A 50-something corporate worker is fearful that the government's plan to integrate the current health insurance card system into the Individual Number Card could reveal her sexual identity.

The worker is concerned that the change, planned for autumn 2024, will out the sexual orientation of those with gender identity disorder (GID) whose sexual identity does not match with that assigned for their physical sex.

"We have been struggling all these years, but all our efforts could be in vain. I have a great sense of fear and crisis," the Tokyoite said.

The worker was born male but identifies as female.

Although she had a surgery a few years ago, she remains registered as a male in the family registration system because people who have minor children are not permitted to change their officially registered gender.

She goes by a female name in her daily life.

DUE ATTENTION PAID

The current health insurance card has an ingenious function.

In the corporate worker's case, her health insurance card only bears her common name on the front side, with the gender section saying, "Refer to the reverse side."

Paying due attention to her sensitive information, her officially registered name and gender are noted in the comment field on the reverse side.

If her officially registered name is listed on the front side, she could be referred to by that name at a hospital and elsewhere while she could be accused of using someone else's card because her appearance doesn't match what the card says.

Such gender-sensitive measures have been gradually improved based on requests from GID people, which prompted the health ministry to rectify the situation.

The ministry notified relevant authorities in September 2012 that the gender can be indicated on the reverse side of the card and in August 2017 that the common name can be displayed on the front side.

But if the government's plan to scrap the health insurance card system and integrate its functions into the Individual Number Card, more commonly known as the "My Number" identity card, is greenlit, GID people will lose the privacy they currently receive. 

The My Number card bears the holder's facial photo, address, name, gender and other information on the front and the 12-digit ID number on the back.

According to the internal affairs ministry, what is listed on the card is determined by the so-called My Number law, directly reflecting information from the certificate of residence.

The back of the card should not be casually shown to others because it contains the holder's ID number, so it is not designed to list the name and gender on the reverse side like the current health insurance card.

COVERING WITH CASE

The government has received requests to scrap the gender section on the My Number card.

In October 2015, the advocacy group jid.jp submitted a written request to the government.

In response, the government devised ways for a card case to be distributed to cardholders when their health insurance card is issued. The case covers the ID number and the gender section when the card is inserted into it.

The general incorporated association has been urging the government to eliminate the gender section, but no other measures have been taken.

But jid.jp points out that the card case that covers the sensitive information is not enough to fulfill the purpose, saying that it would be meaningless if the case is torn and that the gender section on the front side can be easily exposed when the card is removed from it.

When using the My Number card integrated with the functions of the health insurance card, there is no need, in principle, for cardholders to hand over their cards to staff at hospitals and elsewhere as they just need to hold them up to a card reader installed at the counter.

Still, concerns are growing among GID people because the privacy they enjoyed with the health insurance card could be lost with the My Number card.

"Until now, we can choose to pass on the card if we don't want it, but there will be no choice but to obtain (the dual-use card) if it becomes effectively mandatory," a representative said. "It could mean that we will be forced to come out against our will every time we take out our My Number card."

When asked if there is leeway to change how the gender-sensitive information is listed on the My Number card, an internal affairs ministry official replied "no comment," while a health ministry official said: "We are not aware of such a possibility at the moment."

The advocacy group plans to ask the government to improve the situation.