Earlier this year at San Francisco International Airport, a nine-year-old girl watched in terror as federal agents in plainclothes forcibly handcuffed her mother, pried her fingers from an airport bench, and wheeled her away. The child stood alone in the terminal, crying – as so many 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 the mother and daughter, and all who witnessed, the traumatic event will forever be in their memory. And 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, we are compelled to speak clearly: what happened at the San Francisco airport was not simply an immigration enforcement action. It was a traumatic event inflicted upon a child. And it is happening, in various forms, across communities in 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 does not fade when the cameras stop rolling. It 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 not an opinion. 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 when agents arrived. She was a child. And she deserved to be treated as one. She was not shielded. She was not protected. She was treated as an afterthought.

On any given Sunday evening, dozens of children move through the airport’s gates — children of every background and immigration status, traveling 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. Trauma does not require comprehension. It requires only exposure. The American Academy of Pediatrics has been clear that witnessing harm to others is itself traumatic, with lasting effects on development and mental health. What happened that day at the airport rippled through every child in that building who witnessed it — and through every child who has since 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 health care, education, and the basic conditions required 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 directly detained. Families across our region are already avoiding medical appointments, keeping children home from school, and living in chronic fear. Chronic fear is not an abstraction — it is a physiological state, and we see its effects in our clinics every week.

To our elected officials: we urge you to pass legislation introduced in the Senate, 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 in every decision that affects them.

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. Our voices carry weight, and this moment demands we use them.

To our families in our communities: 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 where they were born or what documents they carry.

To everyone: immigration is a policy debate between adults, but its consequences are borne disproportionately by children. Every immigration enforcement decision, every data-sharing agreement, every policy directive carries a pediatric impact that must be assessed and accounted for. We are asking you to remember that.

Pediatricians remain wholeheartedly committed to the physical, emotional, and mental health of every child in our communities. If we as a nation are to put all children first, our policies and actions must reflect that intention.

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Neel Patel, MD, FAAP, is the president of the American Academy of Pediatrics-California Chapter 1 and Elizabeth Grady, MD, FAAP, is the co-chair of the chapter’s mental health committee. They are both pediatricians based in California.

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