(Zhonghua Renmin Gonghe Guo)

Demographics and a Historical Perspective
1. Basic Sexological Premises
2. Religious and Ethnic Factors Affecting Sexuality
3. Sexual Knowledge and Education
4. Autoerotic Behaviors and Patterns
5. Interpersonal Heterosexual Behaviors
6. Homoerotic, Homosexual, and Ambisexual Behaviors
7. Gender Conflicted Persons
8. Significant Unconventional Sexual Behaviors
9. Contraception, Abortion, and Population Planning
10. Sexually Transmitted Diseases
12. Sexual Dysfunctions, Counseling, and Therapies
13. Research and Advanced Education
14. The 1989-1990 Survey of Sexual Behavior in Modern China: A Report of the Nationwide “Sex Civilization” Survey on 20,000 Subjects in China*
References and Suggested Readings

Fang-fu Ruan, M.D., Ph.D., and M.P. Lau, M.D.

Editor’s Note: In this chapter. Dr. Fang-fu Ruan’s report and analysis of sexual attitudes and behavior in China follows our standard thirteen-topic structure. In Section 14, Dr. M.P. Lau provides a summary and analysis of the Kinsey-like Sexual Behavior in Modern China: A Report of the Nationwide. “Sex Civilization “Survey on 20,000 Subjects in China (1992). Readers should consult Section 14 for additional information on specific topics discussed by Fang-fu Ruan.

Demographics and a Historical Perspective

A. Demographics

The People’s Republic of China is the largest country in Eastern Asia, embracing 3.7 million square miles. China has the largest population of any country in the world, 1.2 billion (1995). The vast majority of Chinese, 92 percent, are Hans (ethnic Chinese, or Han Chinese), but the other fifty-five ethnic groups encompass 91.2 million people (about 8 percent of China’s population). Minority nationalities with populations of over one million are Mongolian, Hui, Tibetan, Uighur, Miao, Yi, Zhuang, Bouyei, Korean, Manchu, Dong, Yao, Bai, Tujia, Hani, Kazak, Dai (Thai), and Li.

Slightly larger than the contiguous 48 United States, China is bordered by Korea in the east, Mongolia in the north, Russia in the northeast, Kazakhstan, Kirghizstan, and Tajikstan in the northwest, Afghanistan and Pakistan in the west, India, Nepal, Sikkim, and Bhutan in the southwest, and Myanmar (formerly Burma), Laos, and Vietnam in the south, and the Pacific Ocean in the east. Across the seas to the east and southeast are Japan, the Philippines, Malaysia, Brunei, and Indonesia. Only one tenth of the land is cultivated, although the eastern half of China is one of the best-watered lands in the world, with three great rivers and vast farmlands.

Twenty-seven percent of the 1.2 billion population are urban. The population density is 326 per square mile. The 1995 life expectancy at birth was sixty-seven for males and sixty-nine for females. The 1991 birth rate was twenty-two per 1,000; for 1995 eighteen per 1,000. The death rate in 1991 and 1995 was seven per 1,000, for a 1.5 and 1.0 percent annual natural increase respectively. The 1992 literacy rate was 78 percent, with nine years of schooling required and 96 percent attendance in primary school. China has one hospital bed per 382 persons, one physician per 648 persons, and an infant mortality rate of fifty-two per 1,000 live births in 1995. The 1993 per capita gross domestic product was $2,200.

B. A Brief Historical Perspective

The remains of various humanlike creatures, who lived as early as several hundred thousand years ago, have been found in many parts of modern China. The oldest human remains found in China were those of “Peking man,” who lived approximately 578,000 years ago. Neolithic agricultural settlements, dating from about 5000 B.C.E. have been found in the Huanghe basin. Imperial China lasted almost 4,000 years, from the Xia dynasty (c. 2200-1500 B.C.) to the Qing dynasty (A-D. 1644-1911). Bronze metallurgy reached a peak during the Shang Dynasty of Northern China (c. 1500 B.C.E. to c. 1000 B.C.E.), along with Chinese pictographic writing. Imperial China was marked by a succession of dynasties and interdynastic warring kingdoms. The range of Chinese political and cultural domination waxed and waned, expanding from the north to the south and west at various times, as science, technology, and culture flourished in great sophistication. Rule by non-Hans (foreigners), the Mongols during the Yuan Dynasty (1271-1368) and the Manchus in the Qing Dynasty (1644-1911), did not alter the underlying Chinese character of the culture.

Cultural and political stagnation in the nineteenth century left China vulnerable to internal rebellions that left tens of millions dead and Russian, Japanese, British, and other foreign powers exercising control over some key parts of the country. Imperial rule ended in 1911 with the formation of the Republic of China in 1912. Between 1894 and 1945, China was involved in major conflicts with Japan. In 1895, China gave up Korea, Taiwan, and other territories. Japan seized the northeast provinces of Manchuria in 1931, and invaded China proper in 1937. Following World War II, China regained the territories it had previously lost to Japan. In 1949, the People’s Republic of China was proclaimed by Chinese Communist leader Mao Zedong; the nationalist Republic of China (Kuomintang) retired to Taiwan.

The Great Leap Forward, 1958 to 1960, tried to force the pace of economic development through intensive labor on huge new rural communes and emphasis on ideological purity. The program was abandoned when it encountered serious resistance. In 1965, the Great Proletarian Cultural Revolution was launched in an effort to reestablish the revolutionary purity of the principles of Chairman Mao Zedong with massive purges and the forced relocation of millions of urban teenagers into the countryside. This effort gradually petered out as pragmatism regained its influence. Despite the violent repression of democratic demonstrations by over 100,000 students and workers in the 1989 Tiananmen Square outside Beijing’s Great Hall of the People, China has followed a painfully slow, halting, but definite transition and adjustment to a partial free-market economy and more democratic policies.

1. Basic Sexological Premises

A. Character of Gender Roles

In order to understand and evaluate the recent situation of gender roles in China, it is necessary to begin with some understanding of the roots of female oppression in the traditional Chinese society and family. In its earliest history, China was a matriarchal society, until Confucius and Mencius defined the superior-inferior relationship between men and women as heaven-ordained more than two thousand years ago. In traditional Chinese society, women should observe the Three Obediences and the Four Virtues. Women were to be obedient to the father and elder brothers when young, to the husband when married, and to the sons when widowed. Thus the Chinese women were controlled and dominated by men from cradle to grave. The ideal of feminine behavior created a dependent being, at once inferior, passive, and obedient. Thus for more than 2,000 years, for the vast majority of Chinese women, belonging to a home was the only means to economic survival, but they had no right to select a husband, let alone the right to divorce or to remarry if widowed. They had no right to their physical bodies. Those who defied such institutionalized oppression were persecuted, ostracized, and sometimes driven to suicide. [This may not apply to the lower class and marginal people. (Lau)]

The functional importance of all women in traditional China lay in their reproductive role. In a patriarchal and authoritarian society, this reproductive function took the form of reproducing male descendents. Since descent was patrilineal, a woman’s position within her natal family was temporary and of no great importance. The predominant patrilineal household model, in combination with early marriage, meant that a young girl often left home before she was of significant labor value to her natal family. Hence, education or development of publicly useful skills for a girl was not encouraged in any way. Marriage was arranged by the parents with the family interests of continuity by bearing male children and running an efficient household in mind. Her position and security within her husband’s family remained ambiguous until she produced male heirs. [Then she might become manipulative and exploitive. (Lau)] In addition to the wife’s reproductive duties, the strict sexual division of labor demanded that she undertake total responsibility for child care, cooking, cleaning, and other domestic tasks. Women were like slaves or merchandize.

A real liberation and revolution in the female’s role has occurred in the People’s Republic of China (PRC). The first law enacted by the PRC government was the Marriage Law of 1950. The law is not only about marriage and divorce, it also is a legal statement on monogamy, equal rights of both sexes, and on the protection of the lawful interests of women and children. [However, it took years for the law to become more than words on paper and move into real life. (Lau)]

B. Sociolegal Status of Males and Females

The Changing/Unchanging Status of Women

In 1954, the constitution of the People’s Republic of China restated the 1950 principle of the equality of men and women and protection of women: “Article 96. Women in the People’s Republic of China enjoy equal rights with men in all spheres of political, economic, cultural, social, and domestic life.”

Under this principle, major changes happened in the social roles of women in the PRC, especially in the areas of work and employment, education, freedom in marriage and divorce, and family management. For example, 600,000 female workers and urban employees in China in 1949 accounted for 7.5 percent of the total workforce; in 1988 the female workforce had increased to 50,360,000 and 37.0 percent of the total. [Most women continue to be employed as cheap labor, but this is not a condition limited to China. (Lau)]

A neighborhood survey in Nanjing found that 70.6 percent of the women married between 1950 and 1965 had jobs. Of the women married between 1966 and 1976, those employed stood at 91.7 percent, and by 1982, 99.2 percent of married women were breadwinners.

A Shanghai neighborhood survey reported 25 percent of the wives declared themselves boss of the family, while 45 percent said they shared the decision making power in their families. Similar surveys in Beijing found that 11.6 percent of the husbands have the final say in household matters, while 15.8 percent of families have wives who dominate family decision making. The other 72.6 percent have the husband and wife sharing in decision making. A survey in Nanjing revealed that 40 percent of the husbands go shopping in the morning. Many husbands share kitchen work. Similar surveys of 323 families in Shanghai found 71.1 percent of husbands and wives sharing housework. (Dalin Liu’s study of Sexual Behavior in Modern China (1992) contains statistical data about domestic conflicts and the assignment of household chores.)

Although the situation of women changed dramatically from what was before, in actuality, women still were not equal with men. For example, it is not unusual to find that some universities reject female graduate students, and some factories and government institutions refuse to hire women. The proportion of professional women is low. Of the higher-level jobs such as technicians, clerks, and officials, women fill only 5.5 percent. Of the country’s 220 million illiterates, 70 percent are women. Women now make up only 37.4 percent of high school students and only 25.7 percent of the university-educated population. Moreover, actual discrimination against women still exists, and continues to develop now. Many women have been laid off by enterprises that consider them surplus or redundant. Only 4.5 percent of the laid-off women continued to receive welfare benefits, including bonuses and stipends offered by their employers. Many enterprises have refused to employ women, contending their absence from work to have a baby or look after children are burdensome.

Male-Preferred, Female Infanticide, and the Sex Ratio Problem

China was, and in many ways still is, a Confucianist country. Confucianism said that: “There are three things which are unfilial, and to have no posterity is the greatest of them.” In Chinese society “having posterity” means “having a male child.” Therefore, having no boy is regarded as the worst possible problem a family can have, psychologically, economically, and sociologically.

Even before the founding of the PRC, when there was no birth control at all, China already had female infanticide. For example, in 1948 in China, the nationwide average sex ratio (male to female) was 109.6 males for every 100 females; in Dalian it was 194.0:100.

According to a survey done by gynecology professor Gu Zusan, 80 percent of rural families want a boy, not a girl. Therefore, one of the side effects of the government’s “one child” policy is the practice of female infanticide. For example, the sex ratio in a community in Wuhan (1982) among those under one year of age was 154 (154 males for every 100 females); in a village in Hubei Province (1982), the sex ratio was 503.

In the 1970s, China’s newborn sex ratio was 106:100. It was probable that in Wuhan, Hubei, and other places as well, female infanticide was being practiced. Even the government Beijing newspaper Zhongguo Fazibao (China Law News) reported this problem (September 11,1986): “According to the survey by Zungqing Women Association, there were 2,800 cases of female infanticide in Zungqing in 1984. It was a very serious and severe problem.” The newborn sex ratio in China has risen year by year. In 1986, it was 110; in 1987, 111; and in 1990, 112. In September and October 1992, a nationwide survey of 380,000 newborns showed the sex ratio was as high as 118.5.

C. General Concepts of Sexuality and Love

In mainland China today, the only sexual behavior that is acknowledged to be legally and morally permissible is heterosexual intercourse within monogamous marriage. A wide variety of sexual behaviors are explicitly proscribed. Thus, prostitution, polygamy, premarital and extramarital sex (including cohabitation arrangements), homosexuality, and variant sexual behavior are all illegal. Because even normal sexual expression is viewed with contempt as a less important activity of life, not only are pornography and nudity banned, but any social activity with sexual implications - such as dancing - may be subject to restrictions. Even the marriage relationship is given little consideration. For example, according to official statistics, approximately 360,000 married persons live apart from their spouses, and this figure increases at a rate of 100,000 per year. Most of these separations occur because individual citizens are not free to move from one place to another, or to change their places of employment.

Public policy and law related to sexuality seriously and severely impacts individual and social lives. Contemporary China is a noteworthy example of a totalitarian government’s attempt to control or repress the sexual aspects of the individual’s life. It exemplifies, as well, how sexually repressive policies are not actually effective in inhibiting sexual desire in private lives, nor in curbing the struggle for human sexual rights and freedom.

The major move toward democracy in mainland China after Mao was the “Democracy Wall” movement during 1978 and 1979. During this brief period, the government allowed young people to express their desire for personal freedom and democracy by placing “big character” posters on a wall that came to be known as the “Democracy Wall.” The Democracy Wall was also used for advocating sexual liberation. The author vividly recalls visiting the wall on February 20, 1979, and seeing two poems about sexual rights. One was titled “The Eulogy of Sexual Desire,” the other “Open Sex.” In posters like these, China’s youth first made a courageous stand on the importance of sexual openness to their country’s modernization.

During the nationwide demonstration by university students in the winter of 1986-87, there were also some posters advocating sexual freedom. While sexual liberation was not a major explicit goal of the 1989 democracy movement, its importance was understood, and its value implicit in one of the loveliest events that occurred then. During the hunger strike in Tiananmen Square, a wedding was held for one of the leaders of the demonstrators. The bride and groom, the maid of honor (the General Commander Chai Ling, now an internationally known heroine of the struggle for democracy), and the best man (Chai’s husband, the Vice General Commander Feng Congde) were all fasting, as were the classmates attending the wedding. Yet all the celebrants were laughing joyously. The wedding was the ideal symbol of the connection between the longing for liberty, and the desire for love, romance, marriage, personal happiness, and fulfillment.

[In 1996, Suiming Pan, head of the Institute for Research in Sexuality and Gender at the Renmin University of China in Beijing, analysed 11 social surveys on sexuality in Chinese cities between 1986 and 1995 and reinterviewed 103 men and 73 women. The ten factors list below, which Pan (1996) identified as affecting sexological research and studies in China, also reveal some important insights into the general concepts of love and sexuality that prevail in the Chinese culture.

1. For most people, the Chinese sexual vocabulary is either cryptic or considered dirty and abusive.

2. The more familiar with each other people are, the more difficult it is to talk about sex.

3. There is often a sexual undertone between heterosexual interviewers and interviewees.

4. Many tragic or socially illegitimate sexual matters would rather be forgotten than discussed with the interviewees.

5. Female interviewers are often considered “bad women.”

6. Pornography, sex workers, and non-marital sex are illegal in the minds of Chinese people.

7. Ordinary people do not understand why researchers study sexuality.

8. Most ordinary people are unable to evaluate and express their own sexual feelings, or even their behavior.

9. Most females feel like vomiting when questioned about sexual matters.

10. Ordinary people think that if you ask a question about a kind of sexual behavior or relationship, then it means that you really like it yourself.

