Otsuji was born in Nara Prefecture but grew up in Hannan, Osaka. As a schoolgirl in Kobe, Otsuji was an Asian Junior karate champion, then later enrolled at Seoul University to study Korean and tae kwon do. She lost by TKO to Yoriko Okamoto in 1999. She had hoped to go to the Sydney Olympics in 2000 but was unsuccessful in making the national team. She returned to Japan and enrolled at Doshisha University in Kyoto, where she first became interested in politics. In March–April 2006, Otsuji attended International Lesbian and Gay Association’s world conference in Geneva. In June 2006, Otsuji visited the United States on a trip sponsored by the International Visitor Leadership Program of the US Department of State. During her visit she met representatives from the National Center for Transgender Equality, the National Association of LGBT Community Centers, the National Gay and Lesbian Task Force, Freedom to Marry, and the Stonewall Democrats. In June 2007, Otsuji held a public wedding ceremony in Nagoya with her partner Maki Kimura, although same-sex marriages are not legally recognized in Japan. Otsuji did not stand for re-election in April 2007. Her first term in the Osaka Assembly expired on 29 April 2007, but in July 2007 she appeared on the official candidate list of the Democratic Party of Japan, becoming the first-ever openly homosexual serious contender for election to the National Diet. Otsuji received 38,230 votes, far short of securing the seat, so there were no openly homosexual elected officials in Japan until the election of Taiga Ishikawa, an assemblyman in Tokyo’s Toshima ward, in 2011. August 22, 2009, is the world premiere of director Naomi Hiltz’s documentary film Kanako: Challenging The System at the Vancouver Queer Film Festival. The film covers the last 17 days of the campaign, ending with election day.