Pensioners and Preschoolers Mix it Up in Chinese Nursery


GUIZHOU, Southwest China — It’s late afternoon, and, indifferent to the slight drizzle, children are chasing each other around the playground. A few floors above, a group of retirees is sitting on chairs or leaning against the railing, looking down. “It’s my favorite time of the day,” 85-year-old Liu Guirong says. “Watching them play is very invigorating and satisfying.”

Liu lives in Xiyanghong, a combined retirement home and kindergarten in provincial capital Guiyang. Here, 3- to 6-year-old preschoolers and people aged 73 and up spend parts of the day together. This way, according to the home’s philosophy, the young learn from the old, and the old stay young.

Worldwide discussion about intergenerational centers started when one opened in 1970s in Tokyo. In the decades since, they have spread across Japan, Europe, and North America. But unsupportive governments and hesitant parents have made the idea less popular in China. Despite a growing glut of lonely elderly, Xiyanghong is just one of two such centers in the country.

Xiyanghong — the name means “sunset glow” — wasn’t an instant success, either. Established in 1996, it was Guizhou’s first privately owned nursing home. A few years ago, founder Xue Mei was looking for a way to give Xiyanghong a homier atmosphere and met Deng Sha, who worked in early education. The pair decided to collaborate, and they turned the care home’s ground floor into classrooms for about 50 kindergarteners, with all three floors available for around 80 elderly residents. Two to three people share each room, which comes with a bathroom, balcony, and mountain view.

Founder Xue Mei poses for a photo in the garden of Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying/Sixth Tone

Founder Xue Mei poses for a photo in the garden of Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying

But when the kindergarten opened in 2014, only one pupil joined. “Parents thought putting their kids with the ‘dying’ elderly would be hard to imagine,” Deng, 32, says. There was also some behavior that needed correcting. Retirees sometimes failed to set a good example and would, for example, thoughtlessly discard bones on the floor during lunch. Rambunctious children had a habit of running full speed into their frail neighbors.

Another stumbling block was staff. “Nursing-home workers felt they were already exhausted from taking care of the elderly, while kindergarten teachers had a hard time getting used to the stubbornness of the older residents,” says 69-year-old Xue.

But initial feedback was positive, and word-of-mouth recommendations attracted more and more parents. Now there is a waitlist for new kindergarteners, and staff are more on board. The one group that never needed much convincing was Xiyanghong’s elderly residents. “I saw their eyes shine when watching the kids from upstairs,” says Xue. “Before that, they were just muddling and waiting to die.”

Xue says the presence of children improves seniors’ physical and mental health, reducing loneliness and depression. “For children, interaction with older people supports their learning and boosts their social development,” she says. It also teaches them the traditional Chinese virtue of respecting the elderly. “When kids see with their own eyes that older residents grab plates with trembling hands despite being much taller and bigger than them, they can see the fragility of life; they will take pity on the elderly and establish a sense of caring,” explains head of kindergarten Deng. “Everyone is more responsible for one another.”

Such anecdotes are in line with international experiences. Judith Ish-Horowicz, co-founder and principal of Apples and Honey Nightingale CIC, the U.K.’s first intergenerational nursery, says it hasn’t encountered many problems since its launch in 2017. “The initial difficulty is to get people to understand that we are not going to leave the children in the care of the residents,” she tells Sixth Tone. The mixing of generations has proven beneficial, according to the company’s own evaluations. The elderly, especially those with dementia, enjoy the mental stimulation. Children have improved their language ability faster than before, and, Ish-Horowicz says, they enjoy the patience of people who aren’t in a rush.

Sue Davidson, director of Bethlehem Intergenerational Center in the state of Michigan says the model is also relatively new to the U.S. The institution had been operating as a child care center for decades until it introduced the program to enrich the lives of the elderly two years ago. “Parents all love this idea,” Davidson tells Sixth Tone. “It helps seniors find a new meaning of life.”

In Bethlehem, the two age groups take part in organized activities together, such as reading books or baking cookies. However, in Xiyanghong, shared activities are mostly spontaneous. Children sing and share birthday cakes with the seniors or bring water to a resident’s room for the nursing assistant to bathe them. Most of the day is spent apart. The senior apartments and kindergarten have their own dining rooms, living areas, and entrances.

Apples and Honey Nightingale CIC mentions in its case study report that it hopes to see 500 intergenerational institutes developed across the U.K. over the next five years. Such a rollout is unlikely in China. “We work twice as hard to take care of two vulnerable groups, but we don’t get as much in return financially,” says Deng. The kindergarten is responsible for its own profits. The government subsidizes a one-time 3,000 yuan ($437) operational fee for each bed in the nursing home, and 300 yuan a year for each elderly resident.

