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Genitals and Gender

As part of the build-up to June’s Safer To Be Me Symposium, we are proud to be sharing our Safer To Be Me: Global Voices blog series, showcasing LGBTQ+ themes from around the globe, written by ReportOUT volunteers.

Following last week’s inaugural blog which focused on Minority Stress associated with growing up LGBTQ+ in Zimbabwe, our second blog takes us to Japan where ReportOUT volunteer researcher, Ryoko Umemoto, discusses the impact of the government’s refusal to reform gender laws on the lived experience of the Japanese trans community.

I don’t think I would have got the surgery [to remove uterus and ovaries] if the law was different.

Kento Inoue

In 2004, the Gender Identity Disorder Special Cases Act came into force in Japan. The law allows people to change their gender on legal and official documents—under five strict conditions:

  • Be at least 20 years old

  • Be unmarried

  • Have no minor biological children

  • Have no gonads or permanently lack functioning gonads

  • Have external genitalia resembling that of the alternative gender

Of course, there is a pre-condition to this law. For a transgender person to undergo surgery, as required by the fifth condition, a psychiatrist has to diagnose them with ‘Gender Identity Disorder’ (GID).

As Human Rights Watch reports this law is far from unique in containing such violating provisions. However, certain countries have recently started to amend their laws and remove sterilisation requirements. Some countries, like Sweden and the Netherlands, have even compensated those who under previous legislation felt forced to undergo surgery to change their legal gender (Human Rights Watch 2001). Despite progress elsewhere, the Japanese government has made no move to amend the 2004 Act, ignoring the calls for reform from human rights organisations and the trans community. In 2017, Japan pledged to the United Nations Human Rights Council that they would revise the law (Doi and Knight 2001). However, in 2019, Japan’s Supreme Court upheld that the law does not violate Japan’s constitution. Although the judges took note of the invasiveness of the law, they still unanimously voted to uphold the law (Griffiths and

Wakatsuki 2019). A Mental Disease That Will Destroy Society?

Now, five years after making the pledge, there appears to be no move from the Japanese government to make good on it. Many members of the governing Liberal Democratic Party (LDP) have shown concerning homophobic and transphobic attitudes. various meetings were held in which certain MPs called LGBTQ+ people “morally unacceptable” and “resisting the preservation of the species that occurs naturally in biological terms” (McCurry 2021). LGBTQ+ rights activists protested in 2022 after a LDP panel meeting distributed a booklet stating that “homosexuality is a mental disease or addiction,” which if given more legal protection would “become a social problem which will destroy families and society”(Fujisawa 2022). It is debatable whether the 2004 Act has actually offered trans people more legal protection, considering its severely restrictive conditions. The act has espoused and legitimised the notion that being transgender is a mental health disorder.

Although the World Health Organisation stopped classifying ‘gender incongruence’ (their term for the experience of being transgender) as a mental disorder in 2019, Japan still continues to classify transgender people as having a mental disorder.

Alignment With The Disabled Community

Research done by Karen Nakamura, an anthropologist at the University of California, Berkley, suggests that transgender people have aligned themselves more with the disability community than with the LBGTQ+ community. She explains how a translation “fluke” resulted in Gender Identity Disorder to be understood literally as Gender Identity Disability (Nakamura 2012). While there are various complex reasons behind why trans people have come to be grouped in this way, an important one is the relative success that the disability community has had compared with the LGBTQ+ community in establishing themselves as a minority group in Japan (Eshelman 2015). Therefore, due to the lack of protection and rights that the current system provides, trans people in Japan have had to find ways to take “advantage of the disability aspect of GID” (Nakamura 2012). Although the medical diagnosis gives some leeway for transgender people to exist within a society that is strictly structured according to the gender binary, the classification of being transgender as a mental disorder is a grave misunderstanding of gender identity. Dr. Jun Koh, a psychiatrist who specialises in this area, has stated that the law is wrong, saying,

If the child expresses this gender identity, then let them be – they do not require diagnosis.”

(Feder and Kininmouth 2016).

