This article explores three related phenomena: first, the abandonment and institutionalization of children with disabilities in China that increased disproportionately in the 2000s; second, the important relationships between such abandonments, culture, economics, and politics in contemporary China; and third, the relationship between such abandonments, the increasing rates at which Chinese orphans with disabilities are being adopted to Western countries through Inter-country Adoption (ICA), and the global politics of ICA and disability. Although the rise in the proportion of ICA from China of "children with special needs" is widely acknowledged, the reasons for the recent increase in abandonments of children with disabilities have been largely analyzed from the perspective of Chinese cultural views regarding disability (Holroyd 2003; Qian 2014), market economics (Wang 2016), the lack of Chinese government support for services for families (Shang 2008), as well as government coercion (Johnson 2016), thus, relatively divorced from the demand side of ICA. However, this article highlights the relationship between the disproportionate abandonment of children with disabilities in China and their increasing rate of ICA from China, arguing that discrimination toward persons with disabilities, or ableism, is not merely operative in abandonments of Chinese children with disabilities, but also embedded in the global politics of ICA.
Apprehending a Contemporary Shift in Chinese Orphans
When I first came to China in 2009 and 2010 to do fieldwork with foster families, I expected to find young foster families raising their young children alongside infant girls. Yet, what I discovered in both state orphanages, as well as urban and rural foster care from northern Beijing to southwest Nanning, were poor, elderly foster mothers and fathers raising Chinese orphans with cleft palates, club feet, autism, spina bifida, cerebral palsy, and heart disease. 1 Statistics suggest that children with disabilities have always constituted a significant portion of child abandonments in China; during desperate times like famine or political unrest such as the Communist Revolution, all children, but particularly those with disabilities, were especially vulnerable (Hu and Szente 2009). However, in the past decade, as China has arguably risen to its most wealthy and prominent state in modern history, children with disabilities have quickly come to represent the majority of child abandonments in China (Shang 2008; Wang 2016). 2
Indeed, as I traveled throughout both China's countryside and cities, orphanage directors complained that they were increasingly overburdened with diseased and disabled children who required considerably more resources to care for than their scant governmental supplements provided. Over the past few years, the Chinese government has opened more than thirty "baby hatches" in large cities to enable desperate parents to legally abandon infants into state care in order to prevent harm or death to sick or disabled infants often abandoned on the streets. However, one such baby hatch opened in Guangzhou in 2014 was forced to close after it received 262 infants in just two months. As Leslie K. Wang recounts, "Tellingly, all of the children left in the hatch were ill and disabled, reflecting a broader societal shift away from the relinquishment of abandoned girls…Of the group, 110 had cerebral palsy, 39 had Down syndrome, and 32 suffered from congenital heart disease" (2016:40).
It is hard to come by accurate national statistics regarding child abandonments and children who are institutionalized, given that children are not only constantly moving in and out of Social Welfare Institutes (SWI) in China, but the most recent government census data on people with disabilities is from nearly ten years ago, and the Chinese government remains sensitive and secretive with its reporting because of past allegations of human rights abuses in orphanages (Blewett and Woods 1995; Human Rights Watch 1996). However, according to China's Second National Survey of Disabled People conducted in 2006, China has approximately 500 million children with disabilities, the majority of whom are clustered in rural areas (Chen & Chen 2008). Of the 10,000 children who are abandoned annually by their parents, statistics indicate that in urban areas and as of 2006, 90 percent of these children had disabilities (Shang 2008). While statistics suggest that the proportion of children with disabilities abandoned in urban areas is overwhelmingly high, my own fieldwork conducted from 2010-2012 indicates that rural areas, especially some of the poorest provinces and regions such as Guangxi, Henan, and Anhui boast comparably high proportions of children with disabilities especially in their SWIs. Rural Orphanage directors were even more forthcoming regarding the drama and severity of this trend given that they were some of the heaviest hit when it came to the burden of such children on their more limited resources (see Raffety Forthcoming).
In my fieldwork with hundreds of foster families in Guangxi, I noted that almost all of them were rearing children with disabilities, but also with the hope that they would be eventually adopted to Western countries. According to the 2015 China Statistical Yearbook, during the height of international adoptions, just over 14,000 foreigners adopted from China in 2006, but as aforementioned, that number has dropped dramatically. In 2014, for instance, according to its own statistics, China processed fewer than 3000 foreign adoptions. Although China does not collect data on the proportion of children who are adopted internationally who are also disabled, orphanage directors across the board note the dramatic increase in their "special needs" populations. 3 As Nie Lili, one of the founders of Chinese Children Adoption International (CCAI) stated, "Over 98 percent of children in orphanages now are special needs children. Before 2008 the proportion was 20-30 percent" (Homes for the Abandoned 8-2-2015; also see Vanderklippe 2014).
