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JUMBLED GENDER:
Woman Undergoes Japan's First Legal Sex-Change Operation

November 30, 1998

On October 16, 1998, the first legal sex-change operation in Japan was performed at Saitama Medical College in Kawagoe, a northern suburb of Tokyo, on a female patient diagnosed with gender identity disorder--a condition in which a person's psychological identity does not match the anatomical sex. Many societal and other hurdles remain to be cleared before transsexuals can lead fully normal lives in Japan. But reaction to the operation among experts has generally been positive, and forces favoring similar operations in the future are gaining momentum.

Breaking a Taboo
Sex-change operations--also called sex reassignment surgeries--were regarded as taboo in Japan for many years, but in 1997 the Japanese Society of Psychiatry and Neurology drew guidelines for diagnosing and treating gender identity disorder, or GID, permitting such operations under certain conditions. A gender clinic committee at Saitama Medical College, made up of experts from such fields as psychiatry, gynecology, and plastic surgery, met to discuss the possibility of performing a sex-change operation and concluded after careful diagnosis to give its go-ahead.

The patient who underwent the operation in October--the first of two operations, with the second to follow in six months--was a woman in her thirties. She began receiving psychiatric counseling and doses of male hormones at the college's medical center in 1992, and has been living socially as a man. In a note she released to the media before the operation, she commented: "I always believed that one day I would be able to go through with surgery here in Japan. I am overcome with emotion, and am basking in the realization that I can finally have a body that rightly belongs to me. There are many people who live with similar problems, and I strongly hope that we can all learn to live with one another by respecting our individual differences."

Tackling Social and Legal Problems
Today, there are said to be several thousand Japanese people with GID. Domestic research on this subject is, however, considerably behind that in Western countries. The gender clinic at Saitama Medical College is the country's only specialized medical team for treating GID patients. Many problems remain concerning societal acceptance of people who undergo sex-change operations: Not only do they face prejudice and discrimination, but they are also prevented from changing their gender listing under the current Family Registration Law. "The dark ages are over at last, but the light that is now filtering in has exposed many new problems in the way society deals with this issue," says a member of a mutual-support group of people with GID. "We'll have to go about tackling them one by one."

Saitama Medical College's groundbreaking operation has sparked a flurry of activity to promote understanding and recognition of GID in Japan. People with GID themselves have begun to speak out, such as by holding public symposiums. Takao Harashina, the chief surgeon for the October operation, and others plan to launch in March 1999 an organization whose mission is to create a network that would enable GID patients to receive treatment and sex-change operations in medical centers throughout the country. And although legal revisions have yet to be made, two requests to change names for reasons of incompatibility with the applicants' gender identity have been approved at family courts in 1998. Improvements may be slow in coming, but they are surely on their way.

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Trends in JapanEdited by Japan Echo Inc. based on domestic Japanese news sources. Articles presented here are offered for reference purposes and do not necessarily represent the policy or views of the Japanese Government.

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