China’s Contraceptive Tax: A Controversial Attempt to Boost Birth Rates

In a striking policy reversal, China will begin imposing a 13% value-added tax on contraceptives starting January 1, while simultaneously exempting childcare services from the same tax. This change effectively ends exemptions that have been in place since 1994, when China was still enforcing its notorious one-child policy. The move represents Beijing’s increasingly desperate attempts to address a demographic crisis that has seen China’s population decline for three consecutive years, with only 9.54 million babies born in 2024—roughly half the number recorded a decade earlier. The policy shift comes as China faces an aging population and economic stagnation, with India recently overtaking it as the world’s most populous nation.

The new contraceptive tax has sparked significant backlash within China, ranging from ridicule to genuine concern about potential public health consequences. On social media, some users have joked about stockpiling condoms before prices increase, while others point out the obvious disparity—that the minor cost increase for contraception pales in comparison to the enormous expense of raising a child. Daniel Luo, a 36-year-old father from Henan province, told the BBC that the price increase would not influence his family planning decisions, likening it to small subway fare hikes that don’t alter daily behavior. More concerning, however, are warnings from individuals like Xi’an resident Rosy Zhao, who fears the policy could have dangerous unintended consequences, potentially leading financially strained individuals or students to take sexual risks they might otherwise avoid.

Health experts have raised serious concerns about the broader implications of making contraception more expensive. They warn that reduced access could lead to increases in unintended pregnancies and sexually transmitted infections—China already recorded more than 670,000 cases of syphilis and over 100,000 cases of gonorrhea in 2024. The country has historically reported some of the world’s highest abortion numbers, with between 9 and 10 million procedures annually from 2014 to 2021, though the government mysteriously stopped publishing this data in 2022. The policy could disproportionately affect women, who bear most of the responsibility for birth control in China. Research from the Bill and Melinda Gates Foundation reveals that while only 9% of Chinese couples use condoms, 44.2% rely on intrauterine devices and 30.5% on female sterilization, with male sterilization accounting for just 4.7%.

For many Chinese women, the tax revives painful memories of the government’s long history of interference in reproductive decisions. The Communist Party’s one-child policy, enforced from approximately 1980 until 2015, relied on fines, penalties, and sometimes forced abortions. Children born outside policy guidelines were occasionally denied household registration, effectively making them non-citizens. “It is a disciplinary tactic, a management of women’s bodies and my sexual desire,” said Zou Xuan, a 32-year-old teacher from Jiangxi province, expressing a sentiment shared by many who see this as yet another example of state intrusion into deeply personal decisions. Recent reports that women in some provinces have received calls from local officials inquiring about their menstrual cycles and pregnancy plans have only heightened these concerns. While one health bureau in Yunnan claimed the information was needed to identify expectant mothers, critics view such measures as invasive surveillance that risks further alienating the very families the government hopes to encourage.

Demographers and policy analysts remain highly skeptical that taxing contraceptives will have any meaningful impact on birth rates. Yi Fuxian, a senior scientist at the University of Wisconsin–Madison, dismissed the notion that higher condom prices would influence fertility decisions as overthinking the policy. Henrietta Levin of the Center for Strategic and International Studies described the move as largely symbolic—Beijing’s attempt to address “strikingly low fertility numbers.” She also highlighted a practical concern: many incentives and subsidies for families depend on provincial governments that are already heavily indebted, raising questions about whether these entities can adequately fund such measures. Value-added tax revenue, which totaled nearly $1 trillion last year, accounts for approximately 40% of China’s tax collection, suggesting the financial motivations behind this policy may be more significant than officials admit.

The fundamental challenge facing Chinese policymakers is that reversing decades-long demographic trends requires much more than adjusting prices at the checkout counter. After years of strictly controlling population growth through the one-child policy, the government now faces the much more difficult task of encouraging families to have more children in an era of high living costs, competitive education systems, and changing social attitudes toward family formation. As Levin noted, “The [Communist] party can’t help but insert itself into every decision that it cares about. So, it ends up being its own worst enemy in some ways.” This observation captures the central irony of China’s current predicament: having spent decades forcefully limiting population growth through intrusive policies, the government now finds itself unable to boost birth rates despite increasingly desperate measures. The contraceptive tax represents just one more example of how the state’s heavy-handed approach to personal decisions may ultimately undermine its own demographic goals.