The first nine of these ten points reflect ignorance, stigma, and inhibition, with only the last point expressing a common sense viewpoint frequently encountered in other countries. (Editor)]

2. Religious and Ethnic Factors Affecting Sexuality

A. Source and Character of Religious Values

China is a multireligion country, with a vast proportion of the population professing no religion. Some worship ancestors and/or Shens (“kindly spirits”). Many subscribe to more than one of the main religions: Buddhism, Taoism, Islam, Catholicism, several major Protestant religions, and Confucianism. Taoism, as a religion, is considered a genuine indigenous religion of China in the sense that Buddhism, Islam, Catholicism, and Protestantism were imported from foreign countries, while Confucianism is taken to be more secularly oriented in doctrine.

Confucianism is based on writings which are attributed to Confucius (551-479 B.C.), the first great educator, philosopher, and statesman of China, and his followers, including Mencius (372-289 B.C.), a political thinker who believed in democracy. Confucianism dominated Chinese sociopolitical life for most of Chinese history.

Confucius and Mencius themselves expressed rather a positive view of human sexuality. For example. The Master (Confucius) said, “I have not seen one who loves virtue as he loves sex” (Confucian Analects Book IX, chapter 17); “Food and drink and the sexual relation between men and women compose the major human desires” (The Book of Rites, one of the major Confucianism classics, chapter 9). In The Works of Mencius, one of the major Confucianism classics (book 6, part 1), we find: “Eating food and having sex are both of human nature.”

It was not until much later that sexual conservatism became a feature of Neo-Confucian philosophy. The crucial change was initiated by several famous Neo-Confucianists, including Ch’eng I (1033-1107), and Chu Hsi (1130-1200). Ch’eng I summarized the Neo-Confucian viewpoint as “Discard human desires to retain the heavenly principles.”

When asked whether it was justifiable for a widow to remarry when pressed by poverty and hunger, he replied, “It is a small matter to die as a result of starvation, but a serious evil to lose chastity toward one’s dead husband by remarrying.” Chu Hsi stressed the inferiority of women and the strict separation of the sexes, and forbade any manifestation of heterosexual love outside of wedlock. Chu Hsi laid the foundations of Neo-Confucianism as the sole state religion. It encouraged a puritanical and strictly authoritarian form of government, including the establishment of censorship and thought control. However, the government had difficulty enforcing these views on the lower class or sciao-ren (the non-exemplary class of people).

Taoism has both a philosophical and a religious tradition in China. Although philosophical Taoism flourished early in the fifth century B.C., Taoism as a religion did not develop until the first century A.D. Next to Confucianism, it ranks as the second major belief system in traditional Chinese thought. The philosophy of Taoism outlined in the Lao-tzu’s Tao Te Ching offers a practical way of life. Both philosophical and religious Taoism included in their classics some positive ideas about sex. For example, from Lao tzu’s Tao Te Ching. “All things have their backs to the female and stand facing male. When male and female combine, all things achieve harmony” (chapter 42, translated by S. Mitchell, Harper & Row, 1988). And from Taiping Jing (The Canon of Peace and Tranquility), an early classic of religious Taoism: “Through the way of copulation between husband and wife, the Yin and Yang all obtain what they need and Heaven and Earth become peace and tranquility;” “Based on one Yin and one Yang, Heaven allows both man and woman to exist and to be sexually attractive to each other, therefore life can be continued.”

Yin-Yang is a major philosophical concept developed during the Zhou dynasty (1027-221 B.C.). The concepts of Yin and Yang may be found in the majority of important Chinese classics, including such a major classic of Confucianism as the I-Ching, and such a Taoist classic as the Tao-te-ching. Thus, the Yin-Yang philosophy is among the most important unifying concepts of Chinese culture. According to the Yin-Yang philosophy, all objects and events are the products of two elements, forces, or principles: Yin, which is negative, passive, weak, and destructive; and Yang, which is positive, active, strong, and constructive. It was very natural for the Yin-Yang doctrine to become the basis of Chinese sexual philosophy. The Chinese have used the words Yin and Yang to refer to sexual organs and sexual behavior for several thousand years. Thus Yin Fu, “the door of Yin” means vulva, Yin Dao, “the passageway of Yin” means vagina, and Yang Ju, “the organ of Yang” means penis. The combination of these words into the phrases Huo Yin Yang or Yin Yang Huo He - ”the union or combination of Yin and Yang” - describes the act of sexual intercourse.

Buddhism was first introduced into China in the first century A.D. from India. Chinese Buddhism was of the Mahayana (Great Vehicle) school, so named to distinguish it from the earlier form of Buddhism known as Hinayana (Lesser Vehicle). Among Tibetan peoples, it is distinguished by its emphasis on the Buddhist Tantras. Most Buddhist schools denied sexual desire, and traditionally Buddhist monks have been celibate. But, it is not the case of the school of Mi-tsung (Mantrayana, or Tantrism). Sex was the major subject of Mi-tsung. Mi-tsung was very similar with some sects of Taoism, and stressed the sexual union.

Even Mi-tsung said that Bnddhatvam yosidyonisamas-ritam (“Buddheity is in the female generative organs”). In China, “ Tibetan Esoteric Sect” (Tibetan Mi-tsung) flourished in the Yuan Dynasty, especially from the time of Kubilai Khan (A.D. 1216-1294).

Islam reached China in the mid-seventh century through Arab and Persian merchants. Islam has a large following among ten of China’s minorities: Hui, Uighur, Kazak, Tatar, Kirghiz, Tajik, Ozbek, Dongxiang, Salar, and Bonan. The number of believers is about 14 million, mostly in Xinjiang, Gansu, Ningxia, Yunnan, Qinghai, Inner Mongolia, Henan, Hubei, Shandong, Liaoning, Beijing, and Tianjin.

Catholicism was introduced into China as early as A.D. 635. By 1949, the number of Catholics in China had reached 2.7 million. Protestantism was introduced into China in 1807. After the Opium War, missionary activity increased and Christianity became a part of the Chinese culture. For example, T’ai-p’ing-T’ian-Kuo, a great peasant rebellion in the Ging Dynasty, from 1851 to 1864, was under the banner of God and Christianity. By 1949, China had 700,000 Christians. Generally speaking, Catholicism and Protestantism strengthened the sex-negative and repressive attitudes in China at an official level.

B. Source and Character of Ethnic Values

There are some differences in sexual lifestyles among the different ethnic groups in China. For example, among Tibetan ethnics, plural marriages including polygyny and polyandry exist beside monogamous marriages. In some Tibetan families, brothers may share one woman as a common wife. There is also great variety in the way one religious factor impacts on the sexual attitudes in different ethnic groups. For example, Islam takes on slightly different expressions among its many followers in ten of China’s minority nationalities: Hui, Uygur, Kazak, Tatar, Kirgiz, Tajik, Dongxiang, Salar, and Bonan. [Similar accounts of the material in this section can be found in Ng and Lau (1990) and Bullough (1976). The Yearbooks of the Encyclopedia Britannica provide the latest updates on the religious and ethnic compositions of the population. (Lau)]

3. Sexual Knowledge and Education

A. Government Policies and Programs for Sex Education

In line with its general policy of suppressing any discussion of sexuality, the Chinese government neglected the development of sex education courses for the general curriculum. It was not until the early 1980s that model programs were developed, and even then, discussion was usually limited to the necessity of using contraception to limit population growth. In the 1950s, 1960s, and 1970s, not only was there a complete lack of systematic sex education, but only a few booklets on sexuality had been published. The most popular one, Knowledge of Sex (Xing-di-zhi-shi), was published in 1957. Most of these booklets are devoted to social topics, such as love and marriage, and medical topics, such as sexual dysfunctions. Only a few pages discuss aspects of sexual relationships such as arousal, sexual responses, and frequency of intercourse. Yet, for more than twenty years, Knowledge of Sex was virtually the only sex booklet available to a population of eight to nine hundred million people. (See also Sections 14B and 14C.)

In 1980, heartened by the end of the Cultural Revolution, a few authors and publishers began to produce new materials. The first effort was a new edition of Knowledge of Sex published by People’s Medical Publishing House. The first printing of 2.5 million copies, released in June 1980, was sold out almost immediately, and some people resold their copies at nearly double the original price.

Between 1980 and 1984, more than ten new sex booklets were published. Two of them became bestsellers. The first. Required Readings in Wedding Hygiene was originally published in September 1980, and by November 1981 had already been reprinted eight times, for a total of more than 7.5 million copies. The second, Questions and Answers about Wedding Hygiene, was published in July 1984 with a printing of 4.2 million copies.

Finally, in the mid-1980s, four major types of pressure led national and local officials to acknowledge the need for sex education programs. First, the population growth continued to be a very serious problem. A birth control program had been instituted in January 1973, but it became unavoidably clear that to implement the program effectively, young people would have to be given sexual information essential to understanding and using contraception. Second, rates of teenage pregnancy, juvenile sex crime, and sexually transmitted diseases seemed to be increasing. It was stated that sex education offered the best hope for diminishing these problems. Third, medical professionals felt that the numbers of patients they were treating for sexual dysfunction demonstrated a need for improved education. And finally, as a result of the new “open-door” policy of receptiveness to Western cultural influence, and a simultaneous increase in personal freedoms, the Chinese people were expressing a desire to improve their lives, including their sexual lives.

The first high school sex education courses were introduced in 1981 in Shanghai. In early 1986, forty Shanghai middle schools, about 10 percent of the city’s total, introduced an experimental sex education course for coed classes in the 12- to 13-year age group. In addition to helping students understand the physiological and psychological changes they were undergoing, the Course was designed to teach hygiene and sexual morality. By June 1986, nearly a hundred Shanghai middle schools gave sex education courses. And, by February 1988, 6,000 middle schools all over China had instituted sex education courses. Thirteen of the twenty-eight provinces, including Shanghai, Jiangsu, Tianjin, and Helongjiang, had made sex education courses part of the standard middle school curriculum. In February 1988, the State Council announced that sex education courses would be established in middle schools nationwide.

From January to October 1985, a special series of columns entitled “Essays on Sex Education” by the author of this chapter was published in Required Readings for Parents, the leading national monthly magazine on child and adolescent education. The series consisted of ten rather long articles on various aspects of sexuality and sex education. It was the first systematic treatment of such topics to be published since the founding of the People’s Republic of China in 1949. The “First National Workshop on Sex Education” was held in Shanghai on July 22 to August 7, 1985. This was the first such conference convened in mainland China since 1949. It was an interdisciplinary workshop, attended by more than eighty professionals from eighteen provinces, most them of in the fields of birth control, sociology, urology, and high school and college education. The author was the major instructor. Also in 1985, the author served as chief editor, and as a major contributor, for a large updated volume of the Handbook of Sex Knowledge, published by the Scientific and Technological Literature Publishing House in Beijing in October. Although it was intended to be the most up-to-date text of its kind, the book could not include any descriptions of sexual positions, or any nude illustrations (except anatomical drawings). Despite these self-imposed restrictions, the first printing was limited to 500,000 copies by the government. After the author left China for the United States at the end of 1985, he was asked to prepare a new version to include the knowledge of the prevention of AIDS. In 1988, the revised edition was jointly published by the Scientific and Technological Literature Publishing House and the People’s Medical Publishing House, one of the two publishers officially permitted to publish books on sex. Yet in 1988, the government allowed the showing of a film that explicitly referred to the Handbook. The movie, entitled Mandarin Duck Apartments (to the Chinese, a pair of mandarin ducks symbolizes an affectionate couple), includes a scene in which an old woman counsels a young newlywed who feels that sex is dirty and shameful. The old woman shows her the Handbook, explaining that findings in sexual science show that women have as much right as men to enjoy sex.

After the Tiananmen Square massacre in 1989, the government fell into its old habit of including sexual restrictions in a wave of political repression. But, because of the huge pressure from population control, STDs, and the prevention of teenager pregnancy, the government cannot inhibit and stop sex education any more. The sex education classes, exhibitions, meetings, and publications are still continued and developing in China today. [Pei-Kum Yao has chronicled in detail the development of adolescent sex education since 1920, in Appendix III of Dalin Liu’s Sexual Behavior in Modern China, 1992. (Lau)]

B. Informal Sources of Sexual Knowledge

Given the government’s authoritarian control described in the section above, it is obvious that informal sources of sexual information, such as television talk shows, radio phone-in programs, and popular magazines commonly found in more democratic and open countries are very limited in China because they are illegal and severely punished. [Underground sources continued to flourish, and official control has been relaxing as more emphasis has been shifted from ideology to economy. (Lau)]

4. Autoerotic Behaviors and Patterns

Self-pleasuring is still condemned by most of the Chinese people, included even some sex educators and sex researchers. It was widely said that frequent self-pleasuring will cause neuroses, sexual dysfunctions, and even severe diseases. Although in 1985, the author pointed out in his popular article “On Masturbation” and in his Handbook of Sex Knowledge that self-pleasuring is normal sexual behavior, neither harmful nor sinful, it will take time for people to accept this updated viewpoint on self-pleasuring. According to A Report of the Nationwide “Sex Civilization “Survey on 20,000 Subjects in China (1992), only 39.0 percent of students of colleges and universities said that they engaged in self-pleasuring, male students (59.0 percent) much higher than female students (16.5 percent). But Dr. Lee’s survey in 1989 in Shanghai showed that 93.1 percent of male students of colleges and universities said that they engaged in this behavior. In the “Sex Civilization” Survey, 15.9 percent of married couples said that they engaged in self-pleasuring. (See also Sections 14B, 14C, and 14D for data on masturbation among adolescents, college students, and married couples in the 1992 nationwide survey by Dalin Liu.)

5. Interpersonal Heterosexual Behaviors

A/B. Children/Adolescents

Because of the pervasive social pressures, reinforced by some medical messages and the lack of sexual education, sexual expression other than heterosexual marital sex, including sexual play and sex rehearsal play, both alone and with peers, are punished when discovered. Such behavior is seldom if ever reported or commented on in public. No puberty rites are observed to mark sexual maturation.

Premarital Sexual Activities and Relationships

A study in a major city in Quangdong province found that of 123 young women undergoing premarital examinations, 75 (61 percent) had already experienced intercourse. In 1991, a survey in which questionnaires were distributed to a random sample of 1,003 unmarried university students in Beijing, including equal numbers of men and women, of 559 respondents, 106 (19 percent) said they have engaged in sex. Lack of private space is a major problem for young lovers. Many young people have little choice but to meet in parks. And where, five years ago, couples were likely to sit demurely together on a bench, it is now acceptable to hug and kiss, ignoring people passing by only a few feet away. Some couples disappear into the bushes. In Dalin Liu’s 1992 survey, 18 percent of the married couples admitted to having sex with a previous partner; 86.3 percent of those sampled approved of such encounters. (See also Sections 14B and 14C for data on premarital courtship and sexual attitudes and behavior among adolescent males and females and college students in the 1992 nationwide survey.)

