Updating Japan: From Contraception Education to Proper Sex Education

This series introduces the latest information on sexuality through content created by Dentsu Inc.'s cross-organizational unit, Sexology Creative Lab (SCL), within the framework of "Sex × Creativity." Part 3 features a conversation between professional golfer Riko Higashio—a member of both Dentsu Inc.'s "Umumu" lab (the foundation of SCL) and the production team for "SEXOLOGY"—and Kagoshima, the representative of "Umumu."

※＝Umumu
A project by Riko Higashio and volunteer Dentsu Inc. employees, serving as the foundation for SCL. Collaborating with experts and NPOs, it disseminates reliable information on pregnancy, childbirth, and sexuality.
 

Learn more about Sexology Creative Lab (SCL)
 

Starting April 2022, some infertility treatments became covered by insurance. This change stems from Japan's declining birthrate. While many people, like Ms. Higashio, have struggled with infertility treatments, many others experience unwanted pregnancies. The reality is that sexual health knowledge isn't reaching those who need it most. We'll discuss the future of fertility efforts in Japan and the challenges involved.

<Table of Contents>
▼Is infertility treatment taboo in Japan?

▼Contraception education exists, but pregnancy education does not

▼What we learned while creating SEXOLOGY

▼What is a fertility-friendly company?

▼Updating Japan's DE&I

Is infertility treatment taboo in Japan?

Kagoshima: Ms. Higashio, you personally experienced fertility treatments and share TGP (Trying to Get Pregnant) activities to encourage proactive approaches to fertility. First, could you tell us what sparked this?

Higashio: I started trying for my first child around 2010. I was going to the hospital for treatment, and during that time, I strongly felt there was a lack of information about pregnancy and fertility treatments. Back then, the term "fertility treatment" seemed somewhat taboo, and I think it carried an image of being unhealthy.

Kagoshima: It was much more so back then, wasn't it?

Higashio: When I opened up about my treatment, many people approached me saying, "Me too!" or "Actually, I'm going through it too!" Even though it was treated as something negative, I wanted to convey the message that what we're striving for is positive and worthwhile. That desire was the catalyst for starting this initiative.

Kagoshima: You mentioned feeling a lack of information during treatment. When specifically did you feel that?

Higashio: After getting married, I felt I should take more responsibility for my own body, so I got checked. Beyond basic physical exams, I decided to also get my fertility checked—that was the start. Through the testing process, I naturally moved into treatment: first timing method, then artificial insemination.

Initially, it wasn't like I was thinking, "Alright, let's start treatment!" It was more like, "I'll just get it checked while I'm at it." I had studied abroad in the US since university, and there, even students had regular gynecological checkups. So, it felt like I was reconnecting with my body after a long time.

Kagoshima: I see.


Higashio: That's how it was, so I had absolutely no knowledge about fertility treatments. The first clinic I visited offered timed intercourse and IUI, but didn't perform advanced treatments like IVF. Looking back now, considering my age and my husband's at the time, I wonder if we should have stepped up to IVF a bit sooner. But back then, lacking knowledge, I just followed the doctor's instructions, and before I knew it, a year had passed.

Not having knowledge meant I didn't even know what medications I was taking or what side effects they might have. Since I was over 35, an age when fertility typically drops sharply, I strongly felt during treatment how crucial it is to have knowledge.

There's sex education, but no pregnancy education

Kagoshima: After you gave birth to your first child, we formed "Umumu" together. We started with the goal of spreading accurate information about pregnancy to the world. We invited you to speak at events aimed at young couples.

Higashio: Yes. The most important message we wanted to convey was this: if you experience severe menstrual pain, please visit a nearby women's clinic or obstetrics and gynecology hospital. Find out what your current symptoms mean, what might happen in the future, and what preventive measures exist. We also emphasized that even without pain, don't be afraid to get regular checkups.

When you want to know your fertility potential, one method is the AMH test. When getting a blood test, you might consider adding AMH to it.

Kagoshima: The AMH test shows how many eggs you have left, right? I've heard there's a lot of individual variation.

