Abstract
In recent years, public health officials and scholars have voiced their concerns about comparatively low condom use in China, citing high rates of abortion and the growing HIV/AIDS crisis. By examining condom use through the lenses of gender and the history of medicine, this article traces heterosexual condom consumption in China from the early twentieth century to the present and situates contemporary attitudes toward condoms within long-term contraceptive patterns. Rather than simply taking for granted the role that men play in family planning decisions, this research takes men and masculinity as a central focus. An eye to the past reveals numerous historical obstacles to condom use, as well as an enduring aversion to condoms grounded in fears of reduced male sexual pleasure, and the gendered assumption that birth control is the sole responsibility of women. Analyzing evolving perceptions of condoms sheds light on constructions of sexuality, gender relations, and the roles of the state, society, and the individual in contraceptive decision-making in China.
The “Condom Crisis”
In recent years, public health officials and scholars in a variety of disciplines have voiced their concerns about comparatively low condom use rates in China.1 Studies suggest that a lack of knowledge about contraception among Chinese youth and low condom use rates, particularly in sex work, has resulted in growing rates of HIV/AIDS and STI transmission. For this reason, most public health interventions have focused on increasing access to sex education and awareness about the benefits of protected sex.
Scholars estimate that no more than 57 percent of Chinese high school and college students have been exposed to some form of sex education. Although sex education tends to be more common in urban areas than rural ones, a survey by the Shanghai Municipal Government showed that even in one of China’s largest cities, Shanghai, only 15 percent of high school students had received some form of sex education from either teachers or parents.2 This trend is particularly worrisome to health officials because 60 percent of new HIV infections in China today are occurring among people aged 15 to 29.3
Access to sex education and condom use among Chinese youth are intimately linked, and yet neither issue has been without controversy. According to sexologist, Li Yinhe 李銀河, since the 1980s, Chinese young people have been having premarital sex earlier and more frequently, but the liberalization of sex education has not kept pace with this development.4 The vast majority of official efforts to encourage safe sex and family planning focus on sex within marriage and promote long-term contraceptive options, such as the use of the IUD, which place the full burden of family planning on women. Premarital sex education, where it does exist, is often highly moralized, promoting abstinence and female chastity before marriage.5 This situation, in turn, leaves unmarried youth with little knowledge about birth control, particularly short-term contraceptive technologies such as the condom.6 In terms of preventing pregnancy (rather than curbing the spread of HIV or STIs), the issue of young people not using condoms would be less problematic if the primary alternative – oral contraception – were popular, but it too is not commonly used.7
Moreover, fragmented efforts to address limited premarital sex education have sometimes prompted public outcries. In one case, a mother in Zhejiang province took issue with schools teaching sex education when her second grader obtained access to a sixth-grade sex education textbook. As a result of her protest, at least one local school recalled the textbook.8 The mother also argued that the textbook’s images, which even included references to homosexuality, were far too graphic.9 Sex education books, even those that promoted a strictly heteronormative vision of Chinese society, provoked similar responses among parents in Guangdong and Guangxi.10 In another case, the decision to install free condom machines on Zhejiang University’s campus sparked fears that the school was encouraging (premarital) sex among students, though it is unclear to what extent this case is representative of Chinese universities in general.11
Given low rates of condom use as well as the obstacles to promoting their dissemination, what are the origins of today’s so-called “condom crisis”? In what context did condoms come into use in modern China and how were they received? What can an attention to historical context tell us about contemporary condom use and the changing meanings associated with condoms?
Although condom use in contemporary China has received a relatively large amount of academic attention in fields like public health, these studies tend to approach condoms from a scientific or social-scientific perspective. In other words, most scholarship on condom usage in China employs statistical modeling to interpret condom use patterns among specific populations. This data serves as the basis for policy recommendations. Social scientific research concerned with contraceptive use in China once focused almost exclusively on China’s efforts to curb population growth through “birth planning” and the One Child Policy – the mandate enacted in 1979 that limited couples to one child each. In more recent years, the focus has shifted to preventing HIV/AIDS transmission through condom use advocacy, as the country faces a growing AIDS epidemic. Sex work among specific homosexual, heterosexual, and MSM (Men Who Have Sex With Men) populations is also a common focus for such studies.12 Furthermore, some scholars in anthropology and Science and Technology Studies have begun to explore the meanings associated with condoms and the relationship between gender roles and condom use, but this is a more recent line of inquiry with respect to China.13 Despite the growing scholarly attention to condoms, rarely have patterns of condom use in China been fully historicized. Indeed, looking to the past provides explanations for many of the contemporary challenges related to condom use.
By examining condom use through the lenses of gender and the history of medicine, this article provides an overview of heterosexual condom consumption in modern China and situates contemporary Chinese attitudes toward condoms within long-term contraceptive patterns.14 I use a range of sources from archives across central and eastern China in an attempt to construct a broader picture of condom use nationwide.15 To supplement my archival sources with unofficial accounts, I draw on interviews I conducted with 52 people, 27 women and 25 men, in Shanghai, Tianjin, and Luoyang between 2015 and 2017.16
These sources suggest that contemporary attitudes toward condoms in China are rooted in a constellation of different factors. In the Republican period (1912-1949) and much of the Mao era (1949-1976), obstacles – such as official policing, fears about medical risks, and limited supply – discouraged condom use. Rural-urban disparities in access to contraception in general, and men’s opposition to condoms in particular, were also impediments to the popularization of this form of birth control. While many of these challenges have been overcome, as in the past, a deeply-rooted gender hierarchy and lack of sex education, including a lack of awareness about the benefits of condom use, have endured. Men’s concerns about reduced sensation during intercourse also undergird the “condom crisis.” This research suggests that the challenges policy makers face in promoting condom use are more complex than simply issues of education or access (although limited sex education still remains an obstacle), and that interventions will need to address gendered as well as structural barriers to condom use. Indeed, analyzing condom usage in China sheds light on constructions of sexuality, gender relations, and the evolving relationship between the state, society, and the individual in contraceptive decision-making.
Some feminists, including Margaret Sanger in the early twentieth century, have argued that male-centered contraceptive technologies like the condom are not as liberating for women as female-centered ones, which grant women sexual and reproductive autonomy.17 While this is indeed the case, this article in part seeks to highlight the uneven roles that men and masculinity play in contraception. This speaks to a larger methodological intervention – instead of focusing on women as the only actors in histories of reproduction, a common feature of scholarship on this topic, here, men’s actions are given greater consideration. Somewhat counterintuitively, sex education in the past and today in China tends to depict men as sexually dominant and women as passive.18 According to this logic, men should be eager to take responsibility for contraception. Beyond promoting more equitable access to sex education in rural and urban areas, rebranding condoms and condom use as masculine could be instrumental in promoting safer, more equitable sex.
