Introduction: This study aims to investigate the impact of the health-oriented paradigm on the laws and practices related to gender reassignment in Iran and to explain the legal challenges arising from it.
Methods: The research method is descriptive-analytical and the data were collected through the study of legal, jurisprudential documents and library resources and examined using the content analysis technique.
Results: The findings show that the current framework, by defining gender reassignment as "treatment of a disorder", although it has enabled its legalization, has led to the formation of a hierarchical supervisory mechanism in which medical institutions—especially forensic medicine—and the judiciary, as the main gatekeepers, have marginalized the individual's agency and made his or her identity dependent on clinical assessments and licensing. This model faces major challenges such as ambiguity in diagnostic criteria, a long and costly process, lack of comprehensive health care, and extensive legal gaps in the field of family and marriage.
Conclusion: In conclusion, it is clear that the current purely biomedical approach, by ignoring the dimensions of identity and human rights, is not only unable to provide legal security and psychosocial health of trans people, but has itself become a factor in perpetuating some of the suffering. The transition to a legal model based on self-determination and recognition of human dignity requires a fundamental revision of existing laws and procedures.