Transgender individuals need to be “sterilized” if they want their gender changed legally. Endorsed by Japan’s Supreme Court, this law otherwise known as Japan’s Law 111 of 2003, demands that transgender aspirants for gender affirmation “permanently lack functioning” reproductive organs, or to be sterilized.

In the case of Takakito Usui, the Supreme Court rebuffed his legal claim as he sought to legally change his gender. Usui hoped to overturn Japan’s Law 111 of 2003 which likewise required a completed gender reassignment surgery for gender to be changed legally. However, the Supreme Court did say the law was all-encompassing and must be reassessed.

“It is unthinkable in this day and time that the law requires a sex-change operation to change gender,” Usui’s lawyer Tomoyasu Oyama said in a statement to media.

Tomoyasu elaborated how Law 111 had become a ‘give and take’ scenario for the LGBT community on the issue of transgender rights. “When the law was established 15 years ago, LGBT people had to make a bitter decision and swallow the conditions to pave a narrow way for official change of gender,” he said.

At the start, the law was crafted to avoid what the court portrayed as “confusion” and rapid societal changes. From the time the law was ratified, there had been 7,000 individuals who have changed their legal gender.

Human Rights Watch has strong words for the said Japanese Law. The group calls it as “abusive” and “discriminatory” because to qualify for official gender change in Japan, applicants must not only be sterilized but must also be single, have no children under the age of 20, and must undergo a psychiatric evaluation to be diagnosed with Gender Identity Disorder.

In a letter to the United Nations on legal recognition of transgender people in Japan, the group asserts that “These conditions—and in particular the maltreatment many transgender people must accept in order to meet them—also amount to cruel and inhuman treatment and to a violation of transgender people’s right to health.”