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Iran is not great

Iran does the second most sex change operations in the world.

Tehran University of Medical Sciences

Sex Reassignment Surgery in Iran, Re-Birth or Human Rights Violations against Transgender People?

Bijan Pirnia and Kambiz Pirnia

Additional article information

Dear Editor-in-Chief

Iran is the only Islamic country where the sex reassignment surgery (SRS) is recognized. Many European citizens travel to this Middle East country for gender confirmation and reassignment surgery. The Guardian wrote “Today, the Islamic Republic of Iran occupies the unlikely role of global leader for sex change” (2). Hence, Iran can be called the hell of homosexuals and the paradise of Trans seeking SRS.

Classical Islamic discourse divides gender as one of two categories, male or female, but has accepted the possibility that in the case of hermaphrodites it is difficult and sometimes impossible to determine the body. However, Ayatollah Khomeini, the Supreme Leader of the Iranian Revolution, once in 1964 in his book “Tahrir al-Wasila” and once after the Islamic Revolution in 1982, issued a fatwa on the act of reassignment and confirmation gender only for people whose faces are inconsistent with their gender and considered it legitimate and this issue became one of the emerging issues of Shia Islamic jurisprudence (2). According to the jurists, since it is not possible to change the soul, but at the same time medical advances have made it possible to change the body, the act of gender reassignment is permissible. Furthermore, according to Iranian civil law, each person receives a share of inheritance based on gender. For example, a Trans woman receives as much inheritance as a woman. In article 939 of the civil code of Iran, if in a transgender person sexual signs prevail over other gender signs, the person is subject to the rules of gender in which the symptoms are predominant. According to the Family Protection Law adopted in 2012, a person can refer to the family court to apply for gender matching (2).

On the other hand, in an article the authors did not distinguish between SRS and conversion therapy (1). What is common in Iran is SRS, not conversion therapy or reparative therapies. SRS has a guideline and is designed and approved by the World Professional Association for Transgender People (WPATH). It is a professional organization that has published the health care standards for transsexual, transgender and gender nonconforming people in the latest version (version 7). Psychologically, SRS is in line with the adaptation of physical body to sexual identity and reduces the gap caused by the incompatibility of these two dimensions, allows gender expression and contributes to the mental health of these people (3).

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), distress is caused by gender mismatch, which is an inappropriate and harmful diagnostic method. In the International Classification of Diseases Code (ICD)–11, the Health Organization has suggested that relevant diagnoses be transferred to a new sexual health-related chapter (3).

Although the growth rate of gender reassignment in Iran does not necessarily indicate positive progress towards LGBTQ rights, it seems that SRS, despite aspects of threatening and responding to social demands, has been able to promote transgender health. Becoming a new version of yourself that is loved by the person and is considered a rebirth, liberation from the physical prison that does not belong to him, access to basic rights, the possibility of changing the name, obtaining a birth certificate and a driving license certificate based on the new gender, choosing clothes and finally eliminating the charge of homosexuality and the risk of execution (punishment for sodomy) is only part of the benefits of accompanying religious rule for transgender people. In Iran, the Imam Committee provides interest-free loans to some people eligible for gender reassignment surgery, which is in line with the recommendations of the WHO (2).

In the meantime, we are witnessing discrimination and ridicule from Iranian authorities aware of the act of SRS, conflicts in the minds of Trans people after gender reassignment surgery, and honor violence following gender reassignment surgery.

In Iran, the lack of training programs for health care professionals and mental health professionals in the field of transgender health is strongly felt. The treatment process in Iran does not comply with international medical and psychiatric standards and requires bedrock in the field of medical and psychological education (1). Our suggestion is to change the culture of the society towards Trans genders, to improve the quality of surgeries, to create a culture of dealing with these people, and finally to pass laws that will make life easier for them than before.


Conflict of interest

The authors declare that there is no conflict of interest.


Article information

Iran J Public Health. 2022 Nov; 51(11): 2632–2633.
PMCID: PMC9745420
PMID: 36561249
Bijan Pirniacorresponding author 1 , * and Kambiz Pirnia 2
1. Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2. Bijan Center for Substance Abuse Treatment, Tehran, Iran
corresponding authorCorresponding author.
*Corresponding Author: Email:
Received 2022 Feb 10; Accepted 2022 Feb 23.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license ( Non-commercial uses of the work are permitted, provided the original work is properly cited.
Articles from Iranian Journal of Public Health are provided here courtesy of Tehran University of Medical Sciences


1. Kabir A, Nazareth I. (2022). Conversion therapy: a violation of human rights in Iranian gay menLancet Psychiatry9(4):e19. [PubMed[Google Scholar]
2. Najmabadi A. (2008). Transing and Transpassing across Sex-Gender Walls in IranWomen's Studies Quarterly36(3–4): 23–42. [Google Scholar]
3. Winter S, Settle E, Wylie K, et al. (2016). Synergies in health and human rights: a call to action to improve transgender healthLancet388(10042):318–21. [PMC free article] [PubMed[Google Scholar]
Iran's birthday rate is about 1.6 per woman
Gdp per capita is about $4,500 a year
Drug trafficking and Iran,
Iranian exports are Oil, and Drugs.
Timothy Fitzpatrick has reacted to this post.
Timothy Fitzpatrick

Islam is highly homo-erotic.

Ryan Augustine has reacted to this post.
Ryan Augustine

I read something, the author of which I cannot recall, a while back which offers a good explanation for this.

Islam is essentially a Christian heresy which simplifies, carnalizes, and takes things to their extremes.

Islam was born out of an environment in  the east which was saturated with heresies and so the middle east was, shall we say a very religiously confused place.

The Arabs sought to carve out their empire at the time and use Islam as a uniting force so the chose bits and pieces of Christian, Jewish, and pagan theology combined and simplified them, and denatured the spiritual aspects of them.

Thus all of Islam's core beliefs are rooted entirely in the material world. For instance the five pillars of Islam: the declaration of faith, pray 5 times daily, alms, the Haj, and fasting are all entirely corporeal. That is they have no spiritual aspect to them, they are simply the Muslim does these things because it is his duty.

Islam also takes things, especially Christian Ideas like fasting and tries to create fanaticism through them by making them physically extreme. Thus Ramadan where a Muslim cannot eat or drink water during the day is the Islamic version of the Lenten fast. Confirming this spiritual bankruptcy is the Islamic concept of heaven whereby the good Muslim is rewarded not with Truth, enlightenment, or any other higher ideal, but with unlimited sex.

Once we understand these essentials which make up Islam we can understand why they would have such a homosexual problem. There's is a religion which does not have a morality per se, you do what's moral not because it is right, but because it is commanded of you. The idea of right or wrong doesn't really figure into the Islamic mind as it does in the Christian because higher spiritual concepts are void in Islam.

Getting to the point, because Islam is a religion based on carnal extremes bound by rigid simplified laws, it therefore permits the Muslim to have an unrestrained sexuality so long as he "follows the rules." Thus we can see as a human condition that lust will degenerate into more and more perverse acts if it is not restrained. We also see Muslim men rationalize in engaging in unnatural acts with children, because it's not "gay" because children are not men just as having relations with transexuals is not "gay" because likewise they are no longer men.

I like to think that a bad philosophy will always run its course to its (il)logical conclusions and the transexual absurdity of Iran perfectly encapsulates this.