Transition in Iran? The Ayatollah Allowed It!
🌟 We are used to hearing stories of “forced sex changes”. They are usually associated with tales told by populist politicians. Iran is mentioned much less often in this context.
🇮🇷 In Iran, it is possible to obtain permission to transition and even partial state assistance. Yes, that very same Iran at the centre of global geopolitics, helping russia with Shahed drones. So much for “traditional values”…
🪧🤩 Behind the right to transition there are years of struggle by trans woman Maryam Molkara. Read on to learn how she obtained religious permission and what Iranian trans people face today.
With love, 😳 your supreme NGO.
Contents
Yes, we mean that very same Iran
Iran is an authoritarian Islamic republic. Religious rules have the force of law and extend even to clothing and private life. Consensual same-sex sexual activity is criminalised. Penalties depend on the circumstances and may include death.
Medical transition is permitted in Iran. People can obtain legal recognition, and the state even provides partial funding for transition-related care. Let’s look at how this came about.
First, a little history
In 1979, a revolution overthrew Shah Mohammad Reza Pahlavi. His regime suppressed opposition, so there was no shortage of people who wanted him gone.
Forces with very different views joined the revolution, from secular supporters of democracy to Islamists. After victory, they began fighting one another.
Supporters of Ayatollah Ruhollah Khomeini consolidated power. He became the head of the new Islamic Republic. Political rivals were removed and the independent press was shut down.
Who are these ayatollahs?
Ayatollah is a senior title in the Shia clergy. Khomeini also acquired the powers of the state’s Supreme Leader.
This office controls the military and key appointments. The president and parliament have limited powers. The Guardian Council checks whether laws comply with Islam and decides who may stand in elections.
Ukrainians know this regime through its military assistance to russia. Iran supplied it with attack drones and related technology: the very same Shaheds we hide from at night…
Back to transition
Meet Maryam Khatoon Molkara, an Iranian trans woman who spent years fighting for the ability to transition.
She appealed to influential people even before the revolution. Under the new government, she lost her job in state television and radio. She kept writing appeals and seeking meetings with clerics.
In the 1980s, Molkara met Khomeini. He issued a fatwa, a religious ruling permitting sex reassignment surgery on a doctor’s recommendation.
Molkara later founded an organisation supporting trans people.
How was it explained in religious terms?
One common explanation of transition rests on the idea of a mismatch between body and soul. The soul cannot be changed, but the body can be medically brought into alignment with it. Surgery is viewed as restoring a person’s “true” sex.
Supporters of this approach also point to the absence of an explicit prohibition and the need to relieve suffering. Some clerics oppose these interventions.
In medical practice, however, being transgender is treated as a “disorder” requiring diagnosis and “treatment”. Doctors are given the power to decide who may transition.
Naturally, paperwork is unavoidable
To obtain permission, people undergo psychiatric assessment and apply to a court. The court may refer them for additional medical examinations. The law does not establish one clear route for everyone.
Permission does not automatically mean changing identity documents: that is a separate procedure.
State funding covers only part of the costs. Outright has described cases in which people struggled to obtain payments, or the money provided was insufficient to pay for interventions.
What happens outside the consulting room?
Zara Saeidzadeh’s research describes the story of Fari, a trans woman. In 2014, she had surgery without telling her family. She then returned to her usual life and continued presenting as a man at work.
In 2015, her boss learned about the operation and dismissed her.
Human rights reports contain similar accounts of job loss and family violence. Iran has no specific legal protection against discrimination on grounds of gender identity.
When people are pressured into surgery
The criminalisation of same-sex sexual activity creates conditions for coercion. Human Rights Watch has described cases in which gay men and lesbians felt compelled to agree to surgery to avoid persecution.
Families also approached doctors to “correct” their children’s sexuality. Human rights defenders documented unwanted treatment and pressure from relatives.
These accounts prompted HRW to call on the Iranian authorities to stop persuading people to transition in order to make their lives “legal”.
What about people who want to transition?
In her interviews, Zara Saeidzadeh spoke with trans people who sought surgery despite opposition from relatives. They knew they could lose their jobs and family support. Transition was their own wish.
The explanation that “Iran simply forces gay people to become transgender” erases them from this history, along with Molkara’s years of struggle.
People must be able to obtain the care they need and refuse unwanted interventions. Demanding surgery in exchange for safety or identity documents is unacceptable in a civilised world.
The slides identify these sources: the Home Office; Encyclopaedia Iranica; Iran’s Constitution; the Council of the EU; Outright, pp. 6–8, 11–12 and 46–48; a 2026 study of religious rulings; Afsaneh Najmabadi; Zara Saeidzadeh; and Human Rights Watch, including a 2025 publication. Full titles and URLs were not supplied in the slides.
Sources
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