Transgender people with gender identity, expressions, and behaviors not traditionally associated with their birth sex (Gender Education and Advocacy, Inc. 2001) form a marginal group in every society. In Iran, an Islamic country with a collectivist culture that lays great stress on not losing face in public, this group suffers different psychological, social, economic, and family problems which have not been studied adequately.

After the regime change in 1979, the Islamic government of Iran legalized sexual reassignment surgery based on permission of the su…