Aliaa Dawood earned her PhD from the University of Westminster in London. She’s held teaching positions in the UK, Egypt, and Qatar. She’s the daughter of an ambassador and an expert on Egyptian media and politics. She’s published papers in international journals examining women’s roles in public discourse. But in the eyes of the US government, she’s permitted only to be a wife.

Dawood and her husband, Ahmed Aboumohamed, are Egyptian citizens, as are their two children. In 2011, Aboumohamed, a urologist, was granted a type H-1B visa, created in 1990 to allow those in high-demand, specialized industries like science, technology, and mathematics to be employed in the United States on a short-term basis. At the same time, Congress created the H-4 visa, which allowed spouses and children of H-1B visa holders to live in the country as a family—but not work. H-4 visa holders are legally classified as dependents. For Dawood, who fought years of familial and social pressures to reach each of her professional milestones, finding herself in such a constrained role has been a jarring and demoralizing experience. “I really would like to know why things are the way they are,” Dawood says, on a steel-gray New York day in early spring. “How can they keep accomplished women from working?”

This is the reality for most people who come to the United States on H-4 visas, even after the Obama administration created new guidelines allowing those whose H-1B-holding spouses have cleared a certain number of steps in the green-card-application process to work here legally. Before the new rules went into effect in February of last year, it was estimated they would benefit some 97,000 H-4 spouses; however, this calculation has proved to be grossly and maddeningly inaccurate. While an employer may apply for permanent residency on an H-1B holder’s behalf at any time during the visa’s six-year span, many won’t begin this process until the third, fourth, or fifth year of the employee’s stay, limiting the number of H-4 spouses who stand to benefit from the new rule and forcing them to endure as much as half a decade of forced dependency before they become eligible. For newcomers, as well as those like Aboumohamed whose bosses have not indicated any intention of applying for green cards on their behalves, the rule is meaningless.

Dawood was aware when she first arrived in the States that she wouldn’t be able to work. Her hope, and the hope of many H-4 spouses, was that with her extensive credentials, she’d find an employer who would be willing to pay the thousands of dollars in fees to sponsor her for her own H-1B visa. While her husband worked 14-hour shifts at the Cleveland Clinic on a fellowship in kidney transplantation, Dawood filed applications at local universities. Those who expressed interest backed off once they grasped her visa’s restrictions. Over the next four years, the family moved often: to Buffalo, for a robotics oncology fellowship; back to Egypt because of an immigration snafu; then back to the United States when Aboumohamed landed a new fellowship in Winston-Salem; then to New York City for a third robotics oncology fellowship. In each city, Dawood dutifully sought out professional opportunities. In each city, she was stymied.

H-1B and H-4 visas are technically gender-neutral. But marriage and the particular industries H-1B visas feed are deeply gendered institutions, and therefore it tends to be the husbands who come to this country to work and the wives who are stuck at home. This wasn’t exactly an immigration coincidence, says Pallavi Banerjee, a sociologist at the University of Calgary who has studied the impact of H-4 visa status on immigrants’ family lives. “The inflection of the conversation was, ‘We won’t get workers if we don’t let their wives join them, particularly from Asia and India, so we need to make provisions for families,’” Banerjee says. She calls the H-4 a “feminized visa,” one that lawmakers often implied was intended for women, even if they never said so outright. “There was a hidden notion that most women in India do not work and they are natural dependents anyway, so it shouldn’t be a problem.”

Ask women on H-4 visas though, and you’ll find it is a problem. Banerjee, who has interviewed roughly a hundred H-1B and H-4 visa holders (including female H-1B visa holders and male H-4 dependents), says she found that H-1B husbands typically had undergraduate engineering degrees, but their H-4 wives often had MBAs, law degrees, or PhDs. Many of these women were not only highly educated, they also had their own careers; the visa exploits the social expectation that women will prioritize their husbands’ careers over their own. Banerjee says she met one H-4 spouse who gave up her own H-1B visa after she got married. Her new husband was also in the United States on an H-1B, but their visas were for jobs in different states, so she gave up her legal authorization to work so they could live in the same city.

It’s been eight years since I could work. Who will hire me now?

