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Why Are Trans Women Dying in ICE Detention?

Johana Medina Leon was the second trans woman to die after falling ill in ICE detention in just over a year. Advocates warn that trans people face injury, abuse, and neglect in ICE detention centers.
Immigrants attempt to enter the U.S. between Ciudad Juárez, Mexico, and El Paso, Texas, on April 29th, 2019.

Immigrants attempt to enter the U.S. between Ciudad Juárez, Mexico, and El Paso, Texas, on April 29th, 2019.

On the first day of June, Grecia, a trans leader at Casa Migrante, a shelter for migrants in Ciudad Juárez, Mexico, crossed the border to visit Johana Medina Leon in a hospital in El Paso, Texas. The two had met while Medina Leon, a trans woman fleeing El Salvador, waited for months in Juárez for her opportunity to ask for asylum at the official port of entry in the United States. While she waited, Medina Leon fell increasingly ill, but continued to hope that she would gain entrance to the U.S.—and, on April 11th, she was legally admitted as an asylum seeker.

Two months later, Grecia (who prefers not to use her last name publicly) stood over her friend as she lay unconscious in a hospital bed. Medina Leon had spent seven weeks in an Immigration and Customs Enforcement detention center in New Mexico. That detention center has become notorious for its alleged mistreatment of trans people, and Grecia said in a news release that Medina Leon spent weeks pleading for medical help. In a statement to Pacific Standard, ICE acknowledged that Medina Leon had requested a medical test on May 28th, the results of which had come back positive for a serious illness. That same day, ICE says Medina Leon complained about chest pains, and she was transported to a hospital. She died on Saturday, June 1st, soon after Grecia's visit.

Johana Medina Leon, a transgender asylum seeker, died after spending several weeks in ICE custody.

Johana Medina Leon.

Medina Leon was the second trans woman to die after falling gravely ill in ICE detention in just over a year. Roxsana Hernandez Rodriguez, a Honduran who had traveled with one of the migrant caravans to seek asylum in the U.S., died on May 9th, 2018. Though autopsies found she died of dehydration, an independent autopsy commissioned by civil rights advocates also found that Hernandez Rodriguez's body showed signs of abuse sustained during her 16 days in ICE custody in New Mexico—an allegation ICE denies.

Jennicet Gutiérrez, a transgender and immigrant rights activist who helped found the Familia Trans Queer Liberation Movement says that these deaths continue the "heavy attack" on transgender immigrants enabled by an immigration system that emphasizes criminalization and detention. She also fears for her own well-being: "As a transgender person, living in this country without documentation for some time, it makes me feel like it could happen to me at any time," Gutiérrez says. "That I could be the next victim, that my own life could be at risk just because of who I am."

Alleged Abuse Against Transgender Women in Immigration Detention

In the past few years, attorneys have noticed an increase in the number of transgender people arriving on the U.S. border, as they flee persecution, abuse, and discrimination in Central American and Mexico. Human rights advocates have documented violence against trans people in various Latin American countries, and many trans migrants and asylum seekers have endured rape, exploitation, and assault on their journeys to the U.S.

For some transgender people, the abuse might not end after they enter U.S. custody. In 2016, the watchdog group Human Rights Watch released an exhaustive report of its findings from interviews with 28 transgender women who had been kept in ICE detention. "We found serious and disturbing allegations of sexual harassment and abuse, of mistreatment, of the dangers of being placed with the male population, and [lack of access] to medical treatment," says Grace Sung Ehn Meng, a senior researcher with Human Rights Watch. The researchers heard stories of women facing humiliating strip searches from male guards, women subject to homophobic and transphobic verbal abuse, and women kept in solitary confinement arbitrarily.

One of the main dangers trans women faced in ICE custody was being forced into detention with the male population. According to Meng, when misgendered and placed with male detainees, transgender women are particularly vulnerable to sexual assault, harassment, and violence. (In its 2016 report, Human Rights Watch interviewed one woman who said she was raped by three men in a detention center in Arizona in 2014.)

In 2015, in response to the danger trans women faced when kept with cisgender male detainees, ICE began to create "pods" in detention centers specially for transgender detainees. But Meng says no policy stops ICE from continuing to misgender trans people and keep them in inappropriate gender detention—and advocacy groups continue to report that this practice is common.

