Human Rights Watch has condemned Japan for requiring sterilization in order for people to legally change their gender.

According to NBC News, the statement came as part of a report published last month as part of a campaign by the international rights group against gender-based violence.

In order to legally change their gender, the Japanese Law 111 of 2003 requires transgender individuals to be single, to undergo a psychiatric evaluation, to not have children who are under age 20, and to be sterilized, Human Rights Watch explained.

Sterilization in Japan is defined as not having testes or ovaries.

More than 20 European countries also still require forced sterilization of transgender people looking for legal recognition.

Gender reassignment surgery is also required, according to a 2016 letter from Human Rights Watch to the United Nations on the issue.

Human Rights Watch researcher Kyle Knight told NBC News that “the government shouldn’t decide for people who they are and shouldn’t put people through arduous, harmful, expensive, irreversible procedures as a part of recognizing people for who they are.”