When census officials came to the home of Aisha, a 27-year-old transgender woman in Lahore, she was marked down on their documents as a man.
"I live with my parents and when the officials came to my home I was not there," she said. "My parents marked me as a male as they have not accepted my gender."
Transgender people like Aisha were "disturbingly" undercounted in Pakistan's recent census, campaigners say, leaving them on the margins of mainstream society.
While they were counted for the first time in the census, published in August, the survey identified only 10,418 transgender people out of a population of nearly 208 million.
This, say rights campaigners, seriously underestimates the true size of the transgender community in Pakistan.
"In the province of Punjab alone, we are anywhere between 400,000 to 500,000," said 24-year Mona Ali, who heads the Khawaja Sira Society, a Lahore-based group working for the rights of transgender people.
"We have been providing health facilities to over 30,000 transgenders in Lahore city alone," she added.
Bindya Rana, another community activist, who heads Jiya, a transgender rights group in the port city of Karachi, put the total number of transgender people at 300,000 across Pakistan.
The census - the first in 19 years - identified transgender people according to their national identity cards, said Ali. But many transgender people identify as male or female rather than third gender on their cards to avoid discrimination. Read more via The News