PROFILE: Pezeshkian, the surgeon between two fires — reformist or hostage of the regime?

Introduction: The man who signed with the enemy

June 17, 2026: a historic and ambiguous moment

On June 17, 2026, two men signed from opposite ends of the world the Islamabad Memorandum — a framework agreement aimed at ending a hundred-and-ten-day war between the United States, Israel, and Iran. Donald Trump put pen to paper at the Palace of Versailles, over dinner with Emmanuel Macron in the wake of the G7. Masoud Pezeshkian signed from Tehran, alone, in a regime that watches him as much as it tolerates him. That contrast says everything: on one side, an unpredictable but sovereign American president; on the other, a cardiac surgeon turned head of state, forced to navigate between a nation in ruins and a theocratic apparatus that does not entirely trust him.

This 14-point memorandum — encompassing the reopening of the Strait of Hormuz, a moratorium on uranium enrichment, an invitation to IAEA inspectors, and the promise of a sixty-day negotiating window — is not a peace. It is a fragile truce, built on uncertain foundations. And Pezeshkian is both its official architect and its designated scapegoat should everything collapse.

Understanding the man before judging the president

To understand Masoud Pezeshkian, one must go back to Mahabad, a predominantly Kurdish city in northwestern Iran, where he was born on September 29, 1954. His father is Azerbaijani, his mother Kurdish — two ethnic minorities of Iran, two cultures that gave him a particular sensitivity to the identity fractures of a country as composite as it is authoritarian. He is not a son of the Tehran establishment. He comes from the margins, and it shows.

He began his career not in politics but in medicine. A cardiac surgeon trained at the Tabriz University of Medical Sciences, then specialized in cardiac surgery at the Tehran University of Medical Sciences, he completed his subspecialty in 1993. He spent the years of the Iran-Iraq War (1980–1988) dispatching medical teams to the front — healing, not fighting. That biographical detail matters. He is not an ideologue of the revolution, but a field doctor trained to repair what violence breaks.

From the operating room to parliament: an unlikely ascent

Entering politics through the back door

Pezeshkian entered politics in 1997, when reformist President Mohammad Khatami appointed him deputy minister of health. At that point he had no national profile, no solid partisan network. His asset: a reputation as an honest technician, a competent administrator, a man who does not steal. In a country where corruption is structural, that alone sets him apart. Khatami promoted him to health minister in his second term, from 2001 to 2005. During that period, he extended health insurance to nearly 25 million rural Iranians and almost doubled the ministry's budget — concrete, verifiable numbers that stand in sharp contrast to the regime's usual bluster.

After the Khatami era ended, he turned to parliament. Elected representative of Tabriz, Osku, and Azarshahr starting in 2008, he remained there until 2024, re-elected five times. He served as first deputy speaker of parliament from 2016 to 2020. Those years gave him institutional legitimacy while offering him no real power over the big decisions: foreign policy, the nuclear program, the Revolutionary Guards — all of that remained in the hands of the Supreme Leader.

A man of files in a regime of men of faith

What sets Pezeshkian apart from his peers is his relationship with facts. In 2022, when Mahsa Amini died in custody after her arrest by the morality police, he was one of the few parliamentarians to openly criticize the government for its handling of the affair. He called for explanations, expressed support for the Woman, Life, Freedom movement — without going so far as to question the Supreme Leader, which would have been suicidal. He opposed the violent crackdowns on the protests of 2009 and 2019. These positions earned him the lasting hostility of the regime's hardliners, who consider him a potential traitor.

In 2021, he attempted to run for the presidency but the Guardian Council — the unelected body that filters candidates according to ideological loyalty — rejected him. He had to wait for the accidental death of President Ebrahim Raisi in a helicopter crash in May 2024 for reformists, rallied behind Khatami and former President Rouhani, to bring him back to the fore. This time, the Guardian Council validated his candidacy. Why? Probably because Khamenei the elder needed a presentable face toward the West, without surrendering the levers of real power.