Condoms in the Republican Era (1912-1949)
During the Qing dynasty (1644-1911), neither contraceptives nor abortions were specifically prohibited in the legal code. However, performing an abortion was illegal, and due to the association with extramarital affairs, those undergoing or receiving an abortion met with opprobrium.19 While potentially fatal, abortions arguably constituted one of the most common methods of family planning in the imperial era.20 After the founding of the Republic of China, however, as part of a shift toward Western and Japanese legal models, sterilization and abortion were both explicitly banned (although therapeutic abortions for critically ill women would later be permitted with the 1935 revision of the legal code).21 In contrast to abortion, birth control was neither specifically endorsed nor banned for married couples.22
Records reveal that during this time condoms (baoxiantao 保險套 or guitoutao 龜頭套) were being sold in drugstores to prevent the transmission of syphilis and given out at birth control clinics in major urban centers, particularly port cities with their thriving prostitution industries.23 Sexual hygiene guides and news articles explaining how to procure and use products like the “French Letter” condom (ruyidai 如意帶) were also common in urban areas.24 Critically, the association of condoms with prostitution and infidelity never totally disappeared and may help account for the enduring undesirability of condoms. Despite the existence of condoms and spermicidal douches, abortions were the most prevalent forms of contraception that appeared in the historical record. In other parts of the world, condoms were one of the most popular forms of contraceptives, even though they had a high failure rate.25 Yet, historian Yuehtsen Juliette Chung observes that although condoms were available at the Rockefeller-funded Peking Union Medical College in Beijing as early as the 1920s, “the idea of using condoms did not seep into Chinese men’s mentality.”26
The limited popularity of condoms in early twentieth-century China can be attributed to in part to certain assumptions about medicine and the body. According to traditional Chinese medicine, the balance of yin 陰 and yang 陽, or the female and male aspects of qi 氣, governs bodily health. Daoist teachings argued that men needed a certain amount of female yin to balance out their abundant yang. Excessive sex could drain a man of his yang, but an appropriate amount of sex would benefit him by replenishing his yin. A man could receive yin from female orgasms, but he himself should try to limit emission of his seminal essence (jing 精) so as to avoid depleting his finite qi and causing illness.27 Hence, the practice of “cultivating life” (yangsheng 養生) – preserving jing through proper sleep, diet, temperature regulation, and even engaging in intercourse without releasing semen – arose.28 Following this logic, using condoms would enable a man to have more intercourse, thus depleting his jing while not allowing him to gain any of the complementary advantages of women’s yin. Writing in 1941, sexologist Yao Lingxi 姚靈犀 raised this concern with respect to condom use.29
Condoms were also associated with other health risks for men. When Margaret Sanger visited China in 1922, she argued that frequent use of the withdrawal method or condoms could cause men to suffer from nervous disorders (shenjing shuairuo de bing 神經衰弱的病).30 For this reason, she encouraged female contraception instead.31 In 1946, one vocal female advocate of birth control, Zhen Ni 珍妮, published an article in Xin funü yuekan 新婦女月刊 (New women’s monthly) recommending that women use birth control products such as spermicides, pessaries (zigongtao 子宮套), or condoms instead of undergoing repeated dangerous abortions.32 However, Zhen also warned that using a condom too often can lead to neurasthenic disorders among men, an argument that draws on the language of Western biomedicine. Far from disappearing, this perspective on the negative side effects of condom use endured into the People’s Republic. In fact, a 1955 issue of Xin Zhongguo funü 新中國婦女 (New women of China) affirmed the claim that using condoms and other forms of birth control could cause senility (shuairuo 衰弱).33 Taken together, concerns about the negative side effects of using condoms may have served to deter potential customers. This may also account for advertisements promoting condoms as a tool for male sexual enhancement, a marketing ploy meant to circumvent the issue of the perceived health risks of using condoms.34
Other factors, such as local efforts to selectively limit contraceptive sales, may have also made procuring condoms more challenging. As did governments in many other parts of the world, the Guomindang 國民黨 authorities at times viewed contraception as encouraging abortion and therefore periodically policed the sale of prophylactics.35 Moreover, as in the United States during the nineteenth century, the association of contraception with “pornography” – texts and images deemed harmful for public consumption – made contraception vulnerable to further censure.36 In 1927, for example, after a raid on local drugstores, the Beijing police issued an official report arguing that selling French and Japanese-made birth control pills, devices, and condoms was in fact more harmful to the public than the sale of pornographic books (yinshu 淫書).37 Similarly, in 1929, the Shanghai government banned the promotion and dissemination of drugs with contraceptive, abortifacient, or aphrodisiac properties.38 During an investigation in 1937, Shanghai police disguised themselves as customers and exposed two pharmacies selling “obscene” products. The owners of the two pharmacies were charged with selling a variety of aphrodisiacs, contraceptives, and sexual aids, including eight eight-pack boxes of condoms, 22 boxes of disease-preventing contraceptives, seven bottles of gujing 固精 pills to fight nocturnal emissions, five uterine warmers (believed to help an embryo implant itself and grow by warming the womb and increasing blood circulation), and 483 sex guides.39 Despite the risk of being charged fines and having their property seized, individual peddlers, pharmacies, and medicine companies continued to advertise and sell these types of products.40 It is also unlikely that condoms were systematically banned in any one Chinese city.
Because they were not explicitly banned, condoms rarely appear in legal records. When they are mentioned in the archive, it is often not in connection with birth control. Instead, condoms were used to transport illegal drugs. In 1947, for example, in Beijing a man named Liu Liangyu 劉亮宇 was caught transporting nine jin 斤 of heroin in more than 20 condoms in his cotton vest as part of a large-scale crime syndicate.41 Similarly, in 1948, the Tianjin shi weisheng ju 天津市衛生局 (Tianjin Municipal Bureau of Health) investigated a case in which a woman was caught trafficking morphine and opium in rubber condoms.42 This suggests that, at the very least, people were aware of the existence of condoms but not necessarily using them as prophylactics.
Perhaps yet another reason why condoms were not a popular form of contraception was their high failure rate and the fact that they were not very comfortable. Despite advertisements with slogans like “Flexible and Comfortable, Won’t Break Easily” (Rouren shuchang buyi pohuai 柔韌舒暢不易破壞) and “Soft Texture and Durability” (Zhidi meiruan jingjiu naiyong 質地美軟經久耐用), according to a 1942 clinical study at Shanghai Women’s and Children’s hospital, condoms had a failure rate of 42.8 percent.43 Before the 1850s, most condoms in the US and Britain were made from livestock intestines. Rubber condoms were first developed in the nineteenth century when Charles Goodyear invented vulcanized rubber. By the 1920s, latex condoms, which were more pliable, less combustible, and better suited for mass production on the assembly line, had begun replacing rubber condoms in Western countries.44 In China, however, rigid rubber condoms remained standard until the 1960s, and their limited elasticity made them uncomfortable for men to use. They also came in restricted sizes and could break easily.45 Fish-skin condoms, said to be more comfortable, could sometimes be procured, but these were even more difficult to obtain.46 For these reasons, condoms seem to have been a less used contraceptive option in the Republican period despite their popularity elsewhere.
Condoms During the Mao Era (1949-1976)
Immediately after the founding of the People’s Republic of China (PRC) in 1949, the Chinese Communist Party (CCP) drastically limited access to birth control, sterilization, and abortion because a large workforce – and therefore a large population – was viewed as the key to Chinese economic prosperity. During the mid to late 1950s, fears of an unhealthy population and the desire to mobilize women’s labor more fully led to a gradual loosening of restrictions on contraceptives and fertility-regulating surgeries. The gradual shift from pro-natalism to aggressive birth planning culminated with the 1979 enactment of the One Child Policy, which was recently relaxed to allow for two children per couple under the Two Child Policy (2015-present).
In the 1950s, at the discretion of local governments, the sale of condoms was permitted in certain urban areas but only under strict state supervision. In 1952, the Ministry of Health mandated that all parties involved in the manufacturing and sale of birth control register with the authorities. At the local level, the Shanghai government took this mandate even further, ordering that street vendors no longer sell condoms. Those who still possessed unsold condoms in stock could sell out their inventory under the guidance of local health authorities, but no new supplies of condoms might be sold. All vendors approved to continue selling condoms were required to undergo training in condom standards and specifications.47 By 1957, the government was more explicitly endorsing condom use and had even made imported condoms tax-exempt to reduce prices for buyers, as the majority of condoms came from abroad.48 The showcasing of condoms and other contraceptives at a 1957 exhibition in Shanghai highlights the growing prominence of birth control in public discourse.49 Advertisements for contraceptives in newspapers and on billboards, which could even reach the illiterate population, were also becoming more common.50 Between 1955 and 1956, condom sales nationwide increased by 25 percent (compared to a 100 percent increase in sales of cervical caps).51
Despite some liberalization of regulations governing contraception, access to information about sexual hygiene and the ways in which this material was disseminated varied dramatically based on one’s class background, education level, and proximity to an urban area. While educated urban elites might use health guides to educate their children on their wedding nights about the taboo subject of sex, people from more rural areas and with less education were less likely to have received any formal sex education whatsoever. Instead they learned about sex from friends, through personal experience after marriage, or even watching dogs or livestock mate.52
