Stonewall Japan’s Trans* Guide to Japan 2016

CONTENTS:
1. Foreword
2. Quick Guide
3. Legal Issues
4. Employment
5. Medical Issues
6. Trans-specific: Differences between Japan and the West

1. Foreword
Dear Reader,“In the past 10 years, the concept of transgender [in Japan] has completely changed. It used to be afreak issue, but not anymore. Now it’s a human rights issue.”-Aya Kamikawa
I think Kamikawa, the first transgender person to ever hold office in Japan (who, incidentally,
continues to hold it in to her third term when this foreward was written), puts it perfectly. In the years
following the groundbreaking GID Act she triumphed, the awareness and public image of thetransgender individual has transformed with the bodies and lives of the many people who haveundergone legal and physical transition. And it wasn’t only since 2003, the year the bill passed intolaw. Public opinion and media presentation of the trans* person in Japan has been shifting since thelate 1990s; arguably, most of these shifts have been toward more awareness, inclusion, and support.
However, while no longer a ‘‘freak’’ issue, this country does not have a perfect record of protecting awide variety of human rights, from trans rights to the rights of women to those of the many immigrants
living and working in Japan. Plus many of the strides made in the arena of trans rights have passed
over a large demographic of those who need it most- trans individuals that, due to a lack of Japanese,cannot access the support structures and information that has been built up in the last two decades.
This Guide seeks to remedy that situation. Stemming from a seed of personal need as I struggled tosort through the scattered, contradictory information available in English myself, its completion is not
only testament to the wide variety of resources already available in Japan, but also the strong,
supportive community that watered that seed and let it grow.
I want to personally thank Kim Oswalt, Toby Siguenza, and the many trans folk who reached out andshared their stories, humor, and vast hordes of knowledge. Without them, I would still be googling‘‘new half’’ like a newb. I also want to thank you for your interest in this project, be it personal, political,
or sheer curiosity that drives you to read on and learn. With everyone who understands their rights a
bit better, the history of how these victories were won and the work that still needs to be done, there isa strength that ignorance and fear dare not challenge.
And I challenge you, trans* and ally alike, to take that newfound strength and make it threefold. Livewith integrity to who you are and become a resource to others, be it through joining some of thecommunities of activists listed in these pages or just being available to the people you encounter inyour time in Japan. There are still many out there, Japanese and foreigner, child and adult alike, who
need this information and more than that, an ally they can turn to for support. Trans rights are humanrights; the more free transgender people are to express their own selves in society, the more free weare as a whole to go beyond the pink and blue boxes that keep us tethered in fear and live fully as notjust men or women, but individuals, colorful beyond imagining in our humanity. By not hiding andletting your own colors shine through, you are stretching those boxes just a little more. One day,they’ll be wide enough to show the panorama of who we are and, if we can unite together, what wecan become.
Thank You,Skyler Smela

2. Quick Guide
1. Assuming a start from square one, start seeing a medical professional for GID diagnosis.
2. Join a union and make sure they understand your situation. If you are on the JET program, do
the same with your PA and local CIR. It is also a good idea to contact the ​CLAIR line​ and let
CLAIR know that you will be transitioning.
3. Slowly start feeling people in your immediate circles out for potential allies
4. Once diagnosed, apply for a transgender visa (changing your gender marker on your visa /passport) if your country offers one. The US is one of these countries. For instructions on how
to apply, click ​here​. See bottom for list of countries that allow transgender visas.
5. After your visa is corrected, make sure to have your Residence card (在留カード) changed
to reflect that correction. For instructions on how to change your residence card, click​ ​here​.
You will need to visit your nearest​ ​regional immigration bureau​ to do so.
6. Talk with your contracting organization. I recommend doing this about 2 weeks before avacation period. Bring them a diagnosis as well as resources to help them understand yoursituation in Japanese (link to the Ministry of Health, Welfare, and Labor page on GID​ ​here​).
Provide examples of companies having trans-employees without incident. ECC and NOVA
are two private English schools that employ trans-employees. Large and international
companies are much more likely to be accepting of this– you may find yourself moved to a
new section or transferred for a ‘fresh start’ but that’s about it. For JETs, the reaction varies
depending on the BoE, but having allies at your school, at the prefectural level, and at CLAIR
will intimidate even the most bigoted of BoEs.
7. Find a clinic or doctor that will start you on hormone therapy. For a list of good doctors/clinics
for HRT, click ​here​ or see ​below​.
Countries where transgender visas are allowed:*Note: Countries in BOLD may require applicants be post-SRS to be eligible.
UK, Australia, New Zealand, Mexico, CANADA (unless you were born in Ontario!​ ​1​), USA, JAPAN,
Portugal, Spain, Germany, Austria, Iceland, Hungary, Poland, Sweden, Estonia, Uruguay, Argentina,
Cuba, South Korea, Chile, Nepal (third gender), Pakistan (third gender), BRAZIL, HONG KONG,
TAIWAN, CHINA, COLOMBIA, FRANCE, ITALY, SWITZERLAND, BELGIUM, THE NETHERLANDS,CZECH REPUBLIC, CROATIA, GREECE, TURKEY, DENMARK, NORWAY, FINLAND, CHILE,LATVIA, RUSSIA, UKRAINE, ROMANIA, MOLDOVA, GEORGIA, AZERBAIJAN, BULGARIA,SERBIA, SINGAPORE, SLOVAKIA, SLOVENIA, SOUTH AFRICA (in some cases, just HRT will
suffice), IRAN, ​ECUADOR ​(court granted, no unified criteria), ISRAEL
Useful Links: ​Gender Recognition Approved Countries List
​European Trans* Rights Map​Gender Identity Expression Laws Map

3. Legal Issues●

Legal Issues●

Name Change
Official Name Change
Legal Alias●

Gender Change
Japanese Nationals
Non-Japanese Nationals●●●

The GID Bill
Medical Illness Status
Legal Status of Trans* Individuals
Legal Protections
Safety, Conflict and Violence in Japan

Legal Issues
The legal issues surrounding being trans in Japan differ drastically depending on whether or not you
are a Japanese citizen.
In Japan, a person’s legal existence is determined by their 戸籍 (koseki), the Japanese family registry.
The document records all births, adoptions, marriages, as well as one’s legal name and gender. It
also acts as a de facto statement of citizenship. Without it, you cease to be a person in the eye of thelaw. Luckily, non-Japanese nationals have the 在留カード(zairyuu ka-do), otherwise known as the
Residence Card to make sure we retain our humanity. If you do have Japanese citizenship, a change
to your koseki will require something very different than a change to the residence card of a
non-national. The process for both will be detailed below.
Name Change
In Japan, changing one’s name can prove both easier and more difficult than in your country of origin.
Official ​name change is definitely more of a hassle. Because of the lack of a koseki, very official
documents such as your residence card will only be changed once the change has taken place inyour home country and your documents (such as passports, etc.) reflect that change. However, thereis the option for a ‘legal alias’ that often proves more than adequate.
Official Name Change:
In order to change your name on your residence card, you must first change it in your country oforigin. Depending on the country and the locality, the process will be different. Often it involves time,money, and the ability to actually show up to court hearings. However, if you opt for this route andsuccessfully change it in your country of origin, changing one’s name is simply a matter of pointing out
the discrepancy in your local immigration office and waiting for your corrected zairyuu card.

Legal Alias:
If you cannot or opt not to change you name officially, you can still have your preferred name written
on bank accounts, 住基カード (juki ka-do, basic resident registration card), and other official
documents like a corporate insurance card. The process is simple. Go to your local ward office or city
hall and ask to make a 通称名 (tsūshōmei), a legal alias. Many non-Japanese nationals living in Japan
elect to do this even if they are not trans* in order to have a Japanese name that won’t give away theirstatus as foreign nationals. You will need proof that the alias is in common use. This proof varies
depending on how much of a stickler the person you get at the office is. You may be asked to provide
multiple official documents (such as contracts, bills, etc.) which use your preferred name from at least
3 years back. If this is hard to obtain, an employment certificate (在職証明書, zaishoku shōmeisho)with the alias or a letter drafted from your place of work stating that the name is in use (and makes
company paperwork less complicated, etc.) should do in a pinch. Regardless, you should provide as
much proof as possible about the veracity of the alias such as bills, correspondences, etc. (Wouter)
Gender Change
Japanese Nationals​:
Prior to 2003, it was impossible to change your legal gender in Japan. The Gender Identity act,
proposed by Aya Kamikawa, first trans individual to ever hold office in Japan, changed all that.
Japanese nationals were able to change their gender on their koseki for the first time and since thenalmost 4,000 individuals have​ ​done so​. This is still rather few considering that in 2007 alone, around
5,000 transgender people visited medical offices in Japan (Harima). This may be explained, however,by the qualifications one must meet in order for the change to take place.
In the GID act, there are a variety of stipulations that can disqualify you from legal gender change.
The full passage from the act has been reproduced below.
Act on Special Cases in Handling Gender for People with Gender
Identity Disorder (Japan) Law No. 111 of 2003 (Effective July. 16, 2004)
Article 1: Purpose
This Act provides the statutory handling of special cases for people with Gender Identity Disorder.
Article 2: Definition
In this Act, “Gender Identity Disorder” means a person, despite his/her biological sex being clear, who
continually maintains a psychological identity with an alternative gender (hereinafter, “alternative
gender”), who holds the intention to physically and socially conform to an alternative gender, and who
has been medically diagnosed in such respects by ​two or more physicians​ generally recognized asholding competent knowledge and experience necessary for the task.
Article 3: Procedure to Change the Treatment of Gender
1. The Family Courts are authorized to adjudicate a change in the handling of gender upon theapplication of a person with Gender Identity Disorder who fulfills the following requirements:
i. The person is 20 years or older;ii. The person is not presently married;

