S HOULD TRANSGENDER people be sterilised before they are recognised? Earlier this year Japan’s Supreme Court decided that the answer is yes. Takakito Usui, a transgender man (ie, someone who was born female but identifies as male), had sued over a requirement that, to be officially designated a man, he has to have his ovaries and uterus removed (as well as have surgery to make his genitals look male, be over 20, single, have no minor children and have been diagnosed as suffering from “gender-identity disorder”). He argued that all this violated his right to self-determination and was therefore unconstitutional. The court disagreed.

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.

Critics of Japan’s laws also reject the notion that transgender people are 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 Junko Mitsuhashi, a professor and campaigner who studies the history of transgender issues. She is also a transgender woman who has not gained legal recognition for her gender, having been unwilling to undergo massively invasive surgery.

Japanese courts often seem more concerned with maintaining social harmony than defending individual 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.

Change is coming, however. The court in Mr Usui’s case did acknowledge that the law may need to evolve as society does. Polls suggest that Japan is becoming more liberal on many social issues. Over 70% of respondents to a survey in January said they were in favour of stronger legal protections for gay or transgender people. Almost no Japanese ground their objections to such rights in religion, as people often do in other countries.

In recent years a handful of Japanese towns and cities have introduced partnership certificates for same-sex couples. Some have gender-neutral bathrooms. A small number of firms are trying to be more welcoming to transgender people, as well as offering benefits to same-sex partners. Ms Mitsuhashi says she has had no problems at her university (in contrast, when she first came out as transgender, one of her employers at the time fired her). Nonetheless, Japan needs to be much readier to accept diversity in general, says Ms Ishii. The country can be donkan—“thick-headed”—about where the world is going, says Ms Mitsuhashi.