Deng Sha plays on the seesaw with her daughter at Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying/Sixth Tone

Deng Sha plays on the seesaw with her daughter at Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying/

Elsewhere in China, intergenerational centers have proven unfeasible. When Hu Yanping attempted to experiment with this model over a decade ago, after visiting intergenerational centers in Japan, the lack of support and applicable governmental policies made her reconsider. Now, as the director of Golden Age, a high-end retirement community in the eastern city of Hangzhou, she cooperates with nearby kindergartens to organize activities in which children and elderly residents can interact. Hu says it’s difficult to build a long-term program. “Every activity requires the strict approval from the education bureau, and sometimes the heads of the kindergartens feel that such extracurricular activities have safety risks and more,” she says.

At the end of last year, an intergenerational center in the eastern city of Nanjing closed its nursing home after 16 years. Its head, Chen Qi, tells Sixth Tone that it’s unrealistic to integrate the two vulnerable populations within one institution: “It’s not in line with China’s national conditions and people’s mindsets.” Chen explains that parents proved unwilling to let their children live with the elderly because of concerns about the group’s manners and physical conditions. For many working Chinese parents who leave their children in the care of their aged parents, there are often conflicts in parenting styles. Some objections were also based on deeply held beliefs that people near death bring bad fortune. “As death is still a taboofor Chinese people, they’re against the idea of having the kids and the elderly’s hearse enter and exit through the same gate,” says Chen.

The entrance to the nursing home facility in Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying/Sixth Tone

The entrance to the nursing home facility in Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying/Sixth Tone

Deng says seniors passing away hasn’t been a problem in Xiyanghong, where both groups don’t even share the same entrance to the building. The kindergarteners receive death education, in which they learn about the cycle of life, making death less of a shock to them, Deng says. “When they spend time with the elderly on a regular basis, they see the wrinkles and wheelchairs, and they realize people will get tired when they are older.”

Chen Xuanjin — no relation to Chen Qi — visited her grandmother over the past decade when she resided in Xiyanghong. She recalls that, before the kindergarten opened, her grandmother and other residents didn’t speak much. “I felt like they were just lying and dying,” she says. “Their lives had become black and white; however, the children are like colorful strokes, giving them confidence and hope to live again.” Her grandmother, who had a stroke and paralysis, made the effort to walk around to see what the children were doing. That convinced Chen to send her daughter to the kindergarten.

Every Thursday after their cooking lesson, Chen Xuanjin’s daughter brought cakes to her great-grandmother’s room and fed her. “Usually, we don’t have a strong bond with our great-grandparents, but my daughter remembers my grandmother’s bed and her favorite food, which I believe is the inheritance of family emotions,” she says. “Maybe she can’t integrate these feelings now, but the seed has been planted in her heart to teach her to respect and cherish lives.”

When Hou Ying first visited Xiyanghong to see if it would be a good place to send her son, she noticed the elderly right away and wondered how the combination would work in practice. But when she saw how much residents enjoyed the children, she was reassured. “My grandfather and I had a very good relationship, but when I went to college, I had very little contact with him, which I regret,” she says, tearing up at the thought of her grandfather, who passed away last year. “I want my son to have the love and care from the elderly while he’s little, which I believe will make him strong and optimistic when he grows up.”

Children draw in a classroom at Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying/Sixth Tone

Children draw in a classroom at Xiyanghong, Guiyang, Guizhou province, June 17, 2019. Fan Yiying

Liu, the resident, moved to Guiyang from eastern Shandong province with her husband in 1964 to support railway construction in southwestern China. She’s lived in Xiyanghong since 2012, moving in after her husband passed away. Her only child works in another city and visits her once a year. “Life was somewhat meaningless before these little babies came along,” she tells Sixth Tone. “I was so lonely and waiting to die, until one day I heard the sounds of the children downstairs; all of a sudden, I felt like I had a reason to live again.”

For last month’s Dragon Boat Festival, the children and elderly made zongzi — glutinous rice with different fillings wrapped in bamboo leaves. When Liu recalls showing the children how to fold the leaves, she’s all smiles. “They called me Grandma,” she says. “They made a mess, but who cares?”

Additional reporting: Ai Jiabao.


This article was published on Sixth Tone.

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Chinese Asexuals Navigate Love, Duty, and Ignorance


SHANGHAI — When Marie Guo confided in her dormmates about her asexuality, she received little sympathy. Instead, they questioned how a virgin could be so sure she didn’t feel sexually attracted to anybody. “They suggested I have sex with my boyfriend and emphasized I needed to do it repeatedly before drawing a conclusion,” Guo tells Sixth Tone.

Being questioned, ridiculed, and dismissed is a common experience among people who identify as asexual, a sexual orientation defined as lacking sexual attraction to others. But while there is some public knowledge of asexuality in other countries, in China ignorance is still widespread.

In a 2004 paper, Canadian psychology professor Anthony Bogaert estimated that asexuals account for about 1% of the world’s population, which would mean the sexual minority has about 13 million members in China. Many of them fear coming out — especially to older generations, who often put immense value on marriage and having children. Parents find asexuality hard to accept or see it as a disorder that can be cured. Some interviewees did not use their Chinese given names to protect their privacy.

Asexuality is often confused with sexual dysfunction, where people with disorders experience distress due to their lack of sexual attraction — something asexual people don’t typically feel. Some asexual people say they masturbate to relieve tension — as does Guo, who remembers being met with more disbelief when she tried to explain this to her dormmates. Other people who identify as “little A,” the common nickname in China for asexual people, have sex only to satisfy their partners.

