Introduction　

There are women who wish to remove the reproductive capacity from their bodies. 

This desire may derive from several factors such as childhood discomfort or rebellion against the expectation of "having children someday", a disgust for menstruation that begins in adolescence or a fear of pregnancy, or a realization of a lack of romantic feeling or sexual attraction towards neither men nor women. 

In a society dominated by the belief that it is natural for women to bear and raise children, the existence of women who wish to "remove reproductive capacity from their bodies" has always been overlooked. 

The so-called “Mother’s Body Protection Law” presumes that all women shall bear children. It treats women's bodies as "maternal bodies" to be "protected," and a sterilization surgery requires spousal consent or "already having more than one child."

Whether to "give birth" or "not to give birth" is the most personal matter for women, but their reproductive capacity has always been controlled by the state as a "device" or "resource" to manipulate the quantity and quality of the population. The regulations over sterilization surgery stipulated by the Maternal Health Act are also remnants from an era when the state used childbirth as a means of population policy. As such, the right to reproductive self-determination is completely neglected. 

We decided to sue the state to change the current rules regarding sterilization surgery so that any individual can regain their right to reproductive autonomy. 

▲Reference materials for the “Council on Inclusive Society” in the House of Councillors, November 2000.

　Stories of plaintiffs　

Plaintiff Kazane Kajiya

Plaintiff Tanaka

Plaintiff Chifumi

Since elementary school, I had a vague thought that I didn't want to have children. 

During my job hunting in college, I was irrigated by the widespread assumption that having children is the foundation of a woman’s life. During the COVID-19 pandemic, I became acutely aware of the social and physical burdens women bear by having children. Then, I determined that I will never become a mother. I searched for ways to become infertile, and discovered sterilization surgery. However, I learned that unmarried women without children are currently unable to undergo the surgery in Japan.

I became a plaintiff because I want to change the current situation where women who absolutely do not want to have children are excluded from the social system of Japan, and women’s right to self-determination is violated by the Maternal Health Act, which presumes that all women shall become mothers. I sincerely hope for a society that respects,  celebrates and embraces the child-free lifestyle chosen by those who decide not to have children.

Plaintiff Kuno

Since I was a child, I have felt a sense of discomfort and rejection against having children, and wished to undergo sterilization surgery. Being alone has always been the most important thing to me since I was a child. 

Every time I see news about someone being arrested for killing a baby born in a toilet, I can't help but feel that it could happen to me, and my fear of pregnancy was intensified. About three years ago, I decided and started to use Mirena (an intrauterine contraceptive system). However, Mirena lasts for a maximum of five years and has to be replaced. There also seem to be people who have it come out halfway. I think I will feel much more relieved if I can have the sterilization surgery. 

I just want to decide about my body without being interfered with or persuaded by anyone. Pregnancy and childbirth are choices that greatly affect one's life. I hope that when making decisions for sterilization surgery or abortion, a person’s will be respected and a person can make a decision based on only their own will without the interference of third parties. 

　Regulations in the Maternal Health Act　

Sterilization surgery is an operation that permanently disables reproductive capacity. From the perspective of contraceptive effectiveness, cost, and safety, sterilization surgery is considered to have significantly more merits than other contraceptive methods.

Furthermore, when the purpose of undergoing sterilization surgery is to "remove reproductive capacity," it cannot be achieved by any other means. For those who feel discomfort or aversion to having reproductive capacity in their bodies and wish to remove it, sterilization surgery is the only means to realize a life authentic to oneself.

However, in Japan, performing sterilization surgery for purposes other than medical treatment is prohibited in principle under the Maternal Health Act. To undergo sterilization surgery, one must meet at least one of the following two conditions:

The first condition is when pregnancy or childbirth poses a risk to life. Even in such a case, the consent from, not only the individual, but also the spouse (including common-law marriage) is required. 

The second condition is when: ① one already has more than one children and ② giving birth runs the risk of impairing the health of the individual. Again, consent from both the individual and their spouse is necessary. 

