(June 2009) India, along with China and several other countries, has a history of neglect for girls and women that produced lower female survival rates and an imbalanced ratio of males to females. In recent years, male-to-female sex ratios at birth and among children in India have increased much more than can be explained solely by discrimination against girls. There is evidence that technologies like portable sonogram machines have made it easy to detect the sex of a fetus, enabling families to abort a female fetus if they do not want a(nother) daughter. In spite of a ban on sex-detection tests and sex-selective abortion, the practice has continued, raising questions about the value and rights of women in this society.

During a PRB Discuss Online, Leela Visaria, researcher and president of the Asian Population Association, answered participants’ questions on the issues surrounding the status of women and the imbalanced ratio of males to females in India.

June 11, 2009 1 PM EST 

Transcript of Questions and Answers

Davie Kabwira: What are Gender activists/advocates and government of India doing over this?
Leela Visaria: With the support of NGOs and also donor agencies such as UNFPA and Population Foundation of India, a number of activities, using various media, messages about valuing girl child, and promoting various schemes towards education of girls are being spread. As a result, awareness about the Act banning sex determination test and female selective abortion has increased a great deal among people throughout the country.

Richard Cincotta: Much has been hypothesized about the social impact of a high sex ratio in the pool of marriageable young adults (which should be occurring in India and China as unbalanced cohorts reach young adulthood), but nothing (to my knowledge) has been convincingly demonstrated. Are there any demonstrated social effects from any of the Indian-state cases?
Leela Visaria: I know of qualitative studies that have been carried out in Punjab, Haryana and Gujarat states, to understand social impact of adverse sex ratio, where the female deficit has been one of the worst in the country and which have historically practised other modes of eliminating girls. The available information is very limited based on case studies and so nothing generalisable can be discerned. But typically, in female deficit communities, girls are brought on payment from poor lower caste households, often from other regions. As a result, language, food habits, social customs etc. become huge issues. However, the few reports I have seen indicate that most girls do adjust over time, and accept the fact that their parents could not have been able to marry them well otherwise. Some girls have run away but once children are born, the women stay on. Another interesting thing that has been noted is that such women are not brought alone but other girls known to them also are married and so they have some companions from their own region.

Dr. Anima Sharma: Hi,I am an Anthropologist from India an I deeply appreciate the dire contrasts in the Indian Society. On the one hand, there are women holding responsible posts in politics, bereaucracy, Corporate Sector and Government offices and there is a co-existing reverse scenario, where women suffer from various social abuses like female foeticide, child marriage, early pregnancy, Dowry, poor nutrition, limited role in decision making, subordinate social status and consequently lower self-esteem. This condition is though Pan-Indian but is more severe in the so-called ‘BIMARU’ states plus Panjab and Haryana, which dominate in nurturing various types of social evils. The problem is not limited to the rural areas or among the illiterate and deprived sections of the society but in the urban areas too sexual harrassment and job-related problems are there for the working women. This problem is deep rooted in the Indian society and needs a multi-pronged intervention and strict and systematic implementation in the form of Policy-making, Advocacy, Awareness etc. Programme. Much is being done but still much more needs to be done. What do you think that what strategy should we adopt to address this issue thoroughly.
Leela Visaria: The only strategy in my opinion that would in the long term work is start with children. The education material should be based on gender equality from the primary stage itself and designed very carefully. We have to inculcate the gender equality norm among children from a very early age and stage.

Gouranga Dasvarma: (1) The declining femininity ratio of India’s population for over a hundred years is amply demonstrated with Indian population census data. What proportion of this decline can be attributed to a greater underenumerationof female children? (Please see comments by Prime Minister Manmohan Singh, quoted in Population and Development Review, Vol. 34, No. 2, June 2008). (2) In your opinion, what can be done to convince the Indian parents of northern (and now southern) India of the socio-cultural and demographic necessity of having female children?
Leela Visaria: The age-specific sex ratio of India’s population (knowing fully well that age misreporting and digit preference resulting from not knowing age are part of age data) has indicated that underenumeration of women is not a huge issue. The increase in deficit of girls between 1981 and 2001 cannot be attributed to increase over time in under enumeration. In my opinion, population count has improved over time. I believe we have to work with children using whatever acceptable means that we can use to demonstrate that girls are as valuable as boys are. For this we have to start very early.

