Hyderabad: In a significant ruling reinforcing the rights of couples seeking parenthood through surrogacy, Telangana high court directed the health and family welfare department to issue a certificate of essentiality and eligibility to a woman diagnosed with Complete Androgen Insensitivity Syndrome (CAIS).Authorities had earlier denied her application, citing the absence of a uterus and ovaries as grounds for ineligibility under surrogacy rules. CAIS is a condition in which the body’s cells are completely unable to respond to androgens. This cellular unresponsiveness prevents the masculinisation of male genitalia in a developing foetus, while still allowing female genital and sexual development to occur without significant impairment.Justice Nagesh Bheemapaka delivered the verdict while hearing a petition filed by a 32-year-old Hyderabad-based doctor and her businessman-husband. The couple approached the HC after their application was rejected on the grounds that they did not meet specific rules governing surrogate couples. Ruling that a chromosomal condition cannot be used to deny a couple the opportunity to have a child, the judge set aside the rejection and directed authorities to issue the required certificates under the Surrogacy (Regulation) Act, 2021.In the verdict delivered on March 3, the judge examined the significance of parenthood as reflected in ancient scriptures. He observed that Hindu marriage remains a foundational ‘samskara’ rooted in Vedic and Dharmashastra traditions and is regarded as a sacred sacrament rather than a mere social contract. The court noted that religious texts, such as the Manusmriti and the Upanishads, emphasise that the fulfilment of ‘grihastha dharma’ is achieved through procreation. The judge noted that childlessness often carries social stigma in orthodox circles, where it is viewed as inauspicious. Such cultural pressures, the court observed, can impose considerable hardship on couples as they attempt to reconcile ancient scriptural expectations with evolving modern social realities.The couple, who married in 2021 and registered their marriage in 2022, applied for gestational surrogacy. As part of the process, they obtained a medical indication certificate from the district medical doard, a civil court order granting parentage and custody, and the legally mandated insurance cover for the surrogate mother.Despite fulfilling these requirements, the commissioner of the health and family welfare department rejected their application in Aug 2025. The decision was based on a cytogenetic report showing the wife had a 46, XY karyotype—the typical genetic makeup for human males. Authorities concluded she did not fit the statutory definition of a “couple,” which refers to a legally married man and woman. After examining the medical and legal aspects, the judge noted that individuals with CAIS may possess XY chromosomes but physically present as women and lead normal married lives. He observed that such a condition does not eliminate the possibility of becoming parents through surrogacy. The court emphasised that the medical board had already certified the necessity for surrogacy and that the couple had satisfied all statutory requirements.The court concluded that the Surrogacy Act was enacted to assist infertile couples and women with medical conditions that prevent pregnancy. Denying the benefit of the law solely due to a chromosomal anomaly would defeat the objective of the legislation. The petition was disposed of accordingly.

