The Islamic Republic of Iran is painted by “Western media” as a peculiar site for the legality and regulation of sex reassignment surgery and transgender and transsexual identities. This Article argues that Iran’s position on trans issues is not as peculiar or phenomenal as Western media frequently claims. In Section I, I provide a general history of gender and sexual performance in Qajar Iran. I then explain how Iranian-Western interactions helped create heteronormalization in Iran. Finally, I discuss the Islamic Republic of Iran and its effect on formulations of gender and sex. In Section II, I discuss Iran’s legal-medical-religious sex reassignment framework for those who identify as trans. In Section III, I discuss trans advocacy in Iran, including why trans persons largely seek entitlements rather than rights. In Section IV, I argue that Iranian trans and other gender “deviant” persons are the best situated to affect their situation. I explore the possibilities of liberatory approaches and activism that utilize (1) coalitions that engage and mobilize multiple identity groups, (2) language that allows for new meanings and representations of identity, and (3) Ayatollah Khomeini’s fatwa on sex reassignment surgery.