iii. The person does not presently have a minor child;
iv. The person does not have gonads or permanently lacks functioning gonads; andv. The person’s physical form is endowed with genitalia that closely resemble the physical form of analternative gender.
2. In making an application as provided for in the previous section, an applicant must submit medical
certification indicating the applicant’s status as a person diagnosed with Gender Identity Disorder as
provided for in Article 2 above and other matters as may be provided for by Ordinance of the Ministryof Health, Labour, and Welfare, including but not limited to the progress or results of any medical
treatments.
Article 4: Statutory Handling of People Adjudicated to have Changed Their Gender
1. People who are adjudicated to have changed their gender, except as may be specifically provided
otherwise in the laws, are regarded as having changed to an alternative gender in the application of
the Civil Code (Law No. 89 of 1896) and all other laws and regulations.
2. Except as may be specifically provided otherwise in the laws, the provisions in the previous section
shall not affect personal status and/or any rights and obligations arising prior to the adjudication of
having changed one’s gender.
Article 5: Application of Domestic Relations Trial Act
In the application of the Domestic Relations Trial Act (Law No. 152 of 1947), the adjudication of aperson’s change in gender is regarded as a listed matter included in Article 9, Section1 thereof.

Being medically diagnosed by two physicians as suffering from G.I.D. is not a difficult stipulation.
There are many good psychologists you can find in the mental health section of the Guide who candiagnose you and the counseling sessions are generally covered by National Health Insurance. Like
most countries, you must live as your desired gender for at least a year. Unlike most countries thatallow legal gender transition, article 3 of the act presents hurdles for many people who would
otherwise like to do so. Sections ii and iii make a trans individual’s family an impediment to theirtransition, even if both the spouse and the children have no objection. The GID act has specificallyreceived criticism for section iii, which is not a criterion for gender change anywhere but Japan(Taniguchi, ​Asian-Pacific Law & Policy Journal​).
Sections iv and v force transgender people to surgically transform their bodies before being taken
seriously as their preferred gender in society. This double edged sword is felt most acutely by those
who cannot afford surgery and those who are comfortable in their bodies without surgical intervention.
Without surgery, the gender awareness of trans individuals are not respected in Japan. (Hirano)
If you do meet all the criteria for legal gender change, you can officially change your gender on yourkoseki. You must bring the necessary medical certificates such as your GID diagnosis and the resultsof your surgery to the family register section of your municipal office.
Non-Japanese Nationals​:
The process for changing your gender depends on the country, but if it is changed on your passport, it
can be changed on all official documents in Japan, including your residence card. The processchanging gender designation on your passport for US citizens is available​ ​here​. Some importantpoints to note are that the medical doctor’s certificate must be translated into English if it is written in
Japanese and the process once your documents have been received takes about 2 weeks.
Unfortunately, the process varies so vastly for different countries that I cannot list them all here. If you
are a non-US citizen and wish to change your gender marker, please try to contact your embassy inJapan for details.
Medical Illness Status
In the newest addition of the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders, theofficial guide used to diagnose mental disorders in America and referenced in much of the world),
Gender Identity Disorder has been changed to Gender Dysphoria. Those who wish to learn more
about the new diagnosis can do so​ ​here​.
Within the old parameters of the GID diagnosis, people who are trans were seen as suffering from amental illness. Legally, this was reflected in the status of trans people in Japan. This meant thattransgender people were eligible for various government resources available to mentally ill people
such as reduced fare train passes in some prefectures.
Of course, the fact that trans individuals were seen as mentally disordered had many negative
ramifications as well. Since Article 14 does not protect those who are mentally ill from discrimination
as well, this left a double stigma on those living in Japan who wished to find work, enroll in schooling,etc.
The Japanese mental health field follows DSM standards and at this time are preparing for thechange to the new DSM 5 standards in May of this year. The effects this will have on transgenderpeople's current status as mental disordered is yet to be seen.

Legal Status of Trans* Individuals
Legal Protections​:
The legal protections for transgender people in Japan are severely lacking. Estimates of the transpopulation in Japan range from 4,500 to 46,000 strong, depending on the study (Westlake). However,as of November 2013, there are no legal protections for trans people in the Japanese legal system.
Article 14 of the Japanese constitution prohibits discrimination based on 'race, creed, sex, social
status or family origin.' There is nothing prohibiting discrimination based on gender identity or sexual
orientation (Taniguchi, ​Intersections​). There is also no law prohibiting harassment of an individual
based on their gender display or preferred partners.
There have been movements to rectify this gap in human rights. The Ministry of Justice put the Draft
Bill on Human Rights Protection on the table in 2002. The draft bill designated sexual orientation as acategory against which it was forbidden to discriminate. Furthermore, the commentary, which was
included along with the draft bill, clearly stated that the term 'sexual orientation' should be understoodto include sexual minorities as a whole, including people with GID and intersex, among others. In theend, the bill did not pass in the Lower House because of strong objections regarding issues

concerning sexuality (Taniguchi, ​Niji​). Though the draft bill was subsequently proposed twice more, in2003 and 2005, but was eventually scrapped.
Government services, such as public housing and nationalized health care also operate from an
LGBTI-exclusionary framework. For example, cis-gendered (biologically born) women can havehormone therapy covered under NHI (National Health Insurance), but transitioning women in mostcases cannot.
While there is a great lack of legal protection nation-wide, there are many local laws in place that are
aimed at protecting sexual minorities like transgender people. One example is the ​Ordinance ofCommunity Renovation based on Equality for Men and Women​ in Yame-shi, Fukuoka-ken, enacted 1
April 2004 (Section 7[4]: No-one should discriminate based on gender identity disorder within home,community, school, workplace or other places in society). Whether or not these local ordinances areproperly enforced, it is a good idea to research their existence in your area.

Safety, Conflict and Violence in Japan​:In many places, being trans is an active threat to one’s life. In countries like Russia, Africa, and many
places in so-called ‘modern, post-industrial nations’, those who do not fit into what is seen as
acceptable gender presentation must live in fear that that difference will lead to physical violenceagainst them. In Japan, the rates of violent crimes in general are some of the lowest in the world("UNODC Homicide Statistics.") The fact that non-ethnically Japanese people are still comparatively
rare in this country allows many to pass unnoticed; even those who are out or do not pass rarely facephysical violence. This may be due to differences in religion and culturally history unique to Japan
which will be discussed further in the ​Trans-Pacific​ section.
Even without special protections for transgender people, many individuals living in Japan today feelvery safe. Violence against those who are trans rarely takes the form of physical assault and if it does
occur, unlike some places where the police will unofficially sanction violence against LGBTQ people, itwill be prosecuted. The lack of a special ‘hate crime’ law to protect sexual minorities does not prevent
assault against transgender people from being treated like any other assault by the law.
Most violence when it does occur takes the form of not physical, but emotional and structural violence.
It is not uncommon for transgender people to be barred from being a full member of somecommunities and harassment often occurs. In a country where ‘the nail that sticks up gets hammered
down’ and bullying is so endemic, those who are seen as different often bear the brunt of this societalpressure to conform. However, physically speaking, it is the opinion of this author that Japan is one of
the safest places for transgender people to live in the world.

Citations"UNODC Homicide Statistics." ​United Nations Office on Drugs and Crime​. United Nations Office on
Drugs
and
Crime,
Web.
19
Feb
2014.
<http://www.unodc.org/unodc/en/data-and-analysis/homicide.html>.
"性同一性障害特例法による性別の取扱いの変更数の推移." ​性同一性障害一般社団法人​. 性同一性障害
一般社団法人, n.d. Web. 19 Feb 2014. <http://gid.jp/html/GID_law/index.html>. (In Japanese)
Harima, Katsuki et al. ‘‘Gender Disorder and the Family Registry’’. 70-73, 97. 2007.
Hirano, Keiji. "Rights still lacking over gender identity disorder." ​Japan Times​ 26 11 2010, National ed.
Web. 19 Feb. 2014.
<http://www.japantimes.co.jp/news/2010/11/26/national/rights-still-lacking-over-gender-identit
y-disorder/

Taniguchi, Hiroyuki. "The Legal Situation Facing Sexual Minorities ." ​Intersections: Gender, History
and Culture in the Asian Context ​. 12 (Jan. 2006). Web. 19 Feb. 2014.
<http://intersections.anu.edu.au/issue12/taniguchi.html>.
Taniguchi, Hiroyuki. 'Jinken Yō Hō to pātonāshippu seido' [Draft Bill of the Protection for Human
Rights and the partnership legislation],' ​Niji​ 4 (2003):42-48.
Taniguchi, Hiroyuki. "Japan’s 2003 Gender Identity Disorder Act: The Sex Reassignment Surgery, No
Marriage, and No Child Requirements as Perpetuations of Gender Norms in Japan." ​Asian-Pacific
Law & Policy Journal​. 14.2: 108-117. Web. 19 Feb. 2014.
<​http://blog.hawaii.edu/aplpj/files/2013/02/APLPJ_14.2_Taniguchi.pdf​>.
Westlake, Adam. "1 in 2,800 of Sapporo residents struggle with gender identity disorder." ​Japan Daily
Press
22
04
2013,
National
ed.
n.
pag.
Web.
19
Feb.
2014.
<http://japandailypress.com/1-in-2800-of-sapporo-residents-struggle-with-gender-identity-disorder-222
7407/>.
Wouter, Thielen. "Living in Japan with multiple names." ​Morannon​. N.p., 25 SEP 2013. Web. 19 Feb.
2014. <http://morannon.org/2013/09/living-in-japan-with-multiple-names/>.

