Canada's lost daughters

Western Standard Magazine
Andrea Mrozek - Monday, 5 June 2006


Heather Stilwell noticed something strange was going on in her hometown of Surrey, B.C. A school trustee for Surrey District No. 36 for 12 years now, one of Stilwell's personal causes has been to promote literacy among kids. On her own time and her own dime, she sews bookbags for kindergartners, using wholesale or donated fabric, and stuffs them with books. The girls like Wemberley Worried, tales of an apprehensive mouse. The boys, usually anything to do with dinosaurs. She estimates she's given out about 5,000 of these gifts since she started.

In recent years, Stilwell realized that she'd been having to make more and more of the plaid or striped bags she gives out to the boys, and fewer of the pink floral bags for the girls. More dinosaur books, fewer Wemberleys. She can't put her finger on why, but the boy-girl ratio seems to be increasingly out of whack. "The numbers look pretty skewed to me," she says. She's sure of one thing: "[There're] more boys."

As it turns out, Stilwell is right. According to data analysis by the Western Standard, Surrey is just one part of the country that exhibits a significant deviation in the standard boy-girl ratio. Further evidence obtained by this magazine, including interviews with doctors and clinic workers, suggests a plausible reason why: sex-selection abortions. Canadians are deliberately terminating pregnancies where a girl is expected, in hopes of having boys.

It's a practice that's common in certain countries and cultures, but it's never been reported on, or even publicly considered an issue, here. In China, the one-child policy in place since 1979 has highlighted the cultural sexism there, as millions of parents are careful to ensure that their one permitted child is male. The result: in China there're now an estimated 80 women for every 100 men. "In world history, there has never been a bride shortage as large as is about to hit China," predicted Valerie Hudson, a political scientist at Utah's Brigham Young University, and co-author of Bare Branches : The Security Implications of Asia's Surplus Male Population. In January, the British medical journal, The Lancet, published a study that revealed an alarming trend in patriarchal India, where many parents prefer to have boys: since the popularization of ultrasound technology 20 years ago, allowing parents to know the gender of a fetus, the boy-girl ratio in that country has swung dramatically in the wake of the widespread and mass termination of female fetuses--from 96 girls born for every 100 boys in 1981, to just 93 girls in 2001. The authors calculated that means that roughly half-a-million girls are aborted every year, creating a deficit of at least 10 million girls in that country. So far.

Authorities in those countries are working to discourage, and even prohibit the widespread practice of sex selection. In March, an Indian doctor was the first to be jailed under new laws for revealing the sex of a fetus's gender, and in the Gujarat state of India in February, 45 couples marrying in a mass wedding ceremony, publicly vowed never to seek out sonography scans to determine the sex of their children in advance. The Chinese government, meanwhile, has begun paying cash bonuses to families who have girls. Here at home, however, documents obtained by the Western Standard show that some Asian immigrants are not only bringing the practice here with them, but that Canadian clinics are accommodating it. One front-line clinic worker, who requested anonymity, explains that it's not her job to question anyone's motives for getting an abortion. "If people want it, we'll do it," she says.

Another clinician in B.C. estimates she sees women wanting to abort unwanted female fetuses, motivated by gender preference, at a rate of one a week--though it's an extremely rough guess, since women don't always get into their reasons for choosing to have the procedure. Nor has anyone in Canada ever compiled data that measure live male births against live female births in this country, to ascertain any deviance from the norm of 1.05 boys to every girl. Until now.

Extrapolation from Statistics Canada census data reveals that in several areas highly populated by immigrants from India and China, the gender ratios are often as out of proportion as they are in Gujarat. Boys and girls aren't supposed to be born with equal frequency, of course. Mother Nature accounts for the higher male mortality rate by producing, under normal circumstances, 105 boys for every 100 girls. But in Surrey, where Heather Stilwell noticed she was handing out more dinosaur books and fewer pink bookbags, and where the total population of nearly 350,000 includes 114,725 immigrants--35,380, or nearly a third, of whom are from India--the number is dramatically different. In 2003, instead of 105 boys to every girl, there were 109. In 2000, it was nearly 111, in 1999, 107, and in 1998, 110.

