Sato and Nishi, both medical professionals, met in 2015 at the hospital where they worked and married in November 2019. For Nishi, marriage meant a legal bond registered by submitting a marriage notification. But Sato said she had felt anxious that by taking the surname "Nishi" she would no longer be herself. Before they married, Sato told Nishi several times that she did not want to change her surname, but they did not have an opportunity to discuss it in depth. Eventually, she would get used to the Nishi name, her husband thought. Contrary to that expectation, Sato became exhausted both mentally and physically. After changing her surname, Sato was not allowed to use her former surname at work. As her feeling that she was "no longer herself" intensified, she was diagnosed with an adjustment disorder in April 2020 and was forced to leave her job.