Malak el-Kashif left home on her birthday seven years ago. Walking into an uncertain future, she was underdressed for the weather and armed with little— except for some makeup, a few women’s accessories and 50 Egyptian pounds (at the time about six American dollars). “I was afraid but I didn’t hesitate,” she said. “There weren’t any other solutions.” That night, el-Kashif identified as a 13-year-old boy. She has since emerged as perhaps Egypt’s most outspoken transgender woman activist. It’s a label that in a largely conservative and patriarchal society has meant battling a war on multiple fronts. “When you declare you are different, you should get ready for war. A big war,” she said. “The society will stomp on you and treat you like you are the enemy.”