Thursday, October 17, 2002
Henry Wendt Chair in Political Economy,
American Enterprise Institute
Session 2: Choosing the Sex of Children: Demographics
CHAIRMAN KASS: All right. In this second
session on choosing sex of children, we turn to certain demographic
implications of the use of this capacity, and we're very fortunate
to have Nick Eberstadt, who is the holder of the Harry Wendt Chair in
Political Economy at the American Enterprise Institute, to make a
presentation to us this morning.
It was actually a talk that I heard Nick give.
It must be four years ago on this topic that opened my eyes to how
things quietly initiated here in the United States for one reason wind
up having very powerful effects across the globe to which we should pay
And when this topic came up, I thought it would
be worthwhile for the Council to hear about the uses of sex
And, Nick, thanks very much for joining us. We
look forward to your talk.
DR. EBERSTADT: Leon, thank you very much.
Ladies and gents, it's an honor to be with
you here this morning, and I'm going to start off more or less
exactly where Dr. Haney left off in his excellent presentation.
What I'm going to try to do very quickly is
provide you with some information about the state of conditions in the
world today with respect to the secondary sex ratio, usually called the
sex ratio at birth, and also to offer some speculations about some of
the implications of trends that are now developing.
Demography is a study about three centuries
old, maybe a little bit more than three centuries old at this point.
As soon as students of demography began to look at patterns in human
numbers, one of the first things that they recognized was that there
was quite a regular pattern with respect to births, slightly more boys
born than girls born.
And this was noted and commented upon at the
beginning of the study of demography. I'll read you something that
Johann Sussmilch, who was an early demographer, wrote in 1741. He
said, referring to other early demographers, that "Grant, Durham,
and others have suggested the Creator has reasons for insuring four to
five percent more boys than girls lie in the fact that it compensates
for the higher male losses due to the recklessness of boys, to
exhaustion, to dangerous occupations, to war, to seafaring and
immigration, thus maintaining the balance between the two sexes so that
everyone can find a spouse at the appropriate time for marriage."
Well, as you will appreciate, demographers are
rather more loath today to talk about divine intent, but they do
recognize that there is over time and over space a consistent pattern
of somewhat excess male mortality over female mortality. So that the
early surfeit of boys, if you will, more or less evens out by
marriageable ages so that cohorts are more equal in numbers.
Now, demographers have noted variations in the
secondary sex ratio or the sex ratio at birth associated with a variety
of factors. They have noted variations with respect to ethnicity.
They've noted variations with respect to parity, which is to day
birth order, and with the age of parents.
They've noted some variations with respect
to the nutritional status of parents. Nutritional status may have some
slight influence upon sex ratio. Also various sorts of diseases and
And there is an ongoing question/discussion,
call it a debate, in certain areas of demography about whether there
may be an adaptive response with respect to sex ratio at birth, that is
to say, it's called the operational sex ratio or the sex ratio of
the adult population may have some influence upon the rising
cohort's sex ratios.
I have no opinion about this work. I consider
it an unsettled discussion which continues, and I wouldn't suggest
that there's any conclusive findings that have been found in this
area, but for noting all of these influences upon sex ratios at birth,
I think the overwhelming biological fact about sex ratios at birth in
large and regularly constituted populations is regularity and the
stability of the sorts of numbers one sees produced.
These ratios are almost constant in large
populations over time and over space. Just to give you by way of
background some perspective on this, these are the sex ratios at birth
by ethnicity for the United States from the early 1980s, and you will
see that for the country as a whole, it was about 105 live baby boys
born for every 100 live baby girls. There were differences by
ethnicity, but these were not dramatic, let's say.
By the same token, you can see differences in
sex ratio at birth with respect to birth order, the parity. In general
the sex ratio at birth is somewhat lower at higher parity or higher
birth orders than at lower parity or lower birth orders.
And this result for the United States in 1984
is hardly uncommon. We could have used data from many other countries,
many other times to replicate that.
This was 1984, and we live in 2002 today, and
some things have started to change even in the United States itself.
And one of the things we are beginning to see in the U.S. are sex
ratios for at least certain groups within the population which would be
very hard to explain on the basis of purely random occurrence since
we're dealing with large numbers of people.
The odds against some of these sex ratios at
birth look very forbidding, very imposing. Let me show you here.
These numbers compare sex ratios at birth in
the United states in 1984 and in the year 2000, which is the latest
year for which we have complete birth data, and you'll see that
there's not terribly much difference in the sex ratio at birth for
the total population or for the so-called white population or the
so-called black population.
But when one gets down to Asian Americans, to
the Chinese and Japanese ethnicities in the United States, we're
seeing some very substantial increases in sex ratio at birth, and those
would be very hard to explain on a purely biological basis.
Over the last decade or so, we find, indeed,
that there are many places around the world where these sex ratio at
birth has started unaccountably or seemingly biologically unaccountably
Let me show you some data from other
countries. These data were gathered from the United Nations'
statistical office which publishes an annual demographic year book. Of
course, it's never up to date, and of course, when it is compiled,
the data are from earlier years. These are the most recent data that
the U.N. demographic year book has pulled together on live births in
countries and areas where vital registration is nearly complete.
And what I have listed here are simply
countries reporting now a sex ratio at birth of 107 baby boys per 100
baby girls or higher. In ordinarily constituted populations ratios of
103, 104, 105, even slightly over 105 are not things that would look
One, oh, six starts to need some explanation,
and 107 just usually doesn't happen, and that's why I chose 107
as the cutoff there.
And you will see here a number of different
regions of the world represented with these unusually high sex ratios
at birth: some Latin American countries, Salvador, Venezuela, most
dramatically Cuba, where we have a phenomenal 118 baby boys per 100
baby girls, some of the Maghreb countries, the North Africa, Tunisia,
They represented also some of the post
Communist states from the former Soviet Bloc, Belarus, Bulgaria. I
think we have excluded some additional post Communist countries whose
birth numbers were rather lower, but whose sex ratios were very high.
I think Moldova, Estonia, Lithuania could also be added into this
And then, of course, we have a grouping of East
Asian countries and regions: Hong Kong, the Republic of Korea being
most prominent there.