The 2024 election: real victory, limited power

A choice between two visions of Iran

On July 5, 2024, Masoud Pezeshkian won the second round of the Iranian presidential election with 53.7% of the vote against hardliner Saeed Jalili, who received 44.3%. The margin was clear, but the meaning was ambiguous. Pezeshkian won because a segment of Iran — the young, women, ethnic minorities, the urban middle class strangled by sanctions — wanted a signal of change. He offered that promise: rapprochement with the West, a revival of nuclear dialogue, a relaxation of the veil laws. He described himself as a "principalist reformist" — an oxymoronic formula that says everything about the tightrope he walks.

His victory was met with caution by analysts. Karim Sadjadpour of the Carnegie Endowment in Washington noted that Pezeshkian "identifies as a principalist committed to the ideological principles of the revolution" and that he had been clear about his devotion to the Revolutionary Guards and to Khamenei. The man is not a liberal. He is the product of a system he does not fundamentally challenge — he simply wants to correct its most economically and internationally damaging excesses.

The first hours of the presidency: an immediate test

The limits of his power made themselves felt from the very first hours of taking office. On the very day of his inauguration in Tehran, Ismail Haniyeh, the political leader of Hamas, was killed in an apartment in the Iranian capital. The Islamic Revolutionary Guard Corps (IRGC) wanted a direct strike on Tel Aviv. Pezeshkian opposed it, arguing for targeting Israeli "secret bases" in neighboring countries. He did not prevail. The Iranian retaliatory strikes of October 2024 — the strikes on Israel — took place without the civilian president having truly decided. That latent conflict with the IRGC would be a constant throughout his presidency.

He was officially sworn in on July 30, 2024, having been formally designated by Ali Khamenei on the 28th. His first symbolic visit after the ceremony: the mausoleum of Ruhollah Khomeini, the founder of the Islamic Republic. A ritual gesture of loyalty that no one can avoid without condemning himself.

The 2026 war: one hundred and ten days that changed everything

From nuclear dialogue to bombardment

From the spring of 2025, a series of negotiating rounds took place in Oman, Rome, and again in Oman, between U.S. special envoy Steve Witkoff and Iranian Foreign Minister Abbas Araghchi. Pezeshkian supported these negotiations, hoped for them, defended them internally. But in June 2025, the IAEA declared Iran in non-compliance with its obligations. Israel struck hard. The United States followed. Iranian nuclear sites were hit. Tehran suspended the talks indefinitely.

On February 28, 2026, the United States and Israel launched large-scale strikes on Iran, marking the beginning of what would become known as the 2026 war — one hundred and ten days of a conflict that ravaged Iranian military infrastructure, decimated the Revolutionary Guards' chain of command, and above all, killed Supreme Leader Ali Khamenei on March 1, 2026. The death of Khamenei the elder plunged the regime into a succession crisis without precedent since 1989. An Interim Council was formed in accordance with the Constitution: Pezeshkian sat on it, alongside the chief of the judiciary and a member of the Guardian Council.

Pezeshkian surviving an assassination attempt

During the war, an assassination attempt targeted Pezeshkian. He survived. That biographical detail should not be minimized: it transforms the image of the surgeon-president into something more complex — a man who put his life on the line, whether he chose to or not, in a conflict he did not start. After the death of Khamenei the elder, his son Mojtaba Khamenei — backed by the Guards and his father's former office — was designated the new Supreme Leader. He is inexperienced, contested by senior ayatollahs, and his authority over civilians like Pezeshkian is structurally weaker than his father's. A narrow window opened onto a possible rebalancing of power.

Under Mojtaba Khamenei: a reformist even more alone

A new master, even more unpredictable

The death of Ali Khamenei did not free Pezeshkian — it complicated his situation. Mojtaba Khamenei, his son, is according to Iran International "almost certainly beyond the reach of civilian leaders." Where Khamenei the elder tolerated reformists as useful for regime legitimacy, Mojtaba is harder, less political, more ideological. According to analyses by GIS Reports published in May 2026, the new leadership appears "more authoritarian, increasingly pro-Chinese," and more inclined to heed the counsel of the Islamic Republic's hardest-line factions.

On June 18, 2026, the day after the signing of the Islamabad Memorandum, Pezeshkian spoke publicly. He said that Mojtaba Khamenei's message had "clarified the responsibilities of all institutions involved in the negotiations." He said he remained "committed to addressing concerns raised by Khamenei." He spoke of "red lines": national dignity, Iran's power. This language of masked submission is the only acceptable lexicon in this regime. The real question is what lies behind these formulas.

