Karime, a transgender woman who is being held in immigration detention, is forced to share a packed dorm room with 45 men who sleep in cots less than three feet apart.

The guards don’t wear masks or gloves, and if someone gets sick, they have to make a request to see a member of the medical staff, which can take up to four days for a response.

Adding insult to unhealthy practices, Karime must share two showers and two bathrooms with the men; some of them make unwanted sexual advances toward her and threaten to beat her up.