Korean Sex Is So Hot When You Put It Like That

“Mothers who want boys should have boys and mothers who want girls should have girls. Pre-implanting diagnosis offers the promising of increasing the number of children who are loved and wanted. I look forward to the day when every son knows that his parents wanted a son and every daughter knows that her parents wanted a daughter."

-Jacob Appel, Bioethicst

Korea is a purposeful example of the abortion debate. On one hand, you consider the rights of women to control their own reproduction and destinies. On the other you have the patriarchy that values males over females and the economic implications to the economy and medicine when medical abortion gnaws at the bottom line. The weight upon which cultures place on patriarchy is an incredible force in the abortion debate in developing nations. The debate framed by the New York Times is not about the real issue within Korea and that is abortion for the purposes of sex selection, not abortion for the purposes of aborting an unintended pregnancy.

Patriarchy is similar to pornography in that it is often hard to describe but we know it when we see it. Merriam-Webster defines patriarchy as, "A social organization marked by the supremacy of the father in the clan or family, the legal dependence of wives and children, and the reckoning of descent and inheritance in the male line; broadly : control by men of a disproportionately large share of power." An example is still present in France where inheritance is automatically passed to the first born male without regard to the wife’s life status.

The increased value of male children over female is consistent with the teachings of the patriarchy. While many societies find the overt practice of valuation of males at the cost of destruction to females offensive, some nations in Asia encourage it. It is estimated that by 2020 there could be more than 35 million young "surplus males" in China and 25 million in India. In 2005, 90 million women were estimated to be "missing" in Afghanistan, Bangladesh, China, India, Pakistan, South Korea and Taiwan alone, apparently due to sex-selective abortion. The existence of this practice within a society appears to be linked to culture origins and expectations, rather than by economic conditions. For example, deviations in sex ratios do not exist in many nations in sub-Saharan Africa, Latin America, and the Caribbean.

Sex selection abortions were rarely conducted prior to the 20th century because of the difficulty of determining the sex of the fetus prior to birth. The ongoing medical arms race and the invention of ultrasound changed the landscape of obstetrics. Prior to modern interventions, parents would alter family sex compositions through infanticide. This practice may still skew birth statistics in favor of males in mainland China, India, Taiwan, and South Korea. At current, no scientifically proven and commercialized practices of gender determination exist during the first trimester. Sex determination via ultrasound is not valid until after 12 weeks gestation. Consequently, sex selection often requires late term abortion of a fetus close to full gestational age, killing the child after birth, or abandonment.

Locally, same sex-selection practices are purported to occur among South Asian immigrants residing in the United States. Between 1989 and 1999, prenatal ultrasound use among non-Japanese Asian mothers rose from around 38 percent to 64 percent of pregnancies. A study of the 2000 United States Census suggested observable male bias in families of Chinese, Korean and Indian immigrants, especially in families where the first one or two children were female. In such families where the first two children were girls, the sex ratio of the third child was observed to be 1.51:1 in favor of boys. (To provide some color and perspective: the 1.51:1 ratio was most likely achieved by approximately 20% of these families engaged in sex-selective abortion until they were able to conceive a boy.) In the study published by two economists, the authors concluded there is no plausible innocent explanation for this enormous and directionally abnormal shift in probability. The authors concluded that the numbers are "evidence of sex selection, most likely at the prenatal stage."

Sex-selective abortion has had profound effects in Southern and Eastern Asian countries, where sex-selective abortions have caused an increase in the imbalances between sex ratios of various Asian countries. Arguably that by having a one-child policy, China has increased the rate of abortion of female fetuses, thereby accelerating a demographic decline. As most Chinese families are allowed (that is, given extreme incentives to have) only one child, and would often prefer at least one son, there are fewer daughters, thus preventing the formation of a greater number of families in the next generation.

Studies have estimated that sex-selective abortions have increased the ratio of males to females from the natural average of 105-106 males per 100 females to 113 males per 100 females in both South Korea and China, 110 males per 100. females in Taiwan and 107 males per 100 females among Chinese populations living in Singapore and parts of Malaysia. However, this trend has not been documented in North Korea, possibly due to limited access to prenatal sex-testing technologies.

During the 1994 United Nations International Conference on Population and Development in Cairo, Egypt, policy objectives intended to eliminate sex-selective abortion and infanticide, along with discrimination against female children, were stated in Article 4.15 of the Programme of Action: "...to eliminate all forms of discrimination against the girl child and the root causes of son preference, which results in harmful and unethical practices regarding female infanticide and prenatal sex selection". But the world keeps spinning. Sex-selective abortions continue.

Since 2005, commercial gender test kits such as the Baby Gender Mentor, have been available to expectant parents. These products have been criticized for making it easier to perform a sex-selective abortion earlier in a pregnancy, among others. Concerns have been raised about accuracy of the results. For as much as I have just argued that sex selection is a cultural construct, sex selection as a technology should be considered. The spread of fetal or embryonic sex-identification tests, which can be taken in the privacy of your home at increasingly early stages of pregnancy, makes it easier for sex selection to spread beyond its original cultural base. So does the emergence of pre-implantation genetic diagnosis (PGD), which allows for gender selection of embryos in a fertility clinic. Though PGD is most often used for separating out embryos with genetic concerns, PGD can and has been used for gender selection.

The bottom line is that sex selection isn't a newfangled perversion. It's a historical custom, and a patriarchal one at that. If the sex-selection story teaches us all to be a bit more skeptical of both tradition and technology, that would be real progress. At the minimum, it seems laughable that Korean gynecologists are upset about the practice of abortion when abortion is the prey, not the stalker. more...