Child safeguarding toolkit

Child Sexual Exploitation (CSE)

Awareness of child sexual exploitation (CSE) is essential for GPs and their staff especially in the provision of contraception and sexual health services to young people who may be victims of this form of abuse. Co-existence with substance misuse is often a feature, as is an increased risk to those who have a history of adverse experiences in childhood, including interfamilial maltreatment and being in care.

The NSPCC defines CSE as:

"Child sexual exploitation (CSE) is a type of sexual abuse. Children in exploitative situations and relationships receive something such as gifts, money or affection as a result of performing sexual activities or others performing sexual activities on them."

"Children or young people may be tricked into believing they''e in a loving, consensual relationship. They might be invited to parties and given drugs and alcohol. They may also be groomed and exploited online.

"Some children and young people are trafficked into or within the UK for the purpose of sexual exploitation. Sexual exploitation can also happen to young people in gangs.

"Child sexual exploitation is a hidden crime. Young people often trust their abuser and don'' understand that they''e being abused. They may depend on their abuser or be too scared to tell anyone what'' happening.

"It can involve violent, humiliating and degrading sexual assaults, including oral and anal rape. In some cases, young people are persuaded or forced into exchanging sexual activity for money, drugs, gifts, affection or status. Child sexual exploitation doesn't always involve physical contact and can happen online.

It is vital to acknowledge that a groomed child is not consenting to sexual activity."

Summary of 'Spotting the Signs' – a framework to help professionals detect CSE

Department of Health, BASHH, Brook

CSE is an abuse of power and can take many forms such as:

  • Peer-on-peer abuse
  • Older adults exploiting younger children
  • Online grooming

Factors that put young people at risk of CSE:

  • Sexual health and behaviour, for example sexually transmitted infections, pregnancy, terminations, inappropriate sexualised behaviour
  • Absent from school or repeatedly running away
  • Familial abuse and/or problems at home
  • Emotional and physical condition, for example poor mental health, learning disability
  • Gangs, older age group and involvement in crime
  • Use of technology and sexual bullying
  • Alcohol and drug misuse
  • Receipt of unexplained gifts or money
  • Distrust of authority figures.

Potential risk factors:

Migrant, refugee or asylum seeker • Financially unsupported • Changes in behaviour • Death, loss or illness of a significant person • Staying out overnight with no explanation • Substance misuse by parents, carers or child • Experiencing homophobia • Being groomed on the internet • Disappearing from the 'system' with no contact or support • Being taken to clubs and hotels by adults and engaging in sexual activity • Disclosure of serious sexual assault and then withdrawal of statement • Being moved around for sexual activity • Abduction and forced imprisonment


Although in the UK the age of consent is 16, a 16 or 17-year-old can still be sexually exploited. Irrespective of age, a person's ability to give consent may be affected by a range of other factors, including alcohol, drugs, threats of violence, grooming or an imbalance of power between perpetrator and victim.

Asking about CSE

  • Is there someone who they feel they can talk to?
  • How are things at home?
  • Do they often miss days or parts of the school day?
  • Do they have any contact with other professionals e.g. GP, Social worker, mental health services
  • What do they understand 'sexual contact' to be?
  • Do they understand what consent is?
  • Do they feel they could say "no" to sex?

Have they ever: 

  • Felt uncomfortable or forced to send or receive sexual messages/images?
  • Been intimidated?
  • Pushed into doing something sexual?
  • Offered gifts, alcohol, drugs or protection for sex?
  • Tried to hurt themselves?

If they're having sexual contact: 

  • Where and how did they meet the person they have sex with?
  • Do their friends or family know and/or like their sexual partner?
  • Where do they spend time together? Where do they have sex?
  • How old is their sexual partner?
  • Do they often drink alcohol / take drugs before sex?
  • Have they had a sexually transmitted infection?
  • Is anyone else there when they have sex (or any other form of sexual contact)?

This Child Sexual Exploitation Risk Questionnaire (CSERQ) (Word) is a useful tool for practitioners working with young people.

Prescribing contraception

One of the challenges for primary care is that clinicians may lawfully prescribe contraception for sexually active children under the Fraser guidance. It should be remembered that this was intended to give advice on consenting children who were sexually active. In CSE, the child is not consenting due to the fact they are being groomed or coerced.

Professionals working with children need to consider how to balance children's rights and wishes with their responsibility to keep children safe from harm.

Resources for identifying CSE