Currently, many industrialized nations—including the United States and many European countries—have top-heavy age structure diagrams with many older people. In many cases, the struggle to care for these rapidly aging populations has turned prickly. In 2010, in order to relieve retirement age problems (and thus government pension payouts), France raised the retirement age from 60 to 62, sparking riots throughout the nation. In the United States, the prospect of baby boomers’ retirement bankrupting Social Security has spurred intense and vitriolic debate.

China’s age structure diagram has lost the bottom-heavy shape, reflecting its changing population age structure. Falling birth rates and rising life expectancy have tipped the balance between old and young. In 1982, just 5% of China’s population was older than 65. In 2004, that figure had climbed to 7.5%; by 2050, it is expected to exceed 15%. These figures are lower than those in most industrialized countries (especially Japan, where the proportion of people over age 65 years is 20%). But because elderly people are still dependent on their children for support, this situation could spell disaster.

Demographers call it the 4–2–1 conundrum: As they settle into middle age, the members of each successive generation of only children will find themselves responsible for two aging parents and four grandparents. If that single child fails, family elders would be left with virtually no options—no second children, or nieces and nephews, and not even friends and neighbors who could help out, since most other families would be in an equally precarious situation. In a country without an extensive pension program, this prospect has the government especially worried.

There’s another problem with China’s evolving age structure: the workforce. Economists predict that between 2010 and 2020, the annual size of the labor force aged 20–24 will shrink by 50%. This forecast has global implications. “The deep fertility declines have plunged China into a demographic watershed,” says Feng. “It means the days of cheap, abundant Chinese labor are over.” For countries like the United States, which have come to depend on a steady influx of cheap goods from China, that’s not such good news. But for the only children of China, it almost certainly means higher wages, better working conditions, and more jobs to choose from in the coming decades.

An out-of-whack age structure isn’t the only unintended consequence of the one-child policy. The sex ratio of men to women has also grown alarmingly high. It’s true that almost everywhere in the world, there are slightly more males than females. (However, this differs according to age. Because they tend to live longer, there are more women than men in older age groups.) But in most industrialized countries, sex ratio of men to women tends to hover close to 1.05 (which, coincidentally, is the exact sex ratio of the United States). In China, the ratio soared from 1.06 in 1979 to 1.17 in 2011; in some rural provinces, it was as high as 1.3 in 2011. What does this mean in actual numbers? The State Population and Family Planning Commission estimates that come 2020, there will be 30 million more men than women in China. How did this happen?

Like most Asian countries, and many African ones, China has a long tradition of preference for sons, based on the belief that boys are better suited to the rigors of manual labor that drive rural, and even industrial, economies. This means that they are better able to provide for retired and aging parents than daughters are.

A recent study by Chinese researchers from Zhejiang Normal University shows that the sex ratio is high (favoring males) in urban areas where only one child is allowed. However, in rural areas where a second child is allowed, if the first is a girl, sex ratios are even higher for the second child—as high as 160 males for every 100 females. The researchers attribute this high male bias to sex-selective abortion—deliberately terminating a pregnancy based on the gender of the fetus (in this case, aborting females). The practice has been outlawed in China, but most experts say it is still common, thanks in large part to private-sector health care and the ability of a growing number of Chinese citizens to pay the high cost of a gender-determining ultrasound. Although most demographers agree that outright infanticide is increasingly rare, subtler forms of gendercide—the systematic killing of a specific gender—are known to occur. If a female infant falls ill, for example, she might be treated less aggressively than a male infant would be.

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“The deep fertility declines have plunged China into a demographic watershed.” —Wang Feng

These days, however, it is much more common for girl babies to be put up for adoption than boys. Officially registered adoptions increased 30-fold, from about 2,000 in 1992 to 55,000 in 2001. The trend was especially pronounced in the United States, where families adopted nearly 8,000 Chinese babies in 2005 alone (compared with just 200 or so in 1992). The practice is not necessarily as benign as it sounds. In 2009, the Los Angeles Times reported that many babies put up for adoption had not been abandoned by their parents but confiscated by Chinese family planning officials.

The result of the skewed sex ratio, 30 years out, seems to be lots of prospective husbands in want of wives. Recent census data show that in a growing portion of rural Chinese provinces, one in four men are still single at 40. “The marriage market is already getting more intense and competitive,” says Feng. “Men of lower social ranks—who make up a very significant chunk of the population—are being left out. And it’s only going to get worse.”

A growing number of social scientists say that the dearth of women will ultimately threaten the country’s very stability. Experts worry that such large numbers of young men who can’t find partners will prove a recipe for disaster. “The scarcity of females has resulted in kidnapping and trafficking of women for marriage and increased numbers of commercial sex workers,” writes Therese Hesketh, “with a potential rise in human immunodeficiency virus infection and other sexually transmitted diseases.”