Agatha Onovo: Apart from marriage, family and procreation, what other social impact are there and how does this affect india economicall and politically? In Eastern part of Nigeria, male child preference is a culturally acceptable norm. A female child has no inheritance and a married woman that does not have a male child has no inheritance. She may be neglected or divorced by her husband or be depossesed of all she and her husband labourde for and chased out of the husbands house by husbands relatives at the husbands death. Though sex selection is not very common yet, do you think the Ibo’s in Nigreia will one day get to the point where India is today?
Leela Visaria: I am afraid yes, if the son preference persists and is not addressed through education and other mass media. Yes, also if the sex determination technology such as ultrasound imagery becomes widely and cheaply available, and if abortion becomes legal and the practitioners are willing to perform second trimester abortion at nominal cost. Abortion should be a woman’s right but awareness among both medical fraternity and population should be created to avoid what has happened in India.

Zacharie Tsala Dimbuene: “Is Sex Imbalance in Early Age Mortality Driven by Prebirth Environmental Factors, Child Biology, or Parental Preferences? Evidence from Male-Female Twin Pairs” This paper by Pongou provides new insights about sex imbalance in India.
Leela Visaria: I am not aware of the article. What are the insights that Pongou provides? Available evidence I am familiar with indicates that sex imbalance in India results from parental preference for sons and not desiring many daughters due to social factors.

Cornelius Kondo: Femalenticide is a creation by advance[d] medical technology where at low cost you can determine the sex of baby and decide to abort or carry the pregancy. What is the remedy?
Leela Visaria: Banning sex determination test is not THE only remedy as is quite clear in the Indian case. Behavioural change leading to valuing girls as equal to boys is needed and that can be achieved through education that helps young people to internalise it from very early age.

Barbara J. Isely: How do you explain that the deficit of females in India has increased starting around the time of the 1911 Census of India or before. The INCREASING deficit cannot be simplistically blamed on traditional practices. What has been the role of colonial and post-colonial international influences?
Leela Visaria: The deficit of females in India has been convincingly explained by the prevailing neglect of girls and women after carefully examining all possible reasons or factors. The recent (from around 1981) steady increase in the deficit of girls is explained by the increase in use of female selective abortion once the sex of foetus is detected through use of modern medical technology. The traditional son preference is leading to take advantage of newer methods to avoid daughters.

Pushpanjali Swain: Deficit of girls are seen in most developed states and in urban areas in India, where provision of ultrasound machines are available. There are many loopholes in the PNTD act and people get away by aborting female foetus. The issue is how much one enforces the law if people mindset has not changed, cannot reverse deficit of girls. My question is how to change the mindset of people on girl child so that they would think before aborting a foetus?
Leela Visaria: I personally feel that laws or acts cannot go very far in changing the mindset of people. Gender sensitive education that starts at very early age that consistently conveys the message through examples that girls are equal to boys only can help inculcate the value of girls.

Jose Luis Diaz-Rossello: Where can we obtain updated and verified figures of this problem?
Leela Visaria: The age-sex distribution of population available from the decennial Indian censuses gives indirect estimates of the trend over time of the increase in deficit of women. However, given the fact that since 1994, India has passed an Act banning the use of medical technology such as ultra sound imagery to find out the sex of the foetus has made it very difficult to compile data on the extent of the use of the technology. Some hospital birth records from metro cities, where a large proportion of births take place in institutions, do suggest that the sex ratio of births is adverse to girls.

Richard Cincotta: South Korea’s sex ratio at birth has recently declined from levels as high as some Indian states and Chinese provinces, to near-normal levels. Do recent Indian DHS data show any declines? And if so, is there evidence suggesting what may contribute?
Leela Visaria: In India, where 50-60 percent of births still take place at home, it is difficult to precisely estimate sex ratio at birth. However, efforts to monitor all pregnancies in some states in small areas where the deficit of women has been pronounced, do suggest further deficit is arrested or there has even been some improvement. The ban on sex determination test may partly explain it but multi-pronged efforts to create awareness about the Act and also the value of girls also is responsible for it.

Pham Nguyen Bang: What are the impacts of the ‘stopping rule’ (ceasing the child bearing when obtaining a son) on the sex ratio of the population?
Leela Visaria: This is an interesting question. However, what has been estimated in the Indian context is that the sex ratio of the last birth is much more adverse to girls implying that when the couples have a son, after having had one or more children, they stop having additional children. The impact of this observation or evidence on the sex ratio of the population, to my mind, has not been estimated.

Dr.K..E. Vaidyanathan: NFHS 3(2005-06) gives a rural female-male ratio for 0-6 years (921), which is lower than the 2001 Census figure (934), with no change for urban. How can we explain this when Facilities for sex selection and abortion are unlikely to be better in rural than in urban?
Leela Visaria: The Indian states where deficit of girls is quite pronounced are also the states which are better developed and have good road network and transportation facilities enabling rural women to travel to nearby urban centres to undergo sex determination test or abortion.

