Being Transgender in Iran

The report explores the implementation of the Government of Iran’s policy of limited recognition of transgender people. In 1986, Ayatollah Khomeini issued a fatwa effectively declaring that Gender Confirmation Surgery (GCS) and Hormone Replacement Therapy (HRT) are religiously acceptable medical practices. If a person successfully fulfils all steps in the policy, the government will reclassify them as the gender with which they identify for the purpose of recognition before the law.

The policy requires that a person must be diagnosed with Gender Identity Disorder through multiple visits to a psychiatrist, obtain a court order, and then report to the state’s Legal Medicine Organisation (LMO) for physical and psychological examinations to be considered for permission to undergo GCS. Many trans individuals express discontent with the pre-surgery waiting process, which can last upward of one year, and with the insecurity of the authorisation process, as permits to undergo GCS are not guaranteed. Individuals who do not receive a permit are unable to legally continue with the transition process, and are denied the opportunity to change their gender on government issued documents.

“The medicalisation of gender identity has allowed for vital legal recognition and transition-related healthcare for some members of the trans community,” said Jessica Stern, OutRight Executive Director. “At the same time, it has reinforced stigma. The current policy rests on the notion that trans individuals suffer from psychological disorders and require medical intervention in order to be entitled to full citizenship.”

One of the major obstacles for trans Iranians to full recognition under the law is the fact that completing the legally and medically-mandated procedures is not necessarily financially attainable or personally desirable. Estimates place the cost of hormone replacement therapy at $20-$40 per month, a life-long incurred cost, and gender confirmation surgery as high as $13,000. This amount can be a great financial burden for the average Iranian whose income is roughly $400 per month, and even more so for trans Iranians who face social rejection, family abandonment, homelessness, and lack of access to resources more broadly. While the government provides some financial subsidies for qualified applicants, they are limited and irregular at best.

Sharareh a transwoman from Gilan recounted,

“I learned about hormone therapy when I was 16. I had no money to go see the doctor, so I did not do my hormone therapy under any medical supervision. My liver suffered because I monitored my hormone intake myself… But if I had not taken hormones, I would have died of mental illness at a mental hospital.”

Those who cannot afford the transition-related procedures or do not wish to alter their body based on the government standards are subjected to systemic discrimination and exclusion, particularly in work, education, and housing. The Government of Iran does not recognize individuals who identify outside of the male/female gender binary and prohibits individuals from “cross-dressing.” A trans woman who is not legally recognized as a woman could be accused of homosexuality if she had a sexual relationship with a man and, if convicted, could face the death penalty.

The burden of fear is described in the report by Martha, a transwoman from Arak who fled Iran and sought asylum in Turkey, “When I was in Iran, I was constantly worried about being executed [for being gender-non-conforming.] But more than that I was afraid of being tortured…The fear of execution, torture, humiliation and being beaten always stayed with me. I was scared all the time even though I was never caught.”

Interviews with trans individuals in the report reveal physical, emotional and sexual abuse, and discrimination from family members, employers, educational institutions, and even strangers.

Sonia, a transwoman from Iran interviewed for the report, recounts,

“When I was in my second year of high school, four students pinned my arms and legs to [undress me and] see my genitalia. My father used to say he wished I were dead so that I didn’t embarrass him. I thought there has to be something wrong with me to make me suffer so much during my childhood…”

For trans women, full legal recognition also brings new forms of discrimination based on gender. A trans woman who is legally recognised as a woman will find that, for example, the value of an inheritance or testimony in a court of law are reduced to half that of a man’s.

“Over the past few decades, the Iranian government has taken some steps towards limited recognition of the rights of transgender individuals,” said Kevin Schumacher, OutRight Regional Program Coordinator for the Middle East and North Africa. “However, the government still needs to acknowledge trans individuals’ right to self-identification without the requirement of medical interventions. They must provide the trans community with legal and administrative support against social and legal discrimination. Furthermore, the Iranian government should increase trans individuals’ ability to access medical treatment and ensure full equality before the law.”