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Gender Preferences and Fertility Effects on Sex-Composition. Linking Behaviour and Macro-Level Effects

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Gender Preferences and Fertility Effects on Sex-Composition. Linking Behaviour and Macro-Level Effects Gender preferences and fertility effects on sex-composition. Linking behaviour and macro-level effects. Authors : Sylvie Dubuc1,2 and Devinderjit S. Sivia3 Correspondance: [email protected] 1 University of Oxford and Nuffield College 2 University of Reading (Dep. of Geography) 3 Saint John’s College, Oxford Paper presented at the Annual Meeting of the Population Association of America, 27-29 April 2017, Chicago Abstract Son preference and prenatal sex selection against females has resulted in significant sex- ratio at birth imbalances in a number of Asian countries, including in India and China where subsequent gender imbalances in the population is of considerable policy concern. The masculinisation of sex-ratios at birth (SRB) has in part been explained as a response to the increased likelihood for parents to remain sonless, with fewer desired offspring (the fertility squeeze), a major concern in family planning decisions where son preference prevails. How couples’ gender preference, desired family size and childbearing response combine to account for aggregated sex-ratio bias has received less attention. Revisiting previous conceptual proposals, we developed probabilistic models and interrogated the quantitative relationships between fertility, sex-ratio at birth, parity and the proportion of sex selecting couples to account for the probability to remain sonless. We demonstrate that, adding to the micro-level (behavioural) fertility squeeze effect, a disproportionality effect acts to explain the hyper-sensitivity of sex-ratio bias to fertility changes. We confirm the plausibility of reduced son preference to be associated with increasing biased SRB, observed empirically. Importantly and perhaps counter-intuitively, we also show that the SRB can increase despite fewer couples intervening and fewer sex selection procedures. We demonstrate that a small proportion of parents using sex-selection suffice to distort the sex-ratio especially when fertility is low, indicating that SRB is a problematic indicator to evaluate trends in prenatal sex-selection behaviour. Implications of our findings are illustrated for India, where for instance relatively fewer couples are likely to sex select in Punjab than in Uttar Pradesh, despite a significantly stronger SRB bias in the former state. Introduction Following Amartya Sen’s seminal paper in 1990, ‘More than 100 million women are missing’, numerous studies have confirmed a bias in the sex-ratio of young children, leading to a shortfall of females across much of Asia and North Africa. At the time, the deficit of young girls was probably largely due to female neglect, gender discrimination in access to nutrition and health care, resulting in excess mortality of young girls (Das Gupta 1987; Sen 1990; Croll 2002). With advances in reproductive diagnostics and technologies, the operating mode of sex selection has shifted. The development and geographical diffusion of pre-natal sex- determination techniques such as foetal ultrasound screening have made sex-selective abortion possible. As a result, prenatal sex-selection against females (PSS) is thought to have partly replaced traditional forms of postnatal gender discrimination (Goodkind 1996, Arnold et al 2002), partly added to it, and substantially contributing to the observed increase in early childhood sex bias (Bongaart and Guilmoto 2015). The availability of sex-selection methods is a pre-requisite, while son preference is the necessary (and essential) condition for prenatal sex selection against females. Given both, fertility decline – understood here as a reduction in the average number of children in a population - is seen as a major factor accounting for biased sex-ratio and the extent of prenatal sex-selection in a population (Das Gupta and Bhat 1997; Basu 1999; Croll 2002). We focus on sex bias at birth to revisit the relationship between fertility reduction, sex- selection and its manifestation in the sex-ratio at birth (SRB). We begin by presenting the mathematical model we use to analyse the complex interrelationship between SRB bias, sex-selection prevalence and fertility decline and produce a new indicator of couples’ propensity to sex-select within a population. Clarifying these non-trivial relationships, help us to understand how family strategies translate at aggregated scale on the SRB, how changing bias in SRB relate to trends in sex-selection and the association between weakening son preference and increasing SRB. We use empirical example in India to illustrate our findings and examine the regional patterns intersecting fertility with the measure of sex-selection prevalence