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Saudi Arabia has confirmed the death of at least one transgender Pakistani among 35 who were arrested in Riyadh last week for "imitating the opposite sex".

According to rights activists in Pakistan, two of those arrested were placed in sacks and beaten to death in police custody (see previous blog post).

Yesterday, the Saudi interior ministry denied any torture but said one detainee had "suffered a heart attack and died in the hospital after being treated". The ministry's statement, which was quoted by Reuters, also appeared to confirm a second death, saying "The Pakistani embassy looked into this case and another one." There is no further information about the "other one".

The ministry added that arrangements are being made to send the body of the alleged heart attack victim "back to his [sic] country". At that point it may be possible to clarify the cause of death.

However, there may also be questions about the identity of the body. The Saudi ministry has given the age of the alleged heart attack victim as 61. On the other hand, activists say the two allegedly beaten to death in custody were aged 35 and 26.

The arrests were the result of a police raid on a gathering of Pakistanis who are known in their home country as khawaja sara, sometimes described as the "third sex". 

Khawaja sara have long been a feature of South Asian society and, though they are often despised and abused there, they have gradually been gaining some rights. Many of them live together in organised communities headed by a guru. 

Qamar Naseem, a rights activist in Pakistan, told al-bab on Sunday that those arrested in Saudi Arabia were mostly from the north-western province of Khyber Pakhtunkhwa, bordering Afghanistan. They were working in several Saudi cities, mostly in manual jobs such as carpenters, tailors and car mechanics, and had gathered in Riyadh for a formal ceremony known as Guru Chela Chalan where they choose their gurus and the gurus choose their chelas (students or disciples).

It is unclear how the Saudi authorities became aware of this activity but press reports quote a spokesman for Riyadh police as saying that the rest house where the ceremony was being held had been "under constant surveillance". The spokesman added that "women’s clothing and jewellery" – apparently incriminating items – had been retrieved from the scene.

Transgender people are targeted in Saudi Arabia, the UAE and Kuwait under laws against "imitating the opposite sex". Such laws are viewed as necessary in order to enforce compliance with gender stereotypes and maintain segregation of the sexes. They are also claimed to be legitimised by religious teaching. 

In the hadith – collections of sayings and deeds attributed to the Prophet Muhammad which are not necessarily reliable – the Prophet is said to have cursed "effeminate men and mannish women", and to have condemned "men who imitate women" and "women who imitate men".

There is no mention of that in the Qur'an itself, though one verse in the Qur'an (51:49) says “We created all things in pairs”. Extrapolating from this, Islamic theologians have concluded that God has assigned a sex – male or female – to everyone, and that attempting to change it is against God's will.

This doctrine does allow some flexibility in intersex cases, where the divinely-assigned sex is believed to be hidden. If a person's sex is anatomically unclear, “uncovering” it through surgery is both permissible and religiously desirable – since this also reinforces the idea of a clear-cut male/female binary by bringing the intersex person into conformity with established gender “norms”. On that basis, "corrective" surgery has sometimes been permitted in Saudi Arabia.

However, the insistence that God creates only male or female causes problems for others on the transgender spectrum: for those who identify as gender-neutral and those whose sexual anatomy conflicts with their gender identity (a condition known as gender dysphoria). Sunni Islamic jurisprudence tends to view that as rejection of the sex assigned by God.