Amid high-level government debates over the ethics and efficacy of birth control, a wave of literature promoting contraceptive techniques emerged briefly in the late 1950s and again in the early 1960s. Numerous guides printed in cities across eastern and central China recommended condoms for men, called yinjingtao 陰莖套 or baoxiantao 保險套 (literally, “insurance sheath”), and for women, diaphragms or cervical caps. The authors stressed that condoms are effective in preventing conception 95 percent of the time while diaphragms with spermicidal jelly are effective in 98 percent of cases. One guide, generically titled Jieyu xuanchuan shouce 節育宣傳手冊 (Birth control handbook) and published in 1958, explained how to wash out contraceptive devices such as condoms and cervical caps for reuse, presumably because such items were hard to come by. Condoms were to be treated with talcum powder to ensure that they dried correctly and inflated or filled with water to check for punctures (this strategy was also practiced in Europe and the United States in the early twentieth century).53 These methods were echoed in sex guides from the 1930s and 1940s as well as in materials published in the 1950s, and health publications continued to recommend washing and reusing condoms through the 1970s.54
Given their official endorsement, how were condoms received by the public? Impediments to condom use in the late 1950s and 1960s included price and availability, and socio-economic status and geography shaped birth control practices in important ways.55 For much of the 1950s, for example, the cost of contraceptives differed radically based on location. For this reason, in 1957, the Ministry of Health ordered that regional price differences be eliminated through the establishment of fixed national prices for the four primary types of birth control available within China: condoms, cervical caps, contraceptive ointments, and suppositories.56 In an effort to promote condom sales, the Ministry of Health also broadened the types of establishments where birth control products could be bought from a handful of hospitals to smaller health clinics, delivery stations, midwives, and even street vendors. Although Chinese factories had begun producing limited quantities of cervical caps, condoms, ointments, and suppositories (Figure 1) as early as 1954, a supply of condoms and cervical caps continued to be imported to meet the growing demand for them.57 As of 1957, imported contraceptives in Tianjin were more than twice the price of domestically produced ones, and this disparity continued to grow as the Ministry of Health repeatedly reduced the cost of contraceptives. Condoms imported from Japan cost .12 yuan whereas condoms produced domestically at Tianjin yaochang 天津藥廠 (Tianjin pharmaceutical factory) and other places were only .05 yuan.58 In 1955, Xin Zhongguo funü published an interview with a female cadre, Liu Yunqian 柳蘊倩, about her personal experiences with birth control. According to Liu, two of her elite colleagues had sent someone to Shanghai and Beijing to buy condoms on their behalf and had paid the exorbitant sum of 10 to 20 yuan per condom.59 Although it is difficult to come by accurate income statistics for this period, the average urban couple in China in 1957 had an annual expenditure of 220 yuan. 60 At 10 to 20 yuan each, the cost of a condom would have comprised 5 to 9 percent of a couple’s annual income, an expense only conceivable for wealthy elites. Liu, however, argued that if washed after each use with soap, dried, and wrapped in gauze for safe storage, a condom should last one to two years if only used once or twice a month.61
Problems with condom sales, such as high cost and limited supply, endured into the 1960s. Although the supply of domestically-manufactured condoms was extremely limited, in the 1960s, approximately one third of condoms manufactured in China were exported abroad to places such as Cuba.62 When renowned Indian demographer Sripati Chandrasekhar visited China in 1958, he reported seeing domestically produced condoms made in Shanghai, Wuhan, and Guangzhou. Of those “sheaths,” Chandrasekhar remarked, that they “looked like good products” and were “cheap” compared to Indian condoms yet were “unpopular.”63 In 1963, the Ministry of Chemical Industry released official national guidelines for condom production (Figure 2), including standards for the production of condoms of three different lengths: 31 millimeters, 33 millimeters, and 35 millimeters.64 The Tianjin shi jingji weiyuanhui 天津市經濟委員會 (Tianjin city economic committee) also reported that local factories, such as Yutai xiangjiao chang 裕泰橡膠廠 (Yutai rubber factory) and Yutai rujiao chang 裕泰乳膠廠 (Yutai latex factory), had produced their first condoms (these would have looked something like the condoms shown in Figure 3). However, production costs were high, raw materials were insufficient, and factories were largely unprepared for this type of production.65 At this time, most condoms in Tianjin were either imported or purchased from factories in Shanghai and Guangzhou. With a childbearing population of 1.4 million (700,000 couples), the city of Tianjin reported sales of 646,000 condoms in March 1963 and 126,000 in the first half of April that same year.66 The city ambitiously planned to produce 6 million condoms in the next six months, allowing for around eight condoms per couple.67 Over time, the price of condoms continued to drop and the supply grew nationwide.68 By 1974, factories in Tianjin, as well as those in Guangdong, Shanxi, Shandong, and Liaoning provinces, were producing a total of 420 million condoms a year, all of which were distributed free of charge, and yet condoms were still not the most preferred form of contraception.69
Factory workers manually producing condoms in 1957 at the Guangzhou Number 11 Rubber Factory. The caption below the images boasts that although the condom production process was “backward” in its early stages, production soared during the 1957 factory labor competition pictured on the right.Source: “Jiema Guangzhou” 解碼廣州 133 米, “Bainian gongye chuanqi shi jiu zai zhe chengshi jiyi qiangshang” 百年工業傳奇史就在這城市記憶牆上,” Meiri toutiao 每日頭條, January 25, 2017, <https://kknews.cc/zh-sg/news/p4oen62.html>.
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Factory workers manually producing condoms in 1957 at the Guangzhou Number 11 Rubber Factory. The caption below the images boasts that although the condom production process was “backward” in its early stages, production soared during the 1957 factory labor competition pictured on the right.Source: “Jiema Guangzhou” 解碼廣州 133 米, “Bainian gongye chuanqi shi jiu zai zhe chengshi jiyi qiangshang” 百年工業傳奇史就在這城市記憶牆上,” Meiri toutiao 每日頭條, January 25, 2017, <https://kknews.cc/zh-sg/news/p4oen62.html>.
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Factory workers manually producing condoms in 1957 at the Guangzhou Number 11 Rubber Factory. The caption below the images boasts that although the condom production process was “backward” in its early stages, production soared during the 1957 factory labor competition pictured on the right.Source: “Jiema Guangzhou” 解碼廣州 133 米, “Bainian gongye chuanqi shi jiu zai zhe chengshi jiyi qiangshang” 百年工業傳奇史就在這城市記憶牆上,” Meiri toutiao 每日頭條, January 25, 2017, <https://kknews.cc/zh-sg/news/p4oen62.html>.
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Guide to national condom production standards.Source: Zhonghua renmin gongheguo huaxue gongye bu 中華人民共和國化學工業部, Buban biaozhun: biyuntao 部頒標準：避孕套 (Beijing: Zhongguo gongye chubanshe, 1963).
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Guide to national condom production standards.Source: Zhonghua renmin gongheguo huaxue gongye bu 中華人民共和國化學工業部, Buban biaozhun: biyuntao 部頒標準：避孕套 (Beijing: Zhongguo gongye chubanshe, 1963).
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Guide to national condom production standards.Source: Zhonghua renmin gongheguo huaxue gongye bu 中華人民共和國化學工業部, Buban biaozhun: biyuntao 部頒標準：避孕套 (Beijing: Zhongguo gongye chubanshe, 1963).
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Condom sales also faced other challenges. In 1957, lamenting that birth control products appeared “drab” (dandiao 單調) and “old-fashioned” (chenjiu 陳舊), the Zhongguo yiyao gongsi 中國醫藥公司 (Chinese National Medical Company) recommended that the styles of these products be updated to make them more appealing. Specifically, condoms and diaphragms would be sold in cute boxes made of plastic or bakelite (an early form of plastic) with accompanying perfumed sachets of talcum powder.70 This marketing strategy tacitly acknowledged the materialistic consumer tendencies still apparent in 1950s China. More stylish birth control products could have been an effort to appeal to wealthier elites or style-conscious newly-weds.
Efforts were also made to improve the customer experience of purchasing contraceptives and to overcome the taboo of birth control. In the cities, it was mandated that establishments selling birth control products have both male and female sales associates – male sales associates would sell contraceptives exclusively for and to men, while female associates would attend to the female clientele. This type of gender segregation was particularly intended to prevent shy young women from feeling embarrassed (nanweiqing 難為情) about buying contraceptives in the company of the opposite sex.71 The staff members would be trained in the practice of birth control and able to provide instructions for use to customers. Further underscoring efforts to professionalize the contraceptive sales experience, the Tianjin government even scolded local businesses for allowing their staff to make vulgar remarks during sales rather than taking birth control seriously.72
Paper packaging and accompanying instructions for latex condoms produced in Qingdao on September 6, 1976. This particular package contains two, 33-millimeter-long condoms. The user is advised to wash and dry the condom after each use and to check for punctures.Source: “Shang shiji 60 niandai de baoxiantao, yong wan hou xijing lianggan xiaci jiezhe yong” 上世紀 60 年代的保險套, 用完後洗凈晾乾下次接著用, Meiri toutiao 每日頭條, June 23, 2017, <https://kknews.cc/news/8mn9ol4.html>.
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Paper packaging and accompanying instructions for latex condoms produced in Qingdao on September 6, 1976. This particular package contains two, 33-millimeter-long condoms. The user is advised to wash and dry the condom after each use and to check for punctures.Source: “Shang shiji 60 niandai de baoxiantao, yong wan hou xijing lianggan xiaci jiezhe yong” 上世紀 60 年代的保險套, 用完後洗凈晾乾下次接著用, Meiri toutiao 每日頭條, June 23, 2017, <https://kknews.cc/news/8mn9ol4.html>.
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
Paper packaging and accompanying instructions for latex condoms produced in Qingdao on September 6, 1976. This particular package contains two, 33-millimeter-long condoms. The user is advised to wash and dry the condom after each use and to check for punctures.Source: “Shang shiji 60 niandai de baoxiantao, yong wan hou xijing lianggan xiaci jiezhe yong” 上世紀 60 年代的保險套, 用完後洗凈晾乾下次接著用, Meiri toutiao 每日頭條, June 23, 2017, <https://kknews.cc/news/8mn9ol4.html>.
