KEY POINTS
- Transgender patients lack dedicated wards in Khyber Pakhtunkhwa hospitals.
- Female wards reject them; male wards show suspicion or refusal.
- Alisha’s 2016 death exposed systemic neglect in hospital emergency care.
- Community leaders recall unfulfilled promises for safe medical spaces.
- Activists argue little has changed nearly a decade after Alisha.
- In 2025, still no reserved hospital beds for transgender.
- 197 transgender persons in KP currently live with HIV.
- Census counted 21,774 transgender people, activists estimate over 50,000.
- Violence recorded: 1,800 cases, 158 murders since 2010.
PESHAWAR, Pakistan: In Pakistan’s conservative northwest, where cultural traditions run deep and change comes slowly, one community remains almost invisible in the healthcare system: transgender people.
Despite repeated promises from provincial governments, there are still no dedicated wards or beds for them in hospitals across the Khyber Pakhtunkhwa (KP), leaving many vulnerable patients without urgently needed care.
Nowhere to belong
In Peshawar’s largest hospitals, Lady Reading Hospital, Khyber Teaching Hospital, and Hayatabad Medical Complex, transgender patients often find themselves in limbo. Female wards refuse to admit them, insisting they are men.
Male wards, on the other hand, treat them with suspicion or outright rejection. For people already stigmatised in daily life, this moment of medical crisis becomes another reminder that they don’t quite “fit in.”
This issue came into sharp focus in 2016, when Alisha, a 25-year-old transgender woman, was shot by unidentified men while returning from a music programme in Peshawar.
She was rushed to Lady Reading Hospital, but her friends say the staff refused to admit her either to the male or female ward.
“She kept begging for treatment while lying in the hospital corridor, but no one was ready to take responsibility,” recalls Farzana Jan, president of the Trans Alliance in Khyber Pakhtunkhwa. Eventually, Alisha was moved to the Bolton Block of the hospital, where she succumbed to her injuries.
We have always raised our voices for separate wards and beds for transgender patients, but nothing has changed. Despite promises, the situation remains the same. The trans community continues to be denied its most basic rights.” – Farzana Jan
Jan stresses the memory of Alisha’s final cries still haunts the community. “We have always raised our voices for separate wards and beds for transgender patients, but nothing has changed. Despite promises, the situation remains the same. The trans community continues to be denied its most basic rights,” she emphasises.
Nearly a decade later, activists argue that Alisha’s death has changed little in practice, as hospitals continue to leave transgender patients without safe or dignified access to care.
“It is heartbreaking that in 2025, we still don’t have a single ward or bed reserved for our community,” remarks Arzoo Khan, Chief Executive Officer of the Manzil Foundation, a Peshawar-based non-governmental organisation which advocates for transgender rights in the province.
“When we are attacked and brought to hospital emergencies, male and female wards do not accept us. We are treated like aliens everywhere, even when fighting for our lives.”
Counting the uncounted
The consequences are not just about dignity; they are about survival. According to the Provincial AIDS Control Programme, 197 transgender persons in Khyber Pakhtunkhwa are currently living with HIV.
Data from the 2017 census reported 21,774 transgender individuals in the province, more than half residing in urban centres.
But activists believe the true population is far larger. Farzana Khan, president of the Transaction Alliance—which focuses on Transgender community in Khyber Pakhtunkhwa—estimates that the number could exceed 50,000.
It is heartbreaking that in 2025, we still don’t have a single ward or bed reserved for our community.” – Arzoo Khan, CEO Manazil Foundation
“Every government announces special hospital facilities for us, but these promises remain on paper. We are left to fend for ourselves,” she says.
Without proper medical spaces, HIV-positive patients struggle to receive treatment in environments free from stigma. Others, especially victims of frequent assaults, face delays in critical emergency care.
Violence and vulnerability
For Pakistan’s transgender community, violence is a daily threat. Since 2010, Manzil Foundation has recorded more than 1,800 cases of violence against transgender persons in Khyber Pakhtunkhwa, including 158 murders. Yet, activists contend, no perpetrator has been brought to justice.
“Every day, we see beatings, attacks, and killings, but the police and other authorities turn a blind eye,” laments Arzoo Khan. “Even in death, there is no dignity. There are no dedicated funeral spaces for us, just as there are no hospital wards.”
A cycle of empty promises
The absence of healthcare infrastructure for transgender people is not due to a lack of acknowledgement. In his tenure, former Chief Minister Pervez Khattak directed health officials to establish separate wards.
Later, Chief Minister Mahmood Khan made similar announcements. Civil society organisations, including the Human Rights Commission of Pakistan (HRCP) and the provincial Social Welfare Department, have repeatedly urged the Health Department to act.
Shahid Mehmood, the Coordinator for the Peshawar chapter of HRCP, explains to WE News English that in April 2024 Chief Minister KP directed all the district headquarters hospitals to improve dignified access to health care and combat discrimination against the transgender community.
Yet, nothing has changed.
“These promises have never gone beyond press conferences,” observed Qamar Naseem, Programme Manager of the Blue Veins, an NGO advocating for marginalised groups. “Requests and proposals are sent, but there has been no implementation. It’s neglect in its purest form.”
Claims of care provided
Hospital officials, however, reject claims of neglect. Muhammad Asim, spokesperson for the Lady Reading Hospital in Peshawar, insists that transgender patients do receive treatment.
“They’re admitted to Bolton Block, where beds are available. Almost daily, transgender individuals are brought in injured, and they are provided proper emergency care,” he states.
Despite this historical significance, today the transgender community faces stark challenges.” – Dr. Ibrar
Asim explains that LRH receives hundreds of transgender patients each year for illnesses, violence-related cases, and firearm injuries.
He adds that the hospital administration has issued special instructions to doctors, nurses, paramedics, and security staff to ensure transgender patients are treated with care, especially in emergencies.
“Most transgender patients are given appropriate medical treatment according to their needs, without hesitation,” he maintains.
He also points out that the Bolton Block is a paid facility, but transgender patients are not denied treatment for their inability to pay.
From respect to marginalisation
The struggle of transgender people in Khyber Pakhtunkhwa reflects a broader challenge across South Asia, where centuries-old cultural roles for “khawajasiras”—once respected as spiritual figures.
Dr. Muhammad Ibrar, an assistant professor at the Department of Social Work, University of Peshawar, explains that the transgender community in South Asia has a long and rich history. Various terms have been used across the region, including hijra and khwaja sira.
Recognition of genders beyond male and female is centuries old; it has existed in South Asia for more than 2,000 years. Ancient Hindu religious texts such as the Ramayana and the Mahabharata make references to a third gender.
During the Mughal era, transgender individuals held important positions in society, Dr Ibrar adds. They were trusted figures in the royal courts, serving as political advisors, administrators, and even military generals. Their presence was respected, and they played a vital role in governance and cultural life.
“Despite this historical significance, today the transgender community faces stark challenges,” Dr. Ibrar observes.
Many are subjected to abuse within their own families, while in public, they often face harassment and violence. Discrimination in workplaces further restricts their opportunities, denying them equal chances to succeed in society, he notes.
In Pakistan, the 2018 Transgender Persons (Protection of Rights) Act initially gave hope for equality, guaranteeing access to healthcare and protection from discrimination. But seven years on, activists complain, the law remains largely unimplemented.
For now, transgender people in the province continue to navigate hospitals that see them as neither male nor female, caught in a cycle of neglect, stigma, and violence.
Their demand is not for special treatment but for something far simpler: dignity in life, dignity in death, and the right to healthcare without prejudice.