One of the problems in tracking changes in sex
ratios at birth around the world is that most of the world's
population is not found in countries that have complete or nearly
complete vital statistical systems, vital registration systems.
By the U.N. Population Division's estimate,
in fact, less than one person in 12 in the low income world lives in a
region that would be described as a country with complete or near
complete vital registration. So that's a big problem in trying to
track trends in sex ratio at birth.
However, we can draw some inferences about
changing patterns of sex ratio at birth by looking at the numbers of
children at young ages reported in national censuses and other sorts of
demographic survey data. And I will show you this imperfect, but
perhaps indicative proxy for a number of other countries.
These data were compiled by the U.S. Census
Bureau's International Programs Center. These are their estimates
for 1998 of sex ratios for children under the age of five and for
particular countries where the ratio was 107 or higher. And you'll
see, again, a representation of an Islamic society in Tunisia.
You'll find some post Communist representation in the form of
Serbia and Macedonia. For the most part what one's seeing there
are East Asian countries: Singapore, Taiwan, China, Hong Kong, and
And the sex ratio in some of those settings for
children seem to be very, very unusually high indeed.
There is another smaller area of the world
whose imbalances I've just become aware of thanks to a colleague at
the Census Bureau. Dennis Donahue kindly supplied me with this table.
But in the Caucasus area of the former Soviet Union, the ratio of
children under one year of age — these are not live births, but
tabulated infants and through census materials and demographic counts
— the ratio of children under one year of age has risen very rapidly
and dramatically in Armenia, Azerbaijan, and Georgia.
These Caucasus societies represent a diversity
of religions. Azerbaijan is primarily Islamic. Armenia and Georgia
are not, but as of the year 2001, the sex ratio for infants under one
year of age was approaching 120 in each of these three countries.
Let me turn to East Asia which Dr. Haney
discussed a little earlier. This slide, which is put together by
Daniel Goodkind at the U.S. Census Bureau shows reported sex ratios at
birth for a number of East Asian countries. You'll see that the
sex ratio at birth for Japan, this lower line, falls within the range
that would ordinarily be expected of a large human population.
For all the other countries and regions, for
Singapore Chinese, for Hong Kong, for Taiwan, for South Korea, in
particular for South Korea, some of these ratios have risen really
quite extraordinarily. In the past several years South Korea's sex
ratio at birth had declined, but it has declined only to a degree.
It's still in the range of 110 baby boys per 100 baby girls,
something like that.
The big enchilada is China, which is the most
populous country in the world, and China does not have complete birth
registration statistics. So determining the actual sex ratio at birth
requires quite a bit of inference.
As you'll see, there is a discrepancy in
China between hospital records, which are certainly not complete with
respect to annual births, servicing only a limited fraction of the
population, predominantly the urban fraction, and records from vital
statistics, limited though they may be.
There is a discrepancy there, and this is a
discrepancy which demographers have puzzled over. It has suggested to
some that the imbalance in China may not be as great as some observers
I think, however, the weight of evidence from
demographic records leans towards the more pessimistic rather than, if
you will, the more optimistic assessment, and that's a judgment
reinforced by the initial data from the November 2000 Chinese census.
If one attempts to do reconstructions from that
and from previous censuses, one sees a sex ratio at birth that has
risen perhaps from around 108 20 years ago to something like 117 today,
and if one looks at the sex ratio of children under the age of five
from this and previous censuses, one gets even more extreme indications
of increasing imbalance between young boys and young girls.
As Dr. Haney's presentation indicated
previously, the imbalance in these societies is concentrated
disproportionately in higher parity births, although as I think I
already showed you, in ordinary biologically constituted population,
sex ratios at higher birth orders tend actually to decline slightly.
But what we find in many East Asian societies
today is an increasing imbalance, increasing sex ratio at birth with
higher birth order parities. This slide presents data collected by two
doctors in Hong Kong at St. Margaret's Hospital. Hong Kong does
not ordinarily offer comprehensive data on sex ratios by birth order,
although it does have complete vital registration.
St. Margaret's Hospital, I believe, handles
about a sixth of the births in Hong Kong, SAR. So it is by no means
comprehensive, but it is indicative, and as you'll see there, Wong
and Ho show that for births that were second births, there was quite a
significant distinction between sex ratios for parents, for mothers,
whose first birth had been a boy and whose first birth had been a girl,
and the phenomenon is even more extreme for third order births. In the
cases where the two previous births to a mother had been girls, the sex
ratio was 137.
Even with small numbers of births, as in this
sort of situation, the odds against this being a natural occurrence
become quite astronomical.
Dr. Haney already showed a slide indicating
changing sex ratios by birth order. These are data for Taiwan in 1990
and for China in '89, and as you see, when one gets up to birth
order four, fourth births in Taiwan, by 1990 we are talking about sex
ratios of 160 boys per 100 girls.
But it gets better than that. Let me show you
South Korea. In 1992, by the time one is talking about fourth order
births, we are above 200 boys for every 100 girls born, and you can see
there that blue line is South Korea in 1992. The red line is South
Korea only 12 years earlier, in 1980, for the wide dissemination of
technology, making available sex determination and, therefore, sex
In all of these cases, the inference that one
would draw, I think, is that sex determination has led to sex selective
abortion as a main driver of these biologically unnatural results.
Female infanticide may have played a more pronounced role in China,
especially in the late 1970s and early 1980s, but increasingly, I think
we can draw the reasonable inference that sex determination and sex
selective abortion has been the primary instrument at work here.
Dr. Kass asked me to gather for you some
information on gender preference on the parts of parents, and I had
assumed this was going to be a very easy task for me, very easy part of
my presentation, and was quite surprised to find that it was not.
The reason for the opacity or the difficulty
here is that the ordinary or the regular surveys that are circulated
through much of the world to determine demographic health fertility
patterns, the so-called DHS survey, as a rule now simply do not contain
any information to present to respondents with respect to gender
preference of children. Such information was collected in earlier
rounds of world fertility surveys, but as it happens, for the most part
these are not available now for most low income countries.
It's unfortunate. As you can see, it's
an increasingly unfortunate oversight.
