1. Iran’s transition rate is tiny compared with the West
People sometimes assume Iran is “the world capital of sex-change surgery,” but the numbers tell a different story. One detransitioned man who studied the figures writes, “the rate of transition in Iran is less than 1:60,000… 200× less than Western trans populations that have a transition rate of at least 1:300” – recursive-regret source [citation:72c87627-bcd7-49c3-913f-e32c4d01ae97]. In other words, the spotlight on Iran is misleading; the vast majority of Iranians who feel different about their sex or gender are not choosing medical transition.

2. Transition is used as state “conversion therapy” for gay people
After the 1979 revolution, male homosexual acts became punishable by death and female homosexual acts by lashings. To avoid these penalties, effeminate or same-sex-attracted people are pushed toward surgery. A detransitioned woman from the region explains, “Lots of people transition to be able to be gender-non-conforming without experiencing violence… Society policing gender expression just makes the desire to change biological parts… stronger” – I_want_to_cry_4875 source [citation:2113d974-5e46-4d66-bfd5-730fa8829e38]. The state’s 1986 fatwa from Ayatollah Khomeini formalised this: the “Islamic solution” for gay or effeminate men was hormones and surgery to make them resemble women – MarkTwainiac source [citation:0c77cecf-0d31-486f-9768-2de541705fbe]. Transition, then, is not liberation; it is a survival strategy under threat of death.

3. Western activists sometimes praise Iran’s policy, overlooking its cruelty
Some Western campaigners hold up Iran’s state-subsidised surgeries as “progressive,” yet they miss the coercion behind the offer. As one detransitioned man notes, “TRAs cite Iran’s state-sanctioned transing of gay and effeminate boys… as admirable… [but] policies that promote transgenderism [there] are morally good only if you ignore the death penalty for being gay” – MarkTwainiac source [citation:0c77cecf-0d31-486f-9768-2de541705fbe]. The praise ignores that the same state hangs gay men who refuse to become “straight trans women.”

4. Rigid gender rules create the problem, not the solution
Whether in Tehran or Toronto, the deeper issue is a culture that says, “If you don’t fit the pink or blue box, you must change your body.” A detransitioned woman reflects, “It’s either stay in a small box or be kicked out into another box” – Affectionate_Act7962 source [citation:727b8dbe-b491-4ff6-9484-69a962d9c5f2]. The humane path is to widen the boxes: let boys be gentle, let girls be bold, and let everyone live free of violence or medical pressure.

Conclusion
Iran’s story is not one of transgender liberation; it is a cautionary tale of how rigid gender rules and harsh punishments can funnel vulnerable people toward irreversible medical steps. The real answer lies not in changing bodies to fit stereotypes, but in changing cultures so every person—gay, gender-non-conforming, or simply different—can live safely and authentically without a scalpel or a label they never chose.