Review of the HBO documentary “Be Like Others.”

The poster for Be Like Others, a documentary airing on HBO tonight, looks like a CD cover for a glam rock band. One gay-looking Adonis sits on the arm of a red leather couch, his arm linked with his sexually ambiguous lover. She or he smiles coyly, hands resting on his inner thigh. This suggestive tableau is in fact a snapshot from Iran, and not even some futuristic Iran after the street protesters have won.

Since the reign of the Ayatollah Khomeini, sex change operations have been legal in Iran. Khomeini once ran into a man who wanted a sex change, the filmmaker Tanaz Eshaghian explains in an interview, and he was “very moved.” He said: “You were born in the wrong body and this is a medical issue. It has nothing to do with issues of sin or being a degenerate. You’re allowed to have your body match your soul if it’s done medically.’”

Coming from the Ayatollah, this all sounds very enlightened and queer theory-esque. Except, as the film explains, “homosexuality is still punishable by death.” We are so used to thinking of “transgender” as the last stop on the gay train to freedom and self expression that it takes a minute for these twin realities to sink in. For the reigning powers in Iran, homosexuality exists at the opposite end of the spectrum from transgender. The former is a sin and degenerate. The latter is a useful tool for the regime to restore someone with aberrant behavior to the expected gender norms. As a result, dozens of young men and women in Iran resort to sex-change operations as a step toward a happy, normal life—a step that, the filmmaker suggests, rarely leaves them satisfied.

Those two on the couch, the Adonis Ali and Anoosh, have always been in love. But they cannot be together or get married until Anoosh has the operation to change his penis into some approximation of a vagina and gets injected with female hormones. The surgeon, though, can’t deliver the fairy tale ending. Identity, especially for the transgendered, is a many-layered and complicated thing. As the film makes clear, Islamic law can dictate what happens to the bodies, but it can’t force normalcy or happiness to follow.

When they first arrive at the transsexual clinic of Dr. Bahram Mir-Jalali, the patients experience great relief. They’ve felt trapped in the wrong bodies, and society has sensed something off about them. Nobody will hire them, police harass them. After years of telling him he’s insane, Ali Askar’s father one day suddenly prepares him a “big breakfast with honey” and a “super nice tea.” In a flash of intuition, Askar realizes his father has put rat poison in the tea. This final break with his family drives him to the clinic.

The doctor listens sympathetically and reassures his patients. “He can’t help himself,” he tells some distraught parents from a small town whose young son puts on lipstick and dresses. “What’s going on in his sister’s head is going on in his head.” Vida, the den mother who recently had her own operation, hangs around the waiting room trying to get parents to be supportive, convincing the “girls” to dress respectably, and generally setting the boundaries. “I’m not saying I won’t speak to someone who’s gay,” she explains to a new arrival. “But I can’t be friends with him.”

After the initial relief, though, the patients start to sense that they are blooming in a very tight space. One of most painful scenes unfolds the day before Askar’s operation. He’s trying hard to convince himself he’s making the right decision. His neighbors are nosy, he can’t get a job, he doesn’t want to be gay, he says. (“In the West two men can get married, but what’s the point of that?”) After the operation, “everything will be fine.” But it’s obvious he’s working too hard at it. Finally, the interviewer asks him straight out: If he didn’t live in Iran, would he get the operation? “No,” he says. “I wouldn’t touch God’s work.”