Washington (CNN) -- The uprisings that have swept through the Mideast have inspired the world, but efforts by Arab dictators to crush the dissent have destabilized the region, the U.S. State Department said Thursday in its annual human rights report.
The report, an annual survey of human rights records around the world, said that that China's human rights record was getting worse, with authorities stepping up efforts to crack down on activists and silence public debate.
But after years of criticizing Myanmar as one of the world's worst violators of human rights, the State Department hailed "remarkable" reforms by the government of President Thein Sein, which paved the way for the election to parliament of democracy leader Aung San Suu Kyi and ended decades of isolation for the tiny Asian nation.
In the Mideast, calls for change in Tunisia, Egypt, Libya, Yemen and Syria were "inspirational, and yet change often creates instability before it leads to greater respect for democracy and human rights," the report said. "These acts of repression triggered more confrontation, more chaos, and ultimately greater instability. The events of the year showed that the real choice is not between stability and security; it is between reform and unrest."
After decades of repression and lack of political participation, it will take time to create an open political system, the report warned.
"Transitions are times of uncertainty. They can be chaotic, unstable, and at times violent. And even when they succeed, they are rarely linear, quick, or easy," the report said.
Secretary of State Hillary Clinton rolled out the report as the second and final day of voting opened Thursday morning in Egypt's groundbreaking presidential election. She hailed the peaceful protests that toppled longtime President Hosni Mubarak last year.
"Today in Egypt, we are seeing in real time that those demands are making a difference, as Egyptians are going to the polls to determine, for the first time in their history, who their leaders will be," Clinton said. "Whatever the outcome of the election, the Egyptian people will keep striving to achieve their aspirations, and as they do, we will continue to support them. We will continue to support people everywhere who seek the same."
But Clinton said that in Syria, where thousands of people have died in the crackdown by forces loyal to President Bashar al-Assad, "it's is just not an assault on freedom of expression or freedom of association, but an assault on the very lives of citizens.
"The Assad regime's brutality against its own people must and will end, because Syrians know they deserve a better future," she said.
The report criticized the regime of U.S. ally Bahrain for its crackdown on protests last year, citing the government's state of emergency, "during which time military and civilian security forces committed a number of human rights violations, including torture, arbitrary detentions, limitations on freedoms of speech and association, and lack of due process."
After lifting a state of emergency imposed during the protests, the Bahraini government appointed a Commission of Inquiry, which issued a report on the government's handling of the crisis, including recommendations for reform. Some of the recommendations in the report were implemented, but the U.S. has remained concerned about continued use of force. Clinton has said "much work" remains to fully respond to human rights issues.
The United States resumed some arm sales to Bahrain after suspending them amid the country's crackdown on protesters, but items used for crowd control are still banned.
Amnesty International also published its annual human rights report, which highlights the failure of international leadership to match the courage of Arab Spring protesters.
Frank Jannuzi, head of Amnesty International's Washington office, warned that "stark reports only create real change when they translate into action, not just written and put away for the next year. Otherwise, these reports are seen as a minor slap on the wrist and business as usual continues."
"The United States has traditionally been in the vanguard of the struggle for justice. Disturbingly, in the era of globalization, the United States has too often pushed aside human rights concerns to focus on economic and national security priorities," Jannuzi said. "This is short-sighted. The United States cannot long secure its own prosperity if it turns a blind eye to suffering and repression of human rights around the globe."
In China, the State Department report said, the "human rights situation deteriorated, particularly the freedoms of expression, assembly, and association," with Chinese forces reportedly committing "arbitrary or unlawful killings."
The report said Chinese authorities have held activists in unknown circumstances and placed their family members under house arrest. Abuses "peaked around high-profile events," including visits of foreign officials, milestone anniversaries and calls for street gatherings inspired by the Arab Spring.
The report comes after the arrival in the United States of one of China's best-known activists, Chen Guangcheng, after he escaped house arrest and took refuge in the U.S. Embassy in Beijing, marking a dramatic diplomatic showdown between Washington and Beijing while Clinton was visiting China for talks. China regularly criticizes U.S. interference with what it calls domestic political issues.
Although the report covered 2011, before the high-profile saga over Chen, it detailed concerns about Chen's treatment, including thugs' "severe" beatings of him and his wife. It said that Chen was denied medical care, while activists trying to visit his house in eastern Shandong province said they were "assaulted, detained, forcibly removed or otherwise abused."
The report also said human rights conditions remain extremely poor in North Korea, with an estimated 130,000 to 200,000 people detained in political penal labor camps. It also criticized Vietnam for its continued restrictions on political rights and freedom of expression, as well as Sri Lanka for disappearances and killings by pro-government paramilitary. Iran, Turkmenistan and Uzbekistan, common targets of U.S. criticism, were once again singled out for "extremely poor" human rights conditions.
The report called Myanmar "a model of greater openness, democracy, and liberty, attributes that can lead to greater innovation, prosperity, and inclusion."
While it said "much work remains" to address decades of human rights abuses, the challenges ahead do not "diminish the excitement of these first steps, or the sense of possibility they may inspire in other closed societies, such as Iran, North Korea, Uzbekistan, Eritrea, or Sudan."
In Afghanistan, the report voices concern about the plight of Afghan women, who faced continued violence and discrimination by the Taliban and other insurgents that were in many cases ignored by police.
"Women are critical actors in the reconciliation and reintegration process, they need to be not marginal to the political process, they need to be fully engaged and their rights fully respected," said Michael Posner, the U.S. State Department's assistant secretary for democracy, human rights and labor. "And we are very mindful. Having spent a lot of time with women's leaders there, I can tell you there's a big, a tall agenda in terms of integrating women into the political process."
The report is Clinton's final one as secretary of state. During her tenure, she has sought to improve treatment for what the report described as "marginalized people," such as women, religious minorities, people with disabilities and those who are lesbian, gay, bisexual or transgender.
"Men and women who want to speak, worship, associate, love the way they choose -- we will defend their rights; not just on the day we issue these reports, but every day," she said.