Hence, even with the overall decrease in international adoptions from China and an overall decrease in Chinese child abandonments, an increase from 20-30 percent in 2008 to 98 percent in 2015 constitutes over a 50 percent increase in the proportion of abandonments of children with disabilities in China. And, China still remains a top sending country for intercountry adoptions (ICAs) to the West, and the top country for U.S. adoptions by a very large margin (FY 2012 Report). 4 Although data is not readily available, in recent years researchers agree that special needs adoptions from China have constituted at least 50-60 percent of all ICAs, a number comparable with the proportional rise in abandonments of children with disabilities in China. In this article, I argue that at least half of all ICAs today processed from China to the West are of children with special needs because the data which confirms a number that constitutes half is decidedly outdated (2005-2009); still, this outdated data shows rapidly increasing proportions of such adoptions, from merely 9% of all ICAs from China being special needs in 2005 to a startling 48.8% in 2009 (Wang 2016).
Yet, to conclude that this is uniquely a Chinese cultural problem is far too reductive. Indeed, in the wake of the rise of adoptions of infant girls from China to the West in the early 1990s a similarly reductive explanation of gendered disdain for girls was initially (and sometimes still is) given, but significant anthropological and political studies have demonstrated the complex constellation of domestic and political factors that contributed to such a climax (Greenhalgh 2003; Johnson 2004, 2016). Therefore, my aim in this article is to examine the scholarly explanations offered for this contemporary shift in Chinese disabled orphan populations on the "supply side," including but not limited to explanations that have to do with Chinese cultural and market-driven ideas about disability (Holroyd 2003: Qian 2014; Wang 2016), the lack of government support for families with disabilities (Shang 2008; Shang, Fisher & Xie 2009; Shang & Fisher 2014), as well as government coercion and lack of international regulation for ICA (Johnson 2016; Wang 2016).
Hence, despite the importance and accuracy of these explanations, I argue that they fail to do two things. First, they largely ignore the increasing Western demand for and adoption of Chinese children with disabilities and its relationship to the supply of such children in China and the processing of ICAs. Drawing on literature from scholars such as Kristin Cheney and Kathryn Joyce who have identified the ways in which ICA perpetuates rather than ameliorates global inequalities, I argue that demand must be examined and interrogated as an integral part of not just increasing ICAs of children with disabilities from China but the disproportionate rate of domestic abandonment and institutionalization of children with disabilities.
Second, I argue that just as "child saving" efforts in ICA of healthy children often mask ICA's market dynamics and perpetuation of inequalities (Cheney 2014), Western desire and acceptance of Chinese children with disabilities is not an unparalleled social good, but demonstrates covert maintenance of global, moral hierarchies and reveals rampant ableism. Therefore, in this article I argue that in addition to scrutinizing the role of demand in the making of this upward trend in ICAs of children with disabilities from China, it is also vital that the market for ICAs be assessed from a disability studies perspective in order that ableism not permeate and undermine what is often construed as the "best interests of children." Indeed, by reviewing this phenomenon of ICAs from China of children with special needs through the lens of international demand and a global politics of ableism, we see the way in which ICA contributes to the maintenance and expansion of Western, heteronormative, ableist families.
Understanding Chinese (Supply Side) Cultural Factors, Governance, and Politics
In the introduction to her book, China's Hidden Children: Abandonment, Adoption, and the Human Costs of the One-Child Policy (2016), political scientist Kay Ann Johnson confronts the ubiquitous, popular discourse that readily interprets the widespread international adoption of infant girls in the 1990s and 2000s to Western countries as confirmation that Chinese culture and Chinese parents despise women and girls. It is impossible to summarize the extensive contribution Johnson and her colleagues have made to understanding the complex intersection of birth planning, child abandonment, as well as contemporary domestic and ICA from China. However, among them, this section highlights how her work importantly complicates simplistic notions of son preference, unearths the voices of birth parents and adoptive parents in China, and provides data that shifts the cultural narrative regarding the lack of desire for daughters or adoption within China. "While the one-child policy is usually seen as a background factor," Johnson writes, "the question of why there are children available to adopt in China quickly turns to the question of 'why girls?'"—a query that firmly centers the focus on Chinese culture as the primary, most culpable factor responsible for the pool of children available for international adoption (2016:21). Bringing then what only appears in the background ("the one-child policy") 5 into the foreground, Johnson pinpoints the coercive birth planning policies and the Chinese central government's dogged efforts to implement them (rather than son preference or an unwillingness to adopt) as blameworthy for both the large scale abandonment of infant girls and their international adoptions at the turn of the twenty-first century.