If one undergoes sterilization surgery without meeting either of these conditions, one can be subject to imprisonment for up to one year or a fine of up to 500,000 yen. Thus, by imposing a criminal penalty, the Maternal Health Act severely limits one’s ability to undergo sterilization surgery.

　Legislative History and Amendments of the Maternal Protection Act　　

The Maternal Health Act has its roots in the National Eugenic Law and the Eugenic Protection Law.

1. Population Increase Policy and Sterilization Surgery under the National Eugenic Law

The National Eugenic Law was enacted in 1940 with the dual objective of curbing the proliferation of harmful genes and facilitating population growth during wartime by regulating contraception and abortion. This legislation primarily prohibited eugenic surgery (later referred to as sterilization surgery) for non-eugenic purposes, such as genetic mental illness, and imposed stringent limitations accompanied by criminal penalties. Additionally, the mandate for spousal consent was introduced, reflecting the prevailing societal norms wherein a woman's autonomy was often subject to the authority of her spouse or parents.

2. Population Control Policy and Sterilization Surgery under the Eugenic Protection Law

After the war, population control emerged as a pressing national concern, alongside growing criticism of the National Eugenic Law for its emphasis on increasing births and overlooking women's rights related to pregnancy and childbirth. In response, the Eugenic Protection Law was enacted in 1948, retaining the rules of the National Eugenic Law on eugenic surgery, while adding "the protection of maternal life and health" as a new objective. This act established rules for eugenic surgery (sterilization surgery) aimed at preserving maternal life and health, which were later adopted by the Maternal Health Act.

Yet, the Eugenic Protection Act continued to prohibit general sterilization surgery for non-eugenic reasons, maintaining penalties for such actions. The act viewed sterilization surgery as a tool to manage population "quantity" without compromising "quality," reflecting an ideology from the National Eugenic Law era that advocated for state-regulated childbirth.

3. Principle of Prohibition Sterilization Surgery Mmaintained under the Maternal  Act

Entering the 1970s, criticism mounted against the use of the term "eugenics" and provisions that permitted forced surgery within the Eugenic Protection Law. The criticism culminated in strong international condemnation at the United Nations International Conference on Population and Development in Cairo, Egypt, in 1994. In response to this backlash, the law was revised in 1996, transitioning from the Eugenic Protection Act to the Maternal Health Act.

During the legislative process, there were proposals to liberalize sterilization surgery; however, changes were only made to the eugenic provisions, focusing on surgical requirements for hereditary diseases and leprosy, which were broadly acknowledged as concerns by stakeholders. While there was consideration for repealing or amending articles not aligned with women's reproductive self-determination rights, the contentious rules surrounding sterilization surgery were left untouched. As a result, the principle of prohibiting sterilization surgery, a stance that has persisted from the eras of the National Eugenic Law and Eugenic Protection Law — when the state regulated childbirth as part of its population policy — remains in effect to this day.

The rules on sterilization surgery under the Maternal Health Act are not in line with today's society, where the respect for self-determination regarding sex and reproduction is emphasized. Therefore, the rules need to be updated.

　Points in Dispute

We claim that Articles 3(1), 28, and 34 of the Maternal Health Act (hereinafter referred to as "the provisions in question") are unconstitutional and illegal, and we are making the following three claims against the state:

• Request for confirmation that the plaintiffs are in a position to undergo sterilization
• Request for confirmation that the failure to allow sterilization surgery is illegal
• State compensation for legislative omission

The grounds for considering the provisions in question unconstitutional and illegal are as follows. 

Violation of Article 13 of the Constitution

Article 13 of the Constitution stipulates respect for individuals. Respect for individuals means that each person, as an autonomous being, is "an irreplaceable author of their own life" and must be respected to the fullest extent as they aim to form their own life.

