Transgender right

Confused Judiciary & Transgender Rights: Inside the MENA Region’s Case Law on Legal Gender Recognition

Countries in the Middle East and North Africa lack any legislative framework to allow legal gender recognition (LGR) for their transgender populations. This legislative vacuum has forced transgender people who wish to receive LGR to undergo a lengthy, costly, and complicated judicial review process, where results are not always positive.[i] Judges rely on outdated medical practices, selective readings of Islamic Shari’a, their interpretations of national law, as well as their socio-religious bias on the matter. Thus, judicial rulings often change from one judge to another and sometimes conflict with one another.[ii]

This essay will examine judicial opinions in Lebanon, Egypt, Kuwait, and the UAE on LGR, focusing on the reasoning of the judges in these cases as well as the role of medical and religious authorities, to map out how legal verdicts on the oft-overlooked issue of LGR came to be in these countries.


The Lebanese judiciary has a long history of reviewing cases of transgender individuals, who, after undergoing gender-affirming surgeries, wished to obtain legal gender recognition from the state.[iii] Changing one’s name and gender markers are governed by the Lebanese civil registry code of 1951.[iv]

In 1987, Beirut’s Civil District Court reviewed a motion moved by a transgender woman who requested to receive legal gender recognition from the state. She was a divorcee with two children and had undergone two surgeries to affirm her gender, and submitted medical reports to the courts that argued for the necessity of those surgeries as she was suffering from gender dysphoria. The court was not convinced by the medical reports and brought in forensic medical authorities to examine the plaintiff, stating concerns that a man with two children could not become a woman.[v] Following the examination, the court concluded that, “the plaintiff’s physical appearance is now of a woman and the change in their papers is considered a necessity to prevent any damage to the plaintiff or the social fabric of their community.”[vi] Despite receiving LGR in this case, the court was careful not to mention the full reasoning behind why it granted the change, relying only on the physical examination of the plaintiff as the reason to grant them LGR. Despite the positive outcome for the plaintiff, this case did not clarify whether gender dysphoria can be considered a reason to be granted LGR in Lebanon.[vii]

This lack of clarity came to bear in in 1992, when, in Case 61/1992, the court refused to grant LGR to a transgender woman, even though she had undergone all surgeries. The court again gave its verdict on the basis of a forensic medical report that stated that, “the plaintiff was a complete biological male and did not need to undergo surgeries from the medical perspective.” The medical authorities made their claims on the basis that the plaintiff had male chromosomes and via remarks on the plaintiff’s physical appearance: “the plaintiff still carries a lot of the characteristics of a man, including a bald spot which she hides with a wig and an Adam’s apple.” The court stated in its verdict that “changing one’s gender is about someone’s desire, rather than medical necessity… It is important to regulate such matters to maintain the fabric of Lebanese society.”[viii]

In 2015, another case was examined by the Beirut Court of Appeals; this time, of a transgender man. The Court of Appeals overruled a district civil court’s verdict to not grant the plaintiff’s LGR. The civil court had stated that, “the plaintiff underwent those changes out of will and not out of medical necessity, as, following medical examination, the court found that the plaintiff does not suffer from any case of Hermaphroditismus, but rather gender identity disorder (GID), which is something that requires psychiatric intervention and not surgery”.[ix] Lebanon’s Court of Appeal overturned this verdict, finding that gender identity disorder (GID) is a valid reason to undergo surgical interventions.[x] The Court further added that, “Psychiatrists tried to treat the plaintiff’s GID for more than ten years to no avail, leaving no option for the plaintiff but to undergo gender-affirming-treatment out of medical necessity.” The court also stated that the plaintiff has a constitutional right to health and to cure any illness he may have. Finally, the court stated that since the change the plaintiff underwent is irreversible, not granting them LGR would cause severe damage to them and restrict their ability to enjoy life.[xi]

Social biases influenced the judges, as they expected the transgender person to have the physical appearance and social attitude of their newly obtained gender before granting them LGR.