C. Adults

Unmarried Adults

For several thousand years, the Chinese people have tried to adhere to the simple dictum: “Get married at a marriageable age.” And for centuries it would have been true to say that no Chinese would want to remain single for his/her entire life. But in recent years, China’s unmarried population has been growing at a steady rate. For example, in 1982, there were 11,267,000 unmarried Chinese people aged between 28 and 49 years old, or 4.36 percent of the total 28 to 49 age range, of these, 10,556,000 were male (93.67 percent) and 714,000 female (6.33 percent). (See also Sections 14C and 14D for data on premarital sexual attitudes and behaviors among college students and married couples in the 1992 nationwide survey.)

Recently, the Chinese people have started to replace the old-fashioned social concepts with ones that respect the rights of the unmarried; to remain single is now as much a personal right as the right to marry. An important factor in this shift was a greater respect for the rights of freedom, which should prove a blessing both to individuals and society.

[In every public park in China, a large billboard at every entrance warns against “offence against public decency,” just as there are notices in dance halls prohibiting anyone from “dancing with faces or cheeks touching the partner’s.” In reality, such “indecencies” are practiced by most people, and law enforcers are becoming more and more tolerant.

[An analysis of detailed observations of courtship and petting behaviors engaged in by married, unmarried, and status-unknown couples in 13 public parks in six Chinese cities, Beijing, Guangzhou, Zheng-zhou, Hohe-haote, Chong-qing, and Xian, during the summers between 1985 and 1989 provides an insight into the heterosexual courtship behavior of young Chinese couples in that era. In the five years, from 1985 to 1989, petting behavior in the public parks increased, forcing the authorities to be more tolerant of behavior that previously was unacceptable. The decreasing social control by the authorities reflected more tolerance in the society’s political direction. Attitudes toward public petting were the most diversified in Beijing. The most permissiveness was found mainly in the blue-collar parks in contrast to the parks used mostly by white-collar workers and “cadres.” Finally, in a country with a strong tradition of double standards in sexual morals for females and males, it was surprising that in Beijing, only 31 to 40 percent of the females were fully passive and at least 18 to 27 percent intiated petting to a small degree when it came to less intimate petting behavior in more private settings in the parks. “It could never be imagined in the old days that so many females would allow themselves to be petted in public, even if they were absolutely passive” (Pan 1993: 184).

[In 1987, there was the movement against “bourgeoise liberalization,” and in 1989, a “counter revolutionary rebellion” in Beijing. It is uncertain whether and how these efforts could or did affect the petting limits, but it seems that the grimmer a movement is, the more timid the petting couples are, and the less permissive the nearby people are to the pettings. It is also interesting to note that no amount of social control, be it by propaganda, moral condemnation, or daily administrative measures, is as effective as a large-scale political movement once every few years in reinstating the official petting limits (Pan 1993:192; Burton 1988). (Editor)]


Beginning in the late 1970s, the increased tolerance of nonmarital cohabitation in the West began to influence China’s younger generation. College students and young intellectuals in particular were attracted to this lifestyle. Some of the younger or more open-minded sociologists also asserted the necessity of overcoming the disadvantages of traditional marriage. Actually, the act of cohabitation might be an act of defiance and courage, or simply a consequence of overcrowding and the lack of living space. These young Chinese risked being arrested.

The definitions of unmarried cohabitation used in compiling official statistics make it difficult to estimate the popularity of this behavior in the sense it is understood in the West. The official figure of 2.69 million couples in unmarried cohabitation in 1989 seems low, considering that some areas report that as many as 50 percent of couples living together live in unmarried cohabitation. As for couples marrying under the legal age (22 for males; 20 for females), China’s State Family Planning Commission reports that 6.1 million such marriages took place in 1987 alone. According to China’s 1990 census, 5.8 percent of 15- to 21-year-old males and 15- to 19-year-old females were “married.” That means that 8.5 million Chinese “married” under the legal age. Two and a half million babies - 10 percent of all births - were born to underage couples in that year. The same news article reports an estimate by the Marriage Administration Division of the national Department of Civil Administration that 30 percent of China’s “married” couples are living together without having received an official marriage certificate, and that the number is growing (see Section 9D).

Marriage and the Family

Although China has a long history of polygamy, in contemporary mainland China, only monogamy is legal and morally permissible. On May 1, 1950, the new Marriage Law was promulgated. It stated that “The New-Democratic marriage system, which is based on the free choice of partners, on monogamy, on equal rights of both sexes, and on the protection of the lawful interests of women and children, shall be put into effect,” and that “Bigamy, concubinage, child betrothal, interference with the remarriage of widows, and the exaction of money or gifts in connection with marriage, shall be prohibited.” The revised marriage law of 1980 followed the same principles as the 1950 law.

Marital Sex

A surprising 91 percent of the 8,000 married couples interviewed by Dalin Liu (1992) in cities and rural areas expressed satisfaction with their spouse. However, when Dalin looked deeper, he found that the average Chinese couple has intercourse four to seven times a month, with peasants invariably reporting 25 percent more sex than city couples. However, 34.1 percent of the rural couples and 17.2 percent of city couples admit to less than one minute of foreplay or none at all. Consequently, 44.7 percent of urban wives and 37 percent of rural wives experience pain during intercourse. Only 16.8 percent of rural couples kiss or embrace apart from lovemaking. (See also Section 14D for data on marital sex and satisfaction among married couples in the 1992 nationwide survey.)

Marital dissatisfaction is very common in China today. Some estimate that as many as 60 percent of the Chinese are unhappy with their marriages. A survey of 3,000 young people in Wuhan, the capital of Hubei Province, showed that only 20 percent of respondents were satisfied with their marriage. In a survey of 600 couples, all residents of big cities, 70 percent said they were unhappy with their sex lives. A random survey of married couples in Shanghai found that 45 percent were unhappy with their sexual relationships. A survey of 6,000 divorce cases in five large cities, including Beijing, Shanghai, Guangzhou (Canton), Wuhan, and Xi’an, by ten newspapers showed that 72 percent of divorces are caused by disharmony of sexual life.


Although the divorce rate is not very high in China, it is increasing rapidly. In 1978, some 170,449 couples divorced; 1979, 192,894 couples; 1980, 180,378 couples; 186,891 couples in 1981; 210,930 couples in 1982,420,000 couples in 1983, and 450,000 couples in 1984. In 1985 and 1986, the annual average was 500,000 couples. The divorce figure rose to 587,000 couples in 1987, and 630,000 couples in 1988. In 1989, nationwide official statistics show that 9,851,000 couple applied for marriage; 9,348,000 couples, about 95 percent, were approved and given a marriage certificate. In the same year, 1,307,000 couples applied for divorce; 752,000, about 58 percent, were approved and given divorce certificates. The marriage rate was 16.8 per 1,000 persons and the divorce rate 1.35 per 1,000 persons.

[With rapid economic growth creating new hopes and expectations, and Government interference in personal lives receding steadily, the divorce rate in Beijing more than doubled from 12 percent in 1990 to 24.4 percent in 1994, according to the Beijing Youth Daily. This statistic compares the number of marriages and divorces in a given year. While the national divorce rate in mid-1995 was 10.4, far behind that in the United States and European nations, officials admit that the divorce rate is rising all over China, and faster in the cities than in rural areas. Among the factors contributing to the new trend are the new social and economic freedom, the rising expectations that women bring to marriage, and a remarkable increase in extramarital affairs. More than 70 percent of divorces are currently initiated by women with the most common reason being an extramarital affair on the part of the husband.

[Increasingly, among urban Chinese and even among government officials who once actively opposed divroce, divorce is being viewed as a an acceptable alternative to an unhappy marriage. Many officials even recognize a positive side to divorce. When both parties agree, a divorce can be granted in three days; not long ago, the wait was years. Important as the government’s attitudinal shift is, a larger factor is the growing expectations women bring to marriage today, and their growing demands in an era of expanding opportunity. In the past, women were happy to settle for a stable income, a home, and children. To these expectations, women are now adding romance, sex, and affection. While women increasingly enjoy more independence and choices in career, place to live, husband, lover, they are also more subject to unemployment. Meanwhile, the shift has also brought a resurgence of traditional male values, including the right to have an affair.

[Prior to the current surge in divorces, China experienced two other waves of rapidly rising divorce rates, the first occurred in the 1950s when returning victorious Communist soldiers abandoned their farms and rural wives to move to the city; the second came during and just after the Cultural Revolution, between 1966 and 1980 (Faison, 1995). (Editor)]

Extramarital Sexual Activities

Sex between consenting adults is technically not illegal in China, but the police have broad powers to suppress activities that they consider antisocial. Elderly women who staff local “neighborhood committees,” the grassroots eyes and ears of the government, also try to stop activities of which they disapprove. But discreet affairs have a good chance of escaping detection and interference. Means of birth control were not always available to unmarried youths, but women knew they could get an abortion. Extramarital affairs seem to occur much more than generally believed, although they are conducted in such secrecy that little statistical information is available. Perhaps the best evidence of these affairs is divorce rates: about one third of the divorces in Beijing from 1984 to 1985 were caused by extramarital relationships. In the Third Symposium of Family Problems in 1991, an expert said that 40 percent of divorces are caused by extramarital sexual relationships. If these findings are at all typical, then the increasing divorce rate must reflect an increase in the number of extramarital relationships.

A survey in Beijing found that members of at least 10 percent of the sample of 600 couples had had extramarital sex. Perhaps most significant is a nationwide survey that 69 percent of the people surveyed did not think extramarital affairs are wrong. In Dalin Liu’s 1992 survey, 69 percent condoned extramarital sexual relations.

Incidence of Oral and Anal Sex

Several factors influence both attitudes towards and experience with oral and anal sex. In a 1989 survey with 1,279 respondents in 27 cities, nearly seven out of ten Chinese reported they have had anal sex with heterosexual partners. Professor Pan found that only 6 percent of the 600 heterosexual couples he surveyed in big cities had had anal intercourse at least once.

In ancient erotic art and fiction, oral sex, including mutual “69” oral sex, is not unusual. Considering the lack of information about sexual behaviors that prevailed until recently and Dalin Liu’s finding that 34 percent of rural couples and 17 percent of urban couples engaged in less than a minute of foreplay, it is not likely that oral sex is as common as it was in ancient China. No general survey data is available. Many modern Chinese think oral sex is too “dirty.” In 1988, a survey of 140 homosexual males in Shanghai revealed that only nineteen persons, 13.6 percent, said they had had oral sex, and only four persons, 2.8 percent, had experienced anal sex. At a 1990 World Health Organization meeting on the spread of AIDS in China, Pan reported that 7.7 out of 10 Chinese have had anal sex with a heterosexual partner. Little data are available on anal sex among homosexuals because of the taboo character of that population and studies on same-sex behavior (Burton 1990). (Dalin Liu’s Sex Culture in Ancient China provides extensive information about sexual deviance in China.)

6. Homoerotic, Homosexual, and Ambisexual Behaviors

Male homosexuality may have been a familiar feature of Chinese life in remote ancient times. The official Chinese historical records indicate that during the Spring-Autumn and Chin-Han Era (770 B.C. to A.D. 24), male same-sex behavior was not a crime or considered immoral behavior. On the contrary, it was sometimes the noble thing to do. For example, in Western Han (206 B.C. to A.D. 8), ten of the eleven emperors each had at least one homosexual lover or shared some same-sex behavior. During the Western and Eastern Jin and Southern and Northern Dynasties (A.D. 256 to 581), male homosexuality seemed also acceptable in the broader upper-class society.

Considering the many and varied records of homosexuality in ancient China, one would expect to find evidence of homosexuality in modern China. However, literature regarding contemporary homosexuality is scarce at best, although it is available in Taiwan and Hong Kong. Thus it was a genuine breakthrough when, through a rather unique and unexpected set of events, the situation of homosexuality in China was openly discussed for the first time in a positive context. In 1985, Ruan, the author of this chapter, using a pen name Jin-ma Hua, published an article in a widely circulated Chinese health magazine, To Your Good Health. The article pointed out that homosexuality has occurred in all nations, all social strata, and in all eras in human history, and that homosexuals deserve a reasonable social status. Many of the readers of To Your Good Health, most of them gay, wrote to the magazine’s editor in response to the article.

By April 1986, a total of sixty letters had been received by the editor of To Your Good Health, and forwarded to Ruan. A striking aspect of the letters from gay men is their immense relief at having an opportunity to express their feelings. Many letters expressed their writers’ pain and conflicting desires for confidentiality and a chance to overcome their isolation. Clearly the chief source of pain for China’s gay men derives from the fear of societal punishment, including arrest, and possible sentence to labor reform camp or prison.

The mental pressure and anguish arising from the fear that their true identity might be discovered is often unbearable. The social pressure, pain, and inner conflict homosexuals suffer can be so intense that they come to consider or even attempt suicide. Of the fifty-six who responded to Hua’s article, fifteen, or more than 25 percent, mentioned suicide attempts. Of all the hopes and dreams expressed in these moving letters, three types of aspirations were outstanding. The first concerned the human rights issue - the belief that society should accept homosexuals and their right to express their sexuality without social or legal condemnation. The second concerned the issue of freedom to interact with other homosexuals - the wish that society would provide them with means to make contacts and form relationships, just as it does for heterosexuals. The third concerned the issue of knowledge - the wish that objective and scientific studies would be conducted and publicized in order to improve societal understanding. In twenty letters, the hope that some agency would facilitate social contacts among homosexuals took the form of a request that “Dr. Hua” or his publishers do so. In Hua’s article, two actual cases of gay life in Hubei and Shanghai had been described. All twenty letters requested the names and addresses of these two men in order to establish contact with them. Some men, though they did not use the word for “club,” expressed the wish to create this type of organization. There were eighteen letters pointing out the need for development and/or publication of more information about homosexuality.

Regarding the legal situation of homosexuals in mainland China now, although there is no specific statement concerning the status of homosexuals in the current Criminal Law of the People Republic of China, Article 106 says, “All hooliganism should be subjected to arrest and sentence.” In practice, homosexual activity has been included in “hooliganism.” As noted above, even the small sample of letters Ruan received contained a report of a man who received a five-year jail term for homosexuality.

Silence, especially a silence based on repression and enforced ignorance, must not be mistaken for approval or tolerance. When public figures do speak out on homosexuality, it is usually to condemn it. For example, in the 1990s, a famous attorney even wrote that “homosexuality... disrupts social order, invades personal privacy and rights and leads to criminal behavior.” A leading forensic psychiatrist said that “homosexuality is against social morality, interferes with social security, damages the physical and mental health of adolescents, and ought to be a crime.”

Another common reaction to the suggestion that homosexuality exists in China is denial. Clear evidence of the official denial of homosexuality was provided by the internationally well-known sexologist, Dr. Richard Green, the series editor of “Perspectives in Sexuality: Behavior, Research, and Therapy.” In his “Series Editor’s Comment” for Ruan’s book Sex in China: Studies in Sexology in Chinese Culture, he wrote:

Less than a year before the 1989 massacre in Tiananmen square, I lectured on human sexuality at Peking Union Medical College. I described my research on the nonsexual behaviors of young boys that predicted later homosexuality. I asked the physicians in the audience whether comparable childhood behaviors were found among Chinese boys. I was told that there were no homosexuals in China. (Ruan, 1991)

But, this official attitude of denying homosexuality in China can no longer be justified. In late 1991, officials in Shanghai, the largest city in China, recognized that there are about 10,000 homosexuals in the city. Actually, the number of homosexuals may be over 200,000, according to the World Weekly (September 1,1991). Changzheng Hospital in Tianjin, the third largest city in China, reported in a medical paper that in the past four years, out of 366 STD cases, at least 61 cases of syphilis resulted from male homosexual behavior; 80 percent of the cases involved anal sex, 10 percent oral sex, and other 10 percent anal plus oral sex. Most of the cases (80 percent) had participated in sexual activity in public toilets. More than 80 percent of their homosexual partners were strangers. Their ages ranged from 16 years to 60 years, with two thirds of the group falling between 20 and 30 years of age. Most of them were workers, some were cadres, teachers, and others.

