Government-employed gynaecologists oppose a proposed amendment limiting examinations of survivors of penetrative sexual assault to woman gynaecologists, replacing the earlier protocol that permitted any trained woman medical officer to perform the examination when no gynaecologist was on duty.
Published Nov 24, 2025 | 9:00 AM ⚊ Updated Nov 24, 2025 | 9:00 AM
The conflict began in April 2023 when the State Home Department moved to amend Clause 6 of the Kerala Medico-Legal Protocol for Examination of Survivors of Sexual Offences, 2019.
Synopsis: The Kerala Health Department has appointed a five-member expert committee to re-examine its proposed amendment to the State’s medico-legal protocol, which would require only woman gynaecologists to conduct examinations of survivors of penetrative sexual assault. The move follows months of legal dispute, with government gynaecologists arguing in the High Court that the rule is impractical, medically unnecessary and contrary to existing guidelines.
The Kerala government has set up a five-member expert committee to revisit its proposed changes to the State’s medico-legal protocol for examining survivors of penetrative sexual violence, after months of legal wrangling that pitted government-employed gynaecologists against the Health Department.
Constituted on 21 November, the panel has been tasked with reviewing the amendments to Clause 6 of the Kerala Medico-Legal Protocol for Examination of Survivors of Sexual Offences, 2019.
The proposed change introduced a stringent stipulation: only a woman gynaecologist is permitted to conduct medico-legal examinations of survivors of sexual assault, compared to the earlier protocol that allowed any trained woman medical officer to perform the examination when a gynaecologist was not on duty.
Medico-legal protocol
It prompted a group of government gynaecologists from across the State to approach the Kerala High Court in March 2024.
They argued it was “illegal, improper, unsustainable and contrary to existing national and international guidelines” and said it placed an unreasonable burden on them.
The High Court in July observed that the matter required expert medical assessment and directed the State to constitute an expert committee of doctors to examine the concerns raised.
The panel was constituted by the Kerala Health Department in the wake of sustained exchanges between the petitioners and key State stakeholders, including the State Police Chief and the Director of Health Services, after the Division Bench issued its directive.
The panel includes Dr Arul RB Krishna IPS, Superintendent of Police (VIP Security); Dr Himendranath IPS, Superintendent of Police (Telecommunication); Dr Prasanna Kumari, Deputy Director of Health Services (Family Welfare); Dr Sheena Sreenivasan, junior consultant in forensic medicine and police surgeon at the General Hospital, Thiruvananthapuram; and Dr Jayasree M, chief consultant in obstetrics and gynaecology at the Women and Children Hospital, Thycaud.
The committee has been instructed to schedule a personal hearing for both appellants and respondents, examine every point raised, and ensure alignment with existing medico-legal guidelines and statutory provisions.
The panel must submit its report to the government within one month of the order.
The conflict began in April 2023 when the State Home Department moved to amend Clause 6 of the Kerala Medico-Legal Protocol for Examination of Survivors of Sexual Offences, 2019.
The original protocol had struck a careful balance: it acknowledged the State’s right to secure the “best evidence from the best available expert” while also safeguarding a survivor’s right to immediate treatment and timely medico-legal examination.
Crucially, it mandated that the examination of a woman or girl survivor of vaginal penetrative sexual assault, if brought within 96 hours, should be conducted by a woman gynaecologist, but only if she was on duty at the time.
If a gynaecologist was unavailable or unable to attend, any trained woman medical officer was authorised to perform the examination, with the protocol expressly prohibiting unnecessary referrals or delays.
The only prerequisite for the examining doctor was prior training in the protocol.
Thus, when the State proposed the amendment, a group of government gynaecologists argued before the High Court that the amended clause imposed an unreasonable and disproportionate burden on them and created an unnecessary barrier within the medico-legal system.
Their contention was that any registered woman medical practitioner with the required training is competent to conduct such examinations, and limiting the responsibility exclusively to gynaecologists served no scientific or procedural purpose.
They maintained that the change was rooted in a misconception that gynaecologists possess exclusive forensic expertise, whereas in reality the forensic knowledge required for sexual assault examinations is part of the basic training received by any MBBS doctor.
The matter was first heard by a single-judge bench comprising Justice Devan Ramachandran.
Additional Director General of Prosecutions Grashious Kuriakose, appearing for the State, defended the proposed amendment, asserting that the government’s intention is to ensure comprehensive, immediate and privacy-sensitive care for a particularly vulnerable category, women and girls subjected to vaginal penetrative sexual assault.
Kuriakose clarified that the mandate applies only to this category of survivors, and not to victims of all sexual offences.
He argued that the role of a gynaecologist at the first point of contact is crucial because the situation demands more than evidence collection.
The survivor simultaneously requires expert evaluation to determine life-saving treatment options, which a general registered medical practitioner might miss or inadequately assess.
He reminded the court that under the 2015 protocol, female gynaecologists carried the full burden of examination, reporting and evidence presentation.
This was eased in the 2019 protocol. However, the State now seeks to recalibrate the system in light of both medical imperatives and the survivor’s privacy, avoiding the need for a traumatised woman or girl to be moved from “doctor to doctor”.
The State also stressed that gynaecologists cannot dictate service protocols to the government and that the amendment aligns with medical ethics, prioritising the survivor’s well-being over departmental convenience.
After hearing the matter, the single-judge bench acknowledged the State’s objective of ensuring medico-legal and therapeutic support to survivors of vaginal penetrative assault, a category it described as involving the “worst kind of crime” against women and girls.
While noting the government’s rationale, the court raised an important concern: should every survivor in this category be taken only to a gynaecologist, irrespective of practical constraints or emergency circumstances?
The court observed that insisting on a gynaecologist does serve a dual purpose, medical evaluation and medico-legal documentation. Yet, it also recognised the operational burden on gynaecologists across the State.
Justice Ramachandran held that the protocol may need “fine tuning” to prevent undue hardship to specialists without compromising survivor care.
The bench therefore refrained from striking down the proposal but opened the door for administrative reconsideration.
It directed the petitioning gynaecologists to submit a detailed representation to the government outlining their specific grievances, enabling the State to re-examine the issue on a case-by-case basis.
Challenging that judgment, the petitioners escalated their long-standing concerns to a division bench comprising Justices Sushrut Arvind Dharmadhikari and Syam Kumar VM.
They argued that the single judge had failed to address the core issue raised in their writ petition and had instead relegated them to approach the government, asserting that this would not resolve the gravity of the matter.
The division bench, however, in its judgment in July, observed that the matter required expert medical assessment, noting candidly that neither judge possessed the specialised medical expertise necessary to adjudicate the issue independently.
The bench remarked that, in the absence of prior consideration by the appropriate medical authority and without expert input, it would be improper for the court to make a conclusive determination.
Ultimately, the bench found no grounds to interfere with the single judge’s ruling and disposed of the writ appeal with clear directions.
The petitioners were granted liberty to present a detailed representation to the government, supported by relevant documents. The government, in turn, was directed to constitute an expert committee of doctors to examine the concerns raised.
(Edited by Dese Gowda)
