Addressing Taiwan's Declining Birth Rate: Overcoming Traditional Barriers to Fertility Solutions

For married Taiwanese men Alan Hung and Danny Huang, the journey to have a biological child together was filled with challenges.

The couple had always hoped to start a family shortly after getting married in 2019, right around the time when Taiwan made history by becoming the first Asian region to allow same-sex marriage.

Huang expressed his desire to start a family, inspired by friends who had children of their own. However, being gay men in Taiwan, they were unable to access artificial reproduction methods. As university professors in their mid-40s, the couple had to explore options overseas.

They spent over a week at a fertility clinic in Russia, but couldn't complete the procedure due to regulatory changes. Later, they found success with a surrogate in the United States, but it came at a high cost of over $160,000.

Cases like this trouble Chen Ching-hui, who recently became the first fertility specialist to win a seat in Taiwan's parliament.

Hung and Huang with their baby boy, Aiden.

Hung and Huang with their baby boy, Aiden.

In an interview with CNN, she questioned why people have to spend a lot of money to travel overseas when Taiwan's medical technology is so advanced. Alan Hung and Danny Huang are working to address this issue.

Same-sex couples and single women in Taiwan are currently prohibited from undergoing procedures like in vitro fertilization (IVF) or egg freezing. Additionally, surrogacy is completely illegal in the country.

Chen and other advocates are now advocating for a relaxation of these restrictions. This is in response to the declining population in Taiwan, which not only poses a threat to the economy but also impacts the island's ability to defend itself against a more assertive China.

Declining fertility is a significant issue for many developed economies in East Asia, but it is particularly severe for the democratically governed island of 24 million people. This island has one of the lowest birth rates globally, with the number of newborn babies decreasing each year.

In 2022, the total fertility rate on the island was recorded at just 0.87, which is much lower compared to countries like Japan (1.26) and Singapore (1.05). It is only slightly higher than South Korea, where the rate stands at 0.78.

To maintain a stable population without immigration, a birth rate of 2.1 is necessary.

In some countries in the region, governments have implemented cash reward programs to incentivize parents to have children. For instance, in Hong Kong, parents receive $2,550 for each newborn baby. In South Korea, the subsidy ranges from $1,500 for the first baby to $2,260 for the second or subsequent children. In Japan, the government revealed plans to double the budget for childcare spending last year.

Dr Chen Ching-hui was recently elected as a new lawmaker with the opposition Kuomintang party.

Dr Chen Ching-hui was recently elected as a new lawmaker with the opposition Kuomintang party.

Eric Cheung/CNN

Boosting the birth rate

Chen, a well-known doctor representing the opposition Kuomintang (KMT), is determined to address the population decline issue in Taiwan. One of her main goals as a lawmaker is to make assisted reproduction more accessible.

Her proposal focuses on increasing access to IVF for single women, lesbian couples, and unmarried heterosexual couples. Chen believes that this approach will be more widely accepted in Taiwanese society compared to surrogacy.

"It is important for our society to keep discussing surrogacy," she mentioned. "I hope we can make progress on this during my term as well."

Chen shared that around 17% of the 135,571 births in Taiwan in 2023 were a result of assisted reproduction. She also mentioned that if the regulations are loosened further, Taiwan could potentially see a 20% to 30% increase in the birth rate.

The situation is especially urgent in Taiwan because as the population decreases, so does the number of people in the military.

According to a report from the parliament, the professional military in Taiwan had 155,000 members in June 2023. This is a significant drop from 165,000 members just two years prior, making it the lowest number since 2018.

A graduating cadet sings the national anthem during the joint military academies graduation ceremony, in Taipei, Taiwan June 29, 2018.

A graduating cadet sings the national anthem during the joint military academies graduation ceremony, in Taipei, Taiwan June 29, 2018.

Tyrone Siu/Reuters/File

Related article

Taiwan is facing a fertility problem in its military, which is concerning as China's fears increase and its recruitment pool decreases. This is especially troubling as Taiwan is currently working to strengthen its forces to prevent any potential military action from China. China sees Taiwan as part of its territory and has stated its intention to unify it by force, even though it has never governed the island.