Diane Xie cannot imagine how it would feel to have sex with someone. “When people say someone is sexy, I have no idea what it means,” she says. When searching for answers online, she found AVEN — the Asexual Visibility and Education Network, the world’s largest online community for asexual people. After reading its explanation of asexuality, she exclaimed that this was who she was. But she was still a bit uncertain, wondering if maybe the person who could interest her sexually just hadn’t shown up yet.

Therefore, when studying in Hong Kong in 2015, Xie began dating a Dutch student for whom she had feelings. She tried intimacy up to second base but felt nothing other than uncomfortable. “I thought he was attractive and I really enjoyed hanging out with him, but I just didn’t have the desire to have further physical contact with him,” says the 24-year-old Shanghai native, who wears a black ring on her right middle finger, an internationally used sign for asexuality.

Diane Xie shows her black ring at a café in Shanghai, 2019. Fan Yiying/Sixth Tone

Diane Xie shows her black ring at a café in Shanghai, 2019. Fan Yiying

Chinese academic research into asexuality is, for now, limited to just one paper, published in 2018 by researchers at Southwest University in the city of Chongqing. The findings of their study of 284 individuals who were certain they were or thought they might be asexual were in line with results in the West. But what the country lacks in scientific writing, it makes up for in social media activity. Popular apps like DoubanZhihu, WeChat, and QQ all have asexuality communities whose members can number in the tens of thousands.

When Yin Xuyan’s middle school classmates started to obsess over celebrities or experience their first loves, she remembers feeling nothing. “I don’t even have the experience of having a crush on someone, and I have no impulse at all to fall in love,” says the 19-year-old from the eastern city of Yangzhou. She then began to reflect on whether she’d suffered any physical or mental trauma in childhood, but other than her mother telling her that girls can’t touch boys or masturbate, she couldn’t think of anything. She sought porn catering to female pleasure, but that didn’t arouse her either.

Like thousands of others before her, Yin found the answer on Douban. “The moment I knew I was asexual, I felt so relieved,” she says. “Everything seemed to make sense then.” But when Yin told her best friend, she didn’t take it seriously. “Maybe no one will ever take it seriously,” Yin says. The freshman doesn’t talk much about her sexuality, and when people ask whether she has a boyfriend, “I just pretend I’m a good student who wants to devote herself to studying and has no time for dating,” she says, laughing.

But Yin will have to tell her conservative parents at some point and has been preparing what she calls a “psychological setup” since middle school. “I told them I might not get married in the future, and I act like a proactive feminist who doesn’t accept any patriarchal suppression,” she says. The argument lasted three years before they tacitly accepted that their daughter might be single for the rest of her life.

“While asexual people in Western countries are getting recognition and equal treatment, most asexuals don’t dare come out in China,” says Su Yanchen, one of the authors of the 2018 paper. He hopes their research can increase the social visibility of the asexual community and give them the opportunity to speak up in China. “Asexuals must expand their influence and fight for more rights, just like other LGBT groups, if they want to be recognized and live happily in this sexual-dominated society,” he says.

Compared with other sexual minorities, public awareness of asexuality is much lower. “Homosexuality is at least in line with the mainstream view that everyone needs sex, but asexuality is farther away from the mainstream,” says Frank Gao, a 26-year-old graduate student currently living in Germany. He previously identified as gay, but after dating men for years, he felt that something was off: Sex was boring to him. “It’s just as boring as when we are required to write something 100 times by the teacher as punishment,” he explains. “I don’t want sex, and if I have to do the same action many times, it bores me.”

During his senior year at university, Gao came across the term “asexuality” on an LGBT forum and started to reflect. “It shocked me,” he says. “I had lived as gay for years, and all of sudden it changed.” In 2011, an online survey of 3,436 people aged 16 to 25 who identified as asexual suggested that women asexuals significantly outnumber their male counterparts. And the percentage of asexual people who are attracted to the same sex is much lower than the percentage of those who like the opposite sex. This means that someone like Gao, a male asexual who’s into men, is a minority within a minority.

None of Gao’s ex-boyfriends are asexual. When he told them he didn’t enjoy sex, they thought it was because he is “too rational.” The lack of a sex life affected his relationships. “Most gay men have a strong libido, and that’s why if I didn’t have sex with my exes, they’d often complain that I didn’t love them.”

Gao has been dating another Chinese student in Germany for a year. The couple have a lot in common, from values to interests — except when it comes to sex. But Gao says they compromise and have negotiated to have sex twice a month: “This frequency is quite low for a gay person, but we are willing to sacrifice for each other.”

It’s hard to explain to sexual people what asexuality is, says Gao, who often attempts to do so both online and offline. “They can’t empathize with what it means for someone not to be sexually attracted to any gender,” he says. Once Gao was asked if he had sexual desire for animals. “The public is set on the idea that humans have a desire for something,” he says.