4.
-

-

-

Employment

Legal Protections For Trans* Workers
Nationwide
On the JET program
Legal Redress
Responses to Transitioning Workers
Legal Precedents
Personal Accounts of Transition
Hiring “Passing” Trans-employees

Legal Protections For Trans* Workers
Nationwide​:
As of the start of 2014, there are no legal protections for trans* workers in the Japanese legal system.
Article 14 of the Japanese constitution prohibits discrimination based on 'race, creed, sex, social
status or family origin.' There is nothing prohibiting discrimination based on gender identity or sexual
orientation, including hiring and the treatment of trans-employees (​Taniguchi​). There is also no law on
paper to prosecute harassment in the workplace clearly based on a person's gender expression orsexual orientation (compared to sexual harassment in Japan, with many laws and a catchy shortening
to セクハラ ​sekuhara​). Therefore harassment at work due to one's gender display or preferredpartners is technically not prohibited, as long as it is not sexual in nature (​Kamikawa, 143-4​).
On the JET Program​:
While every situation is indeed difference, it is important to remember that the JET program is agovernmental agency. The Japan Exchange and Teaching (JET) Programme is administered by local
authorities in cooperation with the Ministry of Internal Affairs and Communications (MIC), the Ministryof Education, Culture, Sports, Science and Technology (MEXT), the Ministry of Foreign Affairs(MOFA), and the Council of Local Authorities for International Relations (CLAIR) (See the JET
General Handbook for further details). It's likely that even your CO or PA will have to bend to whatever
the hard line is on paper. The hard line is that firing JETs (and any other employee) from their jobs on
the grounds of sexual orientation or gender expression is not illegal and seems as if it has happenedin the recent past.
However, there are also instances where JETs have been able to transition in Japan and still keep
their jobs. There are systems in place to avoid arbitrary firings and also as non-Japanese nationals,
the rules regarding JETs are slightly different than those that might apply to a JTE. While trans* JETs

are not protected by the law, protections exist to bring the Japanese society in line with JETs inclusive
hiring policy.
Legal Redress​:
If you find yourself in need of legal counsel regarding issues​ ​t​rans-ALTs might face, there are a few
ways you can proceed.
First, contact your Prefectural Advisor and your Contracting Organization (if they are not themselves
the problem). It will be important that those with power above you know and understand yoursituation.
Find and get the information about GID in the hands of your supervisors at work in their own
language. It might be a question not of malicious intent, but of ignorance or unfounded fear. The
Ministry of Health, Labor and Welfare has a page explaining GID in Japanese​ ​here​ . It is specificallyimportant to provide examples of businesses who successfully work with trans-employees, such as
E.C.C.
It is also helpful to contact the local union for this information and general support. They are used todealing with labor issues and even if they do not have direct jurisdiction over you, they may serve as avaluable ally. Remember, your issue is a labor issue, so do not feel afraid to address it as such.
Contact the CLAIR hotline at 03-5213-1729 . CLAIR, the nonprofit “structural broker” of the national
JET program, handles the day-to-day managing that allows it to run smoothly. This of course includes
the relations between the contracting organizations (who have partnered with them in hiring you!) andthe program as a whole. The upper echelon is staffed entirely by bureaucrats from the Ministry ofHome Affairs, but the blood of CLAIR are the former JETs “liaisons” who currently work as a buffer
between the JETs, their COs, and CLAIR itself (McConnell, 49). Many of them are queer or allies.
They can not only give you great advice, but can act as pressure in any situation as they are a(quasi)-governmental organization seen as rather high up in the ranks. No, they cannot change yourcontract but they certainly have your back if you are being treated unfairly.
Seek outside legal counsel. Due to Japan's lack of comprehensive human rights laws and lack of anational human rights institution to enforce them if they were there anyways, many go this route whenin need of legal redress. This is also recommended for non-JET readers who need assistance. A
place you could try is​ ​Japan Legal Support Center​.
You can also seek out the help of the civil liberties administration section of the Ministry of Justice andthe complementing system of civil liberties volunteers, comprised of approximately 14,000 volunteers
nationwide. If they do not provide adequate remedies, judicial remedies can be sought, though theyrequire a lot of time and money. There are also private initiatives, such as the Appeal for Human
Rights Relief system by the Bar Associations. To learn more, about human rights appeals in Japan,
please click​ ​here​.

Responses to Transitioning Workers

Legal Precedents​:
There are many trans-employees who have not allowed themselves to be discriminated against
without a fight despite the legality for employers to do so. A male to female transgender woman wasworking for a publisher when she was diagnosed with GID. In January 2002, she requested that her
employer recognize her as a woman. In March 2002, she began wearing women’s clothing to theoffice. Her employer ordered her not to wear this clothing. However, the woman continued to dress
this way. Her employer fired her in April 2002. The woman subsequently filed a lawsuit. In June 2002
the Tokyo District court found that the initial dismissal of the case was unjust (Taniguchi). In anotherexample, a 50-year-old woman who goes by “K,” used a blog to drum up emotional and financial
support over the past few months when she filed a lawsuit against a former employer in Osaka who
she claims bullied and discriminated against her. She wrote:“Before me, there were many who could not find their voices. If myworkplace keeps the current work atmosphere, I think the samething would happen again. I won’t keep silent, crying alone. I won’t
allow employers to use employees. I won’t allow discrimination
against minority people.” (Larkin)
There are many non-Japanese trans people who have also found their voice. In some cases,transitioning has gone smoothly, without the threat of job termination. Many people find GID to be
strange but not threatening, especially if they have been educated about it in their own language. In
other situations, JETs have been able to “start fresh” after starting their transition by changing theirplacement. This can be done while staying on the JET program, but it is a complicated process.
Inter-prefectural transfers are granted only in three cases:
1. Marriage
2. Having to take care of someone who is ill
3. Medical reasons (such as not having access to a medical center that is vital to your health)
Of course, the argument for many trans* JETs will be the third. There are only a​ ​handful​ of medical
facilities in Japan that specialize in treating individuals with GID. That said, there must be a position
open that needs to be filled in that area before a transfer can be granted. It is recommended that you
let CLAIR know and apply for a transfer in advance if you are worried about acceptance in yourcurrent placement.

Personal Accounts of Transition​:
MtF Private Company ALT
I’ve been with the same company since coming out, so I’ve not faced any problems with regards tobeing hired. While I can’t say for certain, it feels like having a membership in the General Worker’s
Union makes a big difference [to whether you will be fired]. As it’s been explained to me, larger
companies are much more likely to work with trans-employees to create an amiable solution foreveryone. Smaller companies that are family owned are more likely to react out of hand.
MtF Private Company ALT
I first contacted a worker’s general union and got information on worker’s rights and discrimination
policies in Japanese law. I felt a little more secure and coming from a position of strength whencoming out to supervisors.

MtF JET Program ALT
I didn’t have a problem with pronouns at school, but my supervisors did put a restriction on dress
code. I was told that I couldn’t wear skirts for a year. Since they had mentioned a time limit, I asked
again the following year, and they allowed me to wear skirts.

Hiring “Passing” Trans-employees
Generally in Japan, gender awareness is based more on legal recognition than appearance/display.
The GID Act of 2003 allowed Japanese people to become much more aware of trans people and theirstruggle for acceptance. On the other hand, the legal defining of who transitions and how one goes
about it has lead to a tendency for people to accept the sufferer's gender awareness only after theychange their registered sex (Hirano). Once a trans* individual's papers accurately represent theirgender display, the fact that they have transitioned becomes a non-issue for most employers andgovernment services. This is the upside to a culture passionately devoted to following the rules.
However, those who may ‘pass’ in everyday life may face difficulties in seeking and keeping
employment if one's legal gender doesn't match what people see.

