2014 Sex Roles Gender and Confucianism
2014 Sex Roles Gender and Confucianism
2014 Sex Roles Gender and Confucianism
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ORIGINAL ARTICLE
Abstract The gender (male to female) ratio of the Chi- Thus, suicide prevention may need to include culture
nese suicide rates is different from those found in the specific measures.
rest of the world. None of the other societies with
known suicide data has had female suicide rates higher Keywords Gender ratio of suicide . Gender roles . Sexism .
than those for the males. While we investigate the factors Religion . Confucianism . Suicide . China
that contribute to the relatively high suicide rates for
Chinese women, we also need to ask what makes the
relatively low suicide rates for Chinese men. In this study Introduction
we try to examine some social and cultural variables in rural
Chinese youths in order to identify the factors that account The relationship between gender and suicide has been exten-
for the relatively low rate for men and relatively high rate for sively studied, given the cross-cultural paradox that males die
women. In rural China, 392 suicides (both men and women) 3–5 times more often by suicide than do females and reported
aged 14–35 years consecutively sampled from 16 counties of suicide attempts are about 3–5 times more common among
three provinces were studied with 416 community living females than males (WHO 2009). However in China, the
controls of the same age range and from the same gender ratio of suicide rates does not match the international
locations. Case–control psychological autopsy method patterns with the rates higher for females than males or the
was used for the data collection. It is found that be- ratio close to 1 (Wang et al. 2008; Zhang et al. 2011a). When
lieving in Confucianism and being married are both we ask why Chinese women are at relatively high risk of
protecting the rural young men from suicide, while suicide, we should also ask why Chinese men are at such a
the two same variables are either risk or non- relatively low risk, as there is no standardized rate or criterion
protecting factors for the Chinese rural young women’s for suicide in the world. Trying to account for the different
suicide. In rural China, social structure and culture suicide gender ratios and disparities in men and women,
may play an even more important role determining a researchers have studied the biological differences between
society’s suicide rates as well as the gender ratios. men and women in Europe (Hawton 2000; Steffensmeier
1984), mental disorder disparities in the United States (Rich
et al. 1988), physiology in China (Zhang 2000), methods used
in suicide in the United States and Europe (Callanan and
The research was supported by the United States National Institute of Davis 2011, 2012; Schrijvers 2012; Värnik et al. 2008), gen-
Mental Health (NIMH): R01 MH068560. der role in the United States (Canetto and Sakinofsky 1998),
J. Zhang
and culture in the United States (Girard 1993; Stack 1998).
Shandong University School of Public Health Center for Suicide Previous studies on the gender disparities in Chinese suicide
Prevention Research, Jinan, China have focused on the risk factors of female suicide (Li et al.
2012; Wang et al. 2008; Zhang 2010). Given the unique social
J. Zhang (*)
Department of Sociology, State University of New York Buffalo
structure in China, we attempt to address the relatively low
State, 1300 Elmwood Avenue, Buffalo, NY 14222, USA suicide rates for Chinese men through an examination of the
e-mail: [email protected] social and cultural values in rural China.
Sex Roles (2014) 70:146–154 147
Culture plays an important role in gender differences of behaviors as theistic religions do. We believe that as the
suicide rates (Stack 1998). The unique gender ratios found in foundation of Chinese traditional culture, Confucianism and
the Chinese suicide rates might be understood with the Chi- the Confucian ideology of family is an ethnic-religious tradi-
nese culture context. Is the unique gender ratio in Chinese tion that has been profoundly rooted in the Chinese daily life
suicide rates mainly contributed by the more female suicides (de Bary 1988), and familial relationships have been strictly
or less male suicides, or both? Answers to these questions my regulated by the Confucian ideology (Tu et al. 1992). Even
help people better understand the Chinese social and cultural during the reform era, more and more Chinese have been
structure and its normative gender roles introduced by its returning to traditional family roles, as the communist state
belief systems. Of course, the ultimate goal of research in this has continuously enforced Confucian ideology especially fil-
line is to find ways to reduce suicide among both men and ial piety and harmony as a core family virtue to compensate
women in the world. for the lack of social welfare and public services in the post-
socialist era (Ikels 2004; Jacka 1997; Rofel 1999). All tradi-
Religion and Confucianism tional Chinese virtues are subordinated to the Confucian ide-
ology, modified by it, defined in terms of it or even eliminated
Religion is one of the strongest cultural correlates of suicide in by it (Hsu 1998).