However, one of the countries that does collect
information on gender preference among married women is India, and
it's not an inconsiderable portion of humanity. Roughly one out of
six people in the world today live in India. It's a population of
over a billion.
And this shows you results from the national
family health survey, second round done about three or four years ago.
Almost everyone, almost all mothers asked to have no children, and most
of those who had one child desired more children, and as you'll see
below, when asked whether they preferred a boy or a girl, some said no
preference. Some said leave it to God, but of those who expressed a
preference, there's an overwhelming preponderance of preference for
boys, four to one for the sample overall, and in some cases even higher
Let me show you data for a particular state in
India, the State of Punjab. Punjab is a smaller sample, and we have
asterisks there because in some cases there weren't enough
respondents to arrive at statistically significant results, but for the
Punjab as a whole, out of the almost 3,000 married women questioned,
the preference for an additional child being a boy as opposed to a girl
was on the order of ten to one.
Now, let me show you some results from the
latest Indian census. India is another country that has no that
does not yet have complete vital registration of births and deaths for
the country as a whole. So one has to work with census materials and
other sorts of large counts to do reconstructions or to draw certain
sorts of inferences.
The March 2001 Indian census did account by age
for the country as a whole and its various provinces, and what I'll
show you now is the sex ratio for children under age seven or children
zero to six for different provinces in India.
You will see that there are a number of states
and territories in which the sex ratio for surviving children,
surviving up to the age of seven, falls within the range that we might
call biologically expected, maybe up to about there, but there are a
number of states for the most part in northern India where the ratio is
outside of historical biological norms. Mostly these are states in
But I'll point out in particular to you the
results for Punjab. In Punjab today for every four girls under the age
of seven there are over five boys, and it's probably also worth
noting that these newly found differences do not comport with patterns
of tradition or with patterns of traditionally construed under
These heightened abnormal sex ratios at birth
are instead very closely associated with modernization or with some
particular variant of modernization. Punjab, for example, is one of
the most prosperous provinces in all of India. I think we see Delhi.
Delhi at 116 is also one of the most — is an urbanized area with one
of the highest income levels in India and one of the higher literacy
levels in India.
Thus also Chandigarh, thus also Haryana, and
if we go back and review some of those other data that I showed you, I
think we'd say that this imbalance in sex ratios at birth has
coincided with improved levels of income with higher educational
attainment and with heightened interaction with other cultures and
other economies, with what we would call globalization.
So far from being traditionally driven, these
trends have certainly coincided and comported with some form of
I will get to that in a moment.
I think it also mentioned that these heightened
abnormal sex ratios at birth have been associated with fertility
decline, and they're most obviously in low or sub-replacement
As you saw from the East Asian data, all of the
East Asian countries that we were discussing are currently at or below
replacement levels of overall childbearing, which is to say that if
current childbearing patterns continued indefinitely and there were no
immigration, no net immigration, population would stabilize and
ultimately decline indefinitely.
The phenomenon of choosing higher parity, the
sex of higher parity children seems to be more of a pronounced
phenomenon in the context of declining or sub-replacement fertility,
and it is worth noting that the Punjab area of India has been an area
of rapid fertility decline. It is not the lowest fertility area in
India. There are some sub-replacement areas of southern India that do
not exhibit this extreme imbalance between male and female children,
but Punjab is an area of rapid fertility decline and is now close to
the replacement level.
Dr. Kass asked me if I would draw together some
data on sex preference and sex selection in the Arab-Islamic world. I
think I showed you earlier some indications that Tunisia, which is one
of the few areas in the Arab-Islamic expanse to have hit replacement or
sub-replacement fertility, is now exhibiting unusually high sex ratios
at birth or excuse me. I think it's ratios of children under the
age of five, sex ratios of children under the age of five.
And there is precious little information on
gender preference from survey and demographic data for this great
expanse of humanity, but one of the few surveys that I could find is
actually for the Palestinian authority, and it isn't quite as neat
as I would like something to present to you, but I think it is
indicative nonetheless of what we have here from a demographic survey
conducted in the late 1990s, is the preference expressed by I think it
was a total of 3,000 married women for an additional child or for an
additional son or an additional daughter if one already has a son or
daughter, if one already has four-plus sons or four-plus daughters.
And I hope this presentation isn't too
confusing, but I think you'll see from these numbers a very strong
and pronounced disposition towards son preference across the board
Interestingly enough, the sex ratio at birth
for babies within the Palestinian authority area and for Muslims in
Israel proper is no different. It's not appreciably different from
that of Israeli Jews. Both sex ratios for now are in the vicinity of
105, slightly below 105 baby boys per 100 baby girls.
But what we have not yet seen in Palestinian
areas or in the rest of the Arab-Islamic expanse is the dramatic
dissemination of relatively inexpensive techniques of gender
determination prenatally, and so this is a phenomenon which we may yet
experience, although we have not thus far.
What are the consequences of gender
imbalances? One of the most obvious possible consequences of the sorts
of gender imbalances we have seen developing around different parts of
the world is a later, potentially inevitable, inexorable imbalance in
the marriage market. If there are too many boys to marry off to a
given number of young ladies, the market can't clear.
In the past that has not been too much of a
problem even in areas where boys in any given age group have tended to
outnumber girls in any given age group because for the most part, over
the last century certainly world population has been rising, and that
has meant that each year slightly more girls were being born in any
given birth cohort. So that matching up or pairing simply would entail
an average difference in age at marriage.
You will appreciate, to make a very crude
example, if population were growing, if birth numbers were growing by
about two percent a year and there was a ten percent imbalance between
young men and young women, it would take roughly five years in
difference in average age at marriage to make everything square.
But the arithmetic becomes very much less
forgiving when one is dealing with sub-replacement populations rather
than populations that are at or above replacement level. And as you
will have seen already, the gender imbalances that we have seen
developing are most pronounced in societies that are precisely
sub-replacement or below replacement fertility contexts.
What I wanted to show you here is some
speculative projections for china, and I have to emphasize that these
are speculative. The data on the year 2000 are not really terribly
speculative. We've got those data, but then the question is: what
will China look like, say, 25 years from now?
