A 23-year-old transgender activist died at a northern Pakistani hospital Wednesday after a shooting and delays in medical care that her friends blamed on discrimination in the South Asian country.
Shot seven times in an altercation Sunday, the activist -- who went by one name, Alisha -- was brought to Lady Reading Hospital, one of the largest medical facilities in Khyber Pakhtunkhwa province, where staff dithered over whether to place her in the ward for male patients or female patients.
A friend and fellow activist, Farzana Jan, said men at the hospital taunted them outside the emergency room.
One asked whether Alisha's blood was HIV-positive, while another asked for Farzana's phone number and invited her to dance at a party.
Alisha underwent medical procedures Monday and Tuesday to stanch heavy internal bleeding but died Wednesday morning, according to hospital spokesman Zulfiqar Babakhel.
At least five transgender activists have been attacked in recent months in Khyber Pakhtunkhwa, a socially conservative province next to the country's northern tribal areas.
All the victims, including Alisha, were members of Trans Action, an advocacy group that has been increasingly vocal in seeking equal rights for transgender people in the province.
The group estimates there are at least 45,000 transgender people in the province, and at least half a million nationwide. Although most live in the shadows, some are hired to dance at weddings and parties, where they are viewed as novelty acts and harbingers of good luck.
Others have little way to make a living, except through begging or sex work.
Qamar Naseem, a member of Trans Action, said that about 45 transgender people had been killed in Khyber Pakhtunkhwa in the last two years.
Though Pakistan's Supreme Court has enshrined equal rights for transgender people, they say that local governments deny them access to education and healthcare.
Until 2009 transgender people could not even obtain national identity cards.
"Transgender people are not accepted in society," Naseem said. "People take them to marriage parties, rape them at gunpoint and subject them to extortion."
Alisha had been especially outspoken, participating in a December protest outside the Press Club in Peshawar, the provincial capital. Alisha told reporters at the time that she was ridiculed at government offices when she went to apply for a job, despite having 12 years of schooling.
She said she danced to earn money to support herself, her mother and her sisters. Friends said she had been shot at least twice before Sunday.
There were conflicting reports about the circumstances leading to her deathunday's incident. Friends said that Alisha got into an argument with an acquaintance, who shot her seven times outside a building in a busy section of Peshawar.
According to news reports, the shooter was part of a group that extorts money from transgender people. Farzana said the assailant warned her over the phone not to pursue a case against him or she would face "serious consequences."
"I don't know the nature of the dispute," Farzana said. "But transgender people are easily targeted because they are physically weak and have no social support."
Farzana and others rushed a bleeding Alisha to the hospital, where a crowd including male hospital workers encircled and taunted them , Farzana said in an interview. In Facebook posts, she wrote that a doctor asked how much she charged for a dance and that male operating room staffers demanded her number.
For several hours, staff members at the 1,750-bed hospital told them Alisha could not be treated in either the male or female patient wards. Finally, Farzana said, the hospital's medical director intervened and assigned Alisha a room in the VIP wing.
On Wednesday morning, Trans Action posted a Facebook update that said Alisha had died. In a message to local authorities, the post said: "Kill all of us."
Ali is a special correspondent. Times staff writer Bengali reported from Mumbai, India.