all societies in the world (Stack 1983, 2000). Numerous
studies have proved the negative correlation between Confucianism and Gender
religion/religiosity and suicidal behavior in various cultures
(Dervic et al. 2006; Eskin et al. 2007; Malone et al. 2000; Confucianism consists of three core sets of ethics and values:
Marty et al. 2010; Oquendo et al. 2005). The protective effect 1) filial piety, 2) harmony, and 3) female subordination (Hsu
of religion on suicide is true in both developed and developing 1998; Hwang 1999). Filial piety, veneration of the elderly in
countries in the world (Vijayakumar et al. 2005). However, the the family, has been conceived as a preeminent virtue of
findings in Chinese societies are different from the majority in Confucianism and become the most powerful social dictate.
the world. Religion/religiosity is either a risk factor of suicide Specifically, filial piety demands that Chinese persons: (1)
or non-significantly related to suicide (Zhang et al. 2004, “venerate parents”; (2) “care own body: The body and the
2010, 2011b). One reason why Chinese suicide is sometimes limbs, the hair and the skin, are given to one by one’s parents,
positively related to religion/religiosity is that institutionalized and to them no injury should come”; and (3) “not die before
religion is still not popular in Chinese societies with only parents: The white hairs should not go to the funeral of the
about 10 of the people at most claiming themselves to be black hairs; a son should not die before his parents.” Obvi-
religious, and thus, religion may still be a deviance bearing ously, the social values of filial piety imposed to Chinese men
stigma among Chinese people. can serve as buffers for traditional rural young men in Chinese
Confucianism was not categorized as a religion in the societies.
above studies on the relationship between suicide and The principle of harmony is the touchstone for all interper-
religion/religiosity. Actually, it is still debatable whether Con- sonal behavior (King and Bond 1985). As a social theory, the
fucianism is a religion. As the earliest European arrivals in foremost purpose of Confucianism is to achieve a harmonious
China several hundred years ago, the Christians considered society, in which each individual acts towards others in a
Confucianism to be an ethical system, not a religion, and one proper way (propriety) so that the social order can be
that was compatible with Christianity (Elman 2005, p. 112). It established (Fingarette 1972; King and Bond 1985). The
is now commonly believed among scholars that Confucianism ethics and values of harmony stress: (1) “Being harmonious:
is non-theistic, Confucianism is humanistic, and it does not Happy family and nice neighborhood”; (2) “Self-Discipline:
involve a belief in the supernatural or in a personal god (Yang Denying self and returning to propriety”; and (3) “Endurance:
1959, p. 244). However, Confucianism can be described as a Restraining self for long run goals”. The Confucianism prin-
moral science or philosophy, but it can also be described as “a ciple of harmony reflects that being human is conditional on a
means of ultimate transformation” (Streng 1985, p. 2), and as person’s being obedient to social norms in daily interactions
a “sociopolitical doctrine having religious qualities” (Yang (Bauman 1976). Thus, the focus of harmony is not fixed on
1959, p. 27). With the latter definition, Confucianism is a any particular individual but on the particular nature of the
religion, even if non-theistic, in the sense that it “performs relationships among individuals who interact with one another
some of the basic psycho-social functions of full-fledged (Solomon 1971). In the collectivistic society dominated by the
religions,” in the same way that non-theistic ideologies like principle of harmony, individuals are part of the group and
Communism do (Yang 1959, p. 27). suicide for individual reasons cannot be encouraged.
