ISLAMABAD - When Pakistani 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.
The undercounting of transgender people will have serious consequences, said Kami Sid, a transgender woman who works as a model and actor - but whose identity card marks her as male.
Now the government can claim "'you are just a handful and so these many resources are enough for you'" she said, adding: "They can wash their hands of us without feeling guilty."
The concept of a third gender dates back centuries in South Asia and the "khawaja siras" community, identifying as neither male or female, are accepted but marginalised - with transgender and intersex people often forced into begging and sex work.
Anis Haroon, member of the National Commission on Human Rights, said transgender people had been "disturbingly undercounted" and little would change until official records more accurately reflect the size of the community.
"If their numbers are not fully reflected it will affect policies to bring them at par with other citizens. They will be deprived of their share in education and jobs," Haroon said.
In 2010, the Supreme Court ordered the full recognition of the transgender community, including the provision of free medical and educational facilities, microcredit schemes and job quotas for transgender people in every government department.
Pakistan's first law recognising transgender people as equal citizens with penalties for discrimination and violence against them is pending approval in parliament.
It also gives inheritance rights to transgender people - something which has held them back from declaring their gender status on official documents.
"If I declare myself as a trans woman, I will lose my inheritance as Islamic law gives me no such privilege," said Kami Sid, the transgender model.
However Rana from the Jiya NGO said when census officials came to her home she was determined to declare she was transgender.
"Although there was no separate column on the form, they did write my gender as per my wishes on the form," she said, but most transgender people, many of them with little education, did not realise that this was possible.
Farid Midhet, a demographer at the Johns Hopkins University-affiliated health non-profit, Jhpiego, said one way of getting the numbers right would be to include questions about transgender people in the next Pakistan Demographic and Health Survey, which will begin early next year.
"Maybe the PDHS is not as spread out as the national census, but ... (the surveyors) can ask these questions in a more sensitive manner to get honest responses," he said.