The standoff over the Strait of Hormuz and the nuclear file

According to secret correspondence revealed by The Guardian on June 21, 2026, Mojtaba Khamenei reportedly established 11 conditions for the continuation of negotiations, including the right to enrich uranium, the collection of transit fees on the Strait of Hormuz, and American compensation for war damages. A member of the negotiating team, Nabavian, leaked portions of these documents on state television before the broadcast was cut and the recording deleted. That episode reveals the scale of the divisions: Pezeshkian wants to negotiate; a faction of the regime wants to sabotage.

On the nuclear question, Vance's position is unambiguous: "This is not the Obama deal." Washington demands zero enrichment, destruction of enriched uranium stockpiles, restrictions on missiles. Pezeshkian, for his part, publicly declared on May 24, 2026, that Iran "does not aspire to nuclear weapons" — while specifying that "no decision is made without the Supreme Leader's permission." A revealing formula: absolute deference, even in the act of promising de-escalation.

The role of the IRGC: the real shadow government

Generals who answer to no one

To understand the limits of Pezeshkian, one must understand the Islamic Revolutionary Guard Corps. The IRGC is not an ordinary army. It is a state within a state: an economic empire, a regional projection force, guardian of the revolutionary ideology. Its generals sit on the Supreme National Security Council (SNSC) alongside Pezeshkian — but with an ideological legitimacy the elected president does not possess. According to GIS Reports, after the death of Khamenei the elder, IRGC generals "repeatedly signaled their readiness to resume military action if necessary."

In early 2026, when Pezeshkian apologized to Gulf nations for a week of Iranian attacks on their territories and promised to restrain his forces, he triggered an immediate backlash from hardliners. Former general Vahidi harshly rebuked him. The attacks resumed. Pezeshkian was forced to partially walk back his statements. That moment says everything: the president speaks, the generals decide.

Jalili, the bête noire of the negotiation

Saeed Jalili — Pezeshkian's opponent in the 2024 election, Khamenei's longtime representative on the SNSC, a former nuclear negotiator known for his deliberate failures at the negotiating table — is the emblematic figure of the internal opposition to the Islamabad Memorandum. Al Jazeera reported that in the hours before the deal was announced, rumors circulated that Jalili had been removed from his role — without official confirmation. His faction, the Stability Front, controls a significant portion of parliament and hard-line state media outlets such as Keyhan, Tasnim, and Fars.

These outlets maintain an editorial line hostile to any compromise with Washington. Keyhan suggested in an editorial that the new Supreme Leader had deliberately not mentioned the nuclear program since taking office — implying that Mojtaba Khamenei may consider the issue "settled," meaning untouchable. If that is accurate, Pezeshkian is negotiating on air.

Trump, the necessary evil who clears the air

Brutal American pressure, and its results

Honesty requires acknowledging Trump. His approach to Iran — a combination of blunt threats, military strikes, and mercantile negotiations — has nothing elegant about it as foreign policy. But it produced results that twenty years of patient diplomacy had never achieved. On March 7, 2025, Trump sent a direct letter to Ali Khamenei — a mix of negotiating offer and military ultimatum. The Iranians responded. Talks began in Oman. Iran sat at the table, not out of conviction but because the alternative was its total destruction.

On June 21, 2026, Trump threatened to invade Iran if the Strait of Hormuz was closed. The following day, he announced the absence of any transit fees. This is the carrot-and-stick approach in its most brutally effective form. On the 20th, he announced a new ceasefire between Israel and Hezbollah — a real concession to Pezeshkian, who had made any deal conditional on protection for his Lebanese allies. Trump may despise Iran, but he prefers a deal to permanent war. Vance summed it up bluntly before American legislators: "The pragmatists are winning the argument inside Iran, and the United States wants those people to win."

An imperfect deal in an imperfect world

The Islamabad Memorandum is far from a peace treaty. It is described in reports as "an initial framework, not a final peace agreement." The central questions — the definitive status of Iran's nuclear program, highly enriched uranium stockpiles, missile range — remain unresolved. IAEA inspections are promised but not yet carried out. Sanctions have not been lifted. The $25 billion in frozen Iranian assets remain conditional on compliance. Vance is categorical: "The United States is not giving Iran one cent."

