An autopsy released Monday suggests that a transgender woman who died in Immigration and Customs Enforcement custody after being held in a privately operated detention center was likely physically abused shortly before her death.

Roxsana Hernández Rodriguez, 33, from Honduras, Hernández Rodriguez was detained by immigration authorities at the border in early May and died on the 25th of that month, just nine days after being transferred to dedicated unit for transgender women at the Cibola County Correctional Center in New Mexico, which is operated under contract by CoreCivic, the second-largest private prison company in the United States.

“There she developed severe diarrhea and vomiting over the course of several days,” wrote forensic pathologist Kris Sperry, “and finally was emergently hospitalized, then transported to Lovelace Medical Center in Albuquerque, New Mexico, where she remained critically ill until her death.”

“According to observations of other detainees who were with Ms. Hernández Rodriguez, the diarrhea and vomiting episodes persisted over multiple days with no medical evaluation or treatment, until she was gravely ill,” Sperry wrote.

Early reports suggested Hernández Rodriguez died due to complications from pneumonia that were exacerbated by the freezing cold conditions of the detention center. She also reportedly lacked adequate food and medical care and was held in a cell where the lights were turned on 24 hours a day. ICE initially claimed her death was the result of cardiac arrest and HIV complications.

The autopsy concluded that Hernández Rodriguez’s cause of death was most likely “severe complications of dehydration superimposed upon HIV infection,” which made her susceptible to the physiologic effects of untreated dehydration.

Hernández Rodriguez told BuzzFeed News she contracted HIV after being raped by members of the MS-13 gang.She added that violence against the transgender community in Honduras was part of the reason she fled to the United States. Hernández Rodriguez told BuzzFeed, “Trans people are chopped up and put into bags in Honduras. I am scared of that”

Sperry’s autopsy, the second conducted on Hernández Rodriguez’s body following her death, also found evidence of physical abuse, with “deep bruising” on her hands and abdomen, evidence of blunt-force trauma “indicative of blows, and/or kicks, and possible strikes with blunt object.” An accompanying diagram illustrated long, thin bruises along Hernández Rodriguez’s back and sides, as well as extensive hemorrhaging on Hernández Rodriguez’s right and left wrists, which Dr. Sperry found were “typical of handcuff injuries.”

In a statement to The Daily Beast, CoreCivic said “we take the health and well-being of those entrusted to our care very seriously,” while adding that they are “committed to providing a safe environment for transgender detainees.”