The chairman of Japan’s Association of Obstetricians and Gynecologists caused an uproar recently with comments implying that women in Japan couldn’t be trusted with over the counter pregnancy solutions such as the morning after pill.
The Fight for an OTC Morning After Pill
The backdrop for the comments is the legal status of levonorgestrel, a.k.a. the morning after pill. The pill is currently not available in Japan except by prescription from a physician. Proponents of the current law say that changing it would lead to overprescription and encourage the growth of a black market. However, the legislation runs contrary to international guidelines set by the World Health Organization, which encourages countries to make birth control as easily accessible as possible.
With the COVID-19 pandemic leading to a spike in emergency pregnancy consultations by young people, several NPOs in Japan have stepped up their efforts to change the law. The Project for Obtaining Emergency Birth Control at Drug Stores (緊急避妊薬の薬局での入手を実現するプロジェクト」) recently led a signature petition that amassed 67,000 signatures. The Project joined forces with another local organization, PILCON, which focuses on sex education, as well as with OB/GYNs and activists.
Amidst this activity, government broadcaster NHK’s morning program Good Morning Japan (おはよう日本) invited Maeda Tsukio (前田津紀夫), the head of the country’s OB/GYN association, to share his thoughts on declaring the morning after pill OTC.
It did not go well. Maeda told the host:
「日本では若い女性に対する性教育、避妊も含めてちゃんと教育してあげられる場があまりにも少ない」
「“じゃあ次も使えばいいや”という安易な考えに流れてしまうことを心配している」
There are few places in Japan where we educate young women properly about sex education and birth control. I worry that women will think, “I can just use this next time” and start using it casually.
In other words, women don’t know enough about sex and birth control to make decisions. Therefore, giving them access to the morning after pill will lead women down the pernicuous road of casual sex.
What About Male Sex Education?
Women took to Twitter to tear Dr. Maeda’s comments apart. One popular tweet echoed the sentiments of many other Japanese women by pointing out that male sex education isn’t any great shakes, either:
In the news about emergency contraception becoming OTC, a male doctor said, ‘Currently, sex education for women is inadequate, so I worry this will lead to an increase in casual sex.’ Let’s have that chat AFTER we get rid of men who think ‘Pulling out works’, ‘you can’t get pregnant during your period’, and ‘if you wash it with Coca-Cola afterward, it’s fine’.
Another user noted how the doctor ignored men’s role and went straight to criticizing women:
You can clearly see the contempt that says, “Women are ignorant and thoughtless and can’t be given the right to decide” from this doctor who ignores the problems on the male side and says women will use emergency contraception “casually” because of poor sex ed – even though women bear all the risk.
And someone else pointed out that Dr. Maeda’s solution wasn’t an effective remedy to the “problem” he raised:
The solution to “sex education is inadequate” is “give them sex education”, not “refuse medical care as punishment for their ignorance”.
Others argued that, if the tables were reversed, emergency contraception wouldn’t even be an issue. Manga author Sakai Eri, who created the story Hiyama Kentaro’s Pregnancy (ヒヤマケンタロウの妊娠) about a world in which men get pregnant, says that, when she created the story, she decided only one in 10 men in her world could get pregnant. “I thought that if the pregnancy rate matched that of women, emergency contraceptives and abortion pills would be approved, painless childbirth would become the norm, and male birth would be the talk of the town.”
Echoing Sakai, another poster proclaimed: “If having unprotected sex meant your dick swelled by 10kg, you couldn’t drink, you felt like puking for months, your ball sack tore to give birth, and you had to take a bunch of time off from work, you can bet the birth control rate would improve and you’d be able to buy emergency contraception at convenience stores.”
A Call for Action
Other medical professionals emphasized the need for Japan to conform to international standards and offer more choices to Japan’s women. Emmi Sakiko, an OB/GYN and one of the drivers behind the petition effort, argued on her blog that education isn’t enough:
Even if education is sufficient, no method of birth control is 100% effective. Unlikely events happen, such as condoms breaking, forgetting to take pills, or being sexually assaulted. Therefore, access to emergency contraception must be ensured….I hope this inspired society as a whole to think about sexual issues rather than regarding them as a matter of personal responsibility!
Neither Dr. Maeda nor Japan’s Association of OB/GYNs appear to have responded to the controversy. And there’s currently no sign that the Abe government will take up the call to change the law surrounding the morning after pill. Sadly, the activists and professionals leading the charge on this issue appear to have a long fight on their hands.
