CAT/OP/CHL/1 122. The Subcommittee also recommends that health-care protocols and facilities be adapted to ensure that detainees who wish to use ancestral knowledge and medicine as an alternative or in addition to regular treatment may do so. D. Lesbian, gay, bisexual, transgender and intersex persons 123. During its twenty-eighth session, the Subcommittee adopted a document setting forth concerns and recommendations in relation to persons deprived of their liberty who belong to sexual minorities. Such persons often suffer extreme and multiple forms of discrimination that may constitute a form of torture or cruel, inhuman and degrading treatment. There is abundant evidence that the torture and ill-treatment of lesbian, gay, bisexual, transgender and intersex (LGBTI) persons is an endemic problem, as highlighted by the United Nations High Commissioner for Human Rights (A/HRC/19/41). 124. During its visit, the Subcommittee heard reports from LGBTI persons of being subjected to insults, beatings and other degrading treatment at the time of their arrest. During its visit to facilities in Valparaíso, Antofagasta and Santiago, the Subcommittee found that gay and transgender persons were housed in a separate unit and were subjected to discriminatory practices and attitudes and to homophobic and transphobic bias on the part of the prison administration and other detainees. Unlike the situation that it observed in other sections of the same facilities, the Subcommittee noted a lack of opportunities for LGBTI persons to gain access to recreational activities, workshops, employment and education, with their lack of access allegedly being a consequence of poor behaviour. These restrictions also lessened their chances of obtaining good behaviour privileges and conditional release. 125. In Antofagasta, for example, the unit for LGBTI persons lacked heating and was prone to flooding, which posed health risks for detainees, including people living with HIV, who have compromised immune systems. 126. The Subcommittee reiterates that solitary confinement, isolation and administrative segregation are not appropriate methods of maintaining security and can be justified only if used as a last resort, under exceptional circumstances, for the shortest possible time and in combination with adequate procedural safeguards (see CAT/OP/C/57/4, paras. 64 and 78). 127. On the basis of several interviews, the Subcommittee concluded that the authorities discriminate against individuals based on their sexual orientation or gender identity and in some places have subjected them to searches in the presence of men, clearly demonstrating a lack of understanding of the needs of this population. 7 Furthermore, they were not allowed to bring in women’s clothing or make-up. 128. The Subcommittee is gravely concerned about the nature of the medical assistance provided to people living with HIV in the unit for gay and transgender persons in the Valparaíso prison, as noted in a previous paragraph. 129. The Subcommittee is particularly concerned about threats from prison staff of reprisals against the gay and transgender population in Unit 88 at the privately run prison in Antofagasta. 130. The Subcommittee recommends that the State party prevent the ill-treatment and marginalization of LGBTI persons deprived of their liberty, in particular by ensuring that they have access, without discrimination, to education, workshops, employment and recreational activities. The Subcommittee also recommends that training be provided to all prison staff and law enforcement officials on how to communicate in an effective and professional manner with LGBTI detainees. They should also be made aware of the international human rights rules and principles regarding equality and non-discrimination, including in relation to sexual orientation and gender identity. The Subcommittee calls upon the State party to adopt legislation 7 18 For a better understanding of these needs, see the Yogyakarta Principles on the Application of International Human Rights Law in relation to Sexual Orientation and Gender Identity. GE.17-07771