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Elections in Iran are not free and fair, according to international standards.

The Guardian Council, controlled by conservatives, vets all candidates for the parliament, president, and the Assembly of Experts—a body of 86 clerics who are elected to eight-year terms by popular vote.

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According to the BBC, the Iranian regime recently made sexual reassignment even more accessible by announcing that health insurance companies must cover the full cost of sex-change operations, which can cost upward of $3,000.

Iran performs more sex-change operations than any country in the world except for Thailand; the surgery industry has attracted patients from all over the Middle East and as far away as Eastern Europe.

Reformist parties and politicians have come under increased state repression, especially since 2009.

In 2015, two new reformist parties—Nedaye Iranian (Voice of Iranians) and Ettehad Mellat Iran (Iranian National Unity)—were established ahead of the 2016 parliamentary elections.

Nearly all of the eight approved candidates, including Rouhani, were deemed close to Khamenei.