The recognition of identity is central to an individual's psychological well-being, dignity, and sense of self (Erikson, 1968). For transgender people in India, identity is not merely a personal matter but also a legal right. Before the National Legal Services Authority v. Union of India judgment, the identity of transgender persons existed in a complex and marginalized form. The Court declared them as a “third gender” and recognized their right to self-identify their gender under Article 21 of the Constitution. Afterwards in the year 2019 the government made a legislation The Transgender (Protection of Rights) Act 2019. However, in early 2026 the provision of this Act has amended amid the protest by the queer community. As per the government the broad scope of the definition of “transgender persons” under the 2019 Act created practical challenges in its implementation. Consequently, it was considered necessary to narrow and modify the definition to streamline the law and ensure that its protections are directed specifically toward people who are in genuine need of such protection. The amendment also makes it mandatory to obtain a prior report from a medical board to get “certificate of transgender” from a district magistrate.

This article deals with the amendment that requires the approval of medical board for the certification of identity. This change will have a big psychological impact on transgender people, particularly in terms of identity validation, autonomy, and mental well-being (Meyer, 2003) Instead of strengthening rights, it will end up harming the psychological well-being of transgender people. It takes away their autonomy, reinforces social stigma, and makes their self-identity feel less valid (National Legal Services Authority v. Union of India, 2014; The Transgender Persons (Protection of Rights) Act, 2019).

Under the Transgender Persons (Protection of Rights) Act, 2019, a transgender person is required to apply to the District Magistrate for the certificate of identity. This certificate is mandatory to utilize the benefit of various government scheme made for transgender person. The key changes are done in Section 6, which deals with the issuance of a certificate of identity. While the original provision allowed the District Magistrate to issue such a certificate primarily upon an application supported with an affidavit, the amended provision requires recommendation of a designated medical board, thereby introducing an additional layer of verification. (The Transgender Persons (Protection of Rights) Amendment Bill, 2026).

This board is typically headed by a Chief Medical Officer or a Deputy Chief Medical Officer or may also involve other medical experts to assist in the evaluation process. The inclusion of medical authorities in determining gender identity is a shift from self-identification to institutional validation, thereby embedding a system of verification that subjects personal identity to external assessment. The requirement to seek approval from external authorities for the recognition of one's identity reinforces stigma, generates anxiety, and weakens the sense of self identity. (Erikson, 1968).

Erik Erikson, a German-American Psychoanalyst in his theory of psychosocial stages explains that identity is a crucial component of psychological development. Erikson defined identity as a coherent sense of self that emerges through the interaction of personal reflection and social experience, especially during the stage of identity versus role confusion. In this stage, individuals strive to develop a stable and consistent understanding of who they are. Gender identity forms a central part of this self-concept, representing an individual's deeply felt internal sense of gender.

The recent shift from self-identification to medical certification marks a significant transformation in the legal recognition of transgender identities in India When there is alignment between one's self-perception and societal recognition, it leads to a secure and integrated identity. However, when external authorities such as the state or medical institutions impose conditions on the recognition of this identity, it creates a conflict between self-understanding and external validation. This difference can result in role confusion, anxiety, and psychological distress. For transgender person such interference can significantly disrupt identity formation, weaken self-concept, and undermine their sense of authenticity and psychological well-being (Erikson, 1968).

Under the Transgender Persons (Protection of Rights) Act, 2019, identity was initially based on the principle of self-declaration, as per the judgment given by the Supreme Court which upheld the right of individuals to determine their own gender (National Legal Services Authority v. Union of India, 2014). The amendment requiring certification by a medical board represent a move toward the medicalization of gender identity, it is treating it as a condition that must be verified by external authorities rather than an inherent aspect of self. This shift ignores personal autonomy and reintroduces a gatekeeping mechanism that places transgender person under institutional scrutiny.

A transgender rights activist gave her opinion on this matter that the Transgender Persons (Protection of Rights) Amendment Act 2026 will have adverse effects on younger persons who are still in the process of understanding and asserting their gender identity. The older members of the community may have already established their identity and social position but the younger persons remain more vulnerable to institutional hurdles. The requirement of medical certification creates the risk of rejection by medical boards, which can result in a profound mismatch between an individual's self-perceived identity and externally imposed recognition. She claims that such difference may lead to severe psychological consequences, including depression, anxiety, and in extreme cases, suicidal tendency. Also, when a younger person fails to get the certificate due to the rejection by medical board it may expose that person to increased social stigma and bullying as they may be unable to prove their gender in society without the certificate. (Akanksha Pandey, Transgender Right Activist, Personal Communication, April 2026). 

To conclude, this new change can lead to feelings of invalidation, as it implies that one's self-identified gender is insufficient without formal approval. It also reinforces societal perceptions of transgender identity as abnormal or pathological disorder thereby deepening stigma and negatively impacting mental well-being of transgender. (Meyer, 2003). The right to determine one's own identity is intrinsic to personal liberty and dignity by replacing self-identification with medical validation, the law risks eroding the dignity and self-worth of transgender persons, contradicting its original rights-based intent (The Transgender Persons (Protection of Rights) Act, 2019).

References

• Erikson, E. H. (1968). Identity: Youth and crisis. W. W. Norton & Company.
• Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674
• National Legal Services Authority v. Union of India, (2014) 5 SCC 438 (India).
• The Transgender Persons (Protection of Rights) Amendment Act, 2026. Government of India.
• Human Rights Watch. (2026, March 26). India's transgender rights bill a huge setback. https://www.hrw.org/news/2026/03/26/indias-transgender-rights-bill-a-huge-setback