Journal of the National Institute of Public Health
Online ISSN : 2432-0722
Print ISSN : 1347-6459
ISSN-L : 1347-6459
Topics
The history of Japan's health policies related to sexuality
Shinji TAKEMURA
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Keywords: sexuality, maternity, women's health, gender equality, diversity
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2025 Volume 74 Issue 1 Pages 60-73

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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’s health and welfare, and to discuss the future policy directions from the perspective of the diversity of sexuality. Measures to improve women’s 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’s health, particularly maternal health, continues to be considered. After the concept of reproductive health/rights was proposed in 1996, measures to support women’s 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’s 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.

Translated Abstract

本稿では，日本における性に関連する健康政策の歴史に関して，女性の健康と福祉の改善に向けた取り組みを中心に概観するとともに，性の多様性に適合した健康政策の今後の方向性を議論する． 女性の健康のための対策は，女性に固有の状況や役割に焦点を当てて実施されてきた．「母性」を保護するために，貧困の妊婦や母親への公的扶助が古くから実施されていたが，母子保健法制定後は全ての妊産婦の健康を増進する対策が，母性と小児を一体とした形で実施されている．性感染症対策は当初は「売春婦」を主な対象としていたが，公娼制度の廃止と売春防止法の施行によって一般市民に対象が拡大された．また売春防止法に基づいて，売春に従事する女性の保護と更生が実施されたが，その後「困難な問題を抱える女性」に対象を拡大して支援が実施されている．「働く女性」を保護するために，時間外労働，休日労働，深夜労働が制限されてきたが，雇用の分野における男女の均等な機会及び待遇の確保等に関する法律によって制限が撤廃された．しかし働く女性の健康を守る対策は，母性の保護を中心に引き続き実施されている． 1996年にリプロダクティブ・ヘルス／ライツの概念が提唱されて以降，思春期，妊娠・出産期，更年期，老年期を含む，生涯を通じた女性の健康支援が，男女共同参画政策と健康政策の両方において明確に位置づけられるようになった．具体的な施策として，不妊治療を希望する人への支援，「女性の健康週間」やウェブサイト「女性の健康推進室ヘルスケアラボ」などの普及啓発，プレコンセプションケア，性差医療，フェムテック，ジェンダード・イノベーション，生理の貧困への対応，研究開発などが挙げられる． 2003年に日本で初めて性の多様性に関連する法律が制定され，2023年には性的指向及びジェンダーアイデンティティの多様性に関する国民の理解の増進に関する法律が施行された．しかし性的指向や性自認の多様性に関連する健康問題への対応に関しては，エイズ対策や困難な問題を抱える女性への支援を除いては，十分に進展していない．したがって今後は，多様なセクシュアリティを有する人々の健康状態や健康問題を詳細に把握して，それぞれのセクシュアリティにとっての健康の理想像を明確にした上で，性の多様性を踏まえた健康政策を展開していく必要がある．

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