Mara Hvistendahl: Unnatural Selection: Choosing Boys Over Girls, and Print E-mail

the Consequences of a World Full of Men

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Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men

By  Mara Hvistendahl
Scroll down to read excerpt "How Ultrasound Changed the Human Sex Ratio" courtesy of the Scientific American, followed by a selection of high profile reviews

There are over 160 million females “missing” from Asia’s population. That’s more than the entire female population of the United States. And gender imbalance­which is mainly the result of sex selective abortion­is no longer strictly an Asian problem. In Azerbaijan and Armenia, in Eastern Europe, and even among some groups in the United States, couples are making sure at least one of their children is a son. So many parents now select for boys that they have skewed the sex ratio at birth of the entire world.

How did this occur? Why are women and girls becoming scarce in Asia and Eastern Europe as those regions develop? And what will happen when the world’s extra boys grow up?

Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men addresses these questions and more­and reveals some unexpected answers. Drawing on extensive reporting in China, India, Vietnam, South Korea, Albania, and other countries, Science magazine correspondent Mara Hvistendahl weaves together the story behind the world’s “missing” women into a riveting narrative. The cast of Unnatural Selection includes everyone from prostitutes, mail-order brides, and militant nationalists to geneticists, activists, and AIDS researchers­ along with the California fertility doctors hard at work selling the world’s parents on the latest form of sex selection. But perhaps the book’s most disturbing finding is that the gender imbalance is not, as has often been argued, simply the outgrowth of entrenched sexism. In fact the story of the world’s missing women traces, in part, to the United States.
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 ~ June 11, 2011

How Ultrasound Changed the Human Sex Ratio

A technology originally developed for maritime navigation and detection has become the dominant method for sex selection
By Mara Hvistendahl 

GENDER DEVICE: People use ultrasound to determine the sex of babies--and have contributed to more than 160 million "missing" females in Asia and elsewhere. (© iStockphoto.com / Gene Chutka)

Editor's Note: The following is an excerpt from Mara Hvistendahl's book, Unnatural Selection: Choosing Boys over Girls and the Consequences of a World Full of Men.

The technology that ultimately became the dominant method of sex selection around the world began as a tool for navigation. The story of ultrasound dates to 1794, when an Italian biologist curious about how bats find their way in the dark discovered sonar, or the fact that distance can be determined by bouncing sound waves off a faraway object and measuring how long it takes for the waves to ricochet back. Centuries later, when the growing prowess of German submarines during World War I convinced the Allies that to win the war they needed a way to navigate underwater, scientists put sonar to use. The American, British, and French governments jointly funded research into the phenomenon. The effort succeeded, and by 1918 the Allies were using acoustic echoes to correctly pinpoint the location of German U-boats.

After the war, doctors guessed sonar might have medical applications as well. They first used ultrasound in surgery, where it turned out sound waves could heat and destroy tissue, making them helpful for everything from treating ulcers to performing craniotomies. Then in 1949 a chemist stationed at the Naval Medical Research Institute in Bethesda, Maryland, employed the new technology to locate gallstones in dogs, and ultrasound became a diagnostic tool as well. Physicians began navigating the human body as World War I submarines had navigated dark waters, bouncing sound waves off the internal organs.

Ultrasound proved surprisingly versatile. It could clean teeth, treat cysts, and dissolve kidney stones. It may have been with one of these applications in sight that in 1959 Scottish obstetrician Ian Donald used the new technology on a woman who happened to be pregnant and noticed that the fetus returned echoes as well.

Back then, ultrasound offered the simple promise of learning more about a pregnancy. Doctors could not perform x-ray exams on pregnant women because of the risk of damaging the fetus, so Donald’s discovery raised the prospect of an alternative form of prenatal imaging, giving physicians hope of monitoring high-risk pregnancies. If Donald suspected that knowledge would translate into fetal selection and subtraction, he probably envisioned women attempting to avoid debilitating sex-linked diseases like hemophilia. (When the first sex-selective abortions had been performed in Denmark using amniocentesis four years earlier, indeed, they were done for that reason --and discriminated against males as a result.) He could have hardly guessed that ultrasound would one day contribute to a sex ratio imbalance involving  over 160 million "missing" females in Asia and elsewhere.