When Jenny Wang explained to her roommates last year what sex means to asexual people, she used a metaphor. “Everyone has a few kinds of food that they don’t crave but don’t absolutely reject, either.” They understood right away, which Wang doesn’t think would happen with her parents and friends back home in China’s southwestern Yunnan province, where awareness and information about such topics are scarce.

Despite her successful food metaphor, Wang thinks there is little understanding among the public: “If we don’t have sex, people would ask how come we know we are asexual before we try it; but if we do have sex, people question how we can do it if we are asexual.”

Wang started identifying as asexual after moving to Shanghai in 2017 to study journalism. She did the Kinsey Scale test, designed half a century ago by sex research pioneer Alfred Kinsey. In his sexual orientation research, Kinsey reported that 1.5% of the population didn’t have any sexual reactions, and so he created a new category, “X,” for them. “I felt happy when I saw the X result, meaning I’ve fully accepted myself,” says Wang.

Wang joined a WeChat group of over 180 Chinese asexual people last year. There, she found a sense of belonging. Group members chat daily about everything from LGBT events to self-motivation. “I feel they feel me, and it’s easier to find common ground with them — and more importantly, I don’t need to think too much before I share my feelings,” says the 20-year-old.

A few months ago, Wang’s best male friend confessed his love to her. Wang turned him down after hesitating for two days, in large part because she’s afraid her asexuality will affect the relationship. “The most intimate thing I can accept,” she says after a long pause, “is probably hugging, and kissing on the lips at the most.”

Though having a child is not in her life plan, Wang already knows her parents will make her have one. Growing up in a small town where most girls have their firstborn before the age of 20, she doesn’t want to come out to her parents until she’s financially independent. Her parents, who are in their early 50s, still believe gay people are mentally ill — a thought that lingers, despite homosexuality being taken off China’s list of mental illnesses in 2001. “If I want to live the way I want, I must stay in Shanghai after graduation, because people here are much more open-minded,” she says.

Chen Mei, 27, found out she’s asexual while at university and has been married for nearly a year now. She told her husband she’s asexual when he asked her out for the first time. Though he had little clue of what the term entailed, he searched online and was considerate. “He said he’s OK with this, and I have feelings for him, so we’re together,” Chen says.

Just like Gao and his boyfriend, Chen and her husband discussed how often they would have sex before registering their marriage. “Any couple needs to adjust to one another,” she says. “Even in sexual relationships, things don’t always go smoothly. Sexual compatibility is just one of many factors that a relationship needs to take into account, such as life goals, lifestyle, and personality matches.”

Chen isn’t actively seeking asexual friends to bolster her sense of belonging. She’s happy with her current life. “Asexuality is just one of my identities. It doesn’t make my life better or worse. Asexual people just have different needs and meet different challenges from sexual people.”


This article was published on Sixth Tone.

How ‘The Penis Monologues’ Challenges China’s Toxic Masculinity


ZHEJIANG, East China — On a theater stage in the city of Hangzhou, a male character reflects on the time he date-raped a woman. “I finally broke through her defense and forcefully penetrated her. Controlling her, I felt the happiness of a conqueror. The insertion of my penis seems to have stamped a seal on her body, a label marking my sovereignty.”

The unflinching scene is part of a monologue in “The Penis Monologues,” a play that pitches itself as a counterpart to the well-known feminist play “The Vagina Monologues.” Written by Fang Gang, a renowned Chinese sexologist, “The Penis Monologues” examines aspects of what Fang calls “dominant male temperament” — a phrase that shares certain similarities with the English phrase “toxic masculinity.”

Based on real case studies collected during Fang’s research on gender while at Beijing Forestry University, the play’s 12 episodes are all performed by 10 amateur male actors. Before coming to Hangzhou in May, performances took place in Beijing and Shenzhen. However, Fang’s also had to overcome his fair share of obstacles in China, where frank conversations about sex and gender are still taboo. A performance in the southern city of Guangzhou was abruptly canceled for unknown reasons, while the show’s Chinese name deliberately avoids using the word “penis.”

Despite its limited run, “The Penis Monologues” is a remarkably candid examination of sex and relationships in a deeply patriarchal country. In 2017, a wide-ranging online survey of college students found that it was not uncommon for respondents aged between 18 and 22 — most of whom were female — to experience sexual harassment on campus, but that less than 4% would report it to the school authorities or police. And although dozens of women spoke upabout sexual harassment issues in the country last year, the impact has not been as strong as in Western societies, where soul-searching is taking place among certain groups of men.

Fang hopes “The Penis Monologues” will prompt more heterosexual Chinese men to reexamine the ways they approach and treat women. “I want to reflect on and criticize the violence of men against women, and promote gender equality from a male perspective,” Fang tells Sixth Tone. “Unilateral efforts from women are far from enough; men must act, too.”

That raison d’être resonates with Tao Xiaotao, a social worker specializing in sex education who is also the play’s Hangzhou producer. The mother of two young boys hopes that news of the performances will spread on social media and get more straight men thinking about their interactions with women. “Drama is a more acceptable form of expression (than directly calling for change), as it’s easier for people to relate to characters in a play, which then prompts them to reflect,” she says.

