Iran is the leading country for gender reassignment surgeries right after Thailand. It's basically a troon factory, Iran is the only Muslim-majority country where such surgeries are not only legal but actively supported by the state, including financial aid, legal recognition of the new gender on documents, and protections against some forms of discrimination post-surgery. In recent years, Iran has even promoted itself as a medical tourism destination for transgender procedures to attract foreign patients and generate revenue, offering low costs (around $3,000–$7,000 per surgery) compared to Western countries (1).
but why ?
The primary reason stems from a 1987 fatwa (Islamic legal ruling) issued by Ayatollah Khomeini, the founder of the Islamic Republic, which permitted sex reassignment surgery as a treatment for what is officially classified as "gender identity disorder". This shouldn't be confused with homosexuality itself, homosexuality is seen as a choice or deviation from divine norms, not an innate condition requiring medical intervention. However transgender identity (GID) is treated as a real medical and psychological issue, basically, a mismatch where someone's soul (or inner true self) is one gender, but their body is the opposite.
According to the fatwa gender-affirming surgery is allowed (and even religiously okay) because doctors can change the body to match the soul. The idea is simple: the soul matters more than the flesh/body, so fixing the body to fit the soul is permitted when medical experts confirm it.
To put it even more simply,
In Tahrir al-Wasilah (written around 1964–1965 during Khomeini's exile and published in the late 1960s), he permitted corrective surgery for intersex individuals (khuntha or hermaphrodites) with physical ambiguity in their genitalia, allowing the body to align with one determined gender. This did not initially apply to transgender people without such physical intersex traits.
After the revolution, there was a troon named Maryam Khatoon Molkara (born 1950, assigned male at birth), a transgender woman and advocate. She began writing letters to Khomeini in the 1970s (while he was in exile) explaining her lifelong feeling of being a woman trapped in a man's body. After the revolution, she endured persecution like job loss, forced male hormone injections, and psychiatric institutionalization. She lobbied clerics and eventually secured a dramatic personal meeting with Khomeini around 1986–1987.
Here's a JFL moment: Molkara strikingly arrived at Khomeini's home dressed in a man's suit (to gain entry), carrying the Quran for protection. Guards beat her severely, suspecting she might be armed (due to her hormone-developed breasts under binding). She revealed her physical state, and Khomeini's brother intervened. During the brief meeting (about half an hour), Khomeini consulted three trusted doctors about her case and was so moved by her story and medical advice, he issued a handwritten fatwa authorizing her surgery and, by extension, permitting it for others.
read.dukeupress.edu
en.wikipedia.org
en.wikipedia.org
but why ?
The primary reason stems from a 1987 fatwa (Islamic legal ruling) issued by Ayatollah Khomeini, the founder of the Islamic Republic, which permitted sex reassignment surgery as a treatment for what is officially classified as "gender identity disorder". This shouldn't be confused with homosexuality itself, homosexuality is seen as a choice or deviation from divine norms, not an innate condition requiring medical intervention. However transgender identity (GID) is treated as a real medical and psychological issue, basically, a mismatch where someone's soul (or inner true self) is one gender, but their body is the opposite.
According to the fatwa gender-affirming surgery is allowed (and even religiously okay) because doctors can change the body to match the soul. The idea is simple: the soul matters more than the flesh/body, so fixing the body to fit the soul is permitted when medical experts confirm it.
To put it even more simply,
- Transgender = soul and body don't match —> surgery can correct the body (allowed).
- Homosexuality = forbidden behavior —> not treated as a soul-body issue or curable through surgery (Punishable offence under Sharia)
In Tahrir al-Wasilah (written around 1964–1965 during Khomeini's exile and published in the late 1960s), he permitted corrective surgery for intersex individuals (khuntha or hermaphrodites) with physical ambiguity in their genitalia, allowing the body to align with one determined gender. This did not initially apply to transgender people without such physical intersex traits.
Physical ambiguity in this context refers to ambiguous external genitalia, meaning the newborn's visible sex organs (genitals) do not clearly appear as typically male or typically female. This makes it difficult or impossible to assign a binary sex (male or female) based on physical appearance alone at birth.
After the revolution, there was a troon named Maryam Khatoon Molkara (born 1950, assigned male at birth), a transgender woman and advocate. She began writing letters to Khomeini in the 1970s (while he was in exile) explaining her lifelong feeling of being a woman trapped in a man's body. After the revolution, she endured persecution like job loss, forced male hormone injections, and psychiatric institutionalization. She lobbied clerics and eventually secured a dramatic personal meeting with Khomeini around 1986–1987.
Here's a JFL moment: Molkara strikingly arrived at Khomeini's home dressed in a man's suit (to gain entry), carrying the Quran for protection. Guards beat her severely, suspecting she might be armed (due to her hormone-developed breasts under binding). She revealed her physical state, and Khomeini's brother intervened. During the brief meeting (about half an hour), Khomeini consulted three trusted doctors about her case and was so moved by her story and medical advice, he issued a handwritten fatwa authorizing her surgery and, by extension, permitting it for others.
This ruling declared the procedure permissible (halal) under Shia Islamic law through scholarly reasoning (ijtihad) when advised by competent doctors, treating it as a medical correction rather than a sinful alteration of God's creation.
Understanding Socio-Legal Complexities of Sex Change in Postrevolutionary Iran
Abstract. Sex-change surgery has been practiced through a medico-judicial process in Iran based on Ayatollah Khomeini's Islamic juristic legal opinion (fatwa), which he issued just a few years after the Islamic revolution, in 1982. According to the Iranian legal system, judges can refer to the...
read.dukeupress.edu
Transgender rights in Iran - Wikipedia
Maryam Khatoon Molkara - Wikipedia
Last edited:
