Representative Maxine Dexter has a lot of questions. Why were all of the pregnant, unaccompanied minors in the US rounded up and sent to San Benito, a tiny town on the Texas border with Mexico? Are they given appropriate medical care, given their high-risk conditions and Texas’s abortion ban? And most importantly: where are the girls – and their infants – now?

Dexter, a Democratic congresswoman from Oregon and a former critical care physician – one of the few doctors now serving in Congress – detailed these questions in an 8 May letter to refugee and health officials after visiting the San Benito facility and, she said, being blocked from speaking with any of the children. She still hasn’t gotten answers.

In the US, the treatment of immigration detainees has raised concern over rights violations, overcrowding and a lack of medical care – situations that are not transparent even to members of Congress. Senator Andy Kim, a Democrat from New Jersey, says he was sprayed with pepper balls on Monday outside the US Immigration and Customs Enforcement (ICE) Delaney Hall facility, where detainees have spent days on a hunger strike over poor conditions. Health inspectors with the state of New Jersey were denied full access to the facility on Thursday, Mikie Sherrill, the state’s governor, said.

Detainees across the US have said they don’t have safe, nutritious food or adequate medical care, while outbreaks of infectious diseases have plagued facilities, which are often converted warehouses, storefronts or churches that were never meant to house people and frequently lack ventilation.

Detention centers have grappled with “one gross contagion after another”, Nancy Zanello, an ICE assistant field office director in New York, wrote in a 2025 email. One detainee was reportedly held in the overcrowded facility for six days, “and we have a guy with monkeypox”, Zanello wrote in a text message, referring to mpox.

‘They face detention without support’

Unaccompanied minors, who are kept through the Office of Refugee Resettlement (ORR), are “uniquely vulnerable”, Rosalind Rogers, a psychologist specializing in the mental health of immigrants and refugees, said at a recent event with Duke University on the health vulnerabilities of children and families in immigration facilities. “They face detention without the support, nurturing, and protection of a caregiver.”

For the unaccompanied children at the San Benito facility, there is the added stress and confusion of being pregnant and alone. The facility has housed pregnant children as young as 13; about half of the pregnancies are the result of rape.

Following reporting from the Guardian and others, Dexter notified the facility in San Benito that she would visit in late April.

When she arrived, she was blocked from speaking with or even seeing any children throughout her entire visit, she said.

Local immigration attorneys arranged interviews with two girls being held at the facility, but on the morning Dexter was set to visit, “apparently those girls were spoken to harshly by ORR staff, and they were scared to talk to me after that,” she said.

There are also questions about how many children are being held at the facility. One of the attorneys receiving a daily census said there were 11 children that day, but officials told Dexter there were only seven children. When Joaquin Castro, a Democratic Texas congressman, visited a few weeks before, there were 17.

“Where have all of these kids gone? Because there used to be many, many more,” Dexter asked.

The staff responded “it’s case by case” and offered no other details, Dexter said, adding: “Whether they’re in foster care, or in other facilities, or they’ve been returned to other countries, we don’t know.” Dexter says she kept asking, trying new ways to find answers. A representative from ORR’s Washington office was there, but she didn’t answer the questions, Dexter said. “Our experience has been, we’ll keep asking, and no one answers … They had a lot of girls in custody. Where did they all go?”

The ORR case management system can “definitively answer” where each of the unaccompanied children at the San Benito site went, said Jonathan White, a former top official working with children’s programs in the ORR under the Obama and Trump administrations.

The most likely answer is that the girls were moved back to their countries of origin or a third country, White said. That would mean their infants, who are US citizens, are being deported, he added: “I suspect that in effect in this one narrow case the president’s executive order on birthright citizenship is already being in some ways enforced.”

Prior to this administration, departures like these “almost never happened” because the children had to formally request an immigration court judge, he said. When Dexter visited the Harlingen immigration court, more than half the children, all from ORR facilities, had no legal representation.

Dexter and others have expressed concerns about whether the children are receiving appropriate medical care.

“These are high-risk pregnancies, by definition, simply by the age of the girls,” Dexter said. It’s not clear what happens if pregnancy or birth complications occur. “If they have an ectopic pregnancy, if they have a partial loss of pregnancy, will they get the healthcare they need to save their lives?”

‘What are they hiding?’

The Trump administration previously tried to block unaccompanied minors from accessing abortion, and White believes officials moved the girls to Texas because of its restrictions on abortion. Texas law has also limited access to appropriate healthcare in general, Dexter said.

“There is a lack of OB-GYNs in the community in no small part because of the changes to these laws around reproductive healthcare,” Dexter said. “I’m very concerned about whether there is sufficient high-risk fair access, especially with these most marginalized children who don’t have the advocates and don’t have rights in the same way that others do.”

Emily Hilliard, a spokesperson for the US Department of Health and Human Services, said: “Pregnant girls have access to gynecologists and maternal-fetal medicine specialists who provide care for high-risk adolescent pregnancies, ensuring that children with complex medical needs can receive appropriate evaluation and treatment when necessary.”

In 2024, detentions in the San Benito facility were reportedly halted because of insufficient access to healthcare.

“We talked about that and I asked what had changed, and they just said they went from 15 days or more between being able to get an appointment to five days. So we know that it was hard in the past to get appropriate healthcare,” Dexter said. “They did not have glucometers, they didn’t have Dopplers. They didn’t have basic things that pregnant people often have, especially high-risk pregnancies.”

There are no lactation specialists to help with breastfeeding, which can be challenging even for adults. “They’re sent back to class, it sounds like, as early as two weeks after giving birth,” Dexter said.

Staff told her the children receive medical meals to meet their nutritional needs, but immigration attorneys say that’s not the case.

“What we have heard from other folks who directly work with people who’ve been in this detention facility, and what we heard from the people giving the tour, was very different,” Dexter said. “The fact that there appears to have been some coercion or intimidation from talking with me just makes you wonder: ‘What are they hiding? Why do they not want transparency and accountability for what’s going on?’”

Not only are these questions going unanswered, but there is also no state-level accountability after Greg Abbott, Texas’s governor, rescinded the oversight from the state over facilities like these, she said. “ORR is overseeing ORR, which is a recipe for disaster.”