Higashio: Yes, it gives you an estimate of your egg reserve. A low number suggests fewer remaining eggs, while an excessively high number may indicate polycystic ovary syndrome (PCOS). Having regular periods doesn't automatically mean you can get pregnant. Even if your period pain is mild, I think it's worth getting checked as part of a general health screening. You have nothing to lose.

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Kagoshima: For men, you can go to a urologist to get your semen checked. Apparently, more men are proactively getting semen tests these days. There are even self-check kits where you can view your own semen using your smartphone camera. There are also AMH test kits for women, right?

Higashio: Exactly. But while I was active, I started thinking we need to address the root cause – the lack of places to learn these things – rather than just sharing information.

We got contraception education, but conversely, we never learned how to actually conceive a child. We assumed you could have a child whenever you wanted. But some people can't conceive due to illness, age, or various other reasons. I wanted to create something that properly teaches "what to do to get pregnant" from an early stage.

Kagoshima: Just as we were talking about tackling the root cause, we met Ms . Fukuda, who was working on the #WhyNotProject, and that led to developing "SEXOLOGY," the smartphone textbook for learning about sex education.

SEXOLOGY is a smartphone-based sex education textbook. Based on the Global Standard, the "International Guidelines for Sexuality Education," we create original content providing the sex education Japanese people need today, from children to adults. https://sexology.life/

What I Learned While Creating SEXOLOGY

Kagoshima: What are your thoughts after co-creating SEXOLOGY? Did you personally experience any changes?

Higashio: I realized how incredibly important it is to have broad knowledge, not just one specific area. Seeing all the icons lined up on the site, you feel how everything is linked and connected—you can't just isolate one thing.

Especially in today's world, we must avoid biased perspectives. I've become more mindful of multiple aspects—like ensuring content is accessible even to those without prior knowledge or interest.

Kagoshima: Exactly. Talking with you, Higashio, I really sense that in everything you say. I feel like traditional sex education was pretty one-sided, or just one perspective. Kind of like an old-school Showa-era grandpa's worldview. Nowadays, there are people of all generations, and sexual preferences vary widely, yet so much is missing.

Higashio: Exactly. For example, the SEXOLOGY site includes masturbation, and it clearly includes both men and women. Some people might initially think, "Huh?", but I think the amazing thing about SEXOLOGY is that it doesn't divide what's necessary or unnecessary by gender; it just includes it as a matter of course.


Kagoshima: Exactly. Personally, I also feel like society has become much more comprehensive with LGBTQ+ information.

Higashio: I really want to provide this kind of education to children too. Especially now that I have younger kids at home, I want to learn how to explain things like "How are babies made?" or how to talk about sexual violence. I also want to build up my knowledge so I'm better prepared when I'm the one explaining these things.

Kagoshima: We'll definitely need to keep updating this information going forward!

What is a fertility-friendly company?

Kagoshima: Moving the conversation forward a bit, there's data showing that currently, one in 5.5 couples trying to conceive experience infertility testing or treatment. There's also data (*) indicating that 58% of people undergoing fertility treatment haven't disclosed it to their company, and a significant 23% of women end up leaving their jobs.

※ = Ministry of Health, Labour and Welfare "Support Book for Balancing Infertility Treatment and Work"
https://www.mhlw.go.jp/bunya/koyoukintou/pamphlet/dl/30l.pdf
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Amidst this, as briefly mentioned earlier, a national policy change took effect in April, making some infertility treatments partially covered by insurance. Concurrently, measures to prevent power harassment related to pregnancy, childbirth, and childcare became mandatory for small and medium-sized enterprises (SMEs) as well, requiring corporate responses regardless of company size. However, the companies being told to comply seem somewhat perplexed.

Higashio: Exactly. I feel many companies, regardless of size, are unaware of the details of the system. While large companies were mandated in 2020 and SMEs in 2022, the notification of this obligation was sent out last year. Yet, many still don't know about it.

