In 1986, then Supreme Leader Ayatollah Khomeini, issued a fatwa (a ruling or a religious decree on a point of Islamic law given by a recognized authority) permitting the acceptance of sex reassignment surgery for transgender people.34 Sex reassignment surgery is now codified in Article 4 of the Family Law (2013), which stipulates that those seeking medical intervention should obtain prior judicial and medical approval officially stating that they have been diagnosed with Gender Identity Disorder.35 The Ministry of Health has overall responsibility for implementation of this law, by ensuring the provision of medical care to recognized transgender people. The State Welfare Office provides social and psychological support and a number of state institutions, such as the Ministry of Labor, are involved in supporting transgender individuals who pursue or have been through sex reassignment procedures.36 Although State recognition and support have given transgender individuals a certain level of legal legitimization, it also has reinforced the societal stigma due to the pathologisation of transgender identities: that trans persons suffer from a medical condition which requires treatment. Additionally, medical assessment in the Islamic Republic of Iran conflates a variety of sexual and gender identities with transsexuality, resulting in those for whom surgery is neither appropriate nor necessary being ‘treated’ in line with the prevailing medical opinion: that any divergence from cisgendered heterosexuality can only be due to a person’s gender dysphoria and transsexual identity. 37 38 Further, among these individuals, only those who are officially diagnosed with Gender Identity Disorder and who obtained a permit to undergo sex reassignment surgery can have their gender legally recognized by the government. Others cannot benefit from the State Welfare’s services including sex change procedures or counselling and as a result cannot receive a state-issued identity card which legally affirms their gender.39 As a result, individuals of varying sexual and gender identities who cannot or will not pursue medical transition are not protected from abuses, including arrest, detention and prosecution.40 Besides the criminalization of same-sex conduct, a number of other legal provisions directly impact on the rights of lesbian, gay, bisexual and transgender (LGBT) individuals, in particularly Iranian laws related to public decency. For instance, Article 639 of the 2013 Islamic Penal Code criminalizes the facilitation or encouragement of “people to immorality or prostitution.”41 Article 6 of the Press Law (1986) prohibits the dissemination of material “which violates public chastity” including “forbidden practices”42 such as same sex relations. Similarly, Article 14 of 34 Outright International, 2016, https://outrightinternational.org/sites/default/files/OutRightTransReport.pdf Ibid. 36 Ibid. 37 Small Media, 2018, https://smallmedia.org.uk/media/projects/files/BreakingTheSilence_2018.pdf 38 Outright International, 2016, https://outrightinternational.org/sites/default/files/OutRightTransReport.pdf 39 Ibid. 40 Ibid. 41 Islamic Penal Code (2013), Iran Human Rights Documentation Center, https://iranhrdc.org/islamic-penal-code-of-the-islamicrepublic-of-iran-book-five/ 42 International Lesbian Gay Bisexual Trans and Intersex Association (ILGA), 2019, https://ilga.org/downloads/ILGA_State_Sponsored_Homophobia_2019.pdf 35 6