Tag Archives: sex selection

Thirteen Million “Hidden” Children due to China’s One-Child Policy

Genevieve Plaster  

In 1968, Dick van Dyke and Sally Ann Howes starred in a children’s fantasy movie based on a book written by James Bond creator Ian Fleming. While Chitty Chitty Bang Bang celebrates whimsy embodied in a flying (and water-compatible) English racing car, it also features a rather dark storyline: In the faraway land of Vulgaria, children are banned from the country by the baron and baroness, resulting in a sizable subpopulation of illegal minors hiding underground or locked in prison.


When the children are freed by Van Dyke’s crew, they storm the castle and a shocked Baron Bomburst exclaims, “Where are all these children coming from? I thought we passed a law against children!” Eerie, the parallel between fiction and reality.


In 2010, China conducted its latest census, which revealed that the country had 13 million undocumented children. The majority were “over-quota” children born in violation of China’s one-child policy, and who were accordingly denied legal identification or “household registration” known as hukou. Without hukou, a person cannot attend school, receive healthcare or government support, travel by train or plane, or get married.

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Written Testimony of David A. Prentice, Ph.D. in Support of SB 334

David A. Prentice, Ph.D.  

*Click here to download as a pdf: Prentice-Senatetestimony-SB 334

Feb2015 Indiana SB 334_Dr. Prentice testifyingCROPPED

Written Testimony of David A. Prentice, Ph.D.

Vice President and Research Director, Charlotte Lozier Institute

Adjunct Professor of Molecular Genetics, John Paul II Institute, Catholic University of America

Founding Member, Do No Harm: The Coalition of Americans for Research Ethics


Committee on Health and Provider Services, Indiana Senate

February 2015


To the Distinguished Chair and Honored Members of the Committee.


Thank you for the opportunity to testify IN SUPPORT of SB 334, the bill to prohibit prenatal discrimination, by prohibiting abortion based on sex selection or genetic abnormality.


I am a cell biologist, currently working for the Charlotte Lozier Institute in Washington, D.C. as Vice President and Research Director; I also serve as an adjunct professor at a Washington, D.C. university, and as an Advisory Board Member for the Midwest Stem Cell Therapy Center, a unique comprehensive stem cell center in Kansas.  Previously I spent 10 years as Senior Fellow for Life Sciences at another policy think tank in Washington, D.C., and prior to that was almost 20 years a Professor of Life Sciences at Indiana State University, and Adjunct Professor of Medical and Molecular Genetics, Indiana University School of Medicine.  Before that I was a faculty member in the Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Medical School at Houston.  I have done federally-funded laboratory research, lectured, and advised on these subjects extensively in the U.S. and internationally.  I’ve taught embryology, developmental biology, molecular biology and biochemistry for over 30 years to medical and nursing students, as well as undergraduate and graduate students.  I am testifying in my capacity as a scientist and on behalf of the Charlotte Lozier Institute.


This bill deals with preventing discrimination based on gender, or based on genetic differences, in pre-born human beings.  While it might seem to some people that this is a straightforward and logical protection that is unnecessary, there is ample evidence for the need of such protection.


Gender in humans is determined by the sex chromosomes, X and Y, within an individual’s cells. If you have two X chromosomes (XX) you are female, if XY you are male.  This genetic composition is determined at the moment of conception.  Likewise many genetic abnormalities, such as Down syndrome in which an individual has an additional chromosome 21, Edwards syndrome which is trisomy 18, Patau syndrome which is trisomy 13, and numerous other single-gene and multi-gene problems, are determined at conception when the sperm and egg fuse to form the zygote, the single-celled human organism.


Eugenics is the term given to attempts to control human heredity.  In the past, such attempts have included efforts at selective breeding of “high-quality” individuals, selective sterilization of others to prevent offspring, and even infanticide.  Today we see eugenic attempts at what some have termed “gendercide,” usually selecting for boys and against girls, in the womb or as embryos in the laboratory.


