3. Findings
3.1. Enacted Stigma from in-Laws or Husbands’ Siblings
All 59 interviewees were married to MSM and encountered enacted stigma from their in-laws and husbands’ siblings. This stigma is linked to traditional expectations for women to bear sons. For example, Ziwei, aged 31, contracted HIV from her husband. She married in 2011 and gave birth to a daughter the following year. However, her mother-in-law wanted them to keep trying until they produced a son. However, Ziwei noticed that her husband kept several forms of lubricating oil and antiretroviral medication in their washroom. When she questioned him about it, he admitted he was MSM. The revelation stunned Ziwei. Shortly after that, she found she had contracted AIDs from her husband. In her despair, she said the only thing that kept her going was her love for her daughter, who had autism. Ziwei reported that her mother-in-law regularly pushed, slapped, and punched her. She recalled what her mother-in-law once said as she scolded her:
“You married my son because you want a man who can buy you things, feed you, and support your family. But what did you give him? A daughter? My son gave money to your poor family in Shenyang. Don’t ever think you are a queen or a princess. You are only a leftover lady. Who wants an old woman? My son was so generous to pick you up, like he saved the environment by removing trash from a landfill. If you are unhappy, leave this village and find your dream man.” Then, I was beaten with a metal broom. My spinal cord was injured, and I stayed in the hospital for 6 months…
Qingwei (31) said that when she discovered her husband was MSM, they agreed to sleep in separate rooms. Their daughter had been diagnosed with Down’s syndrome, and it was left for Qingwei to raise their daughter and do all the household chores. Her father-in-law showed little sympathy and continually scolded her:
“With your inferior genes, of course, you can only produce a daughter and one who has Down’s syndrome. Our neighbors scoffed at me when I went to the paddy field. Do you know how I felt? AWFUL!” I know it is only an excuse to blame me, and they wanted me to leave the village. My in-laws did not want my daughter, but where could we go?
All the Tongqi identified the mother-in-law as probably the most visible source of enacted stigma. Xiaotung (32) said her mother-in-law aggressively criticized her and blamed her for all their troubles more than any family member. She said,
His whole family knew he was a MSM long before we were married. My mother-in-law criticized everything I did and did not like me at all. One day, she suddenly asked me why I was not seductive enough to change his sexual orientation. Later, he tested positive for HIV— and I found I had it too! She said: “You know, HIV will not make you die immediately, right? Probably, in your previous life, you did something wrong. Do not bring all these inauspicious things to our family and village. Take your things and get out!”
The rumor quickly spread across the village that Xiaotung (32) was not a good wife, mother, or daughter-in-law. In the village, she was not even attractive enough to change her husband’s sexual orientation. Tortured by her husband’s family as a salacious and irresponsible woman, Xiaotung suffered from chronic depression and thought of killing herself and her two young girls. She experienced hallucinations and heard voices in her head telling her to dump their children on a mountain, hide them in the forest, and bury them in the backyard. She saw a doctor and was diagnosed with schizophrenia. Her husband wanted to maintain his face. Her-in-laws took care of the children. She lived in the basement of the house, and her in-laws did not allow her to see her children.
Another Tongqi, Danyi (36), was married to her MSM for 5 years. She gave birth to a daughter during their first year together, but she could not conceive after that. Her husband worked at a factory in Guangdong, several hours and hundreds of kilometers away. Once a year, he would visit her, but only for a few days. She says,
Every time my sister-in-law visited during holidays, she would not even say hi. She would bring fancy food and fruit but always found a way to insult me. “Your folks only bring us salty fish and potatoes. We give you everything, and you just have a daughter?” I knew they were even hiding food. Leftovers would disappear from the fridge, but I could still smell the strawberries. They treated me like an unwanted stepchild. I never felt welcome.
Danyi (36) explicitly stated that patriarchal norms pervade her village. Historically, it has been customary for Chinese parents to prefer sons over daughters (Greenhalgh, 1985). In the Chinese patrilineal family structure, sons are preferred because they can own property, perpetuate the family lineage, live with their parents and care for them in their twilight years, and perform ancestral rites.