But there is something in this deal that its detractors — notably Israeli leaders who call it insufficient — refuse to see: it stopped the war. It reopened the Strait of Hormuz. It created a dynamic that one hundred and ten days of bombardment had failed to produce. And Pezeshkian, whether one admires or despises him, is the interlocutor on the Iranian side — the only one capable of signing without immediately triggering an internal counter-revolution.

Pezeshkian and personal tragedy: a man, not just a function

The death of his wife and son

In 1994, his wife Fatemeh Majidi — a gynecologist — and their youngest son died in a car accident. Pezeshkian was forty years old. He never remarried. He raised his three surviving children alone, learning to cook, to run a household. His daughter Zahra, a policy adviser with a master's degree in chemistry, accompanied him on his ascent to the presidency. This personal trajectory is not anecdotal in the Iranian context: it says something about a man capable of living with loss without being consumed by resentment or fanaticism.

During the 2024 presidential debates, he said: "My supporters come from all walks of life, even those who do not pray." That line earned him attacks for religious betrayal. But it says something essential about his electoral base: he does not represent the guardians of the faith — he represents those whom the regime has exhausted. That is real political capital, but capital the regime does not recognize as legitimate.

A sincere man in a cynical regime

Pezeshkian's personality is described with remarkable consistency by all who have observed him closely: personal honesty, humility, a readiness to acknowledge what he does not know. The Guardian described him as having emerged from the 2024 televised debates as "a figure of remarkable personal honesty and modesty, eager to unite the nation." He is known to say he does not know everything, that he relies on experts. In a regime of absolute certainties, that admitted uncertainty is almost subversive.

But this sincerity also has its limits. In 2026, when protests erupted again in Iran, Pezeshkian initially expressed verbal support — then, as president, accused them of being "fomented by foreign actors" in the face of American and Israeli threats. The same trajectory as Khatami, as Rouhani: the reformist who capitulates under pressure. Britannica notes it soberly: he supported the 2026 crackdown he had condemned in 2022.

The nuclear question: the red line that stays red

What Vance demands, what Tehran is reluctant to concede

The central point of contention remains the Iranian nuclear program. Washington is clear: no enrichment, destruction of stockpiles, snap inspections. Vance said it before the U.S. Congress on June 18: "This is not the Obama deal. The Obama deal allowed the Iranians to enrich uranium. This deal will not." He added that the stockpiles must be destroyed and that any foreign investment in Iran would require American approval via sanctions exemptions.

On the Iranian side, Pezeshkian's official position is that Iran "does not aspire to nuclear weapons" — but the question of civilian enrichment remains a red line for the entire Iranian political spectrum, including reformists. Iran has invested decades and billions in this program. Fully dismantling it would be presented by hardliners as a humiliating capitulation equivalent to Gaddafi's Libya — and everyone knows how that story ended.

IAEA inspectors as a barometer of good faith

The memorandum includes an annex letter addressed to IAEA Director General Rafael Mariano Grossi, inviting him to Tehran with American nuclear inspectors. Their mission: to locate and inventory Iran's enriched materials. It is the first concrete verification measure in two years. It has not yet taken place. The Guardian noted in its June 20 analysis that the role of UN inspectors and "Iran's willingness to accept a strict inspection regime" remain untested.

The Additional Protocol — which allows snap inspections of undeclared sites — is one of the memorandum's provisions. Iranian hardliners view it as an unacceptable sovereign intrusion. Mojtaba Khamenei reportedly demanded, according to sources cited by The Guardian, exclusive Iranian management of the nuclear question as a precondition for any agreement. If that information is accurate — and its leak by a member of the negotiating team suggests it is — the coming sixty days will be decisive.

The internal fractures of June 2026: the regime laid bare

The crisis of secret correspondence

The incident of June 21, 2026 illustrates the depth of Iran's internal divisions. Nabavian, a parliamentarian who was a member of the Islamabad negotiating team, appeared on state television and claimed to possess confidential letters from Mojtaba Khamenei establishing 11 conditions for the continuation of talks — including the right to enrich, American compensation, and full sovereignty over Hormuz. The broadcast was cut. The recording disappeared from the channel's archives an hour later. A senior executive at the channel resigned. Nabavian faced legal proceedings and likely expulsion from parliament.