Sex selection was a dim possibility, indeed, because early ultrasound machines were nothing like those available today. The 1960s machines were cumbersome gadgets that towered over the pregnant women on whom they were used. One model, called the articulated arm scanner, resembled a giant version of the toy cranes fairgoers rent for a few quarters to try their hand at winning stuffed animals. The articulated arm scanner helped doctors take crude measurements of the fetal head, allowing them to track a baby’s growth in the womb. But beyond that the image it produced was hazy, making it impossible to discern fingers and toes, let alone a tiny penis or vagina.

It didn’t matter that the early ultrasound machines yielded fuzzy images, however, or that they only proved helpful in a small proportion of pregnancies. To the 1960s public the technology looked positively futuristic. Around the time pregnancy became a choice rather than an inevitability and the business of having children became about more than generating labor for the farm, we began seeking ways to bond with our babies before birth. An image on which to pin parental hopes made that task a whole lot easier, and so it was a breakthrough to have a preview, however muddled, of the baby growing inside a mother’s uterus. Coming at a time of technological optimism when Americans were enamored of outer space and kitchen appliances alike, an era some were calling the Biological Revolution, ultrasound captured the public imagination.

Even though the high-resolution machines capable of identifying fetal sex and other finer characteristics were still years away, the press seized on the possibility that portraits of babies before birth might help us control the mystical birth process. The flurry of coverage that greeted the new technology forecasted extensive reproductive manipulation­which newspaper editors saw as a great thing. The headlines were bold and optimistic: Ultrasound Device Takes Guessing Out of Pregnancy. Knowledge Is Key to Happy Childbirth. A New Eye into the Womb. One article dubbed ultrasound The Electronic Doctor. The headline on the cover of the September 10, 1965, issue of Life­alongside a hulking machine whose heavy arm nearly eclipsed the mother under examination­ read Control of Life: Audacious Experiments Promise Decades of Added Life, Superbabies with Improved Minds and Bodies, and Even a Kind of Immortality. (Today preimplantation genetic diagnosis­a form of embryo screening during in-vitro fertilization that allows parents to select for sex, is greeted with similar enthusiasm. Girl or Boy? Now You Can Choose, proclaimed a 2004 cover of Newsweek.)

But public fascination also provided a window for criticism, and ultrasound elicited substantial ethical deliberation. Some critics feared overly powerful scientists. Feminists pushing for abortion rights fretted, justifiably, that the machine humanized the fetus. Others worried the new reproductive technology would be exploited by governments intent on manipulating their populations; the Nazis, after all, had screened newlyweds for genetic diseases in their eugenics program. What if the power to create "superbabies" fell into the hands of an evil dictator? But none of these critiques came close to identifying what turned out to be ultrasound’s most pernicious threat. In hindsight, 1960s Americans worried about everything except the possibility that average parents, emboldened by the new knowledge technology brought them, might make small, seemingly innocuous choices­and that those choices, taken together, would add up to disaster.

Excerpt by arrangement with Public Affairs from Unnatural Selection: Choosing Boys over Girls and the Consequences of a World Full of Men by Mara Hvistendahl. Copyright © 2011 by Mara Hvistendahl.
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 London ~ Saturday, 18 June 2011, page 23

Sex selection and the rise of Generation XY

A new book explores western involvement in what has become a scourge of the developing world: sex selection of babies
By Ed Pilkington in New York
Sex selection of babies across the developing world has created many societies with too many men. (Muhammed Muheisen/AP)

In 1979 China signed a $50m four-year deal with a UN body designed to help it control its spiralling population through family planning. It was the largest foreign aid package Beijing had accepted in almost 20 years.

But the funds became entwined in China's one-child policy that was just taking hold, and instead of sponsoring an education drive for small families, the money was used to pay for posters in Chinese villages proclaiming "You can abort it! But you cannot give birth to it."

The story of the complicity of the UNFPA, the UN's main population agency, in the tyranny of China's forced abortion policy is just one of the examples given in a book that explores western involvement in what has become a modern scourge: sex selection.

Unnatural Selection by Mara Hvistendahl charts how the trend towards choosing boys over girls, largely through sex-selective abortions, is rapidly spreading across the developing world.

While the natural sex ratio at birth is 105 boys born for every 100 girls, in India the figure has risen to 112 boys and in China 121. The Chinese city of Lianyungang recorded an astonishing 163 boys per 100 girls in 2007.

The bias towards boys has been estimated to have caused the "disappearance" of 160 million women and girls in Asia alone over the past few decades. The pattern has now spilled over to Azerbaijan, Georgia and Armenia, the Balkans and Albania, where the sex ratio is 115/100.