Similarly, I argue that the role of Chinese culture in the contemporary proliferation of abandonment of children with disabilities in China must be considered in relationship with domestic birth planning policies, as well as the lack of domestic support for families raising children with disabilities. As Eleanor Holroyd's research shows, among parents caring for children with disabilities in Hong Kong, disability was often experienced as a "disruption to the parent-child order" (2003:8), a threat to the cyclical and reciprocal enactment of caregiving responsibilities (18) that facilitates cultural personhood in a Chinese context. As Guo Jinhua and Arthur Kleinman, building on the work of Chinese sociologist Fei Xiaotong (1947) put it,
Being a person [in China] involves the obligation to engage appropriately in interpersonal exchange relationships, build social relationships, and maintain a moral status….Whether or not one should be treated as a person with rights is based on whether or not one has fulfilled the obligation of acting as a person. (2011:243)
Hence, Chinese familial culture necessarily makes exclusions based on individuals', especially children's abilities or inabilities to fulfill their social roles. As Qian Linliang furthers, a familist norm, which idealizes the family as the "axis of all other social relations" (255), causes children who grow up anywhere other than their family to be deemed not just "unfortunate," but "abnormal" (256).
Although Holroyd, Guo and Kleinman, as well as Qian's cultural interpretations, could all be assessed as reasonable explanations for the abandonment of children with disabilities in China, it is important to note that discriminatory cultural attitudes toward people with disabilities in China fail to explain a recent contemporary increase in the proportion of children with disabilities who are abandoned. Indeed, despite the relevance of such cultural ideas, culture is not static, and thus it is vital to examine these ideas about personhood in context with shifting practices of domestic adoption, foster care, and social welfare in modern China.
As Shang Xiaoyuan, Karen Fisher, and Xie Jiawen acknowledge, China's child disability support system, established before the 1990s, is still based on the notion that the family and kinship care is the primary provider for the needs of children with disabilities, but significant social, economic and demographic changes since then in China have reduced family capacity to care for such children (2009:299). Furthermore, healthcare support for such children does not extend to the public school system, forcing the burden to be born by individual families who often report rampant discrimination throughout service provision. In another article where they employed a broad interview methodology and a smaller case-study approach to understanding the "right to life" of children with disabilities in China, Fisher and Shang report that "parents frequently said that they considered abandoning their children while they were raising them because they did not have access to government support" (2014:562). Fisher and Shang conclude, "the social services implications of the research are that China has not yet established an effective system to protect the life of children with disabilities" (570).
In her book Outsourced Children, Leslie K. Wang further criticizes the Chinese central government's complicity in the exportation of children with disabilities to the West, through a phenomenon she titles "outsourced intimacy" (2016). Alongside Johnson, Wang cites a similar "perfect storm" of political will, market forces, lack of government support and cultural beliefs that have contributed to the disproportionate abandonment of children with disabilities in modern China. Wang's point, in collaboration with social welfare researchers like Shang Xiaoyuan and Karen Fisher (2011), is to demonstrate the near total neglect of the Chinese government's post-Communist provisions with respect to the large population of persons and children with disabilities, in tandem with policies and rhetoric that discriminate against such persons as "burdens."
Therefore, even as children with disabilities disrupt the natural order of caregiving and filial piety within traditional Chinese understandings of personhood (Holroyd 2003), Wang charges that "rather than trying to change the larger cultural mindset toward disability, state authorities have tended to blame the situation on the 'backwardness' of rural people" (2015:135). Furthermore she argues that "sending abroad those whose mental and physical ailments have rendered them 'low quality' citizens in China has allowed government authorities to outsource intimacy to willing Westerners while seemingly keeping children's best interests in mind" (2016:134).
