Issue:
May 2025 | Japan Media Review
The new reproductive assistance bill does little for those it is supposed to help
Sachiko Ishizuka's name appeared in various Japanese media this spring. The 45-year-old activist spoke to members of the Constitutional Democratic Party (CDP) on April 9 about a bill now being discussed in the Diet that would address donor information in situations where couples use artificial insemination by means of third-person gametes. Though AID – artificial insemination by donor – has been available in Japan since 1948, it's never been properly regulated, and Ishizuka, who herself was conceived with the sperm of someone who was not the man she calls her father, is pushing the government to mandate greater disclosure of information about sperm donors, including their identities.
The CDP is not one of the four parties – the ruling Liberal Democratic Party (LDP), its ruling coalition partner Komeito, Nippon Ishin no Kai and the Democratic Party for the People – that submitted the bill to the Upper House in February. Ishizuka wants the CDP, considered the main opposition party, to fight against the bill in its present form, which only requires minimum disclosure about sperm donors, specifically, height, blood type, and age. Doctors and clinics that carry out the procedure will not be obliged to disclose the names and contact information of donors without the donors' consent. The reason for the restriction is that the government is afraid that forcing men to reveal their identities would limit the number of potential donors, whom they believe would want to remain anonymous.
Ishizuka's advocacy is personal. According to an interview in Gendai Business, she didn't learn that she was conceived through AID until she was 23, and the shock of discovery turned her against her parents for keeping this knowledge from her. The procedure was carried out at Keio University's Keio Gijitsu Hospital, where almost all the sperm donors were medical students. The hospital's policy is not to disclose the identities of its sperm donors. It also did not tell the donors if their sperm had been used. More than 20,000 AID procedures have been performed at Keio, and many of the children produced don't know that they are the result of AID. Doctors were not encouraged to follow up on the children they helped bring into the world, and they advised the parents to never tell their children about their provenance.
Ishizuka's parents followed this advice, but Ishizuka found out about her origin through a roundabout way. When she was high school-age her father was diagnosed with an incurable disease that is often genetically acquired. When Ishizuka expressed concern, her parents assured her that she couldn't inherit the disease, though they didn't explain why. In university she studied her father's illness and even obtained his medical records, where she learned that the inheritable rate for the disease was 50%. She started talking about it to other people, and so her mother eventually explained how she was conceived to alleviate her worries. She had been unable to get pregnant with her husband and so had received sperm from an anonymous donor through Keio.
Ishizuka was relieved that she was clear of the disease, but devastated by the news of her mother's AID treatment. What disturbed her most was that her parents had sought out the treatment while disregarding the possibility that their child might someday want to know who her biological father is. The break with her parents was severe. She moved out and says that until she locates her biological father she cannot reconcile with her parents. Consequently, she founded the organization Donor Link Japan, which helps people like her search for their biological parents. As she soon learned, there were many other people in a similar situation.
Japan has the second largest number of people in the world who seek treatment for infertility in a given year, after China. According to a survey conducted by a social welfare research center cited by Gendai, in 2021, 22.7% of married couples who were trying to have children accessed infertility treatments. The rate in 2015 was 18.2%. AID is usually used when the male partner has a low sperm count. National insurance can’t be used for AID, which is usually a last resort. Since AID is not regulated, there was no discussion about donor anonymity in the government. There are private sperm banks that require donors to agree to disclose their identities, and one Japanese infertility counselor, Harumi Ito, told Gendai that she herself gave birth to two AID babies in the UK and now works for a foreign sperm bank in Japan. Ito points out that there is a shortage of donors in Japan mostly owing to anxiety over disclosure, and that fertility clinics in Europe, where it has become the norm to not accept donors who insist on anonymity, incorporate mandatory counseling on how to inform children about their origins. In Japan, there is no active disclosure or pre-treatment counseling, which she says are vital to protect a child's right-to-know. Ito's clinic requires donor information on height, weight, blood type, ancestry, health history, family genetic history, employment, and marital status (including whether the donor has children). It also asks the donor to provide their "motivation" for giving sperm. When the child turns 18 and expresses a desire for this information, the file is opened to them, but the donor decides whether there will be any contact. The child also receives counseling before full disclosure is made.
At present, Ito's clinic, which opened in May 2024, has about 140 potential donors, 30% of whom have been approved so far. Many potential donors are turned away because of their position on sperm donation. Ito's clinic does not accept men who believe they are "benefiting society" with their implied "superior genes", or who have always wanted to have children but have yet to find a partner. Gendai was able to interview a few potential sperm donors and the ones who seem to be acceptable to Ito's clinic are those who want to help others have children and who agree to meet with any child produced when the child is older.
Presently, all AID treatment in Japan is carried out by private concerns, so the government will become involved in yet another bid to increase the birth rate when the bill is passed. But as concerned parties like Ishizuka and Ito point out, the guidelines of the proposed bill favor donors rather than the children. The legal purview of the bill so far is vague. Moreover, once national insurance enters the discussion, the cost of such treatment will also be regulated, something that doctors may object to. Presently, they can charge anything they like.
