Gender Ratio - Our World in Data

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Gender
Ratio
by Hannah Ritchie and Max Roser
This article was first published in June 2019.
Reuse our work freely Cite this research
Contents
The ratio between the number of males and

females in a society is referred to as the gender
ratio. This ratio is not stable but instead shaped
by biological, social, technological, cultural, and
economic forces. And in turn the gender ratio
itself has an impact on society, demography,
and the economy.
In this entry we provide an overview of the

variation and the changes of the gender ratio
across the world. We study how it changes
from birth to late life; the forces that change
the ratio of men to women.
Many argue persuasively that the terms

‘gender’ and ‘sex’ are not to be used
interchangeably. 1
In this context here we have however decided

to make an exception: we speak of the ‘gender
ratio’ because it’s the established term and it
will help all those who want to be informed
about this topic and search this term. But we
also speak of the ‘sex ratio’ because this is
arguably the more accurate term and it is
increasingly used within the academic
literature.
Summary
The sex ratio at birth is not
equal: in every country births
are male-biased. There are
biological reasons why there
are slightly more boys born
every year than girls. The
‘natural’ sex ratio at birth is
around 105 boys per 100 girls
(ranging from around 103 to
107 boys). ↓ jump to section
In some countries, the sex ratio

at birth is much more skewed
than would occur naturally.
Today and in the recent past
this is particularly common
across Asia and North Africa.
Here there is clear evidence of
gender selection through
prenatal sex determination and
selective abortion.
↓ jump to section
In countries where there is a

clear son preference, the sex
ratio at birth becomes
increasingly skewed with birth
order (the third or fourth born
children are more likely to be
boys than the first or second
child). ↓ jump to section
In nearly every country, boys

are more likely to die in
childhood than girls. There are
biological reasons for this: boys
are more susceptible to birth
complications and infectious
diseases. ↓ jump to section
In countries where there is

strong son preference,
mortality rates for girls are
higher than would be expected:
this can occur either through
direct infanticide, but also
through neglect and unequal
treatment. ↓ jump to section
The sex ratio tends to

decrease over the life course
(from becoming male-biased to
female-biased). This is because
women tend to live longer than
men. ↓ jump to section
It’s estimated that today there

are over 130 million ‘missing
women’ in the world as a result
of selective abortion and excess
female deaths. ↓ jump to section
The banning of sex

determination scanning and
gender-selective abortion may
have limited the increase in sex
ratio at birth in some countries,
but did not fully address the
problem. ↓ jump to section
Development can have

opposing impacts on sex ratio:
there is evidence that the son
preference declines with
education, but this often goes
hand-in-hand with declining
fertility rates and increased
access to selective technologies
(which can increase the sex
ratio). ↓ jump to section
Interactive charts on
Gender Ratio
Gender Ratio
across the world
IN THIS SECTION
What share of the population is male and female?
What share of the

population is male and
female?
The sex ratio – the share of the population that

is female – varies across the world. And
globally in 2020 the share of women in the
world was just under 50%.
There are three reasons why the sex ratio of

populations varies and is rarely equal:
differences in mortality rates and life

expectancy for women and men. Women,
on average, live longer than men. This
means that all else being equal, we would
expect females to account for slightly
more than half of the total population.
sex ratios at birth are not equal. In all
countries, there are more male than
female births (the extent of which varies
by country as we will see below). This
means that all else being equal, we would
expect males to account for slightly more
than half of the total population.
migration can also affect the sex ratio of
the population. If in some countries there
is a significant amount of imported male-
dominant labour, all else being equal, we
would expect males to account for more
than half of the total population.
The magnitude and balance of these factors

determines the sex ratio of the total
population.
In the map we see the sex ratio of populations:

this is shown as the percentage of the total
population which is female. Countries over 50
percent (shown in blue) have more females
than males; those below 50 percent (shown in
red) have fewer females.
Most countries have a female share of the

population between 49 and 51 percent (within
one percentage point of parity).
There are however a few notable outliers:
across several countries in South and

East Asia – most notably India and China
– there are significantly fewer females
than males. These are countries where
there are large differences in sex ratio at
birth.
in several countries across the Middle
East there are many more males than
females: in Oman, women are
outnumbered 3-to-1; in the United Arab
Emirates (UAE) it’s almost 4-to-1. If we
look at how this has changed over time
(click on the country to see this), we see
the share of the population that is female
has declined from a ratio close to parity
decades ago. The primary reason for this
is a large male migrant stock: in 2017, 45
percent of the Oman and 88 percent of
the UAE population were from
immigration. 2 The UN reports that only
16 and 25 percent of international
migrants to Oman and UAE, respectively,
were female.
there are significantly more females than
males in Eastern Europe. Populations in
Eastern Europe have some of the largest
gaps in life expectancy between men and
women: in Russia in 2021, for example,
the life expectancy at birth for men was
only around 64 years compared to
around 75 years for women.
Click to open interactive version
Gender Ratio at
birth and through
the life course
IN THIS SECTION
How does the sex ratio at birth vary across the

world?
The sex ratio varies with birth order
Sex ratio in childhood
Why do boys die more often than girls?
Sex ratio through adulthood
Why do women live longer than men?
How does the sex ratio at

birth vary across the
world?
Across the world there are differences in the

sex ratio at different life stages. This imbalance
in the male and female population can in some
cases be traced back to birth: in some
countries the number of boys and girls born
each year is significantly skewed.
In the map we see the differences in sex ratio

at birth across the world. Here the sex ratio is
measured as the number of male births for
every 100 female births; a value greater than
100 indicates there are more boys than girls
born that year. A figure of 110 would indicate
that there are 110 male births for every 100
female births.
The first striking point is that in every single

country of the world there are more boys born
than girls. This has been true for all years for
which we have data (as far back as 1950) in all
countries of the world, as you can when you
move the timeslider below the map further
back.
Does this mean every country selects for boys

prior to birth; for example, through induced
abortion practices which preferentially select
for boys? Not necessarily.
In the absence of selective abortion practices,

births in a given population are typically male-
biased – the chances of having a boy are very
slightly higher than having a girl.
Why are births naturally expected to

be male-biased?
For most countries, there are around 105

males per 100 female births. This is what the
World Health Organization (WHO) estimates
as the ‘expected’ sex ratio at birth: in the
absence of gender discrimination or
interference we’d expect there to be around
105 boys born per 100 girls, although this can
range from around 103 to 107 boys per 100
girls. Why is this?
In the most comprehensive study of its kind,

Orzack et al. (2015) monitored the trajectory
of sex ratio from conception through to birth
across five different methods. 3
This produced the largest dataset available on

the sex ratio throughout the stages of
pregnancy.
A key result from this study was that the sex

ratio at conception is equal: there is no
difference in the number of males and females
conceived. For births to be consistently male-
biased, there must be gender differences in the
probability of miscarriage through pregnancy.
The study found that although the probability

of miscarriage varies between genders across
the course of a pregnancy, female mortality is
slightly higher than male mortality over the full
period:
there is a higher probability that an

embryo with chromosomal
abnormalities 4 is male – in the first week
of pregnancy, excess male mortality
therefore means pregnancy is female-
biased;
in the next 10-15 weeks of pregnancy
female mortality is higher, which
increases the ratio in favor of males;
male and female mortality is
approximately equal around week 20;
between weeks 28-35 of pregnancy,
there is higher male mortality.
Overall, a male-biased sex ratio at birth is the

result.
In some countries the sex ratio is

skewed beyond the expected sex
ratio
Some male-bias in births is what we expect

with no deliberate gender selection through
parents or society more broadly. There are,
however, some key outliers in the world today:
in countries including China, India, Vietnam,
Pakistan, and Azerbaijan this ratio is very
skewed. Here it’s likely that deliberate
selection practices explain part of the high sex
ratio as we explore here.
The sex ratio varies with

birth order
Most countries have a sex ratio at birth which

is around the expected range of 105 boys born
for every 100 girls. There are exceptions to
this: there are countries – most notably in Asia
– with highly skewed sex ratios in favor of
males.
The preference in some countries for a son is

seen in the overall sex ratio at birth figures
above. But this bias is even stronger when we
look at how this ratio is affected by the birth
order of children.
In this visualization we look at the case of India

and how sex ratios change from the 1st child in
a family through to the 2nd, 3rd, 4th, and 5th
born children. This is adapted from
the Economic Survey 2018 5 and based on data
from the DHS and National Family Health
Surveys in India. It presents this data in two
cases:
when the child is not the last child born

