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Most hospitals in China only offer reproductive services to married women

A MARTINEZ, HOST:

For four decades, China had a one-child policy limiting families to just one child. China is loosening birth restrictions because it wants families to have more kids - up to three, in fact. But nontraditional families like unmarried women still find themselves constrained by social norms. NPR's Emily Feng has this report.

EMILY FENG, BYLINE: The first thing Teresa Xu noticed when entering a Beijing maternity hospital was how many couples were there.

TERESA XU: (Through interpreter) It was a sea of people, mostly women, accompanied by their worried husbands and parents.

FENG: Like all the other women in the hospital that day, Xu was there to freeze her eggs. It was 2019, and Xu was then 31. But unlike the other women, Xu was unmarried and came alone.

XU: (Through interpreter) The doctor dismissively asked me, why not get a marriage license first?

FENG: Xu wants to have children but is prioritizing her career and can't guarantee she'll find a partner in time. She is now suing the Beijing hospital, which ultimately refused to allow Xu to freeze her eggs. The hospital cited their rules, which only allow married women to do so, but no law in China actually mandates this. Yet, Xu says cities still have rules which prevent unmarried women like her from accessing reproductive services.

XU: (Through interpreter) There are rules which say reproductive assistance services are only available to married couples. And while they don't mention egg freezing specifically, it's considered such a service.

FENG: Liu Minghui is a legal expert who specializes in gender discrimination cases. She testified in favor of Xu at her court hearing earlier this year. She points out unmarried men have no problem freezing their sperm in China.

LIU MINGHUI: (Through interpreter) It comes down to conservative values, and unmarried women who have children are usually found to have violated the catchall legal rule of, quote, "keeping up public order and morality."

FENG: Even though the one-child policy is gone, most hospitals only offer reproductive services to women who can prove they're married by requiring them to bring their marriage licenses to appointments. This is a problem that's likely to grow because 44% of young Chinese urban women say they do not want to get married. A quarter of men say the same, according to a survey by the Chinese Communist Youth League. And divorce rates are rising. And yet, at the same time, China wants its younger citizens to have more children. Years of the one-child policy depleted the country's birth rate, and China's pool of able-bodied workers is shrinking while that of its senior generation is growing as a result. Here's Liu, the legal expert, again.

LIU: (Through interpreter) China's birth rate of 1.3 children per woman is already lower than the international average. Our population is decreasing. I traveled to China's south and see empty factory lines because there aren't enough workers to hire.

FENG: Unmarried people are not waiting around for social mores to catch up to China's three-child policy. In fact, more and more unmarried women and men have been taking matters into their own hands. One of them is Fen, a 33-year-old lesbian who cannot get married because China bans same-sex unions. So Fen bought sperm from an American donor and now has twin toddlers. Fen says mothers like her have to use a private hospital in China for IVF.

FEN: (Through interpreter) Public hospitals won't take a case like mine. Even the sperm has to come from a private donor through an unregistered sperm bank.

FENG: We're not using Fen's full name because having a child this way lies in a legal gray area. And recently, China has been quietly cracking down on such LGBTQ reproductive services. When it came time to register the births of her children, Fen simply left the father's name blank.

FEN: (Through interpreter) I'm in total panic when people ask me who the father of my children is. Sometimes, I don't know how to respond.

FENG: China has made some improvements for unmarried mothers. It used to be nearly impossible to register their children for the Chinese equivalent of a Social Security number. But now just one parent can apply for this identification document, which is key to accessing education and social benefits.

UNIDENTIFIED PERSON: (Through interpreter) Now, the process is similar for all mothers. The only difference is unmarried mothers have to pay the cost of birth. Married mothers have it covered by state insurance.

FENG: This mother lives in Shenzhen, and she wants to remain anonymous because she fears social stigma for having a child outside of marriage. She says she was able to easily get her child a birth certificate but with caveats.

UNIDENTIFIED PERSON: (Through interpreter) The local office notified me that because my child is born outside of the national birth planning rules, my child cannot go abroad before they turn 18. If my child wants to become a public servant, they need to track down the father's information, too.

FENG: The hope is that in spite of all these hurdles that nontraditional families face, China's new three-child policy will liberalize reproductive restrictions. One person betting on this is Shaw (ph) the founder of Pang Baba (ph) or Fat Daddy, a Chinese surrogacy and IVF agency that caters to LGBTQ couples and unmarried parents.

SHAW: (Through interpreter) Look at Russia, another socially conservative country. They legalized surrogacy around when their birth rate was plummeting. A similar drop in China might lead to relaxation of reproduction rules.

FENG: We're using only Shaw's first name because surrogacy is illegal in China, and despite the three-child policy, open discussion about same-sex parents and surrogacy still gets deleted on Chinese social media for being politically sensitive.

SHAW: (Through interpreter) Our advertising has become ever more difficult because of increased censorship, and my social media accounts are often frozen.

FENG: Instead, Shaw now relies on in-person meetings and word of mouth to sign up about 30 clients a month, he says. It's just a trickle, but it is a sign that social mores, if not official policy, are slowly changing. Emily Feng, NPR News, Beijing.

(SOUNDBITE OF GOLD PANDA'S "LONELY OWL") Transcript provided by NPR, Copyright NPR.