VZCZCXRO1433
RR RUEHCN RUEHGH
DE RUEHBJ #0017/01 0060746
ZNR UUUUU ZZH
R 060746Z JAN 10
FM AMEMBASSY BEIJING
TO RUEHC/SECSTATE WASHDC 7508
RUCNDT/USMISSION USUN NEW YORK 2273
INFO RUEHOO/CHINA POSTS COLLECTIVE

UNCLAS SECTION 01 OF 03 BEIJING 000017 
 
STATE FOR PRM/POP 
STATE ALSO FOR DRL/PHD, IO/D, DRL, EAP/PD, AND EAP/CM 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: KPOP SOCI PHUM KPAO KWMN TBIO CH
SUBJECT:  UNDERSTANDING CHINA'S RISING SEX RATIO IMBALANCE 
 
REF: A) BEIJING 2808 B) BEIJING 2795 
 
¶1. (SBU) SUMMARY:  China's sex ratio at birth (SRB, the number of 
male births to 100 female births) reached 120.56 in 2008, marking a 
continued and dramatic rise in the gender imbalance since the 1980s. 
 Across all of China's provinces and municipalities, only Tibet now 
has a normal SRB.  The underlying cause of the sex ratio imbalance 
is a strong cultural preference for sons exacerbated by a strict 
birth limitation policy, leading to both prenatal and postnatal 
discrimination against girls that results in widely practiced sex 
selective abortion and excess female infant and child mortality. 
END SUMMARY. 
 
CHINA'S SEX RATIO IMBALANCE ABNORMALLY HIGH AND STILL GROWING 
------------------------------ ------------ ----------------- 
 
¶2. (SBU) From a near normal SRB of 107.6 in 1982, China's national 
average SRB rose to 116.9 in the 2000 population census, triggering 
the country's first public acknowledgement of the sex imbalance 
problem in 2002. (NOTE: A natural sex ratio at birth is between 103 
and 107. END NOTE) The SRB rose to 118.58 in 2005 and has continued 
to creep up each year since then, reaching a high of 120.56 in 2008 
(National Statistical Bureau/NSB). 
 
¶3. (SBU) In recent years the sex ratio imbalance has spread 
nationwide.  According to the 2000 census data, seven 
provinces--Inner Mongolia, Heilongjiang, Guizhou, Qinghai, Ningxia, 
Xinjiang, and Tibet, had normal or near normal SRBs of less than 
¶108.  By the 2005 inter-census, however, only Tibet still showed a 
normal SRB of 105.15. (NOTE: Tibet has the most permissive family 
planning in China with no birth limitation policies for Tibetans 
residing within the Tibet Autonomous Region (TAR). END NOTE) The SRB 
also has increased across both high-income and low-income 
provinces. 
 
¶4. (SBU) In all regions, the overall SRB conceals dramatic 
differences in SRB by birth order.  For example, in families where 
the first child is a girl, the sex ratio imbalance for the second 
child is much higher.  In 2005, the national average sex ratio for 
first births remained close to normal at 108.41.  The sex ratio 
imbalance for second births was 143.22 and for third births 152.88. 
For second order births, nine provinces had SRBs of over 160; for 
third order births, sixteen provinces had SRBs of over 160 and among 
those four, Beijing, Anhui, Jiangxi and Guizhou had SRB of over 200. 
 
 
HAS CHINA'S GENDER IMBALANCE PEAKED? 
------------------- ---------------- 
 
¶5. (SBU) While the gender imbalance in China has been receiving much 
attention by international press and academics in recent years, 
there is some indication that the magnitude of the imbalance may be 
peaking, at least as a national average.  For example, the sex ratio 
for children under age five showed a small decline from 2007 (123.6) 
to 2008 (123.3), as did the sex ratio imbalances for second and 
third births from 2000 to 2005 (for second births from 151.9 down to 
143.2 and for third births from 160.3 down to 156.4).  Some 
demographic experts speculate that these indicators could signal an 
emerging turnaround in the gender imbalance. 
 
¶6. (SBU) Professor LI Shuzhou, from the Institute for Population and 
Development Studies at Xi'an Jiaotong University and Deputy Leader 
of the Experts' Advisory Group to the National Care for Girls 
Program Office, recently shared with ESTHOff a 2009 study he 
co-published on the "missing girls" phenomenon.  His cohort analyses 
of the sex ratio of children under age five using census data 
(collected every five and 10 years) from 1990 through 2005 show that 
in over half of China's provinces and municipalities, the child sex 
ratio reached a peak in either 1995 or 2000.  In some regions, the 
sex ratio has continued to fluctuate around that peak, while seven 
regions--Beijing, Inner Mongolia, and the provinces of Liaoning, 
Zhejiang, Fujian, Shandong, and Guangxi--have seen a decline in the 
gender imbalance, either from 1995 through 2005, or from 2000 to 
¶2005. 
 