(i.e. the parents have additional children
afterwards) – this is shown in the charts
on the left;
when the child is the last child born in the
family (i.e. the parents stop having
children afterwards) – this is shown on
the right.
Let’s first focus on the top row, which presents

the data for India as a whole. On the left-hand
side we have the sex ratio at birth when the
child is not the last. For the 1st children, the sex
ratio is very close to what we would expect
‘naturally’: a ratio of around 105 boys per 100
girls. But we see that for the 2nd, 3rd, 4th and
5th born children, this ratio is skewed towards
girls. Remember again that this is the case
when it’s not the last child i.e. the parents go on
to have another. In other words this shows us
that when a girl is born, parents are more likely
to have another child. It is evidence that
parents are continuing to have children until
they get a son.
Compare this to the right-hand side where we

see the sex ratio when the child is the last.
These ratios are much more skewed towards
boys. Parents whose 1st child is a son are much
more likely to stop having children. The sex
ratio here is 182 boys per 100 girls. This is
consistent across the birth order: whether it’s
the 2nd, 3rd, 4th or 5th child, a family is much
more likely to stop having children when they
have a boy.
Combined we see a strong preference for a son

in India: parents are more likely to continue
having more children when the child is a girl
and they are more likely to stop having
children when they have a boy.
Now compare these ratios to that of Indonesia

in the second row below. Sex ratios here do not
diverge strongly from the expected ratio of
105, and there is no clear difference when the
child is or isn’t the last to be born. Parental
choices do not point to a strong preference for
a son or a daughter.
In the third row we see that within India there

are large differences in son preference across
different states. The data shows that there are
states with ‘weaker’ and ‘stronger’ preference
for a son.
Sex ratio at birth by order
Sex selection practices also became

more prominent for later births
From the study presented above we see that

the sex of a child can, in some countries, be an
important deciding factor for when parents
stop having children.
But birth order also influences the likelihood of

prenatal sex selection (PSS) i.e. sex-selective
abortion. We see evidence of this across
several countries.
Researchers looked at Indian national survey

data from 1976 to 2005 to see how the sex of
children and birth order affects the use of
prenatal selection. 6 They found a significant
and increasing skew in the sex ratio since the
1980s – a time when the average woman in
India had five children. This was mainly a result
of male selection for the 2nd or 3rd child
within a family. When the firstborn or the first-
and second-born siblings were female then a
boy was much more likely the 2nd or 3rd child.
This skewed ratio can only be explained from
prenatal sex selection in favor of boys.
At a local level, a study of a large Delhi hospital

known for maternal care showed very similar
results. 7 The overall sex ratio was male-biased
with only 806 girls per 1000 boys. But this got
significantly worse when the family already
had a daughter: 720 girls per 1000 boys if
there was one previous girl and only 178 girls
per 1000 boys for two previous daughters.
Even for women who had not practiced sex-
selection abortion, more mothers who had
previously had a girl reported taking
traditional medicines (which were ineffective)
for sex selection purposes.
These examples are of course not restricted to

India. Many countries across Asia in particular
have similar findings. In this chart we see how
the sex ratio in South Korea was affected by
birth order. Here we see a very steep rise in the
sex ratio of third-, fourth- and later children
through the 1980s. By the early 1990s there
were more than 200 boys per 100 girls for
third-born children; for fourth-born or higher,
the ratio was close to 250:100. This occurred
at a time the number of children per woman
was falling quickly: in 1970 its fertility rate was
4.3 children per woman; by 1990 this had
fallen to 1.6. South Korea’s sex ratio has fallen
back to close to natural levels over the past few
decades.
You can also view the data for China, by using

the “change country” button in the top-left of
the chart. Clearly sex ratios in China have also
been affected by birth order. 8 Here we see that
since 1980 –a period in the middle of a rapid
reduction from 4 to 2 children per woman –
there has been some rise in the male bias for
first-born children (rising from the expected
105 boys to 114 boys per 100 girls). But we see
a much more significant skew in the ratio for
second or third-born children. For third-born
children, the ratio was 158 boys per 100 girls,
suggesting a high prevalence of sex selection
abortions.
South Korea provides an important example

where the male bias can be successfully
addressed. But for several countries across
Asia this looks like a major challenge: the data
shows that many parents still strongly prefer a
son.
Sex ratio in childhood
Sex ratios – the ratio of males and females – at

birth is male-biased across every country in the
world; in our section on this, we explain why
biologically we’d expect this to be the case. The
so-called ‘expected’ sex ratio at birth was
around 105 males per 100 females. But how
does this ratio look later in childhood? Does it
change from newborns to five-years-olds?
In the two charts here we see two

perspectives: firstly a global map of the sex
ratio at five years old. Just as with the sex ratio
at birth, we see the highest ratios in several
Asian countries where the share of boys is
higher than we would expect. In China, there is
close to 115 boys per 100 girls at age five; in
India, there are more than 109 boys per 100
girls.
Secondly we see a scatterplot comparison of

the sex ratio at birth (on the y-axis) versus the
ratio at five years old (on the x-axis). The grey
line here represents parity: a country which
lies along this line has the same ratio at five
years old as it does for birth. As we see, most
countries lie above this line: this means the sex
ratio for newborns is higher than for 5-year-
olds.
In other words, the male-bias tends to weaken

through the first years of childhood. Why is
this the case? As we explore in the next section
of this entry: across most countries infant and
child mortality rates are higher for boys than
for girls. This means fewer boys survive the
first few years of life. For most countries this
results in a decline in the sex ratio.
Overall we see that despite higher child

mortality in boys, the sex ratio at age five in the
majority of countries is over 100: this means
boys still outnumber girls in childhood.
Why do boys die more

often than girls?
From life expectancy to mental health;

substance use to cancer rates; there are
important differences in health outcomes
between the sexes. In a related post, my
colleague Esteban Ortiz-Ospina looks at the
evidence to answer the question “Why do
women live longer than men?“
Here we focus on the youngest, asking, why do

young boys die more often than girls?
Child and infant mortality is higher

for boys in nearly all countries
Child mortality measures the share of

newborns who die before reaching their 5th
birthday. In the chart below we see the
comparison of child mortality by sex.
Here, the mortality rate for boys is shown on

the y-axis, and the mortality rate for girls on
the x-axis. The grey line running diagonally
across the chart marks where the mortality
rate for both sexes is equal. In countries which
lie above the grey line, the rate for boys is
higher than for girls.
What’s striking is that with exception of two

countries – India and Tonga – child mortality is
more common for boys in all countries of the
world. This is also true for infant mortality,
which is the share of newborns who die within
their 1st year of life. We study why India and
Tonga are outliers here.
Over the past half-century in particular, child

