Unnatural Selection: Missing Girls, Abortion, and the Perversion of Choice

A few years ago, while visiting a small, prosperous city a few hours from Changsha, in China’s Hunan Province, I paused outside of a primary school to snap a photo of grandparents eagerly awaiting the afternoon bell and the grandchildren who would emerge from the school gate. A few minutes later, when that bell rang, a flood of boys emerged, enough to convince me and several other companions that we had happened upon a boy’s school. It was only later, over lunch, that we were told that, in fact, the school was co-ed.

Mara Hvistendahl describes a similar experience in her important new book, Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men. One afternoon, in the county of Suining, in Northern Jiangsu Province, she watches as a disproportionate number of boys emerge from a co-ed school. The difference in our experiences is that Mara has the data to explain the phenomenon: in 2007, shortly before her visit to Suining, she reports in Unnatural Selection that there were 152 boys born for every 100 girls in the county. The naturally occurring ratio is 105 boys to 100 girls (and anything over 107 boys is biologically impossible).

For as long as I’ve been in China, a range of causes have been posited for this dangerous imbalance, none of which is more popular among foreigners than female infanticide. Hvistendahl, a reporter to her bones (she is now a Beijing-based Asia correspondent for Science), dismisses such theories as condescending, at best, and instead digs into the data and reveals a far more compelling and disturbing explanation: gender imbalance is a byproduct of economic development. As a nation grows more wealthy, more and more people have access to the tools – ultrasound machines and elective abortion – necessary to choose boys over girls.

Mara is a very good friend of mine (we even attended the same high school), and I had the privilege of chatting with her about this book while she was in the process of reporting and writing it. That was interesting: I remember, quite clearly, when she started encountering data suggesting that abortion rights groups in the West were consciously downplaying the role of elective abortion in creating skewed sex ratios in China and other countries (including – and this is critical – countries populated by Caucasians).

Mara is adamantly in favor of abortion rights, and I could see she was uncomfortable with this data. And yet, to her everlasting credit as a journalist, she followed the story, anyway, and, along the way, uncovered important material regarding how population control activists in the West were critical to promoting abortion in Asia – and even in pushing along research into the sex determination techniques that ultimately yielded sex selective abortion.

When I asked Mara if she’d be willing to do a Shanghai Scrap Q&A (this will be her second; the first, on the topic of Chinese computer hackers, is still relevant, and still available here), I told her that I’d like to cover the material related to abortion and population control. Characteristically, she didn’t hesitate.

Scrap: Toward the end of the sections describing the reluctance of the United Nations Population Fund [UNFPA] and other reproductive rights groups to take action on sex selection you write: “After decades of fighting for a woman’s right to choose the outcome of her own pregnancy, it is difficult to turn around and point out that women are abusing that right – that in union with population pressures and technology, choice has been perverted.” I wonder if you can expand on what you mean, precisely, by that last clause – “choice has been perverted.”

Hvistendahl: The gender imbalance has huge ramifications for women as a group: 163 million, the number of females missing from Asia’s population, is more than the entire female population of the United States. We’re talking about half of humanity being reduced to less than half of humanity. How is that not issue number one for groups that work to defend the rights of women?

Because unfortunately feminist and reproductive rights groups are in what Joseph Chamie, the former head of the United Nations Population Division, calls the “abortion bind.” The abortion debate in the West—and particularly in the United States— has been framed around the notion of choice. That idea worked well thirty years ago, when it helped shift the political discussion from one about when life begins toward one about a women’s right to control her pregnancy.

But choice now includes this whole range of options that are essentially frivolous consumer decisions. Now women can also choose not to have a girl. The fertility clinics that offer high-tech sex selection tout the notion of choice when explaining that parents can screen embryos for sex during in-vitro fertilization. And we’re not very far from the day when parents may be able to choose the eye color or hair color of their future child.

All of these developments demand an updating of the rhetoric surrounding abortion rights. There’s an urgent need to reframe the abortion debate around something other than choice. Bioethicists are starting to distinguish between the rights of a pregnant woman and a right of her future child to determine his or her own future (i.e. not to have gender roles or other expectations foisted on him or her from before birth).

That’s an approach that preserves the right to abortion and yet allows the left to say, once and for all, that sex selection is wrong. But aside from a few groups – Our Bodies Ourselves and Generations Ahead – feminists in the West have generally been slow to catch up.

Scrap: While reading the book, there were a few times when I sensed your emotions coming to the fore. Of these, none was quite so powerful as the passages leading up to a description of a mostly female church service in the Chinese town of Suining, in northern Jiangsu province, where the sex ratio is highly skewed.

