Handbook of Clinical Gender Medicine. Группа авторов

Fig. 3. China: Reported SRBs by birth order (parity), 1982-2005. Sources [9, 16–20]. Reprinted with permission.

The critical health service elements in this tableau are China’s universal and unconditional availability of abortion conjoined with access to reliable and inexpensive obstetric ultrasonography. According to Chinese researchers, in 1982 diagnostic ultrasound scanning devices were available in health clinics in about one sixth of Chinese counties; over half of Chinese counties had them by 1985, and virtually all had them by 1990 [14]. By the year 2000, sex-selective abortion had become commonplace in China: rough calculations for that year suggest that no less than half of the nation’s higher-parity female fetuses were being aborted and that well over half of all abortions were female fetuses terminated as a consequence of prenatal gender determination. In effect, most of contemporary China’s abortions are thus intentional female feticides.

      Drivers of Imbalance

Though Western sensibilities may be inclined to attribute the SRB imbalances to ‘backward’ thinking in China, important basic facts are uncomfortably inconsistent with that proposition. For one thing, the abnormal sex ratios appear to be almost entirely a Han phenomenon within China, and China’s Han tend to be better educated and more affluent than the country’s non-Han minorities. However, it should also be noted that SRBs are lower in urban than in rural China. However, these differences may be more related to lower fertility levels in urban areas than to levels of education and income since lower fertility levels tend to be associated with lower SRB imbalances in comparison to those seen with higher-parity births. Further, the rise in SRB imbalances has been occurring during a time when China has enjoyed a historically extraordinary surge of development and prosperity. Between the 1982 and 2005 censuses, China’s reported adult (15+) female illiteracy rate dropped from 25 to 4%, and over roughly that same period the mean years of schooling for Chinese women rose by nearly 50%, from 5.4 to 8.0 [15–20]. Moreover, China’s estimated per capita income jumped nearly five-fold between 1982 and 2005 [21], while the fraction of the population living in extreme poverty (as defined by the World Bank) plummeted from roughly 75% in 1981 to roughly 15% in 2004 [22]. These advances have also been occurring during a time when, despite continuing political restrictions and censorship, China has been becoming vastly more open to the outside world than it was in the early 1980s. China’s increasingly unnatural sex ratios for babies and children and its growing army of ‘missing girls’ must therefore be regarded as a feature - indeed, a defining feature - of ‘globalization with Chinese characteristics’. It is worth noting that Beijing outlawed prenatal sex determination in 1989 [23] and criminalized sex-selective abortion in 2004 [24] - yet these legal strictures have obviously been ineffective in reversing this cultural phenomena. China’s unnatural long-term rise in SRBs emerged under a state-run population control program, but draconian family planning programs are neither a necessary nor a sufficient condition for widespread female feticide. This much is evident from SRB trends in East Asia’s four ‘Little Tigers’: Hong Kong, Singapore (more specifically, Singapore’s ethnic Chinese), South Korea, and Taiwan. All of those societies maintain voluntary family planning programs - nevertheless, each of them has registered disturbing increases in SRBs in the era of unconditional abortion and widespread access to inexpensive obstetric ultrasonography (fig. 4). In all four of these affluent and highly educated populations, SRBs approaching the dawn of the 21st century were a biologically impossible 108 or higher - and, just as in China, SRBs were typically lowest (often ‘normal’) for the firstborn babies and suspiciously elevated for all higher-parity births [25], a tell-tale sign of parental intervention through sex-selective abortion. Like China, these ‘Little Tigers’ all had laws on their books proscribing prenatal gender determination and/or sex-selective abortion that did not forestall subsequent increases in their SRBs. Of all the ‘Little Tigers’, South Korea reached the most demographically disfiguring heights: an SRB of well over 114 in the early 1990s, comparable to China’s at that time. But South Korea’s SRB declined steadily thereafter, and by 2009 it was according to official state statistics a practically ‘normal’ 106 [26] - a matter to which we shall return.