But the play’s subject matter hasn’t made it easy for Tao to find willing actors. Most men she approached declined after reading monologue titles like “Penis Size,” “Domestic Abuser,” and “Erectile Dysfunction.” “They are afraid of being mocked or judged by the public,” she tells Sixth Tone.

When 42-year-old business owner Yu Lei read the play for the first time, he was shocked that it so boldly addressed taboo subjects. But after attending one of Fang’s sex-ed public lectures and seeing members of the audience calmly taking notes, he decided to join the troupe, despite never having acted before.

Tao assigned Yu to the play’s first monologue, “Date Rape,” which tells the story of a male college student forcing his girlfriend to have sex with him in a hotel room. Yu was so nervous about performing that he told his wife he was taking part in a charity event organized by White Ribbon, the advocacy organization launched by Fang in 2013 to end the violence perpetrated by men against women. But he needn’t have worried: His performance wins thunderous applause from the 90 or so people in the audience, though Yu later confesses to Sixth Tone that he slightly regrets doing it. “I’m afraid people might think it was my own story,” he says.

Unlike Yu, Wang Hongqi directly told his wife about the play. On the night of the performance, she sits in the audience alongside their 6-year-old son. Despite the play’s occasionally explicit content, Wang doesn’t worry that sex-related topics might adversely affect his child. “Kids think all this stuff is perfectly normal and natural,” Wang says. “It’s the parents who don’t know how to give them a proper sex education.”

Wang, who used to work for a company that builds subway systems, once accepted the combination of extreme work hours and after-work social gatherings organized by his male bosses. But that culture kept him from spending time with his family, causing his wife to claim she was trapped in a “widow marriage.” So, Wang decided to make a change: In 2015, he quit his job and opened one of only a handful of sex shops in Hangzhou.

But as Wang’s new business flourished, he became more and more concerned about male chauvinism found in sex culture. “Most of my male customers want to buy something that can make them bigger downstairs or last longer in bed, but few of them care about what their female partner wants to experience in her sex life,” says the 41-year-old. “Sexual violence can be more subtle than physical violence, but it’s still something we should discuss and pay attention to.”

Assertions of masculinity come up often in Fang’s play. Several monologues dwell on the so-called masculine temperament, which “requires men to succeed in their careers and be in a dominant position in their relationships with women,” Fang says. The anxiety to assert their manliness brings men not only “welfare and power,” but also stress and pain, he explains.

Two actors portray the story “Gender Queer” during the play “The Penis Monologues” in Hangzhou, Zhejiang province, May 18, 2019. Fan Yiying/Sixth Tone

Two actors portray the story “Gender Queer” during the play “The Penis Monologues” in Hangzhou, Zhejiang province, May 18, 2019. Fan Yiying

That pain is familiar to Ye Chuyang, a queer actor portraying their own experiences in the monologue “Gender Queer.” “I don’t agree with binary gender divisions, because it limits people’s possibilities,” Ye tells Sixth Tone. “Most people think men are supposed to be macho, decisive, and strong. They don’t appreciate feminine or delicate men. Though my parents appreciate the sensitive and gentle side of me, they prefer me to be strong and tough just like other boys.”

Ye thinks the play is a chance to both educate people about sexual diversity and help more men understand the experiences of women. “If men could break the rules and speak out, women would feel encouraged and less lonely in this battle,” he says.

Gu Wei’s story, meanwhile, is probably the most personal. A former domestic abuser, his monologue reflects on how, in the past, he treated his now ex-wife as a possession and didn’t tolerate any challenges to his authority in their marriage. “It’s typical dominant masculinity,” he says.

Gu, who has since reformed his behavior and become an activist and volunteer at White Ribbon, hopes to raise awareness of an issue that many Chinese women suffer in silence. Though a national law to protect victims of domestic violence came into effect in 2016, in reality women who report abuse seldom receive adequate help from the authorities, which sometimes list domestic violence cases as “family conflicts.”

Born in 1999, Luo Bin is the youngest in the crew. Growing up, Luo witnessed how his grandfathers dominated the family and how they snapped at his submissive grandmothers. The young Luo concluded that such behavior was normal. After he got to college, he sided with his male friends when they complained that their girlfriends wouldn’t have sex with them.

Working on the play has convinced Luo that his long-held attitudes toward gender roles are misguided. “It didn’t occur to me that when your girlfriend says no, it means no,” he says. “We hurt girls before we know it. I hope the play can make the public aware of date rape and prevent it from happening.”

The sophomore college student acts as the play’s host, going up to other actors and asking questions like “What’s a real man?” and “What’s your favorite sex position?” The questions sometimes make the spectators visibly uncomfortable, but Luo thinks they’re necessary to foster open conversations about gender equality. “Now I know if we don’t give people the right to choose what they really want, then it’s not equal at all,” he says.


This article was published on Sixth Tone.

Fighting China’s Shame and Ignorance on Postpartum Incontinence


SHANGHAI — When Chen Lijun explains the damage giving birth can do to the body, the young women in her audience gasp. Unsatisfying sex, prolapsed organs, and an inability to hold in your pee aren’t exactly the sorts of things their mothers told them about.