Another Tongqi, Wangyue (31), did not produce a child after she married her MSM. Her husband did not want to touch her after they married. Her brother-in-law scolded her as a useless and stupid woman. She recalled what he said to her:
“You did not need to stay here and complain. You are only an egg machine to give birth to a child! However, you are a stupid woman without a womb to carry a baby. My brother needed to cut off his losses and dump you. However, he is still so kind and provides you food and shelter.” Then he would kick me, wrestle me on the floor, grab fistfuls of my hair, and shake me. I was too weak to fight back and almost knocked unconscious. When it was over and I resumed consciousness, I called 120 (emergency call) and spent one week in the hospital.
Another Tongqi, Beibei (29), said her mother-in-law kept asking her to disappear and leave her family quietly. She was warned against filing for divorce, however. Her mother-in-law said,
“Your marriage is just a bad business deal. You know my son is MSM, so you can leave. Don’t stay, and don’t fight. This is an ultimatum: you will regret it if you try to divorce. You are a total failure. Don’t ever think you can compete with us; we will destroy you. Don’t ask our grandson to go to your poor village with you. You cannot even provide food and education for him. Shameful!”
The verbal attacks and threats continued, and Beibei finally went to the local police. But her complaint was dismissed immediately because there was no evidence. Among all Tongqi interviewed, the rural police were described as unhelpful, even negligent, toward their situations. Beibei (29) went home feeling hopeless and depressed. To the police, no physical evidence of injuries showed the incident was consensual. For example, the police asked Beibei (29) to show them pictures and videos of her in-laws beating her up. Police in China often consider domestic violence to be embodied by a woman’s willingness to sacrifice her life to protect her chastity and honor.
All the Tongqi in these rural settings consider themselves part of patrilineal marriages, adopting their husband’s surnames. Patrilineal marriage refers to a social system in which inheritance and family lineage are traced through the male line (Greenhalgh, 1985). This system prioritizes male offspring to continue the family line and legacy of property. In this context, Tongqi must routinely endure traumatic experiences that are defined by exclusion and a lack of accountability for the perpetrators. Tongqi have to live with their in-laws and MSM as second-class citizens, alone and under constant attacks.
3.2. Enacted Stigma Received from the Villagers
The Tongqi reported they often experienced verbal insults and sometimes physical assaults from villagers. They also faced disapproving silent stares from both male and female villagers. Patriarchal norms reinforce the roles of Tongqi as publicly submissive partners to their husbands, perpetuating a cycle of domination and subordination. In general, the villagers mostly ignored the distress of the Tongqi, only caring if the Tongqi used social media to identify themselves and their plight. They were primarily concerned about the image or reputation of the village if negative posts appeared on platforms like WeChat or shared with specific Tongqi non-governmental organizations (NGOs). Haoyi (39) experienced stigma from villagers. She says,
The villagers always seemed eager to prepare snacks and drinks for the entertaining drama we regularly provided. Criticism became an argument that got louder and louder. Soon, someone is screaming that I am a poor idiot, a leftover lady who cannot afford a house or a divorce. They were even teasing me about my HIV infection from my husband. Those people never thought my husband was MSM! They believed I was a lonely loser who had an affair and a one-night stand, and that is how I contracted HIV! One neighbor always yelled: “We are ashamed of you and hope you pack and leave soon... you are deeply bound by the threads of fate (ming命)”.
In the context of rural village norms and patrilineal marriage, Tongqi are not permitted to disclose their problems online because that damages everyone’s reputation needlessly. A second reason is that Tongqi should remain silent because they already benefitted from the traditional practice of “bride price.” Traditionally, the groom’s family provides substantial money or goods to the bride’s family. In return, the bride is expected to uphold tradition and behave accordingly. Therefore, if a Tongqi gives birth to a daughter rather than a son and subsequently discovers her husband is MSM, she will receive blame for not producing a male heir. The patrilineal marriage system prevalent in rural China significantly intensifies the stigma endured by Tongqi. This system underscores the significance of male progeny for lineage perpetuation, reinforcing societal expectations and entrenched gender norms evaluating a woman’s worth solely by her capacity for producing sons. Tongqi are expected to conform to the traditional customs of ancestral reverence, bowing, and kowtowing outside the ancestral hall, a symbolic act to wash off their family’s sins.
