Far more genital surgeries occur in a year in Thailand than in Iran, so if there were innovation going on anywhere because of volume it'd be there. I'm not aware if there IS innovation going on there, but that's the volume leader.
In Iran, however, genital surgery is COMPULSORY, and often performed on gay men as well as trans women, which is inhumane; the surgeons there are often not interested in the kinds of outcome variables important in other countries (preserving sexual function; aesthetic results), because what they want to do is make the subject "not a man".
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