¶7. (SBU) In a November 30 meeting with population experts at the 
China Population and Development Research Center (CPDRC), the main 
policy research arm of China's National Population and Family 
Planning Commission (NPFPC), Professor GUI Jiangfeng also opined 
that the national average SRB must be nearing its peak.  He 
explained that because ultrasound is already in pervasive use for 
the purposes of prenatal sex selection, continued increases in the 
SRB imbalance are unlikely to occur.  Professor LIU Zhongyi, another 
expert from the CPDRC present at the meeting, suggested that there 
also may be a natural rebalancing of the sex ratio as society begins 
to feel the pressure of the missing girls. 
 
ONE CHILD POLICY INTENSIFIES TRADITIONAL SON PREFERENCE 
 
BEIJING 00000017  002 OF 003 
 
 
------------------------------- ----------------------- 
 
¶8. (SBU) Strong traditional preference for sons is seen as the root 
cause of China's skewed sex ratio.  A patrilineal family system has 
resulted in a dominant male status in property inheritance, family 
succession, and ritual duties.  Additionally, patrilocal marital 
customs--where the wife leaves her own family and joins her 
husband's and where sons, not daughters, take care of parents as 
they age--add the practical need for sons to ensure old age security 
to an already long-standing cultural bias in favor of males. 
Whereas previously families could ensure the family had sons simply 
by having more children, China's implementation of a strict family 
planning policy to slow population growth, beginning in 1979, 
ensured that rural families, facing constraints in the number of 
children they could have, would almost always prefer to have sons. 
(REF B) 
 
CULTURAL PREFERENCES EXACERBATED BY TECHNOLOGICAL ADVANCES 
-------------- ------------------------------ ------------ 
 
¶9. (SBU) Prenatal sex selection, legally banned in China but still 
widely practiced, is largely acknowledged as the primary enabler for 
China's abnormally skewed SRB.  The steady rise in the sex ratio 
across all birth cohorts trends with the increasing availability of 
ultrasound as a tool for prenatal sex determination.  First used in 
the early 1980s, ultrasound technology had reached rural townships 
by the mid-1990s and is now cheap and accessible even to the rural 
poor.  Abortion is also widely available due to the family planning 
infrastructure established to implement China's strict birth 
limitation policy (REF A). 
 
¶10. (SBU) Although both prenatal sex identification for non-medical 
reasons and sex-selective abortion are technically illegal as 
stipulated in the 1994 Law on Maternal and Child Health and later 
reaffirmed by the 2002 Law on Population and Family Planning, all of 
Post's sources consulted in recent weeks underscored the difficulty 
of enforcing these prohibitions.  The burden of proof is 
challenging, the implementing regulations vague, and the penalties 
and sanctions largely ineffective as deterrents.  In a November 20 
meeting with ESTHOffs, Professor HU Yukun of Peking University's 
(PKU) Institute of Population Research described the prevalence of 
private and underground clinics that openly advertise the 
availability of "quick and painless" abortion services.  She noted 
that proving an abortion has been carried out based on sex selective 
criteria and not on government sanctioned family planning grounds 
remains nearly impossible. 
 
¶11. (SBU) Abortion studies and data are limited in China, but one 
2008 doctoral dissertation carried out at Renmin University on sex 
ratio includes a section on abortion, analyzing data on 12,000 to 
18,000 cases occurring each year from 2000 to 2006.  The nationwide 
study found the average sex ratio of aborted fetuses over the 
six-year period to be 72.5 male to 100 female (meaning nearly 50 
percent more aborted female fetuses), with this sex ratio at the 
lowest in 2006 at 64.9 male to 100 female.  A separate 2005 study on 
sex-selective abortion in rural Henan province published by the 
California Center for Population Research at the University of 
California, Los Angeles, examined data from 1,056 rural women and 
followed 2,362 total pregnancies.  The results showed 18 percent of 
the pregnancies were aborted and, among the terminated pregnancies, 
35 percent were reported as due to "undesired gender."  The sex 
ratio of the live births was 116.9. 
 