Johnson similarly blames the Chinese government for their complicity in processing a gross number of ICAs while undermining domestic adoptions in China. As she argues, domestic adoptions from Chinese orphanages in the 1990s, though not significant "certainly exceeded international adoptions at the beginning of the decade" (2004:142-43). However, the 1991 adoption law, "heralded for paving the way to international adoption" also limited adoptions of orphans to childless parents over the age of 35, "an unacceptably advanced age to become a first-time parent, according to Chinese social norms and practice, especially in the countryside" (145). The law, far from encouraging domestic adoption then, made it both more difficult for birthparents to arrange informal adoption for an unwanted or "overquota" child 6 and more difficult for desiring adoptive parents to adopt even formally from a state orphanage, given that they needed to be childless and over the age of 35 (146). As Johnson notes, because of the domestic prohibitions, "foreigners adopted more than 35,000 children" from roughly 1994-2004, "though many times that number of adoptable children remained behind in the orphanages" (146). 7
However, even with revisions to the 1991 adoption law in 1999 that lowered the legal age for adopting parents to 30 and allowed families with children to adopt healthy foundlings, because the revisions only applied to children being raised in welfare institutions, "efforts to publicize the new possibilities for legal adoption were local and sporadic" (2004:147) and birth planning authorities often refused to grant approval or readily blocked such adoptions (Johnson 2016). Thus, ICAs continued to flourish while domestic adoptions dwindled or remained stagnant. As Johnson and others (Dorow 2004; Wang 2016) have noted, the steady and significant fees incurred from foreign adoptions (around 25,000 yuan or US$3000), often commensurate with and thus, prohibitive for domestic adopters, popularized and encouraged ICAs, while further discouraging domestic adoption. Succinctly put, "Over the last twenty years, unknown numbers of 'unwanted,' legally certified 'abandoned children' in China's orphanages have been taken directly from the homes of would-be or existing adoptive families" (2016:165).
Although the situation for domestic adoption of children with disabilities differs significantly, given that the birth planning policy has always presented a loophole for a second child to parents whose first child had a disability, the context of poor social welfare for such families and poor promotion of such freedoms by the government still applies. In my fieldwork, for example, among parents who were eligible for such a second birth or an adoption, I found that parents were unaware of this benefit and many also failed to see the benefit given the cost and care they needed to give to their first child. Even in a context in which domestic adoptions of healthy children have markedly increased in China (see Wang 2016), 8 presumably due to both social discrimination and lack of social welfare, children with disabilities remain largely institutionalized, in foster care, or are adopted internationally rather than domestically. If we take Wang's and Johnson's point that culture is just one factor that, in relationship with poor domestic social welfare and governmental promotion of ICA over domestic adoption, has been used by the government against its people, we begin to see a very different picture of the rise in disabled abandonments and ICAs of children with disabilities from China.
Indeed, one need only look to the statistics to see that whereas the proportion of children abandoned seemingly as a result of their disability is rising, the overall significance of that figure with respect to China's total population is quite low. First, although it may seem obvious to point out, it is important to note that most parents in China, even those who have children with disabilities (of which there were approximately 500 million a decade ago), do not abandon their children. Indeed, even by some of the largest estimates that put Chinese child abandonments at 100,000 per year (and one should note that the range in estimates here is extremely concerning given that most scholarly sources would put that number at 10,000), that percentage in terms of abandonments of disabled children by their parents, even on the most extreme scale, comes to a mere 0.2% (for the more modest number of 10,000 abandonments, this comes to a miniscule .003% of the population). In other words despite the overwhelming scale of Chinese abandonments of children with disabilities, it is so important to keep in view that most people with children in China, even children with disabilities, do not abandon their children.
This statistical evidence, along with the increasing proportion of children with disabilities who are in foster care also serves to confront simplistic assessments that pin the proportional rise in abandonment of Chinese children with disabilities on Chinese culture. Although official statistics are practically impossible to come by, due to government mandate in 2003, alongside financial and social incentives, nearly every orphanage in China today has some version of foster care practices and these are notably expanding to include and even prefer in some circumstances, children with disabilities. 9 In my fieldwork with such families, they cited numerous benefits of foster care to both themselves and the children, including improved psychological and physical welfare, social welfare, and social standing and acceptance in Chinese society. Elderly couples who were previously socially isolated and children who were institutionalized became integrated into Chinese society and these foster parents became fierce advocates for the needs of their children. Given the above statistics on the number of biological families raising children with disabilities in China, alongside the increasing practice of foster care, as well as the willingness and transformations detailed by foster parents in my research, it is impossible to conclude that children with disabilities are culturally and practically unwanted in contemporary China.