The three cases expose how arbitrary Lebanon’s process is due to the lack of legislative framework. Unlike other countries examined later in this article, these cases went through civil courts and were not as influenced by Islamic Shari’a. Despite this, however, social biases influenced the judges, as they expected the transgender person to have the physical appearance and social attitude of their newly obtained gender before granting them LGR. Furthermore, those cases expose the façade of Lebanese liberalism, as it is clear when it comes to transgender rights, the country is still lacking behind.[xii]


Egypt established a sex reassignment committee in 2003 to review applications from people who wish to receive gender-affirming health care.

The Egyptian judiciary and medical authorities have a complex history with matters of transgenderism in the country. Despite not having a law regulating the matter, Egypt established a sex reassignment committee in 2003 to review applications from people who wish to receive gender-affirming health care. Islamic Shari’a plays a role in the livelihood of transgender people in the country, as courts’ verdicts are often governed by Islamic Law.[xiii]

In 1987, a case was filed by Sally, a transgender woman, to obtain LGR.[xiv] Sally was not the first, nor the last person to undergo gender-affirming surgeries in Egypt, but her case attracted strong attention from the public, the media, the legal authorities, the medical syndicate, as well as the highest religious authority in the country, Al-Azhar.[xv]

Sally was a medical student at Al-Azhar University (Egypt’s Islamic university) and had been expelled after undergoing surgeries, as Al-Azhar University disagreed with such operations unless they were biologically needed. Al-Azhar took a step further and filed a criminal complaint with the public prosecution office, accusing Sally and the doctors who performed the surgeries of intentionally giving a medically fit male a permanent disability.[xvi] Al-Azhar bolstered its case with two separate medical examinations, one done by the medical syndicate and another by Al-Azhar’s medical school. Both concluded that Sally did not suffer from any case of Hermaphroditismus, rather only gender identity disorder; thus, Sally should have received therapy and not surgical interventions to change her gender.

The public prosecution investigated the case and employed the expertise of Dr. Fakhri Salah to give a medical opinion. Dr. Salah concluded that even though Sally had an able male body, she suffered from “al-khunutha an-nafsiya”, which roughly translates into ‘psychiatric intersex’. Dr. Salah added in the report that Sally did try to treat her case with therapy alone and failed; thus, surgical intervention was needed to treat her case.[xvii]

Al-Azhar disagreed with Dr. Salah and issued a fatwa in 1988 stating, “It is permissible to perform the operation for a biological need to reveal any hidden male or female organs,” but not “at the mere wish to change one’s sex from woman to man, or vice versa”. Thus, in the eyes of Al-Azhar, gender-affirming surgeries should be only allowed for intersex individuals.[xviii]

Despite this, the public prosecution dismissed Al-Azhar’s complaint and finally, in 1989, an administrative court ruled in favor of granting Sally LGR. The court issued this judgment after Dr. Salah and other experts in forensic medical services concluded that gender identity disorder can be a basis for someone to change their gender. The court also forced Sally to undergo an invasive anal examination to prove that she was not involved in any homosexual intercourse prior to surgery. Finally, the court stated that Sally’s physical appearance was one of a female and the change she underwent was irreversible, so she should be granted LGR to fit into the binary gender designations that exist in Egyptian society.[xix]

This somewhat understanding position of the judiciary changed over the years. In subsequent cases judges issued verdicts within the lines of the Islamic position on the matter. In 2016, a transgender man requested LGR and was refused by an administrative court. The court relied on the medical report provided by the Forensic Medical Authority, which stated that, “after physical and chromosome tests, we found that the plaintiff underwent a sex change operation and not a sex reassignment one.” Thus, it was ruled that the plaintiff had violated the Shari’a principles, which only allows surgeries for intersex individuals.[xx] In its verdict, the court stated that, “Personal freedom is not absolute, especially on the matter on hand. This matter should govern by principles of Shari’a and social standards.” Furthermore, the court added: “Since there is a legislative vacuum on the matter, it shall be governed by the principles of Shari’a, which is one of the main sources of legalization as stipulated in the Constitution.”[xxi]

After he lost his case in 2016, he appealed and his case was referred to the supreme administrative court, which is yet to issue a verdict on the matter. Instead in 2019, it referred the case to a committee of medical experts to provide another opinion on the matter.[xxii]

The dialing back of granting LGR in Egypt’s judiciary is symptomatic of a steady rise in the influence of Al-Azhar in Egyptian politics and policies.