CitationsTaniguchi, Hiroyuki. "The Legal Situation Facing Sexual Minorities ." ​Intersections: Gender, History
and Culture in the Asian Context ​. 12 (Jan. 2006). Web. 19 Feb. 2014.
<http://intersections.anu.edu.au/issue12/taniguchi.html>.
Kamikawa, Aya. “Courage for Change – Messages from me with “gender identity disorder”” (inJapanese) PP. 143 – 144. Iwanamishoten. Tokyo, Japan. February 2007
Accessed from the JAPAN: Discrimination against Lesbians,
Bisexual Women and Transgender Persons Shadow Report Website.
<http://iglhrc.org/sites/default/files/268-1.pdf>
McConnell, David. ​Importing Diversity: Inside Japan's Jet Program​. Berkeley and Los Angeles:
University of California Press, 2000. 49. Print.
Larkin, Thomasina. "Gender identity transformed from ‘freak’ into rights issue." ​Japan Times​ 23 01
2007, Community: The Zeit Gist n. pag. Web. 19 Feb. 2014.
<http://www.japantimes.co.jp/community/2007/01/23/issues/gender-identity-transformed-fromfreak-into-rights-issue/

Hirano, Keiji. "Rights still lacking over gender identity disorder." ​Japan Times​ 26 11 2010, National ed.
n. pag. Web. 19 Feb. 2014.
<http://www.japantimes.co.jp/news/2010/11/26/national/rights-still-lacking-over-gender-identit
y-disorder/

5. Medical Issues--

Medical Procedure for Transitioning
Mental Health Counseling - Diagnosis
Locating a Clinic & Beginning HRT
Sexual Reassignment Surgery
Cosmetic Procedures
Insurance - What Does it Cover?
Access to Medical Care
Recommended Mental Care Providers
Recommended Medical Facilities/Provides

Medical Procedure for Transitioning
This guide will illustrate all the steps it takes to become legally a different gender from the one
assigned at birth. Before all that however, I do want to state one disclaimer that some may forget. It isin no way necessary to take these steps as a ‘set menu’, a list of mandatory procedures that only
afterword qualify the person taking them as fully transitioned. While the government may put artificial
criteria as a prerequisite for gender change, please let it be known that the only thing that truly
qualifies someone as transgender is their own personal gender identity. There are those living happily
as their preferred gender at all stages of the ‘process’ that are content with the way they present andfeel self-actualized. As gender transition is inherently personal and intimate, the transition may vary
greatly based on individual desires and needs- the only one who can dictate what constitutes a totaltransition is the person themselves.
Whether transitioning from FTM or MTF, the process shares many commonalities:
1.​ ​Mental Health Counseling - Diagnosis
The first step is to seek counseling with a certified therapist. There is a list of recommended certified
therapists at the end of this section or on the​ ​website​. Some are able to speak English and cancounsel through video connection. Of course there are also therapists that solely communicate inJapanese that are well qualified and may be more conveniently located. Translators may be available.
Either way, both of these options are covered by National Health Insurance.
*Note that there is some Western privilege with regards to HRT. For some non-Japanesecitizens, only one medical diagnosis is required. If you are a Japanese citizen however,
you will need two separate medical diagnoses.

2. Locating a Clinic & Beginning HRT
After receiving the diagnosis of gender identity disorder or dysphoria, it is time to locate a place where
you can start on hormones replacement therapy, or HRT.
If you already have a prescription for hormones in your country of origin, this is significantly easier.
Through a 約款証明 (yakkan shyoumei), it is possible to have up to a 3 month supply of oral
hormones per shipment shipped from outside of Japan. It should cost about 10,000 per shipment. You
can also often find a place to refill your prescription in Japan, though this will vary depending on thesituation. If you don’t already have a prescription for hormones in your country of origin, it is importantto find a good clinic where you will be prescribed HRT without too much hassle. Please click​ ​here​ toview a list of recommended medical facilities or look below.

First, go to your general practitioner and get a referral to a specialist clinic. It is in some very special
cases possible to get hormones prescribed by a general practitioner, but the vast majority of cases,
you will be referred. In most clinics, you will have to also be examined by that clinic’s psychiatrist or
medical doctor for a number of short interviews of about 15 minutes in length. These medical
consultations are covered under the National Health Insurance plan, and generally cost about 1000
yen for each visit. Be patient, but if these sessions drag on, be assertive in your desire to begin on
hormones. There are also a few rules in Japan that may differ from your country. Much like sexual
reassignment surgery, a person cannot be legally married or have minor children to start thisprocedure. A medical exam to check for intersex is also required and you should be advised on yourstate of health before beginning HRT.
In Japan, hormones are not covered on the NHI plan, but may be covered under certain companies’
plans. So usually, you have to pay out-of-pocket. Even cisgender women who take birth control purely
to control hormone imbalance have to pay out of pocket. It’s about 3500 yen per month for oral
medication, and about 9000 yen per month for injections. The timeline for when you can actually start
on HRT will vary. In some cases, clinics may rush to administer hormones without proper testing andin some cases, individuals have had to wait about 8 months. Be wary of any clinic that fails to properly
test and advise you on your health before suggesting hormones. About half a year after beginninghormones, there should be a follow-up session with the clinic doctor or psychiatrist.
MTF Hormones:
The common hormones to receive in Japan are Progynon (a type of estradiol, info​ ​here​), Pelanin (atype of estradiol, info​ ​here​), and Progesterone (info​ ​here​). The hormones can be received in pill or
injection form. Anti-androgens are rarely prescribed in Japan. However, trans women have been able
to receive anti-androgens such as Spironolactone (info​ ​here​) from Japanese doctors before.
Non-ethnically Japanese people may face some difficulties in figuring out what hormones and at what
dosages are right for them as some clinics may have never worked with this demographic before.
Talking to your doctor about your individual needs is key. Try their methods initially, but if after a few
months it becomes clear that something needs to be changed, don’t be afraid to ask for increased
dosages or different medications.

FTM Hormones:
The common hormones to receive in Japan are Testosterone and Enarmon (a type of hormone withmethyltestosterone and testosterone. Info on methyltestosterone can be found ​here​. The hormonescan be received in pill or injection form. Non-ethnically Japanese people may face some difficulties infiguring out what hormones and at what dosages are right for them as some clinics may have neverworked with this demographic before. Talking to your doctor about your individual needs is key. Try
their methods initially, but if after a few months it becomes clear that something needs to be changed,
don’t be afraid to ask for increased dosages or different medications.

** Like most countries, living as your preferred gender for a year is a requirement
before beginning HRT.

3. Sexual Reassignment Surgery
If you elect to undertake sexual reassignment surgery (SRS), there are many options available anddoing extensive research is vital- what’s perfect for one person might be utterly unsuitable for another.
SRS is also out-of-pocket, though both the Japan Psychiatric Association and private individuals arepetitioning for Japan to come in line with the DSM guidelines for treatment of GID and cover thesurgeries. The petition was sent in April of 2013, but as of now, the Ministry of Health, Labor andWelfare has made no move to address it.
When considering SRS, the things to think about are technique, price, what they prioritize (looks,
sensitivity or depth, in the case of trans women), wait time, and accessibility. In Japan, there are notmany places to choose from as far as SRS is concerned and the waiting period can range frommonths to 1 year. The most recommended place to receive hormone treatment and surgery is the
Nagumo Clinic​, and with offices in Tokyo, Osaka, Nagoya, Fukuoka, Tokushima and Sapporo, they
are also the most widely accessible.
There is also the​ ​Gender Clinic​ at Okayama University Hospital. Okayama University is also the homeof the Gender Center and the Japanese Society of Gender Identity Disorder, which provides a slew ofresources from academic studies on the trans population to conventions to a daily living classes
where trans women can get lessons on makeup and fashion tips​. ​They are even working on a vocal
training class. The selections for living support seem heavily skewed toward trans women, but manytrans people of both genders have undergone surgery successfully there. Another hospital in
Okayama, Kousei Hospital, started performing mastectomies for trans men a few years ago.
Lastly, there is the​ ​Saitama Medical Center​ in Saitama. It is a good resource for hormones, but due tothe many mixed reviews, it is not recommended for SRS or any other surgeries.
The issue with all of these clinics is its lack of doctors who speak English. However, if you would liketo complete SRS in Japan, the​ ​Yorisoi Hotline​ operatives can put you through to volunteer translators
who can help. The average cost for surgery varies drastically on the type, difficulty, and where thesurgery is performed.
For Trans Men​:
Top Surgery (mastectomy) ranges from 400,000 yen to 1.3 million yen, with the average costaround 80,000 yen.
Nipple Reduction/Reconstruction ranges from 80,000 yen to 500,000 yen.
Womb Removal ranges from 500,000 yen to 800,000 yen.