Unfortunately, given the lack of understanding and protection of transgender people, Koh has had to dispense diagnoses of GID in order to make schools accept and accommodate for their transgender students. For example, a transgender girl in middle-school in Osaka, Japan was able to change to girls’ gym classes and use a private bathroom with the diagnosis of Gender Identity Disorder from a psychiatrist (Feder and Kininmonth, 2016). ‘A Diagnosis That No Longer Officially Exists’

To allow medical professionals such authority over an individual’s gender identity is not only outdated, but also dangerously limits trans people’s autonomy. The trans rights activist, Fumino Sugiyama urges that “the GID Special Cases Act must be revised urgently. For the very name of the law refers to a diagnosis that now officially no longer exists.” (Sugiyama 2019) While the LDP cling to their staunchly homophobic and transphobic stance, transgender people in Japan continue to suffer under the restrictive 2004 Act. A Life Limited By The Law

There are increasing reports of the difficulties faced by adult transgender people in Japan. In 2021, the BBC documented the experiences of two trans men: Kento Inoue and Fumino Sugiyama. Inoue has lived as a trans man since he was 22 years old and at 24, he underwent surgery to have his gender legally changed. He states that the current law is very strict, but that “at this point in time people don’t have a choice.” Thinking back on his own experience, he says, “I think I wouldn’t have had my uterus and ovaries removed. I don’t think I would have got the surgery if the law was different.” (Zuo 2021) Sugiyama’s life has also been limited by this law. Despite being a trans man, the law refuses to recognise his gender because he does not wish to have his reproductive organs removed. The law also refuses to acknowledge that he has any legal ties to his partner or children. In the interview, he relates his concerns about this:

It is OK when everything is alright. But if [my partner] becomes ill, or if something were to happen to our [children], I might not be able to visit them in the hospital or sign a waiver. I’m living with that sort of uncertainty.”

Other trans people have faced similar legal challenges regarding their families and children. In 2022, the Tokyo High Court ruled that the one of the children of a trans woman should not be recognised legally as her child. According to the verdict, the woman, who has two children with her partner, is recognised as the legal parent only to her elder child, but not her younger child, who was born after she had changed her legal gender. The injustices that trans people in Japan are forced to face outline the clear and urgent need for reform—which the LDP refuses to enact. As a recent BBC article noted, in Japan, “the modern is more of a veneer”(NHS News, Reuters 2022). For all of its technological marvels and advancements, Japan’s government and laws are still stuck in the past. At any hint of potential progress for the rights of the transgender community, the government disappoints again and again. They refuse to learn and evolve, and the people they are supposed to serve are left to suffer. Ryoko’s blog is part of ReportOUT’s Safer To Be Me: Global Voices series, in support of the

Safer To Be Me Symposium, a joint ReportOUT-University of Sunderland project, which will take place on 22nd June 2023 at Sunderland University in the North East of England. The symposium will create a safe space where some of the most important issues facing international LGBTQI+ human rights can be explored and discussed in great detail, as well as encouraging a call to action where all involved can identify meaningful ways to be proactive and make a powerful impact. To find out more, visit our website Bibliography:

Doi, K, and Knight, K. (2021) ‘Trans Man Fights Japan’s Sterilisation Requirement’. Human Rights Watch. Available at: (Accessed: 30 January 2023)

Eshelman, R. (2015) ‘Yale Professor Nakamura discusses Japanese transgender identity and disability.’ The Georgetown Voice. Available at: (Accessed: 30 January 2023)

Feder, J. L., and Kininmonth, N. T., (2016) ‘Why Transgender People in Japan Prefer To Be Told They Have A “Disorder”.’ Buzzfeed News. Available at: (Accessed: 30 January 2023)

Fujisawa, M. (2022) ‘LDP panel booklet calling homosexuality a ‘mental disease’ sparks backlash in Japan.’ The Mainichi. Available at: (Accessed: 30 January 2023)

Griffiths, J., and Wakatsuki, Y. (2019) ‘Trans people must still be sterilized before changing gender in Japan after top court upholds ruling.’ CNN. Available at : (Accessed: 30 January 2023)

Human Rights Watch. (2021) ‘The Law Undermines Dignity.’ Available at: (Accessed: 1/2/23)

McCurry, J. (2021) ‘Japan’s ruling party accused of violating Olympic charter over LGBT rights.” The Guardian. Available at: (Accessed: 30 January 2023)

Nakamura, K. (2012). ‘Disability, Queer Sexualities, and Transsexuality from a Comparative Ethnographic Perspective.’ Research Center for Barrier-Free Education, Graduate School of Education, University of Tokyo. Available at (Accessed: 31 January 2023)

NHK News (2022) 性別変更前に生まれた長女のみ親子関係認める判決 東京高裁 Available at: (Accessed: 30 January 2023)

Reuters. (2022) “Japanese trans woman denied status as parent of own child – reports” The Guardian. Available at: (Accessed: 30 January 2023)

Sugiyama, F. (2019)“The WHO says I don’t have a mental disorder, but in Japan my government says I do.” Openly News. Available at: (Accessed: 30 January 2023)

Wingfield-Hayes, R. (2023) “Japan was the future but it’s stuck in the past.” BBC News. Available at: (Accessed: 30 January 2023)

Zuo, N. (2021) ”Trans in Japan: Sterilisation and legal gender recognition.“ BBC News. Available at: (Accessed: 30 January 2023)

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