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Asia’s Missing Millions: How Policy and Social Pressure Made Millions of Women Disappear

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In 1990, Nobel Prize-winning Indian economist Amartya Sen noticed something remarkable. By his count, there were approximately 100 million “missing women” in Asia. They hadn’t been kidnapped or stolen or died as the victims of a female-specific plague or war . . . Yet a population equivalent to every single girl and woman in the United Kingdom, France, and Italy was missing. Using records collected by governments, Sen observed that relative to the number of men, there were far too few women. He estimated that 100 million girls who should have been born, and grown into women, had simply never existed.1

The number of men compared to the number of women, baby boys relative to baby girls, is called the gender sex ratio. It is measured at two intervals: recorded live births and the number of men and women across the population. Using both measurements is significant for observing trends in population health, family structure, and demographic planning. In most of the world, the number of women is slightly higher than the number of men—about ninety-eight men to every 100 women, mostly attributed to women’s slightly longer average life span. In Asia, however, there are 106 men for every 100 women. The difference in number grows even more extreme among those born after 1985. In China, a study of more than five million births between 2012 and 2015 showed that 110 boys were being  born for every 100 girls.2 In 2011, the Indian state of Haryana recorded 120 boys born for every 100 girls. Societies with dramatically unequal birth sex ratios can suffer a variety of problems, such as a lack of stable families, “bride kidnapping” of unwilling women, large numbers of unmarried men leaving the country to find wives, and an even higher rate of violence against women and girls.3 The dramatic differences reported across Asia are not an accident of biology, but evidence of a widespread pattern toward “son bias” or “son preference.” The amount of preference families have toward sons instead of daughters is one of the metrics used to measure discrimination against women used by the Organization for Economic Development and Co-operation (OECD) on their Social Institutions and Gender Index (SIGI).

The SIGI, the OECD’s analytical tool, uses complex statistical analysis to compare if women are treated fairly by comparison with men, country by country. Gender equality is sometimes only thought of as concerning basic rights: women’s right to vote or girls’ right to attend school as boys do. While these are vital human rights and far from a given in much of the world, they do not capture the whole picture of women’s social status. To get a better global picture of women’s equality, the SIGI uses a variety of analytical lenses and tools. Some of the tools they use assess the law toward women across the whole society: Do women have the same civil liberties as men, for instance, to speak freely without fear of persecution? Do women have the same physical integrity, for instance, to walk freely without fear of assault? In many countries, the answer is no; even in unstable contexts, when human rights are not guaranteed to anyone, the rights of women are comparatively limited in the public sphere.

Infographic from the United Nations Development Programme on the Understanding Modern China website at

The other tools the SIGI uses measure gender equality in the home: Is the family code discriminatory, awarding inheritance only to male heirs and allowing only men to head households? Are women capable of  holding the same financial and property assets under the eyes of the law and common practice?

The SIGI describes son bias as unequal intrahousehold investments in caring for, nurturing, and allocating resources to sons and daughters reflecting the lower value given to girls. A family preference for sons over daughters can manifest itself in different ways, including higher mortality, worse health status, or lower educational attainment among girls.4

While families around the world joke about preferring a boy or a girl, the prominence of son bias in Asia is evidence of a bleak tendency to deprive baby girls of the necessities of life. When women are perceived as lesser to men, families apply a crude cost-benefit analysis to their newborn infants. Is it worth it to feed the baby an extra mouthful or take the baby to the doctor if that food or money could be more usefully spent on her brother? Is it worth it to send a girl to school if women are perceived as less intelligent, capable, or able to ultimately work
in a socially valued job? Families engaged in this type of thinking are performing a simple version of an economic assessment calleda cost-benefit analysis. They observe the costs of feeding, schooling, and raising children; they observe benefits, like family wealth. In their analyses, boys offer a higher benefit relative to their cost, so they are preferred.

Roadside sign in Danshan Township, China, reads, “It is forbidden to discriminate against, mistreat, or abandon baby girls.” Source: Wikimedia Commons website at Photographed in September 2005 by David Cowhig.

