China's growing underground surrogacy market amid population decline sparks controversy over wealth gap and women's rights
China's growing underground surrogacy market amid population decline sparks controversy over wealth gap and women's rights
In recent years, surrogacy has become a controversial issue in China. A recent scandal involving an underground surrogacy agency in Shandong Province sparked another wave of outrage on Weibo, China's Twitter-like social media platform. The agency, operating under the guise of a "biotech company," was exposed by Henan TV for engaging in illegal surrogacy activities and exploiting women for profit.
According to the undercover investigation by Henan TV, a nearly abandoned auto trade center in Qingdao, Shandong, was hiding what was claimed to be the "largest underground surrogacy lab" in northern China.
"Surrogacy costs 750,000 yuan for one child, with an additional 200,000 yuan if you want to choose the baby's gender. We guarantee success."
In the lab, women were ranked as either high-end or low-end based on their appearance and health. They had no names, only codes, and their bodies were referred to by the lab's boss as "land," with each egg priced and sold like merchandise.
Some young women had "donated" their eggs 17 or 18 times, often as frequently as every three months. In some cases, eggs were extracted without anesthesia, with immense pain and risk.
The report also revealed that doctors from top-tier hospitals were colluding with the surrogacy agency, conducting illegal procedures such as egg extraction and embryo implantation. The cost per procedure was 1,500 yuan, with anesthesiologists charging 2,000 yuan per session, requiring clients to bring their own anesthetics.
It's hard to believe that such an illegal and exploitative industry was operating so openly, right under the public's nose, with the involvement of several experts from top hospitals. [source]
While surrogacy has existed in China for some time, this scandal shocked the public by revealing how far the underground surrogacy market has grown into a large, intertwined industry.
The demand for surrogacy rises
According to an investigation by Caixin, the surrogacy industry has grown into an intertwined industry in China over the past decades:
In 1988, the first test-tube baby was born in mainland China. Ten years later, the country's first test-tube baby born to a surrogate mother was delivered in Beijing. Since then, the surrogacy market has quietly emerged.
In 2004, Lü Jinfeng from Dongtai, Jiangsu Province, discovered the surrogacy business abroad. He then launched what he claims to be China's first surrogacy website, AA69. Today, Lü says his business has expanded nationwide, with offices in Shanghai, Guangzhou, Wuhan, Beijing, Shandong, and other locations. These companies often operate under the guise of "biotechnology companies." In an interview with China Newsweek, Lü stated that AA69 has completed over 10,000 surrogacy cases in more than a decade.
During an undercover investigation, an industry insider revealed that in his city alone, there are over 100 companies of various sizes offering surrogacy services, with nearly 10 being large-scale operations. Based on this estimate, there might be around 1,000 enterprises nationwide providing surrogacy services, with 20 to 30 of them being sizable. Initially, commercial surrogacy existed mainly as certain surrogacy websites or individual webmasters. After more than a decade of industry development, they now operate as health consulting service companies, primarily located in major cities like Guangzhou, Wuhan, Shanghai, and Beijing.
The debate over whether surrogacy services should be legalized has been ongoing in China for years. Two important reasons driving the demand for surrogacy are infertility and the relaxation of the one-child policy. Many women who wished to have a second child by the time China allowed the two-child policy had already reached an age where the pregnancy was unsuitable, leading many to turn to surrogacy instead:
According to reports, the demand for surrogacy has increased significantly in the past two years. A surrogacy agent specializing in overseas services, who wished to remain anonymous, told Caixin reporters, "Now, more middle-aged couples are coming to us for surrogacy." Zhou Ang, a marketing specialist at the Las Vegas Fertility Center in the U.S., said that at her clinic, Chinese clients seeking overseas surrogacy have "increased by two to three times since 2014, many of whom are having a second child." Notably, 2014 was the year when the Chinese government relaxed the "single-child policy" to allow certain couples to have a second child.
