The New York Times notes that despite a "climate of religious conservatism" and a "taboo" towards homosexuality, same-sex activity between men is "common enough," and that in society such relations are not "named" (3 Nov. According to a gay man from Karachi who was interviewed by The Guardian, for gay men from the "more privileged urban community" it is possible to have a gay social life provided it is "discreet and under the radar," but for LGBT Pakistanis who are poor, not well-educated, and lack Internet access, it is difficult; "there isn't even a consciousness about what it means to be gay" (The Guardian 13 Sept. Similarly, the President of Neengar Society said that there are LGBT social media groups and organized meetings in cities like Lahore, Karachi and Islamabad, but that this culture exists "only among the upper middle class, elite and intellectual elite class of Pakistan" (20 Dec. The New York Times indicates that those who self-identify as LGBT in Pakistan tend to be urban, well-educated, and from the middle or upper-middle classes (3 Nov. Media sources describe Karachi as having a "highly vibrant gay subculture" (IBTimes 7 Sept. 2013), and a number of gay "hotspots" (IPS 27 Sept. The BBC described Karachi as a "bustling with same-sex activity" in terms of men having sex with men, however it also indicated that it is difficult for gay men to maintain same-sex relationships, because "sex between men will be overlooked as long as no-one feels that tradition or religion are being challenged" (BBC 26 Aug. The Neengar Society president said that Lahore, Karachi and Islamabad are "more liberal and accepting" of LGBT people than other areas of Pakistan, but that "no one can openly claim to be gay or lesbian in Pakistan as it can still cost them their life to announce their sexuality in public" (Neengar Society 20 Dec. Corroborating information could not be found among sources consulted by the Research Directorate within the time constraints of this Response. Pakistan Enhanced HIV/AIDS Program: Social Assessment and Mapping of Men Who Have Sex with Men (MSM) in Lahore. Correspondence from the President with the Research Directorate. 2002, 4) or "despised and ridiculed" (IBTimes 7 Sept. The BBC notes that because young men in Pakistan are discouraged from having premarital sex with women, men sometimes have their first sexual encounter with other men (26 Aug. Media sources indicate that Pakistani society and families expect men to get married and have families regardless of sexual orientation (IPS 27 Sept. 2013), and that some married men also have male sexual relationships (IPS 27 Sept. According to the New York Times, some Pakistani men may have sex with other men when "they need a break from their wives" or to make money (3 Nov. 2.2 Lesbians According to The Independent, lesbians are "completely invisible" in Pakistani society (27 Mar. Similarly, the New York Times states that lesbians are "even less visible" than gay men (3 Nov. The President of Neengar Society said that the situation for lesbians in Pakistan is particularly difficult (20 Dec. He explained: Because of the situation of women's rights in Pakistan, lesbians rarely get access to good education, awareness about human rights or even their own sexuality.
The proportion of histologically verified diagnosis for various cancers ranged between 98–100%; there were no cases as death certificates only (DCOs); 86–93% of total registered cases were included for survival analysis. The 5-year age-standardized relative survival rates was the highest for cancer of the salivary gland (44%), followed by oral cavity (40%), tongue (39%) and tonsil (3%).
No cases were registered on the basis of a death certificate only.
The exclusion of cases owing to the non-availability of any follow-up information is 7%, ranging from 9% in cancer of the tonsil to 7% for oral cavity.
The New York Times described an LGBT support group in Lahore that conducts research, provides legal advice, helps LGBT people in "difficult family situations," and operates with a high level of vigilance and secrecy "because of the laws against homosexual acts" (3 Nov. Neengar Society provides an emergency shelter to LGBT people who face threats or exclusion (Neengar Society 20 Dec. According to the President of Neengar, there were a total of 70 LGBT people seeking shelter in 2013; of these, 10 were lesbians, 5 were transgender and 55 were gay or bisexual men (ibid.). According to Channel News Asia, the Pakistan Telecommunication Authority banned the website because it claimed it was "immoral," while the website's creators claimed that the ban was "'unconstitutional'" since the website did not contain "'explicit or offence content'" (21 Oct. CNN reports that the Queer Pakistan website noted "religious, political and social" opposition to its existence on its last entry in September 2013 (CNN 26 Sept. According to Channel News Asia, the website's creators do not want to challenge the ban because they do not want to reveal their identities (Channel News Asia 21 Oct. This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. "Gay Pakistan: Where Sex is Available and Relationships are Difficult." [Accessed 9 Dec.
The Neengar Society President noted that LGBT social media sites are prominent in Pakistan (ibid.). This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection.