The purchasing of sexual services by adults from children and adolescents affects an un- known proportion of New Zealand youth, and is present in both rural and urban settings. International research shows that on average girls begin using sex for survival between the ages of 12 and 15. It can be argued that the terms used to denote adolescent transactional sex indicate the researchers’ moral position of the subject; the terms ‘prostitution’ and ‘client’ suggesting equal bargaining power and the terms ‘criminality’ and ‘delinquency’ implying victim responsibility. Recent articles are consistent in their comparison of transactional sex to child sexual abuse. Patriarchal ideals relating to gender roles and female sexuality may perpetuate the selling of sexual services by young people. Three primary pathways into survival sex have been identified: through intermediaries, through child sexual abuse and through inadequate protective systems. Children and young people engaged in transactional sex experience a range of adverse effects related to physical, sexual and mental health, and relationships. In New Zealand the use of children under 18 for sexual services is explicitly prohibited, but there are no comprehensive, nation-wide services for victims of transaction- al sex. Recommendations from the literature support a multi-systemic approach, with an extension of street outreach services, welfare provision and targeted prevention strategies.