[3][1] The Madurai Bench of the Madras High Court was asked to consider whether the term ‘bride’ could include transgender women, within the meaning of Section 5 of the Hindu Marriage Act 1955.

The petitioners further asked the court to consider whether the refusal to register the marriage of a person based on sexual orientation or gender identity violates the right to equality before the law, freedom of speech and expression, protection of life and personal liberty and freedom of conscience and free profession, practice and propagation of religion guaranteed under the Constitution of India.

[3] The court held that while Parliament may not have considered that trans women would fall under the Act, "The expression “bride”...cannot have a static or immutable meaning.

[3] During the proceedings, the Court was made aware that the Ministry of Health and Family Welfare regulates medical procedures, including sex reassignment surgeries, for intersex children only after a thorough assessment of the patient and obtaining written consent from the parent or guardian.

[3] Furthermore, the court highlighted Article 39(f) of the Constitution of India, which declares, "the State shall, in particular, direct its policy towards securing that children are given opportunities and facilities to develop in a healthy manner and in conditions of freedom and dignity and that childhood and youth are protected against exploitation and against moral and material abandonment.

The order stipulates that exceptions in cases of life-threatening circumstances will be granted by the government, following the recommendation of a committee formed by the Director of Medical Education, which must include the following members:[6] In addition to Madras High Court's direction in the current case, the Department of Health and Family Welfare issued its order based on the Supreme Court's ruling in NLSA v. Union of India (2014), the World Health Organization's report titled "Sexual Health, Human Rights and the Law," and expert opinions provided by the Head of the Department of Plastic, Reconstructive, and Facio-Maxillary Surgery at Rajiv Gandhi Government General Hospital.

[6] Tamil Nadu holds the distinction of being the first in Asia and the second worldwide, following Malta, to prohibit the practice of performing genital-normalizing surgeries on intersex infants and children.