>In a region where gender segregation is widespread and dress codes are sometimes enforced by law, the problems of transgender people are especially acute. When so **much of the social structure is based around a clear-cut distinction between male and female, anything that obscures the distinction is viewed as a problem and sometimes even as a threat** to the established order. # 1. Crossing lines In a 2015 Lebanon survey, 80% of the public regard anyone who cross-dresses as a "pervert." In the Middle East, debate about the rights of women has gained traction, and increasingly the rights of gay people. However, transgender rights are largely ignored. ### The proper way to dress Upholding "proper" dress codes is a particular concern of some Islamic scholars. Islamic scholar Yusuf al-Qaradawi advises against cross-gender expression, citing "natural order" that risks being reversed: >“The evil of such conduct, which affects both the life of the individual and that of the society, is that it constitutes a rebellion against the natural ordering of things. **According to this natural order, there are men and there are women,** and each of the two sexes has its own distinctive characteristics. However, if men become effeminate and women masculinised, **this natural order will be reversed and will disintegrate.**” Egyptian cinema, popular throughout the Arab region, portrays homosexuality primarily as comedic and conflated with cross-dressing. ### Enforced dress codes Saudi Arabia has a long history of enforcing dress and behavioral code through its religious police. In 2007, the Kuwaiti parliament amended Article 198 to penalize anyone imitating the opposite sex. Since there was no way trans people could change their legal identity, this criminalized all transgender Kuwaitis, despite GID being recognized by the health ministry. In 2009, Dubai launched a public campaign which cautioned against masculine behavior among women. This was part of a moral panic sweeping through the Gulf region over _Boyat_ (the English word for "boy" with an Arabic feminine plural ending)— a term for women or girls displaying masculine traits. ### The crime of cross-dressing In 2010, Dubai launched a campaign encouraging report of cross-dressing. Press in the UAE portrayed boyat as female bullies operating in gangs and preying on other girls. Government campaigns against gender transgression has given legitimacy to vigilantes. In Iraq, after the overthrowing of Saddam Hussein, men suspected of homosexuality were publicly lynched. These killings tapped into social anxieties about traditional values and masculinity. ### Challenging the norms >Historically, Muslims in various parts of the world have dressed in a variety of ways. In the old days, communities were fairly isolated. This allowed each to have its own distinct customs and traditions. Within each community, though, people would tend to dress similarly, for reasons of practicality rather than religious dogma; they would wear whatever was available locally, and choice was limited. There might be the odd eccentric who dressed differently, but they could be tolerated because no one seriously considered them a threat to the “Islamic” way of life. An anxiety over social norms has overcome the region as women in the Gulf have become more visible, as migrants bring different ways of living, and as foreign media has penetrated culture. Parallel to this, many in the Middle East feel they are under siege from the West and respond to it by asserting traditional "Islamic values." The rules promulgated by "traditionalists" are a far cry from what was originally a simple injunction on Muslims to assume a modest appearance. # 2. A history of ambiguity The goddess Ishtar, depicted with an irregular gender, was a deity of ancient Mesopotamia. She had the power to "change man into woman and woman into man." Rules for the sexes became more formalized when Islam emerged in the seventh century CE. Nevertheless, it was accepted that not everyone fit neatly into a clear male/female binary and early Islam found a way to accommodate them. >There were three types of people recognised as being outside the usual male/female binary: those whose sex was anatomically uncertain (traditionally known as hermaphrodites though the preferred term nowadays is “intersex”); eunuchs (castrated men); and mukhannathun – men who were regarded as effeminate. ### The 'hidden sex' of a _khuntha_ The Quranic statement that God "created everything in pairs" forms the basis of Islamic doctrine that everyone is either male or female. Islamic jurists resolved the problem of intersex people by concluding that everyone has a "hidden" sex that is waiting to be discovered. A remark by the Prophet Muhammad that inheritance is determined by "the place of urination" has provided a way for Islamic jurists to determine an intersex person's (khuntha's) "hidden" sex. If sex could not be ascertained during childhood, then the development of secondary sex