Article

Beginnings of sex reassignment surgery in Japan

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Abstract

The first sex reassignment surgery (SRS) performed officially in Japan - for a female-to-male (FtM) person in 1998 and for a male-to-female (MtF) person in 1999 - are reported. For the FtM, two-stage conversion was applied. In the first operation, salpingo-oophorectomy, hysterectomy, colpectomy, metoidioplasty, and mastectomy were performed. A free flap phalloplasty with the deltoid flap is planned as the second stage. For the MtF, one-stage neovaginoplasty was performed by penile skin inversion technique with sensate pedicled neoclitoplasty.

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... Torai comments that it was this 'one patient who opened the door' for legal SRS in Japan (Harima 2004: 127). The ethics committee commissioned a report on GID and SRS from its medical team, which acknowledged that the disorder existed and that SRS was a medically justifiable activity (Takamatsu et al. 2001). The ethics committee requested guidelines for diagnosis, and physicians at the hospital drew these directly from guidelines by The Harry Benjamin International Gender Dysphoria Association (now named the World Professional Association for Transgender Health), publishing them in 1997. ...
... The first legal SRS in Japan was female-to-male and took place at Saitama Medical School in October 1998. There was no public criticism and the surgery was positively reported in mainstream Japanese media (Takamatsu et al. 2001). ...
... However, an alternative view is that Japan is still largely a homophobic and transphobic society and there are major issues with discrimination on a daily basis (Amnesty International, 2017;Kaleidoscope Human Rights Foundation, 2015). The first GAS in Japan was completed in 1998 (Ako et al., 2001). In Japan, 'Gender Identity Disorder' is still considered a mental illness according to Mental Health and Welfare Law (Masumori, 2012). ...
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