Regardless of the debate that continues between religion Confucianism also imposes strict requirements on women,
and non-religion, we treat Confucianism as an important and women are relegated to a lower status in the Confucian
social and psychological force that affects individual family and society (Tu et al. 1992; Yang 1959). Both the father
148 Sex Roles (2014) 70:146–154
and the husband are the ultimate disciplinarian in the tradi- masculinity and femininity, in terms of traditional gender
tional Confucian family (Slote 1998). Even though the mother roles. Male gender roles tend to emphasize greater levels of
may have authority over son, after her husband dies, the oldest strength, independence, and risk-taking behavior (Payne et al.
son takes over the authority in the family. In addition, the 2008), and reinforcement of this gender role often prevents
principle of gender segregation makes it imperative that males from seeking help for suicidal thought, feelings, as well
brothers and sisters do not associate with each other closely, as depression (Möller-Leimkühler 2003).
and when authority is in question the male is always the In another study by a group of sociologists examining the
dominant party (Ikels 2004). The Confucian expectation of a gender and suicide gap by considering how cultural factors
good woman is illustrated in the “Three Obediences” and the impacted suicide rates, four cultural factors were identified:
“Four Virtues.” A woman in a very traditional Confucian power-distance, individualism, uncertainty avoidance, and
family is discouraged from participating in social activities, masculinity (Webster et al. 2003). Some WHO Data for 66
cultivating talents, and receiving more education than her countries and areas were assessed to measure the four cultural
husband. She must accept arranged marriage by her parents, factors. It was found that cultural beliefs regarding individu-
bear a son to carry out her husband’s family heritage, and alism were most closely tied to the gender gap. Countries that
serve the elderly and take care of her husband at home. The placed a higher value on individualism showed higher rates of
Confucian values that suppress freedom and individuality male suicide. Power-difference, defined as the social separa-
among traditional rural young women, coupled with the gen- tion of people based on finances or status, was a negative
der equalitarianism advocated by the Chinese government, correlate to suicide. On the other hand, countries with high
likely creates a psychological strain that usually precedes a levels of power-difference had higher rates of female suicide
suicide (Zhang et al. 2009; Zhang and Lester 2008; Zhang (Webster et al. 2003).
et al. 2011c, 2013). It has been noted that the gender gap is generally smaller in
developing countries. One theory put forward for the smaller
Gender and Suicide gap is the increased burden of motherhood due to the cultural
norms in the developing societies (Payne et al. 2008). In a
The incidence of suicide is vastly higher among males than review of the countries and areas that have smaller gender gap
females among all age groups in most of the world. In the of suicide rates, we can easily find that most of them are
United States and most European societies, the male to female Confucian ethics dominated societies. For example, the
ratio varies between 3:1 and 10:1 (Hee Ahn et al. 2012). On male/female suicide rates ratio was 1.1 for Hong Kong, 1.3
the other hand, the gender ratio of the Chinese suicide rates for Singapore, 1.8 for Japan (Canetto and Sakinofsky 1998),
has been different from those found in the rest of the world. It 1.5 for Taiwan (Taiwan Government 2003), 1.4 for India, 1.5
used to be .80, and in the recent years is 1.10 (Phillips et al. for the Philippines, and 2.2 for South Korea (WHO 2009).
2002; Wang et al. 2008; Zhang et al. 2011a), while none of the Confucian gender ideology that relegates the role of women
societies, besides mainland China, with known suicide data might have played an important part increasing the female
has had female suicide rates higher than the male rates. suicide risks.
It is commonly believed that suicide, as a violent act In a Confucian society, men and women are expected
against human being, is masculine and that is why it happens differently in terms of life goals, work ethics, morality, family
more in males than in females (Steffensmeier 1984). There- roles, and interpersonal relations, etc. A Confucian society is
fore, males are more likely to end their lives through effective more a “men’s world,” where men’s ambitions, success, and
violent means (guns, jumping, hanging, etc.), while females achievements are encouraged and valued more than those of
primarily use less violent methods such as overdosing on women. Because of the respect and responsibilities expected
medications (Callanan and Davis 2011, 2012). This is the for men in traditional Chinese societies, Chinese rural young
method theory that explains the high gender ratio of the men are less motivated to die by suicide. On the other hand,
suicide rates in the world. Researchers have also ascribed the the suppression on women coupled with the gender equalitar-
disparity to inherent differences in male/female psychology. ian ideology in modern societies is likely to bring about
Greater social stigma against male depression and a lack of psychological frustration on women who value the traditional
social networks of support and help with depression are often gender roles and appreciate the equalitarianism in modern
identified as key reasons for men’s disproportionately higher societies the same time (Zhang et al. 2011c).
level of suicides, since suicide as a “cry for help” is not seen
by men as an equally viable option for women (Canetto and Hypotheses to be Tested
Sakinofsky 1998).
