August 26 should have been a day of celebration for Ezz Eldin, a 26-year-old transgender man, but it ended in tragedy. He bled to death after he was prematurely discharged following a gender-affirmation surgery in an underground clinic, transgender activists told Human Rights Watch. Ezz Eldin, who also went by Ahmed Fares, need not have died, and what should have been a life-affirming surgery instead became a life-threatening procedure in an unauthorized clinic. A dysfunctional, discriminatory system left him with no surgical alternative. This is the situation for transgender people in Egypt who are denied access to appropriate health care under a government that discriminates against them and withholds legal gender recognition. His desperate attempts to get the care he needed arose, in part, due to discord between religious and medical authorities. The impasse originated almost two decades ago and revolves around the extent at which religious authorities should have a say in medical matters. It is based on a fatwa, or religious edict, that permitted medical intervention only for intersex people, who are born with characteristics that vary from what is considered typical for female or male bodies. Transgender individuals, whose gender differs from the sex they were assigned at birth, were disqualified. This confusing, contradictory, and discriminatory policy has left transgender people in Egypt with very few choices—if they want surgery, unregulated and often unsafe clinics are the only options.