There is ample evidence to show that gender selection abortion occurs in countries such as China and India.[1]  One group even claims that the three deadliest words in the world are “It’s a girl.”[2]  Globally it is estimated that there are between 160 million and 200 million missing girls, due to sex-selection abortion.[3]


But this problem also occurs in the United States, Canada, and other Western nations.  The lack of proper records or mandated reports makes it more difficult to accumulate data on prenatal gender discrimination in North America, but there are now a number of studies that document similar sex-selection abortions taking place in the U.S. and in Canada,[4] and evidence as well for the U.K.[5]  As in other countries, the targets are primarily girls, selected against for birth.  Some opponents of prohibitions against sex-selection abortions state that such abortions are rare, but that is a tacit admission that some sex-selection abortions occur.  Even one gender discrimination abortion is too many.


Chapman and Benn note that the availability of a “non-invasive prenatal test” (NIPT) that analyzes DNA fragments in the mother’s blood plasma may lead to greater sex selection in developed countries.[6]  Some centers now even advertise the ability to determine fetal gender as early as 10 weeks post-fertilization,[7] and published papers are pushing this determination even earlier, to 7 weeks[8] or even 6 weeks[9] after conception.


Genetic discrimination abortions, in terms of those against genetic abnormality, show well-documented evidence involving discrimination against babies diagnosed in utero with Down syndrome.  Studies show that such pre-born children are aborted at an extremely high rate.  Documentation from other countries, who keep better records than the United States, tells a chilling tale.


In France, which keeps excellent records on prenatal screening as a matter of public policy, Bradford cites a 96% rate of abortion for those diagnosed in the womb with Down’s.[10]  In the U.K., an earlier study found a 92% abortion rate for children diagnosed in the womb with Down syndrome,[11] while a 2012 study found that 100% of those babies diagnosed in the womb with Down syndrome were aborted.[12]


In the U.S., a 1999 study found almost 87% of those diagnosed with Down syndrome in the womb were aborted.[13]  A 2012 review of the literature on this topic, looking only at U.S. data, found a weighted mean from 61% up to 93% of those diagnosed who were aborted.[14]


Similar rates of selection against life are seen for babies diagnosed in the womb with other genetic conditions, or even physical abnormalities.  Again, this is simply a modern version of eugenic selection.


Sometimes regarding these prenatal diagnoses, we hear the term “incompatible with life.”  Nora Sullivan points out that this label “portrays as a medical diagnosis what is really a judgment call about a profoundly disabled child’s quality of life.  The term is not only offensive to parents who object to the implication that their children’s lives hold less value due to their potential brevity but also has serious implications as to how families perceive these disabilities and their decision-making process.”[15]  She tells the story of Tracy Harkin, a spokeswoman for the group Every Life Counts, and the mother of 8-year-old Kathleen Rose who was born with Trisomy 13.  Harkin points out that the term is “medically meaningless, incorrect, and enormously hurtful.”  Indeed, a study in Critical Care Medicine noted that what doctors tell parents about their child’s prognosis is often influenced by the doctor’s own attitude toward neurological impairment.[16]


Moreover, while older texts say that around 90% of children born with Trisomy 18 don’t live as long as a year, this is simply outdated information.  For example, Bella Santorum, daughter of former Sen. Rick Santorum, will be 7 years old this May.  Mrs. Santorum says that “Bella’s a little girl with a big message, that every person matters.  She’s here for a reason.”[17]


Indeed, more and more children with genetic conditions like Bella and Kathleen Rose are surviving, and thriving.[18]  A recent study by doctors at the Children’s Hospital of Philadelphia, published in the journal Pediatrics, points out the improvements, noting: “Despite the conventional understanding of these syndromes as lethal, a substantial number of children are living longer than 1 year and undergoing medical and surgical procedures as part of their treatment.”[19]


Contrast the prevalent attitude about Down syndrome that leads to a lethal diagnosis, with the recent facts about increased life span, health, learning, and especially satisfaction for those with Down syndrome and their families.  A recent study by Skotko et al. found that 99% of people with Down syndrome are happy with their lives, 99% of parents said they love their child with Down syndrome, and 97% of brothers/sisters, ages 9-11, said they love their sibling.[20]