However, with the Waiting Child program established in 2000 and the government's limitation of the supply of healthy girls for adoption and the more stringent rules applied to such adoption by 2006, the PRC expressly encouraged the increasing proportion of special needs adoptions from China (even in light of a downward trend in ICAs overall). Indeed, by 2009, "the last year for which figures were published, special needs youth constituted nearly half of all foreign adoptees; this was a huge jump from 2005, when they did not add up to even one-tenth of adoptive placements" (Wang 2015:140). Furthermore, as with prior entanglements of birth planning policies that limited domestic adoption, restrictions on foster parents continue to funnel children into ICA rather than fostering a culture that accepts and assimilates them within Chinese families. Indeed, because of the previous limitations on the number of births and the stringent requirements for domestic adoption, most foster parents who had biological children of their own and were of advanced age, were not eligible to adopt. However, even if they were eligible to adopt, they were often dissuaded from doing so by orphanage officials due to their subordinate social status, low income, or even "backwards habits" (see Raffety 2017). The extra-legality of some of the foster care practices in Guangxi due to either economic hardship or poor official oversight actually continued to delimit or undermine the rights of foster parents with respect to the children in their care.
Given the coercive environment created by the Chinese government's enforcement of the birth planning policies and tacit, if not overt discouragement of domestic adoption, Johnson also faults international structures, particularly the Hague Convention on intercountry adoption, for turning a blind eye to these domestic abuses. For instance, Johnson argues that even as the Hague Convention prioritizes preventing trafficking and corruption of children, in the case of China, it failed to interrogate how legal policies and "legally sanctioned punishments" actually increased supplies of children for both international adoption and potential trafficking (2016:23). Thus, she argues that,
Under these conditions, the terrain of international adoption must be seen as built upon widespread coercion as well as enormous inequality between those international parents who ended up in the government's pool of 'adoptable children' and those Chinese parents who lost those children under conditions that made any sort of 'voluntary relinquishment' utterly impossible (167).
In sum, in this section I have attempted to show that both Johnson and Wang's research importantly shifts popular and scholarly attention from the pitfalls of Chinese culture to Chinese government failure and coercion, as well as lack of international responsibility, and inequality between international and domestic adoptive parents. Yet, both scholars stop notably short of considering what role international demand for such children has played in exacerbating, perpetuating, or even igniting these inequalities. Therefore, in this next section, I attempt to expand Johnson's above critique of the international adoption community to consider how the work of scholars who have taken international demand for adoptees into account (see for instance Laura Briggs, Kristen Cheney, and Kathryn Joyce), might deepen our understanding of this rise in proportionate abandonment and ICA of children with disabilities from China.
Understanding the demand side of ICA from the perspectives of international adoption and global disability discourse
By the mid-2000s, when ICAs from China reached their peak, their visibility was incredible not just considering the supply of such children flourishing within China, but also the demand for Chinese children around the world. Many scholars including Dianne Marre and Lisa Briggs (2009), Kathryn Joyce (2013), Jessaca B. Leinaweaver (2008) and Leslie K. Wang (2016, 2015, 2010a, b), with respect to China, have queried the effect of the market's demand on the supply of children in international adoption, which has led to Hague Convention allegations, abuses, and suspensions of adoption policy, especially in the cases of countries like Guatemala and Ethiopia. However, China has also come under fire for allegations that the government fabricated ages of older children or falsified their orphan status. There are also several reported cases in China of parents with sickly infants being urged by doctors to relinquish the children in order to profit from a foreign adoption and numerous concerns and cases of child trafficking in the last five years. 10
Thus, while it is impossible to prove, it is reasonable to consider whether a similar dynamic of supply and demand is at play in the increased proportional abandonment of children with disabilities in China. In my conversations with orphanage personnel (and much in line with Wang's research), I found that the Chinese government, knowing that Western countries will pay for expensive medical procedures, prefers to expedite these adoptions of children with special needs abroad. When I spoke with a program director for the China Center of Adoption Affairs in Guangzhou in 2011, pressing her on why children with special needs were being so increasingly adopted abroad, she hedged, slowly replying that their medical needs often exceeded the expertise of Chinese hospitals. Hence, the Chinese government participates in, or perhaps even exploits the same cultural perception that disability, of many varieties, compromises social personhood, in proffering these ICAs. Therefore, it is not as simple as the Chinese government falling victim to "backward" notions of social personhood; rather, as Wang notes, in this way the Chinese government also benefits from this process of "outsourcing its intimate labor" both to poor foster mothers inside China (see Raffety 2017) and Western adoptive families (Wang 2015:133).