What I have put together for you here is a
Chinese population structure and age-sex structure based on the
presumption or the assumption that the 117 to 100 imbalance, implied
imbalance, in sex ratio at birth that we've seen from the recent
Chinese census is, in fact, real rather than a statistical artifact,
and that that imbalance continues from 2000 to 2025.
I think even by eyeballing this, you can see
that there are at younger ages an awful lot more greens than blues in
this figure. What does that, what would that hypothetically mean?
Well, let's look at this. The U.S. Census
Bureau takes the cautious and, I think, respectable posture that until
there is overwhelmingly persuasive evidence to the contrary, they will
be projecting China's future population on the basis of an
assumption that the true imbalance, the true sex ratio at birth is 109
to 100 rather than 117 as recently reported.
If one accepts that, by the year 2025, the sex
ratio for young men and young women ages 20 to 35 would have risen from
about 106 reported roughly today to about 109. There'd be a
deficit; there'd be a shortage in this particular cohort of about
13 million women as opposed to men.
Now, China has been a society, a cultural
setting, where near universal marriage has been the expectation. One
takes a look at previous censuses or demographic data on China.
Ninety-six, 97, 98 percent of women report eventually — report having
been ever married by the time and heads towards older ages.
But that means that three, four percent of
Chinese women do not get married, do not take a husband, and if one
deals very crudely here, that would be suggesting that something like
ten, 11, 12 percent of the Chinese men in the Census Bureau's
projections in this year would have to find wives if they were to find
wives from outside of this cohort.
If one takes an assumed sex ratio of 117 and
projects that forward, the numbers are even more dramatic. We would
end up with a shortage within these given cohorts of about 16 million
potential brides or 16 million excess husbands.
And if one stuck with this same
back-of-the-envelope sort of calculation that two, three, four percent
of women would end up never marrying, we'd be talking about 13, 14,
15 percent of this cohort having to find wives or partners from outside
of this grouping or never marry.
Now, what are the social and economic and
political implications of having a large group of men for whom the
expectation of never marrying is fairly plausible? My impression, my
very unscientific impression from demographic history is that it very,
very much depends.
One can see all sorts of ominous arguments
about unsocialized or unsocializable young men causing social strains
and perhaps even political problems, and you know, prima facie, I think
that argument is inherently plausible.
But it is also true that there have been large
regions of the world in which the expectation of never marrying has
been quite real for large proportions of the population and where
social fabrics have dealt with this in sort of a regular and
Pre-industrial Europe, for example, is a
setting that comes to mind, although in Europe west of the Danube today
a very large proportion of women end up eventually marrying, end up
being ever married. A hundred years ago or so that was not at all the
case, and at the end of the 19th Century and earlier, it was not at all
uncommon to find birth cohorts of women and of men in which 15 or 20 or
25 percent total never married.
Now, in the western European context, western
European culture provided for mechanisms to deal with this phenomenon.
There were mercenary armies. There's the Catholic church.
There's respectable spinsterhood and bachelorhood, and all of these
were social conventions which helped to deal with this demographic
As best I can tell, in East Asian and in
Confucian societies, there is no parallel set of mitigating social
mechanisms, and rather to the contrary, the expectation seems to be
quite strongly to encourage marriage, if possible, in part to continue
the family line and to respect ancestors and all of the rest.
Social conventions, I think, would have to
change very dramatically and very quickly in large portions of East
Asia and perhaps elsewhere to deal with this impending gender
imbalance, and it seems to me a very reasonable question to ask whether
one can expect this to occur in such a very short period of time.
It's all speculative, but it seems a
question worth asking, and I think I'll stop there.
CHAIRMAN KASS: Thank you very much, Nick,
for a very interesting and provocative presentation.
If we could get the lights, we could start our
PROF. FUKUYAMA: Nick, thanks. I've been
reading your stuff for many years, and it has all been extremely
useful. I've got a series of small factual questions and a larger
one at the end, but maybe you could just answer them serially.
You know, Amartya Sen wrote this famous book
about 100 million missing women, but from your data, it looks like
that's actually a very low figure. Do you know how he got that or
what period corresponds to?
Because it looks like, you know, just China
alone over the next decade is going to —
CHAIRMAN KASS: Would you turn the mic on?
DR. EBERSTADT: From the 1980s. It was based
on U.N. Population Division estimates of total world population.
PROF. FUKUYAMA: Okay, and on Korea, the drop
that occurred from the early '90s to the late '90s, from about
kind of the high teens to, you know, like 110, my understanding is that
sex selection was actually illegal there in that the reason that that
drop happened is that they actually started enforcing their existing
DR. EBERSTADT: Yes, it had been illegal. New
legislation had come on the books in the 1980s with the widespread
advent of amniocentesis and ultra sound. The laws were, as you can
tell, completely ignored.
Then in the mid to late 1990s, the government
started to pay more attention to these practices. Civil society was
also important there. There were festivals in South Korea held,
"love your daughter" festivals and things like this, and that
started to make some sort of more general impact.
PROF. FUKUYAMA: I understand the ratios also
varied by province quite substantially.
DR. EBERSTADT: Yes, yes. That's right.
PROF. FUKUYAMA: Do we have any historical data
on rates of female infanticide in Asia just as a point of comparison
for the current sex ratios?
DR. EBERSTADT: We can only draw inferences
about infanticide from, as you will, the missing girls in earlier
censuses and very limited registries.
In China, in particular, there's a
longstanding imbalance between males and females at almost every given
age. Life expectancy for men at younger ages quite surprisingly is
higher than life expectancy for women, and that suggested a whole
plethora of discriminatory practices, not only infanticide, but
discriminatory practices after those young ages.
PROF. FUKUYAMA: Okay, and then I guess the
longer question, you know, there was a book published by Marcia
Gutentag and Paul Secord. I guess it was over a decade ago called Too
Many Women, talking about some of the social consequences of, you know,
these unbalanced sex ratios, and I guess while the conventional wisdom
is having too many men is a problem, they make the point that there may
be some compensating advantages, which is that if you have a sex ratio
that's tilted towards men, it actually puts women in the
driver's seat in marriage markets, and that one of the arguments
they made was with the Baby Boom one of the reasons that the sexual
revolution happened when it did was that because of this phenomenon of
men marrying younger women, they had more choice, and in effect that
skewed the sex ratio towards women, which led to, you know, a breakdown
of family life and so forth.
