May 11, 2015), 146 l contributor to crossover from congregate care). g eorgetoWn u niv ., c tr . for J uvenile J ust rossover eforM ractice P outh y May 11, 2015), http://www.fightingexploitation.org/ (last visited May , c . r 160. Preventing Child Sex supra 11, 2015); Supervisor Mark Ridley-Thomas, note 149, at 94. , odel M M s , Trafficking in Foster Care note 33, at 346-347. supra Baynes-Dunning & Worthington, 161. ark uPervisor idley t hoMas , c hildren and -r (Apr. 10, 2014), rafficking t uMan , c ervices s aMily f n tress s rauMatic t hild c l ’ at n ., see e.g ; Id. 162. rauMa etWork t elfare W hild , h http:// available at available at ridley-thomas.lacounty.gov/humanservices/index.php/sex-trafficking- t raining t oolkit (2013), http://www.nctsn.org/products/ (ocWtP) rograM P raining t elfare W hild child-welfare-trauma-training-toolkit-2008. hio o in-foster-care/; c available , s http://ocwtp.net/human%20trafficking%20-%20caregivers.html (last dMin , a aMilies f and hildren c f . o dMin ., a ervs . uMan h and ealth h of t ’ eP s d U 163. at t ’ eP . d enn t visited May 27, 2015); uMan o f c hildren , y outh and f aMilies , c hildren ’ s b ureau , c hild M altreatMent 2012 h of s ervs ., h uMan t rafficking s er - 42 ervice s https:// available at 29 (2013), lan P elivery d http://www.acf.hhs.gov/sites/default/ s and oordination c vices available at xi (2013), uMMary f nnie a www.tn.gov/humanserv/adfam/TDHS-2013-HT-Plan.pdf. e. c files/cb/cm2012.pdf#page=31; see asey ound ., kids count enter hild by onfirMed c re a ho W hildren , c c c ata d P rotective ervices as 175. Title IV-E emphasizes child removal and out-of-home services, rather s (2007-2011) , available at t than family preservation and in-home services, which experts have altreatMent M by altreatMent M of ictiMs yPe v http://datacenter.kidscount.org/data/tables/6222-children-who-are- shown to achieve better outcomes for children’s welfare. Title IV-B is - confirmed-by-child-protective-services-as-victims-of-maltreatment- the only federal funding source available for family preservation ser ’ t by-maltreatment-type?loc=1&loct=2#detailed/1/any/fase/867,133,3 of h ealth and h uMan s ervs l . a dMin . for c hildren & etter froM d eP vices. ervs ental aMilies , c & M buse a ubstance . & s f s edicaid & M trs . f or M 8,35,18/3885,3886,3887,3888,3889,3890,872/12951,12950 (last edicare ervs s ealth h irectors 6-7 reatMent t nforMed -i rauMa t on d edicaid M tate s updated Jun. 2014). to . 164. Blace A. Nalavanya, Scott D. Ryan, Jeanne A. Howard & Susan http://www.medicaid.gov/Federal-Poli- (Jul. 11, 2013), available at Livingston Smith, Preadoptive Child Sexual Abuse as a Predictor cy-Guidance/Downloads/SMD-13-07-11.pdf. , P ersPectives on s 176. of Moves in Care, Adoption Disruptions, and Inconsistent Adoptive M agellan h ealth s ervices c hildren ’ s ervices t ask f orce Parent Commitment r c hild a buse & n eglect 1084, 1085 (2008), esidential and c oMMunity -b ased t reatMent for y outh and , 32 f aMilies 2 (2008), http://www.mtfc.com/2008%20Magellan%20RTC%20 available at http://www.researchgate.net/profile/Blace_Nalavany/ available at aura oyd , s tate P olicy W. b dvocacy and r eforM publication/23500259_Preadoptive_child_sexual_abuse_as_a_pre- White%20Paper.pdf; l a -i rauMa , t oMPlex c for are c xcePtional : e are c oster f heraPeutic ., t tr c dictor_of_moves_in_care_adoption_disruptions_and_inconsistent_ - M c outh https://childwel- available at 10 (Jul. 2013), are adoptive_parent_commitment/links/0deec52f398c795d3c000000.pdf oster f in Pacted y faresparc.files.wordpress.com/2013/07/therapeutic-foster-care-ex- (describing the paucity of research on outcomes for children in foster care with child sexual abuse history). ceptional-care-for-complex-trauma-impacted-youth-in-foster-care.pdf supra (“When TFC is conducted according to best practices, it demonstrates 165. Edmond, note 156, at 84 (2002). positive outcomes and cost savings for this highly fragile population of 166. Id. at 83-84. , the and hildren c on . tr , aba c hite r. W Manda a & lain k va e youth.”); at 84. aW l 167. Id. hild MPleMenting i 10 (Nov. 2013), elfare W c in ractices P nforMed -i rauMa t 168. Id. at 87. supra http://childwelfaresparc.org/wp-content/uploads/2013/11/ available at 169. Nalavanya, note 164. 170. elfare W hild c nforMed -i rauMa t Implementing-Trauma-Informed-Practices.pdf. , u etWork n tress s rauMatic t hild c l ’ at n sing c eries s reakthrough b tability s laceMent P MProve i to ractice P iane , d ooney M iMM , k eMel z arabeth s 177. audouin b atie , J ohn & c ath - & k ustice J : ollaborative cad e xecutive s 1 (Jun. 2013) available at http://www.nctsn.org/sites/ uMMary arine t. M ac a rthur f ound at ’ l a . for s tate h ealth P olicy , f acilitating ., n a to h ealth c overage ccess for J uvenile J ustice i nvolved y outh , supra note default/files/assets/pdfs/using_ticwp_bsc_executivesummary.pdf. 96, at 8. 171. n icole t aylor & c hristine b. s iegfried , at ’ l c hild t rauMatic s tress n etWork , n elPing h s ysteM elfare W hild c the in hildren h ealth froM t rauMa : a s ysteMs and ealth h of t ’ eP us d 42 U.S.C. 622(b)(15)(A) (2012); Info. Mem. from 178. c dMin 1-2 (2005), Information Memo- , aMilies f and outh , y hildren c on . available at ., a ervs s uMan h i ntegration a PProach http://www.nctsn.org/ nctsn_assets/pdfs/promising_practices/A_Systems_Integration_Ap- randum, ACYF-CB-IM-11-06 (Oct. 6, 2011). . a , aMilies & f hildren c for . dMin ervs s uMan h and ealth h of t ’ eP d froM proach.pdf. etter l 179. . & s 172. See c tr . for h ealth c are s trategies , i dentifying o PPortunities to i MProve ealth h ental & M buse a ubstance ervs s edicaid & M edicare M or . f trs c u and supra , reatMent t nforMed edicaid M of nalysis a n -i : a are c ealth h ehavioral b s ’ hildren c s ervs . to s tate M edicaid d irector ’ s tilization on t rauMa http://www.chcs.org/media/Iden- available at (Dec. 2013), xPenditures e note 175. tifying-Opportunities-to-Improve-Childrens-Behavioral-Health-Care2. 180. 42 U.S.C. 1396d(r)(5) (2012). , 181. US d eP ’ t of pdf(Describing ways to improve behavioral health services for children ealth and h uMan s ervs ., c tr . f or M edicare & M edicaid s ervices h on Medicaid who, as the authors note, are often involved with juvenile ePsdt - a g uide for s tates : c overage in the M edicaid b enefit for c hildren justice and child welfare systems). and a dolescents 9 (Jun. 2014), available at http://www.medicaid.gov/