Tongqi face significant enacted stigma and ostracization within the context of rural China. The cultural emphasis on family honor in China exacerbates this issue, as MSM and Tongqi are often perceived as bringing dishonor to their families. The widespread fear of AIDS (Deacon, 2006), particularly in rural areas where it is more commonly associated with MSM, further stigmatizes Tongqi. Collectively, these factors contribute to the marginalization and stigmatization of Tongqi in rural China, often leading to significant mental health implications. Consequently, Tongqi grapple with issues such as a lack of sexual intimacy, emotional neglect, feelings of humiliation, and isolation. Efforts to change their bleak circumstances invariably result in societal backlash. Tongqi who pursue divorce are construed to have failed as a wife, a mother, and a homemaker. Thus, the patrilineal marriage system considerably amplifies the stigma and challenges faced by Tongqi.
3.3. Enacted Stigma from Macrostructural Hukou System
As with the majority of Tongqi, their risk of contracting HIV is higher compared to heterosexual wives in rural China (Tsang, 2019; Tsang, 2020). The majority of Tongqi are registered with a rural hukou. As stay-at-home wives, all the informants rely on their husband’s income to cover family expenses and typically do not have financial independence. Because the husband engages in high-risk sexual activity with MSM, 11 of the 59 Tongqi interviewed reported being tested HIV positive. All 11 said they contracted HIV from their husbands. In this situation, their rural hukou status poses additional challenges. The hukou determines where one may receive healthcare, but urban hospitals tend to have better care and medications than hospitals serving rural villages. Thus, Tongqi rarely have money or access to quality HIV medications, which could alleviate the related symptoms. Yangli (32) lived on the outskirts of Harbin with her 2-year-old and 4-year-old children. She could not find the proper medication for her HIV. She says,
I need Triumeq (an antiretroviral drug used in China), but to get it, I have to take a 9-hour train ride to the city center of Harbin. The rural hospital gave me a cheap substitute, but it only kept my life going a little bit longer. For pain relief, I rely on acupuncture and Chinese herbs. Usually, my body is fine, but sometimes, I have a fever, tiredness, and lethargy. Sometimes, I have swelling or a rash, ulcers or sores in the mouth, and sores on the genitals. The villagers tease me and treat me like a monster.
Another Tongqi, Fangwei (28), contracted AIDs in 2021 and complained of daily discomfort. She said:
Where do I begin? My health has rapidly declined. My immune system has deteriorated, and even a cold can knock me out. I am always running a fever, sweating at night, and exhausted. I have lost a lot of weight and often have diarrhea. I am prone to infections like pneumonia and even TB. These bugs, no biggie for a healthy person, could be the end of me. The unknown is the worst part - never knowing what is next or how my body will cope. I feel trapped, like I am living in a prison. Even in China’s hot summers, I am freezing. And the fear of dying? It is always there, lurking.
Another Tongqi, Ziwei (31), said she was infected with AIDs from her husband, she says,
Antiretroviral therapy can help, but it requires strict adherence to a medication regimen, often with unpleasant side effects. If I miss doses, I could develop drug resistance, rendering the medication ineffective. I have been shunned by people who were once friends, even some family members. But you know what is even worse? The way people treat you. Friends who I thought would stick by me turned their backs on me—even some of my family. I have kept my lips sealed, not saying a word to them about it. The loneliness hits you like a ton of bricks. It is like a constant stab in the heart, you know? But I am hanging in there.
The Tongqi are not queer (Engebretsen, 2014; Liu & Tan, 2021; Liu, 2013), but many rural villagers think they are. The Tongqi are not victims caused by marriage fraud by their MSM. The 11 Tongqi with HIV reported feelings of desolation, a sense of victimization and self-reproach, depression, anxiety, and fears of societal condemnation as their emotional responses to their diagnosis. In China, an estimated 780,000 individuals live with HIV (Tsang, 2021). The reported rate of HIV cases due to MSM exposure has increased significantly from 0.2% in 2001 (China Ministry of Health 2010) to 32.5% in 2009 (China Ministry of Health 2010). In addition, more than 10% out of 13.6 million Tongqi infected with HIV through their MSM proactively contact HIV NGOs for HIV/AIDS treatment and medication from the government (Earnshaw, 2006; Li, 2015).
