In December 2012, a 23-year-old physiotherapy student boarded a bus in New Delhi a little after 9 p.m., expecting it would take her home. Instead, she was gang-raped and assaulted so viciously with an iron rod that her intestines were damaged. She died days later as India erupted in rage.

Nearly 12 years later, the nation is convulsing with anger once again — this time, over the ghastly rape and murder of a 31-year-old trainee doctor in a Kolkata hospital, as she rested in a seminar room after a late-night shift. Since the Aug 9. killing, thousands of doctors have gone on strike to demand a safer work environment and thousands more people have taken to the streets to demand justice.

For a country desperate to be seen as a global leader, repeated high-profile cases of brutal sexual assaults highlight an uncomfortable truth: India, by many measures, remains one of the world’s most unsafe places for women. Rape and domestic violence are relatively common, and conviction rates are low.

This week, the Supreme Court of India took up the Kolkata case as one of fundamental rights and safety, questioning how hospital administrators and police officers had handled it and saying new protective measures were needed. “The nation cannot wait for another rape and murder for real changes on the ground,” Chief Justice D.Y. Chandrachud said.

Gender-related violence is hardly unique to India. But even as millions of Indian women have joined the urban work force in the past decade, securing their financial independence and helping to fuel the country’s rapid growth, they are still often left to bear the burden of their own safety.

Longstanding customs that both repress women and in many cases confine them to the home have made their safety in public spaces an afterthought. It can be dangerous for a woman to use public transportation, especially at night, and sexual harassment occurs frequently on the streets and in offices. Mothers tell their daughters to be watchful. Brothers and husbands drop their sisters and wives off at work.

In 1997, India’s Supreme Court issued guidelines intended to prevent sexual harassment in the workplace. Those rules stemmed from the 1992 rape of a social worker, Bhanwari Devi, who tried to stop the marriage of a nine-month-old child.

A bill to put the guidelines into law was proposed in 2007. It was approved six years later in 2013, a year after the gang-rape of the young physiotherapy student in New Delhi, who came to be known as Nirbhaya, or fearless.

The legal protections have been ineffectual partly because the government has been lax about implementing the law and investing in mechanisms to properly handle cases of sexual assault, said Vrinda Grover, a lawyer and women’s rights activist.

She said that investigations she had examined were often “unprofessional, shoddy” and carried out by people with little training. The state’s approach, Ms. Grover said, is colored by prejudice against women.

If the government acts only after people organize protests, “then it is the system that has become dysfunctional and we will not see the end of sexual violence,” she said.

In the Kolkata case, Chief Justice Chandrachud identified a number of breakdowns in the official response to the rape and killing. He asked why hospital administrators and police officers had not followed protocol in reporting the crime in the hours after the victim’s body, which bore signs of rape and brutal injury, was discovered at R.G. Kar Medical College and Hospital, where she worked. The top court also set up a national task force to recommend safety measures to protect medics, who are often subject to violence and abuse.

Three senior officials at the Kolkata hospital have been removed from their posts. A 33-year-old man, who was a volunteer at a police post at the hospital, has been arrested in connection with the killing, but as of Thursday he had not been charged. The Supreme Court ordered the Central Bureau of Investigation, which is handling the case, to submit a status report on Thursday.

The ongoing protests — with dozens of Bollywood celebrities and other public figures lending their voices — have morphed into widespread anger, not just at the plight of many in the medical profession, but also about workplace safety for women.

The millions of Indian women who have entered the work force in recent years have challenged patriarchal norms to pursue the same opportunities that men have in one of the world’s fast-growing economies. Women, along with men, are also increasingly migrating from villages to cities, seeking better earnings.

But India still has a low labor force participation rate among women compared to other countries, a figure that had been on a long downward slide until the past few years. Women make up less than a third of India’s urban labor force, and men vastly outnumber women in both government and private-sector jobs.

Safety in the workplace is essential if more women are to enter the labor force, said Gita Gopinath, the first deputy managing director of the International Monetary Fund.

“No way that will happen if women in India don’t feel completely safe,” Ms. Gopinath, who is of Indian origin, told the journalist Barkha Dutt in an interview posted this weekend on YouTube. “Not having to worry about your safety is absolutely a basic right” as a woman, she said.

The numbers tell a harrowing story for Indian women. In 2023, the Georgetown Institute for Women, Peace and Security ranked India 128th out of 177 countries in its annual index on women’s inclusion, justice and security.

According to the World Bank, 35 percent of Indian women between the ages of 15 and 49 have experienced physical or sexual violence at the hands of their partners, higher than the world average of 27 percent.

Nearly 45,000 rape cases were investigated in 2022, the latest year for which statistics are available from India’s National Crime Records Bureau. But among the cases that went to trial, there were convictions in just over 5,000 — a rate of 27.4 percent, lower than for cases of murder, kidnapping and other violent crimes.

Many more rape cases go unreported because of social stigma and other reasons.

Though gruesome incidents of rape continue to occur and sexual harassment remains a reality for many women, the Nirbhaya case and the #MeToo movement have changed how such matters are perceived, said Ms. Grover, the women’s rights activist.

“There is a marked change in how women across brackets of age, class and caste structures view themselves,” Ms. Grover said. “There is no confusion that this is a crime they are in no way responsible for.”

On Wednesday, hundreds of doctors wearing aprons and stethoscopes protested outside the federal health ministry and at Jantar Mantar, a designated spot for protests in the nation’s capital. They demanded immediate action to ensure the safety of doctors and other medical workers.

“Most of the incidents are not reported,” said one doctor, Pinky Verma. “That is because the attacks happen on women, and people can live with it.”