Japan’s Hiroshima High Court approved on Wednesday the gender change of a transgender woman who did not undergo the legally required gender confirmation surgery.

While the transgender woman was registered as a male on the family registry, she identified herself as a female. She faced legal challenges as Japanese law required individuals to meet certain conditions if they wished to change their gender on the family registry. For example, the Act on Special Cases in Handling Gender Status for Persons with Gender Identity Disorder previously required individuals to undergo surgery to eliminate reproductive functions and modify genital appearances to ensure the individuals’ appearances aligned with their registered genders.

The court questioned the constitutionality of the mandatory surgery requirement, noting that unconstitutionality may be present if surgery is always necessary for individuals to change their legal gender. The court acknowledged that forcing individuals to either undergo gender confirmation surgery or not to change their legal gender may constitute a violation of the Japanese Constitution. The court also stated that the transgender woman was allowed to change her legal gender to female without undergoing gender confirmation surgery as she had become sufficiently feminine through hormone treatment.

The transgender woman’s lawyer Kazuyuki Minami said that the court’s ruling laid out a framework for determining gender change requirements and that this would impact future rulings in Japanese family courts.

Critics of the decision to eliminate the surgery requirement for gender change expressed strong opposition. The Association to Protect Women’s Space asserted that male genitals do not become complete female genitals through hormone treatment. The association also said that a law should be enforced that disallows individuals with male genitals from using female spaces.

Similarly, the Association to Protect the Gender Identity Disorder Special Law expressed that legal gender change should only be granted if the individual undergoes gender confirmation surgery. The association stated that the ruling may cause confusion in society and adversely affect legal discussions.

Public awareness of sexual minority rights has been growing in Japan, the only G7 country that has not legalized same-sex marriages or civil unions. On October 25, 2023, the Supreme Court of Japan made a landmark ruling in which it held that a law requiring transgender people to be sterilized to legally change their gender was unconstitutional. In June 2023, Japan’s national legislature enforced a law stating that all citizens regardless of gender identity are to be respected as individuals with human rights.