Drawing on a qualitative study of women involved in sex work in the UK, this paper focuses on the participants who became involved in sexual exploitation or, what some of them saw as, selling or swapping sex for non‐monetary ‘payment’, under the age of 18. A central aim of the study was to develop an understanding of how the meaning ascribed to risk and protective factors influenced perceptions of victimhood and agency. Findings indicate that the key determinants of pathway outcomes were: whether, and how, the search for approval and affection was resolved; whether feeling ‘different’ led to a sense of defeat or strengthened resolve; whether coping strategies were adaptive or maladaptive; and whether individuals experienced the availability of a secure base. The findings suggest the need for policy which acknowledges the expertise and views of the young people involved, recognises the importance of early intervention, and is holistic in service provision not only for young people who are victims of sexual exploitation, but also for those who perceive that they have exercised agency, albeit from limited options, about their involvement in selling or swapping sex. Copyright © 2013 John Wiley & Sons, Ltd. ‘How the meaning ascribed to risk and protective factors influenced perceptions of victimhood and agency’ Key Practitioner Messages Policy and service provision must acknowledge the agency, expertise and views of the young people involved in sexual exploitation.We need to build on the good practice already in existence in continuing to develop a model of intervention which promotes security and resilience.Service interventions with young people involved in or at risk of sexual exploitation, selling and swapping sex must be trust building, respectful, relationship based, solution focused and strengths based. ‘Service interventions must be trust building, respectful, relationship based, solution focused and strengths based’