Photo/Illutration The release of the revised guidelines on the diagnosis for gender identity disorder announced on the website of the Japanese Society of Gender Incongruence (GI) (From the Japanese Society of Gender Incongruence’s website)

New guidelines are in place to help individuals suffering from gender identity issues find the right physician to deal with their problems.

The Japanese Society of Psychiatry and Neurology worked in tandem with the Japanese Society of Gender Incongruence (GI) to revise the guidelines.

They reflect court rulings that paved the way for transgender people to change their gender in their family register without undergoing gender-affirming surgeries.

Officials said the new rules stipulate that physicians who are properly qualified can determine what hormone treatment to offer and other medical assistance for gender transition to trans people.

The move follows a landmark judgement on sex changes by the Supreme Court last October that spurred both the ruling and opposition parties to advance discussions on revisions to the law governing the issue.

The top court unanimously ruled that requiring transgender individuals to undergo surgery to remove their reproductive organs for gender changes is unconstitutional.

In July this year, the Hiroshima High Court allowed a transgender woman to change her gender in the family register without undergoing surgery to change the physical appearance.

The individual was born male but now lives as a woman.

The amended version of the guidelines on the diagnosis and treatment for gender incongruence was released Aug. 29 by the GI society as well as the psychiatry association’s committee on gender dysphoria.

Officials said the updated material recommends that doctors complete “workshops and training sessions” organized by relevant medical societies.

This is because the former guidelines simply stated that “psychiatrists with sufficient knowledge and experience,” including ideally “one doctor certified by the GI society,” should engage in the diagnostic process.

The latest guidelines also state that the diagnoses of at least “two physicians certified by the Japan GI society, or a pair of psychiatrists with equivalent expertise, must be consistent with each other for changing a patient’s registered gender.”

The special law concerning people with gender identity disorder defines five requirements, including surgery, for gender changes on registers.

Under the law, those eligible to seek a change of gender are transgender individuals who have received matching assessments on their disorder from “two or more physicians with the necessary knowledge and experience to give accurate diagnoses on this matter.”

The ruling and opposition blocs are discussing to make this diagnosis requirement stricter in exchange for reviewing surgery requirements.

As for a possible revision to the law, a project team at Komeito, the junior partner in the ruling coalition, said lowering the hurdle to changing gender now that surgery is no longer a requirement could make people “mistakenly think some depraved individuals may be able to pretend to be transgender.”

The team noted that “doubt may be cast on the validity of diagnoses,” too.

Considering these potential problems, Komeito insisted that ways must be found “to more fully ensure diagnostic validity.”

In the same vein, a report compiled by a special mission committee of the ruling Liberal Democratic Party on the course of legal reform stresses that “some measures will be necessary for securing the appropriateness of diagnoses.”

Mikiya Nakatsuka, a health science professor at Okayama University who is chairman of the Japan GI society, said the amended guidelines for physicians can help dispel that kind of fear.

“Concerns pointed to in the debate for a revision to the special law may be assuaged by our guidelines, while the content of the material is not legally binding,” Nakatsuka said.

The GI society has certified a total of 38 physicians to date. Of that figure, 15 are psychiatrists.

Nakatsuka said supplying more certified doctors and providing greater opportunities for physicians to take dedicated training represented a separate challenge.

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