Bottom Surgery is a bit more difficult because there are so many different surgical techniques.
Phalloplasty is the most expensive and hardest to obtain at around 2 million yen.
For Trans Women​:
Top Surgery (breast augmentation) ranges from 300,000 yen to 900,000 yen.
Bottom Surgery (vaginoplasty) costs an average of 1.9 million yen.
Voice Feminization ranges from 400,000 yen to 1.2 million yen.
Another strong choice for those living in Japan who wish to undertake SRS is to travel abroad. The
world-wide hub for SRS surgery (and cosmetic surgery) is Thailand. The prices are less expensive
compared to Japan and Western countries, but that doesn’t mean one has to sacrifice quality andbedside manner. In fact, the Thai clinics are by far better reviewed and have more experience inpractice than their Japanese counterparts. The three listed in below are the best reviewed in Thailand.
The average cost for trans women in Thailand is between 900,000 yen and 1.9 million yen. A bit overthat is fine, but anything under 900,000 yen should send warning signals.
The biggest argument for Thai surgeons is usually price, but there are two other aspects that makeme recommend Thai surgeons’ bedside manner and service. This may be due to Thai culture as awhole or possibly the more widespread acceptance of trans people in that country. Regardless, mostpatients of Thai surgeons report feeling like the entire clinic just existed for their personal benefit. As
far as service goes, it doesn’t stop at the surgery. Thai surgery costs usually include recovery time inthe clinic, and the recovery time usually includes meals and even day trips once the patient isambulatory. Given the cheaper price of method, which gives superior sensation as well as depth andaesthetics. Dr Suporn SRS in Thailand, many folks basically go on vacation, get SRS, recover in abungalow down by the beach, and then go home. There is a proven medical benefit to recovering insuch an atmosphere, and in Thailand is it pretty cheap to do so. In the words of one person who
completed her SRS in this country,
One member commented:‘‘I had a life changing experience... oh, and I also got SRS.’’More choices for procedures, doctors and locations of surgery in Thailand may lead to option
paralysis. From interviews and research, I have some recommendations for ways to go aboutplanning your SRS in Thailand.
First, decide whether you will be contacting doctors and setting up your surgery yourself or using theservices of support companies.​ ​G-pit​ is one such company with good reviews that offers a variety of
support, from scheduling surgery, hotel accommodations, transport, etc. to being there with you fromthe beginning to the end. They have a variety of packages that can be chosen from depending on thelevel of support (as well as the cost you can afford). They offer services for both trans men andwomen and you have the choice of surgery out of two internationally renowned Thai hospitals. The
first is Yanhee General Hospital where Dr. Greechart Pornsinsirirak, who himself has extremely good
reviews, in usually in charge of the surgery. Without G-Pit or another support company, his SRS cost(including a 14 day hospital stay) is $6,500. He can of course be contracted individually as well.
Yanhee hospital is especially renowned in Japan for performing quality top surgery for FtM people.
While almost all of the reviews are positive, there are obviously some negative.

The three doctors who were highly recommended to me for MtF surgery were doctors Suporn, Pichet,and Saran. Suporn is considered the best of the three, with almost 18 years of experience. He was
the one to pioneer the non-penile inversion has carried out about 1800 cases of primary SRS on
patients from some 40 countries. He currently carries out approximately 160 SRS operations, and 50‘full’ FFS operations each year. Saran is the cheapest of the three, but learned from Suporn and now
teaches his own techniques to new surgeons. Pichet has less information on his website, but all three
have extremely positive reviews.
Of course, the West has much to offer as well if accessibility and price is no barrier. There are many
recommended clinics in the USA and Canada, though the prices are much higher than either Japan or
Thailand.
For more detailed information, such as contact information, price lists based on surgery and websites,
please look below.
4. Cosmetic Procedures
For cosmetic procedures such as electrolysis, there are many salons and other businesses thatspecialize in these services. Any major city should have a few places. Facial reconstruction surgery,most commonly desired by trans women, can also be done at a variety of plastic surgery offices but it
is recommended to go to a plastic surgeon familiar with the specific needs of trans women. For moredetailed information, please look below.

Medical Insurance- What Does it Cover?
In Japan, there is universal healthcare, called 社会保険, or National Health Insurance. As statedabove, NHI as of now covers only the mental health counseling. Many doctors, individuals, as well as
the Japan Psychiatric Association have petitioned for change, but the Ministry of Health, Labor andWelfare has been so far unresponsive. The hypocrisy is that NHI is supposed to cover all illnesses
those protected by it might suffer from. While GID is considered a disease, the treatment of it is notcovered.
According to Stephan Aaron, trans man and activist living in Japan, the problem is that there aremany diseases/conditions you can get a diagnosis for, and there are guidelines for treatment, but thetreatment is not covered by national or social health insurance. For example, if you need to get faketeeth implanted because your teeth are rotten, you can get the teeth covered by insurance, but they
don't cover the temporary teeth while you're waiting for the permanent teeth to get ready. So for the
temporary teeth you can either pay out of pocket, or go toothless for the number of weeks it takes until
the teeth are ready.
There are all kinds of debates about what should be covered or not - Viagra, nicotine patches, etc.
You can get acupuncture treatments covered, but only for 4 specific conditions, not mental healthconditions or PMS or lots of other things people use acupuncture for - those you have to pay in full.
There is also a lot of trans-discrimination that adds to the hypocrisy. For example, men can get
male-hormone replacement therapy, and women can get female-hormone replacement, but there isno column to check off for "opposite-sex" treatment, so trans people can only get hormones coveredby insurance after a legal sex-change. There is currently no legal basis to get the hormones covered

in order to get a sex change. In the same way, if a trans man needs some kind of gynecologicaltreatment after getting a legal sex change, there's no way to get it covered with a health insurance
card listing a male gender.
Here there may be a loop-hole to the system. While NHI does not cover transsexual hormones, if yourhealth insurance card states your desired (but not legal) gender, as can be done relatively easily (seeLegal Gender Change ​here​), you may be able to get your hormones covered. This is not technicallylegal I suppose, but it’s worth a shot. This information also may become dated fast. At the time ofwriting, many activists are petitioning the government to change its policy on trans medical care.
While all this information applies to NHI, private health insurance may have different policies. If you
are covered under private health insurance, please consult with the insurance representatives toascertain what is and is not covered.
Access to Medical CareIn addition to the bureaucratic and language obstacles, accessibility is a major hurdle on the path oftransitioning in Japan. This section is divided into recommended mental health providers andrecommended medical care facilities / providers. With the help of the community, I hope to expand
this list. If you know of any resources that are not yet listed that you can recommend, please contact
Stonewall at ​stonewallsig@ajet.net
Recommended Mental Health Providers​:

Lil Wills, Independent Counsellor/Psychotherapist
Kansai Region, Skype / Phone Sessions Available (English language)
Camilla (Lil) Wills is another good option for those looking for a counselor with experience working
with gender variant and sexual minority people.
She is both a resource on queer issues in Japan as a whole, and a great option for those who

wish to work through issues not necessarily related to their gender or sexuality who don't want theirgender variance or sexuality to become the focus if it is not their main concern.
In their own words:
I am an out member of the LGBT+ community myself and also have significant experience working
with members of the community therapeutically, both regarding their LGBT+ identity and other issues
in their lives.
Until 2017 I have had less therapeutic experience specifically with transitioning individuals due to thepresence of another specialist in Japan. As she is sadly no longer with us I have been gaining more
knowledge and experience in this area. The extent to which my UK counsellor/psychotherapist
registration will be recognised in Japan (or other countries) for diagnostic purposes for access totreatment is as yet untested, however I have begun developing contacts with Japanese medical
specialists in gender dysphoria, among others, which I hope may ease the process for those whowant to take this route.
I do my best to keep informed and sensitive to everyone’s needs but this is a rapidly changing field
especially as our community come from such a variety of countries, backgrounds and socio-political
positions. As such there may be occasions when you are ahead of me and I always welcome yourfeedback about what is important and how I can best support you.
Please click here for details of general practice approach, specialism, and price and contact
information.
www.englishcounselling.com

Recommended Medical Care Facilities / Providers​:
These medical care facilities specifically cater to the needs of trans people and have received good
reviews by the community.
In JapanNagumo Clinic
http://www.gidcenter.com/​ (Japanese only)
Where: Branch Offices in Tokyo, Osaka, Nagoya, Fukuoka, Tokushima and Sapporo.
Nagoya Branch​:
名古屋市中区丸の内 １－１６－４ 第 ４５ＫＴ ビル １Ｆ
Nagoya City, Nakaku, Maru no Naka 1-16-4 KT Building #45 rm.1F
052-229-0555
Tokyo Branch
ゲートシティ大崎イーストタワー 1F, 1 Chome-１１-２ Osaki, Shinagawa, Tokyo 141-0032, Japan
03-3490-0555
Osaka Branch
パシフィックマークス西梅田14F, 2 Chome-６-２０ Umeda, Kita Ward, Osaka, Osaka Prefecture,Japan
06-6346-0555​Fukuoka Branch
肥後天神宝ビル 7F, 2 Chome-８-１ Daimyo, Chuo Ward, Fukuoka, Fukuoka Prefecture 810-0041,
Japan092-722-0555​Tokushima Branch
徳島県徳島市一番町2丁目13 オフィスケイズビル2 F 770-0833, Japan
Tokushima ken, Tokushima City, Ichibanmachi, ni-chome 13−2 F 770-0833
088-602-0555​Sapporo Branch
3 Chome Minami 2 Jonishi, Chuo Ward, Sapporo, Hokkaido Prefecture 060-0062, Japan011-281-0555
Payment Me​t​hods: Cash, Debit Card, Credit Card, Loan
Recommended Physicians:

Saitama Medical Center Gender Clinic
http://www.saitama-med.ac.jp/kc/link3/3.html
Where: Saitama City
０４９－２３８－８２７９​Payment Methods: Cash, Debit Card, Credit Card
Recommended Physicians:*Only recommended for HRT.