DR. EBERSTADT: Yes.
PROF. FUKUYAMA: And that you could expect the
opposite to happen if you had a sex ratio skewed towards men.
Is that a respectable argument? I mean, what
do you make of that?
DR. EBERSTADT: That's a very reasonable,
Economics 101 sort of argument, I think, but not all parts of the world
proceed under the sorts of premises that we presume to be in place in
an Economics 101 setting. In China already, the increased value of
women, increased scarcity value of women has led anecdotally to
distinctly increased reports of woman stealing, of trafficking, of
virtual enslavement, and that is, I suppose, a less attractive, but
still quite real manifestation of an improved value of women.
DR. FOSTER: Just a brief comment. If I
remember it correctly, about the last week The New York Times, you
know, had an article about single women in the United States, and if I
remember the figure correctly, that above the age of 15, about 48
percent of all women are single.
And I don't know where it is in other
places, but if a wife of a mature man dies in Dallas, instantly he is
assaulted by women who want to have a date or go to dinner or something
of that sort. I mean, there does seem to be in our country a very
large group of the excess women, and I don't know what to make of
that. I'm just commenting on it.
PROF. GEORGE: It depends on what you count as
our country, Daniel.
DR. FOSTER: Well, I believe — I don't
know, Robby, whether I'm following you or not, but I believe that
Texas did join the Union some time ago.
CHAIRMAN KASS: Rebecca.
PROF. DRESSER: These are questions for you to
comment on, but as for the group as well to think about.
I guess one issue this raises for me is how
should we as a Council look at patterns and practices in other
nations. Certainly it would have an impact on U.S. medicine when
people from other cultural backgrounds come here and want particular
interventions that are more popular in other nations, but should we go
beyond that? And how should we think about that?
And then the second is provoked, I guess, a
little bit by Leon's point about orthodox Jewish preferences for
sons. I think we're looking at sex selection as part of our,
quote, enhancement project, I think. Is that right?
CHAIRMAN KASS: Go ahead.
PROF. DRESSER: Maybe it's related to some
other project I don't know about, but anyway, if we're to think
about sex selection as being done for non-health related purposes,
putting aside defining what falls under health related purposes, but if
we're just to say, okay, for other reasons, is it possible to make
arguments that would say certain reasons deserve more weight than
So a religious tradition, a cultural tradition,
family balancing; is it possible to really discriminate or
differentiate between preferences, saying some are unjustified gender
or sex discrimination and others are not, or should they all be treated
equivalently, whether that is to say they're all okay or
they're all not okay?
CHAIRMAN KASS: Nick, do you want a word on
this or not?
Let me say something about the first question.
I mean one could argue that what goes on in other countries with the
use of these technologies is a curiosity and we should pay attention,
but finally not of concern to this body, and that might be closer to
the truth than not.
On the other hand, as has been pointed out in
previous discussions, what goes on in other countries has an impact on
what happens here, either where precedents set elsewhere come to be
argued for here. I mean if the British are doing embryo research, why
shouldn't we, or conversely, they would say, "Look. If the
United States isn't doing sex selection, you know, maybe we
But there's also these — there are sort of
social and political ramifications of these technologies, and Nick, in
his characteristic understatement, just alluded I think. The numbers
are by themselves interesting, but what they actually mean socially and
what they mean internationally in an age of globalization is, it seems
to me, of importance and, at the very least, it might be worth our
while to call attention to what goes on with the use of these
technologies and perhaps even recommend nothing so radical, nothing
more radical than the need to monitor and pay attention to what is
happening and where in ways which we are not at the moment doing.
That would be at least the minimum suggestion
as to why that kind of conversation — I mean, the material that Nick
has raised is, I think, of importance to us.
And if I might simply respond just to open up
the other question, yeah, there is a question here as to whether or not
— I mean, whether sex selection is an enhancement or not could be
discussed. That it is a non-medical or nontherapeutic use of medical
technique is part of what makes this of interest.
And I think one of the reasons it's part of
this conversation is that it's one of a whole series of
developments produced for medically related purposes, but which will
yield individuals, unless there are regulations, but will yield the
desire, will support the desire for individuals to use new technical
power to achieve their desires either for self-enhancement or for the
control of their offspring or for the control of behavior of others.
The question is whether if those things are
worrisome, what, if anything, can and should be done about it. I think
that's the context, and what are the reasonable reasons for using
this thing, except for the prevention of disease is, it seems to me,
And does one sit in judgment of the people in
Punjab or is this one of those occasions where who are we to judge the
cultural preferences of other people or, for example, the cultural
preferences of American subcultures, the first slide that Nick showed
about beginning to see changes in the United States in the East Asian
populations where the sex ratio begins to approach 110.
DR. EBERSTADT: I think the ones I showed were
107. The Philippine Americans, it's almost 110.
CHAIRMAN KASS: Yeah.
DR. ROWLEY: Well, I'd like to go back.
Just some of the techniques that are used to achieve these changing
ratios, and one of them obviously is sex selection before implantation,
and the other is selective abortion, and it's sort of surprising to
me, say, in countries that I assumed had restricted availability of
some of these technologies, that there are changes.
For instance, you had the statistic about
American Indians going from 101 in 1984 to 103.5 in 2000. I'm not
sure whether that's within the range of variation because one
thinks of American Indians as not having access necessarily to fairly
And then you also quoted countries like El
Salvador with 107, the Philippines, 108.7, Egypt, 108.7, and Pakistan,
110.9. It would seem to me it's a small portion of the population
within those countries that would have access to more sophisticated
But the implication of all of this is that
it's really some kind of sophisticated technology and access to it
that is causing these changes because these are birth ratios. These
aren't zero to four where you can think of infanticide.
So what is going on actually in these countries
that may be associated with these changes?
DR. EBERSTADT: I would not myself become at
least yet too alarmed by the data reported there for the American
Indian population even though the reported ratio, sex ratio at birth in
the years that I chose had increased. 103 is still well
within the range of ordinarily reported biological variability.
