“It's a girl,” said the doctor. “You want to get rid of it? It'll take just three minutes.”
Lily Zhou trembled — her motherly instincts tinged with lament. “It's my daughter, it's a life,” she recalled thinking. “I can't do this.”
And, according to the mother of four from Brooklyn, her experience is not an uncommon one within the city's gynecological clinics. “Most of my friends would either go to Chinatown or Flushing for this,” she said.
Pregnant women, most of them Chinese and Indian, often go to abortion clinics for early stage fetal gender tests. If the fetus is found to be female, another procedure — abortion — sometimes also takes place, according to interviews with dozens of physicians, community leaders and Asian immigrants in Manhattan's Chinatown, Queens' Flushing and Jackson Heights and Brooklyn's Sunset Park.
Like many of her friends, Zhou tested her baby's sex each time she conceived. Unlike others she knows, she said, Zhou never had an abortion. She now has three girls and a 1-year-old son, her youngest child.
She had not planned on having this many children. “After my first girl, we began to expect a boy,” Zhou, 34, said.
She came to New York in her early 20s from Fujian, a province in southeastern China. She now runs a Chinese takeout restaurant with her husband in Flatbush, Brooklyn. “We don't have a preference for boys,” Zhou said. “We just wanted a boy to make it more of a perfect family.”
Culturally, the Chinese believe a balance of yin and yang will bring a family good luck. Having a boy is simply a wish, not a necessity.
An unscientific street survey with dozens of Chinese women between the ages of 23 and 50 in Manhattan's Chinatown and Flushing suggested that most believe that male preference in Chinese immigrant culture has dissipated. Still, many said, older relatives and close friends continue to favor boys over girls, and sex-selective abortion remains an open secret within the city's Chinese immigrant communities.
But if men and women are pressured by family members, especially from older generations, to have boys, younger would-be parents are becoming more neutral as to gender preference.
“We love our girls,” said Tony Chiu, a hairstylist on Division Street. Chiu and his friends even claim to prefer “daughter to son,” in protest, they said, against the stereotype that Chinese men harbor discrimination towards females.
PRESSURES ARE FAMILIAL, CULTURAL“My husband first agreed that we stop trying after our second daughter,” Zhou said. But not long after, he started to nudge her again, she said. “He would say 'my mother won't cut me lose, let's try again, one last time,'” said Zhou, whose mother-in-law moved to the United States a few years ago and is now living with the family.
Dr. Lisa Eng, a gynecologist who practices in Manhattan's and Brooklyn's Chinatowns, referred to the preference, even insistence, of some older Chinese women on having a male descendent to carry their surname as the “mother-in-law-factor.”
“Half of the time, the women are really remorseful,” she said. “The woman doesn't care about [her husband's] name. It's the mother-in-law.”
Common in China because of that country's one-child policy, sex-selective abortion is a way to preserve one's' lineage. Sons are considered more valuable since they will support the family, while daughters are going to be married off and will no longer contribute to her parents.
“Mothers-in-law can WeChat their in-laws globally and pressure them to get a boy. They will nag, nag, nag until they get what they want,” Eng said, alluding the most popular social media and messaging platform in the Chinese community.
A RECENT PHENOMENONSex screening methods have developed rapidly in past 50 years. Procedures such as the non-invasive prenatal test can detect a fetus' sex as early as seven weeks into pregnancy, while more conventional tests such as amniocentesis and ultrasonography are used in later stages of a pregnancy.
Just a drop of blood from a pregnant woman's fingertips can now reveal the sex of a child. But the procedure can be expensive. With lab processing and appointment fees, Zhou spent $800 to find out her third daughter's sex in 2012. The price has dropped somewhat because of competition among medical companies and is cheaper than sperm sorting, which can cost up to $20,000, according to Eng.
Sex-selective abortion is a more recent development, according to Rohini Prabha Pande, an independent consultant with the World Bank and the International Center for Research on Women.
Male preference “has been going on for hundreds of years,” she said, while “sex-selective abortion is a fairly recent phenomenon” and has spread along with technology. Before that, she said, girls would be neglected, discriminated and abused.