characteristics could clarify the sex. Failing that, the person became legally classified as khuntha mushkil (a “problematic” or “ambiguous” hermaphrodite) and the focus shifted away from body parts and towards accommodating the khuntha within a social system that was highly gendered. ### Eunuchs: crossing and guarding boundaries >Unlike a khunta, the original sex of a eunuch (khasi in Arabic) was not in doubt. He was a man, but one who had been castrated, usually by the removal of his testicles. His penis might be removed too, though apparently that was less common. >Since Islamic jurists disapproved of castration when performed by Muslims it is thought that eunuchs were usually acquired for non-Muslims as slaves. This might imply they had low status but their emasculation meant they were considered “safe” sexually and some of them certainly held positions of trust and influence. ### Mukhannathun: the effeminate men of Medina >A third group who fell outside gender norms but proved more difficult for Islam to accommodate were the effeminate men known as mukhannathun (singular: mukhannath). During the first century of Islam, mukhannathun were not associated with homosexuality, though they later would be. The mukhannathun were generally not considered respectable. >In the hadith it is said that the Prophet cursed effeminate men (al-mukhannathin min al-rijal) and mannish women (al-mutarajjilat min al-nisa') – a remark which is widely quoted today and provides a religious basis for laws against crossdressing in numerous Arab countries. However, the hadith have been handed down over generations and are considered less authoritative. >Elsewhere in the hadith the Prophet is said to have condemned “men who imitate women” (al-mutashabbihin min al-rijal bil-nisa') and “women who imitate men”. This is nowadays interpreted as a general indictment of effeminate men and masculine women. There is only one story involving the Prophet where feminine behavior by a man seems to have been condemned: a man decorated himself with henna, normally a practice among women. However, there is not enough detail to be sure whether henna was the problem or whether the man had been trying to pass himself off as a woman. Everett Rowson, scholar of the Islamic world, remarks on the stigma of homosexuality attached to mukhannathun: >“Increased public awareness of homosexuality, which was to persist through the following centuries, seems to have altered perceptions of gender in such a way that 'effeminacy', while continuing to be distinguished from (passive) homosexual activity or desire, was no longer seen as independent from it; and the stigma attached to the latter seems correspondingly to have been directed at the former as well, so that the mukhannathun were never again to enjoy the status attained by their predecessors in Umayyad Medina.” ### The erotic dancers of Cairo Jumping to the 19th century, the mukannath tradition of Medina were still alive among the erotic dancers of Cairo. The moral qualms surrounding female dancers flaunting their bodies gave rise to young male dancers down as "khawwal"— a term used today in Egypt to refer to effeminate gay men. ### Oman: the man in a pink dishdasha In the 1970s, Norwegian anthropologist Unni Wikan discovered the phenomenon of xanith / khanith in Oman— males with an intermediate gender role, neither regarded as totally man nor woman. Legally, they were regarded as men and referred to by others with masculine pronouns ### A gun-toting Iraqi woman >In contrast to effeminate men, recorded examples of “masculine” women – a female equivalent of the mukhannath – are comparatively scarce, perhaps because they were not considered worthy of note. But the boyat (tomboys) who have caused so much consternation in Gulf states during the last few years are clearly not the first of their kind. >In the mid-1950s, while studying the Marsh Arabs of southern Iraq, German ethnologist Sigrid Westphal-Hellbusch and her husband, Heinz, discovered a class of women known as mustergil a term which implies “becoming a man” or behaving like a man. >Many mustergil declare their decision to lead a manly life after their first menstruation ... This decision is generally accepted without opposition by the community. The young girl, if she has not already begun to live like a boy, henceforth dresses as a man, sits together with the men in the meeting house, takes an active part in her own life, and procures weapons for herself to take part in hunts and war campaigns > >The acknowledgment of a mustergil as a man refers exclusively to her manner of life. She can never quite gain the status of a man. >There were thus plenty of reasons why a woman might choose not to marry and become a mustergil instead. Possibly this institutionalised form of gender-bending served as a social safety valve: allowing the most disaffected women to adopt a male lifestyle (so long as they also accepted the responsibilities of manhood) may have helped to protect this highly patriarchal system from serious challenges. # 3. Making the Transition ### The 1982 Egyptian uproar to Sayyid Muhammad Abdullah's transition to "Sally" In 1982, a psychologist diagnosed Sayyid Muhammad Abdullah with _al-khunutha al-nafsiya_ ("psychological hermaphroditism", now considered gender dysphoria.) After years of psychological treatment, Sayyid was underwent genital reassignment surgery and emerged "Sally." This was met with controversy and rejection by Sally's medical school and by a medical body. A professor of physiology at al-Azhar school claimed Sally was motivated by "sodomistic inclinations." Sally's case re-ignited old Islamic debates about **"necessity" versus "choice."