A State-Imposed “Solution” to Homosexuality
Iran’s reputation as a global hub for transgender surgeries is not rooted in progressive acceptance, but in a 1986 religious ruling. “In 1986, the Supreme Leader Ayatollah Khomeini issued a fatwa… saying that the most acceptably Islamic way to deal with gay and effeminate men is to have them undergo hormonal and surgical treatment to turn them into facsimiles of females.” – MarkTwainiac source [citation:687ffa14-7ed1-42eb-affd-b54fb2df6225]
This decree reframed same-sex attraction as a medical “error” to be corrected, not an identity to be respected. Gay men who refuse risk execution; those who accept the surgery are re-labelled as women so their relationships can be called “straight.” The state thus uses medicine to erase visible homosexuality while claiming to be compassionate.

Coercion Disguised as Compassion
People who grow up gender-non-conforming in Iran describe transition as a survival mechanism, not a choice. “I come from a relatively conservative country. Lots of gender-non-conforming people transition to be able to be themselves without experiencing violence.” – I_want_to_cry_4875 source [citation:2113d974-5e46-4d66-bfd5-730fa8829e38]
Because strict dress codes and social rules punish anyone who steps outside stereotypical roles, the only sanctioned path for an effeminate boy or masculine girl is to “become” the opposite sex. Detransitioners call this state-mandated conversion therapy: the state will literally hang gay people yet praise them if they agree to surgery.

A Tiny, Manufactured Population
Despite the headlines, the actual number of Iranians who have undergone transition is minuscule. “The rate of transition in Iran is less than 1:60,000… the entire Iranian trans population would basically be a rounding error compared to Western trans populations that have a transition rate of at least 1:300.” – recursive-regret source [citation:72e87627-bcd7-49c3-913f-e32c4d01ae97]
This statistic underlines that Iran’s program is not meeting widespread, freely chosen need; it is surgically altering a small, targeted group under threat of death. The “global hub” label is therefore misleading: it reflects state policy, not grassroots demand.

Symbolic Erasure of Same-Sex Love
Once surgery is complete, the law performs a linguistic sleight-of-hand. “It’s illegal to be homosexual, punishable up to death, but perfectly legal to be a ‘straight’ transsexual… homophobic people are more comfortable with a transwoman being with a man than a regular man being with a man.” – HeForeverBleeds source [citation:15ddae02-bc74-499b-a43d-e17ffd4d50bd]
By re-categorizing one partner, the state keeps the bodies and affections the same while pretending the relationship is now heterosexual. This symbolic re-branding protects the regime’s image and preserves harsh anti-gay laws.

Conclusion: Authenticity Without Surgery
The Iranian case shows how rigid gender rules and anti-gay laws can push people toward medical transition as the only escape hatch. Yet the voices of detransitioners remind us that true liberation lies not in changing bodies to fit oppressive rules, but in expanding social space so everyone—gay, lesbian, or simply gender-non-conforming—can live safely without surgery. Healing comes through community support, mental-health care, and collective challenge to stereotypes, not through scalpels and hormones.