According to a report from the Ministry of Health, during the 2021–2024 period, Viet Nam’s sex ratio at birth stood at 112 boys per 100 girls, significantly higher than the natural balance of 104–106. Currently, several northern and north-central provinces continue to record the ratio at very high levels, with some localities approaching 120 boys per 100 girls. In southern provinces and cities, the ratio ranges from 105 to 108 boys per 100 girls. If this disparity is not addressed, projections indicate that by 2034 Viet Nam could have a surplus of 1.5 million men of marriageable age, potentially rising to 1.8 million by 2059.
Professor Nguyen Dinh Cu — former Head of the Institute of Population — warned that the sex ratio imbalance at birth is a silent but long-term threat to national stability. It affects not only individual families but also the social structure and the quality of human resources in the coming decades. Deep-rooted social concepts and beliefs, such as the expectation that sons must carry out ancestor worship, reinforce parents’ social standing, and inherit the family surname, have become ingrained in the mindset, culture, and traditions of Vietnamese individuals, families, and lineages. These concepts and beliefs have, unintentionally, led to serious consequences, including a surplus of men, a shortage of women, increased gender inequality, child marriage, human trafficking, and adverse effects on population structure.
According to a 2023 survey by the United Nations Population Fund (UNFPA), more than 60% of men believe it is necessary to have at least one son; 38% of women reported feeling “pressure” from their husband’s family if they did not give birth to a son; and 27% of pregnant women admitted to having asked about the foetus’s sex despite being fully aware that such disclosure is prohibited.
Pham Vu Hoang, Deputy Head of the Department of Population under the Ministry of Health, said that most families wish to have both sons and daughters. When couples plan to have only two children, the likelihood of selecting a male child increases significantly if the first child is a girl.
Despite sustained efforts and the involvement of the entire political system, since 2016 Viet Nam has not had a single year in which the sex ratio at birth returned to a safe threshold. This situation has led experts and the drafting committee of the Population Law to identify the sex ratio imbalance at birth as one of the four most serious population issues, requiring policy intervention at the highest level.
Previously, the Population Ordinance only prohibited sex selection at birth without concrete control measures and used relatively light sanctions, allowing for widespread circumvention of the law. Under the newly adopted Population Law, medical practitioners who announce, notify, or disclose information about the sex of a foetus to clients will have their licences suspended, except in cases where sex determination is necessary for diagnosing and treating genetic diseases in accordance with regulations of the Ministry of Health.
Dr. Le Thanh Dung, head of the Department of Population (Ministry of Health), emphasised that the Population Law creates a comprehensive legal framework to address sex-selective practices at their root. Only when the law is strict and effectively enforced can the sex ratio at birth be brought back to its natural balance. Apart from using administrative measures, the issue also requires changing outdated mindsets. At the same time, there must be a strong focus on in-depth communication and behaviour change among young people and society at large.
Population experts said that reducing the sex ratio imbalance at birth requires directly influencing those who still hold gender-biased views. Communication efforts must penetrate communities, families, and villages, rather than relying solely on mass media channels. In parallel, inspections of ultrasound facilities and private clinics should be intensified; electronic monitoring systems should be applied to prenatal ultrasound information; criminal prosecution should be pursued in cases of deliberate sex disclosure causing serious consequences; and equal inheritance rights for daughters must be protected in law and local conventions; community-based models should be multiplied, such as “villages with no prenatal sex selection” in areas with high sex ratio imbalance; and intergenerational gender equality clubs need to be expanded.
