Name: Jennifer Ann Deacon

Student Number: n8281611
Tutor Name: Judith Meiklejohn

A Sex Exclusive Death Sentence; China’s One Child Policy and its Fatal Gender Imbalance



(Dalke, & Blankenship, 2009)

Communist China’s One Child Policy was introduced in 1979 and aimed to reduce the country’s birth rate to 2% (Potts, 2006). Prior to this, posters were created as a public health initiative, with the hope of subliminally encouraging citizens to decide independently to have only one child. (Powell & Wong, 1990). The work of propaganda above was distributed in 1986 (Dalke & Blankenship, 2009). The single, chubby, smiling baby suggests that good health and wellness will be the outcome of only having one child, which is appealing to prospective mothers. It advocates the predominate female responsibility of child-rearing by displaying the baby boy on a ladies shoulders. The high rise buildings in the background symbolise economic development, representing wealth and highsocial stature. Interestingly, the figures are clothed in red, symbolising their loyalty to the country of China (Dalke & Blankenship, 2009).


“[population control is] a means of killing off Chinese people without shedding blood.” –Mao Zedong (Chairman Mao)(Unknown, 2012)

Chinas current female to male ratio at birth (SRB) is 5:6, (normal average 20:21) signifying a problematic sex imbalance (National Bureau of Statistics of China, 2012). Sex-selective abortions and neglect of female babies are the results of the One Child Policy being enforced throughout the country (Poston, Conde, & DeSalvo, 2011). This sex imbalance has led to a significant increase in the prostitution industry and in female trafficking which in turn, has caused a rise in the cases of sexually transmitted infections (Jiag, Shuzhuo, & Feldman, 2011). Male suicide and crime levels have also risen as a result of there being fewer females, as there is now an escalating amount of competition among men for suitable spouses (Jiang, Shuzhuo, & Feldman, 2011).


Sex imbalance is currently China’s leading demographic problem according to the Government supported Chinese Academy of Social Sciences (CASS) (Renzong, 2008). All collaborated data highlights the origin of this male, female gap is a direct result of improved sex-selective technology, higher female mortality and the preference for male offspring. This issue is still rising and needs to be addressed (Figure 1.0 and 1.1).

Figure 1.0-( Unknown, 2006)
Chinas sex ratio at birth (SRB) by province in 1982, 1990, and 2000


Figure 1.1-( Unknown, 2006)
Number of males and females currently in China at different ages

Ultrasounds were introduced in China in the mid 1980’s (Wagner, 1999). Research conducted by the British Medical Journal Lancet showed that sex-discerning abortions rose from approximately 500,000 abortions in 1990 to 900,000 in 2000 in China (Wagner, 1999). Results may in fact be higher than this figure as Chinese authorities have withheld the current census data upon realizing it portrayed the situation further worsening (Wagner, 1999). 97% of all abortions in China are female (Hays, 2011). These figures are parallel with increasing availability and affordability ($4 per test) of sex selective technology accounting for roughly 50% of all abortions in China (Wagner, 1999). A study done in the Chinese province of Guangdong showed this statistic increased to 92% if a couple already had one child (Unknown, 2006). As sex selective abortions with the aid of ultrasonography are illegal, comparing trends in these two sets of data is the only way of measuring there effects on Chinas gender imbalance.

Figure 1.3- (Unknown, 2006).
Excessive female infant mortality

Of female children not aborted, 15.9% die as infants (0-12months of age), as a result of the One Child Policy (Unknown, 2006). Again, compared to males, this statistic is much higher (Figure 1.3) (Unknown, 2006). Demographic and health surveys have uncovered that parents will take their sons to get medical help if they’re ill but not their daughters (Fuse, K., & Crenshaw, E. 2006). This research furthermore established that “boys were slightly more likely than girls to receive immunization and treatment for diarrhoea” (Fuse, K., & Crenshaw, E. 2006). Additionally, in financially struggling households, food will first be given to all males before females are allowed to consume their leftovers if there are any (Fuse, K., & Crenshaw, E. 2006). This causes malnutrition. The quality of treatment given to females is a major contributor to higher female infant mortality.

