This journal article presents a study that analyzed familial sex trafficking among a sample of 31 child welfare-involved children referred for behavioral health assessment and treatment. The mixed methods study looked at victim and trafficker characteristics, gender differences in clinical outcomes in sex-trafficked children, and geographical differences in severity of the victimization experience. The researchers found high rates of family members trafficking children for illicit drugs; high severity of abuse using the Sexual Abuse Severity Score, with higher severity of abuse for children living in rural communities; and clinical threshold level scores on the Child Behavior Checklist (CBCL) and the Trauma Symptom Checklist for Children (TSCC-A). They found boys and girls had similar clinical profiles except boys had higher CBCL externalizing scores and females had higher TSCC depression scores. In addition, more than half of the children in the sample had attempted suicide in their lifetime. This study helps expose familial sex trafficking and creates a context for further investigations. The researchers discuss implications for identification and effective responses to familial sex trafficking with a focus on gender and geography.