Undergoing infertility treatment is a challenging ordeal for anyone, but LGBTQ+ couples in Japan face a plethora of barriers, and some are ultimately deprived of the right to safely start a family.

One pair who was able to overcome these obstacles is Mary and Rei, a married couple in their 30s living in Japan¡¯s countryside who asked to go by pseudonyms for privacy reasons. Mary is an American who identifies as agender, and Rei is a transgender Japanese man.

When the couple asked doctors how they could start a family, they were told the pair did not qualify for artificial insemination by donor (AID), normally offered by fertility clinics in Japan when men struggle with infertility, because Rei was assigned female at birth.