Okayama University Hospital Gender Clinic
http://www.okayama-u.ac.jp/user/keisei/indexenglish.html​ (English, limited access)
http://www.okayama-u.ac.jp/user/keisei/seidouitsu.html​ (Japanese)
http://www.okayama-u.ac.jp/user/g-clinic/​ (Gender Clinic, Japanese)
Where: Okayama City
2-5-1,Shikata-cho,Kita-ku,Okayama,700-8558, JAPAN086-235-7214 (Dept. of Plastic Surgery)086-235-7610 (Dept. of Plastic Surgery)086-223-7151 (Gender Clinic)
Payment Methods: Cash, Credit Card, Debit Card
Recommended Physicians:
難波 祐三郎 （なんば ゆうざぶろう）
Doctor Yuzaburo Nanba, specialist in Gender Identity Disorder*Note: Doctor Nanba also performs mastectomies at the Kousei Hospital in Okayama, where the wait
period may be much shorter.
3 Chome-８-３５ Koseicho, Kita Ward, Okayama, Okayama Prefecture 700-0985, Japan086-222-6806
In Thailand
G-pit

SERVICEGID Diagnosis Counseling

FLAT FEE / ​FIRST TIME FEE
8,000円First time: 2500 円
Proceeding: 1500 円
Hormones

3,500円
1,050円～Mastectomy

682,500円

Nipple Augmentation

Only w/ Mastectomy; +99,750円

Breast Implants

580,000-780,000円

Oophorectomy (womb removal)

861,000円

Clitoral Elongation (mini-penis)

525,000円

Penis Construction

1,984,500円

Vagina Closure

Only w/ other surgery+300,000円

Scrotum Construction

Only w/ other surgery+150,000円

Testes Construction

Only w/ other surgery+300,000円

MtF SRS

1,113,000円

Adam's Apple Construction

Only w/ other surgery＋ 76,100円

Discount for Multiple Procedures

YES

6. Trans-specific: Differences between Japan and the WestAn essay in two parts:‘New Half’ as the Main Queer Narrative
The Root of Divergence in Trans Issues Between Japan and the West
Note: While the previous sections of the guide have been rather utilitarian and to the point,
this section delves into cross-cultural sociology and psychology; therefore, it is much more
open to interpretation. While I have done my best to do research and find academic articles
to back me up, there simply has not been that much writing done on the subject in English.
Much of what is written is based on my own personal experience and study in Japan and the
US. There will be an inevitable bias from my own limited experience. I’m a bit verbose andrather opinionated to boot. Do take this part as an opinion piece that can help inform
expectations, but don’t take it as infallible truth. As they say on the JET program, ESIDEvery Situation is Different.

I would also like to qualify my use of the word ‘Queer’. I myself identify as queer, but I knowthat many of my readers may not self-identify or agreed with the term. While I am aware andrespectful of that difference, in this section I use ‘Queer’ to mean the wider community ofsexual and gender minorities. In my Japanese writing, I use the term セクマイ, a shorteningof the term ‘Sexual Minority’ that in Japanese functions similarly to the word ‘Queer’ in theWest. However, many Western readers are much more familiar with the latter term. While I
use it for the sake of convenience, I am fully aware of the issues present in the use of theword.

‘New Half’ as the Main Queer Narrative
In America’s early aught years, the averaged ‘collective consciousness’ was suddenly givena massive influx of fabulous as ​Queer Eye for the Straight Guy f​ lounced on to television sets
everywhere. In a flurry of grooming tips and hair gel, your everyday American was suddenly
exposed to what ‘queer’ was- and queer was, according to the massively successfulprogram, a very effeminate homosexual man. This was not the first brush with queer culturein the media for America- in fact, depictions of ‘fops’ and ‘nancy-boys’ have been ubiquitous.
There seems to have always been a word for it, but ​Queer Eye​’s run-away popularity
solidified it; when Americans hear ‘queer’, by and large, what they really hear is ‘a perfectly
manicured, highlight-tipped, limp-wrist, cisgender gay man’.
Now, there are certainly queers out there that fall into that category and I say that’s
awesome. However, the disparity in visibility between that ‘type’ of gay man and all the restof the LGBTQ spectrum means everyone else has a little bit less of a space in the culturalconversation and a little less comparative privilege. It’s very good that there is ​any​ portrayalof the queer community that is not blatantly negative in the media (even though the only
reason the ‘Fab Five’ existed on air was to help straight cis-men attract straight cis-women).
But the fact that that is the solidified image that dominates the LGBTQ community in‘Straight Eyes’ means it is that much harder for the rest of us ‘queer guys’ to be seen.
Trans people in America have certainly felt that reality first hand. As this was being written,
only 17 states in the US have workplace related legal protects for trans-employees, versus
21 that offer protection based on sexual orientation​ ​1​. Compare the advocacy that is being
done for gay marriage (even though this means gay ​and lesbian ​marriage, note which isused as the umbrella term) to the advocacy for transgender rights in employment andhousing. The latter is much more important for basic quality of life and can even be thedecider between life and death, but by and large it is eclipsed by the former.
In Japan, the situation is quite different for trans people- or at least half of them. Rather
than a cisgender gay man being the shared subconscious image of queer, the ‘okama’ takes
center stage. Okama literally means ‘kettle’ in Japanese, but is used interchangeably to referto cross-dressing gay men (drag queens) and MtF trans women. There are various reasons
why this image might be the ‘face’ of queer culture in Japan. In a rather reserved society, theflamboyance of the Fab Five in their everyday dealings would not go over well in my opinion.
However, the stage (and by modern extension, television) is a place removed from everyday
Japanese social constrictions in many ways. There is a long history of cross-dressing men
who are ‘more women than born women’, known as the Onnagata (literally ‘Woman
Shaped’)​ ​2​. These talented performers acted in women’s roles in Kabuki during the long ban
on female actors from the early 17​th​ century onward (Leupp, Gary P. (1997). ​Male Colors:
The Construction of Homosexuality in Tokugawa Japan​. University of California Press.
P.90).
Rather than being excommunicated, these actors, often young and beautiful, were exalted topop culture fame and often to positions of high power when powerful officials were ensnaredby their charms. Onnagata often played very sexually charged roles and many were adifferent kind of entertainer by night- the cross-dressing male courtesan or prostitute thatcatered to both a male and female clientele. While they were sexualized, their sexuality was
not seen as shameful in a society where ‘the floating world’, the entertainment district thatallowed the new Japanese city-dweller to let loose in any way they pleased, was a needed
respite from everyday drudgery. Their beauty was an integral part of society and accepted;
they were also highly visible, since their popularity coincided with new techniques in printingthat led to the all popular ukiyo-e, a mass-produced print that often depicted them.
Just as the cosmopolitan of the Tokugawa period ate these images up (and made profits forthe actors and the producers of their fan goods), the tuned-in of today’s Japanese media are
well familiar with the okama image. The new term in vogue is ‘new-half’, those who present
in a way that imitates the gender opposite to their biological sex. New-half actors, likefamous singer-songwriter, TV and movie star Miwa Akihiro, have fans of all gender andsexual persuasions and often appear on TV talk shows and variety programs. ‘New Half
Shows’, drag spectacles, proliferate the entertainment districts of Osaka, Tokyo and any city
worth its salt. And on the other side of the spectrum, the performers of the Takarazuka
Review, a troupe that has been expanding in members and popularity since its inception in
1914, put on sell-out shows with its all-female cast playing characters of both genders. The
fans are by and large very female and very infatuated.
The Root of Divergence in Trans Issues Between Japan and the West
It is true that crossdressing performers (especially those of the MtF variety) are well loved inJapan without the stigma that may be attached to them in Western culture. It is also true thatwhile ‘queer’ may be read GLBT in the west, the T comes to the forefront in Japan. However,this is not to say that this country is a wonderland where trans people are accepted into theculture with open arms. To understand the way trans people are treated in Japan versus
other places around the world, an advanced degree in anthropology would be of use- I’ll do
my best with what limited knowledge I have.