** Sally's dysphoria was questioned as necessary. **Everyone is either male or female. Therefore, Khunthas have a "hidden sex."** In previous centuries, Islamic scholars devoted thought to the question of **khunthas**— people of indeterminate sex. They concluded everyone is either male or female, and that a khuntha must therefore have a **hidden sex.** As sex reassignment surgery became available, it became viewed as a religiously permissible-way to uncover this hidden sex. ### The Grand Mufti intervenes Grand Mufti Tantawi defused the situation but did not entirely resolve it, avoiding key questions. Tantawi issued a fatwa officially recognizing Sally as a woman. Mufti Tantawi's fatwa gave authorization of reassignment operations subject to certain conditions, "as long as a reliable doctor concludes there are innate causes in the body itself, indicating a **buried \[matmura] female nature, or a covered \[maghmura] male nature.**" However, this didn't answer whether Sally's surgery had been based on a mere "wish to change sex." **Innate (khiliqi) versus affected (takallufi) effeminacy** >Centuries earlier, in discussions about the mukhannathun, scholars had attempted to distinguish between innate (khilqi) effeminacy and effeminacy that was affected or acquired (takallufi). Unlike “affected” effeminacy, “innate” effeminacy was considered excusable so long as the person worked to overcome it. The innate-versus-affected distinction allows for sympathy for those considered innately gay (so long as they work to be "cured"), but provides justification for punishing those considering willfully gay. Tantawi's ruling seemed to suggest Sally's effeminacy was innate and therefore justified surgery. However, it was not totally clear. ### Saudi Arabia: letting God decide Saudi Arabia performs gender confirmation surgery but prefer to call it "gender correction" since they view it as restoring the patients "original sex." Dr. Yasser Jamal of Saudi Arabia states: >“If the \[chromosome] test shows xx, the person is female, and if it is xy they are male. Also, tests are performed on the testicular or ovarian tissue as well as the patients’ internal organs for example, does this person have a uterus? Then that is a strong indication that she is a female.” Scott Siraj al-Haqq Kugle, author of _Homosexuality in Islam_, writes: >If a doctor examines an infant and determines, through cursory observation and stereotyped notions of genital normalcy, that the child does not have an “adequate penis” then the prevailing practice is to discount the child as male and declare the gender to be female. Female gender category is the default position if penile adequacy is missing or suspect. >In their view, society’s judgment is more valid than that of the patient: the change will be traumatic to family and community and the surgery will only produce a penis that society judges as small, inadequate, and fake. In 2014, the Saudi health ministry announced that all gender confirmation operations would require the ministry's approval. This approval was also contingent on the family's approval, illustrating how community opinion was centered over the trans person's agency. ### The woman who changed the ayatollah's mind Before the 1979 Islamic revolution, Iran had only a small number of gender confirmation operations. However, they have become increasingly common in recent times. This was possible for two reasons: 1. Shia jurisprudence is more innovative and progressive compared to Sunni schools. 2. Maryam Molkara, a transgender woman, advocated for herself. She confronted Ayatollah Khomeini and received his authorization, as well as creating a pathway for other transgender people. Individuals diagnosed with gender dysphoria can be granted a certificate which allows them to cross-dress in public before undergoing surgery and receive hormone treatment. While seemingly enlightened, the conditions in Iran are not ideal. - Some transgender people may not actually want an operation. - Despite legal recognition, **trans Iranians are perceived as deviant and abnormal.