One of the toughest places to be a woman in Japan is within its royal family.

Nearly three decades ago, Empress Michiko lost the ability to speak after public carping about her supposed shortcomings as the wife of Emperor Akihito. Ten years later, Michiko’s daughter-in-law, the current Empress Masako, retreated from public duties to cope with depression after the media harangued her for failing to produce a male heir.

Earlier this month, the imperial household revealed that Michiko’s granddaughter, Princess Mako, 30, had suffered from post-traumatic stress disorder because of unrelenting public disapproval of her choice of a fiancé, Kei Komuro, a recent law school graduate whom she will marry Tuesday.

“She felt like her dignity as a human being had been trampled on,” Mako’s psychiatrist said in a news conference, adding that “she thinks of herself as somebody without value.”

Whether they marry into the monarchy or are born into it, Japan’s royal women are held to ruthless standards not only by the press and the public, but also by the court officials who manage their daily lives. With the emperor and his family standing as symbols of traditional Japan, the royal women are subjected to a concentrated version of the broader gender inequality in the country, where a conservative streak in society often still consigns women to rigid roles.

Although imperial women are not eligible to sit on the throne, the criticism they receive can be harsher than for the men of the family, who are protected in part by their proximity to the line of succession.

“In addition to working as a royal, you have to maintain beautiful fashion, and after getting married, your purpose is to give birth,” said Rika Kayama, a professor and psychiatrist at Rikkyo University in Tokyo.

“Are you being a good mother? People will ask,” she added. “Do you have a good relationship with your mother-in-law? How are you supporting the men in your life? So many jobs must be done perfectly without a hitch. I don’t think men in the imperial family are looked at this closely.”

Japan is slowly changing, with two women standing for prime minister during a recent governing party leadership election. And some corporations are making concerted efforts to elevate more women into positions of authority.

But in many ways Japanese society still treats women as second-class citizens. Married couples are not legally allowed to have separate last names, a system that in practice means most women take their husband’s names. Women are still underrepresented in management, in Parliament and at the country’s prestigious universities.

Women who protest their unfair treatment or advocate for equal rights are often censured for stepping out of line. The kind of criticism hurled at Mako on social media echoes the treatment of women who have spoken out about sexual assault or even workplace rules about wearing high heels.

In the imperial family, the women are expected to adhere to the values of an earlier era.

“There’s this idea that the imperial family is sort of timeless and they are not part of modern society,” said Mihoko Suzuki, founding director of the Center for the Humanities at the University of Miami, who has written about women in monarchies. Traditionalists, she said, want to “project this older, more comforting, stable idea about gender roles onto the imperial family.”

After World War II, the emperor was stripped of his godlike status under the new, U.S.-imposed constitution. And in many ways, the three generations of royal women reflect the evolution of Japan in the decades since.

As the nation shed the shackles of its wartime history, Michiko became the first commoner in centuries to marry into the family. Rather than handing her children over to court chamberlains to raise, she cared for them herself. Accompanying her husband, Akihito, as he traveled throughout Japan and internationally, she brought a human touch to the previously distant imperial family, kneeling to talk to victims of disasters and to people with disabilities.

But when she renovated the imperial residence or wore too many different outfits, the press griped. Rumors spread that court officials and her mother-in-law did not consider her deferential enough.

In 1963, after a molar pregnancy just four years into her marriage, she underwent an abortion and retreated for more than two months to a villa, as speculation spread that she had suffered a nervous breakdown. Thirty years later, she succumbed to severe stress and lost her voice, recovering it only after several months.

Her daughter-in-law, Masako, was a Harvard graduate with a promising career as a fast-rising diplomat in 1993 when she married Naruhito, then the crown prince. Many commentators hoped she might help modernize the fusty royal family and serve as a role model to Japan’s young working women.

Instead, her every move was analyzed for its potential effect on her ability to bear a child. After a miscarriage, she gave birth to a girl, Princess Aiko, disappointing those who wanted a male heir. Court officials, protective of her womb, limited her travel, leading her to withdraw from public duties. She issued a statement saying that she was suffering “accumulated exhaustion, mental and physical.”

The most recent case, involving Mako, shows that segments of the public want her to rise to royal expectations even though she will be forced to leave the family upon her marriage. The public has savagely judged her choice to marry Komuro, assailing his mother’s finances (and by extension branding him a gold digger) and calling him unfit to be the spouse of an imperial daughter. Yet under Japanese law, Mako will lose her imperial standing once the marriage papers are filed.

Eight other princesses have married out of the family and been stripped of their monarchical status, although none have been subjected to attacks like those against Mako.

“I find it very, very odd that the Japanese people believe that they should have a say in any shape or form in who she marries,” said Kenneth J. Ruoff, a historian and specialist in the Japanese imperial family at Portland State University.

Mako’s father, Crown Prince Akishino, originally withheld approval of the marriage after the couple announced their engagement in 2017, saying he wanted the public to accept the match before he gave his blessing.

Some seem to have taken the crown prince’s words to heart.

He “said that they should get married with the blessing of the people, so even he said that we have the right to give input,” said Yoko Nishimura, 55, who was taking a walk inside the gardens of the Imperial Palace in Tokyo last week. “I think the Japanese feel like since the imperial family represents them in a way, we have the right to give our opinions.”

Akishino eventually relented, but the ceaseless commentary in the mainstream press and on social media took its toll.

Even as the couple have quietly prepared for a private registration of their marriage without royal pomp, the attacks have not stopped. In recent weeks, protesters have marched in Ginza, a popular shopping district, bearing signs reading “Do not pollute imperial household with this cursed marriage” and “Fulfill your responsibilities before you get married.”

A writer in Gendai Business, a weekly magazine, fulminated against Mako’s choice, saying she would “expose Japan to shame internationally.” On Twitter, some have called her a “tax thief,” even though she has decided to renounce a royal dowry worth about $1.4 million. Others have accused the princess of faking her post-traumatic stress.

“The public will be suspicious of you if you announce in a few months that you have gotten better,” wrote one user on Twitter.

Comparisons to the British royal family are perhaps inevitable. Before her marriage to Prince Harry, Meghan Markle endured months of attacks because of her family’s background. Like Meghan and Harry, Mako and Komuro, a graduate of Fordham Law School, are expected to flee to the United States, where Komuro works in a New York law office.

Both Harry and Meghan have spoken openly about the cost to their mental health. Harry’s frankness about his depression over the death of his mother, Diana, who also suffered from depression and eating disorders, has helped open conversations about mental health in Britain.

Japan’s royal women, too, may inspire more discussion about mental health in a country where it is still a delicate topic.

“I don’t think the women in the imperial family have been public about their mental health issues in order to start a dialogue,” said Kathryn Tanaka, an associate professor of Japanese literature and culture at the University of Hyogo. “But I think it’s brave of them to acknowledge.”