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EDITORIALS: Tao Liu and Xing-yi Zhang Ratio of males to females in China BMJ 2009; 338: b483 [Full text]

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Don't mention the 'A' word

Robert P. Balfour   (19 April 2009)

Are we sure China's lopsided sex ratio is a problem?

Wayne E Thogmartin   (24 April 2009)

Don't mention the 'A' word 19 April 2009
Robert P. Balfour, retired consultant gynaecologist London SW3 4WJ Send response to journal: Re: Don't mention the 'A' word	I found this editorial strange as it did not mention the obvious causes of the low number of female births in China, namely coercive abortion and selective abortion. This is not a new phenonenon; Wikepedia quotes the lowest fertility rate in the world as 0.41 in Xiangyang, China. An editorial by Sheth in the Lancet (1) compares it to the situation to India despite the fact that abortion on the basis of fetal sex has been illegal there since 1994. In summary he felt that concentration on respecting women's sexual and reproductive rights as well as their human rights was the only answer to the problem. It was calculated that about 100 million girls are missing from the world today. In 1986 the Obstetric and Gynaecological societies of India passed a resolution against the current practice of abortion on the basis of gender which was described as a "crime against humanity". There are no such voices being raised in China, despite the fact that this is the worst example of gender abuse in the world. Ref 1: Missing female births in India, Sheth SS, Lancet (2006) 367, 185-6 Competing interests: President of "Doctors who respect human life"
Are we sure China's lopsided sex ratio is a problem? 24 April 2009
Wayne E Thogmartin, Quantitative Ecologist U.S. Federal Research Facility Send response to journal: Re: Are we sure China's lopsided sex ratio is a problem?	Liu and Zhang (BMJ 2009;338:b483) suggest that a skewed sex ratio represents a problem for China. While there very well may be societal consequences for such skewed ratios, a more fundamental concern underpinning this issue is the ecological and environmental health of China. The one-child policy is a direct consequence of an overabundant population and, as such, deleterious consequences to the demography of a population exceeding carrying capacity are to be expected. Absent limits to population size imposed by ecological and environmental conditions, a skewed sex-ratio would not likely be seen as a problem by the Chinese (recall, the preference for male children is a long-standing cultural tradition in China). The World Wildlife Fund, among others, estimates humanity now exceeds the biotic capacity of the planet by as much 30%. As such, criticisms of a nation's policies for controlling their population should be quite cognizant of the cost to us all if these policies are abandoned in the face of such criticism. For instance, Liu and Zhang reference an alternative to the one-child policy which allows for a second child in a family if their first is female. Such a policy would, while ameliorating the skewed sex ratio, harm China's progress toward a sustainable population size. It is a sustainable population size, in the end, that is the preferred alternative to the current state. Respectfully submitted, Wayne Thogmartin, Onalaska, WI This opinion is that of the author's and does not reflect the policy or position of the U.S. Federal Government. Competing interests: None declared