Peshawar, Pakistan: Alisha, a 23-year-old transgender activist, died at a northern Pakistani hospital on Wednesday after a shooting incident and delays in medical care that exposed the discrimination faced by sexual minorities in the country.

Shot seven times in an altercation on Sunday, 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 if Alisha’s blood was HIV-positive; 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 adjacent to the country’s northern tribal areas.

All the victims, including Alisha, who went by one name, were members of Trans Action, an advocacy group that lately has been increasingly vocal in seeking equal rights for transgender people in Khyber Pakhtunkhwa.

The group estimates there are at least 45,000 transgender people in the province, and at least half a million nationwide. They occupy an uncomfortable place in Pakistan’s more traditional societies; while 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.

Still 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 continue to face discrimination and say that local governments deny them access to education and health care.

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. Having studied until the 12th grade, Alisha told reporters at the time that she was ridiculed at government offices when she went to apply for a job.

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 Sunday’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 issued her a warning over the phone not to pursue a case against him or she would face “serious consequences.”

“I don’t know the nature of dispute,” Farzana said. “But transgender people are easily targeted because they are physically weak and have no social support.”

Farzana and others early Monday rushed a bleeding Alisha to the hospital, where a crowd including male hospital workers circled them and showered them with taunts, Farzana said in an interview. In Facebook posts, she chronicled the abuse; a doctor asked how much she charged for a dance; 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.”