Kerala High Court Permits 'Continuation' Of Hormone Replacement Therapy For Two Transgender Persons Challenging 2026 Amendment

The Kerala High Court on Friday (April 10) directed the continuance of hormone replacement therapy for two transgender persons challenging the validity of Transgender Persons (Protection Of Rights) Amendment Act 2026, after noting that the same was "abruptly" stopped following the recent amendments to the 2019 Act.

After hearing the submissions for some time Justice Bechu Kurian Thomas issued notice on the petitions and directed,

"In the meantime, the Sr. counsel submitted that petitioner apprehends that petitioner's hormone replacement therapy which was commenced in 2019 had been abruptly stopped pursuant to the coming into force of amendment Act. Have regard to the entire circumstances, this Court is of the view that abrupt replacement of the hormone replacement therapy allegedly undergone by the petitioner would lead to absurd results. However, nothing has been brought on record to show that the petitioner is undergoing any such treatment as observed. Document has been handed over across the bar. In such circumstances, this Court is of the view, considering the interest of justice that the hormone replacement therapy, if already commenced, in respect to the petitioners, shall be continued till its conclusion without any interference from any statutory authority."

The court further directed that its order is "qualified by the condition" that the petitioners have already commenced treatment.

During the hearing, senior advocate Arundhati Katju appearing for the petitioner submitted that in the previous hearing the court had asked the Additional Solicitor General P. Sreekumar appearing for the Union of India, to take instructions in the matter.

ASG Sreekumar submitted that the petitioners have stressed on denial of medical treatment etc. however, "This a case where medical urgency will not arise. Almost all categories included in the Act. Self-perceived identity has not been included. Internationally, several issues have arisen."

Katju meanwhile said that the petitioner is a person who is currently undergoing hormone replacement therapy and now it has abruptly stopped for the petitioner. She said that while these legal issues can be resolved, there is an urgent issue with respect to the petitioner's treatment.

To this the court asked, "What is there to show that you were undergoing therapy?" Katju said that the petitioner's treatment started as far back as 2019.

The court further said, "Presumption of constitutionality of statutes (is) there. Courts seldom grant stay. I don't think that I have come across even a single instance where courts have granted stay in the first stage. If there is something that works in the prejudice of the party, does the statute bring an end to that?"

Katju then submitted that "There is a chilling effect on the doctors who were giving non-surgical interventions". To this the court orally said that whatever medical treatment the petitioner was receiving "let it continue".

"Probably the statute takes in persons like the petitioner. May the intention is to exclude persons who just have the self-perception...There must be something more. Let the petitioners medical treatment continue. The petitioner has already commenced hormonal replacement therapy. Because she/he is apprehending stoppage of treatment," the court said.

The ASG however said that either the doctor should certify that treatment is stopped for such and such treatment, adding that the procedure had not been stopped and this was only the petitioners' assertion.

The court however said that one of the petitioner's had been undergoing treatment since 2019 and that was "not protected under the statute".

To this ASG however said, "I am saying that in the amendment also, it is protected. Amendment only excludes self-declaration. Self-declaring is a different category. There, the doctors are also of the view that it is not based on the hormonal. Because amendment also includes hormone treatment".

Katju said that let the ASG make a statement that it is not the intention of the Act to stop those persons who are undergoing any kind of therapy. To this the ASG said, "If there is any private grievance is there, I can understand but this cannot be granted".

With respect to the second petitioner (in the second plea) the court orally asked as to since when was the individual undergoing therapy to which Katju said "since years".

At this stage the court orally said, "You have nowhere pleaded that she is undergoing treatment. One, statute cannot be stayed as an interim measure. Only an interim relief vis a vis the petitioner. That there must be sufficient material. I've granted an order to the other petitioner. In this, I didn't find any pleading".

To this, Katju pointed to the pleadings in the second petition and said that the petitioner has a medical condition that prevents her from taking surgery. "Now she is afraid of treatment being stopped. Unfortunately, we were not able to get all the document due to short notice," Katju said.

The court thus went ahead and passed the same order in respect of the second petitioner regarding continuance of hormone therapy, as granted to the first petitioner.

For context, Section 2(k) of the principal statute defined Transgender as a person whose gender does not match with the gender assigned to that person at birth, whether or not such person has undergone Sex Reassignment Surgery or hormone therapy.

However, the amended definition excludes transexual persons and non-binary individuals who identify on the basis of self-perceived gender identity without medical intervention.

In the last hearing, the Court had refused to stay the operation of the Act, remarking that there is a presumption of constitutionality of statutes.

However, it had orally asked the Centre whether persons already undergoing a hormonal sex replacement therapy would be affected due to their alleged exclusion from the definition of 'transgender person' by virtue of the Amendment Act. It was also orally indicated that reliefs can be granted in individual cases.

In one of the pleas, the petitioner has prayed for a declaration that the impugned Act, in particular Section 2(k) and other related provisions, are unconstitutional, being violative of Articles 13(2), 14, 15, 19, and 21 of the Constitution of India; and that the right to self-identification of gender is a fundamental right under Articles 14, 19, and 21 of the Constitution.

Further, it is also prayed that the Court may direct the to frame inclusive policies ensuring access to education, employment, healthcare, housing, and social security for all transgender persons, including transmen, transwomen, and non- binary individuals as well as to recognize and uphold the self-identification of gender without imposing medical or bureaucratic barriers.

The petitions are moved by Advocate Padma Lakshmi. Senior Advocate Arudhanti Katju is appearing for the petitioners.

The Additional Solicitor General of India P. Sreekumar is appearing on behalf of the Union.