mortality has been falling rapidly across the
world. This has been true for boys and girls
alike.
It has been known for a long time that the

mortality of boys is higher. As early as 1786 the
physician, Dr Joseph Clarke, read a paper to
the Royal Society of London on his
observations that “mortality of males exceeds
that of females in almost all stages of life, and
particularly the earliest stages”. 9
What do infants die from?
Why is it the case that boys die more often

than girls? First of all, it’s important to
understand what young children die from.
In this chart we see global mortality rates in

infants across different causes in 2017. This
data comes from the IHME’s Global Burden of
Disease study, which provides estimates by sex
– on the y-axis we have plotted mortality rates
in boys, and on the x-axis for girls. Just like the
charts above, causes which lie above the grey
line are more common in boys.
The chart shows that for all major causes of

death, mortality is higher in boys. The sex
differences in the causes of infant deaths were
already documented almost a century ago: in
an impressive paper published in 1929, Bawkin
explores the mortality sex ratio of specific
diseases from countries across the world. 10
There are some causes – HIV/AIDS, nutritional

deficiencies, whooping cough, among others –
for which the mortality rates are higher in girls.
But overall, infant boys are more likely to die in
childhood than girls. 111213
Boys are more vulnerable in two key ways:

they are at higher risk of birth complications,
and infectious disease. We explore the possible
reasons for this below.
Boys are at higher risk of birth

complications
From comparison of mortality rates in infant

boys and girls, it becomes clear that boys are at
higher risk of complications in the first few
days of life: preterm births, asphyxia, birth
defects and heart anomalies. But why?
First of all, boys are more likely to be born

prematurely: the share of boys born before
full-term pregnancy is higher than for
girls. 14 This occurs naturally, but is
exacerbated by the rate of induced preterm
births. Boys tend to have a higher birthweight
than girls – which can increase the risk of
waiting to term to deliver – meaning that more
boys are induced before the end of the
pregnancy term. 15 The chart above shows that
more boys die from preterm births. The fact
that preterm births are more common for boys
contributes to this.
Although boys are, on average, heavier than

girls at birth, they are less physiologically
mature at birth. This means they are at higher
risk of having delayed physiological function
(such as lung function) and adverse
neurological outcomes. 1617 For example,
poorer lung function in newborn boys has been
shown for both term and preterm
infants. 1819 Studies have suggested that even
in the case of straightforward pregnancies,
lung maturation in boys lags that of girls by
approximately one week. 20 These differences
in maturity at birth are not restricted to lung
function. 21
The reason for this difference has been an

important question for decades – the answer is
still not clear. But there are some leading
hypotheses: surfactant production for lung
function has been observed earlier in female
fetuses, leading to improved airway flow in the
lungs; estrogen has been shown to affect lung
development positively in females; males, on
average, have a higher birthweight meaning
they may trade-off increased size for
functional development; and the uterus may be
less hospitable to male fetuses – the
introduction of a Y chromosome in females can
create and immunoreactive response to the
central nervous system. 2223
This, combined with a higher risk of premature

birth may explain why boys have higher rates
of asphyxia, respiratory infections and birth
defects.
Boys are at higher risk of infectious

diseases
Boys are also at higher risk of infectious

diseases such as syphilis, malaria, respiratory
infections, tetanus and diarrheal diseases. This
is more generally true for a broad range of
infections, spanning person-to-person, vector-
borne, blood-borne, and food and water borne
diseases. 24
We see this clearly when we compare

mortality rates for boys and girls in the earlier
chart. But why are boys more susceptible to
infection?
Overall, boys have weaker immune systems.

There are two key hypotheses for why.
The Y-chromosome in boys increases their

vulnerability. Biologically, males and females
are differentiated by chromosomes: females
have two X chromosomes (XX) and males one X
and one Y chromosome (XY). Having two X
chromosomes means that the newborn has a
stronger immune system because X
chromosomes contain a larger number of
immune-related genes. 2526 This means that,
since females have two X chromosomes, they
have a stronger immune response; boys on the
other hand, are more vulnerable to X-linked
infections. 27
This makes males more vulnerable to many

infectious diseases. They are also more
susceptible to specific genetic diseases where
the defective genes are carried on either the X
or Y chromosomes; this is because boys have
only one X chromosome so a single recessive
gene on that X chromosome results in the
disease.
But the stronger immune response of females

comes with a cost. It’s the reason why women
are more susceptible to autoimmune disorders
such as HIV/AIDS. 28
Sex hormones may be another key reason for

weaker immune systems in males. Males have
much higher amounts of testosterone which
seem to inhibit two major parts of the immune
system – B and T-lymphocytes. 29
Estrogen, on the other hand, acts as an

effective regulator of this. Overall, male
hormones weaken the immune system relative
to females.
The male disadvantage
The fact that boys are more susceptible than

girls to a range of health conditions is often
summarized as the “male disadvantage”. This is
not restricted to childhood: the female
advantage carries into adulthood. It’s part of
the reason why women tend to live longer than
men.
The leading explanations for the “male

disadvantage” lie in the biological differences
between the sexes. More specifically,
differences in maturity, sex chromosomes, and
hormones.
In circumstances where both sexes are treated

equally, we would therefore expect infant and
child mortality rates to be slightly higher for
boys.
Sex ratio through

adulthood
The sex ratio – the number of males relative to

females – at birth and in childhood are male-
biased in almost every country.
In previous discussion we covered why we’d
expected this to be the case biologically.
How does the sex ratio change throughout

adulthood?
In this chart we see the sex ratio – measured as

the number of males per 100 females – at
different ages through adolescence and
adulthood.
In the global average for adolescents and

young adults we see the result of both the
male-bias in birth ratios and the large impact of
populous countries such as China and India
with very skewed sex ratios: At age 15 and 20,
males outnumber females by 106 to 100.
But as we move through adulthood we see that

this ratio is lower and lower. For 50-year-olds
the ratio is close to 1-to-1; for 70-year-olds
there are only 86 males per 100 females; and
in the very oldest age bracket (people aged 100
and older) there are only 24 men per 100
women.
You can explore this data for any country of

region of the world using the “change country”
button in the top-left of the chart. You will see
that for some countries this decline in the sex
ratio with age is even more extreme: in Russia,
for example, by age 50 there are only 91 males
per 100 females; by 70 years old there are
almost twice as many women as men.
In every country in the world women tend to

live longer than men. Whilst this is true today,
it hasn’t always been the case. In his text ‘Why
do women live longer than men?‘ my colleague
Esteban takes a look at the evidence and
explanations for why this is the case.
Why do women live

longer than men?
On average, women live longer than men – this

is true for every country in the world. This fact
plays an important role in how the sex ratio
changes with age through adulthood.
A detailed discussion of why this is the case is

available in our explainer on ‘Why do women
live longer than men?‘.
Missing girls and

women
IN THIS SECTION
Biology or discrimination: which countries have

skewed sex ratios at birth?
Infanticide
Excess female mortality
How many women are missing?
Biology or discrimination:
which countries have
skewed sex ratios at
birth?
Today, and at several points historically, the sex

ratio at birth in some countries is too skewed
to be explained by biological differences alone.
The ‘expected’ sex ratio at birth is around 105
males per 100 females.
In a recent study Chao et. al (2019) re-

modelled sex ratios at birth (SRB) across the
world based on a range of population sources,
including census and household survey data. 30
The results are shown in the chart below since
1950. The authors identified 12 countries with
strong statistical evidence of a skewed sex
ratio: Albania, Armenia, Azerbaijan, China,
Georgia, Hong Kong, India, Montenegro, South
Korea, Taiwan, Tunisia, and Vietnam. 31
Most of these countries are in Asia. Why is this