Researchers have tried to find explanations for the reason Thus, it is hypothesized in this study that (1) for Chinese rural
why gender is such a significant indicator of suicide. One young males, the more they value Confucianism on the regu-
common explanation relies on the social constructions of lations for males, the lower the suicide risks are for them, (2)
Sex Roles (2014) 70:146–154 149
for Chinese rural young women, the more they value Confu- problems. Interviewing these people could get very biased
cianism on degraded gender role for women, the higher the reports, if marital infidelity and family oppression were pos-
suicide risks for them, and (3) the relationship between Con- sible causes of suicide (Conner et al. 2011). (2) Suicide
fucian values and suicide in Hypothesis 1 and 2 remain persons could be as young as 15 years of age, however
significant even when the major demographic variables are informants had to be 18 years of age or older. (3) For suicides,
held constant. Thus, Confucianism in China can be a protec- informant #1 was always a parent, spouse, or another impor-
tive factor for Chinese men but a risk factor for Chinese tant family member, and informant #2 was always a friend, co-
women. This is an attempt to attribute the gender differences worker, or a neighbor.
in Chinese suicide to the popular cultural values in Chinese Based on the above considerations, different responses
societies. from the two informants for the same suicide victim were
integrated according to the variables based on previous expe-
riences (Kraemer et al. 2003). For demographic information,
Method the answers by the informant who had the best access to the
information were relied on. For example, a family member
Procedures of Data Collection should know the target suicides’ age and birth date more
accurately than does a friend. To determine a diagnosis with
Data for this research were from a large psychological autopsy the SCID, the positive symptom was selected, because the
(PA) and case control study conducted in rural China. Rural other informant might not have had an opportunity to observe
young men and women aged 15 to 34 years who died of the specific characteristic or behavior of the suicides.
suicide were consecutively recruited, and community living Informants were first approached by the local doctor or the
controls were randomly sampled from the same areas for the village administration by a personal visit. Upon their agree-
same age range and gender distribution. Psychological autop- ment on the written informed consent, the interview schedule
sy (PA), the data collection method had been proved to be was arranged between 2 and 6 months after a suicide event.
reliable and valid in Chinese social and cultural environments Each informant was interviewed separately by a trained inter-
(Zhang et al. 2002). viewer, in a private place of a hospital or the informant’s home
Three provinces were selected in China for the study. without interruption. The informants for the controls were also
Liaoning is an industrial province located in Northeast China, interviewed about the same time. The average time for each
Hunan an agricultural province in the Central South China, interview was 2.5 h.
and Shandong a province with economic prosperity in both This study was approved by the IRBs of all the universities
industry and agriculture that is on the east coast of China mid- involved in this study, from both United States and China. The
way between Liaoning and Hunan. The suicides came from 16 research nature of the interview and the background of the
countries (six from Liaoning, five from Hunan, and five from research project were explicitly explained to each interviewee.
Shandong). In each of the 16 counties, suicides aged 15–34 Before each face-to-face interview informed consent and that
were consecutively recruited from October 2005 through June details the rights of the interviewee was read and signed. If
2008. After successful interviews with informants of the sui- distress was present during the interview or the interviewee
cides and community living controls, a total of 392 suicide was upset by the death of the loved one, and the participant
cases 416 controls were collected for study. The community wished to stop, the interview would be ended. Medical assis-
living controls were recruited to roughly match the suicides in tance was provided if needed. If the participant was not able to
gender, age range, and county location, to identify other continue, another replacement informant was chosen. All the
characteristics of the suicides different from those of the interviewers were either young faculty or graduate students
controls. with professional medical trainings, and they had gone
Two informants were interviewed for each suicide and each through strict training workshops before the data collection
control. However, it is recognized that the type of informants for both interview protocols and first-aid assistance in clinical
rather than the number of informants used in psychological symptoms of distress. Additionally, in all cases, the village
autopsy studies was an extremely important consideration head and/or the village doctor led the interviewer to the
(Kraemer et al. 2003). The informants were selected based subject (informant), and the village doctor was in charge when
on the context or environment (how people observe the target, any medical service is needed and could make sure the safety
e.g. home vs. non-home setting). This way, each informant of the villager who is interviewed. Actually, by the end of the
was carefully obtained to optimize the information available data collection in the 16 counties of the three provinces, none
on each case. (1) Suicide informants were selected with rec- of the interviewees had an incident that required medical
ommendations from the village head and the village doctor. assistance.
