“When you change back, it’s like you are born again, and you have to learn everything from the beginning,” she explained. “You get a whole new life. Again.”

From that fateful day she first became a mother — Feb. 7, 1999 — Mrs. Rafaat knew she had failed, she said, but she was too exhausted to speak, shivering on the cold floor of the family’s small house in Badghis Province.

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