Kagoshima: Companies learning about this now are being asked to respond, but they might be stuck wondering, "So what exactly should we do?" What kind of initiatives would be good for companies to take?

Higashio: Since few people disclose their fertility treatment to their company, many companies might think, "This doesn't apply to us." While I don't think you need to disclose the treatment itself, situations like needing frequent hospital visits can make disclosure unavoidable. It would be great if companies had an atmosphere where such disclosures felt easier.

Kagoshima: Exactly. I've heard opinions that it's hard to mention infertility treatment at work because it's taken too seriously. A colleague told me it's even really difficult to tell a male boss about taking menstrual leave.

Higashio: While insurance coverage has lowered the initial barrier, planning can still be difficult for working individuals. Sometimes you get sudden requests like, "Please come to the hospital tomorrow morning."
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Periods can be irregular, right? It would be great to have a work system that allows flexible time off and scheduling, an environment where it's easy to voice those needs, and a broad, flexible leave policy that covers periods, PMS, fertility treatments, and so on. A leave system where you don't have to explain the exact reason would be ideal.

Kagoshima: If your boss has old-fashioned values, you might wonder, "Why do I have to report every little reason for taking time off?"

Higashio: I hear one reason it's hard to speak up is the potential impact on future treatment or work arrangements. I hope we see broader adoption of equal leave policies not just for menstruation or fertility treatments, but also for men taking paternity leave, people choosing not to have children, and everyone else. It would be great if society became more tolerant and accepting of all these situations.

Updating Japan's DE&I

Kagoshima: This might sound contrary to the fertility treatment discussion, but having children or choosing not to is a personal freedom of choice. There's also the option of becoming foster parents.

Higashio: Yes, SRHR (Sexual and Reproductive Health and Rights) is crucial. And preconception care (where women or couples proactively address their lifestyle and health while considering future pregnancy). We want to advance and expand both.

Both concepts include the idea that you have the right to choose whether or not to have children. That decision is yours alone. Achieving a high quality of life leads to better preparation for a healthier pregnancy and childbirth.

Kagoshima: SRHR and preconception care are knowledge everyone should have. Japan's sex education still has a long way to go, but Ms. Higashio, could you tell us what kind of activities you'd like to pursue going forward?

Higashio: The content in SEXOLOGY is incredibly important and valuable. I want us to reach a society where this isn't seen as complicated, but rather as the norm. I hope the information currently on the site becomes something everyone knows naturally, something that comes up casually over tea. I want us to live in a society where we can talk about these things that easily.

Kagoshima: Yes, I agree. I also believe SEXOLOGY must continue to add and update content to keep pace with the times. And I want to keep doing things that give people opportunities to think about these topics.

https://sexology.life/sexnote/
Sex Note is a communication tool for partners. It creates opportunities to share and discuss what you really want to say about sex but find hard to talk about.

Kagoshima: Finally, for those who read this article and are interested, what would you recommend as a first step?

Higashio: Start by understanding your own state. If you catch a cold, go to an internal medicine doctor; if your skin breaks out, go to a dermatologist; if you have menstrual cramps, go to a gynecologist. Don't overlook your body's signals.

Kagoshima: For men, I think the first step might be learning about the female body. Understanding how menstruation works, what happens during pregnancy, and that pregnancy doesn't always happen naturally. Men considering a female partner should really know these things.

Higashio: Conversely, women might benefit from learning more about men's bodies too. It's really valuable for both partners to understand each other's bodies.

And not just between men and women, but also about things like disabilities. I hope we can first get to know each other, keep learning, and build a society where we can support each other.

SEXOLOGY: Learning About Sex https://sexology.life/

【Sexology Creative Lab】
An internal cross-functional team at Dentsu Inc. focused on content development and information dissemination within the 'Sex × Creativity' framework. Launched in 2019 by creative members interested in sexual issues. Partnering with experts in healthcare and sex education, we tackle various sexuality-related challenges—such as sex education and fertility—seeking creative solutions. If this series inspires you to create something addressing sexuality or sex education issues, please contact us.