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UNFPA Policy Brief Series

TOWARDS A NORMAL SEX RATIO AT BIRTH IN CHINA

Overview

As an expression of a harmful that allow parents to know the in recent decades, imbalanced practice, gender-biased sex sex of the fetus have exacerbated SRB favoring boys have grown selection (GBSS) in favor of boys this practice. That is to say, there in a number of South Asian, is a symptom of pervasive social, are three preconditions to the East Asian, and Central Asian as cultural, political and economic behavior of GBSS: son preference well as East European countries injustices against girls and women and fast fertility decline motivated (Guilmoto, 2009; UNFPA APRO (UNFPA Asia Pacific Regional the “need” for sex selection (as 2012). The trend has shifted Office (APRO) 2012). Patriarchal the “demand”), and sex selection geographically over time; thus structures reinforce son preference technology makes it possible (as it began in a number of Asian and perpetuate a climate of the “supply”). countries (the Republic of Korea, violence and discrimination China and India) in the 1980s, against women and girls in GBSS leads to distorted levels followed by some countries of the society. Declining fertility and of sex ratio at birth (SRB)1. Caucasus (Azerbaijan, Armenia rapid technology developments Analysis of data indicates that and Georgia) in the 1990s, and has more recently been followed by Montenegro, Albania, and Figure 1: SRB trend in China since the 1970s Vietnam.

China has witnessed the most prolonged and significantly skewed SRB among the countries facing a similar challenge. An imbalanced SRB first occurred as a problem in China in the early 1980s. It exceeded 110 in the 1990s and reached an unprecedented 121.18 in 2004 (UNFPA 2016). In response to imbalanced SRB, the Government of China together with international partners and non-governmental institutions, have enacted various policy and Source: Official data from China Population Censuses and Population Sample Surveys intervention measures to curb the 2 UNFPA China Policy Brief Series

Figure 2: SRB in China by provinces, in 1982, 1990, 2000 and 2010 distorted SRB. As per official data and statistics, the SRB in China has hit a plateau and consistently dropped for the last seven years - from 119.45 in 2009 to 113.51 in 2015 (Figure 1). Although the ratio has fallen, it is still higher than a normal ratio of 103-107. In terms of geographical spread, first observed in provinces such as Anhui, Henan, Guangdong, and in the early 1980s, the skewed SRB has spread to all provinces in China, except Tibet, as per the 2010 census (Figure 2).

The skewed SRB increases with Source: China population censuses in 1982, 1990, 2000 and 2010 parity. The SRB has been higher for the second child than that of the first one, and is even worse annually in the Global Gender Gap effects on the Chinese society, for the third child (UNFPA China, Report. According to this report, including further discrimination 2007). However, the sixth national in 2013, China ranked 69 among against women. According to census of China in 2010 shows that 130 countries in the world. In predictions by demographers SRB for the first child in families 2014, China’s ranking dropped 18 based on various models (Li 2007; has risen significantly, which has points to 87 among 142 countries. UNFPA APRO 2012), demographic never happened before, while that China dropped even further to masculinization will lead to a growing of the second child has dropped 91 in 2015, 99 in 2016 and 100 population gap between young men and the third and higher parity in 2017 mainly because of China and young women, with the number children has fluctuated (Li, Shang ranking the last on SRB2 among all of prospective grooms3 exceeding and Feldman, 2013). The SRB of countries (World Economic Forum that of unmarried women. According the first child has increased from 2015, 2016 and 2017). to UNFPA APRO (2012), projections 106.5, 105.4 and 107.1 in 1982, show that in China and India, men 1990 and 2000 census to 113.7 in will vastly outnumber women of 2010 (UNFPA 2016). The figure is marriageable age for over two high both in urban areas and rural Consequences of generations. Marriage simulations areas and in most of the provinces. the skewed SRB also suggest that the number of The changing patterns imply that single men trying to marry after 2030 in the Chinese society, the main Skewed SRB leads to an might exceed the corresponding factors influencing son preference imbalanced sex structure of number of unmarried women by may be changing, hence calling the population, which has 50-60% in both countries. According for further studies to explore. For significant demographic and to Guilmoto’s (2012) projections instance, the significantly increased social consequences, including: from 2005 to 2100 based on three cost of raising children may be i) marriage squeeze, ii) different scenarios for the SRB4, encouraging families to seek ways potential insecurity, iii) serious even if China’s SRB were to return to have a son as the first and only consequences for men who to normal by 2020—an ambitious birth despite the revision of the cannot marry, iv) increase in goal—as many as 15% of Chinese one-child policy. trafficking and sex work, and v) men at age 50 would still not be able longer term impact on population to find a wife by 2055 (Figure 3). China’s skewed SRB has a ageing because fewer women significant impact on the country’s means fewer children, among In a presentation made during the ranking on the Global Gender others. Marriage squeeze is World Population Day on 11 July Gap Index (GGGI), which was a phenomenon where men 2014 by the National Health and created by the World Economic vastly outnumber women of Family Planning Commission (NHFPC) Forum in 2006 and presented marriageable age, with widespread in Shenyang, an estimated 30 million

