The Supreme Court of Japan has rejected the case of a trans man who wanted to be legally recognized as such without undergoing sex reassignment surgery, which includes sterilization.

The current legislation regulating the path for legally changing a person’s sex was adopted in 2003 and has strict requirements. To qualify, a person must be at least 20, unmarried, and have no underage children. He or she must also undergo surgery to reconstruct his or her genitals to match the preferred sex, which involves removing the original sex glands – effectively, sterilization.

On Wednesday, the Supreme Court passed a ruling on the case of Takakito Usui, who wanted to be legally recognized as male without losing reproductive ability.

“The law is not fit to cover all cases because the circumstances surrounding people dealing with gender identity issues are widely varied,” Takakito explained back in 2017. “I hear some people who underwent operations came to regret them.”

The essential thing should not be whether you have had an operation or not, but how you want to live as an individual.

The four-member court, however, ruled that the law does not violate the nation’s constitution. Presiding justice Mamoru Miura said the legislation was designed to prevent the social confusion which is bound to arise once gender-switching people start giving birth or fathering children.

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Two of the justices said in their opinions that the law may eventually be successfully challenged, since the argument that it violates the constitutional right to not be physically harmed has merit. The issue also has an impact on society, they said.

“Suffering related to gender, felt by people with gender identity disorder, is also the problem of society as a whole, which should encompass the diversity of sexual identity,” the additional opinion said.

Medical technology today is limited in how much a human body may be changed to conform with the preferred sex of an individual. One cannot be born with a male body and have it transformed into a female body capable of childbirth, or vice versa. Many advocates of LGBT rights say people must be allowed to choose their legal sex regardless of physique.

The requirement for trans people to undergo surgery to have their transition legally recognized is not unique to Japan. Similar requirement are in place in some European countries, although LGBT groups are working on challenging such laws.

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