In China, a Trip to the Altar Starts at the Doctor’s Office

The 47-year-old construction worker says his wife left him because his doctor told her a certain body part of his is “too small.”

How does the doctor know, and why is it relevant?

Because you can’t get married in China without a physical exam. Its purpose, among other things, is to determine whether couples are not only willing but also able to carry out the healthy pursuit of pleasure and procreation.

To most Westerners, this system of peek and probe may seem an embarrassing and unnecessary intervention from the state. The most a government would ask of a bride or groom in the United States is a blood test, and in California, you don’t even need that.

But in China, tying the knot, like family planning, is still regarded as much more than a personal affair. With 1.3 billion mouths to feed, Beijing considers it critical to scrutinize those who intend to marry and multiply.

Doctors say the physicals are necessary to curb diseases and ensure that people with dire mental and physical problems don’t reproduce and burden the state.

The doctor’s job is to look for “unmarriageable illnesses,” but the law does not spell out what those illnesses are. So anything from cancer to schizophrenia, muteness to genital deformity could spur a doctor to classify someone as unsuitable for holy matrimony.

Many Chinese couples consider the premarital physical a minor inconvenience for a greater good. This is a country that still uses physical exams to ration social privileges, from driving a car to applying for college.

But others feel victimized by the system and say the state is playing God by engaging in unnatural selection.

A groom-to-be in his 80s made headlines last year when he proposed to a woman in her 70s. He had no intention of having more children. So he was outraged to learn that he too had to bare all for the doctor.

One woman sued her doctors because they claimed the lines on her stomach were stretch marks from a pregnancy. Their claim prompted the woman’s fiance to break off the engagement. The marks were later attributed to weight loss, and the woman was awarded $900 in damages, according to a case study published by a legal Web site. The fiance still refused to go through with the wedding.

The construction worker, interviewed by phone from his home in northern China’s Liaoning province, said his doctor’s “too small” diagnosis was plain wrong. To prove it, he got six other doctors’ opinions, and each of them rated him “normal.”

He sued the original physician for slander, but the court ruled that it was the doctor’s job to call it as he saw it.

The couple did marry, but the woman left her husband three months after their wedding. She couldn’t live with the doctor’s judgment, said the construction worker, who did not want his name used.

“I’m the only son in the family,” he said. “Of course I want to marry again. But next time, I’ve got to find a different doctor.”

Many experts say China’s marriage law is too vague, with too much room for arbitrary rulings.

“The issue is not whether or not to inspect, but how to inspect and what to look for,” said Xu Anqi, a sociologist at Shanghai’s Academy of Social Sciences. “Some inspecting agencies are poorly regulated. They don’t pay enough attention to the patient’s privacy. They look for things that are irrelevant, such as signs of premarital sex.”

Urban residents complain that the government is less strict with people in the countryside, where medical resources are in short supply.

“It’s hard to enforce in the countryside, but it’s very important that they try,” said Tong Jian, a 27-year-old government official from coastal Jiangsu province, who married last year. “The blood ties there tend to be very close, and diseases are widespread. Many people do not even know they are carriers.”

For some, the medical exams and byzantine marriage application process are enough to make them skip the formalities.

One Shanghai couple had hoped to wed but was stymied by the first requirement on the marriage application: proving that they were single. The woman had just returned to China after more than 10 years of study in the United States, so she could not call on an employer or neighborhood committee to vouch for her. And she was daunted by the request to prove she had never been married in the U.S. The couple simply gave up.

“I had no idea it was this complicated,” said the woman, who nevertheless wears a sparkling diamond ring and platinum wedding band that tell the rest of the world--if not the state--that she is, in essence, married.