The unnatural skewing towards male populations has become so pronounced in recent decades that Hvistendahl, a writer for Science magazine, says it has given rise to a new "Generation XY". She raises the possibility that with so many surplus men – up to a fifth of men will be single in northwestern India by 2020 – large parts of the world could become like America's wild west, with excess testosterone leading to raised levels of crime and violence.

"Historically, societies in which men substantially outnumber women are not nice places to live," Hvistendahl writes. Already, the relative shortage of women in countries like China and Taiwan has helped create new markets in women.

They include arranged wedding agencies that set up marriages between South Korean men and foreigners, often women from poorer nearby countries like Vietnam, that now account for 11% of all marriages in South Korea.

There is also a booming trade in trafficking of women for prostitution out of Vietnam and a growing practice of child marriage in China, where wealthier families secure wives for their sons early by effectively buying young girls for their sons.

Much of the literature on sex selection has suggested that cultural patterns explain the phenomenon. But Hvisten dahl lays the blame squarely on western governments and businesses that have exported technology and pro-abortion practices without considering the consequences. Amniocentesis and ultrasound scans have had largely positive applications in the west, where they have been used to detect foetal abnormalities. But exported to Asia and eastern Europe they have been intricately linked to an explosion of sex selection and a mushrooming of female abortions.

Hvistendahl claims western governments actively promoted abortion and sex selection in the developing world, encouraging the liberalisation of abortion laws and subsidising sales of ultrasounds as a form of population control.

"It took millions of dollars in funding from US organisations for sex determination and abortion to catch on in the developing world," she writes.

Even now, when the pattern of sex selection has been well documented and the prospect exists of the developing world accommodating tens of millions more men than women, the UNFPA is refusing to face up to its mistakes and confront the problem, she says.

"The effects of the major UN agency tasked with population advocacy distancing itself from the issue of sex selective abortion are immense," she writes, noting that the agency's foot-dragging has discouraged other global funds from engaging with the crisis.
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 London ~ August 6th 2011

Sex selection

Cat got your tongue?

Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men. By Mara Hvistendahl. Public Affairs; 314 pages; $26.99 and £17.99.
AS HE walked into the maternity ward of Lok Nayak Jayaprakash Narayan Hospital in Delhi on his first day at work in 1978, Puneet Bedi, a medical student, saw a cat bound past him “with a bloody blob dangling from its mouth.” “What was that thing­wet with blood, mangled, about the size of Bedi’s fist?” he remembers thinking. “Before long it struck him. Near the bed, in a tray normally reserved for disposing of used instruments, lay a fetus of five or six months, soaking in a pool of blood…He told a nurse, then a doctor, I saw a cat eat a fetus. Nobody on duty seemed concerned, however.” Mara Hvistendahl, a writer at Science magazine, is profoundly concerned, both about the fact that abortion was treated so casually, and the reason. “Why had the fetus not been disposed of more carefully? A nurse’s explanation came out cold. “Because it was a girl.”

Sex-selective abortion is one of the largest, least noticed disasters in the world. Though concentrated in China and India, it is practised in rich and poor countries and in Buddhist, Hindu, Christian and Muslim societies alike. Because of males’ greater vulnerability to childhood disease, nature ensures that 105 boys are born for every 100 girls, so the sexes will be equal at marriageable age. Yet China’s sex ratio is 120 boys per 100 girls; India’s is 109 to 100.

The usual view of why this should be stresses traditional “son preference” in South and East Asia. Families wanted a son to bear the family name, to inherit property and to carry out funerary duties. Ms Hvistendahl has little truck with this account, which fails to explain why some of the richest, most outward-looking parts of India and China have the most skewed sex ratios. According to her account, sex-selection technologies were invented in the West, adopted there as a population-control measure and exported to East Asia by Western aid donors and American military officials.

The ultrasound and other technologies that identify the sex of a fetus started out as diagnostic devices to help people with sex-linked diseases, such as haemophilia, conceive healthy children. They were greeted rapturously in America in the 1960s. “Ultrasound Device Takes Guessing Out of Pregnancy” ran one headline. “Control of Life: Audacious Experiments Promise Decades of Added Life” ran another.

But 1960s America was also a period of growing concern (hysteria, even) about population in developing countries. Policymakers, demographers and military men all thought rapid population growth was the biggest single threat to mankind and that drastic measures would be needed to rein it in. One such figure was Paul Ehrlich, whose book, “The Population Bomb”, became a bestseller in 1968. Mr Ehrlich pointed out that some Indian and Chinese parents would go on having daughter after daughter until the longed-for son arrived. If, he argued, they could be guaranteed a son right away, those preliminary daughters would not be born, and population growth would be lower. Sex selection became a tool in a wider battle to stop “overpopulation”.

