On March 19, 2019, the State Security Prosecution renewed the detention of Malak El Kashef for 15 days pending investigations in case No. 1739/2018. The defendant’s lawyers filed requests to investigate the anal examination ElKashef was subjected to during her detention, which constitutes a flagrant violation of her right to bodily integrity. Anal examinations are a form of degrading treatment that was prohibited by the United Nations Committee against Torture. Malak El Kashef's lawyers also filed a request to the prosecution to enable the defendant to secure her constitutional right to receive medical services in custody by presenting her request to the "Sex Correction Committee of the Doctors’ Syndicate" and enabling her to perform the desired complementary surgery.

The conditions of detention of Malak El Kashef, a transgender woman, raised human rights concerns since her arrest. Although she has come a long way in her desired transition, she is still waiting for a final operation based on which she would be able to change her identity papers to reflect her identity as a woman. This has raised serious concern about the location and conditions of her detention to ensure that she is not subjected to any form of violence or ill-treatment.

The Ministry of Interior has subjected the Malak El Kashef to a medical examination, during which doctors in a public hospital have violated her bodily integrity and psychological wellbeing by forcing her to undergo anal examination. Compulsory anal examination is a form of degrading treatment that has repeatedly been prohibited by the Committee against Torture as mentioned before. It is also a flagrant violation of the human right to bodily integrity and dignity. It lacks any scientific basis. It is based on false and misleading knowledge derived from a book by a French forensic physician, Auguste Ambroise Tardieu, published in the mid-19th century. A large international panel of independent forensic experts declared that these examinations do not carry any medical or scientific worth. They also asserted that it is humiliating and degrading and often causes long-term psychological damages. As well as being considered sexual assault according to article 268 of the Penal Code. The facts of the anal examination were recorded in the prosecution's investigation and her lawyers filed a request to investigate the incident.

El Kashef’s lawyers submitted another request to the State Security Prosecution to enable her to exercise her constitutional right to receive medical services in detention in accordance with the Prison Regulations governing the right of a prisoner to receive care inside or outside prison facilities.

The lawyers demanded that she be presented to the "Sex Correction Committee in the Doctors Syndicate" to allow her to complete the steps she requests in her transition, as the "Sex Correction Committee" is the authority delegated to allow transgender persons to receive medical services in public hospitals. And as she already passed psychological review and hormonal therapy and began the early stages of surgical intervention. However, her current status in detention prevents her from taking the medical steps she had already planned. Her detention should not be a hindrance to receiving the desired medical care, like other medical services.

The Egyptian Initiative for Personal Rights stresses the responsibility of the Ministry of Interior for the security and physical and psychological safety of Malak El Kashef, and to ensure that the place of detention is safe and appropriate for her gender. It stresses the rejection of any form of anal examination by forensic doctors or doctors in any medical facility to any detainee, as it is a form of degrading treatment that amounts to torture.