China Faces Two Decades Of Severe Gender Imbalance

Main Category: Public Health
Article Date: 14 Apr 2009 - 2:00 PDT

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In 2005 China had more than 32 million excess men under the age of 20, and over 1.1 million excess male births. This gender imbalance will lead to very high and steadily worsening sex ratios in the reproductive age group over the next two decades, according to research published on bmj.com today.

But researchers at Zhejiang University in China and University College London, say that enforcing the existing ban on sex selective abortion could lead to more balanced ratios.

Most populations have a sex ratio (males per 100 females) at birth of around 103-107 boys to 100 girls. The higher death rate for infant boys usually leads to a ratio of 100 during reproductive years. But in countries where there is a preference for sons the ratio has deviated from this norm.

Historically this has happened through female infanticide and the neglect and abandonment of girls, however, since the 1980s ultrasound has enabled parents to have female foetuses aborted. Even if this practice is illegal it is very difficult to prove terminations are being carried out for gender reasons, say the authors.

They used the 2005 intercensus survey to assess trends and geographical patterns in the sex ratio at birth and in people under 20 years of age in China and to determine the role of sex selective abortion and the influence of the one child policy.

The survey represented 1% of China's population and covered all 2861 counties. In total there were 4,764,512 individuals; 1,073,229 (22%) were urban residents, 813,386 (17%) were town residents and 2,877,897 (60%) were rural inhabitants.

The results show that sex ratios are consistently higher than normal across age groups (apart from urban 15-19 year-olds) but they peak in the 1-4 age group at 126 male births to 100 female births. Only two provinces, Tibet and Xinjiang have normal sex ratios, while Jiangxi and Henan provinces have ratios of over 140 male births compared to female births in the 1-4 age group.

The sex ratio for second births in rural areas averages 143 with ratios as high as 190 in some provinces.

The authors argue that, while the link between sex selective abortion and the sex ratio imbalance in China remains unclear (abortion on gender grounds is illegal in China and obtaining reliable figures is therefore difficult), the findings do suggest that parents are using the availability of very cheap ultrasound to decide whether to continue with a pregnancy.

The policy implications are clear: changing the regulations to permit most couples a second child after a female birth, could help to reduce the sex ratio, write the authors. Indeed, some experts now recommend that all couples should be allowed two children irrespective of sex, and relaxation of the policy is expected over the next decade.

The government is also very aware of the problem and has launched a range of policies to specifically counter the sex imbalance, such as changes to inheritance laws, and an educational campaign to promote gender equality. These measures have had some success and shows that change is occurring.

In addition, the finding that the sex ratio at birth did not increase between 2000 and 2005, and that the ratio for the first (and usually only) birth in many urban areas is within normal limits, means that the sex ratio may fall in the foreseeable future, conclude the authors.

This view is echoed in an accompanying editorial by Professors Tao Liu and Xing-yi Zhang at Jilin University. "Encouragingly, it seems that the tradition of preferring sons is shifting with the socioeconomic changes that come with urbanisation and industrialisation," they write.

They also suggest that China can learn much from its neighbouring countries about reversing the worsening sex ratio. For example, in 1992 Korea faced a severe gender imbalance but, from the mid-1990s, a public awareness campaign warning of the dangers of such distortion, combined with strictly enforced laws forbidding sex selection technology, has led to a decline in the male to female ratio from 116 in 1998 to 110 in 2004.

An accompanying paper examined the impact of frailty on type of death among older adults in China and found that frailty and type of death differs by sex and age. The findings have potential implications for improving China's public healthcare system.

"Research: China's excess males, sex selective abortion, and one child policy: analysis of data from 2005 national intercensus survey."
BMJ online

"Editorial: Ratio of males to females in China."
BMJ online

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