Five women launch lawsuit in Tokyo for right to undergo voluntary sterilisation in Japan

If you're a woman in Japan who wants surgery to prevent having kids, you better ask your husband first. 

Women face up to a year in prison or a ¥500,000 ($4,800) fine if they have a sterilisation procedure without their spouse's consent, according to public litigation group LEDGE.

Even then, it is only allowed under strict conditions, such as if a woman's life is in danger or they already have several children and another would impact their health.

For Reina Sato, a woman who has never wanted kids, that is unacceptable.

"I just wanted to remove my capability for pregnancy from my own body. So why do they decide about my body?"

Ms Sato is one of five women fighting to reclaim their bodies through a lawsuit launched in Tokyo this month.

But the fight is not just about the law: it's about Japan's economic future, approach to child care, and dark history.

What's this lawsuit about?

Sterilisation is a permanent but possibly reversible form of birth control.

For men it includes procedures such as a vasectomy, which blocks the flow of sperm, while women can get their fallopian tubes "tied" to prevent fertilisation.

Human rights lawyer Michiko Kameishi, who is leading the lawsuit, said the restrictions on sterilisation under Japan's Maternal Health Act "violate the rights of individuals to self-determination".

She said it had roots in legislation from the 1940s, when Japan's civil code restricted the rights of married women to make decisions.

"More than 80 years later, the family system is no longer in place and the importance of reproductive health and rights is shared worldwide," she said.

"Yet, the prohibition of sterilisation and requirement for the husband's consent remain."

The law has little regard for women without partners, or married couples who do not want kids.

Ms Sato joined the lawsuit after being unable to afford a sterilisation procedure overseas.

"I feel uncomfortable with having a reproductive capability, so feel uncomfortable with my own body," she said.

"As a woman, I don't want to have the capability."

Another plaintiff, Hisui Tatsuta, has long been haunted by the pressure to provide grandchildren and said it caused her to develop "a strong aversion to my body maturing in high school".

"People who have had a similar childhood to me or people who want to save children like us will understand," she said.

"I want to be respected as a human being. I want to live, not as someone's daughter or someone's mother."

Why does Japan even have these laws?

The legislative approach to sterilisation can be traced to the 1940 National Eugenics Law, which was introduced during the rise of the Japanese empire to help grow the population and eliminate genetic traits seen as "undesirable".

After World War II, it was replaced by the 1948 Eugenics Protection Law, which placed a greater emphasis on maternal health while retaining eugenics principles.

That paved the way for the sterilisation of 25,000 people over the century, many forced into the procedure against their will and some without their knowledge.

People with disabilities, mental illness and children as young as nine had their chance at starting a family snatched away, while sterilisation for non-eugenics purposes was restricted.

After decades of anger and advocacy, the Japanese government apologised and provided ¥3.2m ($31,000) in compensation to victim-survivors.

But while the Eugenics Protection Law was repealed in 1996, the restrictions on voluntary sterilisation live on through the Maternal Health Act.

Ms Kameishi sees a parallel in the way the law has treated women through both forced and voluntary sterilisation.

"The decision to have a baby or not is one of the most essential rights that affect how you want to live your life," she said.

"So it is the same issue."

What does this have to do with Japan's economic crisis?

While lawyers battle it out in the courtrooms of Tokyo, Japanese women are fighting a crisis in society.

Japan has one of the lowest birth rates in the world, leading to the existential threats of population and economic decline.

Ms Sato said women who do not have children, or are seen as not having enough children, are often blamed for the population woes, rather than other factors such as low migration, a demanding corporate culture and the high cost of raising children.

"They think the problem is happening because of people like me, young women, are being too selfish," she said.

"I almost feel like it's taboo to say that I don't want to have baby."

Ms Kameishi said despite the increase in working couples, there was insufficient support to ensure working mothers as well as fathers can take care of children.

"There is a strong sense that mothers should do the child-rearing," she said.

"We need to break free from such thinking."

Is there any appetite for change?

The restriction on voluntary sterilisation is just one of many fronts in the battle for gender equality in Japan.

Japan has one of the widest gender pay gaps in the OCED — 22 per cent — and women are greatly under-represented in leadership positions.

However, the country is making progress: Japan has closed its pay gap by 6 per cent since 2010 and in 2019 introduced free child care for 3- to 5-year-olds.

Ms Kameishi said there had been much discussion about reproductive autonomy in recent years and "a large fringe of Japanese society is pushing for change".

But she said patriarchal values remain strong and it's tough to lobby a government dominated by "older men".

"There are many other issues in Japan, such as making all abortion pills available at pharmacies, and eliminating the need for a husband's consent to undergo abortion surgery," she said.

"No matter how much women speak out, changing the law through politics is very difficult."

Ms Sato remains hopeful the sterilisation law will be changed, even though experience has taught her she "cannot expect a lot".

She says this lawsuit is not just about her, but every woman.

"Our claim is very simple: we want to decide our own future and take control of our own bodies," she said.

"It's not complicated."