Click to expand Image Participants at the Tokyo Trans March in Shibuya district of Tokyo, March 31, 2023. © 2023 Yuichi Yamazaki/AFP via Getty Images A court in Japan has ruled that the legal requirement that transgender people alter the appearance of their genitals to change their legal gender is unconstitutional. The September 19 ruling of the Sapporo Family Court in Hokkaido prefecture adds to the nationwide momentum to respect trans people’s fundamental right to legal recognition.Since 2004, transgender people in Japan who wanted to legally change their gender needed to apply to a family court. Under the Gender Identity Disorder Special Cases Act, applicants must undergo a psychiatric evaluation, be surgically sterilized, and “have a physical form that is endowed with genitalia that closely resemble the physical form of an alternative gender.” They also must be single and without children who are younger than 18.In a 2023 case before the Supreme Court, a transgender woman argued that the sterilization requirement violated her rights to pursue happiness and to protection against discrimination. The 15 justices ruled unanimously that “being forced to undergo sterilization surgery ... constitutes a significant constraint on freedom from invasive procedures” in violation of Japan’s Constitution. It was only the twelfth time in modern Japanese history that the Supreme Court had found a law unconstitutional.When the Supreme Court ruled against the sterilization requirement, it also asked a lower court to review the requirement to have “genitalia that closely resemble the physical form of an alternative gender.” In 2024, the Hiroshima High Court ruled that mandating surgery for the appearance requirement in legal gender cases could be unconstitutional. The court held that hormone treatment could satisfy the requirement. Since then,courts have issued similar decisions, under which trans women must show penile atrophy and trans men clitoral enlargement, making the appearance requirement effectively a hormone requirement. However, therecent Sapporo ruling affirms that requiring trans people to use hormones to change the appearance of their genitals also violates constitutional protections.Japan’s national parliament, the Diet, has been debating for two years how to implement the Supreme Court’s ruling. The Sapporo decision makes it clear that a resolution is urgent, and that it should align with international human rights and global medical consensus: legal recognition of gender should be separate from gender-affirming medical processes and should be based on individual choice.