Son Preference and Sex Selection in America: Why It Persists and How We Can Change It

See all our coverage of the Prenatal Nondiscrimination Act (PRENDA) here and all our coverage of sex selection here.  See also this article on PRENDA by Miriam Yeung.

UPDATE: As of 11:00 am Wednesday, May 30th, the vote on PRENDA has been moved to Thursday, May 31.

Son preference, missing girls, sex selection: We may seek to label these Chinese or Indian issues, but they exist here in America. And with anti-choice crusaders desperate to destroy Planned Parenthood Federation of America, America’s leading provider of affordable reproductive health care for women, the purportedly spreading practice of sex-selective abortion is back in the news. With the Prenatal Nondiscrimination Act (PRENDA) up for a vote in the House, it’s also back in full force on the legislative agenda.

The extent of sex-selective practices in the U.S. is hard to assess, since it’s rarely something people will admit to doing. But we can take an educated guess by observing alterations in expected sex ratios. If nature has its way, women will likely give birth to 100 girls for every 102 to 106 boys. And among first-time parents in the U.S., that’s exactly what we see.

However, as birth order rises, apparently so does selection — at least, in certain ethnic groups. With U.S. 2000 Census data, researchers investigating Korean, Chinese, and Indian communities found that, after one girl, parents have as many as 1.17 boys per girl the second time. With two girls at home, this goes up to 1.51 boys per girl for the third child. These skewed ratios aren’t present among other ethnic groups in America.

This intentional kid picking takes multiple forms. Now, we can know and thus select for sex as early as seven weeks into a pregnancy, using a non-invasive blood test making big news in popular and obstetric circles. Far more reliable than urine-based guesses from Walgreen’s and far safer than other early use options, this new technique is meant to minimize sex-linked diseases. But this product enters a market where some parents-to-be pine not just for any healthy baby; some want what they see as a particular kind.

Although alarmists cite an undocumented rise in abortion due to sex selection, more and more the interest (and well-marketed new product development) is on meddling before implantation. Techniques like sperm sorting and IVF embryo selection are expensive. Even the most generous insurance package doesn’t cover these procedures when not medically necessary. Yet as of 2006, half of American fertility clinics that offer embryo screening allow would-be parents some form of sex selective add-ons… and the market is growing. Never mind that the American College of Obstetrics and Gynecology has come out harshly against non-medically necessary sex selection, and even the American Society for Reproductive Medicine has issued lukewarm cautions about it.

These clinics advertise their sex-selective wares heavily in ethnic language media and enclaves where Asian Americans reside. Offering would-be parents soft focus images of white babies on pink and blue blankets, they couch their practices in the affirming language of “family balancing.” Doesn’t that sound much better than sexism, eugenics, or designer babies?

Some claim environmental motives. Citing opinion research that most parents desire one of each sex in their offspring, they offer to do this in the first two pregnancies and bring down the birth rate. Others say their services minimize sex-selective abortions, because designing your kid before pregnancy is better than during. A few argue that this is an expression of reproductive freedom. And some proffer no reason for breaking their own professional ethical guidelines — an unstated affirmation that the customer is always right.

In practice, sex selection means more sons. In most cultures, there’s a preference for male babies. Whether the motivation is economic (because sons mean higher income potential), religious (because sons perform sacred rites), social (because sons confer status), or a messy mix of the above, son preference fuels the desire to take control of formerly unalterable aspects of impending parenthood.

Obviously, sex preference is a problem. It requires adherence to the fallacy that sons and daughters are biologically limited in what they can do and who they can be. People lusting after a son hardly have a hairdresser in mind. Likewise, the daughter dream is about playing princess, not baseball. Moreover, desperately wanting a specific sex requires us to believe in and thus perpetuate the notion of two genders.

Responses from our own surveys, individual interviews and focus groups among Asian Americans indicate sex preference is alive in America. While respondents generally didn’t have first-hand experience with sex selection in the U.S., 96 percent felt that parents treat boys and girls differently, with boys getting a way better deal. Sex selection may be, to paraphrase one respondent, the operationalization of son preference, but the preference came first and left unaddressed, isn’t going anywhere.

However, before we go corralling this off as just a race or immigrant issue, let’s look at how the majority of Americans view this issue. A Gallup poll from 2011 found that, when asked if they could only have one child, American men of all backgrounds responded that they’d want a boy by a margin of 49 percent to 22 percent, a finding fixed at this level since 1941, when Gallup started asking. Women today report no preference. But still, 40 percent of Americans overall think picking embryos to select for sex is an appropriate use of genetic diagnosis technology. While the numbers attest most Americans aren’t selecting for sex, throwing new early-detection tests along with more and cheaper technology into society’s gender-based preferences and myths -– and we should expect to see increased selection. 

Aside from the long list of ethical, social, and political problems this poses – it’s a consequential challenge for reproductive rights advocacy. Sex selection against girls is the religious right’s wet dream. When opponents declare “abortion hurts women,” they could not have dreamt of a better ‘we told you so.’

They’re riding this wave to new reasons to control women’s autonomy, specifically to curtail reproductive decision-making for women of color. In 2008, anti-choice groups pushed for legislation to ban sex-selective abortions. Trent Franks (R-AZ) introduced the “Susan B. Anthony and Fredrick Douglass Prenatal Nondiscrimination Act” (PRENDA) to ban sex-selective abortion and a new chimera he called “race-selective” abortion. Legislators in Georgia, West Virginia, Oklahoma, Michigan, Minnesota, New Jersey, and New York have tried the same at the state level. In 2010 and 2011, as those of us who support access to safe abortion care looked on in horror, Oklahoma and Arizona both banned sex-selective abortions. 