But, to her audience’s obvious relief, there are solutions, says Chen, a health instructor who specializes in the pelvic floor — the web of muscles that support the bladder, bowels, and uterus in women. Even though pelvic floor problems are common among mothers worldwide, millions of Chinese women remain unaware of them.

The Chinese Medical Association said in 2011 that 18.9% of adult Chinese women experience stress urinary incontinence (SUI), a leakage of urine that occurs when the abdomen is placed under strain, even by simple actions like coughing, sneezing, or laughing. But China Women’s News, a newspaper affiliated with the state-backed All-China Women’s Federation, puts the figure at nearly 50% with just one-tenth of those affected seeking treatment. In absolute terms, this would mean roughly between 93 million and 246 million Chinese women have untreated SUI.

Although postpartum incontinence is common, many new mothers are afraid or embarrassed to talk about their urinary incontinence. The event where Chen is a speaker — called “Pelvic Floor Awakening” and hosted on May 11, one day before this year’s Mother’s Day — aims to raise awareness. It is jointly organized by Yummy, an online platform for Chinese women to discuss sex, and British intimacy brand Durex. More importantly, says Yummy founder Zhao Jing, the message is “to let women know that they are not alone in this battle.”

Growing up, few Chinese women who are now in their 20s and 30s were ever told by their mothers what it is like to give birth, and how to deal with the physical and mental toll it can take. “But the younger generation is paying more attention to their feelings and needs,” says Zhao. She decided to organize the event after noticing an increase in Yummy users sharing their awkward experiences leaking urine while laughing, coughing, or running during pregnancy or afterward.

Attendants watch a video about postpartum mothers at the event, “Pelvic Floor Awakening,” held in Shanghai, May 11, 2019. Fan Yiying/Sixth Tone

Attendants watch a video about postpartum mothers at the event, “Pelvic Floor Awakening,” held in Shanghai, May 11, 2019. Fan Yiying

Huang Jianxuan, one of the 30 or so attendants, has had occasional incontinence since she gave birth to her son three years ago. She wasn’t sure what caused it. “I thought it was normal, as other mothers I asked were going through the same thing,” she tells Sixth Tone.

“It’s common but definitely not normal,” responds Chen, explaining that pregnancy stretches the pelvic floor muscles, which sometimes don’t return to their original positions after childbirth and can leave the bladder and other organs unsupported, potentially leading to SUI. Regular exercise, therapy, or surgery can repair the damage. The pelvic floor is a niche medical field in China, neglected by both women and medical experts, Chen says.

In some Western countries, health insurers require new mothers to undergo postpartum pelvic floor rehabilitation. In China, though, it’s mostly just top hospitals that offer such programs. When, six weeks after giving birth, Huang visited a Shanghai hospital for a postnatal examination, doctors didn’t mention checking her pelvic floor. “But even if they had, I wouldn’t have gone for it, because I was too busy taking care of my baby,” says the 29-year-old.

As China’s medical resources are stretched and doctors are preoccupied with more acute conditions, Chen believes social organizations should lead the drive for better pelvic floor care. That conviction led her to leave the state-owned hospital she had worked at for over 20 years and establish her own practice offering female pelvic floor health services in 2016.

At the event, Chen confesses to the audience that after giving birth to her second child while she was in her 30s, she went through an unspeakable period of time when her underwear was constantly wet. “I looked energetic and cheerful, but deep down inside, I was so afraid of running or jumping,” Chen says. “But then I recovered, and I wanted to help more women.”

So far, Chen’s taken on over 300 cases in her Beijing clinic, and she regularly posts on social media to raise awareness. At the same time, she believes public figures may have a greater influence.

Chen Lijun, a health instructor, gives a speech about pelvic-floor care at the event, “Pelvic Floor Awakening,” held in Shanghai, May 11, 2019. Courtesy of Zhao Jing

Chen Lijun, a health instructor, gives a speech about pelvic-floor care at the event, “Pelvic Floor Awakening,” held in Shanghai, May 11, 2019. Courtesy of Zhao Jing

When celebrating her third Mother’s Day on May 12, Ella Chen Chia-hwa, member of the legendary Taiwanese girl group S.H.E, shared her experiences with pelvic floor muscle disorder after giving birth. “My pad would get completely soaked, and then my pants were wet,” Chen Chia-hwa wrote on Facebook. Recently, she finally opted for surgery, she added. Her post was shared on Chinese social app Weibo, where thousands of users left comments with their own experiences.

When working in the hospital, Chen Lijun says she noticed that new mothers only sought medical advice when facing serious problems like Chen Chia-hwa’s. However, since 2016, she has witnessed a change. Many of her clients have yet to become mothers, or even have sex. “The younger generation has the sense to protect their pelvic floor before giving birth,” she says. Compared with older generations, who bear their symptoms in silence, Chen Lijun finds it “stunning” to see Chinese millennials so eager to figure out why their mothers have urinary incontinence, and why their elder sisters no longer have sex after childbirth.