In Coquitlam, B.C., where Chinese immigrants currently make up 12 per cent of the population, for every 100 girls born in 2003, there were 112 boys. In 2001, it was 109, and in 2000, there was a startling 16 per cent gap--116 boys to 100 girls. In 1998, it was 115 boys. It's the same story in Richmond, B.C. In the city of 164,345, roughly 64,270 people arrived via China or Hong Kong. There, it was 112 baby boys to every 100 girls in 2003. In 2000, the ratio was 111 to 100. In 1997, 114 to 100.

In areas around Toronto boasting large clusters of arrivals from India and China, the numbers are every bit as aberrant. In north Etobicoke, where the population is made up of large numbers of Indian immigrants, the 2001 boy-to-girl ratio for kids under age 4 was 110 to 100. In heavily Sikh areas of Brampton, parents had 109 boys to every 100 girls. In the neighbourhood encompassing Toronto's eastern Chinatown, 108 boys to 100 girls. In southern Scarborough, where large numbers of Indian immigrants have settled, it was 107 boys to 100 girls.

Compared to other areas of Canada, the deviation is as obvious as it is sobering. To put all of it into perspective, since the communities mentioned above have seen hundreds of thousands of live births in the last decade, the number of missing daughters may be somewhere in the thousands.

Taken on their own, the statistics are too spotty and limited to confidently make the sort of firm conclusions drawn from the more in-depth Indian study, cautions Mukesh Eswaran, an economics professor at the University of British Columbia. He'd prefer larger sample sizes than, for example, the 1,108 live births recorded in 2003 in Coquitlam, and points out that it's hard to rule out other contributing factors--for instance, recent studies show that women infected with Hepatitis B (a common virus in the Indian subcontinent) often bear more sons. "Even if you do find that the deviation from the norm of the sex ratio in a region is statistically significant, you cannot immediately conclude that it is due to sex-selective abortion--unless you have direct evidence of this," Eswaran says.

And direct evidence does exist, though you'll not find it in statistics--primarily because Canadian governments are not equipped, or even prepared, to disclose their birth information. In 2001, the B.C. government passed Bill 21, a law that tightly restricts public access to abortion data. One abortion technician in that province explains that sex-selection statistics are kept, but are off-limits even to most of the staff. "The statistics on sex-selection abortions at one Canadian hospital are kept in a password-protected database," says the source, who asked not to be named, fearing career repercussions for speaking publicly about the controversial procedure. While "the reason for the abortion is not recorded, per se," she says, the typical scenario is the "sudden involvement of a husband after a trip to a gender-determination ultrasound," and where no apparent genetic anomaly has been diagnosed in the fetus.

An internal document obtained by the Western Standard from the Women's Hospital in Vancouver leaves no question that sex-selection abortions are not only practised here, they are accommodated. A Care Clinic presentation, from Feb. 9 of this year, was designed to aid health care workers confronted with "implicit or even express requests for sex selection." The document opens with the assurance that, "Most of us are uncomfortable with the idea of sex selection," one of the reasons being that the procedures "violate the principle of equality between males and females." Still, the document manages to reason through the drawbacks, adding that "not allowing sex selection causes increased harm to women who must endure repeated pregnancies in efforts to have a son," and "it is unclear if banning sex selection will benefit women." One case study offered for consideration is "Mary," who already has four boys, and who "during her routine 18 week ultrasound was told she is carrying another boy. She would like to terminate the pregnancy and try one more time for a girl."

As the Women's Hospital document confirms, sex selection is not an unfamiliar procedure in Canada. One doctor recalls attending a lecture, while a member of the University of British Columbia's 2005 medical school class, given by Dr. Garson Romalis, a Vancouver obstetrician (Romalis, who on two separate occasions has been shot and stabbed by anti-abortion activists, did not respond to repeated interview requests). "He said that actually he does do it, although some [doctors] don't," the student says. "And his reason was, and I'm paraphrasing, not quoting, him, that usually it is people from different cultures than his own and he feels it would be insulting to their culture if he said he wouldn't do it." He said, "even if he totally doesn't understand their way of thinking, it is a cultural thing, so he feels obliged to do that for them."

