It is only Iran which has government sponsored gender transitions:

https://qz.com/889548/everyone-treated-me-like-a-saint-in-iran-theres-only-one-way-to-survive-as-a-transgender-person/

Afterwards, she worked with several religious leaders to advocate for trans rights and eventually managed to wrangle a meeting with Ayatollah Khomeini, the “supreme leader” of Iran at the time. Molkara and her group were able to eventually convince Khamenei to pass a fatwa in 1986 declaring gender-confirmation surgery and hormone-replacement therapy religiously acceptable medical procedures.

https://www.independent.co.uk/news/world/middle-east/the-ayatollah-and-the-transsexual-21867.html

"He said it meant I should have the operation but he said I should write to Ayatollah Khomeini, who was then in Iraq and was one of the leading Shia religious experts. Khomeini decided then that it was a religious obligation for me to have the sex change because a person needs a clear sexual identity in order to carry out their religious duties. He said that because of my feelings, I should observe all the rites specific to women, including the way they dress."

It dates back to only a few years after the 1979 Islamic Revolution. A transgender woman, Maryam Khatoonpour Molkara, managed to push her way through the guards to meet Khomeini while dressed in men’s clothes. Molkara explained to the supreme leader how she felt her true gender was different from her physical sex. After consulting with doctors, Khomeini sanctioned gender-transition surgery in a groundbreaking fatwa.

Iran’s current supreme leader, Ayatollah Ali Khamenei, later gave Molkara a black veil to officially recognize her as a woman, upholding Khomeini’s fatwa, she said. She died in 2012 at the age of 62.

Transgender people can go to the courts and receive official permission for gender-transition surgery after going through detailed medical examinations and an interview with a psychiatrist. Afterward, they can receive new identity documents and financial aid for the surgery.

And it is an anomaly because in Islam imitating the opposite sex is forbidden very much:

It was narrated from Ibn ‘Abbaas (may Allaah be pleased with him) that the Prophet (peace and blessings of Allaah be upon him) cursed men who imitate women and women who imitate men, and he said: “Throw them out of your houses.” Narrated by al-Bukhaari (5885).

It was narrated that Abu Hurayrah (may Allaah be pleased with him) said: The Messenger of Allaah (peace and blessings of Allaah be upon him) cursed the man who wears women’s clothing and the woman who wears men’s clothing. Narrated by Abu Dawood (4098) and classed as saheeh by al-Nawawi in al-Majmoo’ (4/469) and by al-Albaani in Saheeh Abi Dawood.

‘Aa’ishah (may Allaah be pleased with her) said: The Messenger of Allaah (peace and blessings of Allaah be upon him) cursed masculinized women. Narrated by Abu Dawood (4099); classed as hasan by al-Nawawi in al-Majmoo’ (4/469) and as saheeh by al-Albaani in Saheeh Abi Dawood.

If wearing the clothes of the opposite sex and imitating the opposite sex is forbidden, why would transgenderism and transgender surgeries be allowed? Even changing the creation in general ie plucking eyebrows, filing teeth is forbidden, it makes absolutely no sense for transgender surgeries to be allowed in Islam.

It was narrated from ‘Abd-Allaah ibn Mas’ood (may Allaah be pleased with him) that the Prophet (peace and blessings of Allaah be upon him) said: “May Allaah curse the one who does tattoos and the one who has a tattoo done, the one who plucks eyebrows and the one who has her eyebrows plucked, and those who file teeth for the purpose of beautification, changing the creation of Allaah.” Narrated by Muslim (2125).

And things are not very simple there, there are lots of sects and different opinions, not all shias agree with this Iran's ruling on this, the shias don't take these Hadeeth as authentic, and lots of complicated things, ie Sunnis don't consider many Shias as muslim, Iran supports a non muslim in Killing muslims in Syria with Russia, etc. I notice this problem where gender critical type feminists who live in the west don't really under stand what things are really like in these societies

The only people that are to be killed are those who do male to male anal sex in Islam, regardless if they identify as gay or not, and it is very hard to accuse someone of consensual male to male anal sex unless they admit it. There is no law killing people for sexual orientation in Islam or as far as I can tell any country in the world. People really need to separate sexual desires from sexual activity. They are not the same and it does not make sense to put them under the same brush.

Even according to the CDC, these people are not the same:

https://www.cdc.gov/hiv/group/msm/index.html

Of the 38,739 new HIV diagnoses in the US and dependent areas in 2017, 27,000 (70%) were among adult and adolescent gay and bisexual men.

1 in 6 gay and bisexual men with HIV are unaware they have it.

One engages in risky behavior that can result in many diseases and health problems being spread, the other does not.

I want to note that these men who rape boys can be considered "killed for being gay"

https://en.wikipedia.org/wiki/Mahmoud_Asgari_and_Ayaz_Marhoni

https://www.youtube.com/watch?v=wYwyYDPiEF0