** - Homosexuality is criminalized and severely punished. - This, along with social pressure, coerces non-trans gay people to register as transgender. - "True transsexuals" are distinguished from gay people seeking to "game the system." - In Iran, **the difference between gay and trans is misunderstood,** even by medical professionals. ### 4. Struggles for recognition Despite some sense of social and legal legibility and visibility, transgender people face struggles for recognition, often two steps forward one step back. Amal, a Kuwaiti transgender woman, travelled to Thailand in 2001 for sex confirmation surgery. Upon return, she was suspended from her job. She was able to get the court to accept her as a woman, citing the 1988 ruling by Egypt's Grand Mufti. However, this was later reversed by a higher court. Zainab Rabie, a transgender man now known as Hussain, had shown signs of intersexuality during puberty. At the age of 25, after getting married as a "bride," her intersex condition was discovered and the marriage was annulled. The Bahraini government funded his sex confirmation surgery and recognized his new name. **Bahrani polishes its "progressive" image for the West using its limited support of transgender people.** >Bahrain, a repressive monarchy, spends vast amounts of money employing PR firms to polish its image in the west and the 2014 trans cases bolstered the picture of a progressive, liberal country (despite the fact the nine men had been jailed just a few years earlier for cross-dressing at a New Year party). **The Middle East tends to medicalize transgender identity to paper over social issues.** >Transgender is primarily a social issue – a question of how societies should respond to gender nonconformity – but the preoccupation with sexual anatomy in the Arab countries leads to it becoming over-medicalised. That in turn leads Ms Janahi, the lawyer, to portray her clients as defective beings. ### Legal Confusion Preoccupation with sexual anatomy results in gender confirmation surgery becoming the sole criterion for changing a person's official sex. In the absence of national laws and policies, transgender people resort to the courts. However, different courts make different decisions. In effect, there is no consistent way for recognizing a transgender person's official sex. ### De-medicalizing gender In the Middle East, strict gender divisions are considered necessary. This results in the medicalization of gender and forecloses the potential for self-declaration of gender. Arabic-Islamic societies, where the interests of family and community eclipse personal freedom, tend to view personal "choice" as selfish. This applies particularly to sex, gender, and marriage. Suppression of personal freedoms and the existence of inequality are justified as simply the natural order of things, especially as ordained by God. **The Quran: "We created all things in pairs." → Only male or female sex.** >In Islam, the religious justification for telling transgender people to accept their lot hinges on five words in the Qur’an: min kul shay’ khalaqna zawjayn (“We created all things in pairs”). Extrapolating from this, scholars have concluded that God has assigned a sex – male or female – to everyone, even if it is not immediately apparent from looking at their body. In intersex cases, where the divinely-assigned sex is believed to be hidden, “uncovering” it through surgery is both permissible and religiously desirable. This also reinforces the idea of a clear-cut male/female binary by bringing the intersex person into conformity with established gender “norms”. ### Egypt steps forward and backwards In Egypt, three decades after the Sally case (described above), the debate over sex confirmation surgery continues. In 2013, an Egyptian medical body recognized gender dysphoria as a medical condition, allowing for gender confirmation surgery. However, each case has to be approved by a medical body. Interestingly, **almost all gender confirmation surgeries carried out in Egyptian government hospitals is female-to-male.** This may be attributed to the stigma of homosexuality that is attached to trans women. Another explanation may be the lower number of specialist doctors. Dr. Abdel-Rassoul considers medical professionals' refusal to accept GID as a major obstacle: "you meet people who are more religious than scientific..." Patients are often advised to isolate themselves and seek a deep relationship with god. Trans women have become targeted under the Sisi regime's crackdown on homosexuality. **Egypt's targeting of effeminacy seems related to anxieties about masculinity** says LGBT researcher Scott Long: >“It may be that ... the people who are in charge have a conception of what men should be that is shaped by the military experience and is not only very heterosexual but also macho. There’s also a sense that youth in general have gone astray and that long-haired revolutionaries are part of a continuum with people who have forgotten how to behave in a manly way.” ### Shielding the Gulf from trans people In an effort to protect Arab masculinity, Gulf states seek to keep transgender foreigners out, refusing to admit transgender workers and travelers.