‘He Says I’d Be of No Use Without a Uterus’: When Men Control Women’s Access to Lifesaving Care in Egypt

This article is co-published with Egab.

At Al-Munira General Hospital in Egypt’s working class neighborhood of Sayyida Zeinab, Suad*, in her late thirties, sits on the floor with her two small children – no older than 10 – and another three-year-old slung on her shoulder. 

“I've been to many gynecologists in public hospitals to get a second opinion; they all agreed that if I don’t get a hysterectomy, I’ll die,” said Suad, whose husband is a construction worker.

A uterine tumor has caused her to bleed for over 10 months, she says, until she became anemic. Yet her husband refuses to sign the consent form for the surgery. 

“He says I’d be of no use to him without a uterus,” she told More to Her Story.

Mona*, a 37-year-old mother of two, has spent years fighting for the right to make decisions about her own body, to the extent that she delayed life-saving surgery to remove a tumor simply to save her marriage. 

In the world of Mona and Suad, reproductive health is controlled by husbands, family members, and even doctors.

Their stories are not unique. Across Egypt, millions of women are denied autonomy over their sexual and reproductive health, treated as if their bodies are community property rather than their own.

Heba Rashed, the founder of the Cairo-based Mersal Foundation, a healthcare NGO, describes  healthcare discrimination in Egypt as “one of the worst forms of violence against women.”

A recent qualitative study by the Edraak Foundation for Development and Equality titled “How Women in Egypt Make Medical Decisions Related to Their Sexual and Reproductive Health”, exposes the depth of this crisis. Researchers conducted focus groups with 135 participants across three Egyptian governorates, including married and unmarried women, and healthcare providers.

The findings are stark: women’s ability to reproduce is seen as central to their value in society, often overshadowing their own wishes or wellbeing. Many women reported that decisions about their health, whether to seek treatment, undergo surgery, or even visit a gynecologist, are influenced or outright dictated by husbands, in-laws, and broader social expectations. 

The study confirmed that the uterus is not considered merely a biological organ, but represents a fundamental element of a woman's identity. The ability to reproduce is a criterion for femininity, and a woman who has lost her uterus has lost part of her gender identity. 

As one woman participant in the study said: “If I remove my uterus, how will I be a woman?”

The study also highlights the damaging role of the “virginity myth” and the persistent suspicion women face when seeking reproductive care.

Najwa Ibrahim, Executive Director of Edraak, said one doctor confirmed that the husband who refused to give consent for a hysterectomy told his wife: “We’ll both be the same; you'll become a man like me.”

Neither the age, nor the duration of the marriage make a difference in attitude, he said.

Afaf*, in her late forties, also from Sayyida Zeinab, has been married for 25 years and has four children. 

Eight months ago she felt severe pain and recurring bleeding outside her menstrual cycle. When her condition deteriorated, she visited a doctor, only to learn that she suffered first-stage cancer in the uterine lining, which required an urgent hysterectomy. 

“But my husband refused,” Afaf said. “He even threatened to divorce me and take away my two daughters. I now have to choose between saving my life or preserving my family.”

“This is yet another manifestation of a patriarchal culture that grants men all rights and deprives women of their most basic right to have control over their bodies,” Magda Soliman, Director of the Sexual and Reproductive Rights Program at the New Woman Foundation, told More to Her Story.

The husband doesn't see his wife as an independent person, she continues, but as a vessel to satisfy his needs. 

“Removing her uterus would make her incomplete, without value, and would threaten the intimate relationship,” Soliman told More to Her Story.

Legally, she continues, Egyptian law does not include any clauses that prohibits an adult woman from making decisions about her body or gives the husband such authority. 

“But this does not come as a surprise in a society that still deprives girls of their right to marry without a legal guardian, deprives them of inheritance as in some Upper Egypt villages, despite their religious right to it,” said Soliman.

Jamila*, 37, an engineer married for 15 years from the affluent Maadi neighborhood of southern Cairo, suffered more than three years from severe chronic bleeding with pelvic and lower back pain. When she learned that she had multiple fibroid tumors and uterine adenomyosis, a hysterectomy was the only option. 

“But my husband, a lawyer, refused and threatened to take another wife,” said Jamila.

Huda Zakaria, a sociologist at Zagazig University, emphasizes that socio-economic class does not indicate appreciation of women's rights, noting that this mindset cuts across all strata of society.

“Reactionary religious discourse contributed to this patriarchal culture, ignoring the basic provisions of Sharia which gives women autonomy over their physical health and human dignity,” said Zakaria. 

Unmarried women are not immune, says Edraak Director Ibrahim.

“The study also revealed the social stigma haunting unmarried women who visit a gynecologist, which is why some prefer to suffer rather than face this negative perception,” Ibrahim told More to Her Story.

Wafa, a single 30-year-old teacher from Old Cairo, says that despite suffering from an ovarian cyst and two fibroid tumors she was unable to undergo urgent surgery which required her father's written consent.

 “But my father lives abroad,” said Wafa. “How can I be this old but not be able to decide whether to have surgery?” Her only option was to postpone the surgery until her father’s return, despite the severe pain and recurring bleeding.

Crucially, the research draws attention to the lack of trust between women and their doctors, and the overwhelming influence of family and societal pressures in medical decisions, resulting in a system where women’s voices are marginalized, and their health outcomes suffer.

Ibrahim and Soliman say that a husband or a male guardian’s consent for procedures related to women's reproductive health primarily reflects a fear of being held legally accountable.

The legal framework in Egypt is unclear regarding women's autonomy in reproductive decisions and leaves room for interpretation, they say, in a system that does not offer doctors protection from verbal and physical assault or even imprisonment.