In 1978, she traveled to Paris, where Khomeini was then based, to try to make him aware about transgender rights.
After the Islamic Revolution, Molkara started to face intense backlash due to her identity. She underwent arrests, and death threats.[6] She was fired from her job at the Iranian National Radio and Television, forced to wear masculine clothing, injected with male hormones against her will, and detained in a psychiatric institution.[2][6][10] Because of good contacts with religious leaders, among them Akbar Hashemi Rafsanjani, she was released.[3]
At the start of the Iran–Iraq War, Molkara volunteered as a nurse on the front lines.[4] She said that some of the men she treated assumed she was a woman due to her gentleness.
Molkara continued to campaign for her right to get gender-affirming surgery. In 1985, she confronted Khomeini in his home in North Tehran. She wore a man's suit, carried the Quran, and she tied shoes around her neck.[3][7] This was a reference to the Ashura festival, and also indicated that she was looking for refuge. Molkara was held back and beaten by security guards until Khomeini's brother, Hassan Pasandide, intervened.[3][7] He took Molkara into his house, where she pleaded her case, yelling "I'm a woman, I'm a woman!"[3] His security guards were suspicious about her chest, as they thought she could be carrying explosives. She revealed they were her breasts, as she developed them using hormone therapy.[3] Having heard her story, Ahmad Khomeini was touched and took Molkara to speak to his father, where he asked three of his doctors about the surgery in an attempt to make a well-informed decision.[3][7] Khomeini then decided that sex reassignment surgery was needed to allow her to carry out her religious duties.[11] This resulted in Khomeini issuing a fatwa, where he determined sex reassignment surgery to not be against Islamic law.[7] Molkara lobbied for the according medical knowledge and procedures to be implemented in Iran, and worked on helping other transgender people have access to surgeries. She completed her gender-affirming surgery in Thailand in 1997,[2] due to "unhappiness with procedures in her native country''.[3] The Iranian government paid for her surgery, and she was able to help establish government funding for many other transgender individual's surgeries.[4]
