Missing Women and Boy Preference
A distressing aspect of gender bias in India that shows little sign of going away is the preference for boys over girls. One of the most pernicious manifestations of this pro-male bias is the relatively higher mortality rates of girls compared with boys, not because girls are killed, but mainly because of the quiet violence of the neglect of their health and illness in comparison with the attention that male children receive. Studies have shown that male priority in care continues for adults as well as children, raising the mortality rates of adult women above those of men.
A distinct bias of “boy preference” can be found in countries extending from North Africa and West Asia to South Asia, including India, and East Asia, including China. That such discrimination has a place in a large part of the modern world is distressing: the number of “missing women” can be quite large. When I wrote on “missing women” in these pages in December 1990,* and also in the British Medical Journal, I based my conclusion on data available up to the 1980s. The missing women could be identified then as the result of the differences in mortality rates between men and women. These in turn reflected discrimination, mainly in health care, against girls and women.
Over the last couple of decades those kinds of discrimination have substantially declined in most of the countries I wrote about. Even though female mortality is still higher than male mortality for children in many Indian states, and the gap is even higher for infants in China, nevertheless in both China and India, and indeed in many of the other countries in the region, women now have a substantially higher life expectancy at birth than men.
However, since the 1980s, the wide use of new techniques such as sonograms for determining the sex of fetuses has led to huge—and growing—numbers of selective abortions of female fetuses, offsetting the gains in declining difference in mortality rates (as I discussed in the British Medical Journal in December 2003). Selective abortion of female fetuses—what can be called “natality discrimination”—is a kind of high-tech manifestation of preference for boys. Because of this counteracting influence, the proportion of missing women in the total population has not declined in many countries, including China and India. Women’s education, which has been a powerful force in reducing mortality discrimination against women and also in achieving other important social objectives such as the reduction of fertility rates, has not been able to eliminate—at least not yet—natality discrimination.
Still, we must not underestimate the effects of women’s education. There is definitive empirical evidence that women’s literacy and schooling cut down child mortality and work against the selective neglect of the health of girls. They are also the strongest influence, among all relevant causal factors, in cutting down fertility rates. The reduction of fertility that has taken place throughout India (and more sharply in Bangladesh) is clearly connected with the expansion of women’s literacy, which empowers women to have a stronger voice in family decisions. The lives that are most battered by excessive bearing and rearing of children are those of young women; any change that increases the force and impact of their voice, such as girls’ education and women’s ability to earn an independent income, has the effect of sharply reducing childbearing.
Bangladesh’s steep fall in total fertility rate from nearly seven children not long ago to 2.2 now (quite close to the replacement rate of 2.1) is strongly connected with the power of women to gain more control of their lives, and both girls’ education and women’s outside employment have done much to yield that result. I should also note here that even China’s shift from high fertility to below-replacement fertility can in many cases be more easily explained by women’s having more say, and more power, in family life—helped by education and greater economic independence—than by the draconian compulsions of its punitive “one-child policy.”
In India too, expansion of women’s schooling has contributed to its significant reduction in fertility rates. While the average of 2.4 children per family for the entire country is still above the replacement level of 2.1, this reflects a big fall from earlier rates, and nine of the twenty largest states of India have fertility rates now that are below the replacement level, which seems to reflect mainly the impact of the increased power of women to influence decisions about bearing children. Women’s education does not seem to be adequately effective in reducing discrimination against giving birth to girls; but it would be a mistake not to appreciate what female education clearly does achieve.
It is important to ask why women’s education and the corresponding enhancement of women’s voice and influence in family decisions have not done much to eliminate selective abortion of female fetuses. Educated mothers seem clearly less inclined to neglect girls compared with boys once they have been born; but they seem almost as keen on having boys rather than girls as uneducated mothers are. Here larger questions of enlightened understanding and scrutiny of traditional values become central and go beyond women’s role and influence in family decisions. There seems to be a lack of adequate awareness of the oddity of seeing girls as inferior to boys, and a lack of knowledge about what happens in other places where such discrimination against girls is not present.
An analogy can be drawn here with Adam Smith’s discussion, in The Theory of Moral Sentiments, of the willing acceptance of the alleged necessity of infanticide by intellectuals in ancient Greece. Smith quoted Plato and Aristotle in defense of infanticide. He thought that the hold of parochial values can be broken primarily by knowledge of what happens elsewhere and how other people think about the same problems. It was with respect to such parochialism that Smith emphasized the importance of considering how a local custom would look to people at “a certain distance from us,” which is a part of his thought experiment of invoking an “impartial spectator.” What is crucial here is not just freedom of action but also freedom of thought and the ability to overcome parochial boundaries of thinking.