I think one starts to ask questions to be
arbitrary at about 106, and one starts to have alarm bells go off at
With respect to Pakistan, the data there for
Pakistan were from their vital registration system, which I don't
think is complete. I would guess in the case of Pakistan — I would
have to go back and double check, but I would guess that those are
hospital deliveries, and hospital deliveries are going to have the
enhanced techniques that you asked about.
With the case of El Salvador or Egypt, medical
services are presumably much more limited than for native American
population in the United States. I'm only speculating, and I have
no basis in fact for this, but just to speculate about this, if a
relatively small proportion of parents felt rather strongly about some
preference issues, it would be possible to alter to some degree the
national sex ratio at birth without having comprehensive medical
services and availability, but I don't know. That's a
DR. ROWLEY: Well, if I can just follow on with
this, and again, toward the end you also tied this in with more
sophisticated family planning, if you will. So if you only want to
have two or, say, three children and you already have one or two
children of a certain sex and you're going to have just one more
child, then may well pay much more attention, and your data has
suggested if you already had two females and you were going to have
only one more child, it was very important to you that you have a boy.
I happen to have four sons and only four
children. So —
DR. EBERSTADT: And I have three daughters.
DR. ROWLEY: So, you know, years ago I'm
not sure if really effective sex selection had been available whether I
might have taken advantage of it for family balance. It wasn't
available. It's not clear that it is even yet available unless you
to go really extraordinary lengths.
But I think that these are intellectually
interesting issues. Again, the question whether it's a matter for
us to consider and pursue, I think, is the kind of discussion that
Michael was suggesting that we have.
CHAIRMAN KASS: Michael, and then Bill May,
and then Gil.
PROF. SANDEL: Well, these were two such
fascinating presentations, and I'd like to go back to the ethical
questions that they raise.
First, a comment that occurred to me at the end
of our first session, or thought rather. There are lots of reasons to
worry about sex selection, but I think that our greatest contribution
can be to resist the reflect or the tendency to translate what troubles
us into overly familiar terms.
And that comes out if we say, well, it must be
the means. And so people have views one way or the other about
certainly infanticide, about abortion, and for that matter, about
embryos. So there's a tendency to translate it into that aspect
or, on the other hand — and in this report, Leon, that you referred to
we have in our binder, to translate it to different kind of familiar
Well, it's going to lead to gender
discrimination. We're familiar in our society arguing about those
two things, about the status of embryos, on the one hand, and about
gender discrimination, on the other.
But what's distinctive about this question
of sex selection — and this connects to the broader issue of
enhancement — is that there are reasons to worry that go beyond those
two familiar reasons, which isn't to diminish those familiar ones,
but this question is philosophically interesting and challenging
because not everything that's objectionable about it can be
translated either into worries about embryos, on the one hand, or about
discrimination, on the other.
And that takes us to the goals or the goods or
the ends to reflect on, and looking at the data, the demographic data,
we all shudder at the numbers, but trying to make sense of the
shuddering is what's interesting.
There are worries obviously about the social
consequences, and here we enter into the kind of speculation in the
exchange between Frank and Nick about, you know, will all of those
extra men in China create instability, make China more warlike. Will
it make the situation with women better? Will it make it worse?
There's that set of worries.
But beyond the worries, there's something
also chilling about this, quite apart from speculating about the social
consequences for China or for the world or for war or for instability
or for all of these extra men rattling around there. And that's
what we should try to get at.
Is it chilling? Well, one thing is, oh,
it's chilling because we know lying behind there, you know, is some
infanticide or abortion or the killing of embryos.
But there's another dimension to what makes
it chilling, and that has to do with — well, I'm not sure, but
here's a speculation or a question just to invite us to direct some
of our energy anyhow in our reflection to this other set of issues.
Is it that we see in those ratios, rising
ratios, is it that we see here's what happens when we have the
technology to actually implement the things that for various reasons we
And is the danger — is what's chilling the
power that the technology give us? And may shrink before the
consequence of that technology when we see it here, or is what's
chilling that the technology being available just reveals to us vividly
desires, things that people want, that themselves — we think people
shouldn't want that sort of thing.
And suddenly the technology lays bare desires
that we haven't been able to act upon in other times. So
here's one way of testing that independent of the technology.
Is it wrong or not wrong, but is there
something morally troubling or questionable about praying for a boy
rather than a girl? And is the problem with the technology that it
answers the prayer that's independently objectionable or it enables
us to answer the prayer, to perhaps obviate the need for the prayer?
But is that the underlying desire; is it the prayer? Would that be
And if it's not, then we have to look
elsewhere, but if it is, then that leads us to some difficult moral
terrain, but at least it's the kind of terrain that may kind of get
at this issue of enhancement.
CHAIRMAN KASS: Could I as Chair ask members
in the queue if they would waive the queue and address the question?
Because I think it's a nice — if we could at least response to
Michael's challenge, if people would like to address it rather than
just run away from it?
Gil, do you want to speak to it? Both you and
Bill were in there.
PROF. MEILAENDER: I do want to speak to it.
CHAIRMAN KASS: Please.
PROF. MEILAENDER: Maybe he does.
DR. MAY: But go ahead.
PROF. MEILAENDER: Well, yeah, I want to pick
up on that actually relate to where it was Rebecca who sort of started
us down this road to some degree by thinking about kind of how this fit
with our larger concerns.
And let's assume an unobjectionable means
for the time being, you know, whatever that means. It probably means
different things to different people, but let's assume an
unobjectionable means so that we're talking about just the goal of
getting a child of the desired sex.
I don't myself think there's anything
wrong with the desire, and if somebody said, "I'm praying to
have a boy," that's all right.
If I may just kind of switch issues for a
moment, St. Paul prays to die and be with Christ. He doesn't act
on that, however.
So that, I mean, I don't think there's
necessarily anything wrong with the desire. So that's not — if
we're looking for kind of a deeper concern, I don't think
that's it, that it reveals to us some desire that's suspect. I
don't think there's anything wrong with wanting a boy or
wanting a girl. I don't think there's anything wrong with not
caring either, but it doesn't matter in that sense.
