“There is such a thing as too many daughters, but not too many sons”: A qualitative study of son preference and fetal sex selection among Indian immigrants in the United States
Highlights
► Although sex selection has been prohibited in India, it is available to South Asian families who have emigrated to the U.S. ► The cultural roots of son preference include the socioeconomic value of sons and the fear of raising daughters in the U.S. ► Eighty-nine percent of sex-selecting women terminated their pregnancy after discovering they were carrying a female fetus. ► Son preference was at times accompanied by verbal and physical abuse toward women who carried a female fetus to term. ► The proliferation of reproductive technology frequently has unanticipated cultural and gender-based ethical implications.
Introduction
Sex selection is a practice historically prevalent in societies that express a strong desire for sons. The cultural basis for son preference may include the necessity or utility of male offspring for manual labor, war, elder care, property inheritance, continuation of the family name or blood line, and/or avoidance of the expense of dowries. In addition to its direct influence on sex-selective terminations and female infanticide, son preference also impacts how parents allocate food, money, and other resources after birth, resulting in greater female childhood mortality due to starvation and illness (Dasgupta, 1987, Miller, 1997, Pande and Malhotra, 2006). In Asia, son preference and sex selection are intertwined phenomena, most visibly in India and China, countries with long-standing histories of female infanticide (Croll, 2000, Greenhalgh, 2008).
More recently, there has been increasing attention from demographers, economists, and journalists towards the use of biomedical technology for sex selection in South Asia. With estimates that there may be over ten million “missing” women in India alone (Jha et al., 2006), health organizations and women’s groups have cited the cultural pressure to have sons as contributory to sex selection, which has been considered a form of violence against women and girls (Dagar, 2001, Fair, 1996, Kishwar, 1995, Patel, 1989). In 1994 and 2003 the Indian government implemented legislation prohibiting the use of ultrasound and sperm sorting technologies used explicitly for sex selection. In contrast, sex determination and selective abortion, as well as pre-implantation sex selection technologies, are legal in the United States. Although there is ample exploration of the ways medical technologies can influence gender hierarchies and notions of empowerment (Franklin and Roberts, 2006, Saetnan et al., 2000), and there are numerous qualitative studies of this in the context of reproductive choice (Beck-Gernsheim, 1989, Becker, 2000, Ginsburg and Rapp, 1995, Inhorn, 2003), there is little known ethnographically about how new reproductive technologies are used specifically for sex selection in the United States.
South Asian families immigrating to the U.S. thus find themselves in an environment where reproductive choice is protected by law and a number of technologies enabling sex selection are readily available. In this context, then, how do women exposed to long-standing cultural pressures to have male children react in a social environment where reproductive choice is respected and sex selection technologies are openly marketed and available? To our knowledge, this report represents the first research investigating and documenting the experiences of son preference and sex selection among Indian women who have immigrated to the United States.
Section snippets
Methods
Qualitative approaches have been successfully employed in exploring cultural and ethical dilemmas in reproductive medicine such as the disposition of frozen embryos, the infertility experiences of low income immigrant Latina women, and the use of pre-implantation genetic diagnosis (Becker et al., 2006, Franklin and Roberts, 2006, Lyerly et al., 2010). More specifically, prior work on son preference and sex-selective abortion in India (George et al., 1992, Khanna, 1997, Ramanamma and Bambawale,
Demographics
The 65 women participants had immigrated from the Indian states and territories of Punjab, Haryana, New Delhi, Gujarat, Andhra Pradesh, and Tamil Nadu. Interviews were conducted by the first author in English, Punjabi, and Hindi. Forty-two women identified as Sikh (65%), fourteen as Hindu (22%), eight as Jain (12%) and 1 as Muslim (1%). Thirty eight women (58%) completed high school, twelve women completed college (18%) and fifteen (23%) had advanced degrees in medicine, law, business, nursing,
Reproductive choice
Most women spoke of their reproductive decision making as mediated by others in their extended family, particularly their husbands and mothers in law. To some extent, women understood and accepted their female in-laws’ desire to make known their expectations of their daughters-in-law. However, women struggled to balance their desire to keep family planning a private matter to be discussed only with their husband and their perceived obligation to consider the opinions of extended family members
Discussion
Despite the proliferation of bioethical (Chervenak and McCullough, 1996, Sauer, 2004) and aforementioned feminist analyses of the impact of reproductive technologies on women’s reproductive choice, there has been comparatively little research exploring women’s narratives about the pressure they face to have sons, the process of deciding to utilize sex selection technologies, and the physical and emotional health implications of both son preference and sex selection. This analysis of the
Acknowledgements
This paper would not have been possible without the brave contributions of all of the women who shared their stories. We are very thankful to them for their courage and willingness to share the most challenging parts of their lives, and hope that their contributions will help to bring about lasting change. For their contributions to this project, we thank Guy Micco, Amar Jesani, Vibhuti Patel, Ameena Ahmed, Osagie Obasogie, and Arjun Rihan. This research was supported by the UCB-UCSF Joint
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