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.

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.

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.

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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.

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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.

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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.”

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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.