On the other hand, surrogacy has also become a last resort for families suffering from infertility. According to a 2012 survey released by the China Population Association, the number of infertile patients in China has exceeded 40 million, accounting for 12.5% of the population of childbearing age, compared to only 3% more than 20 years ago. Chen Hua, an associate professor at the Guangdong Medical Ethics Research Center, said there are no authoritative statistics at present, but it is certain that "the infertility rate is rising, especially in first-tier cities." [Caixin]
As of now, Chinese law does not explicitly prohibit surrogacy. Only the Administrative Measures for Human Assisted Reproductive Technology, issued by the former Ministry of Health in 2001, clearly stipulate that "medical institutions and medical personnel shall not implement any form of surrogacy technology."
It is under such circumstances that discussions about legalizing surrogacy continue to gain traction in China, and the possibility of surrogacy has entered the lives of many Chinese families. Growing demand has led many families to advocate for its legalization, believing that this could create a safe, regulated, and transparent environment for surrogacy.
The controversy: a privilege reserved for the wealthy?
Currently, some underground surrogacy operations involve dangerous procedures performed on surrogate mothers in unregulated environments, where unqualified personnel handle critical medical tasks. This leads to unsafe and unethical conditions. Advocates of legalized surrogacy argue that regulation and law enforcement would make the market more transparent.
However, nationwide legalization of surrogacy services is unlikely due to widespread controversy. The main concern is that if surrogacy were legalized, it could legally exploit women from lower socioeconomic backgrounds who see surrogacy as their way to escape poverty. The bodies of surrogate mothers could be treated as mere vessels.
On one hand, affluent couples could pay exorbitant amounts—up to 950,000 RMB ($130,000)—to select the gender of their children and guarantee a successful birth. However, this comes at the expense of surrogate mothers, often from rural areas, who are exploited by middlemen and agencies.
A unique aspect in China is that, according to one insider, "100% of Chinese couples choose the gender of the child, with 90% selecting boys." Occasionally, clients even pretend they are pregnant and go to great lengths to fake it—"buying fake bellies and obtaining false medical certificates from local hospitals."
Surrogate mothers are typically women from remote rural areas who have already given birth. The money they earn from one surrogacy can be enough to build a small Western-style house in their village, which garners family support as they hope to improve their economic situation.
The terms offered by surrogacy agencies are highly enticing. A Caixin reporter, posing as a job applicant, contacted one such agency and was told: "You can earn 20,000 RMB for referring someone, and the surrogate mother gets 200,000 RMB in cash (with food and accommodation included). The requirements are that the surrogate be under 32 years old, in good health, particularly in gynecological aspects, with regular menstruation, and have had a natural childbirth." [Caixin]
This imbalance of power raises ethical questions about whether surrogacy is a fair transaction or simply a form of economic coercion.
Moreover, many worry that surrogacy could become a privilege reserved for the wealthy. While some families turn to surrogacy due to infertility or unsuitable age, others may simply exploit this privilege.
For instance, in 2021, Zheng Shuang, a prominent 29-year-old Chinese actress with over 12 million followers on Weibo, was banned from the Chinese internet after it was revealed that she used surrogacy in the U.S. to have two children, whom she reportedly abandoned following a breakup with her boyfriend.
The abandonment of children, the use of surrogacy as a convenience, and the involvement of wealthy individuals who can bypass China's laws by seeking services abroad fuel debates about whether surrogacy should be more strictly regulated or legalized domestically.
The global debate
Surrogacy remains a contentious issue not only in China but worldwide. Proponents argue that it offers a solution for infertile couples and LGBTQ+ individuals seeking to build families.
From a social perspective, the issue of surrogacy taps into the broader concerns about China's population crisis. With fewer young people and a rapidly aging population, there is an increasing demand for alternative ways to have children. In China, with a rising number of couples unable to conceive naturally, surrogacy might seem like an obvious solution. However, legalizing surrogacy would not necessarily solve these issues, and it could lead to even more cases of exploitation.
One alternative to surrogacy is adoption. However, traditional Chinese values often place great importance on blood relations, leading many families to prefer having a child of their own lineage, which can make adoption less acceptable.
This brings up the question: Is surrogacy just another example of the wealthier classes exploiting the poor?
