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Japan Upholds Sterilization Law for Trans People Who Change Legal Gender

Law 111 also specifies that in order to receive a change in their legal gender marker, a trans person in Japan must be at least 20 years old, unmarried, and undergo gender reassignment surgery.

On Thursday, Japan's Supreme Court upheld a 2004 law that requires transgender people in the country undergo sex reassignment surgery in order to legally change their gender. Law 111 also specifies that in order to receive a change in their legal gender marker, a trans person in Japan must be at least 20 years old, unmarried, and sterilized.

Japan's Supreme Court decision comes after Takakito Usui, a trans man, challenged the law as unconstitutional. While the decision to uphold the law was unanimous, according to the Associated Press, two judges on the court proposed regular reviews of the law “from the viewpoint of respect for personality and individuality."


Though Usui's attempt to challenge the law was unsuccessful, he appeared to have hope for the future of trans rights in Japan, due in part to these remarks from the judges. “I think the ruling could lead to a next step,” Usui said during a press conference following the ruling. “I hope to find what constitutes a family of my own that does not fit the traditional mold.”

Across the world, the struggle for transgender people's rights has often included similar laws to the one upheld by Japan this week. In parts of the United States and Europe, sterilization in the form of sex reassignment surgery, hysterectomy, and vasectomy has been required for individuals who wanted to legally change their gender, despite human rights organizations' condemnation of the practice. Europe did not stop requiring sterilization for trans people hoping to change their legal gender until 2017, after three French citizens filed a case with the European Court of Human Rights. In the US, where laws for changing gender markers vary by state, multiple states still require sex reassignment surgery before allowing people to legally change their gender.

In 2013, the United Nation's Human Rights Council published a report which described medically unnecessary surgery as mandated by a government as "torture." "The Special Rapporteur calls upon all States to repeal any law allowing intrusive and irreversible treatments, including forced genital-normalizing surgery, involuntary sterilization, [etc…] when enforced or administered without the free and informed consent of the person concerned," reads the report.


In 2016, Human Rights Watch (HRW) filed a formal complaint to the UN over Japan's Law 111, claiming that the legislation "violate[s] internationally protected human rights of transgender people in Japan, including the right to health and the prohibition on inhuman and degrading treatment or punishment."

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LGBTQ researcher at Human Rights Watch Kyle Knight tells Broadly, "We take the strong position—as do most human rights institutions, NGOs, UN agencies, or otherwise—that a legal gender recognition procedure should be an administrative procedure. It should be transparent, accessible, and quick—and it should be based on a self-declaration, not a medical intervention or evaluation."

Knight, who has spent time researching bullying of LGBTQ kids in Japan, recalls speaking with Japanese transgender kids in 2016 who were already living in fear of what the law would mean for their futures. "You're talking about 15-year-olds who were afraid that they were going to have to be sterilized in order to be recognized," he explains, "which meant in order to get a job, in order to get a life, and so on."

Like Usui, however, Knight has hope for the future of trans rights in Japan, and cites a specific reason. As it stands, Law 111 requires a diagnosis of “Gender Identity Disorder” (GID) before a person can apply to change their legal gender. But, Knight explains, doctors in Japan rely on diagnostic codes from the Diagnostic and Statistical Manual of Mental Disorders (DSM), an American publication, and the International Classification of Diseases (ICD). As of May, both have removed the diagnosis of GID as a mental illness.

"This law is now premise on a diagnosis that doesn't exist anymore in modern medicine," Knight explains. "The Japanese government is going to have to adjust for that."