The shift dialing back of granting LGR in Egypt’s judiciary is symptomatic of a steady rise in the influence of Al-Azhar in Egyptian politics and policies. For example, in 2003, a medical committee was established inside Egypt’s medical syndicate to review applications from individuals who wish to undergo gender-affirming health care on the condition that one of the committee members had to be from Al-Azhar. In 2020, Dr. Osama Abdel-Hady, the head of that committee, indicated to ABC News that: “the Al-Azhar representative often refused to attend the meetings, as he disagreed with our medical opinions…. between 2014 and 2017: 87 approvals for “physical” reasons but zero for “gender identity disorder.” Thirty-one were left unresolved.”[xxiii] Thus, since the 1980s,political Islam has been gaining attraction in Egypt, and transgender policies and judicial opinions have been heavily influenced by Islamic Shari’a.[xxiv]


Since there are no laws in Kuwait regulating the matters of LGR, courts rely on Shari’a law.

Like Egypt, Kuwait and other Gulf states rely on the principles of Shari’a law in their national law, especially when it comes to civil matters.[xxv] Furthermore, since there are no laws in Kuwait regulating the matters of LGR, courts rely on Shari’a law to issue their verdicts.

In 1998, the Courts of First Instance and Appeals rejected a LGR request by a transgender man. The plaintiff, who underwent surgical and hormonal treatment in Egypt, submitted medical reports from her surgeons indicating that she was suffering from GID, and that she had tried to treat it with therapy and failed; thus, her only option left was to undergo surgeries. Neither courts were convinced, and they submitted the plaintiff to further medical examination, which found that, “the plaintiff’s physical appearance and genitals have been surgically altered to be that of a man; however, she was born a female and suffered no cases of Hermaphroditism to justify this transition.”[xxvi]

In its verdict, the Court of Appeal stated: “We should not allow our demons to take over our souls, this kind of operation is considered to be a great sin in Islam. If one suffers from a gender identity disorder, they should aim to cure it, not with surgery but with therapy. We reject the plaintiff’s request, as what they have done goes against Islam and human nature.”[xxvii]

In 2003, a transgender woman filed to receive LGR. Case 861/2003 went through all the available levels of litigation in the country. The plaintiff underwent a medical examination by the forensic authority, in which the examiner noted, “The plaintiff’s chromosome map shows that they were born a man. However, with a further psychiatric examination, we found that the plaintiff may have suffered from a gender identity disorder. Furthermore, the plaintiff underwent surgical interventions, which resulted in a change in their genitals and physical appearance. The plaintiff also demonstrates a very feminine attitude and assumed the role of a female in their daily life.”[xxviii] The Court of First Instance ruled in favor of granting LGR to the plaintiff, as it saw that with their transition, they did not harm anyone, and by becoming a woman they treated their GID and avoided being homosexual.[xxix] The Court of Appeals and the Court of Cassation, which has the power to consider challenges filed against the judgments rendered in the Courts of Appeal, had different opinions though: in the Court of Cassation, the plaintiff was refused LGR on the basis of citations from the Qur’an and fatwas.

This demonization of transgender identities has led to further harassment, arrest, and the denying of rights.

