ICE Detention: Deaths, Abuse, and Inhumane Conditions in Immigration Detention Facilities

Overview

The Trump administration's immigration enforcement agenda required detaining vastly more people — and the system rapidly exceeded its capacity and quality controls. ICE detention grew from approximately 41,000 people in fiscal year 2017 to a peak of over 55,000 — the highest level in U.S. history — as the administration directed ICE to detain all undocumented immigrants encountered, including those with no criminal records who had lived in the United States for decades.

The expansion was not matched with proportional increases in medical staff, facility capacity, or oversight.

Deaths in Custody

At least 41 people died in ICE custody during Trump's first term. Deaths included people with treatable conditions who did not receive adequate medical care, people with serious mental illness who were held in solitary confinement, and people who died waiting for medical evaluation.

The Associated Press reviewed ICE medical records and found that in multiple cases, detainees had complained of serious symptoms for days before receiving care; in some cases, care was denied or delayed because ICE facility contracts did not require the level of medical staffing that would have been required in a comparable local jail.

Facility Conditions

DHS's own Inspector General conducted unannounced inspections of ICE facilities in 2019 and found:

• Overflowing toilets and standing sewage
• Rotten food served to detainees
• Detainees unable to access medical care for documented serious conditions
• Evidence of sexual abuse by staff in at least one facility
• Widespread use of solitary confinement for prolonged periods, including on individuals with serious mental illness

The OIG described conditions at multiple facilities as "dangerous" and presenting "immediate risks" to detainee health and safety.

The Irwin County Gynecological Procedures

Among the most serious allegations was a September 2020 whistleblower complaint from a nurse at the Irwin County Detention Center in Georgia, who alleged that a contracted gynecologist had performed numerous invasive gynecological procedures — including hysterectomies — on immigrant women detained at the facility, in many cases without meaningful informed consent and apparently not for documented medical necessity. Multiple detained women came forward with corroborating accounts. The DHS OIG confirmed the investigation was ongoing. A federal criminal investigation was also opened.

The allegation drew comparisons to forced sterilization programs that have been designated as crimes against humanity under international law.