Contraception in Japan

When I began to experience health problems in Japan, I went to a specialist who did a run down on my medical history. After answering all the usual questions, I mentioned offhand that I used a mirena IUD for contraception.

He didn’t know what it was.

I googled it and showed him on my phone, in disbelief that I was educating a medical professional about a widely used form of contraception (which, yes, is available in Japan) in 2016. He immediately freaked out and told me that the hormones were what was causing my symptoms. Logic and advice from a gynecologist told me this was unlikely but I was still trying to trust in the treatment I was receiving back then, so I got it removed. Surprise, surprise nothing improved.

This was my first insight into attitudes towards contraception in Japan which are a teensy bit different from back home. The pill was only legalised in 1999 in Japan (38 years after the UK) and even then was marketed more as medicine for ‘hysterical women’ than as a method of birth control. This is one reason the pill carries some stigma and is not as widely used as in other industrialised countries even today. Another reason for the stigma is that historically abortion has been far more accepted as a method of birth control in Japan than elsewhere. Indeed, it was legalised in 1949, a decade before other industrialised countries, and Japan drew criticism for being so accepting that people would come from abroad to have abortions.

Moreover Japanese national health insurance does usually cover contraception. The pill will cost you ¥3,000 a sheet, the coil up to a whopping ¥50,000. As far as I know the implant and the injection aren’t even available. Even removing my coil cost me ¥18,000. Seeing as childbirth isn’t covered by national insurance either, basically it sucks to be a woman.

So if they’re not into other forms of birth control the Japanese must be using condoms right? Well you would think so. But the stories I hear from my friends paint a different picture; people who refuse to carry condoms because they don’t want to appear slutty or they think it will make their dalliance seem over planned and less romantic. Couples who think the ‘withdraw method’ is safe and, surprise surprise, end up with an unwanted pregnancy. Japanese women who think it’s insulting if a man decides to use condoms with them. A friend once told me that when she asked the Japanese guy she was hooking up with about condoms he actually mimed putting one on hoping that she wouldn’t be able to tell the difference.

On a more serious note, Japan has a rising HIV rate. Misinformation about HIV and other STIs is rife, with some Japanese ludicrously believing that AIDS is a ‘foreign’ disease and can only be contracted by having sex with a foreigner. To be fair to the health ministry, they recently decided to try and combat unsafe sex by and enlisting the help of Sailor Moon.  Yes that’s right right, the anime character Sailor Moon. To combat an alarming high rate of syphilis, 60,000 Sailor Moon themed condoms will be distributed, along with 156,000 information leaflets. ‘In the name of the moon I will punish you if you don’t get tested!’

The Sailor Moon condom in a heart shaped package.

Well, it’s 2016 and traditional institutions are collapsing all around us but, at least we can still count on pop culture.

If you are looking for advice on contraception and you are in Tokyo and don’t speak Japanese, or if you want to speak to a doctor with a more international outlook, I would recommend Primary Care Tokyo in Shimokitazawa or Tomoko’s Ladies Clinic in Omotesando.

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