Earlier this year at San Francisco International Airport, a 9-year-old girl watched in terror as federal agents in plainclothes forcibly handcuffed her mother and wheeled her away. The child stood alone in the terminal, crying — as other children watched. Within 48 hours, both mother and daughter had been deported to Guatemala.
The video went viral and was then perhaps forgotten by most. For those of us who care for children every day, what we saw was not a policy debate. It was a medical emergency.
As pediatricians who have spent our careers protecting the health of children: What happened at that airport was not simply an immigration enforcement action. It was a traumatic event inflicted upon a child. And it is happening across our nation every day.
When a child witnesses the violent arrest of a parent, the body’s stress response floods the developing brain. For a child, this kind of acute trauma is encoded. It disrupts brain architecture and increases the lifetime risk of anxiety, depression, post-traumatic stress disorder and serious physical health conditions.
This is established science — and it is the foundation of the American Academy of Pediatrics’ unequivocal position that children should never be forcibly separated from their parents unless the child’s safety is at risk.
The young girl at the airport did not choose her country of birth, her parents’ legal status or the terminal she was standing in. She was a child. And she deserved to be treated as one.
On any given evening, dozens of children move through the airport with their families. Those children also witnessed what happened. They heard a woman cry out and her daughter crying in desperation. They may not have understood exactly what they were seeing — but their nervous systems did. The AAP has been clear that witnessing harm to others is traumatic, with lasting effects on development and mental health. What happened that day rippled through every child who witnessed it — and every child who watched the video online.
The AAP position on immigration is grounded not in politics, but in science and evidence. We believe every child in the United States, regardless of immigration status, deserves access to healthcare, education and the basic conditions for healthy development.
We are also deeply alarmed by the expansion of enforcement into spaces that families depend on. When airports, schools and hospitals become potential sites of arrest, the consequences extend far beyond those detained. Families are already avoiding medical appointments, keeping children home from school and living in chronic fear. Chronic fear is a physiological state, and we see its effects in our clinics every week.
To our elected officials: we urge you to pass the Humane Enforcement and Legal Protections (HELP) for Separated Children Act, which would codify child-protective protocols for any immigration enforcement action involving minors and require immigration officials to consider the best interest of the child. Children are not collateral. They must be the first consideration.
To our fellow pediatricians and health professionals: Let’s act together. Let’s screen for trauma. Create safe spaces in your clinics. Speak up — in your hospitals, your communities and the public square.
To our families: We see you. We stand with you. Your children are our patients, and their health — physical, emotional and mental — is our highest obligation, regardless of what documents they carry.
To everyone: Immigration is a policy debate between adults, but its consequences are borne disproportionately by children. Every enforcement decision, every data-sharing agreement, every policy directive carries an impact that must be assessed and accounted for.
Pediatricians remain wholeheartedly committed to the physical, emotional and mental health of every child. If we as a nation are to put all children first, our policies and actions must reflect that intention.
Neel Patel, MD, FAAP, is president of the American Academy of Pediatrics California Chapter 1 and Elizabeth Grady, MD, FAAP, is co-chair of the chapter’s mental health committee. They are both pediatricians based in California.