The history of Japan's health policies related to sexuality

Abstract

This article aims to present an outline of the history of health policies related to sexuality in Japan, focusing on challenges to improve women’' health and welfare, and to discuss the future policy directions from the perspective of the diversity of sexuality. Measures to improve women’' health had focused on their specific situations and roles. To protect “maternity,” public assistance has been available for many years , for pregnant women and mothers experiencing poverty, and the Maternal and Child Health Act introduced measures to promote the health of all pregnant and nursing women. These measures were promoted in a way that maternity was integral to the child. Before World War II, the primary measure against sexually transmitted diseases was the control of “prostitutes,” followed by a shift to control of the general public after abolishing the licensed prostitution system and enacting the Anti-Prostitution Act. Furthermore, measures aimed to protect and reform women engaged in prostitution, with the scope of protection and support later expanded to “women with difficult problems.” Measures to protect “working women,” including restrictions on overtime, holidays, and late-night work, were first initiated at factories and then extended to all workplaces. Although these restrictions were abolished under the Act on Equal Opportunity and Treatment between Men and Women in Employment, working women’' health, particularly maternal health, continues to be considered. After the concept of reproductive health/rights was proposed in 1996, measures to support women’' health throughout their lives, including adolescence, pregnancy and childbirth, menopause, and old age, were clearly defined as part of both gender equality policy and health policy. The specific measures include support for those seeking infertility treatments, public awareness such as “Women’' Health Week” and the “HealthCareLab” website, preconception care, gender-specific medicine, FemTech, Gendered Innovations, solutions to period poverty, and research and development. In 2003, the first legislation related to sexual diversity in Japan was promulgated, and in 2023, the Act on Promoting Public Understanding of Diversity in Sexual Orientation and Gender Identity was implemented. Except for measures against AIDS and supporting women with difficult problems, measures to address health problems related to diversity in sexual orientations and gender identities have not progressed adequately. To develop health policies that take sexual diversity into account, it is necessary to identify in detail the health status and problems of people with diverse sexualities and to define the ideal of health for each sexuality.