However, there is another aspect of the bill that a different cross-section of the public finds unsatisfactory, and that is who is eligible for such treatments. Guidelines covering current AID treatments were formulated by the Japan Association of Obstetricians and Gynecologists (JAOG), which only provides the service to legally married couples. According to a recent article in the Asahi Shimbun, however, these guidelines are not legally binding. Some Japanese who are not married have availed themselves of alternative reproductive measures, including in vitro fertilization and the use of overseas surrogates, but once the government passes a law to regulate AID and other reproductive assistance methods, these people may be breaking the law. In addition, any institution that carries out assisted reproductive treatments (except surrogacy, which would certainly remain illegal in Japan) would need to be approved by the government, which, like the JAOG, insists that the procedure only be available to married couples. Violators would be liable for punishment.
JAOG does not guarantee the right-to-know for children of AID. The new bill would also not obligate donors to disclose anything but the most basic, untraceable information. Any further matters regarding disclosure will be decided by the Cabinet. Other matters can be discussed more fully after the bill is passed.
It is the Civil Code that limits infertility treatments to legally married couples. Though AID is only being addressed by the Diet now, the government has been discussing such treatments for more than 20 years. The health and justice ministries submitted a report on the matter in 2003, but nothing was done until 2020 when a bill was passed stipulating the definition of such treatment and the responsibilities of all interested parties. Recipients could only be married couples: the mother of a child is the person who gives birth to that child and the father is the male party who "agrees to the process". Surrogacy is not an option in Japan because only the birth mother can be registered as a child's mother in Japan unless the child is "specially" adopted.
The question of anonymity associated with AID and adoptions is already being debated in Kumamoto, where Jikei Hospital has been operating a so-called “baby hatch” since 2007. The purpose of the hatch is to protect newborns whose biological parents have decided they cannot raise these children for whatever reason, and so the babies can be deposited anonymously in a special box. In 2021, the hospital started a new program where pregnant girls and women who had decided they could not raise their offspring would deliver the baby safely in the hospital anonymously, meaning their identity would be kept secret while the child was put into foster care and/or offered for adoption. According to the Jikei Hospital website, as of now the child's right to know who their parents are is not guaranteed by the hospital, but it acknowledges that such a policy "could be harmful to the child's sense of identity". When a child is deposited in the baby hatch, the hospital cooperates with local police and child welfare services. If the hospital somehow has contact with one or both parents, they will negotiate in order to obtain disclosure, but eventually any child left in the hospital's care will be the responsibility of Kumamoto's child welfare authority.
In the case of anonymous deliveries, the mother is still required to fill out a form, but access to the document is restricted to one or two staff members. This is slightly different from similar programs in Europe, where mothers who wish to remain anonymous are truly anonymous. In March, the Kumamoto Nichinichi Shimbun ran an article that explained how city authorities, including the mayor, are now working with the hospital to discuss ways of handling the information of origin regarding anonymously delivered or deposited children. The goal is to change the current policy to one where all children who come into the hospital's care anonymously will be able to access the available information about their parents when they turn 18, and, in fact, the city has made a request to the central government to normalize such disclosures by law.
The procedure would be to collect as much data about a child's birth as possible and store it with the authorities or at the hospital. The information would be disclosed to the child at a later date, but only with the consent of one or both biological parents. Experts in child psychology and welfare law would be consulted about disclosure.
One of the more important legal considerations when formulating a policy about anonymous parentage is the matter of "special adoptions", meaning children who are adopted as infants or young children. In Japan, the adoptive status of a child is not indicated in the family register if the adoption is completed before the child turns 15 (it used to be up to six years old). A group called International Social Service Japan helps adopted children, and in some cases their adoptive parents, find the children's "roots" by assisting in the location of their biological parents. In some cases, the information they dig up may not be particularly welcome, such as the intelligence that a child was the product of rape, or that the parent gave up the child because of some crime-related matter. In any event, ISSJ contacts any known facilities that may have been involved in the child's birth for information that it then shares with the inquiring child. From that point it is up to the child to access family registers and other relevant documentation.
Again, special adoptions in Japan can only be carried out by legally married couples, a fact that points up how the law, and the proposed assisted reproductive technology bill, would leave out other people who might want to use such methods to make families, including couples in common law relationships and single women. The bill's tacit exclusion of same sex couples is one of the main reasons why the CDP is opposed to it. On April 15, the Asahi published an interview with Maki Muraki, the head of the non-profit organization Nijiiro Diversity, who is raising a child with her female partner. She says the proposed bill effectively denies the existence of her child. The couple obtained sperm from a third party and Muraki's partner carried and delivered the baby through AID treatment. The child is now aware that Muraki's partner is their birth mother and that their biological father was a sperm donor. According to the government, however, the child's existence is essentially the result of actions that will soon be illegal. This unfortunate situation is compounded by the fact that since same-sex couples cannot marry in Japan, the child is doubly stigmatized by being recognizable as "illegitimate" in the family register. Muraki says that same sex couples in Japan are now rushing to undergo assisted reproductive treatment before the bill is passed, since such technology will be legally unavailable to them afterwards.
"We belong to an LGBTQ group whose members are raising children," says Muraki. "We think of ourselves as ordinary families, meaning no different from any other family." Statistically, same sex couples are more likely than heterosexual couples to resort to AID and other alternative procedures in order to have children, so the law and the proposed bill, regardless of its stated purpose, is by definition discriminatory.
Philip Brasor is a Tokyo-based writer who covers entertainment, the Japanese media, and money issues. He writes the Japan Media Watch column for the Number 1 Shimbun.
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