The South Korean Constitutional Court Thursday upheld the nation’s near-ban on tattooing. In a 5-4 decision, the court dismissed the suit and upheld the current policy that only medical professionals can give tattoos.

In imitation of a Japanese ruling that has since been overturned, South Korea’s Constitutional Court ruled in 1992 that tattooing constitutes a medical procedure and can therefore only be performed by medical professionals. Upholding this decision, the court characterized tattooing as an invasive procedure that raises important safety concerns. Those who violate the ban face significant fines as well as prison terms.

Despite the ban, tattooing is still practiced across Korea and enjoys success in an underground market. Still, the ban faces substantial opposition from tattooists unable to openly practice their trade and from politicians. South Korean President-elect Yoon Suk-yeol has voiced support for legislation that would allow non-medical professionals to give semi-permanent cosmetic tattoos. 

South Korea is the only developed country that still prohibits non-medical tattooing. The ban derives, in part, from a historical association of tattoos with criminal activity. But younger generations are challenging this connotation. Ryu Ho-Jeong, the youngest member of the South Korean National Assembly, introduced a bill last June that would legally certify tattoo artists.

In the US, courts have recognized tattooing as a constitutional right that is protected under the First Amendment. More recently, debate has emerged over whether tattoos are protected under federal copyright law.

South Korean advocates for the liberalization of tattooing maintain that the fight will continue.