TOKYO (Reuters) - The stabbing deaths of 19 disabled people in their sleep last July and the silence surrounding their identities are forcing Japan to grapple with its attitudes toward physically and cognitively impaired persons, less than four years before Tokyo hosts the Paralympics.

Almost nothing except their genders and ages - ranging from 19 to 70 - has been made public about those who died when a man went on a stabbing spree at a facility for disabled people in Sagamihara town, southwest of Tokyo, killing 19 and wounding 26.

The silence has sparked debate about the need for change in a society where people with disabilities can still suffer stigma and shame.

“It is true that some may not have wanted their children to be subjected to public scorn,” said Takashi Ono, stepfather of 43-year-old Kazuya, a long time resident of the Tsukui Yamayuri-en facility who survived multiple stabbing wounds in the attack.

Ono and his wife Chikiko are among the few relatives who have gone public. None of the families of the dead has done so.

“In Japan, disabled people are discriminated against so the families wanted to hide them,” Ono told Reuters in an interview, adding he and Chikiko had always been open about their son, who has autism and cognitive disabilities.

Japan has made progress in its treatment of the disabled. It ratified a U.N. rights treaty in 2014 and a new anti-discrimination law took effect in April. Prime Minister Shinzo Abe regularly mentions the disabled when speaking of plans for a more inclusive society to cope with a shrinking population.

But people with disabilities, especially cognitive impairments, can still suffer from stigma and - unlike in many advanced Western countries - their families share the shame.

In a statement released to Japanese media after July’s stabbing spree, police in Kanagawa prefecture, where the facility is located, said that they did not release the victims’ names because it was a facility for cognitively disabled people and they needed to protect the families’ privacy.

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They also said the victims’ families had requested special consideration about how the matter was reported.

SECRET SHAME

Seiko Noda, a prominent ruling party lawmaker who has suffered abuse on the internet for “wasting taxpayers’ money” on medical care for her five-year-old disabled son, Masaki, was not surprised that the Sagamihara victims’ families chose anonymity.

“Some families are positive and try to change the world by being open about their disabled children. But the ‘silent majority’ still has a negative view and does not want it known that they have disabled children,” Noda, 56, told Reuters.

Victims’ families likely also worried about being accused of abandoning their relatives by institutionalizing them, experts and activists said.

The identity blackout stands in stark contrast to coverage of other Japanese victims of mass killings, including seven who died in a July attack by Islamist militants in Bangladesh.

“Clearly, there is a difference in the treatment of those with disabilities and those without disabilities,” said Kiyoshi Harada of the Japan Disability Forum, an NGO network.

“We cannot tell what sort of lives the victims led, what their hobbies were, what their existence was like.”

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The suspect in the Sagamihara killings, Satoshi Uematsu, had been briefly committed to hospital as a danger to himself and others after writing to a lawmaker advocating euthanasia for the severely disabled and outlining a plan for mass murder.

Some who work with disabled people worry ordinary Japanese share Uematsu’s extreme views but experts say they are not mainstream.

Neither euthanasia nor assisted suicide is legal in Japan.

Efforts to pass a law protecting doctors who withhold life-prolonging care with the patient’s consent have stalled in the face of stiff opposition from disabilities rights groups, who fear it could be a first step to legalizing euthanasia.

Those with cognitive disabilities, like residents of the Sagamihara facility, face greater discrimination than the physically impaired, who activists say have seen major progress in recent decades.

Disabled people in rural areas also face greater hurdles to integration than residents of cities, where there is a trend toward care in small group homes away from large, isolated institutions that have increasingly come under criticism.

“Some things do trickle down from the big city but it takes a while,” said Suzanne Kamata, an American living in Tokushima, about 500 km west of Tokyo, whose 17-year-old daughter is deaf and has cerebral palsy.

Preparations for the 2020 Paralympics are providing impetus for an improved barrier-free environment, at least in Tokyo, where Tokyo Metro aims to have all subway stations equipped with multi-purpose elevators by March 2019, up from 81 percent now.

Optimists say the debate itself over the Sagamihara victims’ anonymity gives cause for hope.

“It was a bitter incident, but it is important that it is becoming a trigger for people to think about this seriously,” Japan Disability Forum’s Harada said.