Transgender individuals who do not undergo surgery have no legal recognition and those that do are first submitted to a long and invasive process, including virginity tests, formal parental approval, psychological counseling that reinforces feelings of shame, and inspection by the Family Court.
In addition, non-binary genders are not recognized in Iran and the quality of trans healthcare in the country, including hormone therapy and reconstruction surgeries, is often very low.
[1] Harassment against transgender individuals is common within Iran, and trans people face increased risk of physical and sexual assault, exclusion from education and jobs, poverty, and homelessness.
[4] The United Nations Human Rights Council has reported that "lesbian, gay, bisexual and transgender children are subjected to electric shocks and the administration of hormones and strong psychoactive medications".
A 2018 study of burial sites at Teppe Hasanlu found that around 20% of the tombs did not conform to a binary gender-divided distribution of artifacts or showed signs of the buried having performed masculine roles while wearing feminine dressing (or vice-versa).
A bowl at the site was also discovered depicting a bearded man wearing female clothing shown sitting on the floor, a position that was usually reserved for women in the local iconography.
[8]: 252 [9]: 25 [10] In 1963, Ayatollah Ruhollah Khomeini wrote a book in which he stated that there was no religious restriction on corrective surgery for intersex individuals, though this did not apply to those without physical ambiguity in sex organs.
[1] The new religious government that came to be established after the 1979 Iranian Revolution classed transgender people and crossdressers with gays and lesbians, who were condemned in Shah's era and faced the punishment of lashing or even death under Iran's penal code.
"[17] Most participants in a 2018 study in Quality & Quantity had "experiences of being accused, arrested, and physically abused by the police" and faced discrimination in the workplace, including being fired for being trans.
[19] A 2016 report by OutRight Action International found that "trans Iranians continue to face serious discrimination and abuse in both law and practice, and they are rarely treated as equal members of society" and that "the Iranian trans community faces pressure from both state and non-state actors, ranging from hostile public attitudes to acts of extreme violence, risk of arrest, detention, and prosecution."
[20] Justice for Iran has found that "censorship laws prevent access to accurate information on matters relating to sexual orientation and gender identity.
The teen had originally intended to seek asylum in Portugal, but had been forced to leave the country and flee to Iceland after the Iranian Revolutionary Guard attempted to arrest him and forcibly return him to Iran.
"[31] According to Justice for Iran, the Iranian state fails to "ensure that SRS surgeons and other health care professionals dealing with [transgender people] meet appropriate standards of education, skill and ethical codes of conduct" and that trans people face difficulty accessing proper information on healthcare, which "results directly from the government and its associated medical entities withholding or intentionally misrepresenting modern, scientific information on matters of sexual orientation and gender identity.
[33] People who so much as question their sexuality are encouraged to see a psychologist, and they are usually recommended to undergo sex reassignment surgery in order to fit in with the strict gender binary that is present in Iran.
[35] UNHCR's 2001 report says that sex reassignment surgery is performed frequently and openly in Iran, and that homosexual and cross-dressing men, although unrelated to trans identity, would be safe as long as they keep a low profile.
As well, the report highlighted a culture of gatekeeping in the healthcare system, often imposing extremely long waiting periods on patients out of a belief that it would lower regret rates.
[36] A 2021 study in the Journal of Psychiatric Research found that "depressive and trauma- and stressor-related disorders" were common among trans people in Iran, with "as many as 70% of the clients reported that they had experienced suicidal ideation.
[9] A 2016 study found that European and American literature and media "has widely represented the Iranian authorities legalizing sex-change surgery" in light of the Iranian authorities' "punishments on gay people", and depict Iran's legalized transgender surgery "as an alternative way to force non-heteronormative genders to fit into categories of male and female in order to prevent acts that fall outside gender binaries."
The 2016 study critiques that view and asserts instead that "sex change surgery is not understood by Iranian transsexuals as a way to fit themselves into the category of male or female; neither is it perceived as the last resort to live as a full member of society.