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
In 1958, the Zhongguo yiyao gongsi mandated that in medium-to-large cities preference be given to selling cervical caps whereas condoms should primarily be sold in small cities. This disparity was due in part to the fact that cervical caps required individual fitting with a doctor’s guidance whereas condoms did not, and doctors were more readily available in large cities.73 Limited efforts were also made in some rural regions to market contraceptives. As in the cities, businesses selling contraceptives in rural China were scarce, had limited inventory, and offered “poor” customer service, conditions which likely discouraged condom use.74
Yet, challenges to condom distribution in the countryside were not simply limited to supply issues. In a report from 1964, for example, the Fengshan dadui 豐善大隊 (Fengshan brigade) of 241 households (890 people) near Beijing chronicled the obstacles to selling condoms. When the brigade leader hung a handmade sign that read “condoms for sale,” only 16 condoms were sold in an entire year. In addition, three condoms were ruined in one day when a six-year-old inflated them into balloons and they popped. Male brigade members reported that the condoms were impossible to wash and inconvenient to use, especially in crowded households. They also found buying or discussing them embarrassing, especially since everyone in the village knew each other.75 One young man succinctly summed up the problem: “Dou shi bencun ren, bushi shushu, jiushi daye, shui haoyisi qu mai nage? 都是本村人，不是叔叔，就是大爺，誰好意思去買那個？” (We’re all villagers. If it’s not Uncle (shushu 叔叔), then it’s Grandpa (daye 大爺). Who has the nerve to buy that [a condom]?)76
These issues aside, the most common reasons for not wanting to use condoms were linked to gender roles. In the 1960s, many women reported fearing that using contraceptives would negatively affect their marital lives, cause bodily pain or illness, or result in sterilization, anxieties that dissipated to some degree as contraceptive technologies became normalized.77 These women seemed to think that their husbands would not be sexually satisfied if they used contraception. Their concerns were often warranted, as some men actively resisted using condoms. When asked why they did not use condoms, many men cited the fact that they diminish the male sexual experience.78 In fact, one 58-year-old man in Tianjin told me that he and his wife have long used the unreliable withdrawal method, rather than condoms, to preserve the feeling of flesh on flesh (rou ai rou de ganjue 肉挨肉的感覺). Other men complained that condoms were troublesome (mafan 麻煩), uncomfortable, and expensive.79 Still others mocked their wives relentlessly for bringing home condoms until they gave up the cause of promoting condom use.80 Even when work units began distributing condoms free of charge to employees in the 1970s, few couples would use them.81 Rather than forcing their reluctant partners to use condoms, women were encouraged to insert vinegar-covered cotton balls in their vaginas as suppositories or wash vigorously with soapy water after coitus.82 Given the limited impact of condoms in many contexts, it is not surprising that much of the most prominent historical and ethnographic research on the implementation of birth planning in urban and rural China from the 1950s through the 1980s barely touches on condoms.83 The issue of men not liking condoms was so well known that as early as the 1950s it was even depicted in official propaganda promoting the benefits of contraception. Take the following cartoon, for example (Figure 4).84
The text reads:
When Using Contraception, One Must Adhere to a Reliable Method
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Wang Xiaoyun had five children and was too busy every day. Since she was advised at the health clinic to use condoms, she had not been pregnant for a year.
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Her husband said that condoms were too troublesome, and generally did not use them willingly. One day he heard about a folk prescription for contraception. He copied it down and gave it to Xiaoyun, convincing her to buy the medicine.
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Xiaoyun went to the pharmacy to buy the medicine and took two pills, thinking that she would not get pregnant again.
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After a few months, Xiaoyun became pregnant once more. The doctor said to her: after this birth, only stick to reliable birth control methods, and then you will not get pregnant.85
The cartoon clearly acknowledges that not only did men find condoms troublesome, but also, they would do just about anything to avoid wearing them. In this case, the husband even unknowingly convinced his wife to consume questionable folk prescriptions as contraception, a method that could be dangerous or even fatal. Rather than directly addressing the underlying issue of gender inequality, the cartoon frames the husband’s distaste for condoms as a sign of rural backwardness and failure to grasp modern science.
“When Using Contraception, One Must Adhere to a Reliable Method.”Source: Beijing shi gonggong weishengju weisheng jiaoyusuo, Beijing shi kexue jishu puji xiehui 北京市公共衛生局衛生教育所，北京市科學技術普及協會, eds., Nongcun jihua shengyu huace 農村計劃生育劃冊 (Beijing: Beijing chubanshe, 1958).
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
“When Using Contraception, One Must Adhere to a Reliable Method.”Source: Beijing shi gonggong weishengju weisheng jiaoyusuo, Beijing shi kexue jishu puji xiehui 北京市公共衛生局衛生教育所，北京市科學技術普及協會, eds., Nongcun jihua shengyu huace 農村計劃生育劃冊 (Beijing: Beijing chubanshe, 1958).
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
“When Using Contraception, One Must Adhere to a Reliable Method.”Source: Beijing shi gonggong weishengju weisheng jiaoyusuo, Beijing shi kexue jishu puji xiehui 北京市公共衛生局衛生教育所，北京市科學技術普及協會, eds., Nongcun jihua shengyu huace 農村計劃生育劃冊 (Beijing: Beijing chubanshe, 1958).
Citation: NAN NÜ 22, 1 (2020) ; 10.1163/15685268-00221P05
As a point of contrast, when I conducted interviews with urbanites in Shanghai, Tianjin, and Luoyang, some interviewees told me that condoms were available early on, even in rural contexts, and that some men were willing to use them.86 Demographer Thomas Scharping argues that condoms were the most common form of contraception used in China during the early 1960s, and indeed, condom use emerged in surprising circumstances.87 In 1964, in a case most likely from rural Shanxi, a man called Chen Wei 陳偉 was charged with raping a woman named Zhang Yan 張燕 multiple times. The case stands out in that prior to committing each rape Chen purchased a condom (baoxiantao) he used to ensure that Zhang would not become pregnant. In a 1965 report on the case, Zhang said that her rapist had gotten the condom from his fourth aunt (sigu 四姑) but that using birth control was his own idea.88 The case was exposed as part of the Siqing yundong 四清運動 (Four clean-ups movement), a campaign Mao launched in 1963 to weed out so-called “reactionary” elements. Because of the nature of this campaign, it is unclear whether this was an actual case of rape or a case of consensual sex that was later deemed rape as a political move. If the intercourse was consensual, that may have accounted for the premeditation and Chen’s advance procurement of contraception. In another case set in Beijing in 1958, a married bus driver named Zheng Xiaoming 鄭曉明 began having an affair with his female coworker, Xu Li 徐立. Zheng assured Xu that she would not get pregnant because he always used a condom. The relationship only ended in 1965 when the couple was accused of engaging in improper sexual relations.89 These cases and similar ones aside, the general reluctance to use condoms even when they were made available, reveals an underlying power differential between men and women with the condom as the site of the struggle.90
Condoms since the Implementation of the One Child Policy (1979-2015)
What does the historical analysis of condoms and perceptions of them contribute to understandings of contemporary patterns of condom use? According to the national record of birth planning statistics, in 1981 in a country with 996,220,000 people, only 2,983,992 people (less than three percent) were using condoms, with the majority of users living in cities.91 Similarly, Thomas Scharping estimates that in 1982 only 1.4 percent of married, reproductive-age women nationwide relied on condoms, with substantially higher use rates in centrally-administered cities, such as Beijing, Tianjin, and Shanghai.92
Low condom use rates were due in part to the policy of mandatory IUD insertions or sterilizations after a woman had her first child, or second child in certain circumstances. It is likely that the government emphasized IUDs because they were difficult to remove and therefore a convenient tool for controlling women’s reproduction. Acknowledging the fact that voluntary vasectomies were highly unpopular, the state also deliberately targeted women, rather than men, for sterilization, undermining any official claims to state-sponsored gender equality in family planning.93 The frequency of IUD insertions and female sterilization also precluded the need for alternative forms of birth control in many cases. Yet, in a study of family planning policy implementation in four Chinese villages, Joan Kaufman and her colleagues showed that not all women with one child who married in the 1980s were required to use an IUD or undergo sterilization. The authors argue that compared to women who married before the 1980s, the women they interviewed who were married in the 1980s were significantly more likely to use oral pills and barrier methods (condoms or diaphragms) after the first child, and IUDs after the second, instead of choosing sterilization. The authors suggest that as women became more knowledgeable about family planning, they adapted their contraceptive regimens to their personal preferences rather than operating strictly along preset guidelines.94 However, these findings are not representative, as enforcement of the policy tightened and relaxed during the 1980s, and other sources reported mandatory IUD insertions and sterilizations after the birth of a child, creating less demand for condoms.95
Anecdotal evidence and feminist scholarship suggest that male contraception was and remains generally unpopular in China due to the long-held perception that family planning and related concerns belong in the female domain.96 When I interviewed elderly men and women about their perceptions of, and experiences with condoms, a trend emerged that echoed that of the Republican and Mao eras: a general distaste for condoms among men.97 In the early 2000s, some women were even advised to douche with soap or vinegar and take the “morning after pill” if their husbands refused to use condoms.98 In other instances, men resisted attending birth planning lectures and participating in family planning in general because they felt that birth control did not have anything to do with them.99 While most of my interviewees, male and female, argued that family planning was the responsibility of both men and women, women confided that in reality birth planning was always by default the woman’s responsibility.100 Wa 蛙 (Frog), by Mo Yan 莫言, a fictional account of the implementation of the One Child Policy in a Chinese village, illustrates well this dynamic and even echoes accounts of condom use in the Mao era. In the novel, village “aunties” (women birth planning cadres) give out free condoms to women of child bearing age, telling them to make their husbands use them. But the condoms end up either being thrown into the pig pen, or inflated and painted to be used as children’s toys.101 Though fictional, Mo Yan’s account aligns with other research on this topic.