Medical science has also improved significantly not only in terms of surgeries to alleviate some of the physical problems associated with Down syndrome, but also in potential pharmaceutical treatments.  Bradford notes several clinical trials, all begun within the last five years, with drugs that are hoped will improve cognition for individuals affected by this condition.[21]


Other work has helped elucidate some of the genetic and cellular mechanisms that lead to tissue characteristics associated with Down syndrome.  Work with a mouse model has shown that treatment of newborns with a genetic activator has therapeutic potential to improve cognitive function.[22]  Another group has shown a laboratory mechanism to remove the third (extra) chromosome from cells in culture,[23] and a different team has provided laboratory evidence for possibly silencing the extra chromosome in a trisomy.[24]  A recent 2014 paper used a stem cell model, with cells from Down syndrome patients, to show that certain neural cells called astroglia behave aberrantly in Down syndrome, but that an FDA-approved antibiotic drug, minocycline, can partially correct problems with these cells.[25]


The commercialized non-invasive prenatal tests have made screening much easier and earlier, but have also presented greater opportunities for selecting against individuals with genetic abnormalities, and not just for chromosome trisomies but for an increasing list of genetic disorders and traits.[26]  This should not be the case, but rather these tests should be used, as Dr. Diana Bianchi of Tufts Medical Center has noted, to “develop new approaches to fetal treatment.”[27]  Fetal surgery is undergoing a rapid expansion as more doctors and parents realize the possibility, and even advantage, of surgery while the child is still within the womb.[28]  We are also starting to see some conditions, including genetic abnormalities such as severe immune deficiencies[29] and osteogenesis imperfecta,[30] treated in the womb using adult stem cells or gene therapy.  These are very young patients, and should be treated as such.


Donovan and Messner summarized arguments against disability discrimination abortions, provided by disability rights groups in an amicus curiae brief filed with the Supreme Court.[31]  These disability rights groups point out: “Though some abortions of children with disabilities involve diagnoses that are likely to be fatal, many involve non-fatal conditions such as Down syndrome, cystic fibrosis, and spina bifida.”  Even in these non-fatal cases, the statistics are alarming; they note “recent evidence suggests that as many as 95 percent of parents receiving a prenatal diagnosis of cystic fibrosis elect to terminate the child.”  According to those disability rights groups, the Supreme Court “has never endorsed a right to abort children only because they have been detected to have a disability.”


It is often claimed that late-term abortions in particular are largely due to discovery of fetal abnormalities or health of the expectant mother.  However, Dr. Priscilla Coleman reported in 2010 (citing the Guttmacher Institute) that “the vast majority of late-term abortions are performed for socio-economic reasons, on a healthy and potentially viable fetus.”  Her report also states that “Fetal abnormalities or woman’s health considerations are rarely the reason for undergoing a late-term abortion.”[32]  Similar results were reported by Dr. Elizabeth Johnson in 2015, analyzing a paper published in a journal of the Guttmacher Institute.[33]  Dr. Johnson points out that rather than the usually-cited reasons of fetal abnormalities or health considerations, women seek abortion because of the stress of “unprepared pregnancy, single-motherhood, financial pressure and relationship discord.”  She also notes that these stresses “are not fundamentally alleviated or ameliorated by late-term abortion.  Indeed, late-term abortion places these women at greater risk of surgical complications, subsequent preterm birth, and mental health problems, while simultaneously ending the life of an unborn child.”


SB 334 would provide necessary, distinct protections for developing human beings, preventing discrimination based on genetics or disability.  Thank you for the opportunity to contribute to the discussion on this important issue.