Public opinion, it would seem, is firmly against the practice of aborting female fetuses simply for reasons of gender. Canada's Royal Commission on New Reproductive Technologies released a report in 1993 showing 90 per cent of Canadians were uncomfortable with sex-selection abortions (of either gender). But pro-choice groups are similarly uncomfortable with the idea that society might deem there are any "wrong" reasons for terminating a pregnancy. Joyce Arthur, spokeswoman for the pro-choice Abortion Rights Coalition of Canada established last fall, says that abortion is a woman's choice alone, and should remain so. ARC has even issued a position paper on sex selection that makes its support for the practice clear. "Being pro-choice means supporting a woman's right to decide whether or not to continue a pregnancy for whatever reason, even if one personally does not agree with her reason," the paper reads. The group suggests that those offended by the practice should place blame on the societal norms that motivate couples to abort female fetuses for want of a boy. "The root issue is the value and respect--or lack of value and respect--that society and certain cultures give to girls and women," explains the position paper. "The answer lies in education and raising the status of girls and women over the long-term, not in restricting abortion."

In Canada, the law makes no distinction between those seeking to terminate a pregnancy because the fetus has been diagnosed with a genetic disorder, or even because it's a product of rape, and those seeking to select the sex of their fetus. Nor is sex selection the only rationale for aborting that's liable to offend a good number of Canadians. "My sister-in-law had an abortion because the baby was conceived in an inauspicious month," says one Indo-Canadian now living in Toronto, referring to the belief among some East Indians that certain months are more sacred than others. "They concealed it from their in-laws and had an abortion instead," she says. And if you think these sorts of things are exclusively the result of foreign cultural norms, think again: the UBC student from Dr. Garson Romalis's class remembers the doctor sharing the story of one woman who wanted to have an abortion because her pregnancy would have interfered with a planned beach vacation in Hawaii.

Still, on a political level, selecting the sex of a fetus is considered objectionable enough that Ottawa has banned the practice when it comes to test-tube babies. In March 2004, when Parliament passed the Act on Assisted Human Reproduction--aimed at regulating emerging reproductive technologies, including in vitro fertilization, stem-cell research and cloning--it specifically outlawed the ability for couples undergoing in vitro fertilization to choose the sex of the implanted embryo. The only exception allowed: "to prevent, diagnose or treat a sex-linked disorder or disease." The punishments for violating that rule are not light, with a maximum sentence of 10 years in prison and/or a maximum $500,000 fine. Once the resultant fetus is a few weeks old, however, sex selection becomes entirely legal and the couple is free to abort if it doesn't like the gender. "This act doesn't really cover that because it looks at in vitro fertilization, egg and sperm donations and all of those issues, tampering with embryos, stuff like that," notes Carole Saindon, a media relations officer for Health Canada.

Besides, any attempt to get sex-selective abortions, specifically, banned would have questionable chance of succeeding anyway. "I can find out [the baby's sex] in one place and go elsewhere for an abortion," noted Shree Mulay in 1996, a McGill professor and former co-chair of the reproductive technologies committee of the National Action Committee on the Status of Women, Canada's largest women's group.

Ninu Kang is a counsellor at Mosaic, a Vancouver-based non-profit organization that operates outreach centres for immigrants to help them integrate into Canadian society. As a woman of East Indian descent, she identifies with women who experience depression when they're not respected in the home because they've borne only daughters. "I'm also a South Asian woman and I know of pressures on women about having a boy and, certainly, sort of saying you know, 'we don't mind having a girl, as long as we have a boy as well.'"

The 2004 Canadian film Pink Ludoos tackled the issue head-on. Though actually a romantic comedy set in the Vancouver area, writer Belle Mott, an Indo-Canadian, didn't shy away from some rather heavy issues: cultural discrimination against women in the Indo-Canadian community, as well as sex-selection abortion. (Ludoos are a golden-yellow pastry East Indians serve in celebration of the birth a boy. The pink ludoos in the title are a play on the fact that no such desserts are served for girls.) "I wanted to have that in there," says Mott, of the matter of sex-selective abortions, "because it is part of what is happening. As we grow in technology, we also grow in these options, and we have to question the ethics of it as well."

There's certainly no getting around the fact that the ethics of the issue pose a special challenge, especially for Canadian feminists. For one thing, sex-selective abortions represent a manifestation of the worst kind of chauvinism--the wish to keep women out of the world in favour of more men. But the practice even threatens the women's movement more directly, simply because fewer females born means a thinning of the ranks. The irony isn't lost on pro-lifers, such as Joanne McGarry, executive director of the Catholic Civil Rights League. "The National Action Committee on the Status of Women must have a heck of a time with this one," she says. "All that successful lobbying on the slogan 'the issue is choice,' only to discover that for some, the choice is to eliminate the girls."

