When I spoke with a mother about being separated from her 4-year-old daughter during the “zero tolerance” border policies of President Donald Trump’s first term, she told me “it was like having my heart ripped from my body.”
Today, the reverberating impacts of the U.S. government’s forced family separations still tear across communities, countries and generations. Many believed that after the public outcry and reversal by Trump officials, this shameful chapter of American history would close.
Make no mistake: Mass deportation equals mass family separation. Approximately 4.4 million children who are U.S. citizens have undocumented parents.
Yet this won’t happen if the new president follows through on his threat of mass deportations of all undocumented immigrants.
Trump and those he’s gathered around him have repeatedly stated they would deport all undocumented immigrants. Make no mistake: Mass deportation equals mass family separation. Approximately 4.4 million children who are U.S. citizens have undocumented parents. Of the estimated 11 million undocumented immigrants in the U.S., a substantial number have minor children who are U.S. citizens and cannot legally be deported.
To fulfill his campaign promises, Trump will need to either separate more than 4 million U.S.-citizen children from their parents — or illegally deport more than 4 million U.S.-citizen children to countries they’ve never known. Some 5,500 children were separated from their parents during Trump’s first term. These separations devastated these families and plunged the Department of Homeland Security into crisis, as was detailed in the new MSNBC documentary “Separated” by reporter Jacob Soboroff. Yet now, millions of U.S. children at are at risk, including undocumented children.
I’m a pediatrician who has studied the harms of family separation. I know that either outcome would be a human rights, humanitarian and health catastrophe without precedent.
When Kristen Welker, the host of NBC’s “Meet the Press,” recently asked Trump about his deportation plan’s effect on families, Trump presented two options. He said, “They can all go out together,” meaning children who are citizens would be deported, or deported parents could leave their children behind. He said “the family has a choice.”
This “choice” forces families into an untenable position. Deporting families together ignores the reality that we’re talking about children who’ve built their entire lives here. Forcing them to leave the only country they’ve ever known would mean abandoning their education, communities and other family members in the States. For many, it would mean returning to a place their parents fled because of war, torture, persecution or other turmoil.
I have witnessed firsthand the severe trauma — indeed the torture — that these separations inflict.
In my two decades of pediatric medicine practice and extensive work documenting family separation cases with Physicians for Human Rights, I have witnessed firsthand the severe trauma — indeed the torture, as a seminal PHR report concluded — that these separations inflict. Through my clinical practice and research, I know that children who have undergone such adverse childhood experiences have changes to their brain that we can see on an MRI, physiological and metabolic changes to their body and lifelong psychological effects, including severe depression, anxiety and post-traumatic stress disorder.
As one father I interviewed asked me: Who can return the formative years of these children’s lives back to their families? Who can go back in time and be the parents who lovingly taught them to tie their shoelaces or ride their bikes? Who can repair those broken bonds?
No one can.
The immense damage that family separation causes to children and parents is clear. In addition to the psychological harms, affected families could see a nearly 50% reduction in household income, the Center for Migration Studies has reported. This increases the chances of food insecurity and often leads to chronic stress, which can negatively impact health and development. Researchers are also sounding the alarm on how deporting millions of immigrant families would hobble the agricultural, construction, food service and many other industries, resulting in higher prices for everyone. What message does it send when we force millions of American-citizen children to choose between their families and their birthright citizenship? These are not theoretical questions; they are decisions that will devastate families who have built their lives in the U.S. The proposed mass deportations will lead only to mass separation, mass trauma and mass chaos on a scale far beyond what we witnessed during Trump’s first term. Who looks at the crisis of family separation in Trump’s first term — when some 5,500 children were separated — and believes we should scale it up 800 times? We are at a moment that will define not just our immigration policy, but our national character. We are at a moment that will define not just our immigration policy, but our national character. While the challenges of immigration reform are complex, so-called solutions that traumatize children, fragment families and force American citizens to choose between their own homeland or deportation with their parents violate both our values and our medical understanding of human development. Regardless of political affiliation, we must pursue immigration policies that maintain family unity, protect children’s well-being, and recognize the deep roots many immigrant families have established in our communities. The alternative — implementing mass deportations that would separate millions of families — would inflict generational trauma that no future policy or administration could repair.
Vidya Kumar Ramanathan
Vidya Kumar Ramanathan, MD, MPH, FAAP is a pediatrician in Ann Arbor, Michigan, and a medical expert for Physicians for Human Rights. She is also the medical director of the University of Michigan Asylum Collaborative, and has been working with asylum seekers over the last 20 years. 
