ALBANY, Ga. - Nikkia Scott and other drag queens have been getting illegal, back-room injections of industrial-grade silicone to give themselves some of the things nature denied them when they were born male - breasts, wider hips, more prominent cheekbones.
They know the risks are extreme, and still they do it.
"Anything you put in your body that don't belong there will hurt you in the long run," Ms. Scott said of her $6,000 in injections. "But believe me, it has been worth it. It has been worth it."
The dangers were illustrated recently by the death of 23-year-old Andre D. Jeter, who authorities say suffered convulsions and fell unconscious Dec. 10 after receiving injections during a "pumping party" in Albany. She died a month later.
One of Ms. Scott's roommates, Stephen Oneal Thomas, 31, was charged last week with murder and other offenses, accused of administering the injections.
Ms. Scott and three others were also arrested and charged with conspiracy and practicing medicine without a license.
They were accused, among other things, of helping Mr. Thomas by recruiting patients at drag-queen beauty pageants.
The victim was a man living as a woman, as are the defendants.
The death has thrown a spotlight on "pumping," a thriving underground practice among men living as women, particularly those who compete in beauty pageants and perform in drag shows. Pumping parties are typically held in motel rooms or apartments.
While medical-grade silicone is implanted under the skin in sealed sacs to keep it from leaking, pumping involves injecting silicone straight into the body.
The silicone used is the stuff sold in hardware stores as a sealant. It is not sterile and can cause infections. The silicone is often mixed with paraffin, even peanut butter, said Dallas Denny of the transgender support group Gender Education & Advocacy. In Ms. Jeter's case, it was probably mixed with baby oil, based on how it smelled to others who received injections, said James Paulk, an investigator for the district attorney.
There was so much silicone in Ms. Jeter's body that when incisions were made during the autopsy, a clear, brownish liquid flowed out, Mr. Paulk said.
The scope of the phenomenon is unclear. The Centers for Disease Control and Prevention, the Food and Drug Administration and transgender groups said they don't keep track. Mr. Paulk said a "slew" of people have been hurt, including three in Montgomery, Ala., six in Columbus, Ga., and a few in Jacksonville, Fla.
"The transgender society is a very tight-knit society. They don't like to give each other up because ... you get barred from the pageants," he said. "If they're not hurting ... they aren't calling me."
A day after her arrest, a stubble-faced Ms. Scott, wearing large hoop earrings, was back to gluing weaves to heads at a beauty parlor in Albany. Her roommate Jazz, also arrested in the case, was at home, wearing pajamas and pink flowered flip-flops.
Jazz and Ms. Scott compete in drag shows during "black society" nights at a bar called Queens in Albany. They dress in gowns and perform songs for tips.
They both strongly denied any involvement in giving silicone injections and said they did not know their roommate Mr. Thomas was "pumping."
Ms. Scott, identified as Freddie Clyde in court documents, said the injections have not caused any serious health problems. But Jazz, whose legal name is Mark Edwards, said she has had three procedures - face, bust and lower body - that cost about $3,300, and has suffered severe side effects.
Last year, she said she started coughing heavily and discovered the silicone was in her lungs, giving her chemical pneumonia.