Human Rights Watch and other organizations have also found that, when a transgender detainee experiences harassment or attacks, ICE will often place that person in solitary confinement under the pretext that it's for the person's own protection. More than half the women Human Rights Watch interviewed had spent time in solitary.

Allegations of ICE Withholding Medical Care

Multiple human rights organizations—including Physicians for Human Rights and Human Rights Watch—have documented instances of ICE withholding medications needed by people in detention.

Transgender people who enter ICE custody while on hormone treatment can be particularly vulnerable to their medications being withheld (withdrawal from hormone treatments can cause serious medical conditions). More than half the people Human Rights Watch interviewed for its 2016 report said that they had been unable to access hormone treatment during periods that ranged from one month to five months in detention.

Access to HIV medication has also been an issue. In Human Rights Watch's report, several transgender women said that they had been "unable to access their HIV medications for periods ranging from two to three months after entering detention."

Raising the Alarm About This Detention Center

Many of the issues transgender women have reportedly faced in detention centers across the country have allegedly occurred at the Otero County Processing Center, the ICE detention facility where Medina Leon was held. Otero is, officially, an "all male" detention facility.

Kristin G. Love, a staff attorney with the American Civil Liberties Union of New Mexico, says that, in February and March of 2019, her organization and others interviewed trans women and gay men who had been held at Otero. The detainees reported a variety of abuses. "We've been horrified with the conditions at Otero, and the discrimination that trans women and gay man have experienced there," Love says. "We heard that the guards and staff engaged in rampant discrimination, that the people [who] were detained there experienced sexual harassment and abuse, and just unconscionable transphobic statements." She says that, in various instances, guards told women things like "Walk like a man" or "You better sit like a man."

In March, the ACLU of New Mexico and two other local advocacy groups wrote an open letter to the Otero facility as well as the Department of Homeland Security alleging that ICE's practices at Otero have "created an unsafe environment for transgender women and gay men" detained there, and demanding a response from both the government and the private company that operates the facility. (Love says the letter has received no response.)

One of the co-authors of the letter, Nicolas Palazzo, a staff attorney with the Las Americas Advocacy Center in El Paso, said he'd spoken with more than 10 transgender and queer detainees who had been held in the Otero facility. The transphobic and homophobic harassment the people he'd talked to had experienced was "two-fold," he says: "There's harassment and verbal abuse from other detainees, but also harassment coming from guards and ICE personnel—and the failure of ICE personnel to adequately protect these individuals."

Palazzo says that, besides being placed in solitary confinement, transgender women and gay men were split up between barracks. "There's a lot of power in keeping these communities together," Palazzo says, explaining the sense of isolation his clients have felt when they're "intentionally separated" from other queer people.

The letter also alleges that Otero staff had withheld medication from transgender detainees. According to the letter, multiple detainees, when they asked to continue their hormone treatment, were told either "ICE won't give you hormones," or "This isn't your home."

Medina Leon's Death and ICE's Response

In a statement to the Washington Post, which first reported Medina Leon's death on Sunday, Corey A. Price, field office director for ICE Enforcement and Removal Operations in El Paso, said, "This is yet another unfortunate example of an individual who illegally enters the United States with an untreated, unscreened medical condition."

But Medina Leon had not entered the country illegally. She presented herself for asylum at the official port of entry on April 11th. Asking for asylum at an official port of entry is a right protected under both U.S. and international law.

When Pacific Standard asked ICE for a comment on various allegations made against the agency's treatment of Medina Leon and other transgender detainees on Monday, the agency sent an amended version of Price's statement, which removed references to Medina Leon entering the country illegally. ICE did not respond to other allegations about its treatment of transgender detainees.

Both Love and Palazzo say that the fact that Medina Leon had a pre-existing condition does not take the responsibility off of ICE. "ICE has a legal obligation to provide people with adequate care in a timely way," Love says.

Love also notes that ICE has the power to parole asylum seekers, and anyone else who does not present a flight risk or a danger to the community. "ICE made a decision to detain a seriously ill person, and keep her in detention," Love says. "She should have received adequate and timely medical care."

In ICE's statement to Pacific Standard, the agency noted key dates in Medina Leon's timeline, including the day she entered ICE custody (April 14th) and the day she was issued a notice to appear before an immigration judge (May 22nd). There was no indication she received any medical care prior to May 28th, when she was taken to the hospital.