Trans Amendment Act may disrupt gender-affirmative care, warn health practitioners

Health practitioners across the country have raised concerns regarding the Transgender Persons (Protection of Rights) Amendment Act 2026, stating that it will “disrupt established treatment protocol”, adding that many might stop providing gender-affirmative care “fearing legal consequences”. 

In addition to narrowing the definition of who a transgender person is and removing the right to self-identification of gender, which will automatically exclude many, the amendment includes a section on offences, which states that “compelling” one to “outwardly present a transgender identity” is a punishable offence.

In response to a question in the Parliament on Wednesday (April 1, 2026) to whether the government is cognizant that this section will harm access to gender-affirmative care, B.L. Verma, the Minister of State for Social Justice and Empowerment said, “The provisions relating to forced conversions are intended to prevent abuse, coercion and exploitation, including instances of forced bodily harm or compelled identity and are not intended to restrict legitimate gender-affirmative care.” He did not clarify what is meant by “legitimate” gender-affirmative care.

Doctors point out that the “language” used in the amendments might make gender-affirmative care more inaccessible. Dr. Medha Bhave, President of the Indian Association of Aesthetic Plastic Surgeons (IAAPS), said, “Doctors fear that they might get sued by the families if they are against the surgery, and that fear will lead many to stop providing gender-affirmative care. When such access barriers are created, some might choose to undergo unsafe procedures, and quackery might increase.” 

Dr. Bhave, who currently practises in Thane, recalls an incident from 1998, before gender-affirmative care was a right, saying, “I had conducted a breast reduction surgery for someone prescribed female at birth who identified as male. The next day, the father came and blasted me.” She added that such incidents might become common again. 

Meanwhile, at a government hospital, a doctor said that there is a “lack of clarity” on how gender-affirmative care will be provided. The doctor said on the condition of anonymity, “No patient should be denied care. But we mostly take up patients who have the Transgender Card. We will have to follow the new definition and government guidelines.”

Given that the new definition will exclude many, the doctor added that they will form boards to deliberate on such cases, if needed.

In their note to the President on March 30, the IAAPS, which represents over 1300 specialists, said that the changes may have “unintended adverse consequences, including disruption of established treatment protocols, increased training and system-level burden, and potential barriers to research and standardisation in transgender healthcare”. 

Mariwala Health Initiative, a Mumbai-based organisation working towards greater access to mental health services, issued a statement condemning the amendments, which, as of April 1, have been signed by 1062 mental health practitioners. The statement said that the amendment reinforces the “obsolete and harmful idea that gender diversity is a pathology needing diagnosis”. 

Another group, Jan Swasthya Abhiyan, a network of people advocating for equitable healthcare, said in a statement that the amendment seeks to deny or constrict the right to health for a larger number of transgender women, transgender men, non-binary, gender-diverse and intersex persons who do not fit its “narrow definitions”. “Due to narrowing of the definition of ‘transgender’, those excluded will lose access to transition-related healthcare, mental health support, and various health and welfare schemes,” it stated.