the case? Is there a biological or environmental
difference, or is it the result of discrimination?
Hepatitis B was proposed then later

debunked
Amartya Sen was the first scholars to publicly
bring attention to the concept of “missing
women” as a result of sex selective abortion,
unequal treatment and infanticide of girls. 32
The reason for this skew in sex ratio has been

previously challenged. One of the leading
hypotheses was put forward by economist
Emily Oster. In a 2005 paper she argued that a
large proportion – approximately 45%, around
75% in China, 20-50% in Egypt and western
Asia, and under 20% in India, Bangladesh,
Pakistan, and Nepal – of the
overrepresentation of men could be explained
by the high rates of hepatitis B carriers in
Asia. 33 The rationale was that (1) hepatitis B
carriers have an offspring sex ratio much more
in favour of boys (1.5 boys per girl), and (2) that
hepatitis B carrier rates were notably higher in
Asian cultures than in the West. The
combination of these two observations Oster
calculated could account for a large proportion
of the “missing women”.
A few years later, Oster debunked her own

hypothesis on the role of hepatitis B in a paper
titled “Hepatitis B does not explain male-
biased sex ratios in China”. In a study of 67,000
people in China – 15% of which were hepatitis
B carriers – Oster and colleagues found no link
between hepatitis B status and offspring sex
ratio. 34 The hepatitis carrier status of neither
the mother or the father had an effect on the
offspring sex: carriers were not more likely to
have a boy than non-carriers. The authors
concluded that hepatitis B rates could not
explain the skewed sex ratio in China.
Other studies – such as that by Lin and Luoh

(2008) in Taiwan – have also found minimal to
no effect of hepatitis B on the sex ratio. 3536
Sex-selective abortions and discrimination

against girls
After the hepatitis B hypothesis was debunked,
no clear evidence of a biological factor in such
skewed sex ratios has emerged. There is some
variability in the “expected” sex ratio which
may result from biological or environmental
factors – a figure of 105 boys per 100 girls is
usually adopted, but often this can vary from
103 to 107 boys per 100 girls. But the natural
variability of the sex ratio is too small to
explain the high ratios in some countries.
The evidence for sex-selective abortion and

discrimination against girls is now strong
across several countries. Not only does the
increase in sex ratios coincide with the
availability of prenatal sex determination
technologies, there is also clear evidence from
studies investigating the use and promotion of
such methods.
In India, for example, prenatal diagnosis (PD)

became available in the 1970s, shortly after
legalization of medical abortion in 1971. 37
Whilst its use was intended for detection of
abnormalities, it was soon used and promoted
by the Indian medical profession for sex
determination. 38 Even after its use for sex
determination was prohibited, studies suggest
many gynecologists did not consider sex-
selection abortion to be unethical and argued
that it was an important intervention to
balance population control with the desire for
sons. 39
Results from some of the earliest studies on

abortions following the availability of prenatal
sex determination are striking. Over the year
from 1976 to 1977, at an urban hospital in
India, 96% of the girls who were tested were
aborted; in contrast, all of the 250 boys tested
– including those with an identified risk of
genetic defect – were born. 40 At a clinic in
Mumbai, all of the 15,914 abortions after sex
determination in 1984/85 were girls. Results
from another six hospitals in the city found
7,999 of the 8,000 aborted fetuses in 1988
were girls. 41
The evidence that highly skewed sex ratios at

birth have been largely the result of gender
discrimination and selective abortions has
been well-established across several countries.
We discuss the reasons for this discrimination
here.
There are some additional hypotheses as to

why the sex ratio at birth is skewed in some
countries. Based on Chinese census data, Shi
and Kennedy (2016) argue that the skew in
China’s sex ratio is not the result of selective
abortion practices, but much more the result of
administrative anomalies. 42 The authors argue
that the one-child policy led some parents to
postpone the registration of daughters
(making them appear “missing”), but that they
appear later in Chinese census data. A year
later, Cai (2017) challenged the authors’
conclusions in support of the conventional
hypothesis that this is not a statistical artefact,
but a real demographic and social challenge. 43
Infanticide
Sex discrimination can occur prenatally (in the

form of sex-selective abortions, as we discuss
here) or postnatally when it can lead to the
death of a child in the very worst cases. The
death of a child due to sex discrimination can
be brought about in a deliberate killing of an
infant (infanticide) or can be caused by neglect
or poor and unequal treatment.
Over time, prenatal discrimination has

increased as both abortions and sex
determination technologies have become more
readily available. Nonetheless, postnatal
discrimination still occurs and has a long
history.
Infanticide has a long history
Infanticide (or infant homicide) – the

deliberate killing of newborns and infants – has
a long history. 4445 From hunter-gatherers to
ancient civilizations to the present day:
infanticide has spanned all periods of history.
In fact, anthropologist Laila Williamson goes as
far to say: “Infanticide has been practiced on
every continent and by people on every level of
cultural complexity, from hunter gatherers to
high civilizations, including our own ancestors.
Rather than being an exception, then, it has
been the rule.” 46
And humans are not alone. From birds to

rodents; fish to mammals; we find evidence of
infanticide across the animal kingdom. 47
There are some common misconceptions today

surrounding the practice of infanticide.
Although the term is now often adopted as a
synonym for ‘female infanticide’ – the killing of
unwanted girls – the gender specifics and
drivers of infanticide depend on context and
time in history. 48
Historical evidence and estimates

of infanticide
A number of researchers have studied the

demographic, health and cultural profiles of
prehistoric societies. In rare cases they can use
indirect evidence of the fossil record; but many
rely on modern hunter-gatherer societies
today. 49
Estimates for infanticide in prehistoric

societies are very high. Using recent hunter-
gatherer societies as a proxy, some studies
suggest anywhere from 15% to 50% of
newborns were killed in the first year of
life. 50 Other estimates are lower, but still very
high: in the range of 15-20%. 51
Hill & Walker (2007) looked at the

demographic profiles, death rates and causes
of death of recent hunter-gatherers: the Hiwi
group of Venezuela. They did this using census
and interviews gathered over a seven year
period. 52 They found very high rates of infant
death from violence. Infant mortality rates in
the past were very high – most studies suggest
around a quarter of newborns did not survive
the first year of life. In the Hiwi hunter-
gatherers, researchers found homicide to be
the second largest cause of death, accounting
for 30%. They also found large sex differences:
infanticide rates were four times higher for
girls than boys.
Other studies of modern hunter-gatherer

societies analysed the sex ratio of infants to
estimate the prevalence of infanticide. Very
skewed sex ratio of infants is suggestive of
select infanticide. In studying 86 hunter-
gatherer bands across North America, South
America, Africa, Asia and Australia,
researchers found high levels of female
infanticide across 77 of them. 53
This is shown in the table, where there were

many more young males than females in bands
where infanticide was reported as ‘common’ or
‘occasional’.
The practice of infanticide was not just

common in prehistoric societies, but was also
very common in many – but not all – ancient
cultures. 54 Evidence for this exists either in the
form of preserved burial remains, documented
records or writings suggestive of the
practice. 55
Youth Adult
Number of
Infanticide sex ratio sex ratio
hunter-
reported (males (males
gathering
as: per 100 per 100
bands
females) females)
Common 138 105 71
Occasional 138 80 6
Not
100 85 3
common
Not
94 83 6
practised
Both sexes are victims of infanticide
It’s a common assumption that infanticide

relates only to female infanticide: the killing of
unwanted girls. 56 But the role or direction of
gender discrimination – either towards boys or
girls – is context-dependent. 57
Sometimes here is no clear gender