A major difference would stem from religion. As Kim Oswalt, trans-activist and counselor
profiled under the Mental Health sub-section of the Medical section, states in her article,
Questioning Gender​,The moral and spiritual roots of Japanese culture are different from
Judeo-Christian roots. Japan has a history of polytheism: many small gods. There
are the gods of the mountain, the kitsune fox god, and the gods that live in trees,and even today Shinto priests offer prayers essentially asking for forgiveness fromthe tree spirits before they cut trees to build a house. It’s almost like a shamanisticroot that goes back beyond Buddhism, and they still live in Shintoism andshamanism. Monotheism can foster the notion that “my god is right and yours is
wrong,” or doesn’t exist. But if your god is a god of the mountain, and mine is a
god of the trees, we’re probably going to get along fine because mountains needtrees and trees need mountains.
Spiritually speaking, this is a very pluralistic society. People get married in achurch, and on the same day they may go to the Shinto shrine, and when arelative dies they'll go to the Buddhist temple. On a wedding day, if they want to
put on a kimono and then switch to a white lacy dress nobody’s got a problem. The
more the merrier. My inkling is there’s something here that makes life a bit easierfor transgender people than in the U.S. They're not told that they’re going to hell
for being transgender. God does not hate them; you don’t hear that here in Japan.
3
Japanese society seems to embrace contradiction and celebrates juxtaposition at leastin its aesthetics if not in the culture at large. People seem to have no problem playing
with ‘image’, something you will see evident in the scores of students who trade in theiruniforms for every manner of crazy fashion on the streets of Harajuku each weekend.
The idea of cross-dressing in ‘leisure spaces’ is not at all stigmatized. In fact, at manyhigh schools throughout Japan, the Drag Contest (for both teachers and students) is atime-honored tradition. Having the same event in England or America might lead to theschool’s closure, but locals from the community often come out to celebrate their youths
donning the opposite gender on stage.
However, the thing to remember is that while there is space for gender ​flexibility​ in thissociety, it is compartmentalized in an altogether Japanese fashion. By and large, theplace where trans people are celebrated is created by lighting and stage-magic.
Like the West, those seen as new half are often relegated to the role of ‘entertainer’someone to laugh with or at, to be enjoyed but never taken seriously as someone who could
step out into the light of day. Many of these performers are not what western culture wouldlabel as trans at all, but are cisgender people, both homosexual and heterosexual, whoenjoy the art, the ‘image’ of drag. Often cross-dressing gay men (and gay men as a whole)
are lumped into the category of okama or new half even if they identify as cisgender. Incontrast, trans women who have never worked in the performance industry in their lives
being assumed to be entertainers or even prostitutes, is also true. Even those performers
who do actually identify as the gender they use to entertain often take off their true
expression as they leave the theater and put on a costume as they enter the ‘real world’.
Why, in a society that seems so accepting, in a country where violent crime is so rare,
would trans people feel like they have to hide?
One of the most striking differences between Japan and the West, the one thatpermeates all aspects of life, is not that of religion but of basic societal structure. You
may notice that when Japanese people introduce themselves, not only does their familyname come before their personal name, but that may in turn be preceded by theircompany’s name, their department, and even their specific job title. This makes for very
long self-introductions, but more than that, it reveals an integral feature of Japanese life.
The basic social unit in Japan is the group, the ​uchi​, defined not in relation to theindividual but to other outside groups, known as the ​soto​. The individual certainly exists
in Japan, but from the earliest age, Japanese are taught to sublimate their individual
needs and selfish desires for the good of the group as a whole.

A telling anecdote illustrates this point. I have a lot of experience in preschools in boththe US (where my mother was a Pre-K instructor) and Japan, where I volunteered at
kindergarten and day care centers in Akita prefecture. I was sitting in during lunch,where even children at the age of three and four learn to serve themselves from thecommunal food. One of the children was carrying their bowl to the table and fell,
scattering rice everywhere. Now, in my experience young Japanese children’s energy
level rivals or even surpasses that of their American peers. However, whereas inAmerica the other preschoolers would probably take little notice and run right over the
food in hyperactive glee, the previously raucous room instantaneously stopped
everything. Three year old children put down their lunch, bee-lined it for the cleaningcloset and started helping their fallen peer clean up ​without prompting. ​They had clearly
practiced this before.
In my time in Japan, this lesson in the importance of the ‘good of the group’ has been
repeated over and over, at all levels of society. This emphasis on communal wellbeing
above the idea of individual pursuit of happiness may stem from the many natural
disasters Japan suffers as an island on the Ring of Fire, a geographic fact that would
mean annual devastation even just a hundred years ago. For communities that could be
wiped out by fire, earthquake, tsunami, or landslide in a day, being able to rely on one’s
neighbor could mean the difference between life and death. The iron-clad ties between
group members, especially familial groups bonded by blood, also must be strongly
influenced by Confucianism, which first came to Japan via China and Korea around the3​rd​ century. Confucianism became the basis of Japanese social structure, delineatingthe culture’s model for social and political order. It focused on personal interaction,
explaining the responsibilities and duties relevant to the five basic hierarchical relations:master–servant, parent–child, husband–wife, elder sibling–younger sibling andfriend–friend​ ​4​. ‘If everyone knew their place and performed their duties diligently, there
would be peace and prosperity!’, this new philosophy dictated. From this moral code
(and that of its Neo-Confucian interpretation in the Tokugawa period), the concept of ​giri​,social duty or obligation, was formed.
The delineations Confucius espoused were defined along the line of age but also alongthat of biological sex. As Confucian thought wove itself into the fabric of life, so too did
the gender roles harden into rigidity. A woman was to diligently serve her husband, aman was to diligently serve the Emperor, and the Emperor was to diligently serve his
people. In all of these roles, creating a family with (lots) of children is consideredessential. Therefore, to go against these expectations by refusing to marry due tohomosexuality or refusing to act in the proper gendered way due to gender variance wasseen as not fulfilling one’s giri, or social obligation to their group. Japan is a country ofboxes in boxes- the family ​uchi​ exists within the occupational u​ chi​ which exists within
the geographical ​uchi​, which is housed in the overall group identity as
Yamato-Japanese. The individual is expected to fulfill their role for the good of all ofthese groups. In turn, failure to live up to expectations is seen to effect and reflect poorly
on each ​uchi​ one belongs to, so it is really the society as a whole that you have letdown.
Of course people are still people, with personal needs and wants, individual aspirations,and narcissistic tendencies inherent to humans everywhere. This ego has a name inJapanese- the ​honne​, or one’s true feelings, desires, and preferences that make up theSelf. In order to protect the group’s wellbeing from being undermined by this egotism,
the ​tatemae​, the façade one puts on for interacting in society, is created and enforced.
The kanji for ​tatemae​, 建 (to build) and 前 (before), reveals the constructed nature of thispsycho-social concept that allows the individual ego to exist, safe and tucked away,
while still fulfilling one’s duties to the group. But the pressure to conform and to live up toso many expectations, answering to so many people including, in Japan, yourancestors, can cause an inordinate amount of stress. That stress can over time strain
and even break the dam of ​tatemae​ and send a flood of ​honne​ spilling out wereeveryone can see.
Therefore, there are spaces where ‘we are free to be you and me’ built into thestructure. These social safety valves exist to take off some of that gargantuan pressure.
They are the characters goods that festoon schoolkids and salarymen alike, allowing
people to unobtrusively differentiate themselves in a sea of uniformity. They are Japan’s
unapologetic and in-your-face drinking culture, letting people allow their true feelings toshow in a space where chalking it up to the alcohol means it is stripped of the loss offace and disharmony consequent to other situations. And they exist too in Japan’smassive and diverse entertainment sector, the most varied in the world. While theJapanese may be asked in the name of ​giri​ to ​gaman​ and endure a host of difficulties
ranging from long hours of school and work to an unsatisfying marriage, in the hours
between responsibilities, they are free to indulge in the escapism of their choosing. The
variety of video games, pornography, movies, host(ess) clubs, and other escapes is
testament not only to Japan’s impressive mastery of capitalism but also to its lack ofjudgment in this regard. ‘Different strokes for different folks’ is embraced wholeheartedly
and nothing is taboo- as long as it is confined to a certain time and place.
Gender variant behavior and non-heterosexual orientations are seen just another aspectof the ​honne​. It’s not something to bring up in polite conversation- in fact, not something
to bring up at all in most cases. Still, as long as it is relegated to times that don’t interferewith one’s responsibilities as a ​shyakaijin​, a member of the working world and therefore
a contributor to the group (a prerequisite to being accepted as an adult), it is considered
acceptable, even encouraged. This attitude does not view queerness/LGBT as an
identity, an important aspect of who you are as a person. Who you are is defined interms of what groups you belong to. Who you are is a member of your workplace,family, community, etc. Who you are is a contributor to Japan, the same as everyone
else in schooling, training, or work. Being queer is something you ​do​. Want to be adifferent gender? Want to love the same sex? As long as you do it on your own time, inan unobtrusive way that doesn’t interfere with who you are as a responsible member ofsociety, there is no problem, no judgment.
In the West and especially America, where the cultural narrative is that of the rugged
individual forging out alone to achieve His Manifest Destiny on the desolate prairie,things are a little different. ‘‘Life, liberty, and the pursuit of happiness’’ is one of our
founding features. In Japan, happiness in life is certainly pursued as well, but theconcept of what happiness means is more that of harmony than of personal gratification.
When writing about culture some degree of generalization is unavoidable- of course,
according to location and community, things will differ. But by and large, Western society
is as staunchly individualistic as Eastern ones are communal.
In the West, where the basic social unit is the individual, being queer is a matter of whoyou ​are​. There is a lot of solidarity in that identity. People who are labeled minorities canfind strength in others that bare that label and with identity politics, can find a platform
and a voice to fight with. However, LGBTQ people don’t often get to bare that label bychoice. The major drawback to queerness being a part of identity is that it is seen as
something essential- your gender identity, your sexual identity, that’s who you are, howpeople see you first and foremost.
Even if you are the most closeted person in the world and no one ever finds out you are
one of ​them​, it is still a cross you have to carry. It doesn’t matter if you never even act on
your desires. If you are attracted to members of the same sex or if you want to transition

