Accessing treatment

Referrals and requirements/examinations for treatment

Age requirements

Legal sex reassignment is possible after 18 years old in Iran.

The price

After primary diagnosis, supportive psychotherapy will be initiated including possible cross dressing therapies. Afterward, the hormone therapy is established and based on the results the patient might be considered for sex reassignment surgery. Fortunately, all these treatment expenses even the psychotherapies have been fully covered by the public insurance provided for all individuals with Iranian nationality. Patient should pay about 250000000IRR( about 2500 USD) in Iran.

Usage of the GID diagnosis

Abolished in Denmark and not needed in Spain

Consequences of not requiring a diagnosis

Protective and empowering in India, Iran, Singapore and Japan

Same-sex activity is legal prohibited  in Iran, whereas TS patients are able to get married and even adopt a children after sex reassignment surgery.

Changes in ICD-11

Over the past years, a range of civil society organizations as well as the governments of several EU member states have urged the WHO to remove the categories related to transgender identity from its classification of mental disorders in the forthcoming ICD‐11 (REF). In most countries, the prerequisite of health services in diagnosis of a health condition that is specifically related to those services. If no diagnosis were available to identify transgender people who were seeking related health services, these services would likely become even less available than they are now7273. Thus, the Working Group on Sexual Disorders and Sexual Health has recommended retaining gender incongruence diagnoses in the ICD‐11 to preserve access to health services, but moving these categories out of the ICD‐11 chapter on Mental and Behavioural Disorders (see Table 2). After consideration of a variety of placement options72, these categories have been provisionally included in the proposed new ICD‐11 chapter on Conditions Related to Sexual Health.

Legislation

Formal legal sex change

The treatment procedures, distinguished as surgical procedures, have been permitted both legally and religiously since 1984. in Iran.        
TABLE WITH LEGAL CONDITIONS

Closing remarks

Culture and stigma

Despite all the mentioned clinical and legal facilities provided, Iranian patients are subjected to extreme pressure forced by not only the society, but also their own family members.  

Pregnant trans men

Progress is not inevitable

A warning on how progress is not inevitable with a reference to Indonesia labelling all LGBTQ mental disorders \cite{holmes2018,Yosephine2016}