Japan’s Supreme Court ruled to uphold existing law that transgender persons who want their gender legally changed on official documents must be sterilized in order to prevent “problems” in parent-child relationships and protect society from “confusion” and “abrupt changes.”
As SBS News reported, Law 111, enacted in 2004, stipulates that “any individual wishing to change their documents” must have “no reproductive glands” or at least have “reproductive glands that have permanently lost function,” i.e., no testes or ovaries.
The law also “requires the person to have ‘a body which appears to have parts that resemble the genital organs of those of the opposite gender,'” reported SBS.
The challenge to Law 111 was brought by Takakito Usui, a transgender man — a female impersonating a male — who wants his documents to legally identify him as male.
The four justices on the Supreme Court dismissed Usui’s claim and declared Law 111 to be constitutional.
Two of the justices also wrote in a separate opinion that Law 111 should be reviewed regularly as Japanese society grapples with sexual identity issues.
Sex-change surgery is subsidized through public insurance in Japan; patients must pay up to 30 percent of the costs, according to Japan Times.
The health ministry’s proposed rule change to allow public health insurance coverage of sex reassignment surgery for people with gender identity disorder (GID) offers those who face steep surgery costs a reason to cheer.
But there are concerns that more people with GID will undergo such surgeries without a full understanding of the associated risks.
The Ministry of Health, Labor and Welfare on Wednesday proposed to an advisory panel allowing the cost of sex reassignment surgery for GID patients to be covered under public health insurance from April. The panel essentially approved the proposal.
In Japan, GID patients need to undergo sex reassignment surgery to alter their registered gender on official public records. Public health insurance coverage for medical services is currently limited to psychotherapy.
But Aki Nishino, a representative of an association working for people with GID, expressed concern that the planned change may make it easier for people to undergo surgery even before they are able to come to terms with the possible repercussions.
Nishino, 31, said there are people who decide on surgery even without sufficient understanding of the potential aftereffects, thinking that all their worries will be solved with sex reassignment surgery. Some have later regretted their decisions.
To avoid this, Nishino said, “There is a need to ensure that the insurance coverage will lead to better treatment and support frameworks.”
Under the special law enacted in 2004, people with GID are allowed to change the way their gender is listed in their family registries if they fulfill several conditions, including undergoing sex reassignment operations. By the end of 2016, about 6,900 people had changed their gender.
Among GID sufferers, however, there are also those who choose not to have sex reassignment surgery so they can still bear a child.
According to a survey by the Japanese Society of Psychiatry and Neurology, the number of GID patients who have had treatment at medical institutions in the country totaled 22,435 by the end of 2015.
James E Windsor, Overpasses News Desk
January 27th, 2019