discrimination, and it occurs for both sexes.
There is of course significant evidence of

female-selective infanticide throughout
history: we see that in the sex ratio of many
hunter-gatherer societies above through to
skewed ratios in Medieval England. 58 Evidence
of male-selective infanticide is rarer, but does
exist: in a sample of 93 preindustrial culture, 9
showed evidence of female-selective, while 1
showed male-selective infanticide. 59
Even today, cases on infanticide still exist,

despite being outlawed in most countries. 60
Infanticide occurs in Western countries: in
some (such as the United States) boys make up
a higher share of infant homicides. 61 But the
most widely prevalent – and selection that has
a significant impact on gender ratio – is female
infanticide. This remains reported across
countries with a strong son preference: India
and China are the most documented
examples. 6263
Infanticide is the most direct case of postnatal

sex selection. More often overlooked is the
excess mortality which results from neglect
and unequal treatment of girls. This is ‘excess
female mortality’ is sometimes often referred
to as ‘delayed infanticide’.
Excess female mortality
Poor treatment of girls results in increased

mortality in childhood
In almost every country young boys are more
likely to die in childhood than girls – as we
explore here, there are several biological
reasons for is. But this is not true in a few
counties – India is one notable example today.
There, girls die more often than boys.
When we compare infant (under one year old)

and child (under-5s) mortality rates between
boys and girls in India we see that the
difference is bigger for the older age group.
While infant mortality rates are approximately
the same, the child mortality rate for girls is
higher.
Let’s then focus on children rather than infants.

In the chart here we see mortality rates for
boys (on the y-axis) and girls (on the x-axis) for
various causes in India. This data is shown for
children aged 1-4 years old in 2017. Here we
see that for many, death rates are significantly
higher for girls. Some of these – hepatitis,
measles or tuberculosis, for example – we
expect to be higher for girls. But not for
infections, respiratory and diarrheal diseases.
Note also the much higher mortality rates for
nutritional deficiencies and protein-energy
malnutrition for girls.
Poorer health outcomes for girls across some

countries – often in Asia and not restricted to
India – has been well-documented. 6465 Even
for some countries where the child mortality
rate remains higher in boys than for the girls,
death rates for girls are still higher than would
be expected.
Social preference for a boy has resulted in

unequal treatment of young girls in a number
of ways. Studies have shown in some countries:
poorer nutrition for girls and unequal

food distribution; 66
less breastfeeding from mothers for
daughters than for sons; 67
lower healthcare utilization for girls; 6869
during pregnancy there is evidence of
preferential treatment for boys with
more antenatal visits and increased
tetanus vaccinations. 70
This combination of poorer nutrition and

healthcare investment can result in higher
mortality rates for girls, but also to excess
mortality for women in later stages of life.
How many women are

missing?
The term ‘missing women’ was first coined by

Indian economist Amartya Sen in a 1990
article; he estimated “more than 100 million
women are missing”. 71
‘Missing women’ refers to the shortfall of

women from the number we would expect in
the absence of sex discrimination. It is the sum
of women who are missing at birth (as a result
of sex-selective prenatal practices such as
abortion) and excess female mortality later in
life (either through infanticide, child neglect or
maltreatment).
Many researchers have tried to calculate the

number of missing women. Using sex ratios at
birth, and at different ages we can compare the
observed and expected values: the difference
is then defined as girls and women who are
missing.
There are very obvious challenges in

calculating this figure. For the observed sex
ratio, there is the concern of how accurate the
reported number of births, males and females
are. The other major issue is knowing exactly
what the baseline/expected ratio of males to
females would be at each stage in life. For
example, the ‘expected’ sex ratio at birth is
quoted as 105 male births per 100 female
births. But through time and across the world,
this can often vary between 103 to 107 male
births per 100 female births. The combination
of these measurement issues means any
estimate of the number of missing women will
come with fairly high uncertainty.
In the table here we provide a summary of a

range of estimates – note here that the year of
the estimate is different for each. Here we see
that although there is significant uncertainty in
these estimates, all are within the range of over
50 million by 1990, and likely upwards of 100
million today.
In the chart we see some of the most recent

estimates of missing women from 1970
through to 2015 from Bongaarts & Guilmoto
(2015). 72 In 1970 the researchers estimated
there were 61 million missing women; by 2015,
136 million. This is more than the population of
Mexico. We see that more than 80% are
missing from China and India – 68 and 45
million, respectively.
The authors also provided projections of the

number of missing women through
demographic changes to 2050 which you find
here.
Year
Number of
Source estimate is
missing women
for
More than 100

Sen (1990, 1992) 1990
million
Coale (1991) 1990 60 million
Klasen (1994) 1990 92 million
Klasen and Wink

1990s 102 million
(2002)
Hudson & Den

2000s 90 million
Boer (2004)
Guilmoto (2012) 2010 117 million
Bongaarts &
2015 136 million
Guilmoto (2015)
How many girls and women are

missing every year?
Above are estimates of the total number of

missing women in the world. But how many are
‘missing’ each year?
In this chart we see estimates of (1) the

number of ‘missing’ female births from
prenatal sex discrimination; and (2) excess
female deaths as a result of postnatal
discrimination. 73
3.3 million women is the estimate fo 2015 –

approximately half of which were missing
births and half of which are attributed to
excess female mortality. After the 1970s sex-
selective abortions (shown as missing births)
became more common. Until 1980, nearly all
missing women were the result of excess
female mortality; by 2015 as many were from
missing births each year.
Why is there a
preference for a
son in some
places?
In countries where there is a clear imbalance in

sex ratio, there’s preference for a boy. But why
does this preference exist?
Son preference is most common in countries

across East and South Asia, but also in some
countries in the Middle East and North
Africa. 74 Although there are significant
cultural, economic and societal differences
between these countries there are important
parallels which explain strong preference for a
boy.
What these countries tend to have in common

is a strong logic of ‘patrilineality’: the logic that
productive assets move through the male line
within the family. 75 Although many other
countries also have patrilineality to some
degree, in countries with a strong preference
for a son, researchers find this logic to be much
more rigid. The social order of families resides
with the males: lineage is passed from father to
son. Men within the social order are the fixed
points, and women the moving points: when a
daughter marries, she leaves the current family
to join a new one.
This can produce economic and social benefits

to having a son rather than a daughter,
including:
Family name: the lineage within a family

stays within the male line. Having a son
therefore continues the family name.
Old age support: sons within a family are
often responsible for supporting parents
in illness and old age. 76 Elderly parents
often live with married children and
overwhelmingly so with their sons. This
provides a strong economic incentive for
a son for old age support. It’s a key
differentiating factor between countries
with and without strong son preference:
in Taiwan, it’s rare for parents to live with
a married daughter, but in the Philippines
(without strong son preference) parents
are equally likely to live with the son or
daughter. 77
Dowries: a dowry – the transfer of
property or money from the bride’s to
the groom’s family – is an important
economic concern for having a daughter.
Studies in India have suggested that a
dowry is the most common reason for
not wanting a girl. 78 Even when parents
themselves didn’t have a dowry in their
own marriage, many carry the
expectation of having to provide one for
a daughter, or asking for one from a
future daughter-in-law.
Labor force opportunities: males can bring
better economic opportunities for a
family. This can be the result of real sex
differences in economic opportunities,
but also results from undervaluing the
work of women. In many countries,
unpaid or informal work accounts for a
majority share of female employment. In
this sense, informal employment is often
seen simply as an extension of a women’s
domestic work rather than being valued
in its own right. 79
Family and societal pressure: it’s not just
economic concerns that parents worry
about: surveys also reveal persistent
pressures from family members and
communities. In interviews, women often
note pressures from female in-laws and
husbands, verbal and physical abuse
when they didn’t produce a son or were
pregnant with a girl. 80
Religion: in some cultures it’s believed
that only a son can light the funeral pyre
and carry out death-related rites and
rituals needed for salvation. 81
What are the