Traditional Chinese religious customs take great pride in males to carry on the family line. "There are three ways of being disloyal to your ancestors…not carrying on the family name is the worse" is a well-known Confucius statement (Hays, 2011). Girls are occasionally given names such as Pandi and Yanan meaning ‘expecting a boy’ and second to a boy’ respectively (Hays, 2011). Males are furthermore a financial benefit and in some rural provinces a necessity to work the farm (Bulte, Heerink, & Zhang,2010). The Chinese government does not support most citizens in aged care or health care and thus puts great demand on families to give birth to males who generate a higher income than females (Bulte, Heerink, & Zhang,2010). Due to the One Child Policy, the need for that sole child to be of male sex contributes to the decrease in Chinese females.

Ultrasonography equipment, greater female mortality and male favouritism are merely primary causes of the sex gap in China. Secondary issues include an increase in the prostitution and trafficking industry as well as higher crime rates due to a rise in unmarried men (unknown, 2006). These factors aid the escalating suicide rates in both males and females (unknown, 2006). Research conducted by the CASS established that 24 million Chinese men will be bachelors by 2020 (Renzong, 2008). This is a significant figure when examining the Chinas population of 1.3 billion (unknown, 2006). In 2000, 8.67% of females between the ages of 25-29 years were unmarried compared to 24.68% of males in the same age bracket (Figure 1.4) (unknown, 2006). This data is perhaps limited, as numerous marriages go unregistered because men kidnap women to marry and so do not announce this to authorities. Unmarried men are particularly numerous in rural provinces which coincides with an increased gender gap (13:10), low social economic status and rise in forced prostitution, human trafficking and crime in these areas (Renzong, 2008).


Figure 1.4- (Renzong, 2008).
Chinese marriage rates of men and women

Despite the abolishment of prostitution and human trafficking in China during the 1950’s, there has been a reoccurrence in the 1980’s by 50-60% (Weitzer, 2010). The World Health Organisation (WHO) estimates four million sex workers are currently positioned in China (WHO, 2010). This value is almost certainly higher because of the illegal nature of these trades. According to scholar Andrew Tomas Hall, this is defined as human trafficking as it is forced prostitution (Hall, 2010). Women are kidnapped from neighbouring countries namely Korea, Thailand and India on false hope of employment (Hall, 2010).With heightened prostitution and trafficking, statistics show a trend of increased sexually transmitted infections and diseases (particularly HIV) nationally (Hall, 2010). This can potentially lead to a major crisis in the future for the Chinese public health sector. This is a contributor to female suicide rates in China being five times higher than the world average of 11.3 suicide deaths per 100,000 people (Hall, 2010). Furthermore, the battle to find a wife has enhanced both male crime and suicide rates. (Figure 1.5) (Paul, Yip, Liu, & Song, 2005). One theorist hypothesised that “not being able to meet the traditional expectations of marriage and childbearing will cause low self-esteem and increased susceptibility to psychological difficulties, including suicidal tendencies” (Paul, Yip, Liu, & Song, 2005). In the South west of China in the Guizhou province, a current study found majority of men suffered from low self-esteem defining themselves as “depressed, unhappy and hopeless” (Paul, Yip, Liu, & Song, 2005).

Figure 1.5- (Paul, Yip, Liu, & Song, 2005)

Figure 1.5- (Paul, Yip, Liu, & Song, 2005)
Suicide rates in China by province and sex
Continuous studies show the “combination of psychological vulnerability and sexual frustration… [leads] to aggression and violence….across cultures…most crime is perpetrated by young, single males, of low socioeconomic status” (Paul, Yip, Liu, & Song, 2005).nWhen reviewing this data, it is crucial that one acknowledges that other demographics influence the aspects discussed however majority can be attributed to sex. This puts limitations on the statistics provided.


