The number of transgender persons who have decided to undergo sex reassignment surgery (SRS) in Iran has significantly increased in recent years, according to the health website Salamat News (salamatnews.com), citing a report by the Islamic Republic of Iran Medical Council (IRIMC.)
Salamat reports that more than half of the patients who are currently registered to undergo genital reconstruction surgery are male and the rest are female.
“A small number of people pass the necessary medical tests and qualify for SRS,” Ahmad Shojaei, the director of the IRIMC said in an interview recently. “We do issue a limited number of permits to transgenders who suffer from gender dysphoria (GD), because their existing condition could harm society if left untreated.”
Shaya Goldoost was forced to leave Iran three years ago and settle in Turkey. She is 32 years old and is currently awaiting the outcome of her asylum application with the UN Refugee Agency in Turkey. Shaya underwent genital reconstruction surgery in July 2012 after receiving a permit from the IRIMC.
“Most societies have traditionally viewed people in the LGBT (lesbian, gay, bisexual and transgender) community and those with GD as being sick. Things have, however, changed in recent years,” Shaya said. “Most international health organizations consider transsexualism a sexual orientation rather than a psychological illness. These people are healthy individuals who have been assigned a sex and gender at birth which do not match their gender identity. In Iran, however, they suffer widespread discrimination.”
Shaya added: “I received a brochure that had been handed out in some of the popular parks in Iran to raise public awareness about gender identity. The pamphlets had been distributed by a center which provides support for people with sexual problems. The cover of the leaflet implied that GD was an illness. It would be challenging to change the public’s perception in such a social climate.”
Despite Shaya’s legitimate concerns about the stigma attached to the LGBT community and to transgender people, health workers in Iran must use various socially acceptable terms to acquire a license and help individuals who wish to undergo SRS. That is why they use the word ‘problem’ instead of ‘disorder’ in the brochure to avoid labelling GD as a disease.
Shaya regularly shares her experiences on her Instagram feed. The following is KayhanLife’s interview with her.
Q: When did you decide to undergo genital reconstruction surgery?
A: I knew I was different from others at a young age. That feeling became more pronounced after I started school. There was no Internet at the time, so I couldn’t find information about my condition. I hadn’t even heard the term transvestite. It was after I entered university that I found out about transgenders and gender realignment. I didn’t even know about SRS. I did much research and discovered that it was a costly and risky procedure. There is a high possibility of severe infection and nerve damage. However, I wanted to have the operation.
I believe that a person who decides to undergo SRS will be more concerned with the social, cultural, emotional and psychological implications than the cost and health risks associated with the operation.
Q: How did your family, friends and entourage react after your operation? Did you achieve all your objectives?
A: People around me didn’t react well to my operation. My family, friends, and associates were not accepting and supportive, despite my best efforts to prepare them for years. I lost a few jobs.
There were some sympathetic and understanding people of course. Nowadays, there is more information and greater social awareness about the issue. Families are more accepting of loved ones who intend to undergo SRS. Parents can detect early signs in their children’s characteristics and behavior. It took me years to make my family understand my situation.
People treat me much differently now than they did years ago. There is still a large segment of our society that is misinformed about the LGBT community and transgenders and is even less accepting of people who have undergone gender confirmation surgery. They view us as sinners, morally corrupt, or in the best case, mentally ill.
Q: What is the screening process for those who wish to undergo SRS? Which medical facilities perform the surgery?
A: It is usually the individual who recognizes the need to reaffirm his or her gender identity. Unfortunately, there are no counselors or social workers in schools to help young people who are struggling with their gender identity. It is not part of the education system in Iran. It is usually the parents who first recognize specific characteristics and behavior in a child. Doctors and psychologists get involved later.
The State Welfare Organization of Iran is responsible for creating files for the SRS applicants and referring them to social workers for psychological evaluation. The majority of the psychologists who work for the welfare office, however, are still in university. In my view, professional sexologists should assess the SRS applicants. The welfare office provides financial aid to patients which is not nearly enough to cover the high cost of the operation.
Once an individual has petitioned a court for a permit to undergo SRS, he or she must report to the IRIMC which refers the applicant to a mental health institute for consultation and therapy. The process may take longer in a big city such as Tehran.
The IRIMC approved my case in ten minutes, and I received my SRS permit two weeks after that.
Individuals who are classified by the psychologists as transgender don’t necessarily need surgery. Some people affirm their gender identity and gain social acceptance without undergoing genital reconstruction surgery. They change their attire, appearance, and behavior.
Transgenders, however, don’t have any legal rights under Iranian law, and, therefore, are forced to undergo SRS; otherwise, they will not be able to change their birth certificates, enroll in universities and obtain passports. Only heterosexual males and females have any legal rights in Iran. That’s why many gays and lesbians also undergo SRS.
Q: Can the desire to change one’s appearance and sexual function be a passing phase? Is there a treatment that would curb this tendency?
A: I don’t believe this is a phase. In an ideal world, people should be able to freely and without fear discover their true genders and sexual orientations. For instance, following an operation, a person must try to integrate into his or her environment by appearing in public and interacting with people. That would help an individual to reaffirm his or her sexual identity. Unfortunately, this climate doesn’t exist in Iran. In free societies, people who exhibit characteristics of the opposite sex do not necessarily undergo SRS so they can live a normal life.
Q: Do you know of an instance when a person regretted to have undergone SRS?
A: As I mentioned earlier, some people are forced to have the operation because they’d like to live a normal life in a society that doesn’t recognize their life choices. Many people believe that the world welcomes them with open arms after the operation. However, in most cases, they are in for a big shock. Many people fall into depression because gaining approval from the people around them and society, and it’s an uphill battle.
Translated from Persian by Fardine Hamidi