45 endnotes , About the Project , ediatrics P of http://www. cad . a M a medicaid-chip-program-information/by-topics/benefits/downloads/eps- available at . aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Medi- dt_coverage_guide.pdf; Early and Periodic Screening, Diagnostic, and and tr or Treatment edicare & ., c cal-Home-for-Children-and-Adolescents-Exposed-to-Violence/Pages/ ervs s uMan h . f ealth h of t ’ eP d . U.S. M s ervices , http://www.medicaid.gov/Medicaid-CHIP-Program-In- Medical-Home-for-Children-and-Adolescents-Exposed-to-Violence. edicaid M aspx (last visited May 27, 2015). formation/By-Topics/Benefits/Early-and-Periodic-Screening-Diagnos- . a M of a 189. tic-and-Treatment.html (last visited May 27, 2015). P ediatrics , P reventing s exual v iolence : a n e ducational t oolkit . cad . h ealth 182. l etter froM us d eP ’ t c are P rofessionals , available at http://www2.aap.org/pubserv/ for ealth h of and & hildren c for h dMin . a ervs s uMan f , supra note 175 aMilies PSVpreview/pages/tools.html (last visited May 27, 2015). , at 11 . 190. note 33, at 344 (“Federal supra Baynes-Dunning & Worthington, See 183. Wayne Turner, Early Periodic Screening and Diagnosis and Treatment dvocate (Oct. 2013), benchmarks require systems to monitor and address maltreatment that (EPSDT), Nat’l Health Law Program, 18 h ealth a occurs after youth are in the child welfare system, but the definition available at http://www.healthlaw.org/issues/child-and-adoles- of incidents that are tracked for that purpose is so limited that it does cent-health/epsdt/health-advocate-epsdt#.VWZws89Vikp. not capture the range of daily activities that girls may consider abusive Letter from Directors of US Dep’t of Health and Human Services, Ctr. for 184. towards them. Thus, systems should clearly define what actions by Medicare & Medicaid Services & Ctr. for Medicaid & CHIP Services to whom are considered incidents of “re-abuse” or repeat maltreatment State Medicaid Directors Regarding Policy Considerations for Integrated 1 Care Models (Jul. 10, 2012), http://www.medicaid.gov/ available at for purposes of federal reporting, and what actions not meeting this Federal-Policy-Guidance/downloads/SMD-12-002.pdf. definition still need to be addressed and tracked for system quality k aMala d. a llen & t aylor h endricks , c tr . f or h ealth c are s trategies , improvement.”). 185. f M edicaid https:// available at 7-9 (Mar. 2013), are c oster in hildren c and 191. supra Freundlich, note 158. childwelfaresparc.files.wordpress.com/2013/03/medicaid-and-chil- dren-in-foster-care.pdf. n uzuM , s tePhanie M ika & g eorgette l aWlor , 186. M elinda k. a braMs , r achel , r ealizing c oMMonWealth f und h ealth r t he the oW : h otential P s ’ eforM trengthen a ill W ct 8-10 are c ffordable a atients P enefit b and are c riMary P s (2011), available at http://www.commonwealthfund.org/publications/ 43 issue-briefs/2011/jan/strengthen-primary-care. 187. Id. at 10. 188. Medical Homes for Children and Adolescents Exposed to Violence:

46 This report was made possible by the generous support of The Annie E. Casey Foundation, the JPB Foundation, the Moriah Fund, and the Overbrook Foun- dation. The views expressed in this report are the authors’ alone and do not necessarily reflect the opinions of these foundations.

47

48 Published by CENTER ON PO VERTY and INEQU ALITY 600 New Jersey Avenue NW | Washington, D.C. 20001 www.law.georgetown.edu/go/poverty

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