[1] Sachan D. India’s problem with girls, BMJ 347, f4149, August 2013; Kay M. Five Tamil Nadu doctors banned from practice for violating prenatal sex selection law of an unborn child, BMJ 346, f3788, June 2013; Jha P et al., Trends in selective abortions of girls in India: analysis of nationally representative birth histories from 1990 to 2005 and census data from 1991 to 2011, Lancet 377, 1921, 2011; Xu WX et al., China’s excess males, sex-selective abortion, and one child policy: analysis of data from 2005 national intercensus survey, British Medical Journal 338, b1211, 2009; Hesketh T et al., The consequences of son preference and sex-selective abortion in China and other Asian countries, CMAJ 183, 1374, 2011

[2] It’s a girl, http://www.itsagirlmovie.com/

[3] Mara Hvistendahl, Unnatural Selection: Choosing Boys over Girls, and the Consequences of a World Full of Men, Public Affairs Publishing, p. 5-6 (2011). Hvistendahl writes that an estimated 163 million females were demographically `missing’ from Asia alone, as early as 2005; United Nations Fact Sheet: International Women’s Day 2007, available at http://www.un.org/events/women/iwd/2007/factsfigures.shtml.]

[4] Kale R, “It’s a girl!”–could be a death sentence, CMAJ 184, 387, 2012; Almond D and Edlund L, Son-biased sex ratios in the 2000 United States Census, Proceedings of the National Academy of Sciences USA, 105, 5681, 2008; Abrevaya J, Are there missing girls in the United States? Evidence from birth data, American Economic Journal: Applied Economics 1, 1, 2009; Puri S and Nachtigall R, The ethics of sex selection: a comparison of the attitudes and experiences of primary care physicians and physician providers of clinical sex selection services, Fertility and Sterility 93, 2107, 2010; Puri P et al., ‘There is such a thing as too many daughters, but not too many sons’: A qualitative study of son preference and fetal sex selection among Indian immigrants in the United States, Social Science and Medicine 72, 1169, 2011; Egan JFX et al., Distortions of sex ratios at birth in the United States; evidence for prenatal gender selection, Prenatal Diagnosis 31, 560, 2011.

[5] Adamou A et al. Missing women in the United Kingdom, IZA Journal of Migration 2, 10, 2013

[6] Chapman AR and Benn PA. Noninvasive Prenatal Testing for Early Sex Identification: A Few Benefits and Many Concerns, Perspectives in Biology and Medicine 56, 530-547, 2013

[7] See, e.g., Prenatal Genetics Center, accessed at: http://www.prenatalgeneticscenter.com/

[8] Devaney SA et al.  Noninvasive Fetal Sex Determination Using Cell-Free Fetal DNA, JAMA 306, 627, August 2011

[9] Fernández-Martínez FJ et al. Noninvasive fetal sex determination in maternal plasma: a prospective feasibility study, Genet Med 14, 101, 2012

[10] Bradford M. Improving Joyful Lives: Society’s Response to Difference and Disability, American Reports Series Issue 8, June 2014, accessed at: https://lozierinstitute.org/improving-joyful-lives-societys-response-to-difference-and-disability/

[11] Mansfield C et al. Termination rates after prenatal diagnosis of Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes: a systematic literature review, Prenatal Diagnosis 19, 808, 1999

[12] Nicolaides KH et al. Noninvasive prenatal testing for fetal trisomies in a routinely screened first-trimester population. Am J Obstet Gynecol 207, 374.e1, 2012

[13] Britt DW et al., Determinants of parental decisions after the prenatal diagnosis of Down syndrome: Bringing in context, American Journal of Medical Genetics 93, 410, 1999

[14] Natoli JL et al. Prenatal diagnosis of Down syndrome: a systematic review of termination rates (1995-2011), Prenatal Diagnosis 32, 142, 2012

[15] Sullivan N. The Term “Incompatible with Life” is Incompatible with the Best Care, December 2014, Accessed at: https://lozierinstitute.org/the-term-incompatible-with-life-is-incompatible-with-the-best-care/

[16] Randolph AG et al. Factors explaining variability among caregivers in the intent to restrict life-support interventions in a pediatric intensive care unit, Crit. Care Med. 25, 435, 1997

