Changing Sex, Changing Islam

In Iran, transsexuals, changing sex, have been changing Islam as well, under its still theocratic government:

Everything about Amir appears masculine: his broad chest, muscled arms, the dark full beard and deep voice. But, in fact, Amir was a woman until four years ago, when, at the age of 25, he underwent the first of a series of operations that would change his life.

Since then he has had 20 surgical procedures and expects another 4. And Amir, who as a woman was married twice to men -- his second husband helped with the transition and remains a good friend -- is now engaged to marry a woman.

"I love my life and I'm happy, as long as no one knows about my past identity," said Amir, who asked that his full name not be published. "No one has been more helpful than the judge, who was a cleric and issued the permit for my operation."

After decades of repression, the Islamic government is recognizing that some people want to change their sex, and allowing them to have operations and obtain new birth certificates.

Before the Islamic Revolution in 1979, there was no particular policy regarding transsexuals. Iranians with the inclination, means and connections could obtain the necessary medical treatment and new identity documents. The new religious government, however, classed transsexuals and transvestites with gays and lesbians, who were condemned by Islam and faced the punishment of lashing under Iran's penal code.

But these days, Iran's Muslim clerics, who dominate the judiciary, are considerably better informed about transsexuality. Some clerics now even recommend sex-change operations to those who are troubled about their gender. The issue was discussed at a conference in Tehran in June that drew officials from other Persian Gulf countries.

One cleric, Muhammad Mehdi Kariminia, is writing his thesis on transsexuality at the religious seminary of Qum.

"All the clerics and researchers at the seminary encouraged me to work on the subject," he said in an interview. "They said that my research can help change the social stigma attached to these people and clarify religious decrees on the matter."

One early campaigner for transsexual rights is Maryam Hatoon Molkara, who was formerly a man known as Fereydoon. Before the revolution, under the shah, he had longed to become a woman but could not afford surgery. Furthermore, he wanted religious guidance. In 1978, he wrote to Ayatollah Ruhollah Khomeini, who was to become the leader of the revolution but was still in exile, explaining his situation.

"Maryam Hatoon Molkara, who was formerly a man known as Fereydoon, was an early campaigner for the rights of transsexuals in Iran"/Photograph by S. Reza for the New York Times

The ayatollah replied that his case was different from that of a homosexual and therefore he had his blessing.

However, the revolution intervened and men like himself or those who had already changed their sex were harassed, even jailed and tortured. "They made me stop wearing women's clothes, which I had worn for many years and was used to," Ms. Molkara recalled. "It was like torture for me. They even made me take hormones to look like a man."

It took him eight years after the revolution, in 1986, to get government permission to proceed with surgery. But he could not afford the surgery and did not have it until 1997, when he underwent a sex-change operation in Bangkok. The Iranian government covered the expenses. Four years ago, Ms. Molkara established an organization to help those with gender-identity problems. Co-founders include Ali Razini, head of the Special Court of Clergy, a branch of the judiciary that only deals with clerics, and Zahra Shojai, Iran's vice president for women's affairs. An Islamic philanthropic group known as the Imam Khomeini Charity Foundation has agreed to provide loans equivalent to about $1,200 to help pay for sex-change surgery.

To obtain legal permission for sex-change operations and new birth certificates, applicants must provide medical proof of gender-identity disorder. The process can take years.

It also involves considerable expense. In Tehran, the initial male-to-female surgery runs about $4,000. So far, Amir has spent $12,000 on medical procedures.

The people who pursue this route come from many different backgrounds.

Dr. Bahram Mir-djalali, one of Tehran's few sex-reassignment surgeons, said one of his patients had been a member of the Revolutionary Guards who served five years in the war with Iraq. His operation was paid for by a Muslim cleric he had worked for as a secretary. After the surgery, the man-turned-woman divorced, and then married the cleric.

"When she came to see me years later, she was wearing a chador," the doctor recalled, referring to the black head-to-toe garb worn by religious women. "She took off the chador, and there was no sign of the bearded man I had operated on."

But many who cannot deal with the legal and financial obstacles to a surgical solution have to deal with humiliation in their daily lives.

One 27-year-old man said he ran away from home at the age of 14 because he did not dare tell his family of his urge to become a woman. He wants to be known as Susan and wears women's clothes at home but only emerges dressed that way at night. He says the constant need for secrecy has left him severely depressed, and he has attempted suicide several times.