While there's sufficient evidence to prove that sex-selection abortion is a standard practice in Canada, getting a handle on the extent of the practice is much more difficult. Dr. Prabhat Jha, the Canada research chair of health and development at the University of Toronto, was one of the lead authors on the study published in The Lancet earlier this year, which reported the astonishing gap between female and male live births in India. In his case, he says he was working directly in collaboration with the Indian government as part of a larger study of health, and had access to a great deal of data. "We were struck by the findings from the 2001 census, which showed that the number of females to males in the population, particularly in age zero to six, was becoming quite different," Jha says. In addition to being able to measure absolute numbers of males against females, Jha had access to statistics showing how ratios were affected when children were born second, or third, to families that had no male children. Graphing that data, for instance, showed that in the case of families with one existing daughter, there was a 30 per cent drop in the number of females in second-born children. "The only plausible explanation for that is use of ultrasound and selective abortion," Jha says.

That kind of very specific data is simply unavailable in Canada. The statistics exist, but have never been compiled, says Russell Wilkins, an analyst with the Health Analysis and Measurement Group at Statistics Canada. "We have all the births, and we have the sex and we have the mothers, but one would have to actually do a data linkage and link births to the same mother," he says. No one ever has, and, he adds, for anyone who tried, it would be "a couple of years down the line before you get results." The number crunching itself isn't the problem, notes Wilkins. It's navigating the various bureaucracies that would be necessary to get permission to actually link the data. "A data linkage at Statistics Canada is a very involved process--getting permission--it is very tightly controlled," he says. "It's not so much the time to do the work, it's the time to justify it." Wilkins suggested that it might be possible to get the data from provincial governments, who keep birth records, too. But several access to information requests filed by the Western Standard were unsuccessful. "The gender and birth order of siblings is not collected. I am therefore informing you that access cannot be provided," responded the access and privacy co-ordinator for Ontario's Ministry of Government Services. Alberta acknowledged receipt of the request, but failed to address its feasibility or provide any estimate of timing or cost in advance of their own self-appointed deadline. B.C. estimated the cost would be roughly $40,000 to get provincewide data, but could not guarantee that the result would even deliver the appropriate statistics.

In fact, when it comes to releasing any sort of information about abortion practices in Canada, governments are extremely cautious--and surely cognizant of the political hornets' nest that would result. What we do know is that the number of pregnancies terminated in this country annually surpasses the number of breast cancer diagnoses by five to one, but the issue remains arguably the hottest of political potatoes--even when broached innocuously. It's hard to forget the disaster that followed when then Conservative health critic Rob Merrifield suggested, in the midst of the 2004 election, that he thought women seeking abortions might benefit from counselling beforehand. Toronto's Globe and Mail ran away with the story, strongly implying new abortion rules were Conservative party policy. The ensuing storm helped reverse a slide in Liberal poll numbers, allowing them to regain the lead against the Tories.

Still, some pro-choice groups seem increasingly nervous about the possibility that liberal Canadian attitudes toward abortion might one day shift. Last June, the prominent Canadian feminist Judy Rebick, former president of the National Action Committee on the Status of Women, was touring Canada promoting her book, Ten Thousand Roses: The Making of a Feminist Revolution. At a stop in Calgary, Rebick cautioned her audience that the consequence of liberal abortion laws has been a dearth of fresh and unpleasant stories about women's experiences with unwanted pregnancies, giving the pro-life side of the argument the monopoly on emotional appeals. "If people don't have their own experience with what is an unwanted pregnancy . . . the stories of the anti-choice are more powerful to people," Rebick acknowledged. Any suggestion that abortions have become a method of sexist social engineering won't help. In fact, notes Margaret Somerville, a founding director of McGill University's Centre for Medicine, Ethics and Law, the Lancet study of India managed to reawaken certain dormant elements of the abortion debate. The Lancet, she notes, tellingly referred to the mass abortions of females as "feticide," a term not normally employed in the medical community as a euphemism for abortion. "Why is it only 'feticide' if it is only girls who are being killed?" Somerville asks.

Yet, there's plainly something about the idea of a woman having an abortion, not because she doesn't want to be pregnant, but because she doesn't want to be pregnant with a girl, that makes even liberal pro-choicers uneasy. One abortion counsellor, who identifies herself as staunchly pro-choice, admits that when she's dealing with a woman who wants to terminate her pregnancy for reasons of sex selection, she tries to persuade them not to. "I tell them, your little girl could be the one who could make a difference for your community," says the counsellor. "That little girl could be the best thing that could happen to you." She doesn't say how often, if ever, she's able to change anyone's mind.