Rahat Bari Tooheen: Unless the social mindset of the Indians [changes], the situation will not change. How do you think this can be done?
Leela Visaria: I have argued that unless we start changing the mindset of young children in schools, through gender sensitive text books, etc. I do not expect that we can reverse the situation very quickly or easily.

Dr.K..E. Vaidyanathan: The female to male ratio in the age group 0-6 years is low even in Kerala, Goa and in Northeastern states, where the status of women is not bad. How do we explain this?
Leela Visaria: Within the states with adverse female to male sex ratio, it has been noted that the situation is much worse among those who are better educated, landed, belong to higher castes compared to those who are illiterate, landless, etc. The former group has the resources to obtain the needed services, also want smaller families with at least one son.

Pham Nguyen Bang: Pregnant women and their partners have the right to be informed about the development of the fetal, including the fetal sex information. The legal prohibition of disclosure of the fetal sex via ultrasound has violated this right, doesn’t it?
Leela Visaria: Women have the right to know about the development of the foetus in India. The ban is on informing them or their partners about the sex of the foetus. This ban is imposed because of the prevailing strong son preference and not wanting daughters, which can be eliminated in the situation where abortion is legal.

maureen: What will happen to Indian and Chinese societies when there are too many males and not enough females to marry, work, or procreate? And if females are still being aborted, what are the estimate numbers today with a future estimate and a historic estimate so we could see if the problem is declining or increasing. And, can these people sell their girl babies to Americans or Europeans who want them?
Leela Visaria: I believe that one cannot project on the basis of the current scenario that it will continue in foreseeable future. There are perhaps some self-correcting mechanisms that would come in force, there are efforts by governments and civil society groups to create awareness about gender equality norms which may impact the behaviour of some. In India, more girl babies than boy babies are put up for adoption. However, ‘selling’ or adoption cannot be a long term solution.

sonvi kapoor: Women’s right to abortion and the ban on sex selective abortion are seen to conflict with each other in India . At the same time, son preference, and the tension around women’s reproductive rights in India , appear to stem from a common patriarchal system that is biased against females. Therefore, what according to you are some of the obstacles that could be removed and how, to ensure a reduction in son preference and in the tension around women’s reproductive rights. Are there any concrete steps that you could suggest, or any issues that need to be addressed as a pre-requisite to meet this combined agenda?
Leela Visaria: First and foremost the confusion between abortion as a woman’s right and a ban on knowing the sex of the foetus needs to be removed. Education about the value of girls in every sphere of life must start very early.

Lester Coutinho: 1. How should we interpret and understand the most recent SRS data on SRB that shows some degree of reversal in trends in some states, and even in states where trends are still skewed against girls, the rate of adverse change has slowed? Specifically, how do we interpret HP and Kerala which in just 8-9 years are showing very significant reversal? Also, in light of the analysis offered by Bhat and Xavier (EPW) on the mismatch between geographies where ultrasound technology is most available (reported use) and where sex ratios are skewed, how are we to understand the regulation of this technology as contributing to preventing further decline of sex ratios. 2. The note on this website, mentions “ban on sex selective abortions” – which specific legislation/or section of penal code presently bans sex selective abortions – and if India were to enact such a legislation would that be justiciable?
Leela Visaria: I do not believe that making rules about the use or availability of technology more stringent is the answer to prevent further decline in female to male sex ratio. Future developments in technology may even make it easier for women to know the sex of the foetus without going to an ultrasound imagery centre. I am even willing to venture a guess that lifting the ban on sex determination test altogether would not significantly worsen the female to male sex ratio. The note should have said ban on sex determination test and not sex selective abortions.

Lallie Scott: Is corruption a factor in the indequate enforcement of laws against sex selective feticide? Is there any possibility that the dowry tradition can be eliminated? And finally, please explain how women themselves (especially mother-in-laws)continue to condone the gender bias that has led to the sex ratio imbalance. Thank you.
Leela Visaria: It is difficult to enforce the law against sex determination test. There are loopholes, no matter how and how many one attempts to plug. However, a ban alone cannot bring about social or behavioural change. There is a law against giving and receiving dowry in India; however, the practice does continue. Women have internalised gender bias to such an extent that the role of mothers-in-law in enforcing it is not very important.

Elisa Martinez: What do you make of the arguments presented in this research, that the “missing women” in fact disappear much later in life than we expect, and that GBV [gender-based violence] and lifelong discrimination in the triage of health and nutrition care play a major role? http://www.nyu.edu/econ/user/debraj/Papers/AndersonRay.pdf. Also, is anyone tracking sex ratios in “developed” nations? Finally, is anyone doing longitudinal studies in order to establish better data sets for analysis of the phenomenon (causes and extent)?
Leela Visaria: I agree that due to discrimination, neglect in health care and a range of other factors, women experience both unnecessary mortality (that could be avoided) and also higher mortality than men at several ages. In fact, the age-sex specific death rates for India have shown that at ages from six months to almost the end of reproductive period, death rate among women has been higher than among men. In spite of this understanding, the cause of death data suffer from many data-related problems and tend to be very tentative and are based on very small sample size. Efforts are being made to increase the sample, quality of diagnosis or reporting of symptoms leading to death.