As aforementioned, scholars of ICA, such as Kristin Cheney, have examined how adoption's "child saving" efforts often "mask both ICA's market dynamics and the crises of social reproduction on the 'demand' side that precipitate ICA" (2014:247). In reference to the first point, Cheney points out that although the Hague Convention "encourages co-responsibility between states' parties, sending countries are primarily responsible for implementation—often with inadequate resources" (253). Thus, the politics of development that undergird the flow of orphans from the global south to the north perpetuate inequalities, further disadvantaging sending countries while sentimentalizing the service being provided by adopting countries. For instance, Cheney astutely points out that the egregious costs of intercountry adoption pale in comparison to the scant costs of keeping children with their birth families (256). Even in the cases in which sophisticated medical care is required, it is impossible to believe that a country with human and economic resources such as China could not process its own medical operations and procedures with or without limited financial support. Therefore, outsourcing such medical care to the West in support of orphan care and adoption is not only unnecessary and inefficient, but arguably undermines the further development of a more supportive, robust Chinese disabled child welfare system.
As Cheney puts it, "ICA is ideally about finding families for children who need them, but due to its marketization in an unequal world, in practice ICA is skewed toward finding children for families who want them" (255). This gets to Cheney's second point about how Western demand for children fuels the manufacturing and commodification of orphans ripe for Western intervention. Indeed, as I found in my work with Chinese foster families, they had literally internalized this narrative as they often commented that despite the important role they played in these children's lives, such children would be better off in America or another Western country. Although such families did fight for the rights and care of these children, even struggling to keep them in certain scenarios, they were powerless both against the sway of the economic and political power of Western adoptive families, but perhaps even more importantly against the internalized construction of "a class-based model of appropriate and 'deserving' parenthood that reinforces middle-class entitlement while pathologizing poor parents," such as Chinese foster parents (257). Cheney argues that even with dwindling birth rates and delayed childbirth by women in the West, ICA has become a neoliberal tool of the maintenance and reproduction of the white, middle-class, heteronormative family that perpetuates not just economic and political, but social inequalities (256). As David L. Eng puts it,
in the context of transnational adoption, consumptive labor takes the form of a political economy of passion meant to shore up not just the material but, equally important, the psychic boundaries of the white middle-class nuclear family—guaranteeing its social and ideological integrity as well as its affective ideals (2006:56-7).
Although Wang goes so far as to say this movement of children with disabilities from China to West is an example of "outsourced intimacy" on the part of the Chinese government, the eager reception of, facilitation of surgeries, and processing of adoptions of children with medical needs from China also suggests a "rehabilitative mission" on the behalf of the West to Chinese children with disabilities. As Kathryn Joyce has recently observed in Child Catchers: Rescue, Trafficking, and the New Gospel of Adoption, the Christian desire to provide for the less fortunate through evangelical adoption actually maintains moral hierarchies between the West and abroad through a marginalizing care of Others (2013).
Yet, these global politics of adoption are not new (the very first adoption agencies emerged in the context of providing a Christian home to Korean War orphans), but rather freshly significant in the face of the disproportionate abandonment of children with disabilities and their Western adoption from China. As Joyce has pointed out, "the Christian adoption movement….of children with high medial needs has become a distinguished category of its own," one in which through sacrifice in hardship of raising these children, Christians prove their love for God (2013:216-17, see also Rachael Stryker 2010). Although such accounts are mostly anecdotal and a full-fledged empirical study of ICA of children with special needs and adoptive parents in Western countries has yet to be carried out, the notions of disability tacitly invoked in these practices and comments evokes moral pity, helplessness, and neediness, extending rather than complicating the child saving discourse that contributes to political, economic, and moral hierarchies in ICA.
Therefore, it is necessary to consider how demand and desire for children with disabilities from China harbors and conceals ableism (ironically through a "rehabilitative mission") that both undermines the personhood of children with disabilities and maintains moral hierarchies in ICA. In drawing on, for example Robert McRuer's analysis of disability in neoliberal discourse, we can see that even as disability may be no longer stigmatized but rather celebrated, ICA of children with disabilities also serves to "produce and secure" compulsory able-bodiedness (and heterosexuality) while containing and absorbing disability (as well as queerness) (2006:3). To explain, in quietly rehabilitating and reappropriating children with disabilities from China to Western countries, Western "progress" is complicit in the exclusion and exportation of such children, insofar as it serves to highlight Western morality at the expense of the pitying, subordinating gaze of disability.
As ICA appropriates and absorbs these children into Western, heteronormative families, we see the extent to which the expansion and transformation of such families is both contingent upon disabled bodies, yet also bent upon masking and rehabilitating their difference. In markets where babies have become fetishized as priceless objects of desire, global politics has revealed adoption to be both a profiteering venture for sending countries, but one that also further entrenches and subordinates them to Western demand (Dorow 2006; Marre and Briggs 2009). Thus, what unbridled reception of children with disabilities from China signals is perhaps not so much an increasing acceptance of children with disabilities in the West, but rather a reassertion of the fetishization of the "underdeveloped" child so in need of Western medicine, development, and progress in the form of the disabled child.
