Iranian news services reports that well over a thousand gender reassignment operations have been carried out between 2006 and 2010.

State medical records indicate that from 2006 to 2010, 1,366 Iranians acquired permits to undergo sex change operations.

Khabar-on-line reported on Monday that 56 percent were seeking male-to-female surgery and 44 percent were female-to-male operations.Maryam Khatoon Molkara, the first Iranian to undergo gender reassignment surgery, is one of tens of thousands to have undergone the procedure in Iran Iranians seeking sex-change operations must apply to the country’s courts for a permit, their case is then forwarded to state medical offices to be processed.Maryam Khatoon Molkara, claimed to be the first Iranian to undergo gender reassigment, was instrumental in persuading Ayatollah Khomeini, Iran’s late spiritual leader, to legalize the operations in 1984.While homosexuality is considered a sin and crime punishable by death, transsexuality is categorised as an illness subject to cure (i.e. gender reassignment).Iran has between 15,000 and 20,000 transsexuals, according to official statistics, although unofficial estimates put the figure at up to 150,000.Iran carries out more gender reassignment operations than any other country in the world besides Thailand.Under the current Iranian president, Mahmoud Ahmadinejad, the state has begun providing grants of £2,250 ( € 2,766 US$ 3,625) for operations and further funding for hormone therapy.It is also provides loans of up to £2,750 ( € 3,380 US$ 4,429) to allow those undergoing surgery to start their own businesses.In an interview with the British daily The Guardian, Molkara stated that some of those undergoing operations were gay rather than out-and-out transsexuals.Under Iranian law, only sexual relations occurring inside heterosexual marriages are permissible, anything else is strictly prohibited with a maximum capital punishment for homosexuality.The Safra Project 2004 report stated that it is not possible for presumed transsexual individuals to choose not to undergo surgery – if they are approved for sex reassignment, they are expected to undergo treatment immediately.Those who wish to remain “non-operative” (as well as those who cross-dress and/or identify as genderqueer) are likely to face persecution as gay, lesbian or bisexual people in Iran.Other reports document gay, lesbian and bisexual people being forced into gender reassigment operations.Thus Iran’s police follows the strict Shari’a division of heterosexual gender roles, and many people who are not genuinely transsexual are forced into this procedure.Furthermore, many transgender people face social persecution, are ostracized, or even killed by their family and community after reassignment.Commenting on the news, Omar Kuddus, an openly gay Muslim LGBT rights advocate based in the UK told GSN: ‘It is unfortunate that many gay, lesbian and bisexual Iranians have to resort to gender reassignment surgery as a forced choice.‘The only other viable choice for them if they remain in the country is to try and avoid getting caught which could cost them their lives.‘In fact, the high number of surgeries may indicate this harsh reality – many are probably gay, lesbian and bisexuals who would rather live as such rather than be forced into a gender reassignment surgery.‘Even then, Iranian society, at large, does not accept transgender people who are murdered because they “dishonour” their families’