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It is not just lack of access to hormones that transgenders in Hong Kong prisons deal with. Most of them also suffer from sexual assault because despite having some female body parts such as breasts, the offenders are assigned to male wards based on the gender listed on their identity documents.

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To worsen their confinement, all transgender inmates – such as Navarro Luigi Recasa – are assigned to Siu Lam Psychiatric Centre, a maximum security prison, since being transgender is still considered by Hong Kong a mental ailment. Recasa, from the Philippines, who was given a two-year jail term after being convicted on drug charges, was shocked she was escorted by male correctional officer to the male toilet, reported South China Morning Post.

Because Recasa filed for a judicial review, which would be heard on Aug. 8, in which she challenged to transgender detainee policy, there is a chance she might be transferred to a female ward.

Recasa was planning to visit Thailand to complete her gender reassignment surgery when she was arrested in Hong Kong in June 2015 for drug offences. She was initially assigned to the all-male Pik Uk Correctional Institution.

According to Rain Lo Lan-wai, an advocate of the NGO Midnight Blue, other indignities that about 40 transgendered women prisoners in Hong Kong had undergone include forced shaving of hair, body searches by male correctional officers, refused to be given interpreters, denied hormones, disallowed to wear bras and given male clothes and verbal and sexual abuse by prison guards.

Because of the difficult conditions, some of the transgender inmates in Siu Lam tried committing suicide, disclosed Patricia Ho, lawyer of Recasa from Daly & Associates, a human rights law firm. One inmate, Lo, went on a hunger strike. But after the NGO stepped in, Siu Lam no longer shave the hair of the transgender prisoners and sometimes grant them access to hormones. But the application is on a case-to-case basis.

Because of lack of hormones, Recasa grew an Adam’s apple She was also anally molested by correction officers and have to endure seeing other prisoners masturbate in front of her when using the toilet.