The number of sex-selective abortions performed in this country is difficult to determine. The reasons women have abortions are not officially tabulated. Major abortion clinics, such as Planned Parenthood, do not ask for reasons on consent forms. The city's Department of Health does not list reasons in a summary of vital statistics and they do not keep statistics on numbers of females and males that are aborted. (It does provide though, the percent of live births by infant's sex. As of 2013, the percentage of male live births in the city was 51.3, whereas 48.7 for female, which roughly corresponds to worldwide sex ratio at birth: about 1.06. )
“It is not a subject to be talked about in the open,” said Arpita Appanagarri, the women's health initiative coordinator at Sakhi for South Asian women, a non-governmental organization focusing on domestic violence victims among South Asian Women. “Let alone collect data about it.”
PROHIBITIONS ABROAD, AND DOMESTICALLYBetty Rose Green, Manager of Community and Outreach at New York Asian Women's Center, which helps Asian immigrant women get out of domestic violence situations, said most of the women who come to the center complaining about being forced into a sex-selective abortion are from South Asian countries; nearly all of them had already given birth to more than one girl. “These women were ridiculed or abused in their families” for not bearing sons, said Green. “Their husbands listen to their in-laws,” who have strong preferences for sons. Pande, the World Bank consultant, believes coercive sex-selective abortion amounts to domestic violence, with, oftentimes, emotional violence turning to physical violence.
“First, women who want to keep the baby are often forced to abort; while on some other occasions, women who want to keep the baby but agree on or even initiate the abortion, because they understand that they will be looked down on if not,” she said.
“When immigrants relocate to a new country but still live in an area together, it's essentially like back home,” Pande said. “The social norms can take generations to disappear, and we oftentimes underestimate the power of this kind of social pressure.”
Can legal action help these unborn girls?
In China and India, where the practice of sex selection are highest, prenatal testing, specifically ultrasound, is prohibited to detect a fetus' sex. More than two dozen European countries, six in Asia, two in the Oceania region and Canada have enacted policies to minimize or even prohibit sex-selective abortion. None have been effective in stopping sex-selective abortion.
In October, China brought to an end the country's one-child policy — and will now allow couples to have two children. The one-child policy was implemented in 1979 to curb the country's population and has allegedly prevented 400 million births in the span of more than three decades.
“How do you tell someone that their culture is wrong? And who are you going to target? The mothers-in-law?” said Eng, the Chinatown doctor.
But some fear that banning sex-selective abortion is but a tactic to reduce access to abortion at all.
“That some states are trying to pass laws to ban so-called 'sex selection' abortion is not an indication that (sex-selective abortion) is happening in the United States,” said Sarah Burns, a professor of clinical law at New York University. “Those laws are one of many by-products of a very aggressive anti-abortion political movement which seizes on any possible strategy to curtail access to safe, legal and affordable abortion.”
Those legislative efforts typically target doctors who perform abortions, she said, needlessly threatening them “by making them responsible for policing a patient's reason for seeking an abortion.”
Seven states currently ban sex-selective abortion at any point of the pregnancy.
In January 2015, the Prenatal Nondiscrimination Act (PRENDA) was introduced in Congress and referred to the Senate Judiciary Committee.
Last year, New York Assemblyman Marco Crespo sponsored a bill that, if passed, would ban sex-selective abortion in the state. The bill is now on hold. It is Crespo's second attempt to legislated a ban after failing in 2012. He declined an interview request.
In New York City, Councilwoman Margaret Chin late last year introduced a resolution denouncing bans on sex-selective abortions. Although a committee hearing has not yet been scheduled, Chin's spokesman said the resolution appeared to have support among her council colleagues.
“It's about passing the resolution, certainly, and also starting a conversation,” the spokesman, Paul Leonard, said. “We can't be complacent. These laws are out there.”
Advocates at organizations such as the National Asian Pacific American Women's Forum say that male preference is alarming and must be addressed but that it is not a constitutional matter.
“The real solution is to change the values that created the preference for sons,” said Miriam Yeung, the forum's executive director. “Son preference is a symptom of deeply rooted social biased and stereotypes about gender.”
Pande suggested that community advocacy may work. “We need to help people understand that it's OK to have a girl in this country,” she said. “You don't need to worry here — she can get highly educated like a boy, she can go to work, and she can have a late marriage. It's fine here.”
Editor's Note: The passage referencing the manager of community and outreach at New York Asian Women’s Center indicates that the center has on numerous occasions been contacted by women who have been pressured to have sex-selective abortions. Following publication of the story, representatives at the center, which helps women and their children in otherwise abusive situations, said that they can only recall being contacted by one woman who had been forced into a sex-selective abortion, and that abortion is not among the center’s primary policy issues..