Yet another reaction is to admit that perhaps homosexuality does exist in China, but to insist that when it occurs, it is the result of Western influence; it was referred to as “spiritual pollution,” and “Western social diseases,” originating in “Western ideology and thoughts.”

Finally, there are those who, when faced with undeniable evidence of homosexuality, respond by seeking to eliminate it. Even many physicians still fail to recognize homosexuality as simply one possible sexual orientation. For example, in Harbin, one of the largest cities in northeastern China, physicians now use the discredited approach of “treating” homosexuality with electric shock therapy to discourage erotic thoughts.

In ancient times, Chinese culture was characterized by a very tolerant attitude toward same-sex female behavior. Lesbians in China today are even more closeted than gay males. (See also Xiaomingxiong - alias Samshasha, 1984, and Lau and Ng, 1989).

When Ruan received letters from homosexuals all over China in 1985 and 1986, not one was from a woman. The only women who are willing to discuss their homosexuality are the few who have already been imprisoned for this behavior and have little to lose. An exception to the usual difficulty in locating lesbians is the experience of Chinese journalists He and Fang, who were actually more successful in contacting lesbians than gay males in their 1989 survey of homosexuality in China. They wrote six stories about lesbians compared to one about gay males.

He and Fang had to rely on interviews with women who were jailed for “sex crimes,” or crimes of violence inspired by sexual jealousy. Because so many investigations of female homosexuality are based on interviews with prisoners, it has been all too easy for Chinese people to develop a stereotype of lesbians as immoral, frustrated people (Sheridan and Salaff 1984).

In early 1992, a new and more humane homosexual policy emerged. This started with two young lesbians in Wuwei County, Anhui Province, whose parents opposed their homosexual relationship very much. The angry parents finally reported the affair to the local police department. After several months of investigation, the police department of Wuwei County arrested these two female lovers and restrained them fifteen days on charges of “misconduct.”

The Wuwei County police department then referred the case to higher institutions until the Public Security Department of Central Government in Beijing heard the case. The Public Security Department replied and instructed the county police that since under current laws there is no article that specifies punishment for such behavior and relationship, it could not treated as “misconduct.” Therefore, the Wuwei Police Department released the two women and let them live together as “husband” and “wife.” Usually the older woman takes the role of “husband,” and wears male clothing, while the younger one takes the role of “wife” and prefers to stay in the home. It is a very good signal to show that at least some police officers, especially senior ones, have started to change their attitude toward homosexuality and other sexual variations. But, recently a reversal still occurred. In May 1993, the government closed down the first gay saloon, “Men’s World,” in Beijing, which appeared on November 22, 1992, and came out in public on February 14, 1993.

(See also Sections 14B, 14C, and 14D for data on views of homosexuality and the incidence of same-sex behavior among adolescents, college students, and married couples in the 1992 nationwide survey.)

7. Gender Conflicted Persons

Recognition of transsexualism in human society is a relatively recent phenomenon, especially in the closed society of mainland China. In January 1983, with the author’s assistance, the first male-to-female transsexual surgery was performed in the Plastic Surgery Department of the Third Hospital of Beijing Medical University.

The greatest difficulty facing transsexuals in China is that of gaining the acceptance of their families and society. It is nearly impossible to obtain permission to perform transsexual surgery. A psychiatrist told the author that he had seen two transsexual patients who, after being repeatedly denied transsexual surgery, used knives to remove the penis by themselves. The problem is not a lack of appropriate surgical techniques and facilities. In fact, both general plastic surgery and such precise surgical techniques as reimplantation of severed fingers are very advanced in China. Dr. Xia, in the Plastic Surgery Department of the Third Hospital of Beijing Medical University, has successfully operated simultaneously on a male-to-female transsexual and a female-to-male transsexual with mutual exchange and transplantation of ovaries and testicles; this surgery took nineteen hours. If permission were given, transsexual surgery could be performed with little difficulty in most large hospitals. The problem is really perceptual and ideological. The absence of scientific research on the subject means that there is nothing to counteract the statements of the popular press, which describes transsexualism as not merely outlandish, but as evidence of the inroads of “decadent Western culture.” This ideological tone effectively inhibits surgeons’ willingness to perform transsexual surgery.

[In early Chinese history, hundreds of males were castrated every year to become eunuchs. Some of these were transsexuals. In other words, transsexuals in the past had a legal option transsexuals do not have in China today. (Lau)]

8. Significant Unconventional Sexual Behaviors

A. Coercive Sex

Rape and Pedophilia

Rape, pedophilia, and any behavior which “subjects women to indignities or carries out other gangster activities,” are all clearly illegal, according to Articles 139 and 160 of the 1980 Criminal Law of the People’s Republic of China. It is very interesting to note that although China has an official policy severely repressing sex and heavily punishing sex crime, nevertheless, such crimes in mainland China continue to increase from year to year. The Chinese government does not publicize the number of sex crimes, but some figures are available from academic articles. For example, in Shanghai, the largest city in China, the number of rapes increased from 100 percent (as the basis for comparison) in 1979 to 377 percent in 1983. Nationwide, the number of reported rapes rose from a base 100 percent in 1979 to 340 percent in 1983. (See also Section 14E for data on sex offenders in the 1992 nationwide survey.)

Teenage rapists in particular increased from a base of 100 percent in 1980, to 150 percent in 1981, 192 percent in 1982, and 311 percent in 1983. While there was a slight decrease in 1984, the absolute number still increased, and in 1985 by 42.5 percent over the previous year in Shanghai.

In China, every year a lot of people were shot by the government as the penalty of crime. Many of them were related to crimes of sex, love, and marriage. In Beijing, the capital of the People’s Republic, for instance, out of fifty-two cases of the death penalty in 1984, crimes of sex, love, and marriage accounted for 67.4 percent of all death penalties.

The juvenile crime rate from 1979 to 1981 increased more than 25 percent. Statistics from three cities in 1980 to 1983 showed 13 percent of juvenile crimes involved sex crimes. Most of them were 13 to 15 years old. Forty percent of male delinquents charged by the Juvenile Delinquent Correction Institution were charged with “sexual crimes and mistakes,” 95 percent of the female delinquents, some as young as 12 years, were charged with sexual violations, which may or may not have involved rape.

Incest and Sexual Harassment

Certainly, incest and sexual harassment exist in China. No general survey data is available. “Sexual harassment” as a new word in Chinese (Xingsaorao) translated from English is now used in China. Traditionally, it was included in the concept of liumong xingwei or tiaoxi funu, both terms indicating any behavior which sexually subjects women to indignities. Liumong xingwei and tiaoxi funu are clearly illegal, according to Articles 139 and 160 of the 1980 Criminal Law of the People’s Republic of China.

B. Prostitution

China’s first brothels were likely established in the Spring-and-Autumn period (770 B.C. to 476 B.C.) by the famous statesman and philosopher Guan Zhong (? to 645 B.C.), who used them as a means of increasing the state’s income. It is clear that the institution of government-run prostitution reached its peak in the Tang (A.D. 618 to 905) and Sung (A.D. 960 to 1279) Dynasties. In ancient China, where most women had no opportunity to acquire an education, and formal contact between men and women was frowned upon, it was the role of the courtesan to entertain a man and be his friend. Every prominent official, writer, artist, or merchant customarily left his wife at home when he traveled; instead he was accompanied by women skilled in making men feel comfortable. Courtesans with literary, musical, or dancing ability were especially desirable companions, and many became famous historical figures. However, the prostitutes working in privately owned brothels mainly provided sexual services. (See also the profile of a female prostitute in Section 14E for data on prostitution in the 1992 nationwide survey.)

From the Sung to the Ming Dynasties, government-run and privately owned prostitution existed side by side in China. Early in the Ging Dynasty, from A.D. 1651 to 1673, the Manchu Emperors Shun-chih and Kang-hsi gradually abolished both local and imperial governmental involvement in operating prostitution. Thus, for most of the Ching Dynasty, prostitution in China was a private enterprise. For most of the Republican period in mainland China (1912 to 1949), some prostitutes were registered while others plied their trade illegally.

When the Chinese Communists took power, one of the first social changes they introduced was the abolition of prostitution. Only one month after the Communist army took control of Beijing (Peking) on February 3, 1949, the new municipal government announced a policy of limiting and controlling the brothels. Less that eight weeks after the founding of the People’s Republic of China on October 1,1949, more than 2,000 Beijing policemen raided and closed all 224 of the city’s brothels, arresting 1,286 prostitutes and 424 owners, procurers, and pimps. Other cities soon followed suit. In Shanghai, China’s most populous city, there were 5,333 arrests of prostitutes between 1950 and 1955.

In October 1957, in a new attempt to maintain order, the 81st Session of the Standing Committee of the First National People’s Congress adopted a new law entitled Rules on the Control of and Punishment Concerning Public Security of the People’s Republic of China. The legislation announced the policy on banning prostitution. In 1979, at its Second Session, the Fifth National People’s Congress adopted the first criminal law in the PRC, The Criminal Law of the People’s Republic of China, which took effect January 1, 1980. Under this Law, the punishment for coercing prostitution was more severe: “Article 140: Whoever forces a female to engage in prostitution shall be sentenced to a fixed term of imprisonment of 3 to 10 years.”

The severe repression of prostitution did not prevent its accelerated revival in the late 1970s and throughout the 1980s and 1990s. The first official report of the recurrence and development of prostitution in mainland China appeared in March 1983. It reported that

According to the incomplete statistics from the three largest cities, Beijing, Shanghai, Tianjin, and four provinces, Guangdong, Fujian, Zhejiang and Liaoning, from January, 1982 to November, 1982, more than 11,500 persons were discovered to be involved in prostitution. More than 1,200 persons were owners and pimps of underground brothels; more than 4,200 women were prostitutes; and 1,800 persons, including 223 visitors from foreign countries, Hong Kong and Macao, were customers of prostitutes. Fifteen hundred people were fined, 790 were detained, 691 were arrested, and 662 were sent to labor camps. More than 900 underground brothels were banned and closed.

The growth of prostitution in Guangzhou (Canton) alone was amazing. In 1979, only 49 pimps, prostitutes, and customers were caught. In 1985, this number had increased to approximately 2,000. In one month of 1987, 11,946 people were arrested for involvement in prostitution, and in both the preceding and following months the figures rose to more than 13,000.

Prostitutes and their customers appeared everywhere, in hotels, inns, hair salons, single-family homes, apartments, dormitories, underground brothels, and taxis, in every city and every province. Between January 1986 and July 1987, eighteen prison camps for prostitutes were opened, and by December the number of camps had more than tripled to sixty-two.

Statistics collected in 1986 in the city of Guangzhou (Canton), in Guangdong province, supply some information about the men who patronize prostitutes. In 1986, of the 1,580 customers who were caught, 41 percent were from the city, 34.5 percent from other parts of the province, 15.3 percent from other provinces, 6.1 percent from Hong Kong and Macao, and 3.7 percent from other countries. Fully two thirds of the customers were Communist party members and county officials.

There is no doubt that economic motives fuel the current rapid growth of prostitution in mainland China. The possibility of earning as much as 10,000 Yuan new income in only two or three months versus the average Chinese income of only about 100 Yuan per month is a powerful incentive.

Since the late 1980s, even harsher measures were taken in the effort to curtail prostitution, including arrests of foreign citizens. In June 1988, in the Shenzhen Economic Zone, which abuts Hong Kong, there was a mass arrest of 122 prostitutes and 100 customers. In the small town of Deqing, about a hundred miles west of Canton, a man accused of being a pimp was executed.

The opposition to prostitution also has an ideological basis. In the lexicon of China’s Communist leadership, “prostitution” is a very bad word. Deng Xiaoping, the top leader in China, is particularly strong in his opposition to prostitution and advocates severe penalties because he believes it tarnishes his country’s reputation. According to a formal report, more than 200,000 prostitutes and customers were caught in 1991 alone, and more than 30,000 prostitutes were sent to forced labor camps, 80 percent of them street walkers.

Some of those arrested in the antiprostitution movement received sentences as severe as the death penalty. In Wenzhou city, Zhenjiang province, a woman and a man were sentenced to death because they had owned several underground brothels, employing fourteen prostitutes. In Beijing a 55-year-old man was given a death sentence because in 1988 he had allowed prostitutes to use the offices in a hospital about twenty times.

C. Pornography and Erotica

In China, erotic painting and erotic fiction occurred over 1,000 years ago, in the Tang dynasty. The official prohibition of erotic art and literature started as early as about eight hundred years ago, in Yuan dynasty. After the founding of the People’s Republic of China on October 1,1949, a strict ban on erotic fiction and pornography of any kind was imposed nationwide. In the 1950s and 1960s, the policy of banning erotica was very effective. In the whole country, almost no erotic material was to be found. There were few difficulties implementing this policy until the mid-1970s.

Then, the legalization and wide availability of pornography in several Western countries during the late 1960s and early 1970s, coupled with China’s growing openness to the outside world, increased the supply of such material available for underground circulation.

In recent years, the suppression of pornography has become a very serious political and legislative concern. The number of arrests and the severity of sentences on people involved in pornography have both increased in the attempt to suppress it entirely.

By the late 1970s, “X-rated” films and videotapes were being smuggled into China from Hong Kong and other countries. (In China, these are known as “yellow videos” and “yellow” refers to erotica). Yellow videos quickly became a fad. At first, the only people who could view these tapes were rather highly placed party members and their families, since only they had access to videotape players, which were very rare and expensive in China at that time. Before long, however, “yellow videos,” including the well-known American pornographic movie Deep Throat, were available to more people, although still very secretly and only through small underground circles. Some people used the tapes to make money; tickets for video shows were very expensive, usually 5-10 Yuan per person (at the time most people’s monthly salary was only about 40 to 50 Yuan).

Sometimes people who were watching these tapes engaged in sexual activity, even group sex. Because yellow videos were usually shown in small private rooms to very small audiences whose members knew each other well, a party atmosphere often prevailed. It was very easy for young people to initiate sexual activity when they were aroused by what they saw.

At about the same time, erotic photographs, reproductions of paintings, and books were also smuggled into mainland China. They, too, were sold at a great profit. One small card with a nude photo would cost as much as 5 to 10 Yuan.

There was a strong reaction at the highest levels of the Chinese Communist Party and the Government. The police were ordered to confiscate every type of pornographic material, from hand-copied books to “yellow” audiotapes and films. Severe penalties were ordered for all people involved in the showing or viewing of “yellow” videos, and, in April 1985, a new antipornography law was promulgated. The nationwide crackdown on pornography led to numerous arrests and confiscations in city after city. For example, by October 1987 in Nanchang, the capital of Jiangxi Province, forty-four dealers in pornography had been arrested and 80,000 erotic books and magazines confiscated. It was reported that an underground publishing house with 600 salesmen had been circulating erotic materials in twenty-three of China’s twenty-eight provinces, making a profit of 1,000,000 Yuan (in that period about $300,000 U.S.) in two years.