In China and South Korea, the standard routes to women’s empowerment, such as female literacy and economic independence, have resulted in major achievements. But with the new techniques of sex determination of fetuses, discrimination through selective abortion of female fetuses became surprisingly common in both countries. This has led to organized public initiatives to make women aware of the value of having daughters and not just sons. Such efforts have had much more success in Korea than in China, where the female–male ratio at birth remains lower even than in India.
Contrasts Within India
While female education does not serve as a silver bullet to prevent discrimination against girls, other factors make the experience of the different regions within India quite diverse. In fact, there is a sharp regional divide. In the northern and western states, there is clear evidence of extensive use of selective abortion of female fetuses. In the states in the south and east of India, we do not typically find evidence of its widespread use.
Everywhere in the world more boys are born than girls, and the female–male ratio at conception is even more sharply biased in the direction of males (the standard ratio is often taken to be 910 conceptions of female fetuses compared with 1,000 male conceptions). But females do better than males in survival, if they have equal care, which they tend to get in the uterus. By the time births take place, the female–male ratio is around 940 to 950 females per 1,000 males in European countries. Between 2005 and 2010, the average ratio of females to males at birth for Europe as a whole was 943 females per 1,000 males.
There are variations within the European countries that cannot be plausibly attributed to the effects of presumed practices of sex-selective abortion; and so we have to accept a range of values for “normal” sex ratio at birth. Among the larger European countries, the female–male ratio at birth is 941 in Italy, 940 in Spain, 939 in Greece, and 935 in Ireland. If we take the ratio of 935 per 1,000 (the ratio for Ireland) as a standard against which to measure selective abortion of female fetuses, what can be said about the Indian states?
Since birth registration is incomplete in India, the ratios of girls to boys at birth are calculated by first looking at the actual numbers of girls and boys in the age group between zero and six (counted by the census), and then working backward to the female–male birth ratio by adjusting the zero to six figures for differences in mortality rates at specific ages between birth and age six. Using this method with the data provided by the 2011 census, it appears that all the states in the north and west of India, without exception, show absolutely clear evidence that sex-selective abortion is practiced to a much greater degree than is generally the case in the states in the east and south. Though many of the states even in the south and east have had some fall in female–male ratio among children between the censuses of 2001 and 2011, even in 2011 the female–male ratio at birth in the south and east of India remains not only substantially higher than in the north and the west, but also within the European range for such ratios.
In fact, we can draw a dividing line to cut India into two halves (see the map above), with the states in the west and north (including Maharashtra, Gujarat, Madhya Pradesh, Uttar Pradesh, Rajasthan, Himachal Pradesh, Punjab, Haryana, Uttarkhand, and Jammu and Kashmir) showing clear evidence of widespread sex-selective abortion, with female–male ratios well below the cut-off line of 935 per 1,000 males. In fact, in all western and northern states this ratio actually is even below 920, and in many of these states well below 900.
This contrasts sharply with the figures for states in the east and south—Kerala, Karnataka, Tamil Nadu, Andhra Pradesh, Chhattisgarh, Jharkhand, Bihar, West Bengal, and Assam—all of which have ratios above 935 (with Odisha marginally so). In those states the use of sex-selective abortion, when present, is not on a scale to pull the female–male ratio below the cut-off line based on Irish figures. Incidentally, the data from Bangladesh, where the female–male ratio for the age-group zero to four years is 972, conform strongly to the pattern of eastern India, which it adjoins.
Why is there such a regional difference? I do not know of any convincing clear-cut answer to this question, even though the correspondence of these gender-specific differences with language groups and cultural practices offers fruitful lines of research. Any serious explanation will demand a much fuller understanding of the diversities between India’s different traditional cultures, as well differences in economic, political, and social influences.
While that important research must be done, there are many necessary actions that need not await the results of that research. There is a need for better policing and for greater media attention to neglected issues, including sexual trafficking and marital rape. There is an extremely powerful case for paying much more attention to schooling for girls, for more political and social discussion of the peculiarity—and the moral strangeness and inequity—of “boy preference,” and for more commitment by India’s mainstream political parties to address the issues central to gender inequality. There is a lot to do on the basis of what we do know, even as we remain engaged in finding out more about regional cultures and divergent behavior within India.
'India's Women: The Mixed Truth'—An Exchange December 19, 2013