What this episode reveals is the existence of two parallel lines of negotiation: that of Pezeshkian and his Foreign Minister Araghchi, favorable to a flexible agreement; and that of Mojtaba Khamenei, who reportedly sent contradictory instructions to the Geneva team with gaps of up to two weeks of silence between communications. According to The Guardian, some members of the team reportedly had to wait for those instructions before knowing what to say at the table.

Pezeshkian, the letter, and forced deference

On Thursday, June 19, 2026, Mojtaba Khamenei made public a letter to Pezeshkian in which he expressed a divergence of views on the outcome of the discussions while acknowledging having deferred to the president's judgment on certain conditions. It was an unusual letter: it publicly validated Pezeshkian while signaling that the Leader was not entirely in agreement. It was the Iranian version of a vote of confidence delivered with a knife at the throat.

Pezeshkian responded the following day by reaffirming his total deference to the Leader. He said: "I have always tried to say nothing that contradicts the Supreme Leader's vision." That formula, reported by the NCRI on May 25, is that of a man who survives by bending — and who hopes that survival will allow him, at the margins, to nudge the course of events.

Regional policy: Iran's inconvenient allies

Hezbollah, the hardliners' non-negotiable red line

The June 19 deal announced by Trump — a new ceasefire between Israel and Hezbollah — is directly linked to Iranian demands. Al Jazeera reported that IRGC generals, notably Quds Force commander Ismail Qaani, had made any agreement conditional on protecting Iranian allies, especially Hezbollah in Lebanon. For them, betraying Hezbollah would mean betraying a decade of strategic investments. Qaani made his first public appearance in months to point out that the Bab el-Mandeb strait was still under Houthi control in Yemen.

This regional dimension is a burden for Pezeshkian. He does not run the policy of the Axis of Resistance — the IRGC does that. But he is held accountable for it before Washington and Western capitals. Vance insisted before Congress: Iranian support for armed groups would also need to be addressed in the final agreement. That is a demand that neither Pezeshkian nor Mojtaba Khamenei has officially accepted.

Iran, China, and the pivot to the East

The Guardian, in its June 20 analysis, noted another troubling signal: the new Iranian leadership appears increasingly pro-Chinese. In a context where American sanctions imposed since 2018 have made Western investment in Iran practically impossible, Tehran turns to Beijing as a substitute economic partner. This pivot to the East is not neutral: it means that even if a nuclear deal is signed, Iran could continue to align strategically with China against the West.

Pezeshkian favors a rebalancing toward the West for obvious economic reasons. But he governs within a regime that conceives of China as a bulwark against American pressure. This internal tension — pragmatic rapprochement with Washington on one side, structural dependence on Beijing on the other — is one of the great unknowns of the post-war period.

What ordinary Iranians actually think

An exhausted population, not a naive one

Behind the factional maneuvering and diplomatic formulas, there are twenty-five million Iranians who voted in 2024 — and a majority who chose Pezeshkian precisely because he embodied the hope, however fragile, of a life less strangled by sanctions and less terrorized by the morality police. The Iranian economy had been devastated: galloping inflation, a collapsing rial, an evaporated middle class. The June 17 memorandum represents for these Iranians a possibility — not a certainty, but a possibility — of economic reintegration.

Former reformist President Mohammad Khatami publicly called on supporters and critics of the system alike to "rally behind the negotiations" for "peace and a life without fear or war." That is an important signal: even the marginalized figures of reform are backing Pezeshkian on this issue. Because the alternative — an Iran at open war, pursuing nuclear weapons, under maximum sanctions, led by ideological hardliners — would be far worse for ordinary Iranians.

Popular legitimacy as the last resource

Pezeshkian possesses a resource that IRGC generals and hard-line ayatollahs do not have: electoral legitimacy, however partial, in a system where elections are filtered. That legitimacy is his ultimate protection. As long as the pragmatists — as Vance describes them — continue to "win the argument" internally, Pezeshkian remains useful to the regime for managing the façade of normalization. He represents the only possible interface between a regime hostile to the West and Western powers that cannot officially negotiate with unelected generals.

But that legitimacy comes at a price: it makes Pezeshkian accountable for the results. If the deal holds, he will be credited with saving Iran from destruction. If the deal collapses, he will be the ideal scapegoat — the one who "capitulated" before Trump, the one whom the hardliners will designate to legitimize their return to power. Either way, he has already lost something.

