Ostracised by society and alienated because of their physical attributes, the transgender community in Pakistan is desperately fighting for survival. Alisha, a 23-year-old transgender activist, died at a KPK hospital Wednesday after a shooting incident and delays in medical care.

The staff at Lady Reading Hospital hesitated over whether to place her in the ward for male patients or female patients, and a fellow activist also revealed that at the hospital, men taunted them, one of them asking the patient if she was HIV-positive; another asked for her phone number and invited her to dance at a party. This is only the base problem in a series of issues; there have been reports of prominent members of the LGBT community denied complete medical access, sometimes at great risk to their lives.

At least five transgender activists attacked in recent months in Khyber Pakhtunkhwa. The Trans Action advocacy group has estimated that there are at least 45,000 transgender people in the province, and at least half a million nationwide, and an entirely uncalculated number of homosexuals and lesbians also reside in the country, with the government not only ignoring their plight but also criminalising their very existence.

Though Pakistan’s Supreme Court has enshrined equal rights for transgender people, they continue to face discrimination and say that local governments deny them access to education and healthcare. In 2009, the Pakistan Supreme Court delivered a seminal ruling recognising the dignity of transgenders and declaring them the third gender under the equal protection clause of the Pakistan Constitution. To remedy discrimination against transgenders, the Court ordered provincial and federal governments to protect transgenders’ gender identification, right to inherit property, right to vote, right to education, and right to employment.

The state has solutions to offer but only on paper, as little has been done for the rights of these people. Nothing will change, if people such as these doctors, are not held accountable for treating this community with the same respect they have taken an oath for. When these doctors refused to operate on her – an individual that needed medical help, they not only violated their vow but also became a prime example for intolerance, cruelty and bigotry.