India’s recent amendment to its transgender rights law has left some transgender people and healthcare providers uncertain about access to gender-affirming medical treatment and identity documents.
The changes were introduced after Parliament amended the Transgender Persons (Protection of Rights) Act earlier this year. The amended law changes how transgender identity is defined and introduces additional requirements for obtaining official certification.
The amendment also introduces penalties for forcing someone to assume a transgender identity through surgical, chemical or hormonal procedures. The government has said the changes are intended to protect vulnerable people from exploitation, coercion and trafficking.
However, transgender rights activists and doctors say the new provisions have created uncertainty over consensual, medically supervised treatment. Some healthcare providers have become more cautious about prescribing hormone therapy because of concerns about how the amended law could be interpreted.
For transgender people already undergoing treatment, the uncertainty can have immediate consequences. Some private clinics have continued providing care but have introduced additional consent documents and legal safeguards.
The lack of clarity has been particularly difficult for people who do not have established relationships with doctors or access to private healthcare. Activists say the situation could disproportionately affect those with limited financial resources or little family support.
The amendment has also affected the process for obtaining transgender identity certificates. Under the new system, applications require a recommendation from a designated medical board before a district magistrate can issue the certificate.
The national online portal used for transgender identity applications has also faced disruption since the amendment came into force, according to activists and legal groups.
The issue has reached India’s Supreme Court, where petitioners are challenging the amendment and raising questions about constitutional protections including dignity, privacy, autonomy and the right to self-identification.
During proceedings in August, the central government told the Supreme Court that transgender identity cards issued before the 2026 amendment would continue to operate while the legal challenge is being considered. The court has also been examining concerns involving people whose applications were still pending when the new law took effect.
India’s transgender population is difficult to measure accurately. The 2011 census recorded about 488,000 people under the transgender category, although activists and researchers have suggested the actual population could be several million.
For many transgender people, the legal uncertainty is now affecting decisions about healthcare, identity documents and longer-term plans. As the Supreme Court considers the challenge, activists and medical professionals are seeking clearer guidance on how the amended law should apply to consensual transgender healthcare and existing identity rights.
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