"I have suffered all my life," he said, constantly adjusting his long curly hair to cover his sideburns. "People treat me as though I have come from Mars. Women pull my hair and laugh at me on the street. Most men I am attracted to reject me."

In a society where men enjoy a higher status than women, the stigma against any man who wants to be a woman is especially strong.

"They compliment a girl who behaves and dresses like a man as a strong person, but they look down at us and despise us," said Assal, who was disowned by her father for having surgery to become a woman.

Dr. Mir-djalali said he had to fight on many fronts to help more than 200 patients who had consulted him in the 12 years he had performed sex-change operations. Even if Iran's Muslim clerics are more understanding now of transsexuals' needs, others lag behind.

"We have a problem even deciding at which hospital to do the surgery because society considers these people deviant," he said. "Hospital officials have reacted negatively because they say other patients do not like the looks of my patients."

He said one patient's father pulled a knife on him in his office, and threatened to kill him if he touched his son. "What we really need to help these people," Dr. Mir-djalali said, "is a serious cultural campaign." (Nazila Fathi, "As Repression Lifts, More Iranians Change Their Sex," New York Times, August 2, 2004)

Iran is not the only predominantly Muslim nation where sex-change operations have found growing acceptance. Earlier this year, news of a court ruling approving sex-change surgery in Kuwait was reported by BBC:

A Kuwaiti court has said a 25-year-old man who underwent sex-change surgery can be officially regarded as a woman.

The unprecedented ruling came after the court was told of the plaintiff's physical and mental torment since childhood due to hormonal imbalances.

Lawyer Adel al-Yahya told Reuters news agency the judges were guided by a religious edict allowing gender change if there are medical reasons for it.

The ruling has to be approved by a higher court before it becomes final.

Mr Yahya, the plaintiff's lawyer, said he presented the court with an edict from Sunni Islam's top religious institution, al-Azhar, in Egypt.

This allows people to change their gender if there are proper medical reasons for doing so.

"We have evidence, a fatwa from al-Azhar, because we have a case of illness, not a case of switching gender or as they call it in Kuwait a third-sex case," he told Reuters.

"This is a very rare condition... and the court ruled according to that condition."

Mr Yahya said the process of getting final approval for the ruling may take up to a month. ("Kuwait Sex-Change Case Upheld," April 25, 2004)

Both the BBC article above and a 1998 article about the Turkish transsexual scene in Middle East Report cite "a June 1988 fatwa issued in Egypt by the Mufti of the Republic on the question of Sayid 'Abd Allah, alias Sally [Mursi], who had . . . undergone a sex-change operation" (Deniz Kandiyoti, "Transsexuals and the Urban Landscape in Istanbul," Middle East Report 28.1 Spring 1998).

Sally Mursi strikes a pose in Tahrir Square, Downtown Cairo. Photographer: Mohsen Allam/Egypt Today

Sally herself credits Mufti Sayed Tantawi for preserving individual freedom: "Then, as if remembering something, his face brightens up: 'This great man! Sheikh [Al-Azhar, then Mufti] Sayed Tantawi! He issued his own fatwa during the controversy [over Sally], saying that it's a medical situation best left to the doctor's discretion if he sees the need to operate. I have tons of respect for this enlightened man'" (Azza Khattab, "Sally's Story," Egypt Today 25.7, July 2004).

The fatwa in question reads as follows:

FATWA ON SEX-CHANGE OPERATION JUNE 8, 1988

To the honored general secretary of the Doctors' General Syndicate. This is an answer to the Syndicate's letter number 483 of May 14, 1988, asking for the opinion of religion on the matter of a student of medicine at the al-Azhar university, who has been subjected to a surgical operation (removing his male organs) in order to turn him into a girl.

We find that cUsama ibn Sharik tells: "A bedouin came to the Prophet and said, 'O, Messenger of God, can you cure?' And He said, 'Yes, for God did not send a disease without sending a cure for it, knowing it from His knowledge . . .'" This [hadith] is told by Ahmad [ibn Hanbal]. There is another version: "Some bedouins said, 'O, Messenger of God, can you cure?'. And He said. 'Yes. God's servants can cure themselves, for God never gave a disease without providing a cure or a medicine for it, except for one disease.' They asked, 'O, Prophet of God, what disease is that?' He said, 'old age.'" This version is related by ibn Maja abu Da'ud, at-Tirmidhi, and others. (Muntaqi l-Akhbar wa Sharhan nayl al-Awtar, v. 8, p. 200, and Fath al-Bari bi Sharh Sahih al-Bukhari, by al-cAsqalani(29), v. 9, p. 273, in the chapter on those who imitate women).