A Shanghai Railway Station employee was sentenced to death because he and four other persons organized sex parties on nine different occasions; during these they showed pornographic videotapes and engaged in sexual activity with female viewers. The other organizers were sentenced to prison, some for life.

The climax of this wave of repression seemed to occur on January 21, 1988, when the twenty-fourth session of the Standing Committee of the Sixth National People’s Congress adopted supplemental regulations imposing stiffer penalties on dealers in pornography. Under these regulations, if the total value of the pornographic materials is between 150,000 Yuan and 500,000 Yuan, the dealer shall be sentenced to life imprisonment.

In a nationwide strike against pornography, beginning a few weeks after the Tiananmen Square massacre, on July 11, 1989, 65,000 policemen and other bureaucrats were mobilized to investigate publishing houses, distributors, and booksellers. By August 21, more than 11,000,000 books and magazines had been confiscated, and about 2,000 publishing and distributing centers, and 100 private booksellers were forced out of business. But then Deng Xiaoping, China’s top leader, went further by declaring that some publishers of erotica deserved the death penalty. It may be at least one of the most severe political punishments against “pornography” ever suggested by a national leader anywhere in the world. After this, in July 1990, the Supreme People’s Court issued a new decree stating that the death sentence is the proper penalty for traffickers in prostitution and/or pornography.

9. Contraception, Abortion, and Population Planning

A. Contraception

All kinds of contraceptive measures, from condom to pill, are available and used in China’s practice of family planning. In 1989, it is estimated that more than 70 percent of couples of child-bearing age are using contraceptives, over 8.8 million males have undergone sterilization injections or operations, including a new reversible sterility operation. For females, the most popular birth control method is the intrauterine devices (IUDs). Used by 60 million women in the country, the IUD accounts for 41 percent of the total contraceptive measures; female sterilization operations constitute 36 percent. Research on a variety of oral contraceptives in the country has also reached advanced levels and these are available to the public. Breakthroughs have recently been reported in the development of medicines for terminating early pregnancy. In 1992, a survey showed that 83.4 percent of married couples have adopted contraceptive practices, 40 percent of them are using IUDs, 39 percent female sterilization, 12 percent male sterilization, 5 percent oral pills, and 4 percent condoms. (See also Sections 14B, 14C, and 14D for data on contraception usage among adolescents, college students, and married couples in the 1992 nationwide survey.)

B. Unmarried Teenage Pregnancies

See Section 5C.

C. Abortion

In China, abortion as a secondary measure to terminate an unwanted pregnancy is not only a legal right, it is even a legal responsibility. If a woman already has a child, she will be asked to terminate her unplanned pregnancy by abortion in the first trimester and even as late as the second trimester. Generally speaking, in mainland China one third of pregnant women have undergone an abortion. From 1985 to 1987, 32,000,000 abortions were done, 80 percent of these pregnancies being the result of failed contraception. (See the discussion of “Fewer births - the one-child policy,” in Section D below).

D. Population Control Efforts

China’s population policy consists of two components: decreasing and limiting the quantity of population; and improving the quality of population. To reduce the numerical growth of the population, three main measures are practiced: late marriage, late childbearing, and fewer births - the “one-couple-one-child policy.” The basic measure used to improve the quality of the population involves efforts to prevent birth defects. (See also Sections 14B, 14C, and 14D for data on attitudes toward government limitation of family size among adolescents, college students, and married couples in the 1992 nationwide survey.)

This dual population policy is proving to be effective: China had 200 million fewer babies born in 1988 than in 1970. The result has been a saving of 3 trillion yuan ($802 billion). China has successfully controlled its annual population growth rate to less than 1.5 percent, as compared with 2.4 percent in underdeveloped countries and 2.2 percent in Asia. During the 1960s, the average Chinese woman gave birth 5.68 times (the figure includes infant deaths, still births, and abortions). This dropped to 4.01 during the 1970s and to 2.47 in the 1980s. The average population growth rate dropped from 2.02 percent during the period from 1949 to 1973 to 1.38 percent from 1973 to 1988.

Late Marriage

Generally, until the recent past, the Chinese people were controlled on the local level by danwei - the unit or institution one belongs to. In order to marry, a couple must have a legal registration and a permit letter from his/her danwei. Usually one’s danwei leader checks one’s age - while the minimum legal marriageable age is 22 for males and 20 for females, “later marriage age” policy stipulates an age of 27 to 28 for males and 24 to 25 for females in order to help in the control of population.

A 1991 survey in Nanjing, the former capital of China and the capital of Jiangsu Province, showed that the average marriage age was 27.5 for males and 25.8 for females. In 1949, the average first marriage age for females was 18.57, in 1982 it increased to 22.8 years old.

Late Childbearing

Married women are urged not to have a baby before 25 to 28 years of age, but no later than 30 years of age, in order to achieve the twin goals of later childbearing and healthier birth.

Fewer Births, the “One-Child Policy”

From the late 1970s to the early 1980s, China’s family planning policy evolved from “One couple two children,” to “One couple better one child,” and then to “One couple only one child.” From advocating “One couple one child” the government moved to punishing parents who have more than one child. In 1988, the “one-child policy” became a little more flexible, to allow couples in rural areas with one daughter to have a second child with planned spacing.

[By the mid-1990s, the “one-child policy” had produced an obvious but unintended and serious sex imbalance that is already producing some major improvements in the very low position women have traditionally held in this male-dominated society. Initially, the traditional preference for sons coupled with the “one-child policy” has led to ultrasound scans during pregnancy followed by selective abortion for female fetuses. In January 1994, a new family law took effect that prohibited ultrasound screening to ascertain the sex of a fetus except when needed on medical grounds. Under the new law, physicians can lose their license if they provide sex-screening for a pregnant woman (Reuters, 1994). Even after birth, “millions of Chinese girls have not survived to adulthood because of poor nutrition, inadequate medical care, desertion, and even murder at the hands of their parents” (Shenon 1994).

[The 1990 census showed about 205 million Chinese over the age of 15 were single in a total population of 1.2 billion. Overall, three out of five single adults were male. However, government figures show that, while the vast majority marry before they turn 30, eight million Chinese in their 30s were still single in 1990, with men outnumbering women by nearly ten to one. Demographics suggest that by the turn of this century, tens of millions of Chinese men will be unwilling or willing lifelong bachelors.

[A government-sponsored computer-dating service, the Great Wall Information Company, founded in Beijing in 1989, and others often sponsored by provincial and city governments, are swamped by eager men searching for a mate. One of the most popular television shows nationwide is “We Meet Tonight,” a cross between a talent show and the “Dating Game,” hosted by Ms. Yang Guang since its first showing in 1990.

[With women in short supply, the men are learning to be realistic and not set their expectations too high. In reality, the women now set the standards, making their choice of a prospective husband based on the intelligence, education, and financial status of many candidates. Another benefit for the women, prompted by the concurrent move towards a free market economy in which scarcity equals value, is that women can no longer be treated as chattel.

[Custom has held that a man should marry a woman several years younger and with less education than he has. This left older unmarried women, especially those with more education, almost no hope of finding a husband. With the growing shortage of single women, increasing numbers of men are being forced to consider marrying an older woman. There is a saying being heard more commonly in the countryside that a man who marries a woman three or more years older has found a bar of gold and benefits from her maturity.

[On the negative side, Chinese sociologists and journalists have suggested that the drastic increase of unwilling bachelors in a society that values the family and sons above all else may well produce an increase in prostitution, rape, and male suicide. Bounty hunters have already found a lucrative market for abducting young city women and delivering them to rural farmers desperate for brides.

[To restore the balance of sexes, some observers suggest the government could be forced to offer incentives like free higher education and tax breaks to encourage couples to have girls. This could result in a huge change in the way women are treated throughout the society (Shenon 1994).

[India is facing a similar sex imbalance with similar factors, the value of male offspring and efforts to reduce population growth. With 900 million people, India has nearly 133 single men for every hundred single women. In the industrialized world, sex ratios are more balanced; in some cases, Japan and the United States in particular, unmarried women outnumber single men, Fifty-four to forty-six (Shenon 1994). (Editor)]

Healthier Birth, or “Preventing Birth Defects”

Every year in China, 13 infants per 1,000 are found to suffer from physical defects. The death rate is 26.7 per 1,000 and the deformity rate is 35.7 per 1,000. Most are the victims of inbreeding and such hereditary diseases as some mental illnesses, hemophilia, and chromosome defects. This is a big burden to society and the families that have a child with a serious birth defect.

Since 1988, Dr. Wu Ming, a famous expert in medical genetics has joined the author of this chapter in publications, speeches, and lectures advocating the prevention of birth defects. The basic information was written by the author of this chapter in his book New Knowledge on Prevention of Birth Defects, published in Beijing by People’s Medical Publishing House in 1981. This was the first book of its kind since 1949 and the founding of the People’s Republic of China.

In the early 1980s, the concept of healthier birth, or prevention of birth defects, had already become an important component of China’s policy of population control. In 1986, the Ministry of Health and the Ministry of Civil Administration stipulated that a medical examination would be a national requirement for marriage approval.

Gansu province is one of the poorer provinces in China. Out of its population of 23,000,000, more than 260,000 are mentally retarded. This has become a very severe social burden for the province. In 1988, Gansu province adopted a law to force persons who have severe hereditary or congenital mental retardation (I.Q. 1) to be sterilized before marriage, or abort any fetuses conceived, in order to prevent severe birth defects. From January 1989 to June 1991, 6,271 mentally retarded persons were sterilized. Later, several other provinces, including Fujian, Guangdong (Canton), Henan, Liaoning, and Sichuan, adopted the same law. Premier Li Peng and Ms. Peng Peiyun, the minister in charge of the State Family Planning Commission, have spoken out in support of this local law. This indicates that sterilization of mentally retarded persons may become national law in the near future.

In January 1994, a new family law went into effect that banned sex-screening of fetuses (mentioned above) and forbade couples carrying serious genetic diseases to have children. Marriage was prohibited for persons diagnosed with diseases that “may totally or partially deprive the victim of the ability to live independently, that are highly possible to recur in generations to come, and that are medically considered inappropriate for reproduction.” A list of the applicable diseases was published shortly after the law went into effect (Reuters 1994).

10. Sexually Transmitted Diseases

Since the 1980s, there had been a dissemination of sexually transmitted diseases to every province and all the major cities in China. Statistics show that in sixteen major cities, the average incidence of STDs was 21.02 per 100,000 in 1987. In some cities, the incidence was as high as 336 per 100,000, resembling that in some Western countries. In Helongjiang province alone, the incidence of STDs increased at the rate of 8.9 times/per year from 1982 to 1988. By the end of 1988, when this province had the fourth highest incidence in the country, 4,558 cases had been reported; and it was estimated that reported cases represented only 20 percent of the total incidence. Nationwide, the number of STD cases reported from 1980 through the end of 1988 was 140,648, with more than 56,000, over 39 percent of these, occurring in 1988 alone. In 1992, the figure of 45,996 new reported STDs cases was 4.86 percent higher than in 1991.


China has one of the lowest incidences of AIDS in the world. The first case of AIDS discovered in China, in June 1985, was that of an American tourist. As of August 1989, only three cases of AIDS had been discovered. All three were infected abroad. Also, by July 27, 1989, only twenty-six cases of HIV infection had been diagnosed. In October 1989, the first AIDS case in a native Chinese citizen was identified. The patient had sought medical care using an assumed name and was found to be suffering from secondary syphilis. The hospital later tested his blood serum and found it was HIV-antibody positive. By the time the young man was identified, he had already left the country. According to the head of the National AIDS Center, this patient said he had had homosexual relationships with foreigners. By December 1, 1992, 969 cases of HIV positives and twelve cases of AIDS patients were reported; nine of the twelve AIDS patients had already passed away as of mid-1993. (Gil (1991) has provided a valuable early ethnographic and epidemiologic perspective on HIV/AIDS in the People’s Republic based on field visits to Beijing, Chengdu, and Kunming, the latter in Yunnan province, site of China’s most severe nidus of HIV infection.)

In December 1996, the Health Ministry announced an official count of 4,305 cases of HIV infection. Privately, experts admit the real number already exceeds 100,000 cases (Wehrfritz 1996).

The accelerating spread of HIV/AIDS in China has recently been linked with the cultural aversion to giving blood. This aversion fosters a seller’s market that all but guarantees an impending disaster. Most donors are poor migrants struggling to make ends meet. Some make their living as sex workers as well as from selling blood, and some are drug addicts. In addition, government clinics commonly reuse the needles used to draw blood, and only a third of the nation’s blood supply is screened for HIV contamination.

The sale of blood inevitably leads to people willing to exploit and profit from the shortage. The government has recently broken up rings of blood brokers, known as “bloodheads,” who have kidnapped or drafted people as donors by paying corrupt officials heading work units. The bloodheads then sell the blood to local government blood stations where directors may be willing to overlook the source and its risk just to have an adequate blood supply. In late 1996, a draft law was circulating among senior health officials that would outlaw the buying and selling of blood for clinical use. While such a law could definitely reduce the risk of HIV infection in the normal course of transfusions and surgery, it would leave China with a drastic shortage of essential blood. Officials could fall back on coercion, mandating regular blood donations for members of the military, police, and state unions. The cost of bringing the public health clinics’ blood donation practices up to minimal standards for this age of AIDS will be prohibitively expensive, although this has to be done to avert disaster. Another approach already initiated by the government is to reeducate the people. Pop star Jackie Cheung has been recruited by China’s Red Cross to help break the cultural aversion to donating blood with popular songs with the humanitarian appeal to “Reach out, spread some love today.” This approach has worked in Hong Kong, but the change in attitude there took forty years (Wehrfritz 1996).

12. Sexual Dysfunctions, Counseling, and Therapies

Professor Dalin Liu’s survey showed that 34 percent of rural couples and 17 percent of urban couples said they engaged in less than a minute of foreplay, sometimes none at all. Not surprisingly, 37 percent of rural wives described intercourse as painful. While urban couples may be more adventurous sexually, they are not necessarily more satisfied. Professor Suiming Pan’s sample of 600 couples were all residents of big cities, and 70 percent of them said they were unhappy with their sex lives, and a random survey of married couples living in Shanghai found that 45 percent were unhappy with their sexual relationships. According to Professor Kang Jin, president of the Shanghai Committee of Rehabilitation of Male Dysfunctions, in 1989 at least 20 percent of China’s adult male population was suffering from some type of sexual dysfunction. Now, clinics of sexual counseling, sex therapy, or Western and/or traditional Chinese sexual medicines have been established in most big cities (see Section 5C).

13. Research and Advanced Education

No sex research existed between 1949, when Mao and his Communist Party took control over mainland China, and 1979. There were some studies on reproductive system and reproductive endocrinology, but these were in the biological and medical fields, not behavioral studies. However, since 1979 and especially after 1985, sex research became an apparently growing, even prosperous, field. China’s sex research was started and developed under the names of “sex education” and “sexual medicine,” two fields that are accepted and permitted by the government and society. Before the beginning of the open-door policy in 1979, even sex education and sexual medicine were non-existent.

