29 October 2014

160 Million Problems (Jay-Z didn’t know the half of it)

I mentioned HIV/AIDS a few times in the last post, so this BBC article seems relevant. It discusses how urbanisation and a skewed sex ratio in 1920s Kinshasa likely engendered the AIDS pandemic. Today, the surplus men I discussed in the last post – who are responsible for so very many good things already – also constitute what is known public health circles a ‘bridging population’. Basically, they’re among the most likely to spread the virus from high-risk to low-risk populations (basically picking it up in the misspent youth presumably seeing sex workers or doing drugs and then passing it on to the women they ultimately marry or children they ultimately have).

Okay, so as a refresher, the previous post went into what a skewed sex ration means for men – no wives, more violence. But that’s only half of the social equation. The question remains of what does a world with fewer women mean for those who remain (yes, I know that I’m being rather appalling heteronormative. Unfortunately, aside from a few hilariously offensive historical nuggets about how skewed sex ratios will result in a gay explosion, there’s very little I could find about the impact of gender imbalance on the queer community).

Just to reiterate the scale of gender imbalance we’re discussing, and while the subject of AIDS is still fresh in our minds, it’s interesting to conceptualise masculinization as an epidemic. For example, since its discovery in 1981, AIDS has killed an estimated 36 million people. Sex selection, meanwhile, has claimed 130 million more women. Never let it be said that demographics is a dry field! Girls are being culled from the population in all kinds of creative ways, be it from sex-selective abortion or relative neglect compared to male offspring in early childhood (including abandonment) or desperate life circumstances that might lead to suicide. If that seems a bit heavy-handed, try to remember that there are more girls than boys in orphanages and that in many gender-imbalanced societies, there is actually a higher mortality rates for girls, which is unusual.

If you were to approach this whole absence of ladies things from the angle of remedial economics (which, remarkably, some people actually have), you might come to the conclusion that it’s actually a good thing for the scarcer – excuse me, fairer – sex. After all, a simply supply and demand curve should confirm for us that fewer women makes each one more valuable, yes? True enough. Unfortunately, women are not commodities, despite what many seem to believe, and as they gain value as goods, they lose it as people.

It’s important to note, however, that the inverse is not necessarily true, either – women do not have greater human value in a society in which they outnumber men. Take Congo, my perennial favourite example, where sex ratio at birth is a surprising 1.03 (men to women). I wish I could have recorded the security briefing this morning. It was a litany of abuses against women. In village X, one woman was raped. In village Y, another woman was raped. In village Z, 11 women were raped and four kidnapped. In village N, one woman was beheaded and two girls were raped (for what it’s worth, most deaths are reported as people. Five people were killed in village D. I don’t know if the genders are mixed or men only, but after what came before…there is a small part of me that rather hopes that it’s the latter).

Back to the woman-less world, though, Mara Hvistendahl from Unnatural Selection (which I will be quoting from extensively yet again! You should probably skip the post and just read the book) rather tartly notes that “no majority group has ever aspired to become a minority under the illusion that a decrease in numbers will somehow lead the group’s members to be more valued by the rest of society (zing. Take that, economist demographers).” She goes on to outline a depressing smörgasbord (there’s an ö in that, right?) of ways in which, as they become a more valuable commodity, women lose their personhood (kidnapping or being sold, come to mind, even by family members) and also observes how this paradigm might lead to the propagation of a female underclass in which poor families might actually select for girls so that they can sell them to wealthy families.

There’s lots of precedent here to work with, as most mass population movements in history have been dominated by men (with the exception of refugee flows). The context now is different, of course – we’re more often addressing established societies than burgeoning ones – but the past can still inform our expectations to a certain extent. And those expectations are bleak. Historically, high sex ratio societies have had exceptionally low rates of literacy and female workforce participation. Historically, they have had have exceptionally high rates of prostitution. Historically, they have been unstable. Historically, they have often proven violent.

Some have even tried to use history to explain away the modern gender imbalance as a cultural issue (cultural relativism as an excuse for sexism, homophobia and other forms of violent intolerance has a long and ignoble pedigree). Shenanigans, I say! Sure, there’s a strong preference for men in the countries with gender imbalance problems, but there’s actually a preference for boys globally (“Sexism might be an obvious culprit for imbalance if it weren’t so universal. Parents in nearly all cultures say they prefer boys, and yet sex selection only strikes in part of the world.” Yay?). Moreover, though there was some evidence of traditional female infanticide in China and India, it was not a wide-spread practice, and generally only occurred in very select areas in times of extreme economic hardship. After all, if you only have so many funds to feed so many mouths, boys are often perceived as having more long-term value than girls, especially in societies that use a dowry system in place of a bride price. Generally, though abortion was frowned on in most of classical Asia. Where it was performed, it was anathema. Confuscianism held that life begins before birth, while Hindus specifically warned against killing foetuses. The Buddhist monastic code, meanwhile, stated that life begins at conception, and monks could be expelled for helping a woman abort.