However, the HIV infection rate among Tongqi and its association with the institutional hukou system is often overlooked. Accessing HIV-related medical services in China can lead to discrimination against rural Tongqi, as medications and treatments are legally withheld. Since Tongqi are perceived to be part of the LGBTQ community, wives with MSM husbands are granted higher status in terms of biological citizenship. The Chinese government maintains control over underprivileged groups within society. Possessing a rural hukou relegates HIV-positive Tongqi to the status of marginalized. Some urban residents living with HIV can obtain the antiretroviral drug Triumeq. A monthly prescription of the pills typically costs around 450 yuan (US$73). However, rural hospitals may not have it in supply and instead, dispense inexpensive substitutes that are ineffective against HIV symptoms. By contrast, urban hukou holders can access superior drug cocktails with multiple pills to combat HIV. Consequently, rural Tongqi often receive little or no medical support, while middle-class urban MSM communities receive proper HIV medication and can even travel to the US for treatment. Affluent LGBTQ individuals with HIV have access to various medicines. One method is called Treatment as Prevention (TasP), using antiretroviral therapy (ART) to decrease the likelihood of transmitting HIV. Getting TasP or ART is neither a class issue nor affected by hukou because the medications are difficult to find in China. By reducing the viral load in the patient’s body to undetectable levels, the risk of transmitting the disease to others is significantly reduced (Tsang, 2020). Another method is Pre-Exposure Prophylaxis (PrEP). PrEP refers to the daily intake of HIV medication by individuals who, while not currently infected with HIV, are at risk of contracting the virus, thus, as a preventative measure against HIV infection (Tsang, 2020; Wolkomir, 2009).
3.4. Enacted Stigma by the Government
Jiaxin, a 30-year-old Tongqi, visited her husband’s military camp in 2018 near the Yunnan border after he admitted being an MSM. She wanted revenge because he had repeatedly beaten her. She sought to call him out and ruin his reputation in the camp. However, the camp commander was indifferent and displayed his misogyny with comments that left her disappointed. Jiaxin (30) says,
The supervisor, a man, denied that my husband was an MSM. He said: “We do not have a gay issue in China; it has never been a social problem here. Leave now, or our security crew will escort you out.” As I left, things got worse. Several security guards threatened to report me to the police for trespassing. I left feeling sad and tearful. I was criticized and bullied by a dozen men. They warned me to stay quiet, stay home, and care for my husband. They said that military men are responsible and heterosexual. Therefore, my husband was a good army man devoted to his family…
Siyan, a 30-year-old Tongqi, has been married for eight years and has a 6-year-old son and a 4-year-old daughter. Her husband works in a government office as a party member. She says he engages in daily acts of deception both at work and in their village. Government offices assume employees are heterosexual. Siyan’s husband repeatedly pressured her to attend an annual gala so they could project the image of a stereotypically wholesome MSM family with a traditional and attractive wife and a charming child. Although Siyan had previously attended the galas, this time, she refused to participate in her husband’s dramaturgy, having been traumatized by his physical and emotional abuse. She says,
He routinely hit me, pulled my hair, and pushed me into corners, injuring me and filling me with fear. He said this was the only way to ensure I would not endanger his reputation as a good husband, colleague, and staff member in front of his boss and co-workers. He was afraid his colleagues might gossip that he was MSM, and then he would lose face! Therefore, he treated me like a punching bag.
Zheng (2008) contends that some sectors of Chinese society scapegoat male MSM, viewing them as emblematic of “passive masculinity.” Most supervisors from state-owned enterprises do not express concern about the presence of MSM individuals within their ranks, as this aligns with a fundamental policy in the country. China usually ignores Tongqi as one of the social problems to maintain societal stability (wenweng维稳) and encourage the status quo of the marriage between Tongqi and MSM.