In the previous 20 years, there has been a significant fall of traditional values and beliefs within Chinese culture (Hvistendahl, 2010). Urban residential areas are increasingly more medicinal and sanitary and employment and literacy levels are rising (Unknown, 2006). Directly proportional to this is life expectancy and hence the rapid urbanisation currently occurring in China (Unknown, 2006). This positively lessens incentive for male offspring as they are no longer required as free labour on family farms. Unfortunately this does widen the international gap of life expectancy between the inner-city and remote provinces. This is supported by a modernisation theorist who claims “land inheritance loses much of its social and economic significance as development accelerates, and this in turn may equalize the value of boy and girl children” (Hvistendahl, 2010). Males are therefore decreasingly seen as “pension security” and women less of a commodity, overall closing the gender gap. “China has seen a clear drop in the infant mortality rates” states Hall from the University of Arizona in his thesis ‘Gender Gaps in China: Facts and Figures’ (Hall, 2010). Surviving females are seen to be closing the educational and consequently employment gap (Figure 2.0) (Hvistendahl, 2010). This is yet another demographic characteristic which heightens life expectancy. As religious custom is progressively becoming less strictly adhered to, male superiority is subsequently falling (unknown, 2006). This improves life opportunities for females, successively decreasing the gender gap.

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Figure 2.0-Rural-urban adult illiteracy rate in China (Hvistendahl, 2010).

Figure 2.0-Rural-urban adult illiteracy rate in China (Hvistendahl, 2010).

China’s One Child Policy has had an overall national effect. A few significant inequalities include that between genders as well as provinces (Shu, X. 2004). Both males and females have been harmed in the attempt to reduce Chinas birth rate to 2% (Potts, 2006). Ideologies women questioned encompassed ‘is your body your country’s or your own?’ and ‘what rights do you possess to your body?’ Women have had to endure hardships such as forced abortions for the good of their country. Some may argue this is merely beneficence ethics. These are issues China is still battling with (Unknown, 2006). Likewise, males are still combating bachelorhood and the numerous struggles with this (Renzong, 2008). Rural townships of China have suffered more than urban settlements (Renzong, 2008). The sex gap in remote areas is proven to be larger than that of a city increasing issues mentioned in the previous literature review (Unknown, 2006). Currently in Chinese cities the SRB is 114.2, in urban towns, 119.9 and rural 121.7 (National Bureau of Statistics of China, 2012).

Importance and recommendations

China’s One Child Policy effectively achieved its purpose of rapidly lessening the nation’s population in order to obtain a country which could sustain itself (Uknonw, 2006). Unfortunately in doing so, numerous other issues arose as have been discussed in this analysis. In future, Chinese authorities need to predict consequences of policies prior to enforcing them. In addition, it is vital ethics are considered as irreversible effects are likely to stem from this such as the prevention of 400 million births over the last 30 years majority being girls (Poston, Conde, & DeSalvo, 2011). When currently looking at China the outcomes of this are clear as female survival is reliant on social attitudes and behaviours whereas males are dependent on marital status (Poston, Conde, & DeSalvo, 2011).


This poster ostensibly reflects enforcement of Chinas One Child Policy excluding all negative effects. The issue therefore is not so much what it represents but what it does not represent. This poster is deceptive in that it portrays wealth, success, honour and pride whilst discounting the many public health problems analysed in this article stemming from sex imbalances. The poster’s inaccurate depiction shows how Chinese officials were not thinking ethically which led their nation into further complex issues. As a person seeking a career in the health sector, it is important to consider this historic event when making or following legislations. I have learnt to question more than the surface interpretations that fix the problem on a Band-Aid level. This study has brought to my attention the flow-on effects caused by a seemingly harmless and necessary strategy. From undertaking research into this topic I have realised the benefit of early prevention as opposed to cure which I can apply every day to my future health occupation.

