Inside ICE Facilities, Trans Women Denied Their Medical Care

Valentina was in her cell at Arizona’s Eloy Detention Center when, shortly following an afternoon headcount in June, a corrections officer came for her. With the guard by her side, she was led to an office where a wheelchair and several other officers were waiting.

They patted her down, shackled her wrists behind her back, chained her waist, put her in the wheelchair, and turned on a video camera.

She was told that someone else in detention had accused her of propositioning him for sex — a claim she denies making — and they began interrogating her.

"My heart was racing," she told LOOKOUT. "The guards were mocking me."

Twenty minutes later, she says, she was moved into an isolation cell that had only a mattress and a toilet. She was left there for nine days, a time period that has shown to have lasting psychological effects on people, and is considered a form of torture by the United Nations.

She called the ordeal "horrible moral punishment" because of who she is — a transgender woman.

Valentina, whom we are identifying by her middle name at the request of her lawyer due to fear of retaliation and her pending asylum case, is a 25-year-old migrant from Nicaragua who has spent more than six months in detention. She is one of at least 20 transgender women estimated to be held throughout Immigration and Customs Enforcement facilities between Arizona and Colorado — a number obfuscated by the federal government’s refusal to track their numbers in accordance with President Donald Trump’s orders to deny trans people’s legal existence.

Rather than being housed according to their gender identity, they are almost all housed in men’s units or, sometimes, in solitary confinement.

In Aurora, Colorado’s ICE Processing Center once ran two transgender-specific housing pods for higher- and lower-security detainees. The lower-security pod was dismantled roughly a year ago to free up space to detain more men, leaving trans women there consigned to the general male population.

But the more dramatic effect of trans people being detained in ICE’s immigration camps is that almost all of them are being refused medically prescribed and lifesaving gender-affirming care. Drawing on interviews with currently and formerly detained transgender women in both states, immigration attorneys, detention-center advocates and gender-affirming care specialists, LOOKOUT found that the rollback of federal oversight of medical care inside detention camps has left transgender prisoners more vulnerable than at any point in recent memory.

And while there is a body of research that shows the benefits of gender-affirming care for people who need it, very little is studied on what happens when people are forced off their medication. What research does exist focuses almost exclusively on people who choose to detransition — and has overwhelmingly shown that people do so because of societal pressures. What is known is that people who are forced to discontinue their lifesaving care in immigration detention face dramatic physical changes that can worsen dysphoria symptoms, leading to dire mental health situations.

Treatment across agencies

Access to medically necessary care and protections for transgender prisoners across both the Department of Homeland Security and the Department of Justice has been almost completely denied.

Last December, the DOJ made a significant revision to how the department would use Prison Rape Elimanation Act (PREA) regulations in light of an executive order — signed by Trump on his first day back in office — denying any federal recognition of gender-diverse people.

According to the memo, PREA audits will no longer evaluate jail, prison and detention center standards to protect LGBTQ+ prisoners.

“Everything is hard. It’s so denigrating.”
- Renata, a trans woman who was detained in Eloy and denied her medications.

Following suit, the Federal Bureau of Prisons announced a new policy in February this year to stop providing gender-affirming medical or social transition care to transgender people.

Those policies have been mirrored in immigration detention.

Valentina and the others she knows of — she said there are at least five other transgender people detained in Eloy — have gone weeks at a time without hormone therapy. In her case, it was 22 days before she received any hormones at all — and what she got, she said, wasn't enough to stop her body from rapid alteration.

"I don't feel any change in my body, nothing," she said. Her facial hair started growing back — a source of deep anxiety for her.

At immigration detention centers across the country, transgender women have described being cut off from hormone therapy for weeks at a time, triggering what medical providers call rapid, menopause-like symptoms, spiking suicidal ideation and severe psychological distress, while also facing solitary confinement and being treated as sexual threats simply for existing among men.

Linda McFarlane, executive director of Just Detention International, an organization that works to end all forms of sexual abuse in detention, told LOOKOUT, “The one thing consistent is that transgender people face is being presumed to be predatory.”

“Forcibly detransitioned”

Being taken off hormone therapy can affect transgender people in ways similar to cisgender people. When cisgender men regularly take injected testosterone, their bodies may reduce or stop producing the hormone naturally. If they stop taking testosterone injections abruptly, the body does not immediately resume normal hormone production.

Instead, they can experience withdrawal symptoms including mood swings, depression and low energy. More severe symptoms can include suicidal ideation.

The longer someone has been on hormone therapy, the more difficult the transition off treatment can be.

For trans women who have been on estrogen therapy for extended periods — sometimes decades, depending on their age — stopping hormone therapy can result in menopause-like symptoms, including hot flashes, emotional blunting and worsening gender dysphoria, according to medical experts interviewed, including Ari Kravitz of Spectrum Medical Care, who specializes in gender-affirming care in Arizona.

Renata, who was locked up for eight months in another Arizona detention camp, told LOOKOUT that she had entered into depression after being forced off her medication: “It messes up your body,” she said. “Like it’s eating you up inside.”

Renata said she and others detained with her all asked for ongoing hormone therapy and faced either denials or long delays.

“Everything is hard,” Renata said of detention. “It’s so denigrating.”

Greg Fay, a Tucson-based immigration attorney who has long focused on representing LGBTQ+ people facing deportation, said prisoners held in ICE detention facilities are always immediately taken off hormones. If they do get back on them, he said, there are delays that have only gotten worse under the Trump administration.