In all cases, lawmakers pointed to the cultural attitudes and practices of Chinese and Indians as evidence of what could befall us. Data about sex ratio disparities in specific Asian countries became proxy for sex selection amongst Asian Americans – never mind that the latter group represents a huge range of origin countries and displays sex ratios pretty much identical to the rest of Americans. Details like math and geography need not interfere with a justification for passing this legislation, even in states where few Asians reside. 

The complications of race-specific attacks aside, the central argument of the mainline reproductive rights movement has been that the right to continue or terminate a pregnancy is a “choice.” An implicit, and often times stated, contention that all choices women make about their bodies and reproduction are private, to be made without state interest.

But now, our slogans of individual rights, “my child my choice,” now double as ad copy for the sex-selective clinics we find troubling. Even if people use new technologies to select for girls, and evidence suggests Caucasian women do, they apply the notion of “choice” to germinate restrictive notions of gender. When we fought for autonomy, this did not mean the right to engineer your own namesake or a pinkalicious-shopping buddy. What it meant was a right for women to define who they were and wanted to be in their own terms, on their own timeline.

Research shows that the language of “choice” has left audiences cold. Studies in cognitive linguistics, psychology, and even marketing contend this framework suggests action quickly considered and of little consequence – hardly a rhetorical counterweight to “life” or apt description of how most women undertake this decision.

But the concept of choice no longer fits either. Not only did we not want government out when it comes to financial assistance to access the procedure, we’re not vying for a mandate that says anything goes in the world of parenting.

Sex selection forces us to take stock of what we believe and start saying it. Here is our chance to leave behind the tired, consumer-led, conversation. “My choice,” or even “my child,” never described our community-supported ideals of child rearing. We must move from choice and it’s inevitable path to “what kind of child do I want to have” to the more meaningful question: “what kind of parent do I want to become?”

We need frank public discussion about parenting boys and girls and the often-unconscious biases we all have about gender and children. This is long over due but is only one element of the efforts required to unseat the calcified ideas about sex and gender that permeates our society, across all races and ethnic groups.

We must also defeat discriminatory laws like the one up for vote today in the House. It is a bitter irony that regressive legislation like PRENDA actually reinforces why it’s disadvantageous to be a woman, especially a woman of color. These kinds of policies are part of a culture that makes sex selection a logical choice for women hoping to keep daughters from a sexist, repressive world that seeks only to limit who they are and what they are allowed to do.

Instead of curbing rights, our research specifically in South Asian American communities suggests the way to un-do son preference is to address old assumptions. This would require raising awareness about, and also helping to hasten the dramatic changes underway in gender roles. Girls and women are assuming many of the roles only men once played, and men and boys can play and are now fulfilling many of the roles which have been considered a woman’s domain. In the South Asian Diaspora community, for example, boys aren’t always staying around to take care of aging parents, girls are increasingly staying attached to their maternal families, and investment in girls’ education is paying off richly. But to end son preference, old beliefs and practices, laws and policies, need to catch up to the new reality, both in the United States and in South Asia. Empowering families, communities, and societies to root out biases and alter their own behaviors without shaming, blaming, or curtailing the rights of women is our only real hope of tackling this issue.

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  • coralsea

    Thank you for publishing this piece.   As a child in the early 1960s, I desperately wanted to be a boy because I wanted to play Little League baseball and build soapbox racers–activities from which little girls like me were barred.  In high school (1970s), I was eligible to enroll in an honors-track, two-year science class leading to AP science.  My parents and the parents of the two other girls who were also eligible received threatening and harrassing phone calls from parents of boys who wanted their sons in the class.  I decided not to enroll after I had a conversation with the teacher, who informed me that he didn’t want “gals” in his class.  (Admission — I only went to high school one day a week.  I went horseback riding the rest of the time because I hated high school, so when the teacher was such a dick about it, I was glad to drop the issue.)  One girl enrolled.  She was harrassed and picked on, although she is now a prominent cancer researcher.


    Things are certainly better, on average, for American girls now in regard to the opportunities open to them, but the expectations that society places on people, especially in regard to “gender,” is still responsible for a lot of ruined dreams and squashed talent.  It really is time for society to begin seeing people as the complex and many-faceted beings that we are.  Standing up for those who wish to engage in interests or activities that aren’t supposedly or traditionally practiced by their gender (e.g., dancing, home sewing, decorating for boys who like these things; “hard-core” practical sciences (like field geology), building stuff (ahhh – soapbox racers) or engaging in martial arts or boxing, and competitive achievement for girls who like these things) is an important step.


    My straight-laced and conservative parents recently had their own epiphany when they learned that one of their grandchildren had an intersex condition.  Once they learned about such conditions, and that intersex is far from rare, they happily reached the conclusion that kids are more than simply their obvious gender and set about, eagerly speculating about what types of activities the child would like–whether they would include drawing and painting, like their artistic son (my brother), or building stuff and crawling around getting all dirty from exploring nature like one of their daughters (me), or any of the myriad other activities that, at their core, don’t have to be gender-linked to be appropriate.


    Go humans!  Be yourselves, whoever you are.  We all have worth and value.