The New York Times:

By Pranav Baskar and Leily Nikounazar

For 40 years Iran has performed more gender transition surgeries than many other nations, largely a result of pressuring gay and gender-nonconforming citizens to undergo unwanted operations or risk the death penalty.

Now, faced with an economy crippled by war and sanctions, the Islamic republic is promoting its expertise to a global audience, hoping to attract transgender foreigners with the promise of inexpensive surgeries packaged with luxury hotel stays and sightseeing tours.

Desperate for foreign investment, Iran’s theocratic government has set a goal of generating more than $7 billion from medical tourism annually, according to Iranian state news media, about seven times as much as it earned last year. That objective has resulted in the proliferation of medical tourism companies, marketing not just nose jobs and hair transplants, but vaginoplasties, mastectomies and penis constructions through glossy English-language websites.

“We handle everything from start to finish, providing the best medical services to ensure a stress-free experience,” said Farideh Najafi, the manager of two medical tourism companies, MabnaTrip and MedPalTrip. “This includes booking hotels, hospitals, transportation and more,” she said.

Iran is one of the few places in the Muslim world that allows transgender people to seek gender-affirming care, and even subsidizes it. For many foreigners traveling to Iran for transition surgery, and indeed for many transgender Iranians, these operations can feel lifesaving. But the country’s reputation as a pioneer in the field belies the abusive history of the operations and the grim reality for most L.G.B.T.Q. people there.

In Iran, gay men and lesbians can be punished by public flogging and the death penalty. As a result, the United Nations Human Rights Council found, many gay and lesbian Iranians who are not trans are “pressured into undergoing gender reassignment surgery without their free consent.”

Still, the country’s cut-rate prices are drawing transgender individuals from as far away as Australia, the United States, Britain and Europe, according to medical tour operators and surgeons. Many more patients, they say, come from neighboring countries, like Iraq, where such treatments are strictly forbidden.

“In the United States, the cost of surgery is around $45,000, and in Thailand, it’s approximately $30,000,” according to the website of one operator, IranMedTour. “However, the cost of gender confirmation surgery in Iran is lower, with prices less than $12,000.” Other companies, advertise procedures at government hospitals for as low as $4,500.

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