“We know that lack of medical and mental-health care, including lack of HIV care, is the norm,” Roger Coggan, director of legal services at the Los Angeles LGBT Center, told reporters Wednesday afternoon. “By the Department of Homeland Security’s own count, 300 individuals identifying as transgender have been in custody and at the mercy of ICE since October of 2018. These cruel incarcerations need to stop immediately.”

DHS officials did not immediately respond to a request for comment about the complaint. It is unclear how many LGBTQ people and people with HIV are detained by U.S. immigration officials.

In addition to asking for the release of migrants with HIV or who identify as LGBTQ, the complaint also seeks an Office of Inspector General investigation into detainee treatment at facilities nationwide.

The complaint focuses largely on ICE, which can detain migrants for months or years, but also alleges inadequate health care at Customs and Border Protection facilities, where migrants are initially detained after crossing the border. ICE has more than 50,000 detainees in its custody, an all-time high, and they are facing deportation or being held while they challenge the government’s attempt to remove them from the country.

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The advocacy groups say ICE detention facilities have faced repeated complaints about treatment of LGBTQ detainees, including one in March lodged against the Otero County Detention Facility in New Mexico. Two months later, Johana Medina Leon, a transgender woman who was detained at Otero and had tested positive for HIV, fell seriously ill and died at a hospital in nearby El Paso.

“Even after this complaint was received and after Johana Medina’s death, ICE continues to deny transgender women and gay and bisexual men at Otero basic health care and provides misinformation on how to access hormone therapy,” according to the complaint.

Leon, 25, was the second trans woman to die in ICE custody in New Mexico in the past year. Roxsana Hernandez, 33, died in November 2018 after falling ill at the Cibola County Correctional Facility.

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The complaint says ICE and CBP fail to provide adequate care for detainees with HIV, including withholding treatment that can suppress the virus and greatly reduce the risk of transmission.

“Far too many people in detention are outright denied access to HIV-related care or experience significant delays,” the complaint says. “This delay of treatment is cruel, counterintuitive to ending HIV transmission, and causes irreparable harm.”

A number of individual cases are highlighted in the complaint, including a 34-year-old HIV-positive trans woman whose medication was withheld during her six-month detention in 2017 at the Otay Mesa Detention Center near San Diego.

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“Additionally, she was misdiagnosed with tuberculosis. Rather than treating her HIV, she was overmedicated in attempts to treat tuberculosis she did not have,” the complaint said.

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In another case, a gay man from Mexico detained at the Adelanto Detention Center in California tested positive for HIV seven months after a judge ordered the test, delaying the start of retroviral treatments, according to the complaint.

ICE has discretion to detain or release migrants while courts consider their immigration case.

“For individuals that ICE has concerns about releasing, be it because of criminal convictions or other reasons, ICE could release them and provide alternatives to detention, which ICE uses in many cases but chooses not to use for trans and gender nonconforming people,” Ola Osaze, director of the Black LGBTQIA+ Migrant Project, told reporters Wednesday.

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The groups filing the complaint include Familia Trans Queer Liberation Project, Al Otro Lado, Las Americas Immigrant Advocates, Los Angeles LGBT Center, Freedom for Immigrants, Santa Fe Dreamers Project, Southern Poverty Law Center, Immigration Equality, Center for Victims of Torture, National Immigrant Justice Center, and the National Center for Transgender Equality.