Many in the audience at the event are unmarried and childless, too. Yao Weili joined Yummy two years ago. The state-owned enterprise employee pays attention to her body. She works out regularly and is familiar with Kegel — a pelvic floor-strengthening exercise that Chen explains at the event. Though Yao, 39, is single and has no immediate plans for motherhood, she decided to attend the event to get more firsthand information. “When I was little, I heard my grandma complaining about her leaking urine to my mother and aunts,” she tells Sixth Tone. But when she wanted to know more, they just stopped the conversation or shut the door.

Most of Yao’s friends are married and have at least one child. They often talk about how labor has damaged their bodies and how frustrated they are with their sex lives. “If sex is a meal, then the pelvic floor is like the ingredients,” Chen says. A damaged pelvic floor can decrease sensation in the vagina, making sex less satisfying and orgasm more difficult to achieve. Chen says about 70% of her clients and patients have low sexual desire, sexual arousal disorder, or a lack of orgasm, yet only 3% would see a doctor for such issues. “This is even worse after women have children,” she says.

Postpartum sex lives are a recent focus for Yummy, too. Early this year, it released an online “training camp” to help new mothers recover from childbirth. “We decided to step into this area after witnessing the huge demand,” Zhao says. “We want women to know that they can get back to enjoying sex after following these exercises.”

Zhao Jing, founder of Yummy, gives a speech at the event, “Pelvic Floor Awakening,” held in Shanghai, May 11, 2019. Courtesy of Zhao Jing

Zhao Jing, founder of Yummy, gives a speech at the event, “Pelvic Floor Awakening,” held in Shanghai, May 11, 2019. Courtesy of Zhao Jing

Launched in 2015, Yummy now has over 2 million users in China. In 2018, Zhao was honored to have made the BBC’s list of “100 inspiring and influential women from around the world.” But she was even more thrilled when China Daily, the state-controlled English-language news outlet, shared the news on social media: “I felt the authorities had approved of me and my work and that women pleasing themselves and exploring sex wouldn’t need to be kept under the table anymore.”

As China now encourages couples to have more than one child, Chen says it’s high time to make women aware of how to take care of their pelvic floor. “It’s very likely women will wet themselves more often when they are older if they don’t exercise their pelvic floor muscles after each birth,” she says.

Huang, the mother of a 3-year-old, is thinking about having a second child in a few years. But first, she is determined to go see a doctor and regain control of her bladder. “I always told myself that it would all pass, but it didn’t,” she says after the event. “I’ve realized that whether a mother or not, women should put themselves first and take care of their bodies, rather than just building their lives around the kids.”

Silent for So Long, Elderly Gays Livestream at Full Volume


HUNAN, Central China — Hu Pingsheng never knew there was a name for his feelings until a younger man explained it to him: He was gay. Despite a desire to live his true self, however, he has kept that revelation from his family. But a few months ago, he finally found a place to be who he wants to be, and he’s even found some small-time fame in the process.

On a rainy afternoon in Chenzhou, the relatively small city some 400 kilometers north of Hong Kong where Hu has a sixth-floor apartment, the 68-year-old dons his favorite navy blue suit and sits down in front of his camera. He’s about to livestream on Blued, China’s largest social networking app for gay men and the one place where the twice-divorced Hu feels like he can be himself. “When I was young, I didn’t know who I was, and I didn’t have the chance to get to know men I adore,” he says. “I feel like I’m now making up for my loss.”

A Blued spokesperson says the app’s livestreaming feature, available since 2016, has seen “hundreds of thousands” of users turn their cameras on themselves. Though the majority of them are young, Blued has noticed a rise in livestreamers aged over 50 since the second half of 2018. Hu attributes this to the closeted lives that gay men of his generation lead. “We have a limited circle of friends, and most of us haven’t come out to our families,” says Hu. “Without livestreaming, my life is boring and stressful.”

Hu fills his hourslong livestreams mostly by singing. He kicks off today’s show with his greatest hit, “Qinghai-Tibet Plateau,” one of the best-known tracks in China. Though Hu cannot quite master the high notes at the end of the song without his voice cracking, it still wins him a few dozen likes. He then performs “Over the Golden Hill of Beijing,” which became a household song in the early 1970s. “Chairman Mao is like the bright golden sun,” he sings, gently swaying with the rhythm.

Inside Hu Pingsheng’s home in Chenzhou, Hunan province, April 14, 2019. Fan Yiying/Sixth Tone

Inside Hu Pingsheng’s home in Chenzhou, Hunan province, April 14, 2019. Fan Yiying

Hu, who calls himself “Tasty Mango” on Blued, has learned to sing some 200 songs and has hundreds more downloaded to his phone that he wants to add to his repertoire. Red classics about Chairman Mao and Communist Party history are his favorites, he says. On a good day, he’ll have over 1,000 viewers — but he averages a couple hundred. He greets each of them as they join the stream.