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Figure 3: Proportion of single men at age 50 according to three SRB scenarios, China, 2005-2100 unmarried males pose a threat to social order on a wide scale (Hesketh et al. 2011; Kaur et al. 2016). In China and India such men do indeed have low self-esteem and are inclined to depression. While the current literature points towards a positive, negative or even insignificant relationship between sex ratio and crimes, it is certain that unmarried men will be largely drawn from disadvantaged and low-status groups of society. Evidence shows that the proportion of unmarried men will Source: Guilmoto, Christophe Z. 2012. "Skewed sex ratios at birth and future be highly concentrated in poorer marriage squeeze in China and India, 2005–2100." Demography, 49(1): 77-100. provinces with low fiscal ability to provide social protection programs (Gupta et al. 2010; Sharygin young men will be involuntary or more distant regions (UNFPA et al. 2013). Such geographic bachelors by 2030. Such a APRO 2012). The skewed SRB may concentration of unmarried males significant surplus of men unable thus increase the possibility that could be socially disruptive, hence to marry (in China, referred to as single men in China seek foreign there is a need to expand the “bare-branches”) will inevitably wives from neighboring countries, coverage of government-financed cause a marriage squeeze, followed such as Myanmar, Vietnam, etc. social protection programs. by profound societal changes and Studies are ongoing to ascertain consequences. Studies in China and whether the increased pressure The loss of female population could India reveal an age gap between for foreign brides is creating a also result in further decrease of men and women at marriage and market for trafficked foreign fertility rate, which in turn will also show that women “marry up” women. Even voluntary foreign intensify population ageing, and (Kaur 2013; Kaur et al 2016 B). brides tend to be of lower socio- become a heavy burden on future The age gap lessens the marriage economic background, which socioeconomic development in squeeze because men can choose puts them in a very vulnerable China, especially through the between women their own age situation. Furthermore, despite the reduction of labor force (Li, Jiang, and younger, but “marrying up” increasing trend of foreign brides, and Feldman 2006). One of the worsens it because women want it may not be possible to meet constraints to continued rapid GDP to marry men who are older, the growing demand of bachelors growth in China is the slowdown better off and educated. Gupta et in the highly populous and SRB- and eventual contraction of labor al. (2010) also argue that lower- skewed China and India, as China force, caused by low fertility. The educated men experience higher already has a gender gap of 66 economic consequences of low rates of bachelorhood while million and India a gender gap of fertility and population ageing women favor men with better 43 million—that’s a surplus of 109 may be further exacerbated by prospects, migrating if needed million men (UNFPA APRO 2012). imbalanced sex ratio at birth. The from poorer to wealthier areas. rise in the SRB further reduces the This explains why educated women While some scholars conclude share of women of reproductive and poor men are worst affected that rising sex ratio imbalances age and so further slows by marriage squeeze. increase violence and crime as population and labor force growth unmarried males are more prone (Golley and Tyers, 2012). A few studies on the impact of sex to commit crimes (Edlund et al., ratio distortions in Asia have shown 2007, 2010; Golley and Tyers Sex ratio imbalance due to that men unable to marry locally 2012; Hudson and den Boer 2004, discrimination against women tend to resort to the importation 2008); others argue that there impacts the rights of girls of brides from lower economic is little evidence to support the and women, including their backgrounds, other ethnic groups, hypothesis that low-status and rights to life, participation and