The year 1982 saw a breakthrough for sexology in China. In that year, Robert Kolodny, William Masters, and Virginia Johnson’s Textbook of Sexual Medicine (1979) was translated into Chinese under the guidance of Professor Wu Jieping, with the actual translation being done by his graduate students. The Chinese edition entitled Xingyixue (Sexual Medicine) was published by Scientific and Technological Literature Publishing House, Beijing. It is the first contemporary and updated Western sex book published in China since the founding of the PRC in 1949.

The year 1985 marked another turning point for sexuality education and sexology in China. In that year, Ruan’s article, “Outline of the Historical Development of Modern Sexual Medicine,” was published by the Encyclopedic Knowledge, and his series, “Essays on Sex Education: Ten Lectures,” were published in Required Readings for Parents. From July 22 to August 7, 1985, the First National Workshop on Sex Education was held in Shanghai, with Ruan as the major instructor. In October 1985, the Handbook of Sex Knowledge, the first large modern book on sexuality written by Chinese and in Chinese, was published in Beijing by Scientific and Technological Literature Publishing House, with Ruan as editor-in-chief. All of these events were strong signs indicating the establishment and development of sexology in China. More and more sexual social surveys, publications on sex, and development of academic sexological journals and societies have followed.

As early as 1984, a project on survey and analysis of sex, love, marriage, family conflict, and crimes was carried out by the Beijing Society for Studies on Marriage and Family. This project was headed by Ms. Wu Cangzhen, Associate Professor of Marriage Law at China Politics and Law University in Beijing.

The most famous and important sexual social survey is the Shanghai Sex Sociological Research Center’s National Sex Civilization Survey headed by Dalin Liu, professor of Shanghai University. Using 40 paid assistants and volunteer interviewers, between February 1989 and April 1990, the center obtained responses to a 239 questions surveyed from 19,559 people in over half of China’s twenty-seven provinces. The 1992 publication in China caused a sensation all over South-East Asia. Planned and executed from beginning to end without government order or interference, this survey was supported by private Chinese sponsorship. It has already greatly contributed to a more uninhibited dialogue about sexual issues within China and has strengthened the status and prestige of Chinese sexologists, and facilitated the organization of various regional and national associations and national and international conferences. An American translation of this monumental work will be published in 1997 by Continuum Publishing Company, New York. The most striking trend found in this study is the deterioration of the strong tie between sex and marriage. This survey was published in December 1992 in Shanghai by Joint Publishing, Sanlian Books Company, entitled Zhongguo Dangdai Xingivenhua - Zhongguo Lian-wanii “Xingwenming” Diaoza Baogao (Sexual Behavior in Modern China - A Report of the Nationwide “Sex Civilization” Survey on 20,000 Subjects in China). It is a large volume, with 866 pages and 677,000 characters. (See Section 14, Addendum for details on this nationwide survey.)

Between 1985 and 1991, sex researcher Pan Suiming, Associate Professor of the Department of Sociology at the China Renmin University in Beijing, and his assistants conducted seven social surveys of sex. “Behavioral Analysis of Heterosexual Petting in Public - Observations on Chinese Civil Parks” reported on 23,532 cases between 1985 and 1989 in thirteen parks in six cities. “Dissemination of Three Kinds of Sexual Information and the Accepter’s Response” involved 1,610 respondents in Shanghai, 1989; “Influence of Sex Knowledge and Attitude on Sexual Behavior - The Condition, Motive, and Orgasm” had 603 samples in Beijing, 1988-89, and “Relations Between Satisfaction of Sexual Life and the Marriage” was based on 977 samples in Beijing, 1989. Seven hundred sixty-six respondents participated in the “Chinese Readers’ Answers to the Questionnaire in the Chinese Edition of The Kinsey Report since 1989,” with the research still in progress. “Deep Sexual Behavior Survey - Relations of Sexual Mores, Ideas, Affection, and Behavior,” with 1,279 samples in twenty-seven cities, 1989, indicated that nearly seven out of ten Chinese have had anal sex with heterosexual partners, and that men reached orgasm about 70 percent of the time in contrast to 40 percent for women. “A Sampling Survey on Students’ Sexual Behavior in Every University and College in Beijing” examined 1,026 respondents in 1991.

Between 1985 and 1992, more than three hundred books on sexuality were published in mainland China, including the Chinese translations of classical works by Sigmund Freud, Havelock Ellis, Margaret Mead, Alfred C. Kinsey, and R. Van Gulik. The first professional academic journal of sexology, Sexology of China, was published in March 1992 by Beijing Medical University.

On May 23, 1988, the country’s first college-level sexology course was introduced at China People’s University in Beijing. This special two-week program, called “Training Workshop on Sex Science,” consisted of workshops on twenty topics, conducted by seventeen professors and experts. The program was attended by 120 people from twenty-six of China’s twenty-eight provinces. As of mid-1993, 26.7 percent of the universities and colleges in China have a course on human sexuality or sex education.

Since 1987, a series of six nationwide conferences on sexology have been held in China. For example, the Sixth Chinese Congress of Science of Sex, was held on May 3,1992, in Nanjing, the capital of Jiangsu Province. About five hundred experts attended the congress, over four hundred academic papers in the fields of sex education, sociology of sex, psychology of sex, sexual medicine, and STDs were accepted by the congress. The First International Conference of Sexology was held on September 12 to 15, 1992, in Shanghai. Over twenty participants came from thirteen foreign countries, and over three hundred participants from all over China. About a hundred academic papers on sexual medicine, sex education, sociology of sex, and psychology of sex were accepted by the conference.

There are two important Chinese sexological periodicals:

Sexology (formerly Sexology of China, Journal of Chinese Sexology) (started in 1992). Journal Address: Beijing Medical University, 38 Xue Yuan Road, Beijing 100083, The People’s Republic of China. Editor’s Address: The Public Health Building (Fourth Floor), Beijing Medical University, No. 83 Hua Yuan Road, Beijing 100086, China

Apollo and Selene. A bilingual Chinese/English magazine of sexology published in Shanghai by the Asian Federation for Sexology started in the summer of 1993. Address: Asian Federation (Society) for Sexology., 2 Lane 31, Hua Ting Road, Shanghai, the People’s Republic of China.

The main sexological organizations in China are:

Chinese Sex Education Research Society. Director: Dr. Jiahuo Hong. (Founded in Shanghai in 1985.). Address: The Shanghai College of Traditional Chinese Medicine, 530 Ling Ling Road, Shanghai, 200032, The People’s Republic of China

Shanghai Sex Education Research Society, founded in Shanghai in 1986. Address: The Shanghai College of Traditional Chinese Medicine, 530 Ling Ling Road, Shanghai, 200032, The People’s Republic of China.

Sexology of China Association (Founded in Beijing in 1995; preparatory committee founded in 1990). Director: Professor Guangchao Wang, M.D. Address: Beijing Medical University, 38 Xue Yuan Road, Beijing, 100083, The People’s Republic of China.

Institute for Research in Sexuality and Gender. Address: Professor Suiming Pan, Director, Post Office Box 23, Renmin University of China, 39# Hai Dian Road, Beijing 100872, People’s Republic of China; Fax: 01-256-6380.

Chinese Association of Sex Education. Address: Mercy Memorial Foundation, 11F, 171 Roosevelt Road, Section 3, Taipei, Taiwan. Republic of China. Phone: 886-2/369-6752; Fax: 886-2/365-7410.

China Family Planning Association. Address: 1 Bci Li, Shengguzhuang, He Ping Li, Beijing, People’s Republic of China.

China Sexology Association. Address: Number 38, Xue Yuan Lu, Haidion, Beijing 100083, People’s Republic of China. Phone: 86-1/209-1244; Fax: 86-1/209-1548.

Shanghai Family Planning Association. Address: 122 South Shan Xi Itoad, Shanghai 200040, People’s Republic of China. Phone: 86-21 / 2794968; Fax: 86-21/2472262 Ext. 18.

Shanghai International Center for Population Communication China (SICPC). Address: 122 South Shan Xi Road, Shanghai 200040, People’s Republic of China. Phone: 86-21/247-2262; Fax: 86-21/247-3049.

14. The 1989-1990 Survey of Sexual Behavior in Modern China: A Report of the Nationwide “Sex Civilization” Survey on 20,000 Subjects in China*


*Editor’s Note: The following section is adapted from M.P. Lau’s detailed analysis of the original 1989-1990 Chinese version of the nationwide Kinsey-like survey of Sexual Behavior in China. This survey was published in Chinese in 1992; an English translation is scheduled to be published by Continuum (New York) in 1997. Lau’s review-essay was published in Transcultural Psychiatric Research Review (1995, volume 32, pp. 137-156). The Encyclopedia’s editor, R.T. Francoeur greatly appreciates the permission of Dr. Lau and Laurence J. Kirmayer, M.D., editor of the Transcultural Psychiatric Research Review, to include Lau’s critique in this chapter.

A. The Survey

This is the report of a survey of sexual behavior in the People’s Republic of China, conducted from 1989 to 1990. Unprecedented in scope and scale, the survey involved twenty-eight sites (cities, towns, and villages) in fifteen of the twenty-seven provinces or autonomous regions. A total of 21,500 questionnaires, with 239 items covering a wide range of variables were distributed, and 19,559 of the returned replies were found suitable for study. About five hundred investigators were involved, including about two hundred field workers, most of whom were female volunteers. There was a caucus of about forty core leaders, with coordinating headquarters at the Shanghai Sex Sociology Research Center. The main academic leaders were Dalin Liu, Liping Chou, and Peikuan Yao of Shanghai and Minlun Wu (M.L. Ng) of Hong Kong.

This study has been compared to the Kinsey Reports (1948, 1953) in the popular media (Burton, 1990). For the first time in history, we have extensive scientific data on the sexual behavior of the contemporary Chinese, who comprise 22 percent of the world population. Information is available on puberty, romantic love, mating, marriage, marital life, marital sex, premarital sex, extramarital sex, abortions, divorces, as well as data on family planning, women’s issues, prostitution, pornography, sexual transgressions, and sexual variances, both as to attitudes and behavior.

In this review-essay, I provide a synopsis of some of the major findings of the survey through eight profiles of male and female adolescents and college students, urban and rural married couples, a female prostitute, and a male sex offender. I will then present a brief critique of the study methodology and suggestions for future research.

B. Adolescent Sexuality

In this section, I present two composite profiles constructed from ninety-one tables of statistics compiled during the national survey of twenty-eight secondary (or middle) schools in ten Chinese cities or suburbs. Secondary schools were not common in the countryside and the rural population was difficult to survey. In all, 6,900 questionnaires were issued and 6,092 were collected and analyzed. Each questionnaire contained forty-two multiple-choice questions with some open response categories. While the sample surveyed is not representative of all secondary schools owing to resource constraints, attempts were made to achieve as much diversity as possible. Some significant influences on sexual attitudes and practices were demonstrated, such as exposure to modernization, degree of enlightenment, and gender differences.

In 1989, there were 47,717,000 secondary school students in China (4.29 percent of the national population of 1,111,910,000), of whom 58.4 percent were male. Fully 97.8 percent of children reaching school age were sent to primary schools, and 74.6 percent of primary school graduates proceeded to secondary schools. There are six grades in each secondary school: Junior Middle 1, 2, and 3, and Senior Middle 1, 2, and 3, and the age range is normally 12 to 18. In the sample studied, the mean age was 15.53 (SD = 1.78). The features described in the profiles represent the means, modes, medians, or usual ranges, or the proportions in the sample. There is a wealth of detail in the book for further reference.

Profile 1: An Adolescent Female

The typical female adolescent respondent is a 15.5-year-old student in an urban or suburban secondary school. She comes from a stable family of workers or cadres, and has one sibling. She reached puberty at age 13, with menarche in the summer, and development of secondary sexual characteristics. (This is a later age compared with secondary school students in Hong Kong or Japan, but earlier than that described in China twenty-five years ago). At age 14.5, she began to have sexual interests, and desired to associate with boys, mostly for socialization or mutual assistance, or because of a “crush” on a boy for his good looks, but she has been too shy or “busy” to take action. (For comparison, a Japanese peer would have begun to have

such interests and desires at age 12 to 13). She acquired most of her sexual knowledge from books, magazines, and movies, and would feel excited by casual physical touches and by conversation on sexual topics.

Among the secondary school girls in the survey, 7.4 percent wished for some bodily contact with a male, and 12.1 percent reported having been aroused to desire sexual intercourse. (Again, these percentages are much lower than those of Japanese peers). More than a third of secondary school girls reported having male friends since age 14, without infatuation and often in group settings. By 15.5 years of age, 11.1 percent were dating boys and 6 percent were “in love.” The legal age for a female to marry in China is 20, and most girls think marrying early is not good or “would affect study.”

Only 4.7 percent of adolescent girls reported a history of masturbation, usually since age 13.5; about 50 percent said they continued the practice. (In Japan, 9 percent of secondary schoolgirls have masturbated, and most persist in the habit). While 44.3 percent of female adolescents stated masturbation is “bad,” almost 40 percent said they did not understand the question.

Less than 2 percent of adolescent girls have engaged in each of kissing, hugging, or sexual touching and only 1 percent reported having sexual intercourse (slightly higher in southern China). These rates are far below those in Japanese schoolgirls (up to 25.5 percent and 8.7 percent, respectively).

In well-developed urban areas, adolescent sex education has been available in classrooms, but has focused on physiology and hygiene, with little information on coitus, pregnancy, childbirth, contraception, homosexuality, paraphilias, and sexually transmitted diseases. Secondary schoolgirls would like more guidance on issues of romantic love, sexual impulses, and socialization. They discuss sexual issues with their mothers, sisters, and female peers, but not with teachers or fathers.

Profile 2: An Adolescent Male

The typical male adolescent respondent is a 15.5-year-old secondary school boy who comes from a stable family of workers or cadres and has one sibling. He has had seminal emissions since age 14.5, and most have been spontaneous nocturnal emissions. He has started developing secondary sexual characteristics. (These maturational milestones are later than those of a similar youth in Japan, but earlier than those in China twenty-five years ago.) At age 14.5, he began to show sexual interests, and wished to associate with girls, mostly because of attraction to their appearance or “tender disposition,” but he was too shy or “busy” to act upon his feelings. (A Japanese boy would have commenced to have such interests and desires at age 12 to 13). He obtained most of his sexual knowledge from books, magazines, and movies, and has seen pictures of female nudity and experienced some casual sexual touching.

About one third of adolescent males reported desire for bodily contact with females, and 42.9 percent said they had been aroused enough to crave sexual intercourse. (Again, these percentages are much lower than those of Japanese peers).

Although almost half of male adolescents said that they had had female platonic friends since age 14, often in group activities, only 12.7 percent were currently dating a girl, and 7.6 percent reported being “in love.” The legal age for a male in China to marry is 22, and most boys agree that marrying early is not good or “would affect study.”