As for the condemnation of those who by word and deed resemble women, it must he confined to one who does it deliberately [tacahhada dhalika], while one who is like this out of a natural disposition must be ordered to abandon it, even if this can only be achieved step by step. Should he then not comply, but persist [in his manners], the blame shall include him, as well -- especially if he displays any pleasure in doing so.

The person who is by nature a hermaphrodite [mukhannath khalqi] is not to be blamed. This is based on [the consideration that] if he is not capable of abandoning the female, swinging his hips in walking and speaking in a feminine way, after having been subjected to treatment against it, [he is at least willing to accept that] it is still possible for him to abandon it, if only gradually. But if he gives up the cure with no good excuse, then he deserves blame.

At-Tabari took it as an example that the Prophet (God bless him and grant him salvation) did not forbid the hermaphrodite from entering the women's quarters until he heard him giving a description of the woman in great detail. Then he prohibited it. This proves that no blame is on the hermaphrodite for simply being created that way.

That being so, the rulings derived from these and other noble hadiths on treatment grant permission to perform an operation changing a man into a woman, or vice versa, as long as a reliable doctor concludes that there are innate causes in the body itself, indicating a buried [matmura] female nature, or a covered [maghmura] male nature, because the operation will disclose these buried or covered organs, thereby curing a corporal disease which cannot be removed, except by this operation.

This is also dealt with in a hadith about cutting a vein, which is related through Jabir: "The Messenger of God sent a physician to abu ibn Kacb. The physician cut a vein and burned it." This hadith is related by Ahmad [ibn Hanbal] and Muslim. What supports this view is what al-Qastallani(30) and al-cAsqalani say in their commentaries on it: "This means that it is incumbent upon the hermaphrodite to remove the symptoms of femininity."

And this is further sustained by the author of Fath al-Bari who says ". . . having given him treatment in order to abandon it. . ." This is a clear proof that the duty prescribed for the hermaphrodite can take the form of a treatment. The operation is such a treatment, perhaps even the best treatment. This operation can not be granted at the mere wish to change sex with no clear and convincing corporal motives. In that case it would fall under that noble Hadith which al-Bukhari relates through Anas: "The Messenger of God cursed the hermaphrodites among the men and the over-masculine women, saying 'expel them from their houses', whereupon the Prophet himself (God bless him and grant him salvation) expelled one, and cUmar expelled another one." This Hadith is related by Ahmad and al-Bukhari.

To sum up: It is permissible to perform the operation in order to reveal what was hidden of male or female organs. Indeed, it is obligatory to do so on the grounds that it must be considered a treatment, when a trustworthy doctor advises it. It is, however, not permissible to do it at the mere wish to change sex from woman to man, or vice versa.

Praise be to He who created, who is mighty and guiding. From what has been said the answer to what was in the question will be known. Praise be to God the most High. (qtd. in Jakob Skovgaard-Petersen, "Sex Change in Cairo: Gender and Islamic Law," The Journal of the International Institute 2.3, Spring 1995)

The fatwa, in short, is at once prescriptive and permissive: on one hand, it seeks to fit polymorphous bodies into two biological sexes, with surgery if necessary, arguing that a sex-change operation is permissible if it is to bring out a hidden female or male "nature," rather than "at the mere wish to change sex from woman to man, or vice versa"; on the other hand, it is in practice liberalizing, in that men and women can have sex-change operations simply based upon their wishes, as long as they can find liberal doctors "willing to diagnose them as inter-sex, not transsex," whether or not their physical bodies may be so described (Khattab, July 2004).

The Iranian discourse on sex change, as reported in the New York Times above, similarly medicalizes the question of sex and gender, demanding proof of "gender-identity disorder" before legal sex change. What is different and promising, however, is that, in Iran, liberal clerics are ready to explicitly (rather than implicitly) make room for not just operations on bodies physically labeled "inter-sex," as in the case of Egypt and Kuwait, but also for men and women who want to become transsexuals in order to achieve happiness, fulfilling their social, cultural, and psychological needs and desires.