[17] Dan Majors. “Rick and Karen Santorum’s book shares daughter’s struggle with rare disease,” Pittsburgh Post-Gazette, Feb 13, 2015; accessed Feb 16, 2015 at  http://www.post-gazette.com/news/state/2015/02/13/Rick-Santorum-s-book-shares-daughter-s-struggle-with-rare-disease/stories/201502130105

[18] Gann C. “Trisomy 18 and 13: More Children Like Bella Santorum Survive,” ABC News, April 2012, accessed at: http://abcnews.go.com/Health/trisomy-18-kids-bella-santorum-rick-santorums-daughter/story?id=16090571

[19] Nelson KE et al. Inpatient Hospital Care of Children With Trisomy 13 and Trisomy 18 in the United States, Pediatrics 129, 869, 2012

[20] Skotko BG et al. Self Perceptions from People with Down Syndrome, American Journal of Medical Genetics Part A 155, 2360, 2011

[21] Bradford M. Ibid

[22] Das I et al.  Hedgehog Agonist Therapy Corrects Structural and Cognitive Deficits in a Down Syndrome Mouse Model, Science Translational Medicine 5, 201ra120, September 2013

[23] Li LB et al. Trisomy Correction in Down Syndrome Induced Pluripotent Stem Cells, Cell Stem Cell 11, 615, 2012

[24] Jiang J et al. Translating dosage compensation to trisomy 21, Nature 500, 296, August 2013

[25] Chen C et al. Role of astroglia in Down’s syndrome revealed by patient-derived human-induced pluripotent stem cells. Nature Communications 5:4430, doi:10.1038/ncomms5430, July 2014

[26] Wong AIC and Lo YMD. Noninvasive fetal genomic, methylomic, and transcriptomic analyses using maternal plasma and clinical implications, Trends in Molecular Medicine 21, 98, February 2015

[27] Bianchi DW. From prenatal genomic diagnosis to fetal personalized medicine: progress and challenges, Nature Medicine 18, 1041, July 2012

[28] See, e.g., the Center for Fetal Diagnosis and Treatment, Children’s Hospital of Philadelphia, accessed at: http://www.chop.edu/centers-programs/center-fetal-diagnosis-and-treatment

[29] Loukogeorgakis SP and Flake AW. In utero stem cell and gene therapy: Current status and future perspectives, Eur J Pediatr Surg 24, 237, 2014

[30] Chan JKY and Götherström C. Prenatal transplantation of mesenchymal stem cells to treat osteogenesis imperfecta, Frontiers in Pharmacology 5, 1, October 201.

[31] Donovan CA and Messner T. Twenty-Week Bans Raise Issue of Disability Discrimination Abortion, Charlotte Lozier Institute On Point Series 4; November 2013. Accessed at: https://lozierinstitute.org/twenty-week-bans-raise-issue-of-disability-discrimination-abortion-2/ Original brief accessed at: http://sblog.s3.amazonaws.com/wp-content/uploads/2013/11/FILED-AmicusLeJeuneSDiDSC-BDF.pdf, filed by the Bioethics Defense Fund, Scottsdale, Arizona, http://www.bdfund.org/.

[32] Coleman PK. Late-term Abortion: Antecedent Conditions and Consequences to Women’s Health, The Human Family Research Center, October 2010.  Accessed at: http://humanfamilyresearch.org/HFRC%20womens%20health%20and%20late-term%20abortion.pdf

[33] Johnson E. The Reality of Late-Term Abortion Procedures, Charlotte Lozier Institute On Point Series 9, January 2015; accessed at: https://lozierinstitute.org/the-reality-of-late-term-abortion-procedures/

British Vote Indicates Strong Disapproval for Sex-Selection Abortion

Angelina Baglini Nguyen  

British Members of Parliament recently voted to clarify the status of sex-selection abortion under the Abortion Act of 1967.  The MPs voted, 181-1, in favor of banning sex-selection abortion under the British abortion statute.  Sex-selection abortion has been a topic of intense focus among legislators after investigators exposed doctors agreeing to perform abortions solely based on a baby’s undesired gender.