CHILD SURVIVAL RATES SHOW BIAS AGAINST GIRLS 
--------- ------------------ --------------- 
 
¶12. (SBU) Although overall infant and child mortality has declined 
considerably in China in the 30 years since economic reforms began, 
the plight of girls after birth relative to boys has worsened. In a 
normal population, the under age five mortality rate typically is 
higher for males than for females, which counteracts the natural 
higher number of boys born and leads to a more balanced (or lower) 
overall male-female sex ratio of children under age five than at 
birth.  However, in China, while the sex ratio imbalance at birth 
has been increasing each year, reaching 120.56 in 2008, the overall 
2008 sex ratio of children under five was even higher, at 123.26, 
likely due to excessively high post-natal female child mortality. 
 
¶13. (SBU) In meetings on November 19 with Lisa Ng Bow, UNICEF 
China's Chief for Plans of Action and Promotion of Child Rights, and 
on December 4 with Mariam Khan, UNFPA's Deputy Country 
Representative, ESTHOff learned that the strong preference for sons 
over daughters in China continues to be reflected in the neglect and 
mistreatment of girls.  Bow and Khan noted that while infanticide 
now only occurs in extreme cases, gender inequities in girls' access 
to food, nutrition, and medical care still exist, which lead to 
higher female infant mortality.  Government sources concurred.  As 
former Director MA Li and population experts from the CPDRC 
 
BEIJING 00000017  003 OF 003 
 
 
explained in a November 30 meeting with ESTH officers, the neglect 
of girls is most frequently seen in access to urgent medical care, 
especially in the immediate period after birth. 
 
¶14. (SBU) Academic research findings support the idea that biases 
against girls leading to childhood mortality in China is highest in 
the first year of life, and perhaps even the first days of life. 
Professor LI Shuzhou's "missing girls" study (same as in paragraph 
5) found the male-female ratio of mortality rates for children less 
than one year old has been steadily dropping over the last thirty 
years and in 2005 was the farthest below parity among children under 
five, at 80 boy deaths to every 100 girl deaths, even though in 
normal populations, male children typically have a slightly higher 
mortality rate than female children.  A 2006 study by Fudan 
University's Professor WU Zhuochun that followed a cohort of 3,697 
pregnancies from 20 rural villages in Anhui province from pregnancy 
registration through seven days after birth found not only a sex 
ratio at birth of 159, but also that the likelihood of death for 
girls was almost three times that of boys during the first 24 hours 
of life. 
 
UNDERREPORTING OF GIRLS PLAYS A SECONDARY ROLE 
-------------------- ------------------------- 
 
¶15. (SBU)  A common question is how much preference for sons and the 
pressure of China's one-child policy have caused families not to 
report first born girls so they may try again to have a boy, a 
phenomenon which would explain some of the sex-ratio imbalance in 
reported births.  There is disagreement as to the degree 
underreporting of girls has exaggerated the gender imbalance. 
NPFPC's Care for Girls Leadership Committee gave a presentation on 
sex ratio in 2008 that acknowledged underreporting probably does 
exist but cited adjusted findings for the SRB of 115 in 2000 and 118 
for 2005, only slightly lower than that yielded in census studies. 
Professor ZHAI Zhenwu, Director of Renmin University's Population 
and Development Studies Center (PDSC) argues that the underreporting 
is more severe; his 2009 study comparing population data with later 
education enrollment data for the same cohort determined that 
China's sex ratio imbalance, while serious, is in reality five 
points lower than the census data would indicate.  CPDRC's Ma 
stressed to ESTHOff at their recent meeting that the government had 
studied the issue of underreporting carefully and determined it has 
not been a major contributor to the abnormal sex ratio.  She 
explained that their studies had also found common underreporting of 
boys by parents who wanted to have a second child, regardless of the 
sex of the first child. 
 
¶16. (SBU) UNFPA's Khan agrees with Ma's view on underreporting and 
noted told ESTH Off that she has heard discussed the idea of local 
governments granting "amnesty" for unregistered children to 
encourage parents to register them so that a clearer picture of the 
sex ratio problem can emerge.  Khan was however unaware of any 
locality where an amnesty of this type has been implemented. 
 
COMMENT 
------- 
¶17. (SBU) COMMENT:  Although some experts anticipate that the sex 
ratio imbalance may be peaking, because the growing pressure of 
"missing girls" could become a destabilizing social force, the 
government must make normalizing the imbalance a more urgent policy 
priority.  To bring the imbalance under control, China must not only 
control the means of prenatal sex selection now so commonly (if 
illegally) practiced, but must also target and transform a 
deeply-rooted cultural son preference and bias against girls.  END 
COMMENT. 
 
 
GOLDBERG