The wording used in the judgements of both cases exposes the problematic approach taken by the judiciary in Kuwait: they use interpretations of Shari’a not only to only deny transgender people their rights but also to demonize them in the eyes of the public. This demonization of transgender identities has led to further harassment, arrest, and the denying of rights for Kuwaiti transgender people.[xxx] For example, in 2021, a Kuwaiti transgender woman was harassed by the authorities, before being arrested and convicted later for “misusing phone communication” by “imitating the opposite sex”.[xxxi]


In 2016, the UAE amended its federal medical liability law to allow sex reassignment surgeries, but only in specific cases. The law stipulates that these surgeries should only be allowed for intersex people and should not be allowed for psychiatric reasons only. The law also stipulates that doctors who perform surgeries on individuals who do not meet the criteria defined by the same law shall face criminal liability.[xxxii] Some legal experts argue that since the law prohibits gender-affirming surgeries for transgender people, LGR shall also be prohibited for them.[xxxiii] The law was amended to meet the Shari’a position on the matter for, like Kuwait and Egypt, the UAE follows the Sunni branch of Islam. Fatwas from that branch restrict gender-affirming health care to only intersex people and disqualify transgender people.[xxxiv]

In 2019, the UAE’s Federal Supreme Court rejected an LGR request filed by three transgender men. Their legal battle started in 2016 when they filed to receive LGR from the lower courts and were rejected. The three transgender men were diagnosed with GID in a European country and underwent all the necessary medical treatment needed there.[xxxv] They returned to the UAE in 2016, after the medical liability law was amended, hoping to receive LGR from the state. However, the medical committee appointed by the courts declared that they were not eligible to LGR under the new amendment as their chromosome maps showed that they were able women. The court said that they did not need any surgical intervention to treat their GID and should have followed therapy instead.[xxxvi]

Transgender rights are a red line the government is not yet willing to cross.

The UAE has implemented major social reforms in every regard in recent years.[xxxvii] However, despite those reforms, LGBTQ+ rights in the country are lagging behind. This can be seen in the UAE’s latest amendment to its medical liability law: despite the suggestion of modernisation  in the country, it seems that transgender rights are a red line the government is not yet willing to cross.

Just like in Egypt and Kuwait, UAE uses Islamic Shari’a as an excuse for not providing its transgender population with equal rights to their counterparts. Out of the four countries, the UAE is the only country that made gender-affirming health care to transgender people illegal by law, something which impacted not only access to this health care but also the judicial verdicts on the matter. Thus, even though there is no law regulating LGR, the criminalization of gender-affirming health care for transgender people is viewed by the judiciary as a criminalization of transgender identities in general.

Reflections and Conclusion

As there is no law regulating LGR in the four countries examined, transgender people face a risk of living in legal limbo. Courts only review LGR requests from individuals who undergo all surgical and hormonal interventions needed. However, even after this, when transgender individuals carry the physical characteristics of their new gender, there is no guarantee that transgender individuals will receive LGR. The entire process can be viewed as arbitrary and places transgender people’s livelihoods at the mercy of the court.

In Kuwait, Egypt, and the UAE, Islamic Shari’a plays a key role in these cases. The judges tend to rely on Sunni fatwas,which distinguish between “sex change”, referring to gender-affirming surgeries for transgender people whose gender differs from the sex they were assigned at birth, and what they term “sex reassignment” or “sex correction”, by which they mean surgeries conducted on intersex individuals, who are born with characteristics that vary from what is considered typical for female or male bodies. Only the latter is permitted according to this interpretation of Shari’a.[xxxviii]

Furthermore, the entire process in the four countries relies heavily on the misconceived pathologization of transgender identities.[xxxix] In all cases reviewed here, the plaintiffs had to undergo long and sometimes humiliating medical examinations that violated their bodily autonomy. Moreover, the judicial and medical authorities rely on “The Chromosome Trap”[xl] – a method where the medical authorities examine a transgender person’s chromone map to determine their assigned at birth sex – to justify restricting transgender people’s access to LGR.

Judicial authorities also allow their social bias to impact their judgments, whether positively or negatively. As it was examined, sometimes the courts grant LGR to transgender people onlyif they meet the social standards of their new gender. Where they do not, as in case 61/1992 in Lebanon and Sally’s case in Egypt, courts reject the plaintiff’s requests to be granted LGR.