Some analysts think that Taiwan may face a greater challenge from its declining birth rate compared to other nearby economies like Japan or South Korea. This is because Taiwan has a smaller population base and does not have clear security guarantees from other countries in case of a military conflict.

The Institute for National Defense and Security Research in Taiwan has labeled the decreasing population as a significant "national security concern."

Taiwan, similar to the United States, has been mostly controlled by two main political parties that don't always agree. However, the declining population in Taiwan is one issue that both parties agree on.

The Democratic Progressive Party, which is currently in power, acknowledges the importance of taking action on this matter.

In January, the health minister, Hsueh Jui-yuan, stated that updating reproductive rules was a top priority. Additionally, his ministry plans to conduct public hearings in the next two months to discuss potential changes to current regulations.

Furthermore, apart from the military, Taiwan's economy is facing challenges due to a decrease in the working population. Despite being the world's 21st-largest economy, Taiwan is a major supplier of semiconductor chips, essential components in various electronic devices like smartphones and computers.

But there is a challenge ahead - a shortage of workers. To address this, many industries like manufacturing, construction, and agriculture are turning to migrant workers from Southeast Asia for help.

A nurse handling egg freezing inside a Taipei clinic run by fertility specialist, and now lawmaker, Chen Ching-hui.

A nurse handling egg freezing inside a Taipei clinic run by fertility specialist, and now lawmaker, Chen Ching-hui.

Eric Cheung/CNN

Working towards achieving full equality

Chang Hsun-ming, who is the director of the gynecology department at China Medical University Hospital in Taiwan, believes that gradually easing restrictions around reproduction is a logical step.

Chang, who has over 30 years of experience in the field, assured that our current technology allows us to manage these procedures effectively.

The new lawmaker, Chen, also acknowledged that Taiwan may still lack a clear consensus on the legalization of surrogacy.

Opposition groups in Taiwan have been voicing their concerns about relaxing assisted reproduction tools. They have held press conferences and are calling for legislative amendments to be postponed. The main worry is about the welfare of children born into what they consider as “incomplete families.”

There are also worries about surrogacy leading to the “commercialization of the uterus.” Chen, among others, believes that this concern can be addressed by implementing a comprehensive legal framework. This framework should focus on protecting the rights of surrogate mothers during pregnancy.

Taiwan has one of the lowest birth rates in the world.

Taiwan has one of the lowest birth rates in the world.

Unfortunately, the exclusion of surrogacy in the initial discussions indicates that couples like Hung and Huang, who recently welcomed their baby boy Aiden, will still face barriers in accessing assisted reproduction technologies in Taiwan.

Since same-sex marriage was legalized in Taiwan in 2019, the country has been moving towards full recognition of same-sex transnational marriages and equal adoption rights. The final step towards achieving full marriage equality is ensuring access to assisted reproduction.

Huang believes that all couples, regardless of sexual orientation, put in the same effort when starting a family. They are equally excited to welcome a new member to their family and share the same love for their children.

“We hope with ample discussions, the new law will afford equal treatment to every person who wishes to start a family.”

Editor's P/S:

The article highlights the challenges faced by same-sex couples in Taiwan in accessing assisted reproduction technologies. The journey of Alan Hung and Danny Huang, who had to travel overseas to have a biological child, underscores the need for Taiwan to address the issue of declining fertility and ensure equal access to reproductive rights for all citizens.

The proposal by Dr. Chen Ching-hui, who recently became a lawmaker, to relax restrictions on IVF and egg freezing for single women, lesbian couples, and unmarried heterosexual couples is a step in the right direction. However, the exclusion of surrogacy in the initial discussions indicates that there is still work to be done to achieve full marriage equality in Taiwan. It is important for the country to continue these discussions and implement a comprehensive legal framework that protects the rights of all individuals and families. a society where surrogacy remains a contentious issue. The potential impact on the birth rate, military strength, and economic challenges posed by a shrinking workforce are also explored. The article concludes with the hope for a comprehensive legal framework that protects the rights of both surrogate mothers and the children born through assisted reproduction, ultimately paving the way for full marriage equality and the fulfillment of family aspirations for all in Taiwan regardless of sexual orientation or marital status