Transgender people who haven’t been allowed to change gender on family registry are now allowed to use an alias on their health insurance card.

A transgender woman who underwent a sex- change operation and runs a company in Kyoto city consulted with the national health insurance association in Kyoto about using her female name on her health insurance card. The association allowed her to do so. She is the first woman in Japan that is allowed to use an alias on a document as formal as an identification card such as a health insurance card.

The transgender woman, who’s in her 50s, was diagnosed with gender identity disorder in 2012 and underwent a sex-change operation in 2014. However, she was not allowed to identify herself as a woman on her family registry because she has children. Although she lives her life as a woman using her female alias, her gender status remained the same. That occasionally caused her to encounter stressful situations. For example, she was often called by her original male name written on her health insurance card. She was once told “not to use someone else’s health insurance card” when she visited a hospital. What’s more, she was often taken to men’s changing room for medical checkups. Those stressful situations made her consult with the national health insurance association and ask for the permission to use her alias when she visits a hospital.

The association referred her inquiry to the Ministry of Health, Labor and Welfare. The ministry responded to the inquiry positively. Last August, she received a new health insurance card with her female name on it.

“I have been treated unfairly at hospitals, but now I’m relived to know I can go to a hospital without worrying about it. This is the first step for me to be who I really am. I can use my health insurance card as an official ID card. There are many transgender people out there who have given up receiving a sex-change operation, but I want them to know about me and my case. I hope what I did for myself will make a change.” The transgender woman said.

※ According to Act on Special Cases in Handling Gender Status for Persons with Gender Identity Disorder, a transgender person must meet all the following conditions to change gender on his or her family registry. (1) is not less than 20 years of age. (2) is not currently married. (3) currently has no child who is a minor. (4) has no reproductive glands or whose reproductive glands have permanently lost function; and (5) has a body which appears to have parts that resembles the genital organs of those of the Opposite Gender. (4) and (5) mean a sex-change operation must be done to meet the conditions. Japan is the only country that requires transgender people not to have a child. Many transgender people criticize the system that denies insurance aid and requires a sex- change operation in spite of the high cost.