Wayne Thogmartin: Both China and India exhibit an imbalanced gender ratio. One might presume that a gender ratio favoring an abundance of males may be one mechanism an overcrowded population employs to put a break on their population growth – there are simply fewer females for giving birth. Is this a reasonable presumption? And at what point do ecological considerations trump gender politics?
Leela Visaria: Population size or population growth are not our only concerns. Balanced gender ratio is also important for a healthy nation. Births can be curtailed through means such as effective use of contraception also.

Wolfgang Gasser: According to the data of ‘The 2008 Revision’ of the UN, in India of the 2000-2005 period, 5.235 million male deaths corresponded to only 4.465 million female deaths. This results in a male-to-female sex-ratio-at-death as high as 1.17. If we attribute a male-to-female sex-ratio-at-birth of around 1.08 to discrimination against (born and unborn) girls, why should we not attribute the 1.17 sex-ratio-at-death to discrimination against men? And do you you exclude that this very high male death rate could also be a reason of the relatively high male-to-female sex-ratio-at-birth (as e.g. suggested by ‘demographic saturation’)?
Leela Visaria: In developed countries, male death rate is indeed higher at most ages than female death rate. Analysis of cause-specific mortality data do give ample evidence of why that is the case. The higher mortality among men compared to women is not a result of discrimination, the way one understands discrimination, which results from bias and prejudice against one group.

Katia Mohindra: What role if any is sanskritisation having on sex ratios?
Leela Visaria: The evidence from a few micro studies showing that the women from backward communities and women with little or no education have also been emulating those from higher castes in opting for sex determination tests suggests that there is some demonstration effect.

Michael Teitelbaum: Presumably enforcement of the (Federal?) law against prenatal sex determination and selective abortion is dependent on State and local police and prosecutorial agencies. Are there also State and local laws on these matters? To what extent is anything known about variation across India in such legal and enforcement aspects?
Leela Visaria: The federal or national law is applicable in the states and at the lower district levels also. However, certain states add more stringent action points to enforce the law or make it more effective. In ‘better governed’ states, enforcement is better than in poorly governed states. This applies not only to implementation of the ban on sex determination test but of many other laws.

Sara Friedman: The numerous and dire consequences of gender discrimination from birth in South Asia and elsewhere (eg birth registration, nutrution, medical care, foeticide, son preference and other deeply entrenched social values (or lack of) are well known and not new. Apart from the technology in india and implicit permission in China, what is the reason that singles out this region in its deficit of female human beings.
Leela Visaria: Female deficit in India, for all the reasons that you mention has been known for several decades. Many have termed it as an anomalous situation. Added to this is the increasing use of medical technology, which has aggravated the situation further as evident from the sex ratio of children aged 0-6 years. I do not know of other reasons that can be singled out. Under enumeration of girls or women is often discussed in literature but it has been found not accounting for any significant impact. Sex ratio at birth in South Asia is not any different from that observed or reported in other countries to account for the deficit of women.

Mary Nyasimi: Mankind’s evolutionary journey through the years is filled with quest for a better and fulfilling life. This quest has led to emergency of technological tools such as a portable sonogram machine making it easier for humans to meet their life’s desires…have more boys than girls. It is becoming evident that technological undertaking like sonograms, including its ramifications and spin-offs, will change the course of human evolution, probably drastically. Therefore, by preferring boys to girls and having the means to do that, are we witnessing a slow but inevitable process of human evolution?
Leela Visaria: I do not think so. I feel that mankind can change its value system and behaviour by giving up son preference and value girls as much as boys.

Katia Mohindra: How can gender-sensitive education for children be sufficient if rigid kinship systems are not modified to enable women greater access to and control of productive assets – thereby maintaining economic dependence on sons?
Leela Visaria: Along with gender-sensitive education, provision of education to girls as much as given to boys is also important. Economic independence also helps. The question is how do we provide women greater access to assets and employment?

Janet Huber Lowry: You mention medical technology contributing to an increase in the deficit, but what about the trafficking of women and girls – do we know if it has contributed?
Leela Visaria: how would trafficking of women and girls contribute to their overall deficit at national level unless they are sent to other countries? We do not even have any estimates of the volume of trafficking to estimate its contribution.