Published in BBC News on Aug. 14 ::
For a woman from a low-income, conservative background in rural Pakistan, Azra Ahmed had built a potentially hot career.
But then it went right off the boil.
Ms Ahmed, 29, is in a lesbian relationship – and in a country where homophobia has wide social and religious sanction, that may not help your job prospects.
Ever since she was a little girl she has also wanted to pursue gender reassignment surgery but her remote location has prevented her from doing this. This has also made it more difficult to explore moving to another country where she can lawfully marry her girlfriend.
Now she is keeping a low profile with her partner, stuck in a small town which offers few economic opportunities for her skills as a sales executive.
The story of Ms Ahmed and her partner, Lubna Jamal, broke in January when a little known Pakistani human rights group launched an online appeal seeking support for the couple. Both women’s names have been changed in this article to protect their identity.
The appeal went largely unnoticed by civil rights groups, but the man behind it, former journalist Arshad Sulahri, says he received phone calls from unidentified quarters warning him not to promote homosexuality.
A defiant Mr Sulahri has now launched a political party, which is the first in Pakistan to list eunuchs as a separate gender group on its membership form. He says the party now intends to expand to include lesbians, gays, bisexuals and transgender people (LGBT).
While the launching of the appeal brought initial excitement and hope for Ms Ahmed and Ms Jamal, they soon realised they might have put their lives on the line.
“It still gives me shivers to recall that our full names were mentioned in the appeal, but thankfully our location and other details were not there,” Ms Ahmed says. “Probably that saved us.”
Ms Ahmed comes from a rural family of small landowners. She has two brothers and two sisters, all married with children.
None of them studied beyond high school, but Ms Ahmed was different. She went on to become the only girl in her village to graduate from college.
She says she has felt since childhood that she was a boy caught in a girl’s body, fighting to be released. As she grew up, she was attracted to other girls, and had a series of same-sex relationships at school and college.
She abandoned her plans for university education when one of her regular girlfriends, Ammara Tahir (not her real name), came up with a proposal that would enable them to live together away from their families:
“Ammara had persuaded her family to let her join a computer course in this small town where she would put up at a private hostel. Since one of her aunts lived in a nearby town and could visit her every week, her family agreed.”
Ms Ahmed easily persuaded her own family to let her take the same course as Ms Tahir.
They lived together for seven years. They took up jobs and grew increasingly independent of their families. Ms Ahmed went into sales – considered to be a man’s domain in Pakistan – and built a sustainable career.
But then, in late 2012, an unsuspecting Ms Tahir was called home for a family reunion, and then married off to a distant cousin within a fortnight.
“Some male relatives came to collect her things from the hostel,” says Ms Ahmed, who was devastated.
“I was crying all the time, I couldn’t sleep at night. I think Ammara was also in shock. She rang me and promised she’ll come back, but she didn’t. I told her she was a liar. She said she was helpless.”
A few months later, things looked up when Ms Jamal, who is studying for a masters in physical education, came along.
“I’m thankful to God for sending her to the hostel which had become like a grave to me,” Ms Ahmed says. “She pulled me up and gave me so much love,”
But Ms Jamal only has about 10 more months to complete her degree, after which she will have to go home and, like other young Pakistani women, will be married off to a man her family has already chosen for her.
Ms Ahmed says she has been contemplating two options: “We can either seek asylum in a country which allows gay marriages, or I undergo sex change surgery and marry Lubna.”
Both options are problematic.
The couple don’t have the money and the connections to wade through a maze of human smugglers and immigration lawyers to win asylum.
As for gender reassignment surgery, Ms Ahmed has been trying to get an operation over the last four years, but there have been hurdles.
It is a complicated process, says Dr Fida Malik (not his real name), a psychiatrist who has been counselling Ms Ahmed for gender identity disorder and pre-surgery evaluation:
“It takes several years and involves various medical practitioners, such as a surgeon, an endocrinologist, a psychiatrist, and in a country like Pakistan, preferably also a religious scholar if the transition is to get social acceptance.”
Ms Ahmed decided to take the plunge in 2009.
The team that examined her couldn’t get a cleric on board but they decided to go ahead with the initial hormonal therapy because “Ms Ahmed’s belief that she was a male was too strong, and so was the accompanying pain of having to live the life of a woman”, says Dr Malik.
“We decided to give her the initial hormonal therapy to grow facial hair, and laid down a schedule for a subsequent chest reconstruction surgery and possibly the removal of the uterus.”
Ms Ahmed also wanted phalloplasty, but was told she had to go abroad, maybe to India, to get that.
The surgery promised legal complications. Doctors involved in an earlier case of female-to-male surgery in Pakistan in 2007 were taken to court.
“But we also had to keep the interest of the patient in mind,” Dr Malik says.
Ms Ahmed says she was told by her psychiatrist that even after a sex change, she and her girlfriend would have to elope and live a secret life because their families could find them and possibly kill them, believing that they had breached family honour.
“Still I decided to go for whatever I could get in Pakistan as a first step.”
Changing partners set back Ms Ahmed’s plans for a sex change – they have been on hold for two years and she is yet to get back into the medical process.
Now, she faces another separation and huge decisions – none of them easy – if she is to live the life she wants.