When Jade Dragon Tai was in middle school, her mother often joked that she couldn’t wait to see the faces of her future grandchildren. Ms. Tatsuta, 24, a model in Tokyo, cringes at the thought of one day giving birth.
As her body began to develop female characteristics, Ms. Tatsuta adopted extreme diet and exercise to prevent the changes. She began to think of herself as genderless. “I don’t like being seen as a fertile womb before being seen as a human being,” she said. Eventually, she hopes to be sterilized to eliminate the chance of pregnancy.
In Japan, however, women seeking sterilization procedures such as tubal ligation or hysterectomy must meet one of the most onerous conditions in the world. They must already have a child and prove that the pregnancy would endanger their health, and a spouse’s consent is required. That makes such surgery difficult for many women, and even more impossible for single, childless women like Ms. Tatsuta.
Now she and four other women are suing the Japanese government, saying the decades-old Mother Protection Act violates their constitutional rights to equality and self-determination and should be overturned.
At a hearing at the Tokyo District Court last week, plaintiffs’ lawyer Michiko Kameishi described the law as “overly paternalistic” and said it “assumes we believe women’s bodies are destined to be mothers.”
Ms Kameishi told the three-judge jury, made up of two men and one woman, that the conditions for voluntary sterilization were a relic of a different era and that the plaintiffs wanted to “take an important step towards living the life of their choice”.
Japan lags behind other developed countries in reproductive rights other than sterilization. Neither birth control pills nor IUDs are covered by National Health Insurance, and women seeking abortions must obtain their partner’s consent. A survey by the Japan Family Planning Association shows that the most common method of birth control in Japan is condoms. Less than 5% of women use birth control pills as their primary method of preventing pregnancy.
Plaintiffs in the sterilization cases, which are also seeking 1 million yen (about $6,400) each in interest, face considerable obstacles, experts say. As they fight for the right to sterilize, the government is also working to increase Japan’s birth rate, which has fallen to an all-time low.
Yoko Matsubara, a professor of bioethics at Ritsumeikan University, said: “For women who are able to have children, if they stop having children, it is seen as a step backward for society.” “Therefore, the lawsuit may be difficult to gain support.”
Last week, as five female plaintiffs sat across the court from four male government representatives, Miri Sakai, a 24-year-old sociology graduate student, testified that she had no interest in sexual relations, romantic relationships or having children.
While Japanese women have made some progress in the workplace, cultural expectations about their family responsibilities remain the same. “The lifestyle of not getting married and not having children is still socially ostracized,” Ms. Sakai said.
“Is it natural to have children for the country?” she asked. “Are women who don’t have children themselves unnecessary to society?”
Sterilization is a particularly sensitive issue in Japan because the government has long forced people with mental illness or intellectual and physical disabilities to undergo sterilization.
Sterilization has been practiced for decades under a 1948 measure called the Eugenics Protection Act. In 1996, the act was amended and renamed the Maternal Protection Act, removing the eugenics provisions, but lawmakers retained strict requirements for women who wanted abortions or sterilizations. Despite pressure from advocacy groups and women’s rights activists, the law has remained unchanged since it was revised in 1996.
In principle, the law also affects men seeking vasectomy. They must obtain their spouse’s consent and prove that they are the father and that their partner would be at risk from the pregnancy.
However, experts say that in practice, there are far more clinics in Japan that offer vasectomy for women than sterilization.
In 2021, the last year for which statistics are available, doctors performed 5,130 sterilizations on men and women, according to government figures. There is no breakdown between genders.
The Agency for Children and Families, which enforces the Maternal Protection Act, said in a statement that it could not comment on the lawsuit.
Kazane Kajiya, 27, testified last week that her desire not to have children was “part of my innate values.”
“Because these feelings cannot be changed, I just want to live and alleviate my physical discomfort and psychological distress as much as possible,” she said.
In interviews before the hearing, Ms. Kajitani, the translator, said her aversion to having children was linked to broader feminist views. From a young age, she said, “I witnessed the male dominance across the country and society at large.”
Ms. Kajitani, who is married, once wondered whether she was really transgender. But she considers herself “totally okay with being a woman, and I like it. I just don’t like having the ability to have children with a man.
The entrenched rule of Japan’s right-leaning Liberal Democratic Party, as well as the country’s deep-rooted traditional family values, have hindered progress in reproductive rights, said Yukako Ohashi, an author and member of the Women’s Reproductive Freedom Network.
Ms. Ohashi said in a video interview that the name of the Maternal Protection Act speaks volumes. “Women who are going to be mothers should be protected,” she said. “But women who don’t become mothers will not be respected. This is Japanese society.
Even in the United States, where any woman 21 or older can legally seek sterilization, some obstetricians and gynecologists advise patients not to have it, especially if the woman has not yet given birth.
Likewise, in Japan, the medical profession “is still very patriarchal ideologically,” said Lisa C. Ikemoto, a law professor at the University of California, Davis. Doctors “operate like a cartel to maintain certain social norms”.
Women themselves are often hesitant to go against social expectations due to the intense pressure to conform.
“A lot of people feel it’s selfish to try to change the status quo,” Ms. Tatsuta, a model and plaintiff, said shortly before last week’s hearing. But when it comes to fighting for the right to make choices about one’s own body, she said, “I want everyone to be angry.”
