A transgender woman who identifies as a man has sued Japan's Supreme Court over a ruling earlier this year that requires sterilization before the state will officially recognize someone as the opposite gender, reports The Economist.

Takakito Usui has sued the court over the requirement that in order to be recognized as a man, she has to have her ovaries and uterus removed, as well as have surgery to turn her vagina into a penis. Applicants must also be over 20-years-old, single, have no minor children, and have been diagnosed as suffering from "gender-identity disorder."

Takakito Usui

Usui has argued that this violates a person's right to self-determination and is therefore unconstitutional.

Human-rights groups say demanding irreversible surgery is outrageous. Although several Asian countries, including South Korea, have similar laws, Western countries that once also used to require sterilisation, such as Norway, France and Sweden, no longer do. In 2017 the European Court of Human Rights called for the change in all 47 countries under its jurisdiction. Sweden has started to compensate transgender people who underwent mandatory sterilisation. -The Economist

Critics have argued that transgender people are not suffering from a psychological disorder. "The movement here has not been viewed as about rights but more about helping sick people overcome their illness," says activist and professor Junko Mitsuhashi, a biological man living as a woman who studies the history of transgender issues, yet has not gained legal recognition as a woman due to an unwillingness to undergo gender reassignment surgery.

Of note, transgenderism - also known as Gender Dysphoria, is classified as a mental disorder by the Fifth Edition Diagnostic and Statistical Manual of Mental Disorders (DSM-V), published by the American Psychiatric Association.

As the Economist notes, Japanese courts seem to be more concerned with maintaining social harmony than defending an individual's rights.

In its ruling, the court said that the law was intended to avoid “confusion” and “abrupt change” to society. Yukari Ishii, a researcher at Toyo University in Tokyo, says that whereas in America and Europe long campaigns for gay rights paved the way for transgender people to call for more equitable treatment, Japan is further behind. Japanese society is patriarchal and retains strong gender stereotypes, she says. -The Economist

That said, the court did note in Usuri's case that the law may need to "evolve" along with society. Recent polls have suggested that Japan is gradually becoming more socially liberal, with over 70% of respondents in a January survey saying they are in favor of stronger legal protections for gay and transgender people. Most Japanese do not ground their objections to such rights in religion, as is the case in many other countries, according to the report.

Evidence of Japan's shift towards liberalism is a handful of Japanese towns and cities which have introduced same-sex partnership certificates, while a handful of Japanese businesses have become more friendly to people with alternative lifestyles.