A Monitoring Guide 91 pertise of health professionals working in a prison is insufficient to assess or treat trans detainees, consultations by professionals with the requisite specialized expertise from the community should be made available. After his visit to Argentina, the UN Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity called on the State to “ensure equitable and accessible distribution of medicines and related necessities, including anti-HIV drugs, and hormones, as part of comprehensive health care for all and in particular for transgender persons, while facilitating access by the Public Health Ministry to prisons directly to provide services as well as deliver medicines.74” Specialised care for trans persons should not be limited to gender affirming treatment and should include in particular psychological support and mental health counselling, as well as specific oncological care. LGBTI persons, and in particular trans persons, are particularly exposed to “minority stress” (stress faced by members of stigmatized minority groups), and experience much higher rates of mental health problems than the general population, including anxiety, depression, and eating disorders. The risk of suicidal ideation and self-harm is also reported to be up to 10 times higher than in the general population. Furthermore, mental illness continues to be stigmatized, as do minority gender identities and sexual orientations, and the fact of deprivation of liberty. LGBTI detainees who suffer from mental health problems thus find themselves in extremely vulnerable situations, and the provision of appropriate care and support must be prioritized by authorities. End of Mission Statement by the United Nations Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, Mr. Vitit Muntarbhorn, of his visit to Argentina, 10 March 2017. 74 Chapter III Additionally, prior to their incarceration some trans persons may have taken “street-based” hormones, which were not prescribed by a medical doctor. Once in detention, they may consequently be deprived of hormone therapy because they cannot provide medical evidence of having started such treatment.