Sex selection is a big deal. By "big deal", I mean by as much as 163 million missing women in the world. To put that number into perspective, that's more than the population of women in the United States.
Are most of those women missing from Asia? Yes, but not all. As tempting as it is to say "sexism and traditional gender roles", the truth is more complicated. Mara Hvistendahl's Unnatural Selection: Choosing Boys Over Girls, And the Consequences of a World Full of Men reaches back not only into the histories of China, India and other affected countries, but also the policies of Western nations to find out why so many women were never born. Just as importantly, she also paints a picture of what the world will look like if these trends go unchecked.
Mara was gracious enough to share some of her insights here about sex selection, history, technology and the ethical ramifications of our decisions.
Let’s start with the basics of your book: in certain relatively affluent countries that have access to ultrasound technology, women are choosing to abort female fetuses. We know this is happening because the sex ratio at birth is over 106 males to 100 females, and people have been talking about this for years now. But the real story of your book, as I read it, was, in part, the role that the First World played in this in the 50s, 60s and 70s- the same countries that are bemoaning the development now. What did those countries do and why?
There are several different threads to my book. The first simply tells the story of what's happening. Another describes the dire consequences of a shortage of women. But still another details the role played by Western countries in promoting research into sex determination technology in the 1950s through the 1970s. I included that history because it's a story that hasn't been told, and because sex selection is so often portrayed as a distant problem affecting only Asian nations and stemming from traditional values. I find that portrayal misleading.
Beginning in the 1950s population growth became an issue of major importance in the West, and over the decades that followed American and European governments and organizations funded efforts at reducing birth rates abroad. There were some very real reasons for concern, among them the fact that around the world people were living longer than ever before. But as that concern turned into hysteria a number of unfortunate strategies for controlling population growth were put on the table. In countries like India, for example, abortion was legalized under U.S. pressure as a population control method and not as a woman's right.
Another solution floated to the "population explosion" was sex selection. Groups like Planned Parenthood (which back then was a very different organization) and the Population Council had done research into the reasons women in Asia continued to have children, and one of the things they found was that women in many countries continued to have children, in part, because they wanted a son. In the late 1960s, the idea emerged to somehow figure out a way to ensure couples the boys they so desired. Prenatal sex determination was still in its early stages, but population activists advocated pushing that research along. Some even pushed for the creation of a "manchild pill" that would ensure a son upon conception, eliminating the need for abortion.
Wherever we see this, you paint a bleak picture for all of the inhabitants. Can you talk about how it’s affecting Taiwan, for example?
Taiwan was one of the first countries to really take to sex selection. Sex selective abortion became common in the early 1980s, and today the generation born in that decade has three quarters of a million more men than women. Many of those men are what demographers call "surplus" -- they can't find wives in their country. That combined with changing gender roles has yielded a situation in which many now travel abroad in search of women.
On the other side, Vietnam. They are selecting for sons, but not to the same degree as Taiwan, China or South Korea two decades ago. So it is still a “market” for prospective bride buyers. How are the Vietnamese being affected?
Vietnam's situation is doubly depressing. The country emerged as a destination for men from around Asia seeking wives in part because of the Vietnam War, which left it with a surplus of women. The trade in brides has become alarmingly formalized in the decades since, as professional agencies have been set up in countries like Taiwan and Singapore to handle the marriages. This industry is a little like the mail-order bride industry in the West, and it existed before Asia's "surplus" men started coming of age. But the gender imbalance has undoubtedly made the situation worse. Today so many surplus Taiwanese and Korean men go to Vietnam to buy brides that there are villages in the Mekong Delta where half of all new marriages are between local women and foreign men. I visited one island that has lost so many women that locals jokingly call it "Taiwan Island."
The marriage trade alone is bad enough, but to make matters worse Vietnam recently developed a sex selection problem of its own. Females now only outnumber males among the elderly, and parents in the northern part of the country have begun selecting for boys using ultrasound scans followed by abortions. When Vietnam's surplus boys come of age they'll be especially bad off.