Additional Material

1. Controversial One Child Policy graffiti

Jing, G., Wang, A., & Chen, C. (2012). Photos: Hilarious one-child-policy writings on the wall. Retrieved 10th of October, 2012 from<>

2. The high cost of Chinas One Child Policy


3. The village where they kill their daughters



Bulte, E., Heerink, N., & Zhang,X.(2010). China's one-child policy and ‘the mystery of missing women’: ethnic minorities and male-biased sex ratios. Oxford Bulletin of Economics and Statistics(73)1, 21-39. DOI: 10.1111/j.1468-0084.2010.00601.x

Dalke, A., & Blankenship, L.( 2009).Personal ruminations of the technology of government and Its impact on gender and sexuality as presented in the handmaid’s tale and in real life. Retrieved10th of October, 2012 from <>

Fuse, K., & Crenshaw, E.(2006). Gender imbalance in infant mortality: A cross-national study of social structure and female infanticide. Social Science & Medicine(2)62 , 360–374.
Hall, A. (2010) China’s one child policy and male surplus as a source of demand for sex trafficking to china. Retrieved 16th of October, 2012 from <>

Hays, J.(2011). Preference for boys and missing girls in China. Retrieved 16th October, 2012<>

Hvistendahl, M.(2010). Has China outgrown the One-Child Policy?.Science(329)5998, 1458-1461.dio:10.1126/science.329.5998.1458
Jiang, Q., Shuzhuo, L ., & Feldman, M.(2011). Demographic consequences of gender discrimination in China: simulation analysis of policy options. Population Research and Policy Review(30)4, 619-638.

National Bureau of Statistics of China. (2012) Population, birth rate, death rate and natural growth rate by region 1978-2006 (Statistical database). Retrieved 12th of October 2012 from <>

Paul, F., Yip, Y., Liu, Jianping Hu., & Song, X.(2005).Suicide rates in China during a decade of rapid social changes.Social Psychiatry and Psychiatric Epidemiology(40)10,792-798. Doi: 10.1007/s00127-005-0952-8

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Poston, D., Conde, E., & DeSalvo, B.(2011).China's unbalanced sex ratio at birth, millions of excess bachelors and societal implications. Vulnerable Children and Youth Studies: An International Interdisciplinary Journal for Research, Policy and Care (6)4, 314-320. DOI: 10.1080/17450128.2011.630428

Powell, P. & Wong, J.(1990)Propaganda posters from the Chinese cultural revolution. Historian; Summer97 (59)4, 776-810
Renzong, Q.(2008). Bioethics in China (1990 – 2008): Attempts to protect the rights and health of patients, human subjects and the public. Asian Bioethics Review(1)1, 44-57

Shu, X.(2004). Education and gender egalitarianism: the case of china. Sociology of Education (77), 311-366. Poston, D., Conde, E., & DeSalvo, B.(2011).China's unbalanced sex ratio at birth, millions of excess bachelors and societal implications. Vulnerable Children and Youth Studies: An International Interdisciplinary Journal for Research, Policy and Care (6)4, 314-320. DOI: 10.1080/17450128.2011.630428

Unknown. (2006).Gender gaps in China: facts and figures. Retrieved 16th of October, 2012 from <>

Unknown.(2012) Population Control: Centrepiece of Imperialist AggressionAgainst the Muslim World. Retrieved 12th of October, 2012 from <>

Wagner, M.(1999). Ultrasound: more harm than good?. Midwifery today (51)1.

Weitzer, R. (2010). The mythology of prostitution: Advocacy research and public policy. Sexuality Research & Social Policy(1)7 15-29. doi:
WHO.(2012)Syphilis test availability and uptake at medical facilities in southern China. Bulletin of the World Health Organisation (89), 798–805. doi:10.2471/BLT.11.089813


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