Stepping towards inclusive health care for LGBTQ+ community in Japan

In Japan, the term LGBTQ+ is slowly becoming more widely known, but there is still a lack of understanding in various situations. When it comes to the medical field, some members of the LGBTQ+ community may hesitate to visit a hospital or feel unsafe even though they have the right to receive health services when needed.

“Our standard” possibly hurts LGBTQ+ community’s wellness

Imagine going to see a doctor. You are required to show your health insurance card and fill out a medical questionnaire if it is your first time at a hospital. When your turn comes, you may be called by your full name. These are everyday things for many people. However, LGBTQ+ people, especially transgender people, may feel insecure in these situations.

When there is a visible gap between their appearance and their registered sex, they may be afraid of being asked about their sexuality when showing a health insurance card. They may also feel uncomfortable about attracting the attention of people around them when called by their full name in public. The same thing may occur when name tags are hung up at the door of patient rooms, beds and wristbands when being hospitalized. Also, rooms and bathrooms at hospitals are often separated by gender.

When receiving doctor’s consultations in Japan, patients may be asked about their wives or husbands or whether they are married. Doctors need to know the patient’s background and who can support them while in treatment. Therefore, they sometimes unconsciously ask these questions based on the patient’s appearance or sex. Considering the variety of gender identities and sexual orientations, and the Japanese law which prohibits same-sex marriage, these types of questions have the possibility of hurting LGBTQ+ people. There have also been cases where patient was outed to family members by medical staff who believed the patient already came out to them. These types of cases demonstrate a lack of communication between patients and medical staff.

Balancing medical safety and respecting each patient’s identity

In these situations, we need a balance between medical safety and respect for patients’ identities. One good example of addressing these problems is a notification regarding a health insurance card. It was issued by the Ministry of Health, Labour and Welfare in 2017. The statement allows people who are diagnosed with gender dysphoria to put their common name on the front side of their health insurance card.

Additionally, in Sapporo city, people can choose a label of “refer to the other side” in the gender section on the front side of the card. Registered names and registered sex are still needed to be shown on the other side for medical safety. Still, the anxiety caused by being asked about one’s gender in public can be decreased. It doesn’t affect the authentication process either. To make this a new standard, providing proper training and education to health care workers will be key.

Other good examples include referring all patients by their family name with a given number in some hospitals. For medical safety, all patients are required to wear a wristband with a registered name when hospitalized. At the same time, however, there is a risk of harming LGBTQ+ people, as mentioned. Some hospitals, therefore, allow patients to place their wristbands in a place that can be hidden with clothes. Some hospitals equip all-gender facilities assuming gender equality.

Creating equal health care for all

These circumstances often give the misleading impression that the LGBTQ+ community has to be given special consideration. However, what we need to consider is how we can create a livable society for all. As with accommodating the various irregular demands of other patients, the existence of issues facing the LGBTQ+ community should be recognized more widely as they also have a right to receive health care when they need it. Moreover, it is essential to communicate closely to understand that everyone has different needs and backgrounds.