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Turkey - In Iran the Government denies the existence of homosexuality; being gay can be punishable by death. But the State offers a solution - a sex change operation. The pressure on gay Iranians to agree to a sex change as a 'cure' for their homosexuality can be overwhelming.
For a new BBC World News documentary, Ali Hamedani of BBC Persian goes to Turkey to meet Iranian LGBT exiles who fled their home country in fear of being forced to change sex.
"I didn’t know it was acceptable to be gay in the West," Marie, a 37- year old male to female transsexual, told me.
"I grew up in a small town where everyone wanted to name and shame me. Are you really sure a feminine man can live a normal life in Canada? I had no idea."
I met Marie in the central Turkish city of Kayseri. Like many others from Iran’s LGBT community, she came here to apply for asylum and hopes to be given permission to move permanently to a third country, possibly Canada or Sweden.
(Marie)
I’ve been reporting on the problems facing Iran’s underground gay community since 2006 and I’ve met many Iranian men and women struggling with their sexuality.
But of all the stories I’ve heard over the years, Marie’s is the one that’s touched me most.
Born male, she was persuaded to undergo a sex change by doctors who told her this was the best way to deal with her confusion over her sexuality.
But she still wonders if it was the right thing to do.
It’s a shocking story, but as we discovered while making this BBC World News Our World film, it’s not that unusual, in Iran.
Iran is one of seven countries where homosexual acts are punishable by death. Yet perhaps surprisingly in a conservative country, the attitude to transgender people is different. The state officially recognises gender dysphoria - when a person's sense of their own sex doesn't match their physical gender.
In the mid-1980s the founder of the Islamic Republic of Iran, Ayatollah Khomeini, issued a Fatwa allowing people to change their gender. He had apparently been moved by meeting a woman who claimed to be trapped in a man's body.
Sex changes misused
But the concern is that sex changes have since been misused; offered not just to transgender people but to some gay men and lesbians as a 'solution' to their homosexuality.
"We are told to tell them they are sick and they need treatment," says ‘Shabnam’, who works as a psychologist in a state-run clinic in Iran, and whose name has been changed to protect her identity.
"We usually refer them to clerics who tell them: 'Your religious faith is weak and you must say your daily prayers properly'."
Medical treatments are also offered "on the basis that the individual is suffering from a sexual disorder," says Shabnam, and some are advised to change their gender.
In most countries gender change involves psychotherapy, hormone treatment and - usually - major life-changing operations. It's a complex process that takes many years.
But Shabnam says in Iran the process can be much quicker.
"In fact they show how easy it can be. They promise to give you legal documents and, even before the surgery, permission to walk in the street wearing whatever you like," says Shabnam. "They promise to give you a loan to pay for the surgery."
As well as the enticements, there can be threats.
"My father came to visit me in Tehran with two relatives," says Soheil, a gay Iranian 21-year-old. "They'd had a meeting to decide what to do about me.
"They told me: 'You need to either have your gender changed or we will kill you and will not let you live in this family'."
Soheil's family kept him at home and watched him. The day before he was due to have the operation, with the help of some friends, he managed to escape. They bought him a plane ticket and he flew to Turkey.
"If I'd gone to the police and told them that I was a homosexual and that my family was threatening me, my life would've been in even more danger than it was from my family," he says.
Getting reliable information on the number of sex change operations carried out in Iran is difficult.
(The train line to Tehran and Kaysari)
'More than 200 sex change operations every year'
Khabaronline, a pro-Government news agency, reports the numbers rising from 170 in 2006 to 370 in 2010. But one doctor from an Iranian hospital well known for sex changes told us that he alone carries out more than 200 sex change operations every year.
Supporters of the Iranian government's policy on gender change argue that transgender people in Iran are given help to fulfil their lives and have more freedom than in many other countries.
For some transgender people this is true. But given there is no option to live an openly gay life in Iran, the concern is that some people may feel pressured to change gender for the wrong reasons.
Arsham Parsi, who runs an organisation supporting LGBT Iranians, says he receives hundreds of inquiries every week asking for help. He told me his informal research shows that around 45% of people who'd changed gender were homosexual, not transgender.
"If they go to a psychologist or counsellor they say you are in a wrong body," he says. "When you're 16 and they tell you you're in the wrong body you think oh I finally worked out what's wrong with me." When being gay is not tolerated, it can be seen as a way of having a bit more acceptance and tolerance, he explains.
Many simply flee, most commonly to Turkey, where being gay is not illegal and Iranians don't need visas. Growing up in Iran, Donya kept her hair short and wore caps instead of headscarves.
If a police officer asked for her ID and noticed she was a girl, they would say: "Why are you like this? Go and change your gender."
When she first went to a doctor she asked for help stopping her periods, thinking that would make her more masculine. Seven years of hormone treatment followed, making her voice deeper and giving her facial hair - and, she suspects, causing cancerous tumours in her womb and stomach.
"I was under so much pressure that I wanted to change my gender as soon as possible," she recalls.
When doctors started proposing surgery, Donya began to question what was happening.
She saw that people who had changed gender in Iran had "lots of problems", and after consulting friends overseas, accepted that she was in fact a lesbian. Donya fled to Turkey with her son from a brief marriage, and was granted asylum in Canada, where they are starting a new life.
For Marie, who is settled for now in Turkey, she is still coming to terms with what happened to her in Iran.
"The doctor told me that with the surgery he could change the 2% male features in me to female features, but he could not change the 98% female features to be male," says Marie.
But after her operation she says she felt "physically damaged".
She had a brief marriage to a man but it broke down, and any hope she had that life would be better as a woman was short lived.
"If I were in a free society, I wonder if I would have been like I am now and if I would have changed my gender," she says. "I am not sure."
Our World: Iran’s Sex Change Solution is broadcast on BBC World News (DStv and StarSat channel 400) on Saturday 8 November at 18.10 and Sunday 9 November at 12.10.
