The Supreme Court of Japan published a ruling on Thursday (24 January) upholding a law that requires transgender people to be sterilized before changing their gender on official documents. Japan’s law in question is No. 111, which first took effect in 2003. The law states trans people, in order to secure a gender change, must be diagnosed with gender identity disorder (GID). Two or more ‘respected’ medical professionals must prescribe the diagnosis. According to Japan’s definition, GID describes a person whose biological sex is ‘clear’ but they have a ‘psychological identity with an alternative gender’ and plan to live as that gender. The American Psychiatric Association removed GID from its mental health guide in 2012. They replaced it with gender dysphoria (GD). GD describes the emotional and mental distress of living as a gender that does not align with a person’s true gender.