But how did an obsession of Western policymakers turn into the widespread practice of destroying female fetuses in Asia? Partly, argues Ms Hvistendahl, through aid. The Ford and Rockefeller Foundations gave over $3m to the All-India Institute of Medical Sciences (AIIMS) in the 1960s, helping it to pioneer India’s first amniocentesis tests, initially for genetic abnormalities and later for identifying fetal sex. India at that time was the World Bank’s biggest client, and the bank made loans for health projects conditional on population control.

No less important, American military officers helped make abortion the population control tool of choice in those Asian countries where they wielded influence, first in Japan in the late 1940s and 1950s, then South Korea in the 1960s. USAID, America’s aid agency, provided Jeeps for mobile clinics which roamed South Korea performing abortions. At one point, a quarter of the country’s health budget was going on population control and the number of abortions hit an all-time record in Seoul, where, in 1977, there were 2.75 abortions for every live birth. “What would have happened if the government hadn’t allowed for such easy abortion?” asks one sociologist. “I don’t think sex-selective abortion would have become so popular.”

Ms Hvistendahl is convincing in telling the little-known story of how Westerners helped create the conditions under which sex selection began in Asia. But her emphasis on the West’s role is less sure an explanation for the practice’s spread throughout China and India. China’s coercive population-control policies were developed in the late 1970s, at the end of the Cultural Revolution and the early reforms of Deng Xiaoping. This was a period of isolation and modest opening-up, when China was not much interested in Western advice. The available records are scanty so it is hard to be sure, but the influence of Westerners on the one-child policy seems modest. Westerners had more clout in India, but it turns out some of them used it against, rather than for, sex selection. One (Indian) doctor from AIIMS, arguing in favour of sex-selective abortions, concedes that “this may not be acceptable to persons in the West…” Oh.

Ms Hvistendahl’s history is marred by the occasional lapses into self-righteousness and polemic. She says others who have written about sex-selection technology have not been critical enough “because blaming backward cultural traditions is simpler.” She dismisses a World Bank report that said South Korean actions to combat sex selection had worked, as “flat-out wrong”, apparently because it would let the bank off the hook for previous support of population control. She calls Western population policies a “plot”.

Still, the merits of her book outweigh such flaws. Ms Hvistendahl’s distinctive contribution is twofold. She provides a history of the modern practice of sex-selective abortion, based on new and detailed research, and she helps readers think about its possible consequences. Most of them look grim. America’s violent Wild West, she points out, had a huge preponderance of men. Excess males in central and southern China also contributed to the Taiping rebellion of 1850-64, one of the bloodiest civil wars in history.

Sex selection, Ms Hvistendahl says, still does not get its proper attention. Female genital mutilation is all over the websites of UNICEF and the World Health Organisation. Sex selection, in contrast, hardly gets a mention. One hopes her book will help the subject get its due.

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 JUNE 24, 2011

The War Against Girls

Since the late 1970s, 163 million female babies have been aborted by parents seeking sons

By JONATHAN V. LAST
Mara Hvistendahl is worried about girls. Not in any political, moral or cultural sense but as an existential matter. She is right to be. In China, India and numerous other countries (both developing and developed), there are many more men than women, the result of systematic campaigns against baby girls. In "Unnatural Selection," Ms. Hvistendahl reports on this gender imbalance: what it is, how it came to be and what it means for the future.

In nature, 105 boys are born for every 100 girls. This ratio is biologically ironclad. Between 104 and 106 is the normal range, and that's as far as the natural window goes. Any other number is the result of unnatural events.

Yet today in India there are 112 boys born for every 100 girls. In China, the number is 121­though plenty of Chinese towns are over the 150 mark. China's and India's populations are mammoth enough that their outlying sex ratios have skewed the global average to a biologically impossible 107. But the imbalance is not only in Asia. Azerbaijan stands at 115, Georgia at 118 and Armenia at 120.

What is causing the skewed ratio: abortion. If the male number in the sex ratio is above 106, it means that couples are having abortions when they find out the mother is carrying a girl. By Ms. Hvistendahl's counting, there have been so many sex-selective abortions in the past three decades that 163 million girls, who by biological averages should have been born, are missing from the world. Moral horror aside, this is likely to be of very large consequence.