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The WHO Hopes a Hashtag Can Reduce China's 13 Million Abortions Per Year

Sex education is woeful where it exists in China, and the consequences are stark — unplanned pregnancy and abortion rates are sky high. The WHO hopes to change that with a new campaign.
Photo by Raj Wong/EPA

Last Friday the World Health Organization's (WHO) China team sent out a suggestion to the country via social media: "We think it's time to talk about safe sex." Using the hashtag #gotitcovered on Weibo, China's version of Twitter, the organization aimed to help quell the spread of STIs among young people in the country by spreading information instead.

The fact that in 2014 over 90 percent of new HIV infections in China were sexually transmitted suggests that the organization is right to highlight this now. So do WHO statistics saying that around one in five sexually active young women in China will have an unplanned pregnancy, with a high proportion ending in abortion.


One third of people aged between 15 and 24 did not use any contraception the first time they had sex, according to WHO, which has launched a campaign aiming to provide "practical, factual information" to China's youth and young adults. It will also be conducting a series of polls aimed at finding out what they really think and do behind closed doors, and in which areas they most lack knowledge and confidence.

Despite China's new young urban generation's rapidly modernizing views dovetailing with the country's recent economic rise, China's sex education infrastructure is woeful, where it exists at all. This is causing dire consequences, being a major factor causing a much higher abortion rate than the global average — there are around 13 million abortions per year in China, around 1,500 an hour, according to the country's National Health and Family Planning Commission. Many believe the actual rate to be much higher as the commission's figure does not include abortions carried out at unregistered clinics.

The amount of young people in the country having sex is rising fast as the generation undergoes its own sex attitude revolution. These attitudes are clashing head-on with those of the more traditional older generations and authorities. This was highlighted last August when an amateur sex tape filmed in the changing rooms of a Beijing branch of Uniqlo went viral. Young people largely found it hilarious while the government reacted with fury, striving to punish the frisky shoppers.


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The notion that sex is intolerable outside monogamous relationships, installed by Mao Zedong when he took power in 1949, is still strong among these older generations – i.e. the generations in charge of sex education legislation, implementation and teaching.

The government is all too aware of the problems that this lack of education is causing. But authorities are reluctant to acknowledge that with more young Chinese having sex the most effective way to combat the problems is to equip this generation to the hilt with information about sexual health and contraception.

"China has a long historical tradition of advocating chastity," Li Yinhe, the Beijing-based sociologist, sexologist and author, told VICE News. "During the Cultural Revolution people's face would change when someone mentioned sex. Introducing sex education is so hard here because people want to put it off as late as possible. Mainstream opinion is against sex and for celibacy. Change is taking place but still, compared to other cultures, China is falling behind."

There are currently no standardized sex education classes or reading material lists for schools or universities in China. Some institutions do teach sex education but classes tend to be methodical and biology-led. "The classes are almost mechanical," said Dr Bernhard Schwartländer, the WHO's representative in China. "They don't go into the real issues young people have to deal with. There's no basis for discussion."


With scant sex information available in education institutions, young people in China tend to look to peers and the internet instead. But by the time many get motivated to seek out sex education online, it's often too late. "The unwanted pregnancy rates in China are mind-boggling," said Schwartländer. "It's almost like people are using abortion as a method of contraception and that obviously has a huge traumatic impact."

Speaking to China Daily last January, Guo Min from sexual health promotion NGO Marie Stopes International said: "Many young women who had abortions in our clinics said they did not know what a condom looks like. Most of these women are not well educated, including migrant workers, urban professionals and students. They are between 13 and 24 years old and never received any sex education. They had not heard of oral contraceptives or female condoms before."

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Shocked by the reluctance of authorities to act more decisively on this, some have taken matters into their own hands. Professor Fang Gang, director of the Institute of Sexuality and Gender Studies at Beijing Forestry University, is a social activist who promotes sex education and gender equality. He runs private sex education classes that cover relationships and emotional wellbeing as well as STIs, the biology of reproduction and contraception.

"Young people in China can know about sex by talking about it with friends and the internet, but knowledge through these channels is often wrong," he told VICE News. "Some schools teach about STIs and simple physiological knowledge. But what I teach is empowerment education that includes gender equality and how to be a good partner.


"China's sex education is usually just about abstinence, which aims to prohibit teenagers from sexual behavior, neglecting the joy of sex. The attitude is prohibition, punishment and threat. We are against this thinking. In some schools students are not even allowed to date. In our camps, however, we discuss what they will gain and lose in love and how to deal with problems so that we empower them to make their own decisions."

The style of teaching Fang advocates is incredibly rare in China. His camps usually only attract about 18 attendees per session, with parents generally reluctant to be proactive in signing up their kids to the paid-for courses. He has failed to set up sessions in Beijing, a city of 19.5 million people, due to lack of interest.

"When talking about sex education, parents automatically think it's unnecessary, as they think kids will know it naturally from the internet," said Fang. "But we have to teach them things they can't find on the internet."

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Those advocating for compulsory sex education also faces vocal opposition. "The Ministry of Education has issued documents calling for schools to have sex education but there has been strong resistance from anti-sex activists," said Li.

"For example, a few days ago someone was training teachers in Shandong province about how to conduct sex education and protesters went there," she added. "They sneaked in by pretending to be parents then claimed that the education would harm children. These people aren't in the majority, but their actions are extreme."


One step forward was made in Zhejiang province last month, when it was announced that machines distributing free condoms would be introduced to universities across the region within a year. The move was hailed as a small victory for sex education supporters, but an online backlash once more highlighted the attitudes causing the blockage.

Some riled Chinese citizens called the free condom move "government-approved promiscuity". Dr Schwartländer says: "If you say things not in line with mainstream opinion you get comments like, 'You're teaching my children to have sex.' And of course, if teachers don't have neutral, objective, or constructive attitudes to sex themselves, it's difficult to expect them to talk about it in a way that creates dialogue.

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"I've actually been trying to get this social media campaign idea through for a few years. My staff, especially the Chinese staff, were reluctant because they felt we couldn't talk about it in public. But that's exactly why I was pushing for it."

Many believe that true change will only happen when archaic views about sex die out with the older generations. "Maybe in ten years sex education will be acceptable, because the younger generation will have had sex at an early age," says Li. Fang, who is 47, is less optimistic, saying: "I probably won't see it happen in my lifetime. Maybe after 30 years or so."


The core problem is that "Chinese parents want to control their children," he said. "They are considered their property and they want to make them obedient even when they are at university. This is a matter for change for the whole concept of education, not just sex education."

It's too early to say whether the WHO's hashtag campaign will significantly increase awareness across the country, although early signs are positive. The hashtag has been viewed over 900,000 times since it was launched on Friday, with a WHO spokesperson telling VICE News on Wednesday: "There is clearly a thirst for more information from young people about sex and how to have safer sex."

This can only be good news, as small victories such as these build towards a critical mass and and hopefully makes legislative change eventually unavoidable.

Follow Jamie Fullerton on Twitter: @jamiefullerton1

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