Tomoya Asanuma, a prominent transgender activist in Tokyo, faced the triple abuses of Japan’s “hostage justice” system, hostile detention conditions, and mistreatment trans people face in the absence of meaningful legal protections. 

For Asanuma, March 14, 2024, was supposed to be another Thursday at work. At around 7 a.m., he woke up to the sound of someone repeatedly ringing his doorbell. Through the intercom, Asanuma saw three men wearing dark-colored clothes, this time pounding his front door. When he opened the door, the men identified themselves as police officers and showed him an arrest warrant.

This was the beginning of what Asanuma recently described to Human Rights Watch as being “difficult to put into words.” After Japanese police arrested him for sexual assault for allegedly hugging an acquaintance from behind, the authorities held him for months at a pre-trial detention center. 

During this time, they mocked his transgender identity during interrogation, denied him access to medical services such as dental care, and initially denied hormone treatment until he obtained a recommendation from a doctor.

While some authorities showed a level of consideration for Asanuma, including letting him shower away from other detained men, the abusive treatment he faced led him to attempt suicide twice.

Trans people in Japan are in legal limbo. Historically, they have faced outright discrimination — including a law compelling them to be surgically sterilized for legal gender recognition — and barriers to accessing education, employment, and health care. A landmark Supreme Court decision in 2023 declared the sterilization requirement unconstitutional, but reform has stalled in parliament — leaving trans people’s basic rights in limbo.

The courts finally granted bail to Asanuma in July 2024 and found him not guilty in January 2025. But in a country with a 99.8 percent conviction rate for indicted cases, Asanuma had to live through acute fear as authorities forcibly tried to obtain a confession from him during interrogations without the presence of his lawyer.

His fears are grounded in a justice system with a well-earned reputation for abuse and arbitrariness. His experience is part of systemic treatment in Japan called “hostage justice,” under which criminal suspects are detained for prolonged periods, sometimes months or years, unless they confess to the charges. This denies them the rights to due process and a fair trial. 

The authorities ultimately dropped the sexual assault allegations, but charged Asanuma with assault, which is punishable by up to two years in prison or up to a 300,000 yen fine ($2,000.) Prosecutors sought a 200,000 yen fine. Despite this, because he pleaded not guilty, a court rejected his request for bail four times and detained him for more than 100 days in pre-trial detention, punishing him disproportionately since the prosecutors did not even seek imprisonment for his alleged crime.

In Japan’s hostage justice system, authorities frequently subject suspects to harsh interrogations to coerce confessions from them during pre-indictment detention. Defense lawyers are not permitted to be present, and the questioning does not stop even when a suspect invokes their constitutional right to remain silent. Indeed, Asanuma invoked his right to remain silent, but authorities interrogated him for hours on 13 occasions. 

The case of Iwao Hakamata highlights the dangers of this practice. Hakamata, a former professional boxer, was arrested on Aug. 18, 1966, for murdering a family of four. Following harsh interrogations by the police and prosecutors, he confessed nearly a month later. Based on this coerced confession, Hakamata was indicted and subsequently convicted and sentenced to death. He maintained his innocence and was eventually acquitted — 58 years after his arrest — on Sept. 26, 2024, following a retrial.

To prevent further abuses and wrongful convictions spurred by the “hostage justice” system, the Japanese government should not as a general rule deny bail to suspects in pretrial detention, and should end interrogations without legal counsel that often involve coerced confessions through manipulation and intimidation.

The Japanese government should also improve the conditions under which suspects are being held, including by ensuring adequate access to all medical services, and revising the Notice Regarding Treatment Guidelines for Detainees with Gender Identity Disorder by specifying that hormone replacement therapy and other gender-affirming medical interventions are medically necessary and should be made available to all imprisoned people who want them.

“My case is just the tip of the iceberg, as there are others who are detained much longer,” Asanuma said. “I think this experience gave me a good reason to speak up even more for the rights of suspects going forward,” he added.

Teppei Kasai is a program officer for Japan at Human Rights Watch. 

The rollback of the U.S. Agency for International Development under the Trump-Vance administration represents a global setback for LGBTQ rights. A report from the Observer Research Foundation, a leading Indian think tank that advises the government on policy, however, highlights a unique opportunity for the country to rely less on overseas funding to promote LGBTQ inclusion and integrate the “pink economy” into its broader economic growth strategy, fostering a more inclusive and self-reliant framework.

The “pink economy,” defined as the purchasing power of the queer community, is valued globally at approximately $3.7 trillion. In India, this market is estimated at $168 billion, but remains largely untapped due to persistent stigma that obstructs economic inclusion for LGBTQ people.

The ORF report notes that, as a result, India’s LGBTQ community has relied heavily on international aid and funding, with Western narratives often shaping perceptions of queer identities.

