Federal inspections of the U.S. government’s only dedicated detention unit for transgender immigrants last year found hundreds of unanswered requests for medical attention, poor quarantine procedures and deficient treatment for mental illnesses and other chronic diseases, Reuters has learned.

Details of the inspections of the transgender unit at the Cibola County Correctional Center in New Mexico, which have not been reported previously, were contained in internal reports from the U.S. Immigration and Customs Enforcement (ICE) health corps and a U.S. Department of Homeland Security (DHS) civil rights office.

The problems, which led to the transfer of all detainees to other facilities in January, were described to Reuters by congressional aides who were briefed on the documents and spoke on condition of anonymity.

The reports come to light as Democrats in Congress accuse ICE of not living up to the agency’s own standards for caring for detained transgender immigrants.

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April Grant, an ICE spokeswoman, did not comment directly on the specifics outlined by the congressional aides but confirmed that a December 2019 report by the ICE health corps found “several health care-related deficiencies” at the center, such as failing to complete laboratory orders or arrange for HIV patients to see infectious disease specialists within 30 days of arrival.

Grant said many of those problems were addressed in December, for instance by speeding up backlogged lab orders and educating staff on detention standards and medication policies.

However, the concerns led to the transfer of all of the approximately two dozen detainees in the transgender unit, as well as other chronically ill detainees in the general population. About half were sent to a facility Aurora, Colorado, and the others to one in Tacoma, Washington, according to transgender detainees, former detainees and their advocates.

At Cibola, some told Reuters, detainees had made desperate attempts to get adequate care.

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“Every time we felt sick the first step was to raise a request, but they never answered,” said Kelly Aguilar, a 23-year-old transgender woman from Honduras who said she had been detained at Cibola for two years before being transferred to Aurora.

“When people had fevers, headaches, stomach problems, we just tried to help each other by giving sips of water or buying pills in the commissary, but a lot of times we didn’t have money.”

ICE was not able to immediately comment on individual cases described in this story.

Amanda Gilchrist, a spokeswoman for CoreCivic Inc (CXW.N), the private prison company that operates Cibola and holds immigrant detainees under an ICE contract, said the company was “committed to providing a safe environment for transgender detainees” including training staff about preventing abuse and harassment.

A debate in Congress

Revelations about the medical concerns at Cibola come as Democrats in Congress are scrutinizing care for the approximately 100 self-identified transgender detainees in U.S. facilities, a small portion of migrants in immigration custody. Many are awaiting resolution of asylum claims.

Democratic lawmakers are pushing ICE to enforce the agency’s existing detention standards for transgender immigrants laid out in a 2015 memo. The memo, signed by former ICE Director Thomas Homan during the Obama administration, offers such protections as allowing immigrants to be housed according to their gender identity (transgender women with other women, for instance), as well as to be given access to medically necessary hormone therapy and mental health care.

Homan told Reuters it had proven difficult to find facilities willing to modify their contracts to adopt the transgender care standards. Currently none have done so.

Some ICE facilities, like Cibola, are operated by private prison companies. Others are run by federal, state or local governments. In December, Democrats directed ICE, in legislative guidance that accompanied a spending package, to adhere to the memo – but ICE rebuffed the request at the end of January, according to a congressional aide. The legislative guidance from Democrats is “not legally binding upon the agency,” according to an ICE statement that was provided to Congress and seen by Reuters.

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Legislative guidance accompanying spending bills is commonly followed by government agencies, former federal officials and legal experts say.

Grant said several of the country’s more than 200 immigration detention centers have “informally” implemented aspects of the 2015 memo. She said ICE is continuing to look for facilities willing to run a dedicated transgender housing unit and “remains optimistic that some locations will sign the formal contract modification.”

Sharita Gruberg from the Washington D.C.-based liberal nonprofit Center for American Progress, one of the groups that filed complaints with ICE about the treatment of transgender detainees, said the transfers only shuffled the problems to other facilities.

“Congress is asking ICE to adopt its own standards for care,” she said. But “instead of complying with their own standards and complying with congressional direction, they went with secret option number three of just transferring (detainees) to other private prisons.”

Since taking office in 2017, U.S. President Donald Trump has rolled back protections for transgender people in the U.S. military, public schools and federal prisons.

Trump also has made an immigration crackdown – including increased detention of unauthorized immigrants – an important part of his presidency and his 2020 re-election campaign.

From hope to disappointment

ICE opened the dedicated transgender unit at Cibola in 2017 after a similar facility in California ended its contract with the agency.

Some detainees told Reuters that arriving at Cibola initially seemed a respite, allowing them to live among others like them, without the fear of abuse they had suffered in their home countries and other U.S. detention centers.

Zsa Zsa, a 54-year-old Jamaican who asked that her last name be withheld, said that after stints at ICE facilities in the general population of male detainees in San Diego and El Paso, she felt safer at Cibola. But soon, she said, she came to believe that the medical care in Cibola was “very poor.” She said she repeatedly tried and failed to get a specific medication to control her high blood pressure, becoming dizzy from lack of treatment.

Honduran detainee Shantell Hernandez, 29, said she had asked repeatedly for hormones at Cibola, but to no avail. It took her transfer to detention in Washington to get the medication she said she needed.

Before that, she said, “They never gave them to me.”