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Figure 4: The “2+2+1” Mechanism

campaign “Care for Girls” to Government enhance the value of daughters in Response society and support families with China has been actively engaged girls. The “Care for Girls” campaign in different initiatives to combat employed a “Five-in-One” GBSS and SRB imbalance, mechanism, also referred to as the especially since 2000. The central “2+2+1” governance model (Figure government, in collaboration 4) (Li, Shang and Feldman, 2013). development. Furthermore, with provincial governments, the associated marriage market has amended regulations and This governance model includes imbalance may drive an increasing laws to make sex identifying a specific component on data pressure on women to marry and ultrasounds and sex-selective collection and performance perform reproductive duties, which abortions as “two illegalities”5. evaluation. After the government may stimulate mercenary marriage A comprehensive governance set a specific target within the and trafficking of women and girls, response to address skewed SRB 12th Five-Year Plan (2010-2015) and a rise in sex violence against in China was instituted in 2006, for National Family Planning and women and girls. All of these when the Central Committee of the Development, that is, to decrease are threatening to the safety of Communist Party of China (CPC) the SRB to below 115 by 2015, women and girls (Yang et al. 2012; and the State Council promulgated the former National Population Li and Jin 2012). the “Decision on Fully Enhancing and Family Planning Commission Population and Family Planning established an assessment system Programme and Comprehensively to evaluate the performance Addressing Population Issues”. In of government entities on the same year, the State Council implementing policies addressing officially launched the nationwide the imbalanced SRB.

Gaps and Opportunities

Although this governance model different actors. Furthermore, local practices and also does has made notable progress in there has been little systematic not address key drivers of bringing down the SRB, there is analysis of these policies and their the practice like gender room for improvement. implementation, which makes it inequality. For example, gender difficult to improve upon them (Li, discriminatory customary rules Firstly, policy response to SRB Shang and Feldman, 2013). and regulations may result issues is fragmented amongst in hindering women’s equal different levels and departments Secondly, the “Care for Girls” rights to property and land of government. Social policy governance model does not inheritance, further exacerbating management of SRB issues thus address conflict between son preference in rural areas (Li needs to be coordinated amongst existing laws and policies and 2015; Du, Li and Liang 2015).

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Thirdly, the “Care for Girls” social services, education, and However, experience in other campaign focuses mainly on civil affairs. For example, unlike countries without restrictive the causes of the skewed the Office of HIV/AIDS, which is fertility policies contradicts SRB, but does not address the under the State Council in China, this expectation. For example, consequences (Li, Shang and until now, the national SRB Vietnam already has a two child Feldman, 2013). For example, comprehensive intervention office policy, but still has a very severe there are no policies addressing is placed under NHFPC and not sex ratio imbalance. A close the social needs of bachelors under the State Council, which attention needs to be paid to or the potential increased negatively impacts on its ability the impact of the new fertility vulnerability of women as they to mobilize multi-sectoral support policy on the SRB trend in China, become scarcer in comparison to and engagement (Zheng 2012). especially given rapid changes in the growing male population. In addition, the participation of social and economic conditions. NGOs, civil society organizations Fourthly, the accuracy of SRB and local communities is required The merger of the former data has been an issue of to change people’s preference ministries - Ministry of Health concern (IPDS 2014). There for sons (Li 2007). “Intervention and the National Population and is a discrepancy among without adequate support from Family Planning Commission - administrative data on SRB the top and without active into the NHFPC in 2013 created collected from different sectors, participation from the community an opportunity to streamline e.g. from family planning, health, would be neither effective nor the SRB data collection in public security and education. sustainable” (Zheng 2012). family planning and health Large-scale population migration departments. A real-name in China further complicates the In a positive step, the Communiqué registration system for new data collection. In addition, the of the Third Plenary Session of births by health departments has strict performance assessment the 18th Central Committee of become a national policy7. This may have an impact on the the Communist Party of China policy provides the government accuracy of reported SRB data. (CPC 2014) used the phrase with real-time SRB data and For example, the targets set for “social governance” instead data on population growth, performance assessment may of the previously used “social among other issues. It allows have unintended consequences management.” Thus, this linguistic a more effective monitoring of and lead to under-reporting. shift indicates a greater willingness the SRB trend and provides a Thus, there is a need to further to engage civil society in the basis for well-informed policy- strengthen mechanisms to social sector and public services. making to prevent GBSS and track precise SRB data in This change in the government’s address skewed SRB (IPDS 2014; order to objectively assess the attitude towards civil society Li, Shang and Feldman, 2013). effectiveness of relevant policies creates a window of opportunity The issue of imbalanced SRB is and measures. for new interventions and addressed in the Program for partnerships with the social sector. the Development of Children Fifthly, although leadership and (2011-2020) as one of the major management is a key component Starting from 1 January 2016, objectives. Section 5 on children of “Care for Girls” Campaign, all married Chinese couples are and legal protection includes there is a lack of strong allowed to give birth to two comprehensive strategies and multi-sectoral leadership and children, a policy approved by measures for normalization synergized efforts to work on the the National People’s Congress in of SRB. Indeed, since 2011, intervention among government December 2015. This is a further the Chinese government has departments, CSOs and step following the 2013 adjustment prioritized reducing the high academics (Zheng 2012). Despite of the fertility policy, a significant SRB in national development ongoing efforts and initiatives6, change in the direction of full strategies. According to the SRB is primarily being addressed compliance with the Programme of 13th Five-Year National Family by the health and family planning Action adopted at the International Planning Development Plan sectors, and lacks involvement of Conference on Population and (2016-2020) released by the other important multi-sectoral Development in Cairo in 1994. The NHFPC, China’s SRB is expected mechanisms at higher levels hope is that this change in fertility to be reduced to 112 by 2020. and large scales, such as actors policy will reduce the skewed in women’s empowerment, SRB with increasing fertility rate.

