Patriarchal societies are part of the problem of altered sex ratios, female infanticide and foeticide. This needs to be acknowledged and changed.

India's sex ratio, among children aged 0-6 years, is alarming. The ratio has declined from 976 females (for every 1000 males) in 1961 to 914 in 2011. Every national census has documented a decline in the ratio, signalling a ubiquitous trend. Preliminary data from the 2011 census have recorded many districts with sex ratios of less than 850. The ratio in urban areas is significantly lower than those in rural parts of the country. Reports suggest evidence of violence and trafficking of poor women and forced polyandry in some regions with markedly skewed ratios. The overall steep and consistent decline in the ratio mandates serious review.

Sex selection and technology: Medical technology (like amniocentesis and ultrasonography), employed in the prenatal period to diagnose genetic abnormalities, are being misused in India for detecting the sex of the unborn child and subsequently for sex-selection. Female foetuses, thus identified, are aborted.

A large, nationally representative investigation of married women living in 1.1 million households documented markedly reduced sex ratios of 759 and 719 for second and third births when the preceding children were girls. By contrast, sex ratios for second or third births, if one or both of the previous children were boys, were 1102 and 1176 respectively. A systematic study in Haryana documented the inverse relationship between the number of ultrasound machines in an area and the decline in sex ratios. Studies have also documented correlations of low sex ratios at birth with higher education, social class and economic status. Many studies have concluded that prenatal sex determination, followed by abortion of female foetuses, is the most plausible explanation for the low sex ratio at birth in India.

The steady decline in the sex ratio suggests that marked improvements in the economy and literacy rates do not seem to have had any impact on this index. In fact, the availability of new technology and its easy access for the urban, wealthy and the educated have worsened the trend and harmed the status of women in Indian society.

Sex selection and statutes: A prolonged campaign by women's groups and civil society organisations all over the country, in the wake of the skewed child sex ratio in the 1991 census, led to the enactment of the Pre-Natal Diagnostic Techniques Act in 1994. However, this statute was not effectively implemented, leading to further skewing of the sex ratios as recorded in the 2001 census. Social and financial pressures for smaller families intensified the misuse of such technologies to ensure the birth of sons. Such misuse cut across barriers of caste, class, religion and geography. The Act was amended in 2003, to include the more recent pre-conception sex selection techniques within its ambit, with the aim of tightening regulation to provide more teeth to the law to prevent the practice. It mandated the regulation of sale of technology, the registration of diagnostic centres, the monitoring of medical personnel, procedures and protocols. It has procedures for complaints and appeals and regulation by local authorities.

And yet, the problems of implementation are ubiquitous. Violations go unpunished with very few cases being booked and a zero conviction rate. The collusion between people, the medical fraternity and the administration has resulted in the worsening of the sex ratio and failure of the Act to make a difference.

Patriarchy and prejudice: The social system of patriarchy, with males as the primary authority figures, is central to the organisation of much of Indian society. The system upholds the institutions of male rule and privilege and mandates female subordination. Patriarchy manifests itself in social, religious, legal, political and economic organisation of society. It continues to strongly influence Indian society, despite the Constitution's attempt to bring about an egalitarian social order.

Patriarchal societies in most parts of India have translated their prejudice and bigotry into a compulsive preference for boys and discrimination against the girl child. They have also spawned practices such as female infanticide, dowry, bride-burning and sati. They have led to the neglect of nutrition, health care, education, and employment for girls. Women's work is also socially devalued with limited autonomy in decision-making. The intersections of caste, class and gender worsen the situation. Despite its social construction, patriarchal culture, reinforced by the major religions in the country, maintains its stranglehold on gender inequality. The prevalent patriarchal framework places an ideological bar on the discussion of alternative approaches to achieve gender justice.

Ethical blindness: The declining sex ratio cannot be simply viewed as a medical or legal issue. It is embedded within the social construction of patriarchy and is reinforced by tradition, culture and religion. Female foeticide and infanticide are just the tip of the iceberg; there is a whole set of subtle and blatant discriminatory practices against girls and women under various pretexts. It is this large base of discrimination against women that supports the declining sex ratio.

Many approach the problem superficially and focus on the declining sex ratio and its medical and legal solutions. But those who seriously engage with the issues have found that much unethical conduct that goes on, whether in one's social or work life, happens because people are fooling themselves. Men, the dominant figures, and older women, who have lost the battle and have joined hands to form the ruling coalition, overlook many transgressions because it is in their interest to maintain the patriarchal culture. With such focus on patriarchal goals, the ethical implications of important decisions fade away. Such ethical fading results in engaging in or condoning behaviour that one would condemn if one were consciously aware of it. It results in ethical lapses in our social world, which are pervasive and intractable.

While viewing the girl child from only the narrow and bigoted, or financial perspectives, one fails to notice that many decisions have an ethical component. Consequently, one is able to behave unethically in relation to girls and women, while maintaining a positive self-image. Ethical fading also causes one to condone the unethical behaviour of others. Such “motivated blindness” tends to disregard issues that work against patriarchy. With the acceptance of patriarchal standards, based on religion or culture, even the most honest people have difficulty being objective. Those who overtly or covertly accept and defend patriarchy have a conflict of interest which biases their decisions against girls and women, in contexts both big and small. It is the everyday casual and hurtful misogyny — gendered language, sexist innuendo, stereotyping and jokes, small institutional inequities, sexualisation of society encouraged by advertising, media and capitalism that actually undergird violence of all types against women.

Need for gender justice: Viewing the sex ratio as an individual or medical issue and suggesting medical or legal interventions to end the practice reflect poor understanding. While strict implementation of the law will help reduce female foeticide and infanticide, it will not eliminate the problems. Simply exhorting the general population and the medical profession to desist from such practice without attempting to change patriarchy will prove futile.

The major barrier to mainstreaming gender justice and scaling up effective interventions is gender inequality based on socio-cultural issues. The systematic discrimination of girls and women needs to be tackled if interventions have to work. Although medical intervention (of sex determination and selective abortion of female foetuses) in the sex ratio stands out as causal, it is the more hazy but ubiquitous and dominant relationship between gender and patriarchy that has a major impact on the outcome. The failure to recognise this relationship and the refusal to tackle these issues result in the declining sex ratio. Debates on gender equality should not be reduced to talking about culture, tradition and religion. The prevalent patriarchal framework needs to be acknowledged as causal, interrogated and laid bare. Discussions on alternative approaches to achieving gender justice are mandatory.

While women are guaranteed equality under the Constitution, legal protection has little effect in the face of the prevailing patriarchal culture. India needs to confront its gender bias openly. It would appear that nothing short of a social revolution would bring about an improvement in the health and status of women in the country. Irony and hypocrisy are the two words that come to mind when patriarchal societies talk about justice for their women. Surely, the disappearance of millions of girls in India is reason enough to question the acceptance of patriarchy and search for an egalitarian social order.

(Professor K.S. Jacob is on the faculty of the Christian Medical College, Vellore.)

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