When one thinks about this in strictly theoretical economic terms, there’s an impulse to conclude that because there is a smaller “supply” of women, 1) their bargaining power goes up and therefore 2) this can lead to an improvement in conditions for women. Unfortunately, that’s not what’s going on. What is this doing to the status of women?
Strictly speaking, the value of women has gone up. But while for some women -- mostly educated women living in developed cities -- that translates into more bargaining power, it also means the vast majority of women are now at greater risk. The shortage of wives in South Korea, Taiwan, India, and China is fueling demand for trafficked women and girls for both marriage and prostitution. Even when Asia's bought brides cross borders willingly, as many do, they typically do not speak the same language as their husbands, and they remain dependent on the men for income and immigration status. For those women, the gender imbalance is hardly a great thing.
To the extent that this was sold as a relief to the population problem, I can’t help but think of the economic, social and population pressures many African countries face. Is there a danger that this practice could be marketed there?
There is a danger sex selection could catch on in other countries if the same combination of factors that have played a role in Asia and Eastern Europe take hold there. A rapid drop in the birth rate and an influx of new technologies are two of the most important ones. That said, at the moment demographers are much more concerned about the Balkans and north Africa than they are about sub-Saharan Africa.
The other thing to watch out for is rapid advances in prenatal testing -- fetal DNA tests that make it possible to determine the sex of a fetus with a prick of the pregnant woman's finger, at seven weeks. Widely available blood tests could be a game-changer. [Interviewer's note: And it looks like they're getting closer.]
While there is some evidence that Asian American families are practicing sex selection for boys, for the most part, that’s not the issue in the United States. We are selecting for sex, but we’re selecting for girls, and we’re doing it before there’s even a pregnancy. This is also something that only the most affluent among us can do. In your book, you don’t characterize this as a positive development. Why?
To clarify: it's only the Americans who turn to preimplantation genetic diagnosis (PGD) or sperm sorting for sex selection who favor girls, and that's only according to fertility clinic directors. There is, however, a separate trend in our culture at this moment in time toward favoring daughters -- whether because they do better in school, because they are believed to have fewer behavioral issues, or because today's generation of parents is determined to raise strong and successful daughters.
In any case, from an ethical standpoint I don't think it matters so much whether parents select for boys or girls. In both cases they are heightening the expectations put on their children from before birth. In that sense the Chinese boy who is chosen because he is expected to get married and carry on the family line has a lot in common with the American girl who is chosen because she is expected to dress in pink frills -- neither child may want that fate. Sex selection, along with many other forms of selection, isn't just harmful when it causes huge demographic imbalances. It's also harmful at the level of the individual -- the level of the child created not in wonderment but according to his or her parents' ideas of what a child should look like.
Your book was published shortly after the Republican-controlled Congress led a failed effort to defund Planned Parenthood. Conservative writers and activists have used you to support their opposition to Planned Parenthood and abortion itself (I’m thinking right now of Ross Douthat). It’s obvious to anyone who reads your book that this is a distortion of your position, but can you speak to how being critical of sex selection is not the same as opposing reproductive rights?
It's possible to support Planned Parenthood today and yet acknowledge that the organization has a very different past. And it's possible to support abortion rights while also being outraged when women are forced to abort, or when abortion is legalized not as a woman's right but as a population control method. That's a nuanced understanding of the situation. And I do hold out hope that there is still room for nuance in the American political landscape.
What needs to happen in order to end sex selection?
That's a complex question, and I'm afraid I don't have any easy answers. But for starters, the issue deserves a lot more international attention that it now gets. I'd like to see an international body along the lines of UNAIDS formed. Such a body might take up the question and give careful thought to just how we go about solving it. To truly be effective all possible solutions should be considered -- including crackdowns on sex selection and tighter regulations. That is one route tried in several countries in Asia that hasn't been given full consideration in the West, in part because of the contentious state of abortion politics in the United States.
We should also keep in mind that new technologies that make possible other, more sophisticated forms of prenatal selection are being introduced every year. Ethical issues surrounding selection are just beginning. And ultimately we cannot shy away from them.
Many thanks to Mara for a great book and a wonderful interview. Run, don't walk, to your bookstore and pick up a copy.