Therefore, the discourse of ICA of children with special needs is alarmingly ableist in that it hinges upon the rehabilitative and curative potential to not only rid China of children with disabilities but to reimagine such children's restoration within Western, heteronormative, ableist modern families. Therefore, although ICAs are often understood as a solution to the problem of disabled child abandonment in China, it is vital to examine how demand for such children in ICA may be part and parcel of the problem. With so much social-political change in China regarding the social value of girls and restrictive birth planning policies, it may be hopeful to consider that this present problem of disabled abandonment may be nearing resolution. But as aforementioned, there's not only lacking political will for the services people with disabilities and families who care for them need in China, but there is also a seemingly sustainable, income-generating demand for their international exportation. Even though under the "one child policy" families with children with disabilities were always permitted to have a second child, this option rarely proved to be comforting given the above mentioned stigma of their lack of personhood and the financial burden to be born in caring for them for life. Thus, even the unfolding of the two child policy presents little hope for the resolution of the disproportionate abandonment and exportation of children with disabilities from China given both their inability to be productively and socially incorporated into the modern Chinese family and their presumed fate to be adopted to families abroad.
In this article I have shown that the increased proportion of children with disabilities being abandoned in China and adopted abroad is not just a domestic, but an international, modern phenomenon. Given the evidence, I think it is fair to conclude that on a grand scale, China's children with disabilities, due to a constellation of complex international and domestic factors, are being exported abroad. In my larger book project, I show that despite the challenges and disruptions Chinese foster families pose to traditional ideals of Chinese kinship and even some of the processes of ICA themselves, the growing system of state-sponsored foster care in China largely serves to support and sustain the practice of ICA rather than challenge or replace it with domestic practices (Raffety Forthcoming). Therefore, even as domestic adoptions in China of healthy children have substantially increased (whereas ICA of such children has plummeted), it appears that ICA of children with special needs from China is becoming something of a fringe practice to ameliorate the problem of disabled abandonments.
But while it is tempting to frame these new politics of abandonment as an extension of China's cultural deficits, I argue that there is more to the story. Indeed, I am concerned with simplistic cultural renderings of the problem which place the culpability squarely upon China rather than seeking to understand how global discourse surrounding disability and the economy of international adoption often play a role in an alarmingly separatist, ableist politics. These simplistic cultural renderings serve to justify and fuel demand for children with disabilities yet fail to interrogate how such demand further disenfranchises such children by undermining the development of domestic welfare systems in China. Furthermore, they fail to see how the maintenance and extension of the White, heteronormative, ableist family operates by absorbing and rehabilitating such orphans rather than considering, validating, or attending to their domestic circumstances. In this new phenomenon in which children with disabilities from China are being disproportionately exported to the West, we see how both the Chinese government and Western countries attribute the problem to cultural backwardness, all the while perpetuating a cultural politics in which the West maintains its own families by incorporating and rehabilitating Chinese adoptees.
Therefore, any proposed solution to the problem of disabled abandonments in China must take into account not only the Chinese government's lack of welfare provisions and discrimination toward children with disabilities, but also the demand for such children from the West and international structures that facilitate ICAs at the expense of sending countries and in favor of adopting countries. The political and economic inequality rampant and reified through the practice of ICA takes on a eugenic, moral quality with the movement toward the processing of a high number of ICAs of children with disabilities, not just in the case of China but with respect to other countries, as well (Joyce 2013). The fact that there are families in China readily fostering and eager to adopt children with disabilities, and yet they are being disproportionately adopted abroad goes to show that the efforts of ICA are not serving the best interests of Chinese families. And that is a problem that should not merely be the concern of China but of all parties involved.
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This claim is based on my own anthropological fieldwork, completed in Beijing, as well as Guangxi, Hunan, and Anhui provinces from 2009-2012, that has also been corroborated by numerous firsthand accounts, among them Hu and Szente 2009, Shang & Fisher 2014, and Wang 2016.
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It is important to note that these statistics are based on Chinese reporting, a phenomenon scholars such as Kay Ann Johnson, Huang Banghan and Wang Liyao trouble, may not be highly trustworthy. Although rather outdated, in a publication in 1998, they point out that the Chinese government, defensive after attacks by human rights groups, "often refers only to 'abandoned and disabled orphans' when discussing its orphanages population, implying that healthy children are not abandoned in China today" (469,479). Despite the outdated nature of the claim, with the subsequent increase in domestic adoptions of healthy girls in China, it is reasonable to trust that the increase in proportionate abandonments of children with disabilities is likely not as high as reported.
