A 24-year-old transgender woman with HIV is struggling between life and death in India after a state hospital refused to admit her, saying she needed judicial permission for that.

The woman, who sought treatment for a severe urinary infection, is suspected to have been infected in February when she underwent castration.

The castration was performed by hijras, members of India’s eunuch community, in the eastern Indian state of Bihar, using primitive methods that inflict terrible pain and carry a high risk of infection.

The person undergoing the operation is held down by force by members of the community and after castration, has the wound cauterized with scalding hot oil.

The trans woman, whose identity has not been divulged because of her HIV status, was brought to the state-run SSKM Hospital in Kolkata, the workplace of Mother Teresa, by members of her community this month.

According to local media reports, urologists at the hospital said she should be admitted for treatment.

However, the hospital authorities refused to admit her, saying there were no wards for third-sex patients. She was asked to bring an order from a district judge if she wanted to be taken in.

Getting an order from a district judge or any government official is a near-impossible task for India’s eunuch community, given their lowly status in the eyes of society.

Most of them are disowned by their families and manage to survive by singing and dancing at weddings and birth ceremonies. They are mostly uneducated, live near the poverty line and run a high risk of becoming infected with HIV and sexually transmitted diseases due to lack of awareness and vulnerability to sexual violence.

The Association of Transgender and Hijra in Bengal asked the West Bengal State AIDS Prevention and Control Society to intervene but to no avail.

Finally, tired of hanging around the hospital, the patient’s friends in the community decided to take her back to Bihar and seek traditional remedies there.

Traditional remedies usually mean going to village quacks, lessening a seriously ill patient’s chances of survival.

Though the eunuch community is more visible than gays and lesbians in Indian society, has been the subject of films and have taken part in elections, their condition remains appalling with little effort by state governments to provide them education or employment opportunities.

Last month, Aadhaar, an identity card issued by the central government, recognized transgenders but few transgenders are in a position to claim the card.