we calculated. Prenatal sex-selection (PSS) and its manifestation in the SRB bias PSS, evidenced by an increased in the sex-ratio at birth (SRB) is increasingly well documented in Asia, having been studied extensively in South Korea (Park and Cho 1995), China (Zeng et al. 1993), India (Das Gupta and Bhat 1997) and more recently in Vietnam (Guilmoto et al. 2009), Nepal (Frost et al. 2013) and the Caucasus (Duthe et al. 2012, Guilmoto 2015). Biased SRB has also been found in Western countries with important Asian diasporas, notably in the UK (Dubuc and Coleman 2007), the USA and Canada (Almond and Edlund 2008; Abrevaya 2009, Almond et al. 2013). Substantially contributing to the masculinisation of the juvenile sex-ratios since the 1980s, PSS is thought to have led to more than 30 million missing female births, mostly in Asia, and an estimated about 1.7 million missing female births in the sole year 2015 (Bongaart and Guilmoto 2015). Hitherto, prenatal sex-selection is thought to have largely resulted from foetal sex- determination followed by the abortion of female foetuses. Recent advances in medically assisted reproduction techniques offer novel means to sex select offspring. In particular, in vitro fertilisation (IVF) combined with pre-fertilization selection of male spermatozoa (sperm sorting) (Boada et al. 1998) or pre-implantation genetic diagnosis (PDG) and selection of male embryos (Mayor 2001) allow the sex of offspring to be selected in a way potentially viewed less ethically problematic by prospective parents and society and with the potential to increase the practice. The biomedical ethical debate on sex-selection in the last decade has largely focused on how developments in IVF associated techniques might increase the demand for gender selection on social grounds and the need (or not) for regulations. Prenatal sex-selection against females (PSS) poses increasingly recognised social, medical and ethical challenges, including the use of prenatal diagnostics, maternal health, population gender imbalances and justice (Watts and Zimmerman 2002; Holden 2009; WHO 2011; UNFPA 2014). Many interventions implemented at local, regional or national levels have been introduced (see UNFPA 2014 and references therein), to reduce sex-selection against females. The continuous rise in the SRB imbalance has been interpreted as an evidence of a failure of initial policy to tackle sex-selection. For instance, in India, the continued rise in sex imbalances seen in the 2001 census engendered stricter legislation restricting access to prenatal sex-selection methods (PNDT Act, 1994, revised in 2003) and alternative policies, including Pregnancy Tracking and Monitoring schemes and Child Protection Schemes and the multiplication of Conditional Cash Transfer schemes (Sekher 2012). The efficiency of such policy interventions remains difficult to evaluate. For example, the interagency statement ‘Preventing gender-biased sex selection’ (OHCHR, UNFPA, UNICEF, UN Women and WHO) called for the development and use of indicators for tracking change and the impact of interventions (WHO 2011). Analysing gender imbalances at birth (ratio of boys to girls) provides the only readily available (indirect) method to quantitatively evidence PSS. However, the sex-ratio at birth (SRB) can be misleading for evaluating potential changes in attitudes and behaviour towards sex selection, as we will show. This is because the average fertility of a population strongly impacts on the SRB (in countries like India) where the fertility transition is well engaged. The dual desire for small families and male offspring exerts strong pressure on sonless parents to select for a son, and at increasingly lower parity (Park and Cho 1995; Das Gupta and Mari Bhat 1997). This is due by the probability of remaining sonless - when left to chance - decreasing exponentially with fewer children (Dubuc and Coleman, 2007). Christophe Guilmoto (2009) introduced the concept of the ‘fertility squeeze’ whereby, with fewer desired children, the cost of having additional children until male offspring is achieved without sex selection becomes decreasingly acceptable (expressed as acceptable proportion of female births, APFB), resulting in more parents reverting to sex selection and at lower birth order. Accordingly, empirical evidence in South and East Asia have shown that the distortion in the sex-ratio at birth (the ratio boys/girls) is particularly noticeable at higher birth orders, when only daughters were born previously (e.g. Park and Cho 1995; Zeng et al. 1993; Retherford and Roy 2003; Bhat and Zavier 2003). A number of studies have evidenced the Male-Preferring Stopping Rules of Childbearing (Yamaguchi, 1989), where the parents of daughters only are more likely to progress to the next parity in an attempt to achieve a male birth and stop childbearing after a son is born, resulting in a strong biased
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