For centuries, unwanted female children were treated more poorly than their brothers in times of plenty and plainly rejected in times of famine. Boys were needed for farm labor and to carry on family names; through marriage, they would acquire a wife who would join their family, meaning the parents could always rely on their sons. Conversely, girls would be taken by marriage away from their own families and could not serve their parents in old age. In the worst circumstances, baby girls were ritually killed or left to die of exposure. The cost and effort to raise them was perceived as disproportionate to the benefits a girl (and later, woman) could confer upon a family. Deliberate infanticide of female infants is mercifully in decline in many places.

However, despite this trend, Asia’s total female live births began to significantly decline after 1985. This drop-off did not reflect a change in attitudes, but a change in technology: the ultrasound machine. A vital tool for maternal health, the ultrasound can be used to detect birth defects and problems with the fetus, allowing doctors to intervene early to save the lives of mother and child alike. As Asia, particularly China, began to rapidly develop in the 1970s and 1980s, health care access improved for millions of people, including expectant mothers. However, the ultrasound machine offered an “opportunity” to families with strong son bias—they could observe the fetus’s sex before it was born. If the fetus were male, the pregnancy could continue; if the fetus were female, and therefore less desirable or even undesirable, it could be aborted. This spared families the medical risks of labor and delivery, as well as the legal risks of infanticide, while still ensuring that sons would be born. Family structure as desired could be maintained.

It might be tempting to assume that because son preference is common across Asia, the patterns of missing women might be similar across countries—more missing women in rural regions, for instance, or more missing women in major cities. In fact, the patterns of missing women in India and China are opposites. In China, rural areas are missing many more women than men, and poorer families tend to have fewer daughters.5 Urban Chinese families, who do not have farms in need of labor, are more likely to accept daughters, and this likelihood increases as families become richer. Conversely, in India, richer, urban, and highly educated demographics have more missing women.6 Wealthier families appreciate that they would be investing significant resources into their children—not simply food and care, but payment for high-quality education in the hopes of professional success.

The reasons for the birth sex disparity are also different. In China, they are likely the result of the law, whereas elsewhere in Asia, they were not influenced by overarching laws or policies, but predominantly by social attitudes.

In China, the rise of sex-selective abortion coincided with the emergence of the One Child Policy. Designed to manage the rapidly growing population, the 1979 policy only allowed the typical Chinese family—not of an ethnic minority or families where the father was a disabled veteran—to have a single child. The birth of additional children would cause families to be subject to significant fines. After giving birth in a hospital for the first time, Chinese mothers would be fitted with an intrauterine device, or IUD, a permanent contraceptive that prevented further pregnancy. After having their second child, mothers would be permanently sterilized through a procedure called tubal ligation. More than 400 million Chinese mothers endured these procedures, many against their will—noncompliance to the compulsory sterilization could be met with loss of their jobs or removal of their children from school.7 Suddenly, son preference went from being a question of resource allocation to a matter of urgency: if they were only allowed to have a single child, that child would have to be a boy. By the time policy was revised to a Two Child Policy, and repealed in 2015, more than eighty million Chinese girls had been selectively aborted.

The Chinese case is unusual, however. In India, no law prevents families from having as many children as they please, even though government messaging began to encourage family planning in the mid- to late-twentiethth century. Yet in some Indian states, particularly the wealthier ones with better access to maternal health care like Punjab, Kashmir, and the previously mentioned Haryana, sex ratios are just as skewed as in China. No law has controlled birth rates in Pakistan, but the country is estimated by some to have the highest percentage of missing women relative to its total population. Its son bias is measured at 0.669 by the SIGI—one of the highest in the world.8

Shyam Sundar Paliwal swore that each time a girl child was born in the village, the community would plant 111 fruit trees in her honor. Shyam Sundar Paliwal (center in white) surrounded with women and girls from the village of Piplantri. Source: CJ website at


Both India’s and Pakistan’s missing women represent a significant policy issue. Sometimes, like in the case of One Child, a government policy has one intended outcome, but unintentionally causes another with negative implications, or in economic terms, a “negative externality.” The Chinese government’s intent was to reduce the birth rate and control the growing population, but it had intended for the population to still be balanced male-female. To correct the problem, or at least to mitigate it, the solution the government (eventually) undertook was to amend the policy. In India and Pakistan, there is no policy that controls the birth rate, but the problem is nevertheless severe. Their birth sex ratio problems are not the result of a law or policy. However, the problem could potentially be corrected by a policy.