consequences of a
skewed sex ratio?
Across several countries in Asia, and North

Africa we see highly skewed sex ratios in
favour of males. Strong preference for sons has
led to an increasing number of “missing
women” and therefore an “excess of males”.
There are a number of adverse consequences

which could result from highly imbalanced
numbers of men and women in society. These
present a risk to men, women, family
structures and society as a whole.
The obvious consequence of gender imbalance

is a large number of unmarriageable men. 82 A
lack of women of marriageable age could have
several impacts on marriage dynamics for
men: 83
many men will have to delay marriage;

this will have a knock-on impact on
younger men: not only will they be
impacted by a skewed sex ratio for their
generation, but will also have a ‘backlog’
of men from the previous generation in
the ‘marriage market’;
a significant number of men will have to
forego marriage altogether;
the poorest men will likely be most highly
impacted by this – it’s hypothesised that
women will “marry up” in society, leaving
the men with least resources
disproportionately affected;
one of the most common reasons for son
preference is for family lineage (the
passing down of the family name through
males in the family) – this will likely not
occur in families where sons do not
marry.
Whilst we might assume that this dynamic

would favour women, they could also suffer
negative consequences:
a women’s value may be increasingly lie

in her role as a wife, daughter-in-law or
mother. This may deny her alternative
pathways, such as remaining single or
becoming more career-oriented;
women may feel increased pressure or
incentives to marry or have children
earlier in life (possibly closing off
different economic or labour
opportunities);
women may be at increased risk of
violence (emotional, sexual or physical)
or trafficking. 84
Imbalanced gender ratios could have negative

consequences for both men and women. For
society more broadly, there are several
hypotheses that it will also result in more
crime, violence and disorder in communities.
The rationale being that not only will there be
an excess of men who do not marry and have
their own family, but that the most affected
will be those of lowest socioeconomic status,
the most uneducated and with fewer
opportunities.
Hudson and De Boer (2004) propose that this

situation will result in significant social stability
and security concerns. 85 Although studies
have found correlation between the
prevalence of violence and more imbalanced
gender ratios, it’s difficult to disentangle a
causal effect. 86 Other researchers suggest that
the evidence does not support this concern:
that rather than showing through aggression
and violence, excluded men will be more
marginalised, lonely and at risk of
psychological problems. 87 What’s clear is that
the persistence of imbalanced sex ratios means
there will be demographic consequences for
many decades to come.
What a!ects the

strength of
gender bias?
IN THIS SECTION
Are richer and more educated parents less likely to

have gender preference?
Does banning prenatal practices reduce sex-
selective abortion?
Are richer and more

educated parents less
likely to have gender
preference?
If our aim is to address the issue of a skewed

sex ratio and female discrimination, an obvious
question to ask is: will development fix the
problem? Is it the case that son preference is
restricted to those at lower incomes, therefore
the problem disappear if poverty falls and
societies develop?
The evidence to date suggests, no:

development on its own does not address it.
Studies which have looked in detail at the

extent of sex ratio imbalances by demographic
(comparing income level, education, literacy,
employment factors amongst others) often
conclude the opposite: that richer, urban
families tend to discriminate more than the
poor. 88 For example, in North India higher
castes (who tend to be richer) had more
skewed sex ratios than lower castes. 89
Narrowing in on specific districts and
household in India and South Korea suggested
that it is richer families who show greater
discrimination. 90
Despite rising incomes and development

across many countries in Asia, North Africa
and Eastern Europe, the sex ratio got worse,
not better. An important driver which may link
the increase in sex ratio with development and
rising incomes is fertility rates. As we show in
our entry on fertility rates, there is a very
strong impact of improving development and
falling fertility. And falling fertility rates in turn
play a key role in exacerbating gender
preference. This is often called the ‘fertility
squeeze’.
In smaller families, you’re less likely to have a

son by chance
Imagine you have five or six children: there’s a

very high chance that at least one of them will
be a boy. For five children, there’s around a
98% chance you’ll have a son. 91 Now imagine
you have only one or two children: the
likelihood you have a son is much smaller. If you
have only one child, you’re chances of having a
son are just over half (52%); if you have two
children, the odds are 77%. 92
In many countries across the world, this

transition happened: in India, average fertility
rates fell from almost 6 to 2 children per
woman; in China from over 6 down to 1.2
children; in South Korea from over 6 to just
under one child per woman. As countries got
richer; education levels increased; women
gained more rights to education labour
participation and healthcare decisions; fertility
rates fell rapidly.
But the result is that if you really want a son,

your chances of having one naturally are now
much lower. For parents of fewer children with
a strong son preference, a sex-selective
abortion becomes therefore a much more
important option.
Evidence from India
Seema Jayachandran (2017) tried to quantify

how much of the skew in sex ratio in India
might be attributed to the decline of the
fertility rate in the country. 93 In this
visualization we summarize results from this
research, through three charts:
Left chart: we see the percentage of

respondents of a survey in India who said
they would prefer a son when given a
hypothetical family size (number of
children) from one to five i.e. having only
one child; two children etc. 94 Here we
see that if they were having only one
child, more than 80% of both mothers
and fathers would prefer a son. This
preference rapidly declines when they
are asked about additional children; in
fact, in the scenarios in which parents
already have some sons parents
preferred to have daughters. 95 These
results suggest that parents have a very
strong preference to have a son if they
have a small family.
Middle chart: in red we see that the
desired fertility rate – the number of
children a woman desires to have – has
declined in India in recent decades. At
the same time, the child sex ratio – the
number of males per 100 females –
increased. The dashed line here shows
the estimated change in sex ratio which
results from falling fertility rates alone.
Right chart: the blue line shows how the
child sex ratio has increased over time.
Shown in grey is the estimated increase
in the sex ratio which can be attributed
solely to the decline in fertility rates.
Seema Jayachandran (2017) results suggest

that between one-third and one-half of the
change in sex ratio in India since 1981 can be
attributed to the decline in fertility rates. Or in
other words: If there had been no change in
fertility rates over time, there would still be a
skew in the sex ratio. But fertility declines have
had a significant impact on exacerbating son
preference.
Fertility impact on son preference
Development drives factors which

can both increase and decrease
gender preference
Disentangling a clear relationship between

development and changes in the sex ratio is
difficult because better education and rising
incomes can impact aspects of gender
selection in opposing ways.
The reason is that the skewed sex ratio not

only the result from the gender preference
alone, but crucially also the ability to act upon
it – by having a sex-selective abortion, for
example. Kashyap and Villavicencio (2016)
suggest that sex-selection practices result
from three conditions being met: 96
1. willingness to consider sex selection

because you have a gender preference;
2. ability to act upon it through access to

prenatal sex-determination screening
and abortion services;
3. readiness to act upon it to get the desired

sex preferences within the family.
How these three conditions change with

development, education, and rising incomes
can be in conflict. For example, research results
suggest that higher education of the parents
means a lower preference for a son. 97 But,
increased education is also associated with
falling fertility rates and this decline in fertility
(the ‘fertility squeeze’) increases son
preference, as we explored above. Education
therefore has two counteracting effects on the
sex ratio: education decreases the willingness
for gender preference, but increases
the readiness for influencing sex preferences
within the family.
Development also affects condition (2): the