As on other Chinese platforms, viewers on Blued can buy virtual gifts for livestreamers, which they can then exchange back into money. So far, Hu has earned more than 10,000 so-called beans, which amounts to 1,000 yuan ($150). But Hu’s not in it for the money. The retired accountant has a monthly pension of over 3,000 yuan, which he says can ensure him a comfortable life in Chenzhou.

Compared with more developed coastal cities such as Shanghai and Guangzhou, where people are more open about and tolerant toward sexual minorities, public gay life in inland cities such as Chenzhou is almost nonexistent. “I realized many people here still don’t know what ‘gay’ means,” says Liang Junjie, a swimming coach who hails from Guangzhou but has been living in Chenzhou for a few years. He is a fan of Hu and has sent him virtual gifts. “I think he’s handsome, and I’m happy that he can do things he really enjoys,” says the 26-year-old.

Liang has known he was gay since middle school. A few years ago, he came out to his parents — which he says is something people his age would consider doing, but is rare for older generations. Hu, for his part, didn’t know he was gay until 2000, a year before homosexuality was declassified as a mental illness in China. A young man approached him at a park in Chenzhou and took him to a gay bar. There, someone told him he was gay. “I always knew I admired men, but it had never occurred to me that there is a word to define my sexuality,” he says.

Born and raised in the countryside, Hu always longed for an urban lifestyle. He moved to the local county seat in his late teens and in 1984 married his first wife after they’d been introduced by a matchmaker. A few years later, fed up with her short temper, he filed for divorce and moved to Chenzhou, where he married his second wife. This union also ended with a separation, on account of “personality clashes.” He’s not sure whether his sexuality played any role in the divorces.

Hu has two daughters — one with each of his ex-wives. He hasn’t come out to either of them and doesn’t plan to, uncertain of whether they will accept it. Hu’s family also doesn’t know about his antics on Blued, but he doesn’t worry about what might happen if his relatives saw him on the platform. “I’m not doing anything nasty or wrong,” he says. “I’m just doing what I love: singing.”

Hu Pingsheng’s livestreaming equipment in Chenzhou, Hunan province, April 14, 2019. Fan Yiying/Sixth Tone

Hu Pingsheng’s livestreaming equipment in Chenzhou, Hunan province, April 14, 2019. Fan Yiying

While it’s just a passion project for Hu, others hope the nascent popularity of elderly livestreamers will become a source of income. Wang Liyun, originally from the northeastern province of Jilin, stepped into the senior gay livestreaming business after hearing about its profit-generating potential from friends. China’s livestreaming market is already huge and still growing: According to a 2018 National Copyright Administration report, the market was worth nearly 40 billion yuan in 2017, fueled by virtual gift-giving. Popular streamers can earn a living wage, if not significantly more.

Wang’s approach was to start a group — a common format in which several singers live together and alternate behind the microphone. A “boss,” like Wang, organizes the group and provides accommodation and food. Participants get a cut from the gifts they earn. According to Wang’s own observations, there are over 200 groups of men over 45 on Blued. Their fans are of all ages. “A successful group can attract over 8,000 fans and receive as much as 60,000 beans per day,” Wang, 55, tells Sixth Tone.

With that goal in mind, Wang started looking for candidates all over the country to join his group in his home in Dongguan, a city in the southern province of Guangdong. Wang, who identifies as gay, only wants to hire gay men — he scoffs at groups on Blued that hire straight, amateur singers pretending to be queer — who are between 40 and 60 years old, decent-looking, and good at singing and interacting with fans.

Since he started in March, over a dozen men have livestreamed with Wang’s group, but turnover is high, especially when gift-giving disappoints. “When they realize they are incapable of getting beans, they just leave after a few days,” Wang sighs. He has invested over 30,000 yuan into his venture with returns, so far, of about 10,000 yuan. “When I start to make a profit, I’ll buy fancy lights and LED wallpaper to decorate the studio,” he says.

Last November, Hu joined a similar group. He took the train to Zhuzhou, a city about 300 kilometers north of Chenzhou, and sang with a group called Magic Dragons, consisting of four men — all gay and about the same age. For eight hours a day they sang from a living room-turned-studio, adorned with a color-changing crystal ceiling light and background wallpaper featuring the Great Wall. “It was more gorgeous and magnificent than any karaoke rooms that I’ve been to,” he recalls.

Before Hu would start his shifts, an announcer would hype up the audience and introduce him: “Now let’s welcome Uncle Hu from Chenzhou, Hunan. He’s 68 years old, 165 centimeters tall, and weighs 60 kilograms. Look: He’s slim, light-skinned, and handsome! Show your love with flowers, grass, or whatever (digital gifts)!” Hu says he felt embarrassed at first, but later started playing along, asking for more beans. He enjoyed singing with others and was paid 1,600 yuan for half a month’s work.

But most of all, Hu feels relieved finally knowing who he is, as do many gay men his age, he says. He’s got trips planned to the eastern cities of Nantong and Shanghai, as well as southern Shenzhen, to join livestream groups there. “If there’s a platform where I can do what I love,” he says, “I don’t want to waste another minute regretting not doing things that make me happy.”


This article was published on Sixth Tone.