Male resistance to condom use can be found in many parts of the world at many points in history, yet men arguing that they have nothing to do with family size and birth control – a claim I encountered several times during my interviews – is not universal.102 In contrast to China, some studies of birth control in Western countries argue that for hundreds of years men were primarily responsible for contraceptive use, as knowledge about birth control and the ability to control one’s fertility were construed as evidence of masculinity.103 In fact, the condom was the most popular form of contraception in the United States until the 1950s, and sales only decreased in the 1960s following the invention of oral birth control for women.104 In 1998 (as well as today), Japan boasted a 78-percent condom use rate due to historically limited access to other forms of birth control, such as the pill.105 Similarly, a 2017 study found that condoms are the most popular form of contraception among Korean women, while less than three percent of women use oral contraceptives.106 Given these statistics, how can we account for the limited appeal of condoms in China?
As mentioned in the introduction, a contemporary challenge faced by the Chinese state is the promotion of condom use among sex workers and patrons of commercial sex. A number of scholars have highlighted the integral role soliciting sex plays in cementing ties among Chinese businessmen or political officials and demonstrating loyalty to the Communist Party.107 Men seeking to forge lasting relationships with potential clients and collaborators are expected to patronize commercial sex both to “perform manliness” and to fulfill job expectations.108 Likewise, keeping high-end mistresses is important for men in their exhibiting wealth and status.109 Although few reliable statistics exist for the sex industry, China was estimated to have at least 10 million sex workers in 2009 with condom use rates ranging from 15 to 58 percent.110 According to Elanah Uretsky’s study of HIV transmission in Yunnan, few male clients of sex workers used condoms, claiming that they could prevent disease transmission through other means or that only people at the margins of society were susceptible to HIV/AIDS. Of those men who did sometimes use condoms, they were less likely to do so with partners they felt more familiar with: lovers not engaged in the formal sex industry (believed to be “clean” and loyal) and sex workers they had already slept with. In other words, social context, perceptions of cleanliness, and the potential benefit or risk to a man’s career informed the decision of whether to use a condom.111
As with adult businessmen and politicians, condom use trends among unmarried Chinese youths today tend toward unprotected sex. According to a 2004 study of undergraduates at 19 universities in East China, while 16.1 percent of students had had sexual intercourse, of these, 21.8 percent did not know how to use a condom at all, and almost 70 percent reported not knowing how to use a condom correctly.112 Other studies found that only 20 percent of female undergraduates used a condom the first time they had sex, while more than 25 percent of young unmarried women relied on the rhythm or withdrawal methods.113 Rising rates of premarital sex, coupled with lack of contraception use, account in part for a sharp increase in unplanned pregnancies and abortions among women below age 25.114 Furthermore, frequent advertisements for inexpensive and “painless” abortions in cities have reinforced the idea that abortion is a valid substitute for prophylactics.115 Indeed, almost 90 percent of pregnancies among unmarried Chinese youth end in abortion, and yet abortion carries with it a social stigma for unmarried young women, making it more difficult for them to find a partner later on.116
As dire as the situation may look to public health advocates, at least the Chinese government’s stance on condoms has changed dramatically in the last twenty years. Between 1989 and 2002, advertising sex aids and contraceptives was considered pornographic, and therefore, banned. In Guangzhou, for example, advertisements for Jissbon (Jieshibang 傑士邦) condoms were removed from 80 buses for violating the ban. Although the law was “ambiguous” and “arbitrarily enforced,” its existence did not bode well for promoting sex education.117 The association of condoms with pornography – and to some degree, prostitution and promiscuity – is likely to discourage condom consumption further, and may even account for the unwillingness of men to admit to using condoms in public surveys. However, in response to the growing HIV/AIDS crisis and the high abortion rates among unmarried young people, in 2006 the State Council reversed its position on condom advertising.118 Authorities in Beijing and Shanghai have since allowed the public access to free condoms, and made condom-related sex education a priority.119 Still, given that limited access to sex education has been an enduring problem across the twentieth and twenty-first centuries in China, public health officials have a lot of work ahead of them.
Scholars have also reported a contemporary correlation between awareness of sexual hygiene and geography. Female college students who had spent their middle school years in the countryside were less likely to know about the importance of condoms than their urban counterparts. Moreover, urban young people were more likely to use a condom during premarital sex with a new partner than undergraduates from rural backgrounds.120 This development is part of a self-perpetuating cycle: there are more efforts to promote awareness about safe sex and HIV/AIDS in the cities, where rates of premarital sex and HIV/AIDS transmission are higher, than in the countryside.121 This pattern mimics the urban-rural divide in access to sex education apparent in both the Republican and Mao eras. In the Republican period, information about sex and sexual hygiene tended to be concentrated in cities. Similarly, in the Mao era, access to both contraceptives and information on sex was stratified based on proximity to the city and social class. Although the contemporary situation is not grounded in formal policies deliberately intended to heighten rural-urban disparities, as was the case in the past, structural inequalities – such as uneven access to sex education and HIV/STD prevention campaigns – continue to reinforce this divide today.
Conclusion
This study shows that contemporary attitudes toward condoms in China emerged in a particular historical and gendered context that is relevant to public health interventions. Examining condom consumption from the Republican period to the present reveals that each era of modern Chinese history – the Republican period, the Mao era, the One Child Policy era, and the Two Child Policy era (2015-present) – has presented a unique set of obstacles to condom use. Whereas condoms were distrusted for medical reasons and policed in the Republican era, in the Mao era they were expensive and hard to come by. Since the initiation of state-sponsored family planning campaigns in the 1950s, the government’s emphasis on long-term, female-centered contraception within marriage, uneven access to sex education, and men’s unwillingness to use condoms have inhibited their use. In light of these findings, it makes sense that condoms are one of the least popular forms of contraception in China today, as they never really gained a following even before other birth control technologies, such as IUDs and the pill, came into common usage. Enduring disparities in access to sex education for unmarried youth, particularly rural youth, as well as gendered ideas about responsibility for family planning, are persistent impediments to condom use.
The normalization of resistance to condoms and reliance on female contraception have further reinforced the gendered burden of family planning. Matthew Gutmann has argued that prior to the invention of the birth control pill, heterosexual men in Mexico were much more active in contraception than in later years. He attributes this decline in participation in part to the fact that governmental and nongovernmental institutions focused almost exclusively on mobilizing women for health development programs at the exclusion of men.122 Perhaps a lesson can be drawn from the Mexican case: that making women the singular focus of family planning programs, a trend that has long been the case in China, serves to further exclude men from the entire process.123 Greater emphasis on the male role in condom use, as opposed to men using condoms because women demand they do so, could help level the gender playing field and normalize male participation in contraception. Encouraging condom use in China both as contraception and for disease prevention likely will require greater attention to historical context and the gendered meanings of condoms.
Condom use rates among youth in China are low in comparison to the US, Japan, and Korea; Huachun Zou, Hui Xue, Xiaofang Wang, and Damien Lu, “Condom Use in China: Prevalence, Policies, Issues and Barriers,” Sex Health 9, no. 1 (2012): 27-33; Yang Wanli, “High Abortion Rate Triggers Fears for Young Women,” China Daily, January 27, 2015, <http://www.chinadaily.com.cn/china/2015-01/27/content_19412949.htm>; Gladys Martinez, Casey E. Copen, and Joyce C. Abma, “Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2006-2010 National Survey of Family Growth,” Vital Health and Statistics 23.31 (2011): 1-47; Soo Hyun Lim, Hae In Jang, Dong-Yun Lee, Byung-Koo Yoon, and Doo-Seok Choi, “Recent Trends in Contraceptive Use among Korean Adolescents: Results from a Nationwide Survey from Year 2013 to 2015,” Obstetrics & Gynecology Science 59.6 (2016): 519-24.
Jonathon Watts, “China Sex Education Lags Behind Sexual Activity,” The Lancet 363, April 10, 2004, <http://www.thelancet.com/pdfs/journals/lancet/PIIS0140673604159941.pdf>.
