Overview
JOICFP plays a critical role in advancing sexual and reproductive health and rights (SRHR) as well as in the broader ecosystem of efforts to improve women’s wellbeing, by serving as a bridge between international expertise, local stakeholders, and underserved communities. Our approach ensures complementarity with existing initiatives by enhancing the capacity of communities for sustainable health systems while avoiding duplication of efforts.
Current Global SRHR Status
According to the WHO, almost 800 women died daily in 2020 due to preventable causes related to pregnancy and childbirth. Unfortunately, the risks to womens’ wellbeing extend beyond medical issues. In some areas, girls are forced into child marriage or genital mutilation, denied an education, and stripped of their right to make choices about their own lives, simply because of their gender. Marginalized groups — such as women, people with disabilities, adolescents, and sexual minorities, particularly in low- and middle-income countries — often face barriers that prevent them from accessing essential sexual and reproductive health services, leaving them disproportionately underserved. These barriers are reinforced by stigma and discrimination, which silence conversations around SRHR. Compounding this issue, access to accurate information and essential services — including contraception, abortion, and sexuality education — is severely limited. As a result, women face higher risks of unintended pregnancies, unsafe abortions, pregnancy complications, and sexually transmitted infections. This not only restricts their life choices, but too often costs women their lives.
Many of these tragedies can be prevented through access to essential medical care, comprehensive sexuality education, and community support. Since its establishment in 1968, JOICFP has worked over 40 countries to address these challenges. By advancing SRHR, we strive to create a world where everyone can live authentically, with health and empowerment.
Overview of Japan’s Current SRHR Status
Despite Japan’s progress in maternal and child healthcare, Japan’s SRHR landscape remains highly restrictive, with significant legal, financial, and social barriers to contraception, abortion, sexuality education, and gender equality. Urgent reforms are needed to ensure universal access to sexual and reproductive health services, remove outdated legal obstacles, and uphold fundamental human rights.
*The following information, as of October 2024, is drawn from the 2024 Japan Women’s Watch Report chapter entitled ‘Women and Health,’ authored by JOICFP’s Hiromi Kusano: https://jaww.info/doc/JAWW-NGO-Report-2024.pdf
Contraception:
In Japan, only three modern contraceptive methods classified by the WHO are available: male condoms, oral contraceptive pills (both combined and mini pills), and intrauterine devices/systems (IUD/IUS). Other female-controlled options such as contraceptive implants, rings, patches, and injections remain unavailable. Sterilization is restricted under the Maternal Protection Act, requiring individuals to have at least one child and obtain spousal consent. Emergency contraceptive pills (ECPs) are not yet widely accessible despite repeated advocacy efforts. A pilot program for pharmacy sales, launched in November 2023, has had minimal impact — only 145 out of 62,000 pharmacies nationwide participate, and even in Tokyo, only five pharmacies offer the service. The pilot program also does not cover those under 15 years, and 16- and 17-year-olds must be accompanied by a guardian for permission. The cost of ECPs remains high (7,000-9,000 yen), and access is hindered by cumbersome requirements such as confirming stock availability, signing consent forms, and taking the medication in front of a pharmacist. These barriers exacerbate stress and delay access to urgent care.
Japan received a critically low Atlas score of 36.7% for its policies ensuring access to modern contraception. © 2024 Global Contraception Policy Atlas
Abortion:
Abortion in Japan remains criminalized under a law dating back to 1907, reinforcing stigma despite its necessity for reproductive autonomy and health. Under the Maternal Protection Law, abortions are permitted under restrictive conditions, including a controversial spousal consent requirement. The procedure is only performed by designated doctors and is not covered by health insurance, making it expensive (100,000-200,000 yen for early abortions of less than 12 weeks). Oral abortion pills were approved in April 2023 but are restricted to pregnancies within nine weeks. Use of the pills requires hospitalization and additional medical fees, pushing total costs beyond 100,000 yen, which is equivalent to the cost of a surgical abortion. In July 2024, the Ministry of Health, Labour and Welfare announced plans to ease restrictions, allowing non-hospital facilities to administer the medication.
Comprehensive Sexuality Education (CSE):
Sexual intercourse is not covered in Japan’s compulsory public education curriculum, leaving critical gaps in knowledge about sexual and reproductive health. Japan’s national sexual education is conservative, covering basic human anatomy related to reproduction and some information on STIs, while failing to adequately discuss topics considered ‘taboo’ such as contraception, pregnancy, and diversity in gender identity and sexuality. Many international bodies (including CEDAW [CEDAW/C/JPN/CO/7-8], the Convention on the Rights of the Child [CRC/C/JPN/CO/4-5], and the UPR review [A/HRC/53/15/Add.1]) have repeatedly recommended that Japan implement CSE, yet progress remains slow.
LGBTQ+ Rights:
No laws exist that grant marital status to same-sex couples in Japan. For the first time in the country’s history, the government’s ban on same-sex marriage was ruled as unconstitutional on the local level — this ruling came from the Sapporo High Court in March 2024. Within the following year, four additional high courts came to the same decision, with the latest ruling made in the Osaka High Court in March 2025. These rulings are huge steps towards achieving marriage equality in Japan, although great legal action must be taken by the national government to protect LGBTQ+ individuals and couples across the country. Presently, the limited recognition of same-sex partnership provided by local certificate schemes do not offer the same legal benefits as marriage, such as parental recognition and inheritance.
A major legal breakthrough occurred in October 2023 when Japan’s Supreme Court ruled that the sterilization requirement for transgender individuals to change their legal gender was unconstitutional. Previously, the Gender Identity Disorder Special Law mandated the removal of reproductive glands as a condition for state-sanctioned gender change. The ruling affirmed that forcing individuals to choose between unwanted sterilization and legal recognition of their gender identity was unjust. This decision marks a critical step toward protecting the reproductive rights and bodily autonomy of transgender individuals in Japan. However, other stringent requirements remain for an individual to legally change their gender markers, including being unmarried and having genitalia that resembles the sex they wish to transition to, the latter of which essentially necessitates a costly gender-transition surgery.