He added that it’s a particularly difficult problem for people who had been taking hormones without a prescription on the outside, as they face indefinite interruptions in care.

Emily Snyder, a nurse practitioner at Prisma, a community health provider in Phoenix where she specializes in HIV treatment and gender-affirming care, said there are “extreme mental health exacerbations” as a result of discontinued care, but also physical ones: “If you just discontinue therapy, you’re basically putting yourself into a very rapid menopause,” she said.

According to recent reporting from the New York Times, the federal government has stopped offering specialized care for transgender people in at least 10 detention centers. The Times also reported that a DHS spokesperson said, “We are NOT wasting U.S. taxpayer dollars to provide hormone therapy to illegal aliens seeking to change their sex.”

In Arizona and Colorado, transgender people are still sometimes receiving hormone therapy. But that access to treatment could change.

Jorge Ramallo, a Virginia-based primary care physician focusing on LGBTQ+ health and president-elect of GLMA (formerly known as the Gay & Lesbian Medical Association), told LOOKOUT that transgender people inside immigration detention are effectively “being forcibly detransitioned.”

“That is a huge concern for us in the medical community,” Ramallo said, “because we know that these patients are suffering unnecessarily without access to these life-saving medications.”

An ICE spokesperson, responding to a detailed series of questions about Valentina’s specific experience and changes in general detention conditions for transgender people in the system, said that ICE does not use solitary confinement, referring to the isolated confinement as “segregated housing,” and that people are subjected to it “based on heightened concerns related to the detainee’s health or safety. Those concerns include “medical illness, physical disability, mental illness, suicide risk” — none of which apply to Valentina, according to her and her attorney.

The statement also referred to Valentina’s arrest, which took place in February when Valentina turned herself in at a Maricopa County Sheriff’s Office “to serve a two-day sentence for a misdemeanor DUI conviction.”

Valentina’s attorney explained to LOOKOUT that she had been taking all steps to comply with the court order.

The ICE spokesperson added, “ICE has a longstanding practice of providing comprehensive medical care from the moment an alien enters ICE custody. This care includes medical, dental, and mental health services, as available, along with access to medical appointments and 24-hour emergency care.”

They further encouraged people to leave the country voluntarily: “Individuals in the United States illegally may choose to take control of their departure through the CBP Home App.”

The changes and lack of care may rise to a violation of the Eighth Amendment’s prohibition against cruel and unusual punishment.

Last August, a class action lawsuit was filed in Georgia about a state law banning any gender-affirming care that relies on state funds. Attorneys in that case wrote that taking people off medically necessary care for gender dysphoria puts them “at grave risk of physical and psychological harm, including resurfaced gender dysphoria, depression, anxiety, mood dysregulation, self-harm, self-surgery, or death by suicide.”

Scaling back protections

While the Trump administration has stopped reporting how many transgender people it detains in immigration camps, recent reporting estimates there are roughly several dozen transgender people currently in immigration detention. Talking to advocates and attorneys, LOOKOUT was able to count at least 20 transgender people detained between Arizona and Colorado.

In Aurora’s ICE Processing Center in Colorado, transgender people held in detention were typically held in a pod specifically for them. A similar pod in a New Mexico immigrant detention camp transferred all the people out in 2020, making Aurora the only transgender-specific pod in immigration detention, according to Isabella Muscara, the program coordinator at Casa de Paz, an immigrant rights advocacy center in Colorado.

Muscara explained that there used to be two trans-specific pods in Aurora, one for each level of security, but that changed in late 2025 to make room to hold more men, and there is now only one trans-only pod for people held in the higher-security wing.

Muscara said that as of mid-August, there were two women held in Aurora’s trans-specific pod, and four women held in the men’s unit.

While the transgender pod offers some protections and some mental reprieve, Muscara underscored that they are still confined in trying conditions: One transgender woman from an Arabic-speaking country, Muscara said, was recently detained in Aurora for about two years, suffering isolation, bad food, little programming such as access to the outdoors or a library, and persistent transphobia.

Muscara said that lights in the transgender unit were sometimes left on all day and night, meals were often delivered late, and “specific guards made it obvious they were treating the women worse because they were in the trans pod.”

“They were last of the line, almost forgotten about,” Muscara added.

When asked about the treatment of transgender people in Aurora, a Department of Homeland Security spokesperson referred to Trump’s Jan. 20, 2025, executive order, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” and added that “ICE has taken appropriate action to ensure that detention space is designated by biological sex and not by gender identity.”

Back in Eloy, Valentina said that even as she’s fighting for basic care and dignity, she’s also fighting to stay in the United States. She said that she has nobody, except for her attorney, fighting for her on the outside, and fears being sent back to Nicaragua, where LGBTQ+ people can face discrimination and violence. She said the discrimination she has faced in her home country is “horrible.”

“It’s not good,” she said of her prospects in Nicaragua. “The machismo, homophobia and transphobia are really intense.”

For now, she is left facing what both she and her former attorney, Ashley Moy-Wooten, describe as intense transphobia in Eloy.

Moy-Wooten, who worked until recently with the Florence Immigrant and Refugee Rights Project, said she recognizes the palpable transphobia when she was with Valentina in court, but insisted that she is resilient and full of determination to advocate for herself and other transgender people inside.

Moy-Wooten described Valentina’s self-presentation when she met with her, how she always found ways to put on makeup and do her hair. And yet, she said, “You can absolutely see the deterioration in her. It’s inevitable.”

She added, however, that Valentina’s resilience is “testament to her beauty and willingness to fight.”

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