People living with gender identity disorder hasn’t been able to use public health insurance for SRS in Japan, which usually costs more than a million yen. There are many people who cannot take the surgery because of that.
According to Ministry of Health, Labour and Welfare, approximately twenty- two thousand people have received medical examinations in the medical institutions, but only seven thousand of them could change the way their sex is listed in their family registries.(only 900 people could do so as of 2016.) Considering the fact that the social awareness of sexual minority has widely spread, Ministry of Health, Labour and Welfare has come to the conclusion that more discussions regarding SRS is needed.
If public health insurance were to cover SRS, people could take the surgery with 30% of the medical costs. Ministry of Health, Labour and Welfare is planning to exclude hormone therapy from the subject of public health insurance.
Ran Yamamoto, the representative of a support group that has strongly urged the government to allow SRS to be applicable to public health insurance for twenty years, expressed her joy saying “our hard work has finally paid off.” There has been many people who committed suicide knowing they couldn’t take sex reassignment surgery for financial reasons. There are some problems left regarding the safety of the surgery and regional discrepancies. “I hope people living with gender identity disorder will be able to have more access to medical institutions when they think about getting sex reassignment surgery”, Ran Yamamoto said.
On the other hand, there is also criticism to the current laws that prevent people from changing the way their sex is listed in their family registries.
“Making it easier for people to access sex reassignment surgery might create some pressure that forces them to take the surgery and change their sex on their family registries even if they don’t want to,” Minata Hara, the representative of “Kyoseinet”, a nonprofit organization working to provide support for LGBTQ people, said.
Mameta Endo, a female-to-male transgender activist, also criticized the current laws. “For transgender men, it is mandatory to undergo hysterectomy because of the current laws. There are many transgender men who have taken or will take the surgery just because it is mandatory. Whenever they think about marrying someone or getting a job, being a woman on their family registries always gets in their way, but they must take the surgery in order to change their sex on their family registries. Making it easier for them to undergo hysterectomy might lead more of them to take the surgery not because they want to, but because the laws force them to do so. I don’t think that is what we want. That is not self-determination at all. We can never discuss sex reassignment surgery right without discussing the current laws. ”