Skilled nursing facilities’ reluctance to admit transgender residents is poised to become a “national problem,” according to a report published Thursday.

The story, published in the Des Moines Register, highlights 52-year-old LeQuan Edwards, a transgender woman who claims to have been denied admission to all but one of the 90 nursing homes and rehabilitation facilities contacted by hospital staff. Edwards was placed in a rehabilitation facility after a stroke and sent to a hospital in March with leg wounds, in addition to other health problems.

The main issue, the Register reports, is that many of the facilities contacted to admit Edwards say both male and female residents don’t want to share a room with someone who is biologically male but identifies as a woman.

The report cites a survey attempted last year by Iowa-based LGBT advocacy group One Iowa that asked 50 facilities if they accepted transgender residents, and if they would be willing to train staff to be more welcoming to transgender residents. Only three facilities responded, said Donna Red Wing, executive director of One Iowa.

“The reception was very chilly,” Red Wing told the newspaper. “It’s the law that people are to be treated with dignity and respect, and it’s the right thing to do.”

The number of transgender people seeking skilled nursing or rehabilitation care is expected to grow along with the country’s increasing transgender and elderly populations, the Register report noted.

A recent report from the Atlantic found many elder care facilities to be ill-equipped to address the needs of transgender seniors. In July, the Centers for Medicare & Medicaid Services released a tool to help providers handle the needs of older LGBT adults.