The official leaders of the ghettos and the members of the Judenrat (Jewish Councils), generally German appointees, were almost all men. The Russian-compiled documentation of war crimes known as the Black Book reveals the occasional woman in an official ghetto position. For example, in Ghetto Baranowicze (today Belorussia), Mrs. Ninove was the assistant to the Judenrat chairman. Yehoshua Isikson. Ninove and Isikson were affectionately called "Mordekhai and Esther" after the two beloved biblical characters. In Ghetto Pruzhany (Pol. Pruzana, today Belorussia), Dr. Olia Goldfein, an MD, headed the ghetto sanitary department. Her work on behalf of the ghetto population was very favourably recorded.

Many women, although not officially part of the Judenrat, were vital members of the ghetto community. Teaching in the various legal and clandestine educational systems, organizingcultural activities, working with youth groups and in hospitals, soup kitchens, workshops and factories, they participated actively in all aspects of ghetto existence and played an important part in the constant struggle for survival. 

Certain problems faced by ghetto dwellers were specific to women: birth control, pregnancy, abortion, and the birth and nursing of babies by mothers who existed on substarvation diets insufficient for one, much less two, hungry mouths. For religious women, the German prohibition against Mikveh baths (the ritual purification bath that was to follow menstruation and childbirth) was another hardship. Mothers of young children had to spend virtually all of their time caring for and often hiding their children, who were subject to seizure during the notorious Children's Aktions as well as the regular Aktions and whose presence, if discovered, could endanger the lives of other members of the family. To keep the youngsters quiet during these raids, mothers would spend large sums of money on poppyseeds and other narcosis-inducing substances, often going without food themselves to pay for them.

Women did hard physical labour. In Ghetto Kovno they joined special women's work forces that slaved at building the nearby airport and at other physically demanding jobs. Such labour provided women with the chance to obtain food for their families or, if they were single, for themselves. Single women in Ghetto Kovno had an even smaller chance of survival than other women, and searched desperately for male protectors. Many formed fictitious unions, which sometimes became life-long marriages.

Being part of a family was also dangerous, however. The great sense of responsibility family members felt for each other spelled down for many, since it often prevented young people from abandoning their families and trying to escape. Fear of German retaliation against their families also deterred many people from taking drastic actions against the Germans, and thereby delayed Jewish armed resistance. Only when their families were decimated and the final destination of the Jews became clear did armed resistance become a reality.

Though their lives were more precarious than men's in the ghetto, women and girls who managed to escape the ghetto had a better chance of survival than men did, again because there was no telltale sign such as circumcision to set them apart from the rest of the population. Some Jewish boys living on the Aryan side were disguised as girls, so that they would not be betrayed by their circumcision.