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With respect to China, the term "special needs" can be somewhat misleading because it has referred to both children of older age in the orphanage system (roughly 8 to 13) and children with significant medical or developmental needs, broadly defined (see Tan et. al's discussion of the development of the special child waiting program, 2007). Although this conflation of older children and children with disabilities makes it difficult to ascertain accurate statistics on children with disabilities who are adopted abroad, there is also significant overlap between the two populations. Therefore, I use the two terms "children with special needs" and "children with disabilities" interchangeably. This also helps to foreground the language, concept, and politics of disability, which have been under-discussed with respect to ICA from China.
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The United States still accounts for nearly half (47 percent) of all ICAs, with Western countries making significant contributions, thus this article considers demand from the West for ICAs from China (see Selman 2013).
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In truth, China's infamous "one-child policy," was never about only children or even policy, but a series of incentives and disincentives issued by the Communist Party beginning in the 1970s to control the growth of the population (see Potter and Potter 1990 and Greenhalgh 2003). Over the years the policy has been radically expanded to include provisions for minorities, only children, and rural citizens to have more than one child, even as much of China's urban population continues to drastically limit birth.
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Johnson and others use the legal category "out of plan" children to refer to "children who were born in violation of the local birth planning rules at the time, rules that specify timing as well as number of permitted births" (2016:5). As she further explains, this term is often used interchangeably with "overquota births," births that exceed the birth planning rules, but "out of plan" is a larger category in that it includes "children who are born outside marriage or to parents below the legal marriage age, children born before the required interval between births, or children whose birth has been hidden by parents, regardless of timing or birth number, and are therefore not registered" (see note 10, p. 176). Children who are unregistered, lacking a hukou or household registration are often referred to as heihaizi or "black children," because they literally fail to exist in the eyes of the state, lacking basic rights to healthcare and education.
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The large number of children that remained behind in Chinese orphanages as international adoption began to take shape inspired Western INGOs, such as Mercy Care, to intervene.
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Wang writes that "According to the Ministry of Civil Affairs, in 1999, Chinese citizens adopted nearly 32,000 children from orphanages (compared to only around 6,000 international placements). In 2000, the number of domestic adoptions reached more than 49,000, and in subsequent years has tended to fluctuate between roughly 30,000 and 40,000 children per year. These numbers are quite high, especially considering that legal adoption can be a tedious process, requiring parents to provide proof of household registration, marital status, and the ability to raise and educate children" (2016:68).
Although these numbers are significant, they reflect only domestic registered adoptions and notably do not include informally arranged domestic adoptions of girls that Johnson estimates are in the "hundreds of thousands" during the height of birth planning (1999-2010) (2016:11). Johnson states that government officials estimate de facto adoptions in China at four times the total of domestic registered adoptions, yet points out that since 2000 at which domestic registered adoptions peaked at 50,000, they actually decreased below 25,000 in 2013 (160). She writes that this decrease "reflects the increasing difficulty of registering adoptions that take place outside orphanages as well as the general decline in numbers of children available for adoption" (160) (on this difficulty in registering see prior note in this paper).
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By the late 1990s, foster care was becoming widely credited by both foreign INGOs and the Chinese government with physical and psychological interventions into better readying children for both domestic, but primarily international adoption. In 2000, the State Council issued "A Notice on Forwarding 'the Opinion of Accelerating Socialization of Social Welfare," and in late 2003, the Communist Party promulgated a "Temporary Policy on Foster Care," which officially mandated the development and participation of state orphanages in foster care projects. Setting standards for best practices and responsible parties, the central government demonstrated philosophical interest and financial commitment in the national development and practice of foster care. Simultaneously, the vast majority of children in orphanage, foster care units, and private foster homes were being adopted abroad. In fact, at the time of the official implementation of these national policies on foster care, the central government reached its peak in international adoptions in 2005 of nearly 15,000.
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While the Chinese government suggests around 10,000 children are trafficked every year, some experts estimate that number may be as high as 70,000. In the past two and a half years according to government statistics, 54,000 children have been rescued from child traffickers (McDonald 2012). In Guangxi, the poverty of neighboring Yunnan and Guizhou provinces, as well as the porous border with Vietnam, presented a particularly precarious situation for trafficking, and during my time there numerous busts of elaborate child trafficking circles were reported by the local police (Yan 2011). Charlie Custer's documentary, Living with Dead Hearts (2013), follows families whose children have been abducted and children who find themselves growing up in strange homes.
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