Rashi Bhatnagar, who was a correspondent for fashion and lifestyle magazines in India before coming to the United States as an H-4 spouse in 2009, was so frustrated after an acquaintance made snide remarks on Facebook about her idle American life that she started a Facebook group called “H-4 visa, a curse.” She also runs a blog by the same name and considers herself an old-timer in the H-4 community.

Bhatnagar, whose husband is a supply-chain consultant, has moved around from Dallas, where her husband worked for JCPenney, to Minneapolis (Target), Portland (Nike), Milwaukee (Kohl’s), and Atlanta (Home Depot). With so many empty hours at her disposal, she became an activist, using her Facebook group and blog as a clearinghouse of testimonials, information, and links to scripts for calling congressional representatives and urging them to vote for immigration reform. Today, Bhatnagar’s Facebook page has more than 14,000 likes and is a hub of information and online advocacy. When we talk, she rattles off arcane technicalities and acronyms of US immigration law like the inadvertent expert she’s become. However, even if she were to go out on the job market, Bhatnagar is pessimistic about her chances for success. “It’s been eight years since I could work,” she says. “Who will hire me now?”

Dawood has experienced similar fears, although after returning with her family to Cairo in March of 2013, she was able to secure two teaching jobs, including a coveted part-time position at her alma mater, the American University in Cairo. But when Aboumohamed was offered the fellowship in Winston-Salem, he wanted her to return to  the United States with him. Dawood, who was intimately familiar with the competitive academic-job market, as well as what awaited her upon her return to the States, resisted at first. Her decision became even more complicated when she found out that she’d been shortlisted for a full-time faculty position at AUC.

“I tried to convince him that we should stay on in Egypt, the kids and I, and he would move, because I didn’t want to lose my job,” Dawood says. “We had huge fights, one of those fights you never forget.” Worse still, Aboumohamed had gone ahead to Winston-Salem, and they were arguing over Skype. With the emotional stakes, the seven-hour time difference, and the choppy video delay, “it was terrible,” she says. “A nightmare.”

In the end, Dawood relented. Her husband made the case that sixteen months apart, even if Dawood and the kids visited regularly, would be too much separation for their young family. “He said it would be very difficult for him to miss out on a whole year of the kids’ childhood. At the end I felt this was a sacrifice I had to make for my family.”

Once back in the States, Dawood grew increasingly depressed. The isolation of being in a new city and spending all her time alone with their twin toddlers drove her to what she’s sure was depression. “My husband would leave the house at 6 a.m., and if he came back at 7 p.m. I was very lucky,” Dawood says. Her hair started falling out, and her husband realized she was unraveling. She and the boys returned to Egypt for a semester “because I couldn’t take it,” she says.

Not only is it common for H-4 spouses to describe experiences consistent with depression, says Banerjee, the sociologist, some of the women she’s spoken with have also mentioned considering suicide. The lasting mental-health toll of being bound to their homes affected their husbands too. “One of the men I interviewed said before his [H-4-visa-holding] wife started seeing a psychologist, he would call home every hour to make sure that she had not jumped out of the window of their apartment,” Banerjee says.

Today, Dawood attends journalism and media conferences around New York City just to get out of the house and keep her brain sharp. She worries about her future employment prospects in Egypt. Her doctoral-thesis work concerned the intersection of women and media in the run-up to the Arab Spring, but she has been unable to do any follow-up research on its aftermath. Earlier this year, Dawood sat for an interview for a vacancy at her old university, “but I don’t think I did very well,” she says. “The only thing I could talk about was Egypt before the revolution.”

Dawood insists that her husband has been supportive of her career and understanding about her plight. But she’s not sure how things would play out if the opportunities were reversed. “Him not having a job at all? I don’t think he would go that far,” she says. “It’d be too much to ask of him.”

They’ve stopped posting photos of their American life on Facebook. Dawood says that Aboumohamed told her, “‘When you post pictures of us in Central Park, all people see is that we’re in this beautiful place. They don’t know that the day before, I worked until 2 a.m., and you cannot work and you’re cleaning the toilet. They don’t know anything about all of that. They only see that photo and think, Wow, they’re in heaven.”