--With files from Sean Ollech

WHEN THERE ARE TOO MANY MEN

What would you ever do without us?" That's a question many women regularly ask of the men in their lives. But in some countries it's not hypothetical. The widespread practice of sex-selective abortions has China and India both grappling with a substantially distorted population ratio. Women are missing in the millions.

Even slight deviations from natural male-to-female ratios can have severe public health implications, says Dr. Prabhat Jha, the University of Toronto professor who's helping compile the world's largest public-health study in India. That's the same study that estimated half-a-million female fetuses are being aborted every year in India, and Jha predicts all those missing girls will pose big problems down the road. "Issues around the status of women can be affected," he says. "Even, potentially, HIV could spread more because you just have fewer females to marry and therefore males may resort to risky sex, like gay sex or the like," says Jha.

Women may find an overwhelmingly man's world to be a more hostile environment, theorizes Harvey Skinner, the public-health sciences chairman at the University of Toronto. "Women tend to have a more moderating effect," he says. "So it could lead to more abuse. More violence . . . . That's a concern." And as women become increasingly sought after, Skinner predicts a higher mental-stress level. "It could increase the pressure on young girls," he says.

Some scholars predict global unrest will follow. In their 2004 book Bare Branches: Security Implications of Asia's Surplus Male Population, Valerie M. Hudson and Andrea M. den Boer warn that millions of men unable to find mates will create high levels of crime and social disorder. China and India will likely be motivated to build up their armies to channel all those aggressive energies.

But India's not waiting to find out what happens. They've banned gender-determining ultrasounds (though that's difficult to enforce). And, says Jha, "in some districts in Punjab, in households that only have two female children, the government provides a cash incentive" for mothers who bear girls. In China, some parents are also rewarded with cash for having daughters. Of course, if it weren't for Beijing's one-child limit (still enforced in some regions), as individualist feminist scholar Wendy McElroy has noted, the imbalance probably wouldn't be so severe in the first place. Still, it's impossible not to hope that Beijing's communist government proves as effective in fixing the problem as it was in creating it in the first place.

--Andrea Mrozek

SAFETY IN NUMBERS: HOW SOLID ARE THE STATISTICS

Lies, damn lies and statistics. That was Mark Twain's catalogue of untruths. But what about polling? Take, as an example, the widely reported May 11 SES poll that measured the Conservative party's climbing popularity against the Liberals. It's "accurate to within 3.2 percentage points, plus or minus, 19 times out of 20." Does that mean it's accurate or not? And what about the birth statistics analyzed by the Western Standard? Since the data was culled from the federal census, we're also dealing with poll results. Is our report accurate?

Let's start with the SES poll. The first number is the margin of error in the popularity numbers--they could be 3.2 per cent higher, or lower, than the poll's estimate. The more people polled, the smaller the margin. The second number, the standard deviation, reflects the probability that a data point could be there by chance. One time out of 20, the SES will produce a poll that's a blooper. Picture a bell curve, with all the results of a survey indicated by points along the bottom. If the average (the mean) is the line in the middle of the bell, then the numbers closest to the average (within one standard deviation) are part of the biggest chunk of the bell, meaning they have a greater chance of being entirely random. The points out on either end of the curve, far away from the middle, where the bell shape is at its smallest, are less likely to be the result of chance.

So, when it comes to analyzing the data of male-to-female births, the number of total births within the measured communities happen to be in the thousands--that's the sample size. Therefore, the margin of error in the 2001 census is no greater than 0.06 per cent for the smallest sample. That's miles better than you'll find with most polls.

As for the chance that the aberrant boy-girl ratios occurred randomly--as reflected by the standard deviation--that's extremely unlikely. In Coquitlam, B.C., where the boy to girl ratio in 2003 was 112 boys for every 100 girls (expressed as 1.12), the point is three standard deviations from the average. So, the probability that this statistic occurred by chance is less than 0.1 per cent. In B.C., there was also a cluster of four communities--Surrey, Abbotsford, North Vancouver and Richmond--that, in 2001, all showed 107 boys to 100 girls. While there is a one in three chance that one of those four points occurred randomly, the chance that they are all random is 1.2 per cent. Statistically speaking, there's no such thing as a perfectly accurate poll. But these statistics are pretty darn close.

--Sean Ollech