Activists have filed a civil rights complaint with the Department of Homeland Security on behalf of five transgender and nonbinary migrants who say they were mistreated at an immigration detention center in Colorado.

They are currently detained at the Aurora Contract Detention Facility, a prison privately owned and operated by the GEO Group, where Immigration and Customs Enforcement incarcerates people who have pending or recently concluded immigration legal matters.

The complaint, filed Wednesday, says the five suffered medical neglect, inadequate access to necessary medical and mental health care, dehumanizing treatment, and more. It calls for major changes in ICE’s handling of transgenderand nonbinary migrants. The migrants are represented by the National Immigration Project, Rocky Mountain Immigrant Advocacy Network, and American Immigration Council.

“Our clients and medical experts reveal that ICE cannot safely and humanely incarcerate people who are transgender and nonbinary (‘TNB’),” the complaint states. “Immigration detention negatively impacts their mental health, impedes timely access to gender affirming care, and triggers prior trauma. … We call for an end to the practice of detaining people who are TNB in civil immigration detention. At a minimum, ICE must both implement new policies that provide more robust safeguards to TNB people in the agency’s custody as well as exert regular oversight to ensure that protective policies are followed in practice.”

Under President Barack Obama’s administration, DHS implemented policies aimed at mitigating some of the worst outcomes faced by trans people in ICE custody, “but the policies clearly failed to improve conditions of confinement,” the complaint says.

The migrants are identified by pseudonyms in the complaint to protect their privacy. One of them, Charlotte, sought transfer to the Aurora facility from an ICE detention center in Georgia and was told that she would have better access to gender-affirming care at Aurora, according to the complaint. But in Aurora, she and other trans women she is detained with are locked in their dorm for at least 23 hours a day, she says.

“I thought they’d take care of us, give us more freedom, recognize that we have suffered the most, we are the most vulnerable,” she says in the document. “We came from our countries being horribly treated and we get here and they treat us horribly.”

Another, Victoria, “who has been detained in ICE custody for more than two years, is on hormone replacement therapy but has faced months-long waits to see doctors about her hypertension,” the complaint says. “She recalls that on one occasion her ‘blood pressure was so high, [she] thought she was going to die.’”

“The traumatic experiences detailed in this complaint make clear that ICE is incapable of safely and humanely incarcerating transgender and nonbinary people,” Ann Garcia, staff attorney at the National Immigration Project, said in a press release. “As a result, we urge DHS to put an immediate and permanent end to ICE’s practice of detaining transgender and nonbinary people. Until that happens, at a minimum, ICE must immediately implement new policies to provide safeguards to transgender and nonbinary people in their custody while also implementing regular oversight practices to guarantee adherence to these protective policies. Ultimately, however, we know the abuse and mistreatment documented in this complaint are emblematic of a detention system that is inherently inhumane and flawed beyond repair, and we will continue fighting to end this cruel and harmful system.”