Iran is the only Muslim country in the Persian Gulf region that gives trans citizens the right to have their gender identity recognized by the law—but violence, rejection from their families and society, and financial issues that come with being ostracised have added to the plight of transgender people in Iran.
Saman Arastoo, formally Farazaneh, is a transgender man who acts and directs in Iranian theatres to give a platform to the struggle many transgender people face.
He spoke to Euronews about his latest biopic production "Khodkar-é-Bikar," which means "useless pen"—a play on words referring to those who are vocal about trans issues but do not act in accordance with what they say.
"This piece aims to make society examine its own behaviour. Society needs to increase its consciousness, stop this culture of being passive (towards transgender people) and act. This is the only solution."
Arastoo explained how many transgender people were being forced into prostitution "just for somewhere to sleep or for money".
"They have no place to go or even sleep. Their families rejected them, they have no job, most of them were students but they abandoned their studies," he said.
The subject of transgender identity in Iran was not officially addressed by the government before the 1979 revolution.
In the mid-1980s, however, transgender individuals were officially recognised by the government and allowed to undergo sex-reassignment surgery.
The first person underwent surgery at the beginning of the 1980s after Ayatollah Khomeini, the religious leader and politician who led Iranian Revolution and the founder of Iran as an Islamic republic, gave his green light (Fatwa).
However, trans people were seen as having a medical illness for which the perceived cure was sex-reassignment surgery.
Dr Shahryar Kohanzad, a urologist specialising in sex-reassignment surgery, told Euronews how many of his "patients" were still struggling, despite their new identities being legally recognised.
"Unfortunately, many of my (trans) patients have suffered in solitude for a long period of time and even denied their identities to themselves. They believe that they are guilty and for this supposed crime, they curse themselves, but we know they didn't choose to be like this," he said.
Iran's transgender population is growing, with the number of applications for sex-reassignment surgery rising exponentially from 170 in 2006 to 319 in 2010.
The BBC reported that as of 2008 Iran carried out more sex-reassignment surgeries than any other nation in the world except Thailand.
Iran's government provides up to half the cost for those needing financial assistance, and a sex change is recognized on birth certificates.
Despite all of this, trans people often find themselves on the edges of society.
One of the actors performing Arastoo's play, in which a trans person is beaten, said the piece is an accurate representation of trans people in Iran.
"This story (in the play) is not mine but could be the story of many other transsexuals. We've all experienced at least some part of this piece in my personal life."