Introduction <p>Transgender and gender non-conforming persons have a long, complex history in Pakistan. This descriptive study explores the cultural context and investigates key factors impacting the health of transgender and gender non-conforming participants in Pakistan as part of the Global Pride study.</p> Methods <p>The Pakistan sample (<i>n</i> = 81) of transgender and non-transgender participants completed a self-administered questionnaire. Bivariate analyses explored differences in victimization, discrimination, and basic needs by transgender identity. Linear regression analyses examined the extent to which victimization, discrimination, basic needs, and social support predict disability and general health, controlling for gender identity, sexual identity, age, and education.</p> Results <p>Among participants sexual violence and threats of violence were the most frequently reported forms of victimization, while being prevented from living in a desired neighborhood and losing a friendship were the most frequent forms of structural and interpersonal discrimination. Transgender, compared to non-transgender, participants were significantly more likely to be prevented from living in a desired neighborhood and to experience disrespect. Disability was significantly associated with increased victimization and discrimination. General health was significantly predicted by experiences of discrimination, victimization, fulfillment of basic needs, and access to social support.</p> Conclusions <p>Discrimination and victimization have serious health consequences. These findings highlight the urgent need for policies and programs that promote safety, inclusion, and cultural acceptance.</p> Policy Implications <p>Strengthening the enforcement of legal reforms and the development of social interventions are needed to protect the health and rights of transgender people in Pakistan.</p>