ability to act upon gender preference. It is
often the case that richer, urban families have
greater access to technologies which would
allow for sex identification during pregnancy,
and also a safer abortion. Poorer families in
rural areas may not have this opportunity,
despite having strong son preference. As they
get richer, these opportunities may become
available to them.
Kashyap and Villavicencio (2017) tried to

model how the changes in willingness, ability,
and readiness all affect the change in sex ratio
in specific countries. 98 They found that even
very low levels of son preference can have a
significant impact on the sex ratio if sex-
selection technology diffuses steadily and
fertility declines quickly. This means that in
contexts where economic development is fast
– meaning fertility rates fall quickly and
prenatal screening technologies become
widely accessible – even very small levels of
son preference across a population can have a
significant impact on the overall sex ratio.
The relationship between development and

sex ratio is complex and non-linear: what’s
clear is that the issue does not quickly
disappear through economic development
alone.
Does banning prenatal

practices reduce sex-
selective abortion?
One of the three conditions for sex-selection is

the ability to act upon gender practices through
access to technology.
Prenatal sex selection (PSS) relies on two

technologies: prenatal sex determination (the
ability to determine the sex of a foetus during
pregnancy) and selective abortion.
This raises the question of whether policies

that aim to regulate prenatal sex
determination and abortion have an impact on
the prevalence of sex selection.
Several governments limited prenatal sex

selection through regulation when it became
clear that sex selection was common and
increasing. South Korea, China and India all
implemented sex-selective abortion bans.
Were they successful?
Much of the literature on the topic suggests

the bans alone were not effective enough to
address the problem. 99100
Looking at how the sex ratio at birth changed

pre- and post-ban in each country also does
not suggest that they were very effective.
South Korea enacted a ban on prenatal sex
identification in 1987/88. At this point the sex
ratio at birth was around 110 male per 100
female births – as we see in the chart here.
Following the introduction of the ban, the sex
ratio continued to increase – reaching over
115 males per 100 female births in 1990 and
maintaining a high ratio through the early
1990s.
For China the evidence is similar. in 1994 – as

part of its Law on Maternal and Infant Health
Care – China introduced a ban of prenatal sex
determination. As we see in this chart, the sex
ratio at birth continued to increase after the
introduction of the ban. In 1993 the ratio was
114 male per 100 female births; by the early
2000s this had increased to 118:100.
India introduced the Pre-Conception and Pre-

Natal Diagnostic Techniques Act (PNDT) in
1994 which prohibited sex selection practices,
including pre-screening to determine the sex of
a fetus. In the decade which followed the
introduction of the act, the sex ratio at birth
did not improve.
At first glance, this would suggest that the

banning of sex-selection practices was
unsuccessful. The sex ratio continued to
increase after their implementation.
Whilst researchers agree that bans alone were

not effective enough to stop the practice, many
acknowledge that we don’t know the
counterfactual scenario without a ban. 101
Without a ban the sex ratio might have
increased even further. Some studies have
argued that bans were effective in preventing a
worsening of gender imbalance, even if they
didn’t reduce it. 102
These policies may have had some impact on

reducing the increase, but they clearly did not
come close to ending the practice.
Definitions
Sex ratio at birth: the number of males born

per 100 females.
‘Expected’ sex ratio at birth: the expected sex

ratio at birth is not completely equal: under
ordinary circumstances we would expect there
to be slightly more boys born than girls. This
means that in all countries, births are male-
biased. The expected sex ratio is
approximately 105 boys born per 100 girls.
This is the ‘natural’ sex ratio reported by the
World Health Organization (WHO). There can
be some variability in this expected ratio,
ranging from around 102 to 107 boys per 100
girls. Having a male-biased sex ratio at birth
therefore doesn’t necessarily represent gender
discrimination, although much more skewed
ratios (above 107 boys per 100 girls) does
suggest the use of gender selection practices.
Prenatal sex selection: prenatal sex selection

practices are those which are used to
discriminate based on gender during a woman’s
pregnancy. This requires the use of prenatal
screening practices which can determine the
sex of the fetus – this is often referred to as
prenatal detection (PD). This is followed by
abortion in the case that it isn’t the desired sex.
Postnatal sex selection: postnatal sex

selection is the discrimination based on
gender after the child has been born. Postnatal
sex selection can occur either directly through
selective infanticide, or indirectly from the
premature death of girls due to maltreatment,
neglect or unequal treatment.
Infanticide: infanticide (or infant homicide) is

the intentional killing of infants.
Data Sources
World Bank
Data Source: World Bank – World

Development Indicators
Description of available measures:
Population female (% of total)
Sex ratio at birth
Child mortality, by sex
Time span: 1962-2017
Geographical coverage: Global, by
country
Link: http://data.worldbank.org/data-
catalog/world-development-indicators
Chao et al. (2019)
Data Source: Chao, F., Gerland, P., Cook,

A.R., Alkema, L. (2019). Systematic
assessment of the sex ratio at birth for all
countries and estimation of national
imbalances and regional reference levels.
PNAS.
Description of available measures:
Sex ratio at birth (modelled
estimates)
Time span: 1950-2017
Geographical coverage: Global, by
country
Link: https://www.pnas.org/content/earl
y/2019/04/09/1812593116
Endnotes
1. Pryzgoda, J., & Chrisler, J. C. (2000). Definitions of

gender and sex: The subtleties of meaning. Sex
Roles, 43(7-8), 553-569.
2. United Nations, Department of Economic and Social

Affairs, Population Division (2017). International
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P., Munné, S., Scholl, T., … & Zuckerman, J. E. (2015).
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112(16), E2102-E2111.
4. In the paper the authors differentiate between

‘karyotypically normal’ and ‘karyotypically abnormal’.
This refers to whether there are mutations in
chromosomes, such as an extra, missing or irregular
portion of chromosomal DNA. ‘karyotypically
abnormal’ embryos have a lower probability of
surviving to birth, or often lead to other human
diseases/conditions.
5. Jaitley, A. (2018). Economic Survey 2017-18: Volume I,

Chapter 7: Gender and Son Meta-Preference: Is
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and female infant mortality are more common in
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7. Manchanda, S., Saikia, B., Gupta, N., Chowdhary, S., &

Puliyel, J. M. (2011). Sex ratio at birth in India, its
relation to birth order, sex of previous children and
use of indigenous medicine. PLoS One, 6(6), e20097.
8. Jiang, Q., Yu, Q., Yang, S., & Sánchez-Barricarte, J. J.

(2017). Changes in sex ratio at birth in china: a
decomposition by birth order. Journal of Biosocial
Science, 49(6), 826-841.
9. Clarke, J., & Price, R. (1786). XVII. Observations on

some causes of the excess of the mortality of males
above that of females. By Joseph Clarke, MD
Physician to the Lying-in Hospital at Dublin.
Communicated by the Rev. Richard Price, DDFRS in a
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estimating sex differences in childhood mortality
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Tatter, D. (1971). Neonatal mortality, the male
disadvantage. Pediatrics, 48(6), 902-906.
13. This is also the explanation reported by the World

Health Organization: “Newborn girls have a biological
advantage in survival over newborn boys. They have
lesser vulnerability to perinatal conditions (including
birth trauma, intrauterine hypoxia and birth asphyxia,
prematurity, respiratory distress syndrome and neonatal
tetanus), congenital anomalies, and such infectious
diseases as intestinal infections and lower respiratory
infections.“
14. Peelen, M. J., Kazemier, B. M., Ravelli, A. C., De Groot,

C. J., Van Der Post, J. A., Mol, B. W., … & Kok, M.
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Rivera, L., Ancel, P. Y., Blondel, B., & Kaminski, M.
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in boys and girls born very prematurely. Pediatric
Research, 71(3), 305.
17. Hintz, S. R., Kendrick, D. E., Vohr, B. R., Poole, W. K.,

