For Tacaquito Usui to marry his partner, Japanese law first requires him to undergo sterilisation surgery and be diagnosed with a mental disorder because he is transgender. Usui, who lives with his partner and stepson after coming out as trans five years ago, lost a three-year legal bid to change the rules in January. “If I don’t get operated on, I cannot change sex and cannot get married,” the 45-year-old farmer told the Thomson Reuters Foundation, from his home in western Japan’s rural Okayama prefecture. “I don’t need this operation to become a man – I am a transgender man for my family, maybe one option is going to another country to live.”