to a different gender, by virtue of that desire alone, you are a queer in most people’seyes. You cannot escape it- even if you celebrate it, it is an identity you cannot simply
choose or refuse. If you are anything but cisgender and heterosexual, you areautomatically part of the LGBTQ community. While that means solidarity with others whoshare similar traits, it also means a world of hurt from other individuals and a society that
equates being LGBTQ with being essentially wrong, essentially deserving to bepunished.
Many would blame this on Western religion and one can understand that reasoning.
Many of the worst atrocities committed against LGBTQ people have been done in thename of God. But more than religion, which is structured similarly to society at large but
given a celestial mouthpiece, it is this essentialism so intertwined with how we define
reality and ourselves that is to blame. Essentialism has been highly influential since thetime of Plato and Aristotle, when Platonic Idealism and Aristotle’s ​Categories​ proposedthat all objects are the objects they are by virtue of their substance, that the substancemakes the object what it is. Diana Fuss, LGBTQ rights activist and feminist theorist,
brings this notion into a 20​th​ century context when she summarizes Essentialism as, ‘‘abelief in the real, true essence of things, the invariable and fixed properties which define
the 'whatness' of a given entity’’ (Fuss, Diana. ​Essentially Speaking: Feminism, Nature
and Difference​. New York: Routledge, 1989. xi. Print.).
Focus on the ‘invariable’ and ‘fixed’ part of that sentence. If someone does an action in
the West, it is a reflection of who they are as an individual, the product of a set,predefined identity that may have been determined even before birth. If you are awoman who wears men’s clothing and acts in a masculine way, it is because you ​are​ a‘dyke’. You being a dyke is a fixed attribute and your masculine presentation only acts to‘reinforce’ or ‘give away’ this static fact. When you are denied a job, denied housing,assaulted or even murdered, as trans women are 16 times more likely to be comparedto the ‘average American’ in the United States​ ​5​, it is not because you ​did​ something
wrong. It’s because you ​are​ something wrong.
In Japan, where Plato and Aristotle were not heard until relatively recently, very little isseen as ‘invariable’ and ‘fixed’. Philosophically, it was Buddhism, specifically the esoteric
Buddhism of the Heian period (794-1185), which most influenced Japanese thought.
According to the Routledge Encyclopedia of Philosophy,‘‘Esoteric Buddhism did for Japanese philosophy what Plato and Aristotle didfor Western philosophy. It laid out a set of assumptions and a ​Problematik​ that
had a profound influence on the thought to follow. Two assumptions wereparticularly influential.
First, esotericism has a distinctive view of the relation between part and whole.
The whole is recursively manifest or reflected in the part. It is not that the partsconstitute the whole nor that the whole is more than the sum of its parts; rather,since the part is what it is by virtue of the whole, if we truly understand the part,
we find the whole imprinted in it. In Shingon Buddhism’s case, for example,
since any individual thing is an expression of the cosmos as Dainichi, when wetruly understand the part (the individual thing), we encounter the whole(Dainichi) as well. (​6​)
As you can see, this way of viewing reality is diametrically opposed to classic Westernthought. In the philosophy that still defines Japanese society in same way Aristotle andPlato still define the West’s, in the part, the whole is present and conversely, the wholeis encompassed by the part. Zen Buddhist theory adds that ‘‘form is emptiness, andemptiness is form’’. To put it a bit less mystically, the individual (person, object, concept,etc) and everything outside of it is essentially the same thing- while they may seem todiffer, the truth is that these differences are constantly fluid and that at their very
essence, they are simply aspects of the same great oneness. As Oswalt previously
points out, this is exemplified in how the Japanese feel very comfortable switching fromtraditional Shinto garb at a shrine to white wedding wear at a church on their weddingday. While this would seem mutually exclusive to a Western eye, to the Japanese
couple, they both are ​functionally​ similar (celebrating the union) and are therefore simply
aspects of the same thing.
Of course living day to day life without any sort of fixed categories would be very hard.
Since Japan is a country made up of people, not Buddhas, Confucianist thought exists
as a way to help structure the daily dealing of life. But even though people are separated
along the lines of age and gender, it is with the knowledge that these things are not in
reality mutually exclusive- they are just divided in such a way to help society runsmoothly. The fact that Confucianism, Buddhism, and Shintoism can all exist in harmonyin Japan is in itself testament to how the Japanese are much more concerned withresults than ideological consistency. In this inclusive background of thought, it is theresult of the individual’s actions on the whole that are important, not some sort of‘essential’ nature of the individual that can be viewed as right or wrong. Right or wrong
are seen as two aspects of the same whole - it is the functional results of actions on thatwhole that hold weight.
It is my personal opinion that this pluralistic way of living leads to a healthier, happiersociety. Still, don't go extolling the virtues of the rising sun just yet. Japanese society has
its issues. It may be criticized for the inhumane pressure it places on its members to be‘good team players’, constantly sublimating their own interests for the sake of the often
viciously hierarchical group. This hierarchy is supposed to be a mutual relationshipwhere loyalty and obedience from the inferior is rewarded by benevolence andprotection, but in a reality without laws to enforce that ‘benevolence’, this often leads tosystematic violence. The oppression of women in Japan is a good, sobering example,
where as of 2010 women earn 30% less than men in the same position, twice theaverage of other countries in the Organization for Economic Cooperation andDevelopment (​7​)
Also, this pressure to fulfill your ​giri​ means that while you can do as you please with
impunity as long as it doesn’t slip into the light of day (or in the case of ‘new half’
performers, as long as it is in the service of entertaining the masses), you can never betruly ‘out’, living consistently true to what you feel in your heart, without societal censure.
For example, you can be the most flamboyant drag queen on the weekends or at thebars- as long as you have a wife and kids and a job well paying enough to support them.
Responsibility to society includes the responsibility to create a family that can bear many
children for the state (and Confucius didn’t leave any room for same-sex families who
adopt). The man takes care of the woman and children monetarily, the woman is a
‘Good Wife, Wise Mother’, and the nail that sticks up gets hammered down. In theJapanese language, there is no way to express 'different' (違う) without also saying'wrong'- these words are one and the same. So basically, fulfilling one’s social
responsibility as a Japanese citizen is, for those who are not in the cisgender
heterosexual majority, means living a part-time life and a full time lie.
In the Western essentialist mindset, your queerness is viewed as an intrinsic feature
whether you act on it or not. The danger and discrimination the LGBTQ person faces isoften incurred regardless of whether they let their queerness interfere with their 'social
obligations'. Since the queer is already relegated to the outskirts of society based on
who they are, there is little pressure to conform to the culture that actively excludes
them. Plainly put- if you lose if you do and lose if you don't, why play their game at all?
Generally people are either all in (the closet, desperately hoping no one will find out who
you ​really​ are) or all out (of society, but also the closet that keeps you from living they
way you want to live). From this outside position, the LGBTQ community has been able
to form and then advocate for a more fair playing field where they can be included.
However, this is a marked reversal of the issue queers face in Japan of being ​too
included in the group- expected to go about life in the same way everyone else is eventhough they have desires that often directly clash with their expected role.
That said though, while there is not as much of a community and support for those who
outright reject society's demands, at least Japanese queers have the ability to choose
the kind of half-acceptance detailed in the paragraphs above. Even for those who dobreak with society and forsake their ​giri​, violence is rarely the consequence. Of theOECD countries, Japan has the second lowest homicide rate, with the police reporting 1
in 200,000 citizens murdered (​8​). In the United States, that figure is 10 in 200,000,
making it the third highest rate (exceeding the OECD average) (ibid). For trans people,
the chances are exorbitantly higher.
Legally, transgender people in Japan have less rights and protections than their
Western counterparts. However, the discrimination they face is also not nearly as dire. A

transgender person may be ostracized by their family, friends, and coworkers when theyrefuse to confine their gender identity to proper, unobtrusive contexts. But while they
may have to endure cultural censure and economic violence, the group harmony ethic
dictates that those in the In-Group cannot risk destabilization by acting violently againstthem unless they want to risk their own place in society as well. Being trans* is wrong
because it interferes with the neat social constructs that allow Japanese society to runsmoothly, not because it is an inherent sin.
Even now, those social constrictions are being loosened, finding a place for transgenderpeople within the system. Most recently, the Japanese Supreme Court ruled thatchildren born of married couples where the husband is a post-op transsexual can beregistered as legitimate children even though they were conceived through artificial
insemination and don’t have ‘true blood relations’(​9​). The ability for these couples tostart a socially condoned family is huge. In a country where forms are facts and legality
reigns supreme, this and the landmark GID bill in 2003 that allowed for gender changeon the family register (koseki) de facto admitted post-op trans people into the In Crowd.
But even before that, Aya Kamikawa, the Tokyo municipal official who triumphed thecause, was elected to office in the most populous district in Tokyo ​as an openlytransgender woman​. By no means am I saying that the work is done in securingtransgender rights. Japan, like the rest of the world, has a long way to go before transpeople can live their lives with the security and human decency afforded to theircisgender peers. But the ideas that form the basic foundation of Japanese society are astrong and stable platform that, with time, will be more than capable of supporting us as
we build toward that future.