A few paragraphs in advance of it, you provided readers with one of the book’s most jarring conclusions: “Reproductive rights activists often blame men for sex selection … [A]cross China and India, across South Korea and Vietnam and Azerbaijan, the decision to abort is most often made by a woman – either the pregnant woman herself or her mother-in-law, who has a vested interest in her son’s offspring … ” As a feminist, I wonder if you could describe the process by which you came to that conclusion, and why it – the female mediated discrimination against female children – hasn’t become a feminist issue.

Hvistendahl: To some extent I think it’s just easier to blame domineering men —or the one-child policy, or any other number of external factors that have been named as causes of the sex ratio imbalance. Acknowledging that women are making these decisions themselves is much more complex.

Again it comes back to that notion of choice. Reproductive rights organizations tend to argue that sex selection exists because of entrenched gender discrimination, and the way to prevent it and balance out the sex ratio at birth in China and other countries is to focus on discrimination as the root cause—and funnel resources toward things like education and job opportunities for women. Well, it turns out that the sex ratio at birth is very skewed among educated women in India, while among illiterate women is close to balanced.

The same holds true for China to some degree: sex selection is happening not in poor western provinces but in booming second-tier cities in the east. Liao Li, the Suining women who took me to the church service, had aborted two female fetuses, and at some point she said, look, this is about gaining face—about earning respect from other people in the community.

[Below, a male-dominated coed classroom in Suining. Photo courtesy of Mara Hvistendahl]

I’m sure there are men who pressure their wives into aborting female fetuses, but my conversations with women revolved much more around things like face and social standing. On some level, sex selection abortion is prompted by a basic human craving for status—a craving to which women are just as susceptible as men.

To be honest, I struggled with how to tell this part of the story. As a feminist, I was wary of placing too much blame on women for perpetuating gender discrimination. But I’m a journalist as well, and if a strong, independent Chinese woman tells me that she aborted two female fetuses and assures it was her decision, I’m going to report it.

Scrap: You are an adamant supporter of abortion rights – you make that clear in the prologue, and imply it throughout the text – and yet, from our conversations while you were writing the book, I sense that your feelings about abortion went through an evolution of sorts during the research and writing of the book. I wonder if you couldn’t say something about what it was like to go through the process of reporting this material, and your feelings – as a reporter, and a “civilian” – as you did that. Did it change your outlook regarding reproductive rights? Did it change anything?

Hvistendahl: Reporting the book didn’t change my fundamental support for a woman’s right to terminate a pregnancy. I supported abortion rights when I started the book and I still support them. But I did come to a deeper understanding of just how different the context surrounding abortion is in Asia today. Chinese abortion clinics advertise on prime-time television and offer discounts to students. That’s in stark contrast to the United States, where many women live several hours’ drive from the nearest clinic, and when they arrive have to put up with protesters and brave harassment just to terminate a pregnancy.

Cultures in both East and West have had debates over when life begins, and I don’t know that there’s any place on earth where settling that has been easy. But today we’re at very, very different places when it comes to how accessible and available abortion is—and how it’s used.

[Below, two online Chinese advertisements for abortion, courtesy of Mara Hvistendahl. One advertises “painless abortion.”]


Scrap: The story of how sex selection became an acceptable means of population control in the developing world is, in many ways, a story of how white men formulated and supported often brutal policies to control the darker skinned populations of developing countries. To what extent do you think that colonialist and racist attitudes played a role in the approaches to population control adopted in the developing world?

Hvistendahl: Racism definitely played a role in the population control movement, and I don’t think it’s a coincidence that that movement arose in the 1950s, as colonies around the world were gaining independence and Western powers were losing their grip on the developing world.

But there were other pressures at play as well. People around the world were living longer, and the United Nations Population Division had begun issuing population projections that suggested what the effect of all those extra years of life would be. Many in the West—environmentalists as well as McCarthyites—feared the global population would spiral out of control.

One thing that these various camps shared was a tendency to think of population in the abstract and forget that people are individuals, with rights that need to be safeguarded. In the 1960s, as the population control movement picked up steam, a number of prominent people called for perfecting a quick and easy method of sex selection. (I detail what happened here in my book.) And yes, perhaps it was a bit easier to entertain that idea because the big targets were distant countries like China and India—and because at the time very few women and people of color held positions of power in the population control movement.

