A Tokyo court is handling a rare case in which five women who want to stop their reproductive functions are fighting over their right to have sterilization surgery in Japan — currently banned under the Maternal Health Law.
The first trial hearing held Wednesday at the Tokyo District Court deliberated over the case in which Kazane Kajiya, 27, and four others filed a lawsuit against the state, arguing that the law infringes upon their constitutional rights by restricting a woman’s ability to make decisions about their own bodies. They are seeking ¥1 million in damages per person.
Growing up, Kajiya always felt disgusted by her fertile body and never wanted children. When she was near children, she would feel mentally distressed and experience palpitations.
Birth control pills, which made her lower body bloated, don’t help solve the emotional agony she feels about having reproductive functions.
She is married, and her husband, whom she regards as her greatest and only ally in her journey, is supportive of her choice not to have children.
But when she tried to undergo sterilization surgery, she was appalled to discover that it was illegal in Japan, unless medically necessary, leaving her with no choice but to go to the United States to have the operation last year.
Her surgery went smoothly with no complications, she said. Unlike in Japan, the doctor did not ask her intrusive questions such as: “Do you have children?” or “Do you have consent from your spouse?”
“I’m not asking (the state) to shoulder the cost (for the surgery). I’m not asking for your support,” Kajiya said in a statement submitted to the court on Wednesday. “I just don’t want you to take away my options.”
Kajiya said she filed the lawsuit so that others who feel the same way won’t have to go through the same difficulties she did.
In Japan, under the Maternal Health Law, sterilization surgery for women can only be performed on those who are at risk of endangering their lives due to pregnancy or delivery, or those who already have several children and whose physical health has been affected with each delivery.
Another requirement is spousal consent, including from a common-law husband. If the surgery is performed before the requirements are met, the offender may be subject to imprisonment for up to a year or a maximum fine of ¥500,000. The law also applies to men who want to undergo a vasectomy.
Another plaintiff, who goes by the pseudonym Reina Sato for privacy reasons, also read out a statement before the court, saying that she never wants to have children. She revealed that she is not attracted to either men or women.
“We are first and foremost human beings with a will, rather than women or maternal organs. My body is my body, not a ‘maternal organ’ for the state, and there should be no reason why the Maternal Health Law should prohibit sterilization for the protection of maternal organs,” she told the judges.
According to the plaintiffs’ legal team, the conditions stipulated in the maternal law for sterilization surgery originated from a prewar eugenic law, aimed at reducing the number of people with recessive genes so that there would be more people with “better” genes, but also to prevent people from having contraceptive operations and abortions, which would decrease the size of the overall population.
After World War II, concerns about overpopulation led to the law being replaced by the Eugenic Protection Law, which eased regulations on sterilization operations and abortions to control the population while maintaining its “quality” — often targeting people with disabilities.
In 1996, the Eugenic Protection Law was replaced with the Maternal Health Law, removing some provisions deemed discriminatory toward people with disabilities. However, several conditions have remained unchanged on sterilization surgery: spousal consent; medical reasons; and penalties.
Yoko Matsubara, a professor of bioethics and vice president at Ritsumeikan University, said the Maternal Health Law, drafted nearly 80 years ago, should be revised since the law is aimed at protecting doctors from being criminally implicated from performing such surgeries, rather than from the viewpoint of women.
“The current Maternal Health Law is not based on the idea that people, both women and men, would make their own decisions about sterilization or abortion as part of their reproductive rights,” she said.
However, Matsubara added that performing an irreversible sterilization surgery on a healthy body could still be controversial.
“Allowing sterilization procedures, regardless of gender, based on one’s own will requires substantial debate and consideration,” she said.