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Recommendations and Way Forward Experience gained from efforts to address other traditional practices that are harmful to women has shown that long-term change can only be Legislation and policy achieved when a broad range of actors is engaged in a concerted effort. The joint interagency statement by OHCHR, UNFPA, UNICEF, UN Women • Analyze the impact of laws and and WHO (WHO 2011) provides a series of recommendations for effective policies on gender equality action. Based on consideration of the contexts of China, the following and accordingly promote legal recommendations are derived therefrom as part of the way forward frameworks and socioeconomic towards the normalization of SRB in China: policies that will sustain gender equity, and in particular Supportive measures for girls and women encourage active participation from civil society. • Improve girls’ and women’s services. • Formulate and implement equal access to information, • Provide incentives for policies and agreements health care services, and families with daughters only (including village rules and employment opportunities; to increase the perceived regulations) targeting son ensure their personal security value of girls, while longer- preference, to ensure gender and raise their awareness of term efforts to change deep- equality with respect to self-determination. rooted thinking and attitudes inheritance, dowry, marriage, • Ensure that high birth take effect. land distribution, financing old order girls (i.e. those born • Provide measures to prevent age and other personal security second, third or fourth in a and respond to gender-based issues, pension, individual family) have equal access violence including support to safety, education and family to education and health survivors of violence. name determination.

Strengthen evidence base • To provide a sound basis system for new births by different age and population for policy development and health departments can be groups. action, more reliable data are strengthened to collect reliable • In monitoring and evaluating needed on the magnitude data on SRB. ongoing interventions, of GBSS. SRB data from a • All the determinants and indicators for tracking change variety of sources need to be consequences of skewed and impact should include not analyzed not only to provide SRB must be addressed using only the SRB but also other a more comprehensive different types of research, markers of gender inequality. picture of the situation and including qualitative studies Documenting and analyzing its complexities, but also that explore the contextual the reasons for the success and to study the interplay with realities that underlie sex- failure of specific and collective socio-economic variables. selection motivations and interventions must be part of The real-name registration practices, and their effects on this process.

Proper use of technology • Promote ethical management that they are fully aware of the should not limit economic, on fetal sex identification and issues around sex selection, social and/or geographical sex selection services using and are in a position to act access to technology for health professional associations, responsibly and in accordance reasons by all individuals. with guidelines on the use of with guidelines. • Ensure women’s access to technologies being developed • Avoid reinforcing gender safe abortion and related and promoted that proscribe discrimination – for example, services - efforts to manage the use of technologies by women should be able to or limit sex selection should unqualified people. access health care without also not hamper or limit • Particular attention needs to spousal authorization. access to legitimate sexual be given to engaging health • Avoid reinforcing inequities – and reproductive health care professionals to ensure efforts to limit sex selection technologies and services.

TOWARDS A NORMAL SEX RATIO AT BIRTH IN CHINA UNFPA China Policy Brief Series 7

Advocacy, communication and community mobilization • The social norms that imbalances. that the behavior change govern son preference will • Use all available media communication contents ultimately have to change channels to conduct and activities are context- within families and within advocacy and communication appropriate, reinforced with social networks. Thus, activities, build strong social systematic and rigorous advocacy to change attitudes support for the concept of assessments. and behavior towards girls the equal value of girls and • Complement national-level and women has to be a boys. activities with mutually central part of work to • Encourage the broadest reinforcing activities at the redress gender inequalities possible participation from local level in order to fully manifested through sex-ratio civil society to ensure engage communities.