Qiaoqin Ma, Masako Ono-Kihara, Liming Cong, Xiaohong Pan, Gaozhang Xu, Saman Zamani, Shahrzad Mortazavi Ravari, and Masahiro Kihara, “Behavioral and Psychosocial Predictors of Condom Use among University Students in Eastern China,” AIDS Care 21.2 (2009): 249-59.
Alyssa Abkowitz, “More and More Chinese People Are Having Pre-Marital Sex,” The Wall Street Journal, April 16, 2015, <https://blogs.wsj.com/chinarealtime/2015/04/16/more-and-more-chinese-people-are-having-pre-marital-sex/>.
Yang Faxiang 楊發祥, “Dangdai Zhongguo jihua shengyu shi yanjiu” 當代中國計劃生育史研究 (Ph.D. diss., Zhejiang University, 2003), 57; Kailing Xie, “Premarital Abortion – What is the Harm? The Responsibilisation of Women’s Pregnancy among China’s ‘Privileged’ Daughters,” Journal of the British Association for Chinese Studies, 8.1 (2018): 1-31; Alessandra Aresu, “Sex Education in Modern and Contemporary China: Interrupted Debates Across the Last Century,” International Journal of Educational Development 29 (2009): 532-41.
Aresu, “Sex Education,” 538.
Why has the pill never been popular in China? First, the supply has never been great enough to serve anyone other than urbanites. Second, since the late 1980s, obtaining oral contraceptives has required users to pay a deposit, as users need to prove their willingness to consistently take the pills. Third, surveys showed that oral contraceptives even in the mid and late 1980s had failure rates of 27 to 33 percent, which deterred potential users of the pill. Finally, many women fear that oral contraceptives will permanently alter their hormones, impeding future conception. Thomas Scharping, Birth Control in China, 1949-2000: Population Policy and Demographic Development (London: RoutledgeCurzon, 2003), 107-8; “Interviews conducted in Shanghai (2017) and in Xiamen (2019)” with author.
Jiayun Feng, “Controversy Over Sex-Ed Textbook,” SupChina, March 6, 2017, <https://supchina.com/2017/03/06/controversy-sex-ed-textbook>.
“Xiaofang huiying xiaoxue xingjiaoyu keben zhengyi: jiang zeji tui xiangguan kecheng” 校方回應小學性教育課 本爭議：將擇機推相關課程, Zhongguo xinwen wang 中國新聞網, March 7, 2017, <http://www.chinanews.com/sh/2017/03-07/8167055.shtml>.
Aresu, “Sex Education,” 539.
“China’s Campus Condom Giveaway Both Protects and Offends,” Global Times, November 29, 2015, <http://www.globaltimes.cn/content/955525.shtml>.
Shusen Liu, Lin Chen, Li Li, Jin Zhao, Wende Cai, Keming Rou, Zunyou Wu, and Roger Detels, “Condom Use with Various Types of Sex Partners by Money Boys in China,” AIDS Education and Prevention 24.2 (2012): 163-78; Susanne Y.P. Choi and Eleanor Holroyd, “The Influence of Power, Poverty and Agency in the Negotiation of Condom Use for Female Sex Workers in Mainland China,” Culture, Health and Sexuality 9.5 (2007): 489-503; Lijun Tang, Rucheng Chen, Danqin Huang, Haocheng Wu, Hong Yan, Shiyue Li, and Kathryn L. Braun, “Prevalence of Condom Use and Associated Factors among Chinese Female Undergraduate Students in Wuhan, China,” AIDS Care 25.14 (2013): 515-23.
Examining the shift from condoms as contraceptives to tools of disease prevention in his study “Rubber Wars: Struggles over the Condom in the United States,” Journal of the History of Sexuality 1. 2 (1990): 262-82, Joshua Gamson argues that the meanings associated with condoms in the US have evolved in different sociopolitical contexts. Speaking to condom use in contemporary China, Tiantian Zheng explores the discourses associated with condom use among sex workers and clients in Dalian in Ethnographies of Prostitution in Contemporary China: Gender Relations, HIV/AIDS, and Nationalism (London: Palgrave Macmillan, 2009). Zheng argues that male clients reject condoms because they want to defy government control over sexuality, they view contraception as a female responsibility, and they want to appear masculine in front of their peers. Similarly, Elaine Jeffreys and Haiqing Yu investigate the Chinese state’s recent efforts to promote condom use for HIV/AIDS prevention in their book, Sex in China (Cambridge: Polity Press, 2015). Jeffreys and Yu counter claims that the Communist Party is “anti-sex” and that condoms are taboo in contemporary China. Rather, they demonstrate that the Chinese government is actively promoting condom use for HIV/AIDS prevention.
This analysis focuses on condom use in heterosexual intercourse, rather than in the full spectrum of sexual orientations and practices.
This article relies on archival materials collected at municipal, provincial, and private archives in Shanghai, Tianjin, Luoyang, Beijing, Guangzhou, and Hangzhou. My findings are not meant to be applicable to all of China – my intention is simply to make some general observations about heterosexual condom use that will pave the way for future micro-level research.
The interviewees were all ethnically Han, ranged in age from forty-six to eighty-six (the majority being in their sixties and seventies), and were socioeconomically diverse (from workers with little formal education to white-collar employees, such as professors and doctors). The interviews were conducted individually, in couples, and in groups with some interviewees reflecting on their own lives and others relating the experiences of their parents and friends.
Andrea Tone, “Making Room for Rubbers: Gender, Technology, and Birth Control Before the Pill,” History and Technology 18.1 (2002):51-76, and see page 66.
Harriet Evans, Women and Sexuality in China: Dominant Discourses of Female Sexuality and Gender Since 1949 (Cambridge: Polity Press, 1997), 27; James Farrer, “Sexual Citizenship and the Politics of Sexual Story-Telling among Chinese Youth,” in Elaine Jeffreys, ed., Sex and Sexuality in China (New York: Routledge, 2006), 102-23; Xie, “Premarital Abortion,” 7.
Historian Matthew Sommer argues that abortions were taboo and uncommon in late imperial China. Traditional abortifacients, he contends, were unreliable, dangerous, expensive, and difficult to use. Therefore, they were neither mechanisms for female empowerment nor tools of routine family planning. Rather, abortion was an emergency response to either a medical crisis, such as a pregnancy that was dangerous to a woman’s health, or to a social crisis, like an extramarital affair that resulted in pregnancy; see Matthew H. Sommer, “Abortion in Late Imperial China: Routine Birth Control or Crisis Intervention?” Late Imperial China 31.2 (2010): 97-165. In contrast, James Z. Lee, Wang Feng, and Li Bozhong have argued that, unlike the West, China did not experience a Malthusian population crisis, in part because abortion had been widely practiced for centuries; see James Z. Lee and Wang Feng, One Quarter of Humanity: Malthusian Mythology and Chinese Realities, 1700-2000 (Cambridge, MA: Harvard University Press, 1999); and Li Bozhong 李伯重, “Duotai, biyun, yu jueyu: Song Yuan Ming Qing shiqi Jiang-Zhe diqu de jieyu fangfa ji qi yunyong yu chuanbo” 墮胎，避孕，與絕育：宋元明清時期江浙地區的節育方法及其運用與傳播, in Li Zhongqing 李中清, Guo Songyi 郭松義, and Ding Yizhuang 定宜莊, eds., Hunyin jiating yu renkou xingwei 婚姻家庭與人口行為 (Beijing: Beijing daxue chubanshe, 2000), 172-196.
Long Wei 龍偉, “Duotai feifa: Minguo de duotai zui jiqi sifa shijian” 墮胎非法：民國的墮胎罪及其司法實踐, Jindaishi yanjiu 近代史研究 no. 1 (2012):92-104, and see 93-94.
Ling Ma, “Gender, Law, and Society: Abortion in Early Twentieth Century China” (PhD diss., State University of New York, Buffalo, 2016), 243.
Tyrene White, China’s Longest Campaign: Birth Planning in the People’s Republic, 1949-2005 (Ithaca: Cornell University Press, 2006), 22.
Gail Hershatter, Dangerous Pleasures: Prostitution and Modernity in Twentieth-Century Shanghai (Berkeley: University of California Press, 1997), 463; Xu Wancheng 許晚成, Zuixin shiyan nannü biyunfa 最新實驗男女避孕法 (Shanghai: Guoguang shudian, 1941), n.p.; Anon., “Gulou yiyuan zhishi jieyu: yi you sanshi ren” 鼓樓醫院指示節育：已有三十人, Guangxi weisheng xunkan 廣西衛生旬刊 2, no. 33 (1935): n.p.; Mao Xian 毛咸, “Yiyao wenda: da di 365 hao beiliuxian guan sa zhangjun wen jieyu” 醫藥問答：答第三六五號北流縣關薩彰君問節育, Guangxi weisheng xunkan 廣西衛生旬刊, 3, no. 2 (1935): 18-19; Ling Ma, “Gender, Law, and Society,” 122-123.