The case law examined here reveals how dysfunctional transgender policies are in the countries examined. By not granting transgender people the right to legal recognition, they are pushed to further marginalization, as having a mismatch between one’s gender identity and their ID can results in harassment by society and authorities and restrictions on their access to employment or health.[xli]

Reform is needed to ensure that transgender people’s constitutional rights are not violated. Countries in the MENA region could pass legislation that establishes clear and accessible mechanisms to LGR. That legislation could ensure that the process is not dependable on particular judge’s socio-religious bias on the topic, but rather is governed by law and reflects the World Health Organization’s new category of “gender incongruence”, thus avoiding the outdated and pathologization of transgender identities.[xlii]

[i] Noralla, Nora. “Sunni Islamic Jurisprudence, Sex Reassignment Surgery and Transgender Rights.” openDemocracy, December 13, 2021.
[ii] نجيب سعيدى محمد. “التغيير الجنسي من منظور قانوني وشرعي.” المجلة الأكاديمية للبحوث القانونية والسياسية 4, no. 2 (2020): 401.
[iii] Hania Fakih, (2017) “Sex transformation in Lebanese legal system تحويل الجنس في النظام القانوني اللبناني,” BAU Journal – Journal of Legal Studies-ة: Vol. 2017 , Article 7. Available at:
[iv] “: الجامعة اللبنانية – مركز المعلوماتية القانونية: التشريعات قيد وثائق الاحوال الشخصية”.  
[v] فقيه, د. هانيا علي. 2016. “:تحويل الجنس في النظام القانوني اللبناني- الجامعة اللبنانية مركز الابحاث والدراسات في المعلوماتية القانونية”.
[vi] Ibid
[vii] Ibid
[viii]  فقيه, د. هانيا علي. 2016. “: تحويل الجنس في النظام القانوني اللبناني- الجامعة اللبنانية مركز الابحاث والدراسات في المعلوماتية القانونية”.
[ix] Ibid
[x] مخلوف, يمنى. 2016. “تغيير الجنس في حكم قضائي جديد: احترام حق الفرد في تغيير حاله | Legal Agenda”. Legal Agendaتغييرالجنسفيحكمقضائيجديداحترامحق/.
[xi] Younes, Rasha. 2019. ““Don’t Punish Me for Who I Am””. Human Rights Watch
[xii] Project, The Gender Security. “Liberal Facade Hides Lebanon’s Patriarchy.” GSP, January 5, 2022.
[xiii] Dabash, Ahmed. (2019). The Egyptian Constitution and Transgender rights: Judicial Interpretation of Islamic Norms. 10.13140/RG.2.2.28351.46241.
[xiv] فزاع, رانيا. 2010. “سالى “سيد” سابقا: عملت راقصة لأثبت للجميع أنى امرأة.. وتزوجت مرتين دون حب.. وأجريت العملية بـ 3 آلاف جنيه عند طبيب مسيحى لأن المسلم طلب منى 30 ألفاً”. اليوم السابع.سالىسيدسابقاعملتراقصةلأثبتللجميعأنىامرأةوتزوجت/258382.
[xv] Jakob Skovguard-Peterson, “Sex Change in Cairo: Gender and Islamic Law,” Journal of the International Institute (MPublishing, University of Michigan Library, April 1, 1995),–sex-change-in-cairo-gender-and-islamic-law?rgn=main%3Bview.
[xvi] Ibid
[xvii] Ibid
[xviii] Noralla, Nora. “Sunni Islamic Jurisprudence, Sex Reassignment Surgery and Transgender Rights.” openDemocracy, December 13, 2021.
[xix] Alipour, M. ” Transgender Identity, The Sex-Reassignment Surgery Fatwās and Islāmic Theology of A Third Gender”, Religion and Gender 7, 2 (2017): 164-179, doi:
[xx] Nora Noralla, “A Discriminatory System Killed a Transgender Man in Egypt,” Human Rights Watch, November 10, 2021,
[xxi] الجهيني عبده. “حيثيات رفض دعوى تعديل اسم و‘نوع’ متحول جنسيا في ‘الرقم القومي.’” فيتو. فيتو, January 25, 2016.
[xxii] عبد الظاهر أحمد. “صناعة التشريعات الجنائية في عالم متغير.. تغيير الجنس.” نقابة المحامين المصرية, July 5, 2021.
[xxiii] MICHAEL, MAGGIE, and MARIAM Fam. “In Egypt, Transgender Activist Fights Battle on Many Fronts.” ABC News. ABC News Network. Accessed February 15, 2022.
[xxiv] Noralla, Nora. “Elkarakhana: History of Sex Working in Modern Egypt between Legalization and Criminalization.” cairo52. Cairo 52 Legal Research Institute , June 16, 2021.
[xxv] “Sharia Law Countries 2022.” Sharia law countries 2022, January 5, 2022.
[xxvi] الشايع فهيم عبد الإله. حكم تغيير الجنس وأثره في عقد الزواج وفقاً للنظام السعودي والقانون الكويتي (دراسة مقارنة). جامعة الدول العربية, June 1, 2020.مجلةالباحث/2018/العددالأول.
[xxvii] Ibid
[xxviii] المرشدي أمل. “بحث قانوني حول موقف القانون بشأن أحقية الشخص في تغيير جنسه.” استشارات قانونية مجانية, December 3, 2017.
[xxix] صالح المانع ريمه, علي محجوب جابر محجوب, and السيد راشد طارق جمعه. “إشكالية تحويل الجنس في القانون القطري والقانون المقارن.” QScience Connect 2020, no. 1 (March 15, 2020).
[xxx] Willie, Belkis. “Being Transgender in Kuwait: ‘My Biggest Fear Is a Flat Tire.’” Human Rights Watch, July 15, 2013.
[xxxi] “Kuwait: Quash Conviction against Transgender Woman.” Human Rights Watch, October 14, 2021.
[xxxii] الأستاذة حنان صالح المعيني, and الدكتورة منال مروان منجد. “التنظيم القانوني لعمليات تحويل الجنس في دولة الامارات -دراسة مقارنة ببعض أحكام الشريعة الإسلامية.” ASJP. ASJP, May 30, 2020.
[xxxiii] Ibid
[xxxiv] Noralla, Nora. “Sunni Islamic Jurisprudence, Sex Reassignment Surgery and Transgender Rights.” openDemocracy, December 13, 2021.
[xxxv] Nowais, Shireena Al. “Transgender Emiratis Have Case Rejected by UAE High Court.” The National. The National, January 5, 2019.
[xxxvi] أب عمرو بيومي -. “‘الاتحادية العليا’ ترفض تغير هوية 3 إناث تحوّلن إلى ذكور.” الإمارات اليوم, January 1, 2019.
[xxxvii] “UAE Enacts Largest Legal Reform in Its 50-Year History.” The National, November 21, 2021.
[xxxviii] Noralla, Nora. “Sunni Islamic Jurisprudence, Sex Reassignment Surgery and Transgender Rights.” openDemocracy, December 13, 2021.
[xxxix] Castro-Peraza, Maria Elisa, Jesús Manuel García-Acosta, Naira Delgado, Ana María Perdomo-Hernández, Maria Inmaculada Sosa-Alvarez, Rosa Llabrés-Solé, and Nieves Doria Lorenzo-Rocha. “Gender Identity: The Human Right of Depathologization.” International Journal of Environmental Research and Public Health 16, no. 6 (2019): 978.
[xl] KLUGER, JEFFREY. 2018. “The Idea of A ‘DNA Test’ For Transgender People Is Part Of A Long, Dark History”. Time.
[xli] نادر آية. “”اللي تحت ميخصكش”… رفع الوعي في مواجهة وصم العابرين جنسياً بسبب أعضائهم الجنسية.” رصيف 22, November 26, 2019.
[xlii] “Transgender No Longer Recognised as ‘Disorder’ by WHO.” BBC News. BBC, May 29, 2019.

Similar Articles

Search the site for posts and pages