First sex-change surgery in nation slated this fall

Pair of ladies will become pair of gentlemen

URAWA, Saitama Pref. (Kyodo) The Saitama Medical School is expected to perform the nation's first legally approved sex-change operations on two women as early as this fall., doctors said Wednesday.

A special team of doctors at the school has decided to ask the school's ethics committee to approve the surgery, the doctors said, adding that approval is expected in September.

The team, formed by doctors specializing in psycho-surgery, plastic surgery, obstetrics and gynecology, and urinary organs, gives treatment to those who feel as sense of incongruity with their gender and want to change, the doctors said.

The two women have already undergone psychoanalysis and have been receiving male hormones for some time, the doctors said, adding that the women are at this point living their lives as men.

In 1995, Takao Harashina, a professor of plastic surgery of the school, called on the ethics committee to approve sex-change surgery on the two women.

The request was rejected in July 1996, with the committee saying the operations would be correct but that not all the necessary conditions have been met.

Last May, the Japanese Society of Psychiatry and Neurology said a sex-change operation should be permitted on condition that a patient is at least 20 years old, has lived as a different sex for one year or more, and will undergo psychoanalysis and hormone therapy.

According to the school, some 2,000 to 7,000 people are suffering from a desire to live and be accepted as a member of the opposite sex and need to undertake some treatment in Japan.

copyright ｩ1997 The Japan Times

The Japan Times (Saturday, June 21, 1997, page3)

Transsexuals given hope for change

Committee's approval may put end to secret sex-change surgery

By KEIJI HIRANO Kyodo News

In her early childhood, Masae Torai, a 33-year-old freelance writer from Tokyo, never doubted that she would turn into a boy some day.

"I thought a male genital organ would sprout when I became an adult," she says.

However, her desire to be a man was dealt a major blow in the fifth grade when she learned the mechanism of menstruation.

"I felt like I was locked in the wrong body, and I didn't want the boys or girls around me to see my wrong body," Torai says.

She was uncomfortable wearing swimming suits for physical education classes limited to female students, and she refused to bathe with others when on school excursions.

"Imagine a man waking up one morning to find his breasts swollen and his genital organ gone.

I had that feeling, chronically," Torai says.

In a bid to replace her body, Torai headed off to the United States four days after graduating from college to undergo "sex reassignment surgery," popularly known as a sex-change operation.

The removal of her breasts in the first operation in 1987 was "just like the excision of a malignant tumor."

After undergoing three operations in two years in New York and San Francisco, her genital organs as well as breasts were gone, and Torai had gained a male genital organ, formed by transplanting flesh from other parts of her body.

At last, Torai physically became a man, the body and gender identification finally harmonized.

People like Torai are known as transsexuals, with the World Health Organization defining transsexualism, or "gender identity disorder," as "a desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex, and a wish to have surgery and hormonal treatment to make one's body as congruent as possible wit h one's preferred sex."

According to some medical studies, the incidence of transsexualism is estimated at about one case per 50,000- 100,000 people, suggesting that there may be upward of 2,000 transsexuals in Japan.

Torai was compelled to go to the U.S., because such operations have not been conducted openly in Japan since 1969, when a gynecologist, who had conducted sex-change operations for three male prostitutes, was convicted of violating the country's Eugenic Protection Law.

The law says no one may conduct operations that make reproduction impossible "without reason."

Since then, sex-change operations have been considered taboo in Japan, doctors say, and those who are unable to live with their given gender have had operations in secret or have gone abroad to countries where such operations are legal.

However, a recent decision by the Japanese Society of Psychiatry and Neurology has given transsexuals hope that they may not have to depend on secret operations or overseas surgery much longer.

A special committee of the academic organization came out with guidelines at the end of May approving for the first time sex-change operations as a way of medically treating gender identity disorder.

The guidelines say patients should receive psychiatric counseling and hormone therapy before undergoing the operation.

The patients must be more than 20 years old and are required to live as a member of the desired gender for a certain period of time before the operation, the guidelines say.

In addition, doctors should obtain written consent from their patients before the operation, as the surgery will have a major impact on their lives, such as removing reproductive ability.

The first open sex-change operation may be conducted at Saitama Medical School within a year, as its doctors have been successful in re-generating genital organs injured in accidents.

According to an official at the Health and Welfare Ministry, "Doctors will not be convicted as long as they conduct sex-change operations according to these guidelines."

Meanwhile, one major problem relating to transsexuals remains unsolved.

After completing the series of operations, Torai worked part-time at a factory for five years.

Given a chance to be a full-time worker, Torai declined.

"I had to submit to my employer a resident's certificate, in which I am still registered as a woman, to gain full-time status," Torai said.

"They would know I had been a woman if I chose to be a regular employee."

Torai sought a legal change of sex in 1994 but withdrew the suit, saying, "It was clear that the court would reject the proposal, as transsexualism was not recognized as a serious problem at that time.

I did not want to leave the wrong precedent by being rejected."

Other transsexuals have shared similar experiences and many have financial problems because they only feel able to work part-time, Torai says.

According to Yuko Higashi, a student at Ochanomizu University majoring in sexology, many countries, including some European nations and South Korea, permit transsexuals to legally change their sex after the operations.

"Transsexuals will face various difficulties if they don't have legal approval of their gender changes," Higashi said.

Torai has a girlfriend now, but cannot marry her under the current legal system.

"We could live together as a common-law husband and wife, but it would be impossible for us to enjoy the social benefits given to ordinary couples," Torai said.

"Sexual minorities, such myself, who are transsexuals or homosexuals, may have to establish our own facilities to secure living places in our old age, as we will not be accepted at old-people's homes for couples if our existence is not recognized legally," Torai said.

copyright ｩ1997 The Japan Times

(The Japan Times, Thursday, May 29, 1997, page 2)

Ban on sex change operations lifted

The effective outlawing of sex change operations in Japan was scrapped Wednesday when the Japanese Society of Psychiatry and Neurology gave final authorization to such operations for people suffering from sexual disorientation.

The Health and Welfare Ministry had said it would consider sex change operations for people suffering from gender identity disorders as "proper medical treatment" if the society came up with guidelines and the operations satisfied those descriptions.

In guidelines the society adopted the same day, the operation can be conducted if all other treatment, including hormone injections, have failed to end the patient's distress.

After a gynecologist who conducted a male-to-female sex change was found guilty in 1969 of violating the Eugenic Protection Act, sex change operations were effectively outlawed in Japan.

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