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UK Fails to Uphold Sex-Selective Abortion Ban

Nora Sullivan  

The news came of the United Kingdom this past week that the Crown Prosecution Service (CPS) rules that it would not be in the “public interest” to prosecute two doctors who agreed to arrange illegal sex-selective abortions.  This ruling was made despite the fact that prosecutors admit that there is more than enough evidence to take these doctors to court for violating the law.

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Abortion Limits are NOT a Form of Torture

Nora Sullivan  

This past Friday, March 8, marked International Women’s Day.  The observance, quite admirably, draws attention to the social, political, and economic struggles of women throughout the world as well as the plethora of human rights abuses committed against them. There is no doubt that women have made and continue to make vital contributions to society and every day we seem to make substantial gains in the global arena.  However, it quite often seems that, throughout most of the world, to be a woman is to be born already facing an almost insurmountable struggle and, in many cases, a life of tragedy.

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International Day of the (Unborn) Girl Child

Nora Sullivan  

Today, October 11, the United Nations marks the first annual International Day of the Girl Child.  The observance was formally adopted by the U.N. General Assembly on December 19, 2011 as an official day on which to raise awareness of the situation of girls across the globe.  The institution of this day is a decidedly positive symbol.  Young girls worldwide face a multitude of obstacles, such as poverty and a lack of education, which can prevent them from fulfilling their human potential.  Additionally, a plethora of problems face young girls in developing countries as well as in prosperous nations that violate their human rights every day on a massive and frightening scale.  A day such as this can call attention to the very real concerns facing girl children throughout the world.  With any luck, that attention will bring about much needed action to protect these little girls.

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Sex Selection Abortion: A Worldwide and U.S. Problem

Charlotte Lozier Institute  

Download PDF here: Sex Selection Abortion- A Worldwide and U.S. Problem, Fact Sheets


  • Sex selection abortions are playing a role in skewing the male-female sex ratio at birth (SRB) in dozens of countries around the world.  The problem is worst in China and India where provincial and even national birth ratios evince the widespread practice of elimination of baby girls by sex selective methods including abortion, preimplantation sex selection in IVF, and even infanticide.
  • Here is a sample of nations (and year studied) showing national-level skewing (a natural SBR rate is in the range of 103 to 106 newborn boys per 100 newborn girls).  (Eberstadt, varioustables, “The Global War Against Baby Girls,” The New Atlantis, Number 33, Fall 2011, pp. 3-18)



Country Year Sex ratio at birth (boys/100 girls)
China (nationally) 2005 118.9
China (Anhui Province) 2005 131
China (Shaanxi Province) 2005 134
China (third births. nationally) 2005 160
Taiwan 2005 110
Hong Kong 2005 110
India   2004-06 112
Albania 2004 113
El Salvador 2007 110
Phillippines 2007 109
  • Naturally impossible sex ratios at birth have also occurred in the United States, as documented in study data from 2000 and after.
  • These ratios, however, are occurring in subpopulations and are not prevalent enough to drive the national U.S. data outside the range (103 to 106) that would naturally occur.  Skewed sex ratios (108), favoring boys over girls, have appeared in U.S. subpopulations mirroring the international data (Chinese-Americans, Korean-Americans, Indian-Americans and Filipino-Americans).
  • Though relatively few in number, these studies have been carried out by prominent scholars at secular institutions (Columbia, University of Texas, and Berkeley), using standard data collection and/or interview methods, and have appeared in leading publications.
  • These findings are further strengthened by their statistical significance, consistency in direction and overall harmony with international trends for the same populations.
  • Douglas Almond and Lena Edlund of Columbia University identified these trends, including a male bias of 50% among third-order births, in U.S. populations of Chinese, Korean, and Asian-American heritage.  “We interpret the found deviation in favor of sons to be evidence of sex selection, most likely at the prenatal stage,” they write. (Proceedings of the National Academy of Sciences (2008), at http://www.pnas.org/content/105/15/5681.full.)
  • University of Texas economist Jason Abrevaya “found that on the basis of census and birth records through 2004, the incidence of boys among immigrant Chinese parents in New York was higher than the national average for Chinese families.  Boys typically account for about 515 of every 1,000 births.  But he found that among Chinese New Yorkers having a third child, the number of boys was about 558.” (New York Times, June 15, 2009).
  • Puri et al. in a study of 65 Indian immigrant women in the U.S. on both the East and West Coasts, between 2004 and 2009:  “We found that 40% of the women interviewed had termin-ated prior pregnancies with female fetuses and that 89% of women carrying female fetuses in their current pregnancy pursued an abortion.”  Social Science and Medicine (February 15, 2011).
  • The use of ultrasound and abortion as the primary means of sex selection are commonplaces in international analysis of the issue, as the cost of these interventions has been steadily reduced and has played a dominant role in popularizing sex selection of baby boys.
  • Again, these numbers are not large enough to skew the national data Guttmacher relies upon (Barot, Guttmacher Policy Review, Spring 2012, Vol. 15, No. 2).  But they are real in the relevant subpopulations and Guttmacher, though deploying numerous qualifiers, acknowledges there is “some evidence” of the sex-selection phenomenon.
  • Guttmacher’s review ultimately opposes sex-selection bans on policy grounds and not on the existence or prevalence of the problem at either a subpopulation or national level.  There is no SBR ratio at which Guttmacher would support a ban based on the premises of its spring 2012 review.  Such bans have been enacted in nations like China that continue to evince a skewed SBR and in South Korea, which has deployed both legal and cultural means to reverse the practice.

