Nepal should stop subjecting transgender citizens "invasive and humiliating" medical examinations before officially recognising their gender identity, Human Rights Watch said in a new report Thursday.
The Himalayan republic is celebrated for having some of Asia's most progressive laws on LGBTQ rights, with landmark 2007 reforms banning discrimination based on gender or sexual orientation.
But activists say the LGBTQ community -- estimated to be more than 900,000-strong -- still faces endemic discrimination.
Nepal introduced a third gender category for citizenship documents in 2013 on the basis of self-identification, but it has not enshrined a clear legal process for transgender citizens seeking to officially change their gender to "male" or "female".
Human Rights Watch said that attempting to do so "invariably involves an invasive and humiliating physical exam in a medical setting, an experience that is rife with human rights violations".
Manisha Dhakal of the LGBTQ rights organisation Blue Diamond Society said that the legal grey area around changing one's documents was upholding barriers faced by "generations" of transgender Nepalis.
"We need real change now," she said in a statement.
Bhumika Shrestha, who was profiled in the report, told AFP that she was forced to undergo a medical exam despite showing documents detailing her gender reassignment surgery.
"I had to take my clothes off to be checked. They touched and checked minute details on my body, it was very uncomfortable," she said.
"Other Nepalis are not asked to remove their clothes to get their citizenships. Why are we subjected to this?"