Only 12.5 percent of male adolescents reported a history of masturbation, usually starting at age 13.5; half reported they had continued the practice. (In Japan, 30 percent of junior high school students have masturbated, and fully 81.2 percent of those in senior high school, with most students continuing the habit). More than half of adolescent males consider masturbation “bad,” but 21.2 percent said they did not understand the question.

Less than 5 percent of secondary school males have engaged in each of kissing, hugging, or sexual touching, and 0.9 percent have had sexual intercourse (slightly more in Southern China). (These rates are remarkably low compared to those in Japan, where up to 23.1 percent of high school boys have experienced sexual kissing and 11.5 percent coitus).

Adolescent boys tend to discuss their needs and problems with male peers, rather than with teachers, parents, or siblings.

C. College Students

In 1989, there were about 82,000 post-secondary students in China. A study of this group is of immense importance as they are destined to become the future leaders of the country. Intellectually well endowed and highly educated, they are still young, malleable, open minded, and sensitive to new ideas and trends. In the process of maturation as scholars, they confront the various phenomena associated with modernization and accelerating change. They interact with a “campus culture,’ which may be a cultural melting pot and a frontier of novel concepts and ideologies. Restricted by demands for sexual abstinence and expectations of monogamy, they try their best to cope with their libido and desire. Their perceptions, perspectives, beliefs, and behavior will have profound effects on the future of nation-building, participation in the world community, and global stability.

This section presents two composite profiles condensed from 136 tables of statistics collected during the survey of twenty-four post-secondary colleges (including universities, teachers’ colleges, academies of traditional medicine, training centers for cadres and security personnel, and an oceanography institute) in nine metropolitan areas. The institutions were selected according to practicality and diversity. Questionnaires with sixty-three items were distributed in classrooms and the purpose of the investigation explained. Confidentiality was assured. In addition to the group administration, some individual interviews were conducted. A total of 3,360 valid replies were analyzed. The mean age was 20.28 years (SD =3.13) with 56.8 percent male.

Profile 3: A Female University Student

The typical female college student in the survey is a 20-year-old student in the faculty of arts. Her father was college-educated and holds a professional, technical, or managerial job. She had menarche at age 13.5, followed by the development of secondary sexual characteristics. She was unprepared for menarche and sought advice from her mother or peers. She received little sex education and acquired most of her sexual knowledge from books, news media, novels, peers, her mother, and her sisters. She found her teachers and parents “ignorant, busy, uncaring, conservative, and rigid.” She would feel excited by depictions of sexual matters, and has been exposed to nudity through pictures in the media.

She thinks romantic love should be allowed but “properly guided,” that the main purpose of copulation is to have a family, and that the female can be an active partner during sexual intercourse. She believes that premarital sex may be acceptable if the partners are mutually in love and willing, but extramarital sex should be censured, even if consensual. She considers homosexuality to be a perversion or illness, and would offer comfort to a homosexual friend and advise him or her to seek psychiatric treatment. She feels that homosexuality is something to be ashamed of and pitied but not severely punished.

Fully 70 percent of college women were not content with their bodies, with concerns about being overweight, hirsute, or other features; 25 percent were not satisfied with their secondary sexual characteristics, for example, thinking that their breasts are undersized. While 15.6 percent did not like their own gender, 42.8 percent stated they would prefer to be a male if they had a choice.

Among the college women surveyed, 16.5 percent had a history of masturbation, starting from age 13 to 14 and 8.2 percent still masturbated at a frequency of about once a week. Most respondents thought masturbation is “harmless” and “normal.”

While 63.4 percent of female college students in the sample desired a heterosexual relationship, only 6.3 percent of them had had a sexual partner. Sexual contacts (including kissing, embracing, genital touching, and coitus) were infrequent and covert and commonly began after age 17. Contraception involved the use of “safe periods,” pills, or condoms.

While 5.8 percent reported an inclination towards exhibitionism and 2.8 percent were predisposed to transvestitism, interest in other paraphilias was uncommon. The majority (87.3 percent) of college women reported that on seeing a nude female in a public bathroom, they would probably feel indifferent, but 3.9 percent said they might “come to like it.”

Homosexual contacts were infrequent: 8.4 percent reported having been kissed or caressed, 3.2 percent had experienced homosexual masturbation, and less than 3 percent reported genital-to-genital contacts; 0.7 percent reported they would engage in homosexual con tact if the opportunity arose.

Profile 4: A Male University Student

The typical male college student in the survey is a 20-year-old student in the faculty of engineering, science, or medicine. His parents had post-secondary education, and his father is a professional, technical, or managerial worker. He had his first seminal emission at age 14.5, followed soon by the appearance of pubic and then facial hair. (Compared with his secondary school counterparts, his sexual development started at a slightly later age). He received little sex education and was quite unprepared when he had his first seminal emission. He did not ask anyone for an explanation.

He acquired most of his sexual knowledge from books on hygiene and health, news media, novels and pornographic art, and from his male peers. He found his parents and teachers insensitive and outdated in knowledge and attitude. He holds liberal views about romantic love and is permissive about reading sexual material. He thinks that masturbation is harmless and normal. He believes that sexual intercourse would enhance love and give physical pleasure, as well as serving the purpose of building a family. He endorses the idea of a female being an active partner during sexual intercourse.

He thinks premarital sex would be acceptable if the partners are both willing and mutually in love, especially if they are prepared to marry each other, and extramarital sex, if consensual, may be permitted under certain circumstances. He would be quite aroused by references to sexual matters, and has seen pictures of nudes in the media, but is unlikely to have seen women in the nude.

One fourth of college males were not satisfied with some of their secondary sexual characteristics, such as sparsity of pubic hair or perception of the penis as undersized. A larger proportion (70 percent) were not content with other aspects of their body, such as shortness of stature, presence of pimples or freckles, and sparsity or grayness of scalp or facial hair. Gender dysphoria was uncommon, and only 8.3 percent of male college students surveyed wished to be female.

Almost two thirds of college males (59 percent) had a history of masturbation, starting at age 14 to 16, and 39.5 percent continued to masturbate at the rate of about once a week. Sexual contacts, including kissing, embracing, genital touching, and coitus, were reported to be infrequent and mostly covert. These activities usually began after age 17 and the male tended to take an active role. Only 12.5 percent of college males reported that they had had sexual partner(s), usually only one. Contraception involved “safe periods,” condoms, and coitus interruptus.

While most male college students considered homosexuality a perversion or illness, to be sympathized with and offered treatment, 11.9 percent conceived of homosexuality as normal behavior for a small group of people. Homosexual contacts were infrequent, with 7.0 percent reporting kissing or caressing, 8.6 percent homosexual masturbation, and less than 3 percent or anal touching; 1.5 percent would consider seeking someone out to engage in homosexual activity.

Paraphilias were rare among male college students, with 5.6 percent feeling prone to exhibitionism, but hardly any reporting other paraphilic tendencies. On seeing a nude male in a public bathroom, most would feel indifferent, but 5.4 percent said they might come to “like it.”

When asked how they would respond if they found out that their fiancee had lost her virginity to another male, 20 percent of male college students said that they would leave her, but 60 percent would find it tolerable.

D. Married Couples

This section presents composite portraits of an urban couple based on 6,210 married persons surveyed in fifteen cities (nine coastal and six inland urban centers), and a rural couple typical of 1,392 married residents surveyed in three villages. A mixture of random and non-random sampling methods was used, steering a fine line between what was practical (e.g., considering the difficulties of gathering data from illiterate or unsophisticated persons) and what would be theoretically desirable (e.g., relative representativeness). A total of 396 tables of actuarial data were compiled, covering a wide range of sexual, marital, and family variables. There was a preponderance of female interviewers and interviewees. Many volunteer field workers came from women’s groups, such as labor unions, family planning units, and obstetrical teams, and they were able to build good rapport with women respondents, who often appeared eager to share their intimate knowledge of family life with those whom they could trust. Overall, 68. 1 percent of urban and 78.2 percent of rural interviewees were female.

Profile 5: An Urban Couple

The spouses in the typical urban married couple in the survey were about 36 to 37 years of age and of above-average education compared with the general national population. They reported their health status as average or above average. The husband was a professional, technical, office, or managerial worker, and had received slightly more education than his wife, being twice as likely to have attended a post-secondary institute. The wife was a professional, technical, factory, or office worker. They have been married for about eleven years. They married of their own will, after an introduction by a third person and a period of courtship.

They consider mutual “love” and “understanding” more important in marriage than material comfort, political views, or evaluation by society. They believe that the purpose of marital sex is primarily to satisfy emotional and physical needs, rather than to fulfill an obligation or a “tradition” or to achieve reproduction, and there should be no prudery about it. They have sexual intercourse four to five times per month on average. The couple would like to have children because the latter “would add interest to life” and it is an aspect of “social responsibility.” They would like to have a boy and a girl.

Of urban couples surveyed, 60 percent considered their marriage satisfactory, with greater satisfaction reported by the male partner, those with more education, those in professional, technical, or managerial positions, and those in the earlier years of marriage. Of those surveyed, 55.5 percent indicated good or fair (25.3 percent) levels of sexual satisfaction. Husbands reported greater enjoyment of coitus and gave more importance to coital frequency, styles of intercourse, and climaxes. The duration of foreplay tended to be brief, most often less than ten minutes, and gave less pleasure to the woman. In case of sexual disharmony, 44 percent felt there should be open discussion, 13.4 percent would seek medical help, and 24 percent would just “leave it” alone. Most couples endorsed women taking initiative in sex, such an attitude being especially common among males, the better educated, and in the southern cities. As urban married women gain more freedom, independence, and self-esteem, they feel less compelled to have sex against their will, and would ask to be excused without feeling guilty.

Most couples experienced their first sexual intercourse on their wedding night, but prenuptial sex was admitted by 24.9 percent of urban husbands and 15.8 percent of urban wives. It should be noted that premarital coitus was most often (80 percent) consummated with a “future spouse,” and such behavior was endorsed by a majority (90 percent) of the urban couples polled. Sex before matrimony with someone who is not a “future spouse” tended to occur among urban youths in southern China, soldiers stationed in cities, and the less educated. (The number of abortions of premarital pregnancies has been on the rise, reaching 16 percent of those age 20 and over and single in a city in Jiangsu, and 90 percent of first abortions in a city in Zhejiang, both cities in the vicinity of Shanghai.)

Higher frequency of intercourse was associated with younger age, the earlier years in marriage, highest or lowest levels of education, being a manual or service worker, more privacy of the bedroom, temperate climate, and greater sense of obligation to perform. Sexual intercourse occurs most often just before sleep among younger and middle-aged couples, and at “no fixed time” among the young and the elderly. In terms of sexual practices, 56.5 percent of couples change positions during sex, and 65.2 percent are nude sometimes or often during sex; nudity during sex is more frequent among the young, the better educated, and in the southern cities.

Questions about orgasms were not asked as the investigators had found it quite difficult to elicit such information, but enjoyment of “sexual pleasure” was found to depend on the techniques, experience, and relationship; sexual pleasure had a more gradual onset in women, both physiologically and psychologically. Most couples reported they experienced Sexual pleasure frequently (especially males) or sometimes (especially females), with highest rates in southern China. In a sampling of 1,279 men and women in 41 cities, Suiming Pan found men reach orgasm 7.2 times out of every 10 attempots; this contrasts with 4.1 times for women. In Dalin Liu’s survey, one third of the urban women and one fourth of the rural women claimed to experience a feeling of pleasure (kuaigan) “very often,” while 58.2 and 76.8 percent, respectively, experienced it “sometimes.”

A history of masturbation was obtained from 17.1 percent of respondents - much more often from husbands than from wives, and from couples in southern cities - but nearly all of the respondents claimed it happened only occasionally. While 41.7 percent regarded masturbation as a “bad habit” and 13.1 percent considered it normal, fully 30 percent gave no clear answer. Only 0.5 percent admitted homosexual experience, but considerable denial or ignorance was suspected.

Among urban husbands, 10.2 percent admitted to a history of extramarital sex. Extramarital sex was more common among service or manual workers, or businessmen, those less than 25 years of age or more than 56, and those espousing a liberal or hedonistic attitude towards life. Urban wives were unlikely to have risked extramarital sex, but it was more likely to occur in middle age. These rates are far below those published in the Kinsey reports (1948; 1953). Nevertheless, the impact of extramarital affairs may be considerable. During divorce proceedings in five cities in China in 1985, the occurrence of extramarital affairs was confessed in two thirds of the cases. In Shenzhen, a town bordering Hong Kong, 91.8 percent of divorce cases in 1987 involved a “third person.” While 66.2 percent of married urban respondents said that they accept the national policy of having only one child per family, 28.5 percent think such a restriction unreasonable. If they had only a daughter, 35.5 percent would want to have one more child, but not if this would incur punishment from the government. Birth control measures used by urban couples included: diaphragms (42.8 percent), tubal ligation (9.4 percent), other mechanical means (18.3 percent), pills (5.9 percent), vasectomy (2.3 percent), other methods (e.g., “safe periods,” coitus interruptus, unknown) (15.5 percent), and none (5.8 percent).

Sexual knowledge was generally quite limited and resource material not readily available, especially to women. About two thirds (62.4 percent) of urban couples had read one of the four popular basic manuals on sexual knowledge available at the time of the survey, such as the one written for the newly wed, which mostly consider anatomy and physiology. Additional sexual knowledge was obtained from books, movies, and radio (35.6 percent), through personal experience (22.7 percent), and from same-sex peers or those in counseling positions. Most couples (70.4 percent) are interested in reading or viewing media with sexual themes, but 48.9 percent have found opportunities lacking. Women would like to know more about child education and physical hygiene, while men are interested in sexual techniques and interpersonal skills. Although 61.8 percent of urban couples would explain the birth process to a child, 25.4 percent would evade the question, and the rest would express displeasure or indifference, or give a false answer.

Profile 6: A Rural Couple

The typical rural married couple surveyed were about 35 years old, of average education compared with the general national population, and reported their health status as average or above average. They were engaged in farming, herding, fishing, or forestry, and were unlikely to have received post-secondary education. They have been married for about 11 years; he at age 23 and she at 22. They married of their own will (wholly or partly), although match-making was prevalent until one or two generations ago, and still occurred in a few locales.

They consider “love” and “understanding” more important in their union than the opinions of society. They believe that the main aims of marital sex are to fulfill physical and emotional needs, to go along with tradition, and to accomplish reproduction, and that they need not be prudish about it. They have sexual intercourse five to six times per month on average. They would like to have children, mostly for the sake of old age security, but also to propagate their lineage.

Of rural couples surveyed, 65 percent regard their marriage as satisfactory. Greater satisfaction was reported by the female partner, those better educated, and those under 25 or over 45 years of age. In case of sexual disharmony, 44 percent would engage in open discussion, 23.2 percent would seek medical help, and 21 percent would just “leave it” alone.

Most married rural couples experienced sexual intercourse for the first time on the wedding night, but premarital sex was admitted by 7.3 percent of rural husbands and 17.3 percent of rural wives. Premarital coitus was usually performed with a future spouse, and such behavior was endorsed by the vast majority of rural couples surveyed. Sex before marriage with someone who was not a future spouse occurred more commonly among older males and females when the feudal system allowed sexual permissiveness in certain forms of social transactions, and also among those who are younger, more educated, and liberal minded.