The sixty-day deal: what remains to be done

A tight calendar, immense obstacles

The memorandum opens a sixty-day window to negotiate a final agreement. Technical talks in Geneva were postponed on June 18 — the first sign of fragility. On the 22nd, Vance announced alongside the prime ministers of Pakistan and Qatar that progress had already been made in the first hours of discussions. He remained committed to the comprehensive regional ceasefire sought by Trump, including Lebanon. But Israeli officials opposed it head-on: they contended that the MOU resolved none of the war's key objectives — not the nuclear issue, not the missiles, not regime change.

The unresolved questions include: the precise permitted level of enrichment, the fate of highly enriched uranium stockpiles, the timeline for IAEA inspections, the phased or total lifting of sanctions, the status of Hezbollah and the Houthis in any regional peace agreement, and the possibility of a $350 billion development fund for Iran — a figure mentioned but immediately denied by Vance as involving any American money.

Pezeshkian in Geneva: representative of a state that does not represent him

In this context, Pezeshkian's role is both central and peripheral. He is the elected president, head of the SNSC, signatory of the memorandum. But the real decision-making power on nuclear issues and regional alliances remains in the hands of Mojtaba Khamenei and the top brass of the IRGC. He negotiates on behalf of a state whose most powerful institutions can at any moment invalidate his commitments.

Foreign Minister Abbas Araghchi — also a reformist, also in favor of a deal — is at his side in Geneva. But facing them, within the Iranian delegation, sit representatives of hard-line institutions whose definition of success is fundamentally different. Pezeshkian knows it. Araghchi knows it. And Vance, who asserts that the pragmatists "are winning the argument," knows it too. The question is how long this fragile internal balance of power can hold.

Conclusion: a reformist between two powerlessnesses

Neither idealize nor despise

Masoud Pezeshkian is a real man in an impossible situation. He is neither the hero that Western optimists wish to see, nor the mere façade that skeptics denounce. He is a cardiac surgeon who has spent his life repairing what violence breaks — and who now leads a regime built on institutionalized violence. He is sincerely in favor of a deal with the West. He is structurally incapable of guaranteeing it on his own. These two realities coexist, and any analysis that fails to incorporate both is incomplete.

Iran under Pezeshkian remains a real threat to regional stability. The missile program continues, the regional proxies exist, the Revolutionary Guards are intact. The Islamabad Memorandum does not erase this reality. But it creates a possibility — fragile, conditional, reversible — of an Iran less nuclearized and less openly at war with the West. That possibility is worth defending, even with eyes wide open to its limits.

What the West must take away

The West has a vested interest in Pezeshkian surviving politically through these sixty days. Not because he is an ally — he is not, and cannot be within this regime. But because the alternatives are worse: an Iran led by ideological hardliners, backed by China, with an intact nuclear program and a doctrine of permanent confrontation with the West. In that spectrum, a reformist president constrained by institutions is preferable to an ideological general freed from all constraints.

Trump, with all the unpredictability that defines him, understood something essential: maximum pressure combined with a real exit offer is more effective than passive containment. The result — imperfect, unfinished, but real — bears that out. The West can criticize Trump's methods on its own institutions. It cannot deny that on Iran, the method produced what twenty years of diplomacy had not. Pezeshkian, for his part, must manage that reality from within a regime that does not want it, with allies who watch his every move and enemies who wait for him to stumble.

Signed Maxime Marquette, columnist

Sources

Primary sources

Iran International — Pezeshkian vows to heed Khamenei's conditions for negotiations — June 18, 2026

Al Jazeera — Hardliners and moderates: What do Iran's factions think of deal with US? — June 16, 2026

The Guardian — Secret correspondence claims suggest tensions at top of Iranian government — June 21, 2026

Secondary sources

The Guardian — What lessons will Iran's new leadership draw from the 110-day war? — June 20, 2026

Wikipedia — 2025–2026 Iran–United States negotiations — updated June 2026

Reuters — Cracks emerge in Iran's leadership as it reels under bombardment — March 7, 2026

Wikipedia — Masoud Pezeshkian — full biography

Encyclopædia Britannica — Masoud Pezeshkian — biographical profile — June 2026