How then, could this happen, especially in the second world? We’re used to violence against women in the third world, but these places are supposed to be better than that. “Development was not supposed to look like this. For as long as they have speculated about the status of women, social scientists have taken for granted that women’s position improves as countries get richer. Economic growth means that more girls go to school, and that those girls have access to a broader array of job opportunities when they grow up…” Etc., etc.

So it is true, for the most part, that economic development, along with the urbanisation, education, and the new job opportunities it brings, may well make parents less sexist. But because development is accompanied by plummeting birth rates, it raises the stakes for each birth, thereby increasing the chances parents will abort a female foetus. “Most parents wait until they already have one or two daughters before resorting to sex selective abortion; very few abort because of the fetus’s sex during the first pregnancy. We know this because around the world the sex ration at birth jumps abruptly with birth order.”

This, of course, suggests that it’s not a simple matter of coercion; for as riddled as the history of this topic is with forced sterilisation and abortion, most modern gender imbalances seem to occur in countries and among segments of the population (educated, urban, affluent) where women are reasonably reproductively empowered, to the extent that the really ever are. Social coercion is subtle and nefarious and nearly as strong as outright familiar pressure (totally interesting and unrelated side note? Fertility is generally set in the DRC by the paternal mother-in-law. So women do generate much of the pressure on other women to have children beyond their financial and physical capacity). Indeed, feeling an imperative to have boys speaks to an institutionalized, internalized sexism.

And not just that! It also has to do with modern means of population control, economics, and racism. This is going to get messy. In the mid-twentieth century, the West began exporteding the doctrine of population control largely out of a fear of communism. “Between 1965 and 1976, money spent on research and development for contraceptive methods around the world more than doubled. Developing countries received the lion’s share of that money while contributing less than 3 per cent of it. The most funding came from the US” (my, how times and global gag rules have changes). Aid was actively linked to population control measures, especially health programmes. As I understand it, the reasoning of Western donors went like this: if they promoted better access to and quality of health services, thereby saving lives, they would have to offset that population increase through birth control. Essentially, developing countries were obligated to exchange longer lives for control over their own reproductive rates.

Further, a critical component of improving health care is ensuring access to better technologies, such as prenatal screenings. The population control brigade quickly determined that promoting sex selection quicker and easier and cheaper than actually advancing the status of girls and women (which also tends to slow down birth rates). Some Western family planning orgs even extolled abortion as preferable to birth control. As I’ve alluded to a bit, horror stories abound of Western-sponsored field clinics that inserted IUDs and conducted sterilizations, despite the medical staff having no gynaecological experience. By 1977, doctors in Seoul were performing 2.75 abortions for every birth, makring the highest documented rate of abortion in human history.

Which, in fairness, is actually a lot less fishy that some of the other absurdities that were suggested, such as introducing sterilizing agents to the food chains or compulsively sterilizing men with three or more children or even “flying planes over India once a year to spray it with a contraceptive aerial mist”. Promoting sex-selective abortion: less horrific with the right context – just compare it against eugenics! It tickles me that one of the strongest arguments against sex selection was a fear that it might well increase homosexuality, as though having fewer women would essential turning Asia into a giant men’s prison (others pointed out that queer couples can’t conceive – this was the old days – and so should be encouraged as a ‘humane alternatives’ to population control).

The Western fetish with population control is even indirectly responsible for China’s One Child policy, though that might be a bit of an overstatement. It was a zealous non-demographer highly placed in the Chinese DoD who took the Western obsession to an absurd conclusion. Who was it that said that all things, when taken to their logical conclusion, become cancerous? At any rate, when China jumped on the population control bandwagon in the 1970s and 1980s, they did so without reservations. Graphic PSA were released, bearing slogans like: Better to let blood flow like a river than to have one more than allowed. Or: You can beat it out! You can make it fall out! You can abort it! But you cannot give birth to it.

By 1982, fourteen million women, accounting for 2/5 of all pregnancies, underwent abortions. Between January 1981 and December 1986, Chinese women underwent 67 million abortions. Sweet God. In 1983, in a moment of either unbearable gross naiveté or perfect historical dark humour, the UNFPA jointly awarded Qian Xinzhong, the former People’s Liberation Army general who was the architect of the one-child policy, and Indira Gandhi, who had overseen India’s mass sterilization (involuntary) campaign, with the first United Nations Population Award. Oh, the UN. You can be so difficult to forgive.

In fairness, while a lot of tremendously sketchy stuff went down in the name of population control, some have pointed out that this may yet be a step – a weird, extreme step to be sure – in the demographic transition.

This is possibly a valid point, especially as people (should) continue to become richer and more educated and understand the long-term consequences of gender imbalances. There are even a handful of effected countries that have starting to try and ameliorate their sex ratios, now that their cocks have come home to roost and have found no hens. Indeed, it might well be over or nearly over in South Korea, India, and China (where the imbalance is expected to peak sometime in the next 30 years. So…sort of nearly over). “In regions and countries that were touched by economic development later, however, the phase is just beginning.”