For those who feel a strong sense of discomfort with their own reproductive capacity or are convinced in choosing a life without children, sterilization surgery is an indispensable means to live their own life in their own body. Whether or not one can undergo sterilization surgery is directly linked to the personal autonomy of those who desire it, and the right to self-determination in this matter (the right to undergo sterilization surgery) is protected by Article 13 of the Constitution. 

The provisions in question prohibit sterilization surgery in principle with penalties and deprive the right to undergo the surgery. These provisions are supported by the ideology from the era when the state managed childbirth as a means of population policy, which is not rational at all today. Therefore, the provisions in question violate Article 13 of the Constitution.

Violation of Article 24(2) of the Constitution

Article 24(2) of the Constitution provides that "With regard to choice of spouse, property rights, inheritance, choice of domicile, divorce and other matters pertaining to marriage and the family, laws shall be enacted from the standpoint of individual dignity and the essential equality of the sexes," and imposes a duty on the State to enact legislation that enshrines individual dignity in matters pertaining to family life (Article 13) and gender equality (Article 14). 

The purposes of this provision are to reject the family view rooted in the Meiji Constitution and to break away from the idea that the state constructs legal systems based on a certain family view and enforces family formation.

The provisions in question stipulate that women must obtain permission from their spouse and have already given birth as conditions for undergoing sterilization surgery. This assumption mirrors the traditional family structure outlined in the Meiji Constitution, prioritizing childbirth and childcare responsibilities over women's autonomy in reproductive decisions.

The provisions in question reinforce the prewar patriarchal family structure through the imposition of criminal penalties. By doing so, they undermine the intent of Article 24 of the Constitution, which aims to reject and move away from traditional family structure, thereby contravening Article 24(2) of the Constitution.

　Call for donations　

Through this lawsuit, we hope to encourage a nationwide discussion in Japan about the issues with the current rules on sterilization surgery and bring about change. We kindly ask for your support to help create a society where each individual can make their own decisions regarding their sexuality and health.

　Use of Donations　

• Litigation expenses: expenses for stamps, photocopies, etc.
• Opinion writing expenses for scholars: Given the specialized nature of this field, we plan to engage constitutional law scholars, administrative law scholars, and other experts to write opinion letters.
• Evidencing overseas knowledge: We are considering conducting interviews and obtaining written opinions from overseas experts. This will require translation fees and standard honorarium expenses.
• Travel expenses for lawyers, plaintiffs, etc.: We plan to use the donation to cover travel expenses for plaintiffs and some of their lawyers to appear at the trial, as well as for experts and others traveling toTokyo.
• Publicity and events: We would like to use the donation to cover publicity and events associated with the trial.
• Legal fees: We would like to use the donation to cover the legal counsels' start-up fees, contingency fees, daily travel expenses, and related costs.

  
  

  
  
  

About the defense team　

Michiko Kameishi (Law Office Eclat Umeda)
Daisuke Igeta (Miyamura and Igeta Law Offices)
Kaori Oka (Kowa Law Office)
Motoki Taniguchi (Tokyo Public Law Office)
Yoshitaka Toda (Law Office LEDGE)
Yukiko Hayasaka (Senkawa-dori Law Office)

　Message from the Counsel　

In a society with a declining birthrate, where having children is encouraged, it can be challenging to declare a choice to live without children. Moreover, it may be not well known that there are individuals who want to undergo sterilization surgery as a reliable and safe method of contraception, or those who feel discomfort with their inherent reproductive capacity and wish to remove them through sterilization surgery. Together with the plaintiffs, we aim to use this lawsuit to reclaim women's right to self-determination regarding reproduction, and to strive for a future where each individual can live a fulfilling life in a body that feels true to themselves.

Michiko Kameishi, Attorney

　About LEDGE　

This lawsuit is supported by LEDGE. LEDGE is Japan's first citizen-donation-based public interest litigation group dedicated to human rights advocacy and social change. (Some of the lawyers in this lawsuit are members of LEDGE).

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