El Refai was born to Sunni Muslim parents in Tripoli, Lebanon and her family moved to Sweden to live in Eslöv just a few months after her birth.

She has talked about her condition in two works: in her stand-up show En komisk depression ("A comical depression") in 2016–2017 and later in her late-2019 self-scripted and self-led four-part two-hour mini-documentary series "Livet lyckopiller" ("The happiness-pill life") which aired on Sveriges Television, Sweden's national public television channel, in November–December 2019.

El Refai first came into prominence in 2006, when she had a role in the crime drama movie Beck – Det tysta skriket.

[7] In one notorious segment, she flashed her breasts to a man in Humlegården, which is famed for male flashers, and she was reported to the police.

[1] In 2008, El Refai was assigned as a reporter on stage for the Melodifestivalen 2008; the Swedish national selection for the Eurovision Song Contest.

[1] During 2009, El Refai acted as the character "Bitterfittan" (English: "The bitter cunt") on the comedy show, Ballar av stål, the Swedish version of Balls of Steel.