Despite India’s efforts to advance LGBTQ rights — through recognizing a “third gender” in the 2011 Census, the Supreme Court’s 2018 decision to decriminalize consensual same-sex sexual relations by striking down Section 377, and the passage of the Transgender Persons (Protection of Rights) Act in 2019 — these measures have done little to meaningfully to elevate the social and economic status of the LGBTQ community.

India’s queer community constitutes roughly 18 percent of the global queer population. A 2025 study reveals it receives only 1 percent of global LGBTQ funding, despite heavy reliance on international donors.

The Against All Odds — Advancing Equity for India’s LGBTQIA+ Communities report reveals that, within India, only one of the nation’s top 50 donors explicitly funds queer causes, underscoring a significant gap in domestic philanthropy for the LGBTQIA+ community.

India’s Social Justice and Empowerment Ministry for the 2025-2026 fiscal year allocated $1.07 billion to support education, skilling, healthcare, and rehabilitation for marginalized groups. The ORF report, however, emphasizes this funding falls significantly short for the estimated 140 million-strong queer community, as it narrowly focuses on trans people, thereby limiting its impact on the broader LGBTQ community.

A 2014 World Bank report, the Economic Cost of Homophobia and The Exclusion of LGBT People: A Case Study of India, found that excluding the LGBTQ community from economic participation results in a GDP loss of between .1 and 1.7 percent, translating to an annual economic impact of $1.9 billion to $30.8 billion.

The ORF report underscores that social stigma restricts access to education and hinders opportunities for meaningful employment. 

A 2024 report, Fundamental Rights of Work Inclusion for LGBTQ in India, reveals that fewer than 6 percent of trans people are part of the formal workforce, with their presence in the public sector being nearly negligible. It further notes that, for daily survival, many trans people are forced into hostile environments or resort to street begging.

Thailand, with a marriage equality law that took effect in January, is widely recognized for its relative tolerance toward the LGBTQ community, fostering a vibrant queer culture in cities like Bangkok. The country actively promotes itself as a gay-friendly tourism destination, with businesses capitalizing on the “pink economy” through events, nightlife, and tailored travel services. A 2017 report highlighted Thailand as a leading hub for gay-friendly holidays, significantly bolstering its pink economy.

China stands out as a major player in the “pink economy,” valued at an estimated $300 billion annually in 2017, the largest in Asia, fueled by at least 70 million people. Despite government restrictions on queer content, businesses like Blued, a gay social networking app with 54 million users, and Taobao and other e-commerce platforms have tapped into the “pink market,” offering services such as same-sex wedding packages abroad.

Japan has made gradual strides in LGBTQ inclusion with Goldman Sachs, Panasonic, Rakuten and other companies implementing inclusive policies, such as same-sex partner benefits, since 2015. The Japan Business Federation in 2017 issued guidelines to promote LGBTQ-inclusive employment. Tokyo’s rising status as an LGBTQ-friendly city bolsters tourism and consumer markets tied to the “pink economy.” Japan’s tech and tourism sectors remain robust, despite the country’s modest economic growth, with “pink economy” initiatives driving urban economic vitality.

Anish Gawande, the first openly gay national spokesperson for India’s Nationalist Congress Party, told the Washington Blade that excluding the LGBTQ community carries a tangible financial cost. He emphasized India must soon recognize that marginalizing this group not only triggers a brain drain of top talent but also bars hundreds of thousands of highly capable individuals from driving the nation’s economic progress.

“I am a firm believer in a politics of care. If we only want LGBTQ+ inclusion for the sake of economic prosperity, there will never be true inclusion,” said Gawande. “What we must understand is that an embracing of diversity — across caste, class, religion, region, gender, and sexuality — is fundamental to ensuring that we build communities that listen to and learn from each other. By embracing diversity, which has been at the very heart of what it means to be Indian, we do not just prosper economically — but also build more resilient, more equal, and more harmonious societies.”

Kalki Subramaniam, a prominent LGBTQ activist and artist, told the Blade the issue transcends mere economic gain, emphasizing the vibrant spirit and unrecognized potential of LGBTQ people across India.

“We are here, we exist, and our contributions are invaluable. But the government is yet to recognize and fully tap it,” said Subramaniam. “If they are not listening, they will lose out, not just on money, but on the richness we bring to the fabric of India. This is not just an economic report, it is a heartbeat of a community yearning to be seen, to be accepted, and to be allowed to shine for the prosperity of our shared home.”

The Indian Supreme Court on May 14 ordered the central government to consult experts and address policies that label transgender people as “high-risk” blood donors, a designation rooted in assumptions rather than scientific evidence.

“Are we going to brand all transgender individuals as risky and stigmatize them?” said Justices Surya Kant and Nongmeikapam Kotiswar Singh. “You cannot say that all transgender individuals are indulging in sexual activity.”