Endnotes 1 Sex Ratio at Birth is a statistical Chinese culture. In Confucian culture 5 The term “two illegalities” refers to indicator captured as the number of and the socialist value system, family illegal fetal sex identification and illegal boys born alive per 100 girls born alive. is seen as a central and essential unit sex selective abortion for non-medical In most countries, the normal sex ratio of society, which puts great pressure purposes. at birth varies between 103 and 107 on Chinese men and women to marry. boys per 100 girls, and a higher ratio Furthermore, the purpose of our 6 For example, since 2011, through its is a sign of deliberate sex selection, discussion of the marriage squeeze is Country Programmes of cooperation rather than natural sex ratio to articulate the consequences of an with China, UNFPA worked with imbalanced SRB on heterosexual men national partners in selected project 2 This index shows the gap between and does not assume that women’s sites to support comprehensive men and women, not indicating level of role in society is solely as a wife or as interventions that are gender-sensitive, development. Besides, the number of the possession of a man. incorporate multi-sectoral cooperation, countries ranked is different from year and fully engage communities. to year, so the data from different years 4 Simulations rely on three different may be incomparable. population projections based on SRB 7 The real-name registration system parameters, namely the no-transition was first introduced by the 3 UNFPA recognizes that some people scenario, the rapid-transition scenario, provincial government in July 2007, may not desire a heterosexual and the normal-SRB scenario. These which requires newborns to undergo a marriage, however in this paper, a three scenarios lead to three different real-name registration when mothers heteronormative approach to male- sets of age and sex distributions for the are in hospital after their delivery. female relations was taken because period 2005-2100. of the importance of marriage in References Communist Party of China (CPC). Edlund, Lena, Hongbin Li, Junjian Yi and Gupta, Monica Das, Avraham 2014. “Communiqué of the Junsen Zhang. 2010. “Marriage Ebenstein, and Ethan Jennings Third Plenary Session of the 18th and Crime: evidence from China’s Sharygin. 2010. China’s Marriage Central Committee of the CPC.” rising sex ratios”. Retrieved Market and Upcoming Challenges Retrieved from http://www.china. from http://empac.ucsd.edu/ for Elderly Men. Policy Research org.cn/chinese/2014-01/16/ assets/001/501502.pdf Working Paper, WPS 5351. World content_31213800.htm Bank. Golley, Jane, and Rod Tyers. 2012. Du, Fangqin, Huiying Li and Jun Liang. “China’s Gender Imbalance and its Hesketh, Therese, Li Lu, and Zhu Wei 2015. “Revising Village Rules Economic Performance”, Working Xing. 2011. “The Consequences of and Regulations and Promoting Papers in Economics, 2012-10, Son Preference and Sex-selective Gender Equality,” in Liu Hongyang UWA Business School, Perth, June. Abortion in China and other Asian and Tang Mengjun Eds. Gender Countries.” Canadian Medical Equality Promotion and Addressing Guilmoto, Christophe Z. 2009. "The sex Association Journal, 183 (12): Sex Imbalances: Experiences from ratio transition in Asia." Population 1374–77. Three Counties in China. : and Development Review, 35(3): China Population Publishing House. 519-549. Hudson, Valerie M. and Andrea M. den Boer. 2004. Bare Branches: Edlund, Lena, Hongbin Li, Junjian Yi and Guilmoto, Christophe Z. 2012. "Skewed The Security Implications of Junsen Zhang. 2007. “Sex Ratios sex ratios at birth and future Asia’s Surplus Male Population, and Crime: Evidence from China’s marriage squeeze in China and Cambridge, MA: MIT Press. One-child Policy”, IZA Discussion India, 2005–2100." Demography, Paper 3214, Bonn: Institute for the 49(1): 77-100. Study of Labor.

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About UNFPA UNFPA China UNFPA, the United Nations Population Fund, is the lead UN 1-161, Tayuan Diplomatic Office Building, agency for delivering a world 14 Liangmahe Nanlu, Beijing 100600, China where every pregnancy is wanted, Tel: 86 10 6532 0506 every childbirth is safe, and every Fax: 86 10 6532 2510 young person's potential is fulfilled. Currently, UNFPA works with Website: http://china.unfpa.org/ national partners on the UNFPA- QR code for UNFPA Weibo account China Eighth Country Programme (2016-2020), which aims to strengthen policy environment to advance universal access to sexual UNFPA and reproductive health and rights, 在这个世界实现 particularly for young people and 每一次怀孕都合乎意愿 vulnerable populations, to address 每一次分娩都安全无恙 gender-based violence and gender- 每一个年轻人的潜能 biased sex-selection, and to promote 都充分发挥 integration of population dynamics in policy making and planning.

TOWARDS A NORMAL SEX RATIO AT BIRTH IN CHINA