Changing Their Sex in Iran

Khomeini reasoned that if men or women wished so intensely to change their sex, to the point that they believed they were trapped inside the wrong body, then they should be permitted to transform that body and relieve their misery. His opinion had more to do with what isn't in the Koran than what is. Sex change isn't mentioned, Khomeini's thinking went, so there are no grounds to consider it banned.

"There is no reason why not," says Kariminia, the cleric. "Each human being is the owner of his body, and therefore he can make changes."

Before Khomeini, some Islamic edicts had approved sex changes for hermaphrodites, but nobody had given carte blanche for sex reassignment without medical deformities. To this day, some Shiite clerics argue against operating on healthy bodies.

But in a low stone house in the twisting alleys of Qom, Kariminia is writing his doctoral thesis on transgender law. His writings tease out the work of Khomeini, tackling legal questions such as: If a married woman wishes to become a man, must she first get permission from her husband? Must a man seek permission from his wife?

"Islam has recognized the rights of transgender. We can't say to anybody that they must be a man or a woman," Kariminia says. "But do you think just because they don't have legal or Islamic problems, their problems are solved? I certainly do not."

Iran's acceptance of sex-reassignment operations raises the specter that gays and lesbians may be able to find a place for themselves here only by changing their gender. Some transgender patients complain that lesbians and gays are exploiting the surgery to create a legal way to sleep with their preferred partners.

Mir-Djalali, a kinetic man with an irrepressible enthusiasm for spelling out the more delicate details of the surgeries, says that in 15 years he's transformed about 320 men into women, and 70 women into men.

He is careful to point out that those were only half of the would-be patients who came to his office. He disqualified the others after they were examined by a panel of three psychiatrists.

The psychiatric team tries to sort out homosexuality from gender disorder by asking a series of questions. A man hoping to become a woman, for example, is asked whether he has dreamed of removing his penis. Gay men recoil at the idea, the doctor says -- but transgender men are eager at the suggestion.

"They say, 'Yes, yes, yes, I've always dreamed of it,' " Mir-Djalali says.