With his wrestler's build and deep voice, it is hard to believe that Hussein Rabei could ever be mistaken for a woman, but in the Middle East cultural norms can blind people to the glaringly obvious.
Formerly known as Zaineb, 33-year-old Rabei was raised as a girl after being born with genitalia that more closely resembled a vagina than a penis. Arab culture and its rigid views on gender meant doctors ignored growing signs that Rabei may in fact be male, he said.
"When I married, my husband used to say, 'It's funny, but when I'm with you it feels like I'm with one of the guys, not my wife'," said Rabei, who is now divorced.
Rabei returned recently from an operation in Thailand to correct his gender a procedure for which he obtained consent from both Sunni and Shi'ite clerics.
He is the first Bahraini to go public with news of such an operation, his lawyer said. It triggered a flood of media coverage and condemnation from many of his fellow Bahrainis for what they see as a procedure forbidden by Islam.
Most Muslim scholars say changing one's sex is forbidden unless it is related to an intersex condition such as Rabei's.
His is one of a range of relatively rare conditions in which there is a mismatch between the body's sexual genetic code and its physical make up. Instead of having two X chromosomes the female pattern he has an XY or male configuration.
This is a complex issue that Rabei said much of Arab and Islamic society was not yet ready for.
"I want to talk, to educate society that this is an illness, not a sexual perversity. . . many aren't listening," he said.
Although Iran permits sex-changes, homosexuality is punishable by death in Iran and by imprisonment and lashings in other Middle Eastern countries, highlighting rigid adherence to perceived gender norms.
A champion shot-putter and discus-thrower, Rabei has photos of himself as a woman towering over other female competitors, which prompted sporting authorities to raid his home looking for performance-enhancing drugs.
But his build was not enough to prompt doctors to entertain the idea that he was not a woman.
"Every time I went to hospital, they told me I was a woman," he said, adding doctors routinely failed to diagnose a lack of internal female reproductive organs. Staff at one clinic laughed when he went for tests to determine his genetic sex.
Doctors instead prescribed pills to induce menstruation and suggested an operation to open the hymen when Rabei could not consummate "her" marriage.
Not all those with intersex conditions are unhappy with their assigned gender, but Rabei was.
"It's Arab society, that's all I can say, with its customs and traditions. A man's a man and a woman's a woman," Rabei said.
Rabei turned to a foreign clinic, which found he was genetically male and lacked a female reproductive system.
Rabei's lawyer, who is fighting to have his sex and name changed on official documents, said her work was not easy.
"People have been attacking me personally, asking me why I encourage sex correction. According to them, this is haram, or forbidden in Islamic and Arab society," Fouzia Janahi said.
Rabei's employers have demanded his resignation and psychiatrists have declined to counsel him for life as a man.
"I'm not saying I'm not under intense pressure, but as long as what I'm doing is right medically, religiously and legally, I don't care what people say," he said. "Praise God, I feel like I'm a man, I feel like I'm myself."