That said, an end-justifies-the-means approach to population control was later embraced by governments in Asia—by China, obviously, but also by India, Vietnam, South Korea, and Singapore. In 1975 Delhi’s All-India Institute of Medical Sciences introduced sex selective abortion, offering free determination tests to hundreds of poor women and then tracking whether they aborted based on the sex of the fetus. The doctors who wrote up the results in the journal Indian Pediatrics discussed the undertaking as a population control exercise.

A similar study was carried out at a hospital in Liaoning province, in China, that same year. But really the linking of sex selection and population control was an idea India and China owed to the United States.

Scrap: Focusing on China – it’s almost accepted gospel, for those not familiar with the issue, that infanticide, the one-child policy, and abandonment account for the country’s skewed sex ratio, and that abortion is only part of the mix. Yet you not only object to that formulation, you seem to imply that it’s both condescending and a gross distortion that obscures the real issues. Could you give a sense of how important each of those facts is, in fact, to China’s gender issues, and why they are only a small part of the overall picture?

Hvistendahl: That is the typical explanation given for China’s skewed sex ratio at birth, and it’s amazing how consistently it crops up in reports by news organizations and NGOs. I think abandonment is on the radar in the West because of our history of adopting children from China. But it is a relatively small part of the story in 2011, and infanticide happens very rarely today. Skewed sex ratios at birth are now found in many countries with no tradition of infanticide and no one-child policy. By and large, the gap is the result of sex selective abortion.

I think these local or cultural explanations persist in part because they’re easy. It’s easier to say this is a culture that has a tradition of killing girls than it is to interrogate our own role in bringing sex selection to Asia. Too often Western narratives about China explain what happens there as either the product of a monolithic government or an immutable past—as if China were not home to the same complexity and deep, varied history as the West.

I do find that condescending—especially when Americans are happily screening for sex during in-vitro fertilization. In the book I profile the Los Angeles fertility clinics that offer embryo screening. Ultimately I see a lot of similarities between what’s happening in China and the sort of consumer eugenics now on offer in the United States.

A free excerpt from Unnatural Selection is available on Mara’s website, here, or at the book’s facebook page, here. Another excerpt, “How Ultrasound Changed the Human Sex Ratio,” was published last week at Scientific American. Mara is currently on a US book tour promoting the book; a complete itinerary of appearances is available here. And finally, the book is available at bookstores all over creation, including HERE. Highly recommended.



  1. Great Q&A and book Adam. But beyond analysis of mechanism of gender imbalance, what are the prospects and possibilities for action? Economic development will soon provide choice of gender and why not colour of skin or life-expectancy to the last farmer’s hamlet in Botswana (and a bit earlier in deep Alabama) while providing equal opportunities for those traits will take decades if ever. Can/should we do anything to avoid the loss of human biodiversity? Laws and their enforcement are likely to reflect the drive to more individual rights which goes hand in hand with economic development. Is Mara’s book giving any potential avenues or should we turn to Sci-Fi novel for help?

  2. 163 million missing women…that’s probably more than the number killed by Stalin, Hitler and Mao combined. Oh, wait, most of those were “female fetuses”…so nevermind, just a statistic to frown at, not mass murder.

  3. Thanks for posting this, Adam. I’m only 36% of the way through the book, and it is a lot to digest, and none of it goes down easily.

  4. I haven’t had a chance to read the book yet, but does it also look into environmental factors that might skew the sex ratio? Obviously gender selective abortion seems to be the main issue, but I have heard other explanations too. There seems to be a growing consensus that times of plenty lead to more boy births, for example, and lord alone knows what the chemicals in the water/food do to hormones here.

    On a separate quibbling note, I find the dismissal of “infanticide” claims a bit irritating, as I’m sure many would happily describe gender-selective abortion as female infanticide. I’m an abortion rights agnostic, but I know I would certainly use it that way. Anyway, just a choice of terms I guess.

  5. Hi Duncan –

    Mara doesn’t touch on the enviro factor that you bring up. I’ll see if I can get her to comment on that …

    As for the term ‘infanticide’ – I get your meaning. However, I think in the case of its usage in the debates the book describes, it really is applied to the killing of an actual infant AFTER birth. A gruesome distinction, I’m afraid.

  6. All Chinese couples want a boy for a child, that’s their retirement plan. For the Chinese families that I have meet, if they have a girl first then they would try to get a boy next time and pay for the fines. If they have a boy they would be satisfied.

