As Hvistendahl reports in her massively well-documented book, male births are far outnumbering female births in East Asia, South Asia and West Asia, all the way to Albania. While the normal sex ratio at birth is about 105 males to 100 females, in the county of Suining, China, for example, 152 boys are born for every 100 girls. These surplus boys may feel happy when they are small, but they will grow up condemned to singlehood. According to the French demographer Christophe Guilmoto, we are facing an epidemic of “rampant demographic masculinization” that will have “grave effects for future generations.”
In the first two-thirds of her book, Hvistendahl explores the reasons for such a cataclysmic population shift. When scientists and sociologists first began to draw attention to this imbalance in the 1990s, they thought that large-scale female infanticide had reemerged and that infant girls were being killed. But slowly they realized that female offspring were being identified in the fetal state by amniocentesis and ultrasound, and aborted by parental wish.
Feminists blame the gender imbalance on patriarchal cultural prejudice against girls and daughters. But Hvistendahl, who has not only done her research but has also carried out extensive investigative journalism in several countries, blames much more complex geopolitical and economic forces, including imperialist political decisions, American medical technology and the drive for population control.
She traces the development and marketing of amniocentesis and American ultrasound machinery, the rise of genetic counseling, and drastic government policies to curb population, such as China’s one-baby policy, instituted in 1980. The international availability of prenatal screening in the 1980s and government tolerance or support of abortion as a means of birth control made it possible for parents to choose the sex of their children. Hvistendahl identifies the common elements from country to country: First, rapid development allows prenatal screening; second, abortion is easily available; third, the practice starts with elite groups and trickles down to the general population.
Despite these factors, the most significant cause of the imbalance is still the widespread desire for male children, especially among elite groups with access to advanced medical technology. Population-control experts realized that in many countries, people kept on having children until they had a son; Guilmoto notes that “there is a general trend of son preference” in much of the world. Demographers and Asian policymakers realized that if couples could have a male child early, they would stop having multiple children. In the words of New York Times journalist Elisabeth Bumiller, sex selection is “a powerful example of what can happen when modern technology collides with the forces of a traditional society.”