Biological sex determines eligibility for ART services, irrespective of a person’s self-perceived transgender identity.

The petitioner, assigned female at birth, identifies as a transman and holds a gender identity certificate as 'male' issued under Section 7 of the Transgender Persons (Protection of Rights) Act, 2019.

Having undergone hormone therapy and mastectomy but not a full hysterectomy, the petitioner sought to cryopreserve oocytes (eggs) before completing gender reassignment surgery.

A medical report confirmed the petitioner’s reproductive organs (uterus and ovaries) remained intact.

The 5th Respondent (an ART Clinic) refused the service, citing that the Assisted Reproductive Technology (Regulation) Act, 2021 (ART Act) limits services to "commissioning couples" and "women," and contains no express provision for transgender persons.

The petitioner challenged the constitutionality of Section 21(g) of the ART Act as discriminatory.

Section 21(g) and Section 2(1)(u) of the ART Act, which restrict services to a "woman" or "commissioning couple".

Sections 6, 7, and 15 of the Transgender Persons (Protection of Rights) Act, 2019, which protect the right to self-perceived identity and healthcare.

The precedent of Suchita Srivastava v. Chandigarh Administration [(2009) 9 SCC 1], established that reproductive choice is a fundamental dimension of personal liberty under Article 21.

The 'Third Gender' recognition established in National Legal Services Authority (NALSA) v. Union of India [(2014) 5 SCC 438].

The court found that sex and gender are conceptually distinct; sex refers to biological attributes, while gender refers to internal identity.

It interpreted the term "woman" in Section 2(1)(u) of the ART Act as a "biological woman"—an adult human female with the capacity to produce eggs.

Since the petitioner remains biologically female with intact reproductive organs, the court reasoned that the petitioner possesses a fundamental "naturally inbuilt" right to reproduction under Article 21.

The court noted that the State had failed to issue a Health Manual under Section 15(d) of the Transgender Act, leaving trans persons without necessary guidance on fertility preservation before surgery.

It concluded that because the petitioner is biologically female, the refusal of oocyte retrieval based solely on a legal gender change to 'male' would violate the right to dignity and reproductive autonomy.

The court distinguished between ART "clinics" (which perform procedures) and "banks" (which handle storage), noting that under Section 2(1)(b), only ART banks are authorized for independent cryopreservation.

The court declined to strike down Section 21(g) of the ART Act, leaving the constitutional challenge open for a future proceeding.

The Court directed the petitioner to approach an ART Bank of his choice, which is ordered to take steps to retrieve and cryopreserve the petitioner’s gametes for future use, and the petition was partly allowed.