Higgins, R. D., & Nichd Neonatal Research Network.
(2006). Gender differences in neurodevelopmental
outcomes among extremely preterm, extremely-low-
birthweight infants. Acta Paediatrica, 95(10), 1239-
1248.
18. Jones, M., Castile, R., Davis, S., Kisling, J., Filbrun, D.,
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19. Hoo, A. F., Henschen, M., Dezateux, C., Costeloe, K., &
Stocks, J. (1998). Respiratory function among
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Care Medicine, 158(3), 700-705.
20. Fleisher, B., Kulovich, M. V., Hallman, M. I. K. K. O., &

Gluck, L. O. U. I. S. (1985). Lung profile: sex
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21. Peacock, J. L., Marston, L., Marlow, N., Calvert, S. A., &
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in boys and girls born very prematurely. Pediatric
Research, 71(3), 305.
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gestational foundation of sex differences in
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Hussain, N. (2017). Gender differences in respiratory
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Grubeck-Loebenstein, B. (2015). How sex and age
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(2015). Sex differences in immune responses to
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Systematic assessment of the sex ratio at birth for all
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31. Note that this does not imply that other countries do
not have male preference or some evidence of a
skewed sex ratio. Results of the Chao et al. (2019)
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evidence of this imbalance.
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35. Lin, M. J., & Luoh, M. C. (2008). Can hepatitis B

mothers account for the number of missing women?
Evidence from three million newborns in Taiwan.
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36. Monica Das Gupta, Can Biological Factors Like

Hepatitis B Explain the Bulk of Gender Imbalance in
China? A Review of the Evidence, The World Bank
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38. Sharma, B. R., Gupta, N., & Relhan, N. (2007). Misuse

of prenatal diagnostic technology for sex-selected
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49. This of course introduces uncertainty as to how good

an analogue modern hunter-gatherers are to
prehistoric societies. Modern hunter-gatherer
societies may have some contact and transfer with
external influence. As a result, researchers often
focus on societies with as little external influence as
possible, for example having no nutritional, health,
sanitation or technology transfer.
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adult mortality among Hiwi hunter-gatherers:
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the middle and upper palaeolithic: Inferences based
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Life: The Stain of Human Infanticide. Lanham/New
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57. Hughes, A. L. (1981). Female infanticide: Sex ratio

manipulation in humans. Ethology and Sociobiology,
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58. Kellum, B. A. (1974). Infanticide in England in the

later Middle Ages. The Journal of Psychohistory, 1(3),
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59. Hughes, A. L. (1981). Female infanticide: Sex ratio

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Historical Reflections/Réflexions Historiques, 163-177.
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Gendered effects of siblings on child malnutrition in
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India? Longitudinal evidence on dietary diversity and
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consequences of son preference and sex-selective
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consequences of son preference and sex-selective
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153-187.
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82. Hesketh, T. (2011). Selecting sex: The effect of

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association between uneven sex ratios and violence:
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preferring sons. Early Human Development, 87(11),
759-761.
88. Filmer, D., Friedman, J., & Schady, N. (2008).

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91. To calculate this, we need to calculate the probability

that in having 5 children, we have five girls. Because
the ‘natural’ sex ratio at birth is around 105 boys per
100 girls, the probability of having a girl at each birth
is slightly lower than half: it’s around 47.6%. To
calculate the probability of having 5 girls, we then do
0.476^5 = 0.0245 [or 2.45%]. The probability that
you have at least one boy is therefore 100% – 2.45%
= 97.6%.
92. Since the ‘natural’ sex ratio at birth is around 105

boys per 100 girls, the odds of having a boy are
slightly higher than having a girl: 52%. To calculate
the odds of having a boy when you have two children,
we start by calculating the probability of having two
girls. The probability of having a girl at each birth is
47.6% [100/105 * 100]. The probability of two births
producing two girls is then calculated as 0.476^2 =
0.227 [22.7%]. The odds that one is a boy is therefore
100% – 22.7% = 77%.
93. Jayachandran, S. (2017). Fertility decline and missing

women. American Economic Journal: Applied Economics,
9(1), 118-39.
94. The survey was actually posed to mothers and

fathers of what they would want for their own
children (who were all in secondary school at the time
of the of survey). Asking it of a future hypothetical
scenario helps to avoid hindsight bias.
95. The reason for a switch to daughters is not totally

clear. It’s suggested having daughters within larger
families is preferred to provide care for others in the
family and the household. It may also be the case that
a larger number of sons creates tension and conflict
with regards to resource allocation.
96. Kashyap, R., & Villavicencio, F. (2016). The dynamics

of son preference, technology diffusion, and fertility
decline underlying distorted sex ratios at birth: A
simulation approach. Demography, 53(5), 1261-1281.
97. Jayachandran, S. (2017). Fertility decline and missing

women. American Economic Journal: Applied Economics,
9(1), 118-39.
98. Kashyap, R., & Villavicencio, F. (2016). The dynamics

of son preference, technology diffusion, and fertility
decline underlying distorted sex ratios at birth: A
simulation approach. Demography, 53(5), 1261-1281.
99. Gupta, M. D. (2016). Is banning sex-selection the best

approach for reducing prenatal discrimination?. In
Population Association of America meeting, Washington
DC.
100. Subramanian, S. V., & Selvaraj, S. (2009). Social

analysis of sex imbalance in India: before and after
the implementation of the Pre-Natal Diagnostic
Techniques (PNDT) Act. Journal of Epidemiology &
Community Health, 63(3), 245-252.
101. Gupta, M. D. (2016). Is banning sex-selection the best

approach for reducing prenatal discrimination?. In
Population Association of America meeting, Washington
DC.
102. Nandi, A., & Deolalikar, A. B. (2013). Does a legal ban

on sex-selective abortions improve child sex ratios?
Evidence from a policy change in India. Journal of
Development Economics, 103, 216-228.
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The ratio between the number of males and

In this entry we provide an overview of the

Many argue persuasively that the terms

In this context here we have however decided

In some countries, the sex ratio

In countries where there is a

In nearly every country, boys

In countries where there is

The sex ratio tends to

It’s estimated that today there

The banning of sex

Development can have

What share of the population is male and female?

What share of the

The sex ratio – the share of the population that

There are three reasons why the sex ratio of

differences in mortality rates and life

The magnitude and balance of these factors

In the map we see the sex ratio of populations:

Most countries have a female share of the

There are however a few notable outliers:

across several countries in South and

Click to open interactive version

How does the sex ratio at birth vary across the

How does the sex ratio at

Across the world there are differences in the

In the map we see the differences in sex ratio

The first striking point is that in every single

Does this mean every country selects for boys

In the absence of selective abortion practices,

Click to open interactive version

Why are births naturally expected to

For most countries, there are around 105

In the most comprehensive study of its kind,

This produced the largest dataset available on

A key result from this study was that the sex

The study found that although the probability

there is a higher probability that an

Overall, a male-biased sex ratio at birth is the

In some countries the sex ratio is

Some male-bias in births is what we expect

The sex ratio varies with

Most countries have a sex ratio at birth which

The preference in some countries for a son is

In this visualization we look at the case of India

when the child is not the last child born

Let’s first focus on the top row, which presents

Compare this to the right-hand side where we

Combined we see a strong preference for a son

Now compare these ratios to that of Indonesia

In the third row we see that within India there

Sex ratio at birth by order

Sex selection practices also became

From the study presented above we see that

But birth order also influences the likelihood of

Researchers looked at Indian national survey