Pathologizing Identities, Paralyzing Bodies: Human Rights Violations Against Gay, Lesbian and Transgender People in Iran Justice for Iran & Iranian Lesbian and Transgender Network (6Rang) June 2014 CONTENTS Terminology ......................................................................................................................................1 1. Introduction and Background ...................................................................................................4 1.1. A Word on the Background................................................................................................7 1.2. How Many Sex Reassignment Surgeries Are Performed in Iran? ......................................9 1.3. Organization of the Report ............................................................................................. 12 1.4. Methodology ................................................................................................................... 13 2. Sexual Orientation and Gender Identity in International Human Rights Law ....................... 15 2.1. The Right to Equality and Non-Discrimination ............................................................... 15 2.2. The Right to Privacy and Recognition before the Law .................................................... 17 2.3. The Right to Liberty and Security of Person ................................................................... 18 2.4. The Right to the Highest Attainable Standard of Health ................................................ 18 2.5. The Right to be Free from Torture and Other Cruel, Inhuman or Degrading Treatment 19 2.6. The Right to Education .................................................................................................... 22 2.7. The Right to Freedom of Expression and Access to Information.................................... 23 2.8. The Right to a Remedy for Violations of Human Rights ................................................. 25 3. Discriminatory Laws and Practices and Acts of Violence based on Sexual Orientation and Gender Identity in Iran .................................................................................................................. 28 3.1. Iran’s Legal Framework on Sexual Orientation and Gender Identity ............................. 28 3.1.1. Treatment of Homosexuality .................................................................................... 29 3.1.2. Treatment of Trans-Dressing .................................................................................... 30 3.1.3. Treatment of Transsexuality ..................................................................................... 32 3.1.4. Restrictions on the Right to Freedom of Expression and Information ..................... 34 3.2. Violence and Discrimination against Lesbian, Gay and Transgender People ................. 35 3.2.1. Arbitrary Arrests and Detention and Police Abuse ................................................... 35 3.2.2. Discrimination in Education ...................................................................................... 42 3.2.3. Abuse and Violence by Members of the Public ........................................................ 45 3.2.4. Abuse and Violence in the Family ............................................................................. 47 4. Legal Gender Recognition Procedures in Iran ....................................................................... 50 4.1. Background and Context ................................................................................................. 51 4.2. Psychiatric Diagnosis ....................................................................................................... 53 4.3. Hormone Therapy ........................................................................................................... 58 4.4. Sex Reassignment Surgeries and Change of Legal Documents ...................................... 60 4.5. Exemption from Military Service .................................................................................... 65 5. Torment in the Name of Treatment: Abuses Against Lesbian, Gay and Transgender Persons in Health-Care Settings .................................................................................................................. 71 5.1. Background & Context .................................................................................................... 71 5.2. Reparative Therapies ...................................................................................................... 78 5.3. Negligent and Substandard Non-consensual Sex Reassignment Surgeries .................... 84 6. Conclusions and Recommendations ...................................................................................... 93 Acknowledgments ......................................................................................................................... 99 1 | Pathologizing Identities, Paralyzing Bodies Human Rights Violations Against Gay, Lesbian and Transgender People in Iran TERMINOLOGY Bisexuals are people whose emotional, affectionate and sexual attraction can be toward both women and men. Dojense is a term used in Persian for referring to both intersex (physical dojense) and transsexual (psychological dojense) people. Its literal meaning is “bisexed”. Gay refers to men whose emotional, affectionate and sexual attraction is primarily toward men. Gender refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for men and women. Gender Expression refers to the means by which individuals express their gender identity. This may or may not include dress, make-up, speech, mannerisms and surgical or hormonal treatment. Gender Identity is a very personal and subjective matter. It refers to each person’s deeply felt internal and individual experience of gender, which may or may not correspond with the sex assigned at birth. It includes the personal sense of the body (which may involve, if freely chosen, modification of bodily appearance or function by medical, surgical or other means) and other expressions of gender, including dress, speech and mannerism. Gender Identity Disorder or Gender Dysphoria is a discomfort characterized by a feeling of incongruity with the physical gender assigned to one at birth. Frequently misunderstood by the individual, these feelings can remain suppressed and hidden from others. Unhealthy coping mechanisms include self-abuse, addictions, relationship difficulties and suicidality. Gender Identity Disorder may be experienced by biological males or females of any cultural, ethnic or socioeconomic background. In 2013, the American Psychiatric Association updated the term “Gender Identity Disorder” to “Gender Dysphoria” in the fifth version of the Diagnostic Manual of Mental Disorders (DSM-V). However, the former term will be used throughout this report. Gender Marker is a gendered designator that appears on an official document such as a passport or an identity card. It may be an explicit designation such as “male” or “female” or a gendered title such like Mr. or Ms. Gender Queer refers to gender identities other than “man” and “woman”, thus falling outside of the gender binary. Genital Reassignment Surgeries refer to operations aimed at modifying genital characteristics to accord with a person’s gender identity. They include gonad removal and genital removal as well as reconstructive procedures such as orchidectomy, penectomy, genito-vaginoplasty or labiaplasty for the male-to-female individuals; or vaginectomy and genito-phalloplasty for female-to-male individuals. 2 | Pathologizing Identities, Paralyzing Bodies Human Rights Violations Against Gay, Lesbian and Transgender People in Iran Hamjensbaz is a derogatory Persian term for referring to homosexuals. Its literal meaning is same-sex “gamer” and it implies that homosexuals are people with loose morals who chase people of the same sex for sexual pleasure. Heterosexual people are individuals whose emotional, affectionate and sexual attraction is primarily to members of the opposite sex. Heteronormativity refers to a system of norms, attitudes and biases that assumes that people fall into distinct and complementary genders (man and woman) with natural roles in life. It asserts that heterosexuality is the normal sexual orientation, and sexual and marital relations are only fitting between a man and a woman. Consequently, a “heteronormative” view is one that involves alignment of biological sex, sexuality, gender identity, and gender roles. Homosexual people are individuals whose emotional, affectionate and sexual attraction is primarily to members of the same sex. Hormone Therapy or Hormone Replacement Therapy (HRT) is a form of medical treatment that transgender people may wish to take in order to develop some secondary sex characteristics of the gender with which they more closely identify. Irreversible effects testosterone on female-to-male transsexuals include deepening of voice, growth of facial and body hair, and enlargement of the clitoris while reversible effects include cessation of ovulation and menstruation and muscle development. Partially reversible effects of estrogen on male-to-female transgenders include breast tissue growth (gynaecomastia), and reversible changes include lightening of body hair, smoother skin and reduction in testicle and gonad size. Estrogen has no effect on male-to-female transgenders’ voice pitch. Intersex individuals possess genital,