I think the issue is when desire turns to
action, it's control, and I think to me at least the issue is or
one of the issues anyway is the kind of control of offspring that is
set up there in the sense that means a less than unconditional
affirmation of somebody who turns out to be other than one desired.
That to me would be the problem, not just
having a desire.
I think there's a second kind of issue that
probably moves beyond —
PROF. SANDEL: Could I just add quickly? But
you don't think the desire could ever condition the affirmation?
PROF. MEILAENDER: I think it could, but I
think it's much more likely that the availability of the technology
is what brings the conditions rather than just having the desires.
Because technology turns out not just to free us and give us new
options, but to shape us and constrain us in various ways.
So that, in fact, is what I think generally
happens. Now, if I may make one more point that kind of in a way
relates a little more to where Rebecca had started us, but I think an
additional question here — I mean I think you're right, Michael
that it's important to ask, you know. Get out the means and
everything. Is there any reason to just object to choosing the sex and
can we articulate what it is?
But relates to the demography stuff is if there
are undesirable larger consequences, one of the issues that we're
raising then is if my desire is innocuous, if there's nothing wrong
with it, whether I have to suffer for the larger good, whether my
desire should be thwarted, whether we should regulate it.
And that is a question I think at least in a
society like ours that also needs to be faced.
CHAIRMAN KASS: Bill, Bill May.
DR. MAY: Partly a response to yours, but also
to return to the issue you were raising. As I listened to you, I
couldn't help but think about how studying comparative information
of this kind accentuates for us the difficulties of anticipating
As I think about India, just a passing word.
The fact that towards the third and fourth child, one even more
intensely wanted a boy does relate to economic circumstances there.
The dowry that has to accompany the girl into a marriage, and I know
farmers there who have gone into major debt and wanted a boy.
Terrific pressure on boys later on. If they
don't happen to hold to that system of a dowry and coming to this
country and working on computer work to be able to send money back at
home to help out the father to escape from the economic bag or trap he
So there are lots of pressures of that kind
that haven't surfaced in this discussion, but at the same time it
was very interesting you mentioned that at Punjab modernization tended
to move us in this direction. I wondered to what degree that related
to the fact that the boys in those provinces or regions, modernization
meant to move to the city, and there is more mobility in the boys and
girls, and so there might be more reason, again.
But all of this traffics in the question of
micro controlling as opposed to macro controlling, and you say the
problem of micro controlling is acute only if it's going to produce
macro problems, and that may be the wrong way of looking at it, and
that I think is what you, Michael, are forcing us to consider.
The deeper problem as it relates to parenting
for me is the whole question of how parenting relates us to the
question of the unbidden and the unelected in life.
I mean, we elect a mate in our kind of culture,
but we pick up with that a lot of things that we haven't elected:
the in-laws, and the genetic load, and so forth. There's a whole
unelected, and the testing out of a relationship very much depends on
our capacity to rise to what has been unbidding and unelected.
And that's certainly also true of
children. In that very delicate issue is it okay to desire something
else because is that going to hamper your ability to be open to what is
unelected is the exchange I see between the two of you.
You happened to mention prayer, and it's a
very interesting issue, intercessory prayer in the setting of the
Christian tradition. Is intercession the way in which we, absent of
technology, look to God to provide us with the deus ex machina
Within the machine we don't have the
technology. So we need this cosmic bellhop who will do certain things
to fulfill our wants and our desires.
And there's another way of looking at
intercessory prayer, is that circumstance under which we now temper our
desires. We express them, but we temper them. "Let this cup pass
from me, but not my will, but thine be done," and suggests a way
in which one hands over into the hands of another, and that other is
not defined as the cosmic bellhop.
But the way in which I am sustained and
supported to be open to the unbidden in life, the unelected in life,
which nevertheless to which I have to rise.
So I see you, Michael, have raised a very
important issue for us in your opening statement here. In addition to
harm and so forth or long range impacts and so forth, what are the
impacts in our whole understanding of the relationship of parents to
children, mates to one another, is the issue to which we return here.
CHAIRMAN KASS: Frank and then robby Ó-
sorry. Bill and robby.
PROF. FUKUYAMA: Well, this may not answer
Michael's question of why this is chilling, but I have my own take
on why this is important as an issue, which is that this is a textbook
case of a negative externality where you have a decision based on
medical technology that is individually rational for the parents, but
has a negative social cost and has a population level effect.
This is not a moral. You know, this is, I
think, a good answer to people who say, you know — use this
libertarian argument that says, "Well, the only thing wrong with
eugenics was that it was state sponsored, and as long as it's
individual parents that are doing it, we don't have to worry
because, you know, they love their children and they know what's
best, and so forth."
And so this just seems to be — and this may
not be the most important issue, but it does seem to me it's a
model for other decisions that will be possible in the future where you
could have perfectly individual, rational decisions that will lead to
population level effects that will be bad for society as a whole, which
then, you know, I think even for the most libertarian economist, I
mean, you know, is grounds for some kind of social regulation.
Now, the troubling desire, you know, I have
this mental exercise of a different case of this kind of selection that
would be a lot more troubling to a lot of people. Let's say that
there is a gauging or, you know, you can actually in the privacy of
your doctor's office, in effect, select the sexual orientation of
your child and speculate as to what the population level effects of
that kind of power would be
And my private, you know, privately held
opinion is that even the most tolerant, you know, person with plenty of
gay friends, and so forth, in the privacy of their doctor's office
is very likely to, all other things being equal, you know, if they had
that choice available, you know, they would avoid having a child with a
proclivity to gayness, and it doesn't have to be genetic. You
know, it could be just, you know, done through drugs or some other
If you had that kind of technology cheap and
relatively simple, I would think that you'd get population level
effects, you know, that would seriously affect the number of, you know,
distribution of gays within the society. It could happen, you know,
within a generation.
So the importance is really not the sex
selection issues per se, but just the fact that this does demonstrate
that there are new technologies that can have, you know, larger social
consequences on the basis of individual choice. So that eugenics is
not troublesome simply because it's state sponsored, but can be
quite troublesome as a result of disbursed, decentralized individual
CHAIRMAN KASS: Bill Hurlbut and then
robby, and then I think we'll have to break.
