Gender Reassignment Surgery In Iran In The United

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Although it may come as somewhat of a surprise, Iran performs a large number of gender reassignment surgeries. According to BBC News, Iran performs the second most number of such procedures in the world. The government even regularly subsidizes such surgeries, which can be very expensive. Considering Iran is a conservative Muslim country with scarce tolerance for any behavior outside hetero-normative bounds?

Since the 1980s, religious leaders in Iran have come to somewhat embrace gender reassignment. There are various reports that sometime after the Iranian Revolution, Ayatollah Khomeini met with a transgender woman. The meeting left an impact on Iran's supreme leader and he issued a fatwa (religious ruling), stating that "If somebody wants to undergo a sex change because he feels trapped inside someone else's body, he has the right to get rid of this body and transform into the other sex."

However, this is not to say that Iran supports a progressive environment when it comes to sexual orientation and gender identity. Reports indicate that the state subsidizes these procedures as a way of "diagnosing" and "treating" homo sexuality. It's viewed as a way to restore hetero-normative gender roles. Those who identify as trans but do not want to undergo surgery are left with few options. Iran's LGBT population continues to face violence and discrimination.

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Iran - an Islamic theocracy that criminalizes consensual same-sex relations, forces women to adhere to a strict and modest dress code in public, and has zero-tolerance for dissident’s freedom of expression - presents a surprisingly lenient attitude on trans issues. On the surface, the Iranian government seems supportive of the trans community. Official reports reveal that gender confirmation surgery for trans individuals is subsidized by the state. Trans activists are also legally allowed to organize and register an advocacy group and benefit from public assistance, such as access to free office space provided by Tehran’s Municipality. In reality however, while the trans community in Iran enjoys more rights than in any other Muslim country in the region, pervasive social discrimination and legal abuse against trans individuals remains a consistent fact of life.

Over the past decade, the Iranian State Welfare Organization has provided consistent -though limited- support to trans individuals in need of medical, psychological, or financial assistance. Iranian universities - notoriously monitored and controlled by the government- organize conferences and research projects on the social status and medical needs of the trans community. Even pro-government Shiite religious leaders speak in defense of the trans community in sermons, books and articles, and media appearances.

Iranian government policies on trans issues have provided opportunity for artists to show solidarity with the country’s nascent trans movement. In 2011, the government allowed the screening of Facing Mirror, a highly acclaimed feature film chronicling the life of a trans man who is disowned by his family and ridiculed by society. The film was highly praised by the Iranian media, including by the ultra-conservative Kayhan newspaper. In recent years, an Iranian movie super-star, Behnoosh Bakhtiari, with over 5 million followers on Instagram, has become the honorary ambassador of the trans community, educating the public about gender identity and advocating for society to embrace trans individuals and treat them with respect.

While positive steps towards trans rights recognition have been made, the reality of daily life in Iran is still plagued by discrimination, abuse, and arbitrary arrest. Trans individuals are both grossly misunderstood and horrendously mistreated in Iran. As documented in OutRight Action International’s most recent human rights report, “Being Transgender in Iran”, Hasti, a 30-year-old trans woman was detained and harassed by the Iranian police for wearing makeup and presenting as a woman at a private function. She said:

...The [police] would lift up my dress, looked at my ID card and ask me if I was a man or a woman. In the end they forced me to sign a pledge letter [to promise that I would no longer dress as a woman] and then released me.

Iranian authorities firmly root trans experiences in pathological explanations, believing that it is a psychosexual disease. In Iran, trans individuals are officially referred to as people with a “gender identity disorder” (GID). This goes against global trends of declassifying trans identity as a disorder. In 2012, the Diagnostic and Statistical Manual of Mental Disorders reclassified GID as Gender Dysphoria, and currently the World Health Organization is moving towards declassifying trans identity as a mental disorder altogether. In line with such a narrow medicalized understanding of trans experiences, the Iranian government only recognizes the preferred gender of trans people who have successfully undergone complete gender confirmation surgery.

These strict requirements are prohibitive. Not all trans individuals are willing, able, or allowed to surgically change their anatomy as the right to access gender confirmation surgery is not guaranteed. The Iranian government has set up an elaborate legal and medical system to evaluate each and every sex reassignment application. Only those who successfully pass a long medical evaluation and are officially diagnosed with GID can obtain the government-issued license to start the gender reassignment process, and hopefully obtain their new legal national ID card, which reflects their gender identity.

The scope of Iran’s laws fail to recognize the rights of trans individual who do not wish to undergo the medical transition process. Many Iranian trans individuals do not wish to alter their body. Some simply cannot afford the multiple medical procedures, which can span over several years and may cost thousands of dollars. This is a hefty price tag for low and middle-income Iranians, thus making the medical procedure unattainable. Additionally, many trans individuals face financial instability because social, educational, and employment barriers deprive them of economic opportunities. Due to social stigma and discrimination, trans individuals often also cannot rely on the financial or moral support of their families.

The Iranian government can, do more to demonstrate its commitment to the rights of its trans citizens. Revisiting the narrow medical definition of the trans experience is a critical first step in this direction. Debunking the medicalized understanding of the trans experience would help Iranian trans community members fight against demeaning social stereotypes and avoid being subjected to medical experiments. It would also allow the gender identity of trans individuals to be legally recognized without forcefully altering their body or being labeled as suffering from an illness.

Iran prides itself on being one of the few Muslim countries with legal recognition for trans rights. Isn’t it time for the Iranian policy makers to revamp their views on gender identity and develop a progressive legal framework, one that discontinues categorizing transgender persons as deformed individuals warranting pity and sympathy? Iran should evolve the discourse and treatment of transgender citizens and recognize that these individuals as wholesome human beings with the right to dignity and respect.

**Note: Outright Action International has recently released two reports concerning the situation of Transgender people and Lesbians in Iran accessible at the following link.

Kevin Schumacher is the Regional Program Coordinator for the Middle East and North Africa for OutRight Action International. OutRight Action International’s mission is to advance human rights for everyone, everywhere to end discrimination based on sexual orientation, gender identity, and gender expression.

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