This paper explores the history and modern-day social relevance of state-sanctioned acceptance and support of trans-identified individuals in Iran. As a result of a declaration made by Supreme Leader Ayatollah Ruhollah Khomeini in 1987, Gender Confirmation Surgery (GCS) has become a state-subsidized option for trans-identified persons looking to transition. Iran now completes more GCS annually than almost any other nation. Additionally, Iran furnishes its newly transitioned citizens with new identification, corresponding rights, and other tools to proceed in a gender-segregated society. Although these statistics may seem progressive, other alternative expressions of sexual identity are illegal and even punishable by death. Research indicates that trans-exceptionalism in Iran creates pressure for non-trans-identified men who have sex with men (MSM) and women who have sex with women (WSW) to undergo GCS in order to gain legality, safety, and acceptance in Iran. Furthermore, the social experience of the LGBT community as a whole has not caught up to the progressive policies that some in this community enjoy.