These restrictions stem from guidelines that the National Blood Transfusion Services, under India’s Health and Family Welfare Ministry, issued on Oct. 11, 2017. The regulations categorize trans people, men who have sex with men, female sex workers, IV drug users, and those with multiple sexual partners as ineligible to donate blood due to presumed risks of HIV, Hepatitis B or C, and require clearance by a medical officer.

The justices considered a petition that contested the constitutional validity of Sections 12 and 51 of the guidelines.

Solicitor General Aishwarya Bhati, representing the central government, stated the rules, which the National Blood Transfusion Council’s panel of medical experts crafted, aimed to prioritize public health and safety without intending to stigmatize any group. The justices during the hearing noted barring trans people from donating blood reinforces their social exclusion, questioning whether these restrictions deepen existing societal biases.

“Just think of something that such feeling does not come, and health standards are not compromised,” they said, granting the government time to address these concerns while maintaining medical safety.

The justices further observed that evolving times and emerging medical technologies offer solutions to screen blood donations for infections without excluding entire groups, allowing broader participation in civic programs.

Bhati said she would relay the court’s recommendations to medical experts for consideration. She explained that donated blood goes directly to blood banks, critical for thalassemia patients and other vulnerable groups who depend entirely on these supplies for their survival.

“As a group, transgenders are considered a high-risk group the world over, with certain exceptions,”Bhati told the justices. “There is a period within which infection has to be identified, and the risk window has to be carefully considered. Nobody can claim to have a fundamental right to donate blood. These guidelines must be seen from the perspective of public health as the idea is not to stigmatize anyone.”

The Washington Blade on Aug. 28, 2024, reported Shariff D. Rangnekar, a gay man from Delhi and director of the Rainbow Literature Festival, challenged the constitutionality of India’s blood donor rules, which bar trans people, MSM, female sex workers, and others from donating blood due to presumed health risks.  

The Supreme Court on July 30, 2024, agreed to hear Rangnekar’s petition that Ibad Mushtaq filed and lawyer Rohin Bhatt wrote. It questions the policy’s reliance on outdated stereotypes from the 1980s. Rangnekar notes the U.S., the U.K., Canada, and Israel are among the countries that have updated their blood donor policies. He urged India to adopt individualized risk assessments. 

South Asian countries have varying blood donation policies for trans people and gay men, with some avoiding blanket bans and others enforcing them. 

Equaldex notes Nepal allows MSM to donate blood without specific restrictions based on sexual orientation or gender identity, suggesting trans people and gay men face no categorical bans. Bangladesh also lacks a specific ban on such donors, although its policies remain ambiguous due to limited documentation.

Pakistan, Sri Lanka, and Malaysia ban MSM and trans people from donating blood, categorizing them as high-risk groups for HIV and other infections.

“It is not just LGBTQIA+ people whose blood can test positive for infections, it could be anybody. All blood that is transfused needs to be tested before transfusion,” said Harish Iyer, a prominent LGBTQ activist in India. “If that is not happening, we have much reason to worry. There is no test on fidelity, regardless of the sex, gender, or sexual orientation. There are open marriages and clandestine affairs that happen in every sexuality. The solution is to speak of safe sex practices and not to take anyone’s word and to test every packet of blood before transfusion.”

Iyer told the Blade that branding and banishing minorities by stereotyping them is an underlying cause of hate crimes. He highlighted that MSM and trans people for years have been seen as simply vectors of HIV, and not as people who lead happy, fulfilling lives. Iyer added the blood donor ban further accentuates this divide and further marginalizes the community.

Iyer said the government should enhance public awareness campaigns around safer sex practices and ensure that all blood undergoes rigorous testing before transfusion. Ankit Bhupatani, a global DEI leader and LGBTQ activist, told the Blade the justices’ directive represents a long-overdue recognition that India’s blood donation guidelines require scientific scrutiny rather than perpetuating stigma.

“By asking the government to seek expert opinion, the bench has opened a path toward evidence-based policy reform. The bench’s observation that labeling all transgender persons as ‘risky’ is troubling, shows judicial wisdom in identifying how these guidelines institutionalize prejudice,” said Bhupatani. “This intervention creates an opportunity to align our healthcare policies with constitutional values of equality and dignity while maintaining necessary medical safeguards.”

He said the 2017 guidelines are a form of structural discrimination.

“Such policies do not merely restrict access to a civic activity; they codify stigma into our healthcare system and reinforce harmful stereotypes about LGBT individuals,” said Bhupatani. “The international trend has indeed moved toward individual risk assessment rather than categorical exclusions. India’s policy remains anachronistic in its approach.” 

“The government absolutely should implement individualized medical screening based on specific behaviors rather than identity,” he added. “The current policy creates the paradoxical situation where a heterosexual person engaging in high-risk behaviors faces less scrutiny than a transgender person in a monogamous relationship. The selective application of supposed ‘public health concerns’ reveals that these guidelines are more informed by social prejudice than medical evidence. Rigorous individual screening would better protect our blood supply while eliminating discriminatory practices.”