So what does it mean for women now, especially in those states that seem to be in the heart of their crisis? “Surplus men have been going to great lengths to find women – and in many cases succeeding.” One South Korean province, for example, has sponsored trips to Vietnam, and the national government endorses the trade in other ways, recently setting aside around 23 million USD for adaptation programs for new brides. “As the first generation touched by sex ratio imbalance grows up, the silent biological discrimination that is sex selection has been exacerbated by more visible threats to women, including sex trafficking, bride buying, and forced marriages.” Not all of these sins can be considered equal (women who willing emigrate for the purpose of marriage cannot be considered the same as a trafficking victim), but they all have their dark sides, as evenly legal cross-border brides tend to be in precarious situations with regards to their human and social rights, and others might even be pressured into accepting polyandrous arrangements.

That’s just the tip of the ice berg, really, as forced marriage “has become common enough in Asia that it has joined FGM, domestic abuse, and marital rape as a basis on which a woman can petition for political asylum in the US.” It also gets us into the territory of child brides (India accounts for 40 per cent of the global totally of marriages of adolescent girls) and (in what sounds like an appropriately Halloween-y urban fable but is not) ghost brides.

We really should have seen this coming. No less an authority than Amartya Sen warned about the phenomenon more than 25 years ago in his classic, More than 100 Million Women Are Missing, in which he observed that “economic development is quite often accompanied by a relative worsening in the rate of survival of women...The deterioration in women’s position results largely from their unequal sharing in the advantages of medical and social progress.” Sen pointed out that it’s not just about sex-selective abortion, but general neglect aimed at women from birth onward that decreases their risk of survival when, all thing being equal, women are actually heartier than men. “These numbers tell us, quietly, a terrible story of inequality and neglect leading to the excess mortality of women.” At the same time, and like Mara Hvistendahl two decades later, Sen cautioned against the axiom that it’s poverty alone that results in a gender imbalance. Rather than development being good for women, it is the inverse that is true: investing in women is good for the economy.

As a quick aside, one might reasonably ask, in light of what we’ve discussed previously, whether fewer women mean a smaller population. Might this help our youth bulge problem? Well, no. Not anymore than it increases the prevalence of male bi-curiousness. Two distinct types of fertility patterns currently contribute to population growth in the developing world. “Some developing states, such as Nigeria (6.5 lifetime births per woman) and the DRC (6.6 lifetime births per woman), continue to have high fertility rates. Such nations will continue to grow for at least two more generations. Other developing states, such as Brazil (2.5 total fertility rate), Mexico (3.1), Egypt (3.6), China (1.8), India (3.4), and Indonesia (2.7) have reduced their fertility rates but will continue to see population growth for at least another generation because of population momentum.” In other words, the high fertility rates of the previous generation mean that we can expect population growth even in the absence of a balanced population.

I want to wrap this up, but I do think it’s worth delving into why this issue is so little discussed in the West. After all, we’re talking about reproductive rights and gender empowerment, right? This should be catnip to progressive donors. At least, so it would seem. But there is an elephant in the room, and that elephant’s name is Abortion Rights. Activists and well-meaning NGO types such as myself will be hard-pressed to identify sex selection as a human rights issue as long as it feels like we might also be curtaining a woman’s right to choose. In Unnatural Selection, the author even goes so far as to suggest that those in developing countries should not be allowed to know the gender of their child so long as there is a risk of sex selection. And, as troubling as I find the idea of culling girls from the population, sweet fancy pants, but does that feel paternalistic in the worst traditions of humanitarian aid (many of which the author had spent much of her book decrying).

This is, however, a limited way to approach the topic. Ms. Hvistendahl herself notes that “…when societies liberalise abortion laws, they tend to improve access to contraception as well, so that with the right not to give birth comes the right not to get pregnant in the first place. But in Asia and much of Eastern Europe, where family planning policies were developed without concern for the needs of women and abortion was introduced as a crash population control method rather than as a backup to contraception, legal abortion has instead meant more abortion.” So, if in conjunction with improving prenatal care and access to safe options to terminate pregnancies, as much or more emphasis is placed on improving the place of women and girls and ensuring the ready availability of multiple methods of birth control, we might be able to have our cake and eat it, too. I know that this is pretty simplistic, but I think it would be infinitely more beneficial to reach for all options rather than to either continue to ignore the absence of more than one million or take deliberate steps back in prenatal care.





Finally, because it’s very difficult for me to bring up abortions and regressions in reproductive rights without bringing up the US, let me direction your attention to this slightly old but still amazing piece. It’s all about women’s rights and reproductive health and faith and made me tear up, which is not often something I say about Esquire.

To be totally completest, you might also be interesting in reading about how some Afghan families are dealing with their own gender imbalance that skews the other way (a standard legacy of long-running conflict). And no matter where we turn our gaze, we are confronted with the inescapable fact that the world is hard on little girls.