TOKYO (AP) — An international rights group on Tuesday urged Japan to change a law that it says puts “abusive and outdated” burdens on transgender people seeking to have their gender change legally recognized, including sterilization surgery and a psychiatric diagnosis.

The report by New York-based Human Rights Watch said such requirements are inhumane, unnecessary and discriminatory.

“Tokyo officials should embrace public opinion and local-level policies and update the law to reflect current medical and legal perspectives,” Kanae Doi, the group's Japan director, said in a statement.

The report comes as activists in Japan push for the passage of an equality act, which would remove such barriers as well as legalize same-sex marriage. The legislation faces resistance from conservative members of Prime Minister Yoshihide Suga’s ruling party.

The Japanese public has slowly shown increased support and awareness of sexual diversity, but there are still a lack of legal protections for the rights of lesbian, gay, bisexual and transgender people. Pressure to conform still forces LGBTQ people in Japan to hide their sexual identities out of fear of discrimination at school, work and even from their families.

The current law dating to 2004 has several requirements for a transgender person to have their gender change legally recorded in official documents, including being older than 20, unmarried and not having any children under the age of 20. Most burdensome, activists say, is the requirement that they also must remove their reproductive organs or have reproductive organs that don't function.

Human Rights Watch said these requirements contradict Japan's international human rights obligations and are opposed by the World Health Organization and other medical organizations.

The group said the medical requirements are especially problematic and are based on an outdated notion that a transgender identity is a mental disorder. The required surgery forces transgender people to undergo “lengthy, invasive and irreversible medical procedures" to get legally recognized, it said.

Hiroyuki Taniguchi, a law professor at Aoyama Gakuin University, said the law is “designed to force transgender people into the existing legal system rather than ensuring them to live according to their own gender identity.”

More than 9,600 people in Japan have legally changed gender since 2004 including about 950 in 2019, according to the latest available Justice Ministry data.

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