Xu Wancheng, Zuixin shiyan nannü biyunfa, n.p.; Hui Mingzeng 惠明贈, “Cong Luo Guifang de duotai shuoqi” 從駱桂芳的墮胎說起, Wufeng banyue qikan 舞風半月期刊 2, no. 3 (1938): 15; Xue Deyu 薛德焴, Chan’er tiaojie zhi lilun yu shiji 產兒調節之理論與實際 (Shanghai: Shanghai xinya shudian, 1933), 37.
Tone, “Making Room for Rubbers,” 62.
Yuehtsen Juliette Chung, Struggle for National Survival: Chinese Eugenics in a Transnational Context, 1896-1945 (New York: Routledge, 2002), 119.
Hugh Shapiro, “The Puzzle of Spermatorrhea in Republican China,” Positions 6 (1998): 551-96. Everett Yuehong Zhang argues that jing was originally translated as seminal essence because it signified more than just semen. Since the Republican period, however, the term has become synonymous with semen; Everett Yuehong Zhang, The Impotence Epidemic: Men’s Medicine and Sexual Desire in Contemporary China (Durham, NC: Duke University Press, 2015), 137-38.
Zhang, The Impotence Epidemic, 149.
Yao Lingxi 姚靈犀, Si wu xie xiao ji 思無邪小記 (Tianjin: Tianjin shuju, 1941), 34.
Hugh Shapiro investigates at length the historical reconceptualization of yijing 遺精 (spermatorrhea) as the disease of neurasthenia (debilitated nerves) in his article, “The Puzzle of Spermatorrhea in Republican China,” 553-54.
Michelle T. King, “Margaret Sanger in Translation: Gender, Class, and Birth Control in 1920s China,” Journal of Women’s History 29.3 (2017): 61-83.
Zhen Ni 珍妮, “Duotai he biyun” 墮胎和避孕, Xin funü yuekan 4 (1946): 20-21.
Zhou E’fen 周蕚芬, “Biyun wenti da duzhe wen” 避孕問題答讀者問, Xin Zhongguo funü 12, no. 74 (1955): 26.
Hershatter, Dangerous Pleasures, 462.
Ling Ma, “Gender, Law, and Society,” 201.
Y. Yvon Wang, “Whorish Representation: Pornography, Media, and Modernity in Fin-de-siècle Beijing,” Modern China 40.4 (2014): 351-92, and see page 368; Tone, “Making Room for Rubbers,” 57.
Beijing Municipal Archive (BMA), J181-018-21000; it is possible that the focus on policing foreign-made contraceptives was part of the National Products Movement, a nationalistic campaign in the 1920s and 1930s encouraging consumers to “buy Chinese” and fight imperialism. Karl Gerth, China Made: Consumer Culture and the Creation of the Nation (Cambridge, MA: Harvard University Asia Center, 2003).
“Shanghai tebieshi qudi yinwei yaowu xuanchuan pin zanxing guiding” 上海特別市取締淫猥藥物宣傳品暫行規定, Shenbao 申報 22, no. 20157 (1929): n.p.
“Liang yaofang chaohuo yinju chunyao” 兩藥房抄獲淫具春藥, Shenbao 13, no. 22925 (1937): n.p.; Charlotte Furth, A Flourishing Yin: Gender in China’s Medical History: 960-1665 (Berkeley: University of California Press, 1999), 292.
“Speton,” Funü shijie 婦女世界 17 no. 7 (1931), n.p.; “Yue yue hong 月月紅,” Funü shijie 7 (1931), n.p.; “Lady’s Friend,” advertisement, Funü zazhi 婦女雜誌 1, no. 2 (1931): 14.
“Ping pohuo mimi duku” 平破獲秘密毒窟, Shenbao 6, no. 25052 (1947): n.p.
Tianjin Municipal Archive (TMA), J0116-1-000707-107; TMA, J0116-1-000707-108.
Yu Lianshi 俞蓮實, “Minguo shiqi chengshi shengyu jiezhi yundong de yanjiu: Yi Beijing, Shanghai, Nanjing wei zhongdian” 民國時期城市生育節制運動的研究：以北京，上海，南京為重點 (Ph.D. diss., Fudan University, 2008), 258, 288.
Tone, “Making Room for Rubbers,” 70-71; Ross McKibbin, Classes and Cultures: England, 1918-1950 (Oxford: Oxford University Press, 1998), 305.
Yu Lianshi, “Minguo shiqi,” 205.
Yu Lianshi, “Minguo shiqi,” 205.
Shanghai Municipal Archive (SMA), B242-1-585.
Zhejiang Municipal Archive (ZMA), J123-013-051-071.
Deng Liqun 鄧力群, Ma Hong 馬洪, and Wu Heng 武衡, eds., Dangdai Zhongguo de jihua shengyu shiye 當代中國的計劃生育事業 (Beijing: Dangdai Zhongguo chubanshe, 1992), 78-79.
“Chulemi Contraceptive Cream,” Inside Red China, <http://t.cn/R23gOnv>; “Jiajiale biyun pian” (Happy Family Birth Control Pills), Hangzhou Daily 1959, n.p.
Yang Faxiang, “Dangdai Zhongguo jihua shengyu shi yanjiu,” 57.
Interview with author, Shanghai, August 10, 2016; interview with author, Ningde, June 12, 2016; interview with author, Shanghai, August 11, 2016; interview with author, Shanghai, December 22, 2017; Anchee Min, Red Azalea (New York: Anchor Books, 1994), 71; Rae Yang, Spider Eaters: A Memoir (Berkeley: University of California Press, 1997), 262; Emily Honig, “Socialist Sex: The Cultural Revolution Revisited,” Modern China 29.2 (2003):143-75, and see page 156.
Tone, “Making Room for Rubbers,” 64.
Xu Wancheng, Zuixin, n.p.
Sarah Mellors, “Less Reproduction, More Production: Birth Control in the Early People’s Republic of China, 1949-1958,” East Asian Science, Technology and Society: An International Journal 13.3 (2019): 367-89.
TMA, X0092-Y-000123-007.
TMA, X0092-Y-000123-007.
TMA, X0092-Y-000123 － 007.
Zhou E’fen, “Biyun wenti, 26.
“Per Capita Annual Income and Expenditure Urban and Rural Households,” All China Data Center, chinadataonline.org.
Zhou E’fen, “Biyun wenti,” 26.
Thomas Scharping, Birth Control in China, 181-82; SMA B76-1-590－62;
“China Trip, 1958,” Box 19, Folder 43, Sripati Chandrasekhar papers, University of Toledo Archives, Toledo, Ohio.
Zhonghua renmin gongheguo huaxue gongye bu 中華人民共和國化學工業部, Buban biaozhun: biyuntao 部頒標準：避孕套 (Beijing: Zhongguo gongye chubanshe, 1963).
TMA, X0110-D-000192-005.
TMA, X0110-D-000192-005.
TMA, X0110-D-000192－004.
Guangdong Provincial Archive (GPA), 296-A1.4-26-130; GPA, 281-5-47-025～025.
Guangdong Municipal Archive (GMA), B123-8-1020-7.
TMA, X0092-C-000429-039.
TMA, X0092-C-000429-039; Luoyang Municipal Archive (LMA), 16-14; Fudan University Contemporary China Social Life Data and Research Center (abbreviated CDRCSL; hereafter, CCSL); (CCSL, SA201700000409).
TMA, X0092-C-000429-039.
TMA, X0092-C-000429-039.
TMA, X0092-Y-000123-007; Mellors, “Less Reproduction, More Production,” 382.
BMA, 100-001-00897.
BMA, 100-001-00897.
BMA, 002-020-00379; LMA, 99-7.
BMA, 100-001-00897;
BMA, 100-001-00897; BMA, 002-020-00379; interview with author, Shanghai, December 24, 2017; interview with author, Tianjin, February 13, 2017; interview with author, January 14, 2017; interview with author, December 22, 2017.
CCSL, SA201700000409.
Interview with author, Shanghai, January 12, 2017; interview with author, Luoyang, August 2, 2015; interview with author, Shanghai, December 22, 2017; interview with author, Tianjin, February 13, 2017.
Zheng Tiantian, Ethnographies of Prostitution in Contemporary China (London: Palgrave Macmillan), 52; Shandong sheng weisheng ting 山東省衛生廳, Jieyu xuanchuan shouce 節育宣傳手冊 (Jinan: Shandong renmin chubanshe, 1958): 25-26.