However, we tried to avoid as much as possible husbands and The suicide sample (n =392) is representative of the rural
the in-laws of those female suicides triggered by family young suicides aged 15–34 years as they were consecutively
150 Sex Roles (2014) 70:146–154
recruited in the selected areas. Because of these carefully (informants) were asked to tell how strongly the target person
designed procedures, we had an excellent response rate with agreed or disagreed with each of the statement on a five-point
almost 100 % of the approached having finished the interview. Likert Scale. The sum of the eight items indicates the score of
Confucianism for women, and the higher the score, the stron-
Measures ger their agreement with the statements.
Table 1 Characteristics of the case control samples for men and women
Suicides (n =214) Controls (n =202) X 2/t p Suicides (n =178) Controls (n =214) X 2/t p
Age years, mean (sd) 26.95 (6.6) 25.47 (6.1) 2.362 .019 26.70 (6.1) 25.91 (6.2) 1.277 .203
Education years, mean (sd) 7.40 (2.6) 9.36 (2.4) −7.910 <.001 8.90 (12.2) 9.79 (9.0) −.821 .412
Family income RMB, mean (sd) 14700 (30023) 21100 (20212) −2.453 .015 13500 (9610) 20300 (19273) −4.330 <.001
Marital status, n (%)
Never married (0) 93 (43.5) 71 (35.1) 36 (20.2) 48 (22.4)
Ever married (1) 121 (56.5) 131 (64.9) 3.004 .083 142 (79.8) 166 (77.60) .281 .596
Religiosity, n (%)
Atheist (0) 161 (75.2) 182 (90.1) 118 (66.3) 162 (75.7)
Believer (1) 53 (24.8) 20 (9.9) 15.871 <.001 59 (33.1) 50 (23.4) 4.545 .033
Confucianism for men, mean (sd) 27.02 (3.8) 28.59 (3.3) −4.383 <.001
Confucianism for women, mean (sd) 23.62 (5.0) 21.97 (5.2) 3.107 .002
Family income is measured by Chinese Renminbi (RMB) with the exchange rate of US$1 ≈ 7.00 RMB at the time of data collection
suicide risk for these young women in rural China. As in such Confucianism for women
other traditional societies as India, females are also at high risk
(1) Women should stay at home
of suicide due to the traditional bonds out of the social values
她赞同“女人应在家干活不应外出工作”吗?
coupled with the modern ideologies in which women’s free-
(2) Caring her husband and kids
dom and liberation are promoted. Psychological strains, re-
她 赞同女人应该 “ 相夫教子” (侍候丈夫、 教育孩
sulted from the conflicting social values, are usually among
子)吗?
the sources of frustration, depression, and even suicidal idea-
tion (Zhang et al. 2011c). (3) Bearing a son
The focal finding of this study is that Confucianism protects 她赞同“生儿子”比生女儿更重要吗?
Chinese rural young men from suicide but put Chinese rural (4) Keeping marriage without divorce
young women at high risk of suicide. This partially explains why 她赞同“守寡”(为了保持贞节不再婚)吗?
the gender ratio in the Chinese suicide rates are so close to 1, and (5) Three Obediences
why the ratio could be reversed a couple of decades ago. Besides 她赞同妇女应“三从四德”(凡事服从男人)吗?
this culture value explanation, there could be many other ways to (6) No social activities
account for the low rates of suicide for Chinese men and the 她赞同“妇女应该持家,而不应该参加社会活动(抛头
relatively high rates of suicide for Chinese women. Among them 露面)”吗?
may be economic development, political structure, psychological (7) Women working at home only
characteristics, as well as the physiological differences between 她赞同“女主内男主外”吗?
men and women. Further studies on the gender differences in (8) Woman is less important than man
suicide rates in China as well as in the rest of the world are called 她赞同总体上讲“男人比女人更重要”吗?
for in future research projects.
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