To date, there is no policy that has been implemented on a wide scale, but there is evidence to suggest that changing incentives can help deter sex-selective abortion and correct the birth sex ratio. As mentioned earlier, many communities place less value on their daughters, partly for social reasons and partly for financial ones. However, novel “girl-valuing” incentives are being developed to change the perception of girls. In the village of Piplantri, in the Indian state of Rajasthan, villagers took strides to increase the value of the girl child in the eyes of both her parents and the community. When Shyam Sundar Paliwal, the village’s sarpanch (elected leader) lost his daughter, he wanted to ensure she would be remembered.9 He swore that each time a girl child was born in the village, the community would plant 111 fruit trees in her honor. As the trees grow, they generate food and revenue for the village; their growth as the girl grows symbolizes the girl as a symbol of wealth, not financial burden.

To solidify the relationship between girlhood and wealth even further, Paliwal established a fund of 21,000 rupees (about US $330 and the equivalent of roughly four months’ wages in India). The fund cannot be opened before the girl turns twenty; to receive the fund, the girl’s parents must sign a legal document guaranteeing that she will be educated and not sold as a child bride. While statistics about births cannot be gleaned at the village level, the project appears to be a success, with more than 250,000 trees planted since 2006.10 The trees have generated a small aloe boom for the village, helping it become both more ecologically and financially stable.

The story of Paliwal is a hopeful one—demonstrating how local-level policy can reverse longstanding social biases against girls, while also generating economic opportunity. China’s 2015 reversal is positive, too, demonstrating how changing policies can help restore the birth sex ratio. What the Chinese and Indian cases can teach us is that, historically, son bias has been common throughout Asia, but varies significantly from country to country. It can have impacts for girls and women, and for couples trying to plan for their families. Ultimately, it has significant impacts for society. No policy can bring back the missing women, but with stable and consistent efforts on the part of local, regional, and national governments, the demographic crisis caused by bias and policy could be significantly reduced within a generation or two.

The women may be missing, but the girls are coming home.



1. Amartya Sen, “More than 100 Million Women Are Missing,” The New York Review of Books, December 20, 1990.

2. Yan Huang, Wen Tang, and Yi Mu, et al., “The Sex Ratio at Birth for 5,338,853 Deliveries in China from 2012 to 2015: A Facility-Based Study,” Public Library of Science (PLOS) One, December 12, 2016.

3. Therese Hesketh and Zhu Wei Xing, “Abnormal Sex Ratios in Human Populations: Causes and Consequences,” Proceedings of the National Academy of Sciences of the United States of America (PNAS) 103, no. 36 (2006): 13271–13275.

4. Organization for Economic Co-operation and Develpment (OECD), “About the SIGI,” OECD Social Institutions and Gender Index (SIGI), accessed August 10, 2017,

5. Veronica Pearson, “A Broken Compact,” China’s Deep Reform: Domestic Politics in Transition (Lanham: Rowman & Littlefield, 2006).

6. Tina Rosenburg, “The Daughter Deficit,” New York Times Magazine, August 23, 2009.

7. Sui-Lee Wee “After One Child Policy, Outrage at China’s Offer to Remove IUDs,” The New York Times, January 7, 2017,

8. Stephan Lausen and Claudia Wink, “Missing Women: Revisiting the Debate,” Feminist Economics 9, nos. 2–3 (2003): 270.

9. “Celebrating Girl Child: Here’s What India Can Learn From Rajasthani Village, Piplantri,” FirstPost, last modified March 20, 2015,

10. Andy Meek, “Indian Village Plants Future for Young Girls,” Time Magazine, June 13, 2013,