Kohama Masako 小濱正子, “Jihua shengyu de kaiduan – 1950-1960 niandai de Shanghai” 計劃生育的開端 ─1950-1960 年代的上海, Zhongyang yanjiuyuan jindaishi yanjiusuo jikan 中央研究院近代史研究所集刊 68 (2010): 97-142; Kohama Masako, “Zhongguo nongcun jihua shengyu de puji – yi 1960-1970 niandai Q cun wei li” 中國農村計劃生育的普及－以 1960-1970 年 代Ｑ村為 例, Jindai Zhongguo funü shi yanjiu 近代中國婦女史研究 19 (2011): 173-214; Susan Greenhalgh, “Controlling Births and Bodies in Village China,” American Ethnologist 21.1 (1994): 3-30; Hua Han, “Under the Shadow of the Collective Good: An Ethnographic Analysis of Fertility Control in Xiaoshan, Zhejiang Province, China,” Modern China 33.3 (2007): 320-48.
Beijing shi gonggong weishengju weisheng jiaoyusuo, Beijing shi kexue jishu puji xiehui 北京市公共衛生局衛生教育所，北京市科學技術普及協會, eds., Nongcun jihua shengyu huace 農村計畫生育劃冊 (Beijing: Beijing chubanshe, 1958), n.p.
Beijing shi weisheng jiaoyushuo, ed., Nongcun jihua shengyu huace, n.p.
Interview with author, Luoyang, August 2, 2015; interview with author, Tianjin, February 15, 2017.
Scharping, Birth Control, 182.
East China Normal University Center for Research in Modern Chinese History, Archive, document B 022-010-035.
Stanford University Cadre Archive (SUCA), Box 33.
Zheng Tiantian, Ethnographies of Prostitution, 8.
Guojia jihua shengyu weiyuanhui zonghe jihua si 國家計劃生育委員會綜合計劃司, Quanguo jihua shengyu tongji ziliao huibian 全國計劃生 育統計資料彙編 (N.p.: N.p., 1983), 65, 67.
Scharping, Birth Control, 110.
Huang Shu-min, The Spiral Road: Change in a Chinese Village Through the Eyes of a Communist Party Leader (Boulder: Westview Press, 1998), 181.
Joan Kaufman, Zhang Zhirong, Qiao Zinjian, and Zhang Yang., “Family Planning Policy and Practice in China: A Study of Four Rural Counties,” Population and Development Review 15.4 (1989): 707-29, and see page 725.
Tyrene White, China’s Longest Campaign, 135; Judith Banister, China’s Changing Population (Stanford: Stanford University Press, 1987), 192-215.
GMA, 233-2-267-33-39; Zheng, Ethnographies of Prostitution, 8.
Interview with author, Luoyang, August 2, 2015; interview with author, Shanghai, December 22, 2017; interview with author, Shanghai, January 13, 2017; interview with author, Tianjin, February 13, 2017.
Zheng, Ethnographies of Prostitution, 51.
GMA, 233-2-267-33-39.
Interview with author, Shanghai, August 31, 2016; interview with author, Shanghai, August 30, 2016.
Mo Yan, Wa 蛙 (Frog) (Shanghai: Shanghai Art and Literature Publishing House, 2009), 32.
Iris Lopez, Matters of Choice: Puerto Rican Women’s Struggle for Reproductive Freedom (New Brunswick: Rutgers University Press, 2008), 59, 122, 149; Atina Grossman, Reforming Sex: The German Movement for Birth Control and Abortion Reform, 1920-1950 (New York: Oxford University Press, 1995), 68.
Kate Fisher, Birth Control, Sex, and Marriage in Britain, 1918-1960 (Oxford: Oxford University Press, 2006), 194, 229; Kate Fisher, “The Delivery of Birth Control Advice,” in Joanna Bornat, Robert Perks, Paul Thompson, and Jan Walmsley, eds., Oral History, Health and Welfare (London: Routledge, 2000), 249-69.
Tone, “Making Room for Rubbers,” 67.
Tiana A.E. Norgren, Abortion Before Birth Control: The Politics of Reproduction in Postwar Japan (Princeton: Princeton University Press, 2001), 8.
Kim Min Jeong, “The Contraceptive Trend in Korea,” Maturitas 100 (2017): 93-202, and see page 173.
Harriet Zurndorfer, “Polygamy and Masculinity in China: Past and Present,” in Kam Louie, ed., Changing Chinese Masculinities: From Imperial Pillars of State to Global Real Men (Hong Kong: Hong Kong University Press, 2016), 13-33; Elanah Uretsky, “Sex and Work: HIV/AIDS and Elite Masculinity in Contemporary China,” in Howard Chiang, ed., Sexuality in China: Histories of Power and Pleasure (Seattle: University of Washington Press, 2018), 188-204.
Zurndorfer, “Polygamy and Masculinity,” 14; Uretsky, “Sex and Work,” 194; Geng Song and Derek Hird, Men and Masculinities in Contemporary China (Leiden: Brill, 2014), 25.
Zurndorfer, “Polygamy and Masculinity,” 14; Elanah Uretsky, Occupational Hazards: Sex, Business, and HIV in Post-Mao China (Stanford: Stanford University Press, 2016), 123.
Zurndorfer, “Polygamy and Masculinity,” 28; Yuhua Ruan, Xiaoyun Cao, Han-Zhu Qian, Li Zhang, Guangming Qin, Zhengqing Jiang, Benli Song, Wei Hu, Shu Liang, Kanglin Chen, Ye Yang, Xinxu Li, Jun Wang, Xi Chen, Chun Hao, Yanhui Song, Hui Xing, Ning Wang, and Yiming Shao, “Syphilis among Female Sex Workers in Southwestern China: Potential for HIV Transmission,” Sexually Transmitted Diseases 33.12 (2006): 719-23.
Korean and Japanese businessmen also share their Chinese counterparts’ reliance on soliciting sex as part of building loyalty. However, a study of condom use in Japanese massage parlors found that between 83.3 and 98.4 percent of female sex workers used condoms during intercourse, a markedly higher percentage than in China. Similarly, according to a 2019 survey of the frequency of condom use among Korean women sex workers, 88.1 percent of participants responded that they “often,” “usually,” or “always” use condoms. Future research might benefit from examining condom use rates in sex work in a comparative East Asian framework. Uretsky, Occupational Hazards, 125-26; Motonobu Miyazaki, Hiroshi Une, Akira Babazono, Masumi Kato, Shigeru Takagi, and Hiroshi Chimura, “Sexually Transmitted Diseases in Japanese Female Commercial Sex Workers Working in Massage Parlors with Cell Baths,” Journal of Infection and Chemotherapy 9.3 (2003): 248-53; Minsoo Jung, “Risk factors of Sexually Transmitted Infections among Female Sex Workers in the Republic of Korea,” Infectious Diseases of Poverty 8.6 (2019): 1-8.
Tang, Chen, Huang, Wu, Yan, Li, and Braun, “Prevalence of Condom Use,” 517.
Tang, Chen, Huang, Wu, Yan, Li, and Braun, “Prevalence of Condom Use,” 516; Jinke Li, Marleen Temmerman, Qiuqiu Chen, Jialin Xu, Lina Hu, and Wei-Hong Zhang, “A Review of Contraceptive Practices among Married and Unmarried Women in China from 1982 to 2010,” The European Journal of Contraception & Reproductive Health Care 18. 3 (2013): 148-58.
Qian Xu, Shenglan Tang, and Paul Garner, “Unintended Pregnancy and Induced Abortion among Unmarried Women in China: A Systematic Review,” BMC Health Services Research 4.1 (2004): 1.
Langchao gongzuoshi 浪潮工作室, “Zhongguo dajie shang weishenme dou you rengong liuchan guanggao?” 中國大街上為什麼都有人工流產廣告？Huxiu 虎嗅, June 11, 2018, <https://www.huxiu.com/article/247901.html>.
He Chen, Lei Zhang, Youli Han, Ting Lin, Xinming Song, Gong Chen, and Xiaoying Zheng, “HIV/AIDS Knowledge, Contraceptive Knowledge, and Condom Use among Unmarried Youth in China,” AIDS Care 24.12 (2011): 1550-58; Xie, “Premarital Abortion,” 11.
Jo McMillan, “Selling Sexual Health: China’s Emerging Sex Shop Industry,” in Elaine Jeffreys, ed., Sex and Sexuality in China (New York: Routledge, 2006), 124-38.
Elaine Jeffreys and Haiqing Yu, Sex in China, 137-138, 142.
Jeffreys and Yu, Sex in China, 142.
Tang, Chen, Huang, Wu, Yan, Li, and Braun, “Prevalence of Condom Use,” 515.
Qiaoqin Ma, Liming Cong, and Xiaohong Pan, “First Sexual Behavior and the Correlated Sexual Behaviors among Male College Students,” Chinese Journal of School Health 28 (2007): 209-11; Tang, Chen, Huang, Wu, Yan, Li, and Braun, “Prevalence of Condom Use,” 520.
Matthew Gutmann, Fixing Men: Sex, Birth Control, and AIDS in Mexico (Berkeley: University of California Press, 2007), 11-12.
Fudan University Contemporary China Social Life Data and Research Center (CCSL), SA201700000409.