She has attempted suicide, beaten down by strict Islamic laws that activists say subject transgender people to increasing legal constraints, discrimination and marginalisation.
"The way they treat you is like you don't have any rights, you don't have any dignity," said Nisha, 37, dressed in the flowing skirt and long-sleeve shirt favoured by Malaysian Muslim women.
But she channelled the fury over her mistreatment into advocacy, and has become the country's most prominent LGBT activist, despite the personal risk that entails.
A Muslim, Nisha's first overt gender-identity expression came at age nine in a costume contest at her straight-laced boy's school -- she dressed as a ballerina.
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Years of family and societal rejection followed, she told AFP at SEED Foundation, an NGO she runs in a crime-ridden neighbourhood in the capital Kuala Lumpur.
In 2000, just 21-years-old, she was arrested by the feared state religious enforcers who swoop on Muslims suspected of "un-Islamic" behaviour.
Nisha said she had fully transitioned to a woman by then, although like many in the transgender community she did not disclose details which are considered private. However, she was sent to a men's prison.
"So that I can come back as a real Muslim man," she ruefully recalls the judge saying.
She attempted suicide in prison, and again after release. Traumatised, she drifted briefly into sex work, like many others in her situation.
Human Rights Watch said in a 2014 report that Malaysia was "one of the worst countries" in the world for transgender people.
In 2010, she co-founded Justice For Sisters, which highlights trans persecution and, four years later, SEED Foundation, which assists transgender people, sex workers, HIV sufferers and other marginalised groups.
Transgender is the umbrella term for individuals who identify with a gender different to their sex at birth.
While there are no official figures for Malaysia, transgender women are commonly seen -- especially in the capital Kuala Lumpur -- working in restaurants and retail outlets.
But violent attacks remain an ever-present threat. One recent assault left a transgender woman in a brief coma, Nisha said. The attacker was fined just 400 ringgit (USD 100).
Many transgenders fear seeking police help over abuses, and Nisha advises victims on where to turn if attacked or arrested.
Despite a thriving underground gay scene, homosexuality also is forbidden in Malaysia, where laws criminalising sodomy can result in imprisonment, corporal punishment, and fines.
Many keep their sexuality private even from their families. A 2015 HRW report said discrimination against such groups was "pervasive".