Dr. M & another v. Union of India & another, 2026
It reinforced that biological or chromosomal variations cannot override gender identity in law where medical infertility exists.
Judgement Details
Court
Telangana High Court
Date of Decision
28 April 2026
Judges
Justice Nagesh Bheemapaka
Citation
Acts / Provisions
Facts of the Case
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The petitioners were a married couple married on 24.11.2021, with marriage registered on 03.10.2022.
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The wife was diagnosed with Complete Androgen Insensitivity Syndrome (CAIS), with absent uterus and ovaries, making natural conception impossible.
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A District Medical Board certificate (22.10.2023, later extended on 23.08.2024) confirmed her medical condition under Rule 14(a) of the Surrogacy Rules, 2022.
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The couple also obtained:
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A court order regarding parentage and custody of the child to be born through surrogacy
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Required insurance coverage for the surrogate mother
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Despite compliance, the State Authority rejected their application for certificate of essentiality and eligibility for surrogacy (18.08.2025).
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The rejection was based on:
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Section 2(h) definition of “couple” (man and woman)
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A Government communication excluding transgender persons
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The wife’s cytogenetic report showing 46 XY karyotype
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The petitioners challenged the rejection as contrary to law and violative of Article 21.
Issues
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Whether a woman suffering from Complete Androgen Insensitivity Syndrome (CAIS) with 46 XY karyotype can be denied surrogacy eligibility under the Surrogacy (Regulation) Act, 2021?
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Whether the State Authority can override the District Medical Board’s certificate under Rule 14(a) of the Surrogacy Rules, 2022?
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Whether denial of surrogacy on the ground of chromosomal pattern amounts to violation of Article 21 of the Constitution?
Judgement
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The Court held that the petitioner-wife had all physical characteristics of a woman and was not a transgender person.
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It observed that she suffered from CAIS, which medically prevented natural conception.
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The Court held that denial of surrogacy on the ground that she was not a “perfect woman” was contrary to the Surrogacy Act, 2021.
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It ruled that once the District Medical Board had certified eligibility under Rule 14(a), the State Authority could not reject it based on chromosomal analysis.
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The Court held that the authority had no jurisdiction to sit in appeal over medical findings of the Board.
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It relied on Arun Muthivel v. Union of India, affirming that Rule 14 is woman-centric and intended for medical infertility cases.
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The Court held that the Surrogacy Act is a beneficial legislation aimed at enabling infertile couples to become parents.
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It observed that denying surrogacy would defeat the purpose and spirit of the Act.
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It found that the petitioners satisfied all statutory requirements including legal marriage, age eligibility, and absence of prior child.
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Accordingly, the rejection order was held to be illegal and unsustainable
Held
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The rejection of surrogacy eligibility on the basis of 46 XY karyotype was unlawful.
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The petitioners were held entitled to certificate of essentiality and eligibility under the Surrogacy (Regulation) Act, 2021.
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The writ petition was allowed.
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The State Authority was directed to issue the required certificates.
Analysis
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The Court adopted a purposive interpretation of the Surrogacy (Regulation) Act, 2021, focusing on its welfare objective.
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It reinforced that biological or chromosomal variations cannot override gender identity in law where medical infertility exists.
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The judgment limits administrative discretion by holding that Medical Board findings under Rule 14 are binding unless legally challenged.
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It strengthens the constitutional protection of reproductive autonomy under Article 21 (right to life and dignity).
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The Court rejected a rigid biological determinism approach (XX/XY classification) in defining eligibility.
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It highlights that surrogacy law is a beneficial social legislation aimed at addressing infertility and stigma associated with childlessness.