Sex-Selection Abortion: Worldwide Son-Bias Fueled by Population Policy Abuse

Charlotte Lozier Institute  

Download PDF here: CLI Fact Sheet on Sex Selection Abortion


A growing number of legislative bodies worldwide and an increasing number of American states are adopting laws against abortions performed solely on the basis of the sex of the unborn child.  This global phenomenon, nearly always carried out against female children developing in the womb, has resulted in an estimated deficit of 163,000,000 girls (Hvistendahl, 2011).  Evidence suggests that this problem is not abating on its own, and that significant and concerted cultural, communications, ethical, and legal pressure is needed to ensure that no child is aborted simply because he or she is of the “wrong” sex.



The Problem: “Ruthlessly Routine”


Sex selection abortion is a tragic phenomenon of relatively recent vintage.  The ability to identify the sex of a child in the womb at the genetic level was first developed in the 1950s.  It was not until the 1970s, with the development of ultrasound technology and the dissemination of less expensive machines in the decades after, that prenatal determination of the sex of the unborn became widespread practice.  The invention of in vitro fertilization techniques in the late 1970s also encouraged the development of techniques for determining sex prior to conception.



The availability of sex identification technologies has combined with legal regimes that essentially permit abortion on request and that strongly disincentivize or forcibly limit the number of children couples may have. China’s “one-child” policy imposes a particularly strict limit on family size.  The final factor encouraging sex selection abortion is the enduring preference in many societies for male offspring. 



These factors are individually potent but particularly powerful operating in tandem, and any strategy designed to reduce sex-selection abortions must address them all.  As demographer Nicholas Eberstadt of the American Enterprise Institute wrote recently, the confluence of these forces has become “so ruthlessly routine in many contemporary societies that it has impacted their very population structures, warping the balance between male and female births and consequently skewing the sex ratios for the rising generation toward a biologically unnatural excess of males.”[1]  This reality prompted delegates to the Beijing Conference on Women in 1995 to list (Paragraphs 115 and 116 of the Platform of Action) prenatal sex selection and female infanticide as forms of violence against women.



Sex Ratio Imbalances Worldwide



A sample of the numbers underscores the warping of the natural balance of the sexes.  The table below shows the Sex Ratios at Birth for children born in selected nations.  A natural rate is in the range of 103 to 106 newborn boys per 100 newborn girls.  As the table makes clear, the skewing of sex ratios is more severe for higher order (2nd and subsequent) births in these nations as couples’ son preference mixes in a lethal way with government-imposed child limitation policies.



