Japan's Supreme Court has upheld a law that effectively requires transgender people to be sterilised before they can have their gender changed on official documents.
The court said the law is constitutional because it was meant to reduce confusion in families and society.
But it acknowledged that it restricts freedom and could become out of step with changing social values.
The law states that people wishing to register a gender change must have their original reproductive organs removed and have a body that "appears to have parts that resemble the genital organs" of the gender they want to register.
The decision, published Thursday, rejected an appeal by Takakito Usui, a transgender man who said forced sterilization violates the right to self-determination and is unconstitutional.
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