Higher frequency of intercourse was associated with more demand by the husband and greater compliance by the wife, having been married for a longer duration, and temperate climate. Sexual coitus occurred most often just before sleep, but also often “at no fixed time,” as rural couples tended to have a less structured schedule of daily life compared with their urban counterparts.

About half (45 percent) of rural couples reported changing position during sex, and 57.2 percent said they were nude sometimes or often during sex; sexual nudity was more common among the young, the less educated, and in southern climates. In Shanxi province, some farmers traditionally sleep naked.

A history of masturbation was obtained from 10.1 percent of rural husbands or wives, more often from those in the South; nearly all described it as episodic. Most (73.4 percent) considered masturbation a “bad habit,” but 9.6 percent deemed it “natural.” Only 2.3 percent admitted homosexual experiences, suggesting considerable ignorance about the term.

Among rural married couples, the level of sexual satisfaction reported was good (66.6 percent) or fair (27.6 percent), with wives more easily satisfied than husbands. The duration of foreplay tended to be brief, usually five minutes or less, but neither partner had high expectations of gratification from it. Most couples endorsed women taking initiative in sex (this attitude was more common among males, the better educated, and in south China), but they would still prefer the male partner to be more active.

Among rural husbands, 9.3 percent admitted to a history of extramarital sex; higher rates were found among service or manual workers or businessmen, those under 25 or over 56 years of age, and those who gave evidence of a “pleasure-seeking predisposition” on several attitude measures. Rural wives were unlikely to have experienced extramarital sex.

Most rural couples would like to have a boy and a girl, but 48.5 percent would accept having only one child. After having a daughter, 60.3 percent want an additional child, and 6 percent still want one at the risk of sustaining some official penalty. In a 1989 survey, 68.1 percent of rural women wanted to have two children, 25.7 percent wanted one child, and 3.1 percent did not want children. Slightly lower percentages were found among rural men. Contraceptive methods utilized include: diaphragm (50.8 percent), tubal ligation (21.8 percent), pills (7.5 percent), vasectomy (1.2 percent), others (12.3 percent), and none (6.4 percent). On the other hand, infertility due to sexual dysfunctions was common (e.g., more than 25 percent of about 40,000 family planning counseling cases seen in 1984 to 1989), but most were said to be somewhat amenable to medical or herbal therapy.

Sexual knowledge was generally quite deficient, and resources not easily available, although 77.1 percent of rural couples had read one of the four popular basic manuals on sexual knowledge available at the time of the survey. Otherwise, the pattern was similar to that of urban couples. While 47.8 percent of rural couples would explain the birth process to a child, 33.8 percent would evade the question, and the rest would ignore or upbraid the child, or give a false answer.


An overview of the accounts of urban and rural married couples given in this section shows the emergence of two patterns: (1) respondents who are traditional and conservative in ideology, cautious and guarded towards novel ideas, moralistic and suppressive of self-expression, and less imbued with modern education tend to reside inland and in rural territories, are service or manual workers, and are more commonly female; and (2) respondents who are modernistic and individualistic in orientation, liberal and open in attitude, rational and objective in deliberation, and have been exposed to more contemporary and/or Western ideology tend to reside in urban areas, near sea-coasts or in southern China, are professionals or technical workers, and are more often male.

Of course, there are many exceptions to these broad generalizations. Those who are not well educated may also be gullible and suggestible, and experience sexual permissiveness as a relic of feudal systems, such as variations of a master-slave relationship, indigenous forms of marital or quasi-marital arrangements or cohabitation, such as concubinage and other forms of polygamy (McGough, 1981). Other situational, subcultural, idiosyncratic, or deviant variations in sexual behavior are noted throughout the book. The investigators also present detailed analyses of factors affecting sexual satisfaction and sexual pleasure as well as data on marital cohesion, domestic conflicts, marital breakdown, and sex in old age.

We see in this section a spectrum of variations in sexual behavior corresponding to the different stages of adaptation and change, resistance and retrenchment in response to modern and Western ideologies. There has been a general liberalization of attitudes, which is not yet matched by comparable changes in practice. Keenly aware of the dangers of an abrupt eruption of sexual instinctual drive, and deeply ingrained in a tradition of moderation and communal responsibility, the writers of the book repeatedly urge caution, restraint, and “proper socialization.” While stressing the importance of being knowledgeable and educated, and of individual entitlement and gratification, heavy emphasis is also placed on family harmony, social stability, and the inculcation of moral values by advice and counseling, didactic education, and “propaganda.” An analysis of sexual mores and superego and their possible practical impacts can be found in the books by Ng (1990) and by Wen and colleagues (1990) and in the paper by Ng and Lau (1990).

E. Sex Offenders

In the 1980s, rates of crime in China rose in leaps and bounds, with alarming increases in sexual offenses in the young and relatively less increase in violent crimes. This section presents composites of a female prostitute and a male sex offender with modal characteristics abstracted from 137 tables of statistical information, gathered in a survey of inmates of prisons and reformatories, supervised by security and reform officials, with guarantees of strict confidentiality. These institutions were located in nine areas, with most of the respondents from Shanghai (49 percent), Chengdu (22.8 percent), and Soochow (11 percent). A total of 2,136 subjects took part, with 67.5 percent males; 385 were female prostitutes.

Unfortunately, the various kinds of sex offenses were lumped together (except for female prostitution), and the data analyzed as a whole. Subjects included categories of “criminals,” people with “infractions of the law,” and those accused of “misconducts (wrongdoings, misdemeanors).” The judicial system gives latitude to officials to grade antisocial behavior and to dispose of violators according to pragmatic and situational considerations. For details and the extent of variations, the reader must refer to the book under review and its bibliography.

Profile 7: A Female Prostitute

The typical incarcerated female prostitute in the survey was 20 years old and came from a rural family, financially “average” or “above average.” She was discontented with her lot and inclined to seek more money, pleasure, or adventure. She left school early and may have retained some part-time manual work. She may have been betrothed or married, with an “average” or discordant relationship, but a sex life that has been mostly satisfactory. Although emphasizing feelings as an important element in human relationship, she was cynical about romantic love, and may have become bitter and vindictive after she had been cheated or abused. She was ambivalent towards traditional feminine roles, chastity, and sexual restraint, but still viewed them as ideals and wished that she could conform.

She first ran afoul of the law after age 15. She was often seen as a victim of circumstances as well as an offender, and evoked sympathy from public officials, who would subject her to criticism, warning, “education,” and “administrative discipline,” before instituting legal penal measures, such as labor reform, and “thought reform.” While incarcerated, she would indulge in daydreaming or in artistic diversions to sublimate her libido.

The number of prostitutes, pimps, and their patrons known to the law has been increasing rapidly in China, especially in Shanghai and Guangzhou. Prostitutes make up most of the nation’s female sex offenders. The survey data and clinical observation show that prostitutes tend to be young and immature, vain and “insatiable,” given to pleasure-seeking rather than to toil and tedium, vulnerable to temptation, and deficient in self-restraint. Also noteworthy are the contributing social factors of inequality of gender status, lack of emotional nurturing and support for dependency needs in parental and marital homes, and the prevalence of opportunities for deviant outlets. The survey also uncovered the “low quality” or “poor civilization” of the parents and other family members, in the forms of less education, ignorance, narrow world views, weakness of bonding, and lack of moral guidelines. These social forces need to be considered in any plans for prevention. After release from jail, 20 to 30 percent of female sex offenders released in Shanghai relapse. Relapse rates depend on the intensity of rehabilitation.

Profile 8: A Male Sex Offender

The typical incarcerated male sex offender in the survey was about 28 years old and single. He had some secondary school education and was a manual worker or tradesman. He had his first seminal emission at age 16.5, still has nocturnal emissions once or twice a month, and masturbates about six times a month. He first witnessed sexual coitus at age 17, most likely at a peer’s home or in a movie or videotape. He admits having “average” or “strong” sexual desire, and exposure to sexual scenes tends to arouse him and predispose him to errant sexual behavior.

He came from a home where his parents, especially his mother, had little education but an “average” or “comfortable” income, yet he still tended to feel deprived. He seldom talked to his parents and felt that family life was dull and meaningless. The family was generally permissive, but would express anger when a sexual offense or misconduct was committed. In a small percentage of cases, there was another family member with a history of criminal or sexually promiscuous behavior.

He emphasized the importance of sex and love, but relished instant pleasure. He would choose a partner based on appearance, feelings, and temperament, and would want a mate for sexual purpose even at an early age and outside the boundaries of wedlock. He likes movies, music, socializing, gossiping, womanizing, gambling, detective stories, and martial arts. He would be easily aroused by sexual material but may not act on it. Such material has become increasingly public and readily accessible. He probably has a few friends with a history of sexual offense or misconduct. He acquired his sexual knowledge mostly from his peers or the media, rather than from parents, siblings, or teachers, and has often found his questions unanswered.

Most offenders were convicted of their first sexual offense before age 29. The most common offenses were “hooliganism” (a vague umbrella term comprising various kinds of uncivil, indecorous, unmannerly, or licentious behavior), “promiscuity,” rape, and sex with a minor. Other male sex offenses included bigamy, extramarital relations, abetting prostitution, male prostitution, incest, and enforced sex with the aged or the disabled. There has been a trend to commit crimes less by violent means, and more by deception and enticement. The survey data and clinical observation show that the male sex offenders are generally immature, chauvinistic, and emotionally needy. They are said to be of “low quality,” and their families and social backgrounds are described the same way. Married male sex offenders reported fairly good marital and sexual relationships with their spouses, with frequent sexual intercourse (about ten times per month).

Upon conviction, most offenders expressed regret and cooperated with the sentence. While in prison, they try to suppress their sexual drives, but 6.3 percent admit to masturbation and 0.7 percent to homosexual activity. While some psychological or medical therapy may be provided for this sexual frustration, there has been no general policy to cope with the problem.

F. Comments on the Research Methods

Technically, the nature and scope of this survey made the task very difficult. Sexuality is a matter of privacy and confidentiality and a topic often misunderstood and stigmatized. The peasantry was difficult to reach, in terms of both logistics and communication. There was little financial support, especially after the Tiananmen events. However, there was a ground swell of moral support from both inside and outside China, and many “comrades” from the tightly organized, stratified bureaucratic infrastructure in the nation, especially from women’s groups, contributed their time, energy, and ingenuity, frequently working “to the point of exhaustion.” Professor Liu and the core leaders were able to marshal the support of diverse groups at various levels in governmental, academic, educational, legal, labor, industrial, literary, media, and publishing sectors. The results have been partially presented at conferences inside and outside China, but since the book was written in Chinese, a wider dissemination of the findings awaits translation into other languages. An English translation of this full report is planned for 1997 by Continuum (New York), the publisher of this International Encyclopedia of Sexuality.

The investigators were well aware of the limitations of the study. They experienced numerous stumbling blocks and frustrations, and encountered criticism and derision. It was not possible to obtain a completely representative sample, but a study of selected mainstream or significant groups in accessible locales is still very meaningful. Efforts were made to collect data from diverse parts of China, and a mixture of random and non-random sampling was used. The large sample sizes may allow statistical adjustments for some of the biases in further analysis.

The questionnaires were as comprehensive as circumstances permitted. In the interest of not being too intrusive, many questions were addressed only to attitudes and beliefs, as respondents would feel too hesitant to report actual behavior or practice in some areas.

Limitation of time and resources precluded the compilation of an index. Materials on some special topics are scattered throughout the book. For example, data on homosexuality have to be found laboriously from more than ten places, and information on premarital sex must be traced from some eight sources among the pages. Bibliographical notes are appended to each section, but even the names of European authors are written in Chinese.

G. Discussion and Conclusion

This ground-breaking study is of immense value from a heuristic and theoretical point of view. No study of human sexuality can be complete without including a major human culture of the world and its most populous country. This study should provoke further questions at biological, psychological, sociocultural, and historical levels, and stimulate the emergence of new hypotheses and concepts, both in Chinese and other cultures. The methodology developed can serve as a template for future testing and improvement.

The practical import of this study cannot be overemphasized. It should equip the nation with more knowledge to meet the challenges of sexuality both at the individual and at the societal levels. Wary of the perils of a sexual “revolution” with sudden release of pent-up drives, the authors repeatedly stress the importance of an interpersonal perspective and “sociological imperative.” Despite the authors’ claim to be non-authoritarian, many opinions and conclusions are judgmental and moralistic and delivered in a didactic, paternalistic tone not usually encountered in scientific writing.

As much as it is a towering accomplishment, this study should be placed in perspective by considering directions for future research. Professor Liu came up with a short list of tasks: further analysis of the data collected; more publicity and application of findings, and further study of special groups, such as homosexuals, ethnic minorities, the aged, the disabled, and servicemen. This inventory, however, is very limited and should be amplified to include the following: (1) improvement of the questionnaires and methodology; (2) extension of sampling, to include more under-represented groups, including the overseas Chinese, and to allow further cross-cultural comparisons; (3) replication of the study and follow-up in longitudinal studies; (4) detailed case studies of individuals, subcultures, communities, families, institutions, opinion leaders, practitioners, practices, policies, and polities in this field; (5) further interpretation in cultural and historical terms and contribution to theory building; and (6) study of the impact of sociocultural changes and biological breakthroughs.



Because the People’s Republic of China is one of the most populous nations, decisions made by its people and by its government about sexuality directly affect its population growth and therefore have global importance. Since the establishment of the People’s Republic in 1949, China has undergone immense and sometimes profoundly convulsive changes. A half-century ago, China was devastated by years of civil and external war, its people widely illiterate, and its poverty profound. No matter what one feels about the Mao dynasty - if that word is metaphorically permissible - the achievements of the Chinese people in the past fifty years have been awe-inspiring. China has become a major industrial power and its population is widely literate.

From the 1949 revolution onward, China’s government has increasingly become deeply involved in the reproductive decision making of its citizens. Those who study sexuality and understand its implications for world population growth must surely hope that China’s own scholars, and others who know its rich history, many languages, and varied cultures, will continue and expand their studies of sexuality in China. Because China is both a crucible and a harbinger of the future, these studies will be invaluable for documenting how decisions made by the Chinese people and government will inevitably affect the future of everyone on the earth.

Acknowledgment for Section 14: A Report of the
Nationwide “Sex Civilization” Survey on 20,000 Subjects in China

The secretarial help of Christine H.K. Lau and of Lucie A. Wilk is hereby gratefully acknowledged.

References and Suggested Readings

Bullough, V.L. 1976. Sexual Variance in Society and History. Chicago: University of Chicago Press. Chapter 11: “Sexual Theory and Attitudes in Ancient China.”

Burton, Sandra. 1990 (May 14). “China’s Kinsey Report.” Time Magazine, p. 95.

Burton, Sandra. 1988 (September 12). “The Sexual Revolution Hits China.” Time Magazine, pp. 66-67.

Evans, Harriet. 1997. Women and Sexuality in China: 1949 to the Present. New York: Continuum.

Gil, V.E. 1991 (November). “An Ethnography of HIV/AIDS and Sexuality in the People’s Republic of China.” Journal of Sex Research, 28(4):521-37.

Kinsey, A.C., W.B. Pomeroy, and C.E. Martin. 1948. Sexual Behavior in the Human Male. Philadelphia: W.B. Saunders.

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