Country                                                                 Year                                        Sex ratio at birth (boys/100 girls)

China (nationally)                                                 2005                                       118.9
China (Anhui Province)                                       2005                                       131
China (Shaanxi Province)                                    2005                                       134
China (third births)                                              2005                                       160

Taiwan                                                                    2005                                       110
Hong Kong                                                             2005                                       110
India                                                                       2004-06                                 112
Albania                                                                   2004                                       113
El Salvador                                                             2007                                       110
Philippines                                                           2007                                       109



Making progress against a problem with such profound interpersonal as well as society-wide implications is difficult and requires a multi-faced strategy.  Nonetheless, even as the phenomenon of massive skewing of sex ratios has appeared in new countries and worsened in others, experience has shown that gendercidal effects can be countered and reversed.  The United States is not immune to the challenge of sex selection, and it can draw upon the lessons of other nations to adopt policies as well as cultural messages that prevent the problem from worsening here and that ultimately lead to the global cessation of this deadly form of sex-based human rights violation.



Occurring in the U.S.


Naturally impossible sex ratios at birth are also occurring in the United States, as documented in survey data from 2000 and after.  Skewed sex ratios (108), favoring boys over girls, have appeared in U.S. subpopulations mirroring the international data (Chinese-Americans, Korean-Americans, and Filipino- Americans).  Douglas Almond and Lena Edlund of Columbia University identified these trends, including a male bias of 50% among third-order births, in U.S. populations of Chinese, Korean, and Asian-American heritage.  “We interpret the found deviation in favor of sons to be evidence of sex selection, most likely at the prenatal stage,” they write.[2]  This fact has prompted several U.S. states to ban sex selection abortion in their jurisdictions.  These states include Illinois (2008), Pennsylvania (2008), Oklahoma (2010), and Arizona (2011).



Worldwide Condemnation


Cultural policies to deter sex selection abortion have been pursued by countries around the world for many years, and legislative bans have been adopted in many countries.  Abortions for sex selection are illegal in China, Hong Kong, Singapore, South Korea, Taiwan, India, the United Kingdom (which has banned sex selection abortion for “social reasons”), and Vietnam.  While legislative action is not enough to undo centuries-long cultural biases, it has often proven to be the threshold step for galvanizing cultural reform.



Public Support for Action


Besides the legislation that has been enacted in diverse regions of the world, evidence exists that legislative bans on sex selection abortions have broad support.  A March 2006 Zogby poll found that 86 percent of Americans believe that an abortion performed because of the sex of the developing child should be illegal.  A LifeCanada poll conducted by Environics Research and released in October 2011 showed that an astonishing 92 percent of Canadians thought that sex selection abortions should not be legal in Canada.[3]  To this can be added the new poll released on May 16, 2012 by the Charlotte Lozier Institute, which found that 77 percent of American adults (80 percent of women) would support making sex-selection abortion illegal when that is the sole reason for seeking an abortion.

[1] Eberstadt, Nicholas, “The Global War on Baby Girls,” The New Atlantis; A Journal of Technology and Society (Fall 2011); viewed January 25, 2012 at http://www.thenewatlantis.com/publications/the-global-war-against-baby-girls.

[2] (Proceedings of the National Academy of Sciences (2008), at http://www.pnas.org/content/105/15/5681.full(May 3, 2012)).

[3]  “Canadians’ Attitudes Towards Abortion,” Commissioned Research Conducted for Life Canada, October 2011, p. 3 at http://www.lifenews.com/wp-content/uploads/2011/10/lifecanada2.pdf (January 26, 2012).

Sex Selection Abortion: Human Rights at Risk East and West

Nora Sullivan  

Recent undercover investigations by the Daily Telegraph (United Kingdom) into the incidence of sex-selective abortion in England have revealed a startling pattern:  the nation’s ban is only being selectively enforced.  Despite a nationwide prohibition on aborting a child because of his or her gender, the Daily Telegraph reports that several abortionists were willing to perform the procedures even though their faux-patients made it clear that they planned to abort their unborn children, as in the great majority of sex-selection cases, solely because they were female.

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