There are no gay bars, 'LGBT rights' is an unheard phrase and homosexuality is considered to be against the ruling religion - but one gay man has said he finds life easier in Pakistan than in the US.
Qasim, 41, made the controversial statement in an interview with AFP when the reporter met him and his boyfriend Ali in a coffee shop.
'We can hold hands,' said Qasim. 'We can sit casually like this. Nobody gives it a second thought.' He added that he's never been insulted in the street in Pakistan, like he was when he lived in the US.
In Parkistan's Islamic society where men and women are kept segregated, it is easier for a gay male couple to spend time together than it would be for a non-married straight couple. Men holding hands and hugging in the street is a sign of friendship.
Qasim lived in the US from the age of three until his mid-20s, when the law at the time said that he had to give up his US-citizenship because he contracted HIV. When he retuned to Pakistan he says it was a 'culture shock' but after a few years he set up a charity for gay men and transgender people, which is covertly supported by the government.
'I get respect,' Qasim said. 'I feel appreciated for the work I'm doing. Hopefully I'm changing people's lives and making a difference.'