  7. Good post. Refreshing to see something about china and these issues other than the same old boring stereotypes.

  8. It’s amazing that no one has commented (including the author from all accounts) on the effect that this will have on demographics. How many children can be produced when all these potential mothers are removed. Rather short sighted if you’re trying to take over the world….! China? What China?

    Be careful what you wish for!

  9. Hi Brian –

    Thanks for the comment. Actually, the last third of the book is concerned with that very question. Also, you’ll note that the last eight words of the book’s subtitle are “… the Consequences of a World Full of Men.”

  10. Glad you did the interview, but I wish you’d asked her about how she rationalizes supporting abortion rights while condemning sex-selective abortion. I’m very curious to hear the arguments (which I assume exist) for how the pro-abortion-rights crowd does this. Her comment here was interesting, I just wish there’d been follow-up:

    Bioethicists are starting to distinguish between the rights of a pregnant woman and a right of her future child to determine his or her own future.

    Future child? Not merely a fetus/tissue/non-person/etc.? With rights to self-determination?

    The abortion advertising in China is even more notable than you alluded to here. I translated one of the discount cards that are inserted into most pregnancy tests sold in Tianjin and described the radio ads here: “Painless”, “cozy”, “cheerful”, “3-minute”, “sweet dream” abortions in Tianjin, China

  11. The thinking that adamantly defends some choices but condemns others is absurd; the unassailable autonomy so valued by feminists leaves the unborn with no rights. The Law of Unintended Consequences always lies in wait for the unwary. Once they got into the business of downgrading what had once been a class of people, they cut the ground out from under any subsequent moral stance.

  12. Having discussions about how to “update the rhetoric about abortion rights” seems absurd. It seems like a convenient way to justify my own action to abort while making myself feel better since “they” are aborting for reasons I would never be aborting for.

    It is completely fruitless to distinguish between the “right” to abort simply because this child is going to inconvenience my life and the “choice” to abort because I’m doing so to have the gender of the child I want. Why is it fruitless? Because either way, it’s selfish–I either choose to not inconvenience my life or I choose what type of child I want. No matter how much or what type of “updating of rhetoric” you employee, the motivation is still self. I just don’t see how you can be so blind to the motivation behind this action.

    To be a parent, you can be a selfish jerk. BUT to be a decent parent, it takes continuous acts of unselfishness. Each day is a sacrifice of my “rights” (self) because I would love to sit down with my cornflakes and read the paper for breakfast; instead, I have children calling for me, and with each call, I give up my “right” to my self, my time, my space. I suppose people who have an abortion are at least being honest with themselves that they themselves are the most important and that they couldn’t properly raise a child. On the other hand, you have to ask yourself, if this is the type of choice you make now, do you think you can just ‘flip a switch’ when you decide you’re ready for a child? It just doesn’t happen.

  13. A worthwhile critical review of this book at WSJ: The War Against Girls

    There is so much to recommend in “Unnatural Selection” that it’s sad to report that Ms. Hvistendahl often displays an unbecoming political provincialism. … Her desire to fault the West is so ingrained that she criticizes the British Empire’s efforts to stamp out the practice of killing newborn girls in India because “they did so paternalistically, as tyrannical fathers.” She says that the reason surplus men in the American West didn’t take Native American women as brides was that “their particular Anglo-Saxon breed of racism precluded intermixing.” (Through most of human history distinct racial and ethnic groups have only reluctantly intermarried; that she attributes this reluctance to a specific breed of “racism” says less about the American past than about her own biases.)[ … ]

    She believes that something must be done about the purposeful aborting of female babies or it could lead to “feminists’ worst nightmare: a ban on all abortions.”

    It is telling that Ms. Hvistendahl identifies a ban on abortion—and not the killing of tens of millions of unborn girls—as the “worst nightmare” of feminism. Even though 163 million girls have been denied life solely because of their gender, she can’t help seeing the problem through the lens of an American political issue.

  14. This discussion did not look at the effect of removal of abortion. China has a policyu prohibiting amniocentisis for gender selection (however it is clearly ignored!). If gender selection abortions were in fact prohibited, the underground abortionists, with little training and unhygienic conditions would increase, infanticide and abandonment would increase. The drive for status etc would not disappear. These practices were well established prior to the ease of access to abortion clinics.

  15. Cripes, what did anyone expect when we started treating ourselves like disposal commodities? There has never been ‘free love’ anymore than there has been an ‘altruistic abortion’. There are always upfront costs and unintended consequences to eugenics, whether it be a matter of ‘personal choice’ or ‘enlightened public policy’.

Comments are closed.