DR. HURLBUT: I want to ask you a quick
question, and then I want to make a comment.
Are there statistics on the gender realities of
abortion in America?
DR. EBERSTADT: Not that I'm aware of.
There may be some data of some sort kept. Dr. Haney, you may know this
better than I, but since the total estimates for the number of
terminated pregnancies or abortions in any given year aren't
exactly fixed, there correspondingly are other sorts of data one might
want to get.
DR. HURLBUT: I mean, it seems apparent if you
add up the huge numbers of lost females in your international
statistics that that must be driving the abortion rate strongly in
I've read statistics concerning India,
certain hospitals where 99 percent of the abortions are female fetuses.
DR. EBERSTADT: I've read the same sorts of
DR. HURLBUT: The second question I want to ask
you: is there a correlation with being noted with crime rates as there
are disproportions of males to females?
DR. EBERSTADT: Internationally?
DR. HURLBUT: I know it's a hard one to
DR. EBERSTADT: Not that I am aware of.
Everyone has — in all societies one always has impressions about the
way things worked in the good old days and the way that things are, you
know, falling apart now.
And certainly in most of the places in East
Asia that we describe, they're not seen as high crime settings. I
wouldn't have the data to support that sort of generalization right
DR. HURLBUT: It seems to me that one likely
consequence of this in the regions of the world where there's a
strong disproportion maybe 18 years later is going to be a high rate of
prostitution and maybe increased rates of sexually transmitted
diseases, which may be local to some extent, but has international
DR. EBERSTADT: I think that's a very good
question to ask.
DR. HURLBUT: What strikes me about this is if
you add some of this up, you might actually say that there could be a
social advantage overall. This is the individual versus the state.
There might be a social advantage by governmentally imposed sex ratio
of the opposite dimension, that at least in our country crime rates
correlate with the number of young males more than they do with
They've tried to correlate this with drugs
and post war and so forth. It always comes out that it's the
number of young males, and so you could theoretically hypothesize a
better society by doing something like sex ratio engineering.
That leaves certain questions unanswered like
who's going to marry whom, but I just bring it up because when I
think about Michael's very deep and important questions, it seems
to me that there's something going on under the surface about
nature, and we somehow relate this question of God and prayer and
nature all together as a single unit.
You start out with the interesting and ironic
comment about God's provision for the balancing of the sexes
because of male recklessness and death and war and so forth. And it
was kind of funny; it seemed an anachronism.
Nevertheless, underneath the surface that
assumption seems to be holding in a broader way for both religious and
nonreligious people; that there's something about the way nature
does things that seems to be better, wiser, more balanced. Even if we
could produce a better society by decreasing the number of males,
therefore decreasing crime or something like this, that it wouldn't
be right even then and that, therefore, when we pray for one particular
sex or another, there's the element that Bill May was suggesting,
that there is a humility in our prayer. Whereas in our technologies
the humility seems to be lost.
DR. EBERSTADT: I think that Sussmilch did not
intend his comment about the Creator at all to be ironic. I think he
was completely serious in his description.
It sounds a little antique to some people
today, but I think he was completely serious in his description.
And as for speculating about young males, if
there were a technology which could cryogenically freeze our children
at the beginning of adolescence and unfreeze them at the end of
adolescence, people might pay a lot for that. I don't know what
the ethical implications of that would be.
CHAIRMAN KASS: robby, and then we'll
PROF. GEORGE: Dr. Eberstadt, a quick question of
clarification, and then I want to discuss the matter that Michael
In the charts that gave us information about
the expressed preferences of women in various countries with regard to
additional children or having children or additional children, the
question was put to married women or was it married women of
DR. EBERSTADT: It was married women of
PROF. GEORGE: Of childbearing age. Okay.
DR. EBERSTADT: Yes.
PROF. GEORGE: I didn't think that was
I'm sorry Michael is not here. I thought
Michael was right or is right to warn us not to assimilate concerns we
may have about sex selection entirely to familiar concerns that have
been expressed in other domains, and the two that he mentioned were
discrimination and abortion and infanticide.
But I wonder if that means we need to find that
when we think the thing through we'll find a new set of concerns, a
new set of concerns laying somewhere deep in our consciousness or
whether it might not be yet another familiar concern, but not one of
And the concern I have in mind, particularly in
listening to Bill and Gil is the concern that Leon expressed many years
ago and influenced some of us. I realize not all of us accept this,
and that is the concern about turning procreation into production or
It was a concern that was voiced by some of us,
including Leon, at the very beginning of our deliberations about human
cloning and, of course, has been expressed by critics of IVF and other
And it does sound to me when I hear Bill and
Gill, and their points sound very persuasive to me, that there is
something about sex selection which seems incompatible with a posture
toward a child, a posture toward the coming to be of a new child that
really does treat that child not as a product of manufacture, but as a
gift to be received.
And I think that if that distinction holds, and
if we can also distinguish, as I think Christians and Jews would want
to do — and I'm not saying that other religious traditions would
think about this differently, I just don't know enough about them
to say — but if we would do what Christians and Jews do about
distinguishing prayer from magic so that we're not trying to use
prayer as an efficient means. It's just the best one we happen to
have to this productive end.
Then I think we can begin to understand that
there really is a distinction between praying to have a boy or praying
to have a girl and an act of the will, a choice, the use of a
technology, and in the process willing that we're going to have a
boy or going to have a girl such that the lack of success in that
enterprise would constitute a failure of our effort in a way that a
Christian or Jew would never say our prayers were a failure. They
didn't produce the result that we aimed to produce.
CHAIRMAN KASS: Thank you.
Dr. Haney, Dr. Eberstadt, any final comments
that you'd like to make?
I want to thank you both for a really very
informative and instructive and interesting morning. We've run
over, as is our habit. We were supposed to start at 1:45. It gives
members an hour and 15 minutes for lunch.
(Whereupon, at 12:27 p.m., the meeting was
recessed for lunch, to reconvene at 1:45 p.m., the same day.)