In one of many unnerving dystopian scenes in her debut book, Unnatural Selection: Choosing Boys Over Girls and the Consequences of a World Full of Men, Beijing-based Science magazine correspondent Mara Hvistendahl encourages the reader to imagine America without women.

“Imagine the country’s malls and supermarkets, its highways and hospitals, its boardrooms and classrooms exclusively filled with men. Imagine the bus or the subway or the car that takes you to work, then erase the females commuting alongside you. Erase your wife and your daughter. Or erase yourself. Imagine this and you have come close to picturing the problem.”

One hundred and sixty million females are “missing” from Asia — more than the entire female population of the United States. Since they began recording birth rates, demographers have noted the natural ratio at birth is 105 boys to 100 girls. But in cities like Lianyungang, China, that balance has been destroyed. In 2007, there were 163 boys for every 100 girls under the age of five.

Western media and world reproductive health organizations have long attributed gender imbalance to entrenched cultural biases or local policies that have led to use of sex selective abortion, but Hvistendahl uncovers ways in which Western technologies and ideologies share the blame and forecasts long-lasting global repercussions.

For her investigation, Hvistendahl (full disclosure: we were both journalists in Shanghai in 2006, when we became friends) traveled to nine countries, where she interviewed doctors and demographers, brides bartered by their families to men abroad, mothers who aborted multiple female fetuses in the hopes of conceiving a boy next time, restless bachelors unable to find wives, and a non-profit volunteer who, braving  threats made by murderous pimps, conducted a transnational rescue mission of young kidnapped girls forced into prostitution.

Hvistendahl argues that as countries grow richer, people have fewer children, making it necessary for women to achieve their preferred number of boys with fewer births. Instead of having babies until a boy comes — a practice that would keep sex ratios in balance — women, with the help of Western sex-determination technologies, such as amniocentesis and ultrasound, terminate female fetuses, carrying only male fetuses to term.

In sometimes wry, other times coldly seething language, Hvistendahl — who identifies herself as pro-choice but doesn’t crouch in the familiar trenches of that side of the debate — demonstrates that when it comes to the world’s missing girls, both the right and the left have blood on their hands.

She traces the cause of the Asian imbalance to actions set in motion by anxious Americans. Projections about soaring world populations from 1950 to 1970 gave rise to family planning programs — which were often financed by Western organizations. Population growth and limited resources, it was feared, would lead to unrest, scarcity, and, worst of all, the spread of communism. Many early global population-control advocates, therefore, were also the greatest champions of capitalism — the millionaire inventor of Dixie Cups and a Rockefeller heir, among others.

These Western donors and the organizations they founded, the Population Crisis Committee and the Population Council, along with the Ford Foundation, the World Bank, the United States Agency for International Development and the International Planned Parenthood Federation, among others, propagated the idea in Asia that fewer children at home equaled more money in the bank.

On the right, Henry Kissinger supported abortion as a curb to population growth; on the left, so did Paul Ehrlich, author of The Population Bomb, first published in 1968. Ehrlich also suggested that sex selection could be particularly effective for population control — if people could have their preferred gender the first or second time, they’d make less attempts and have fewer children.

Western aid to Asia often hinged on the fulfillment of a nation’s population control targets. Draconian campaigns, such as forced sterilization in India and forced abortions in South Korea, happened at a time when the countries received major support from Western organizations. Despite evidence of the use of ultrasounds in widespread sex selective abortion, Western companies continued to develop cheaper ultrasound machines for release in rural Asia and persisted in denying they shared any culpability for the gender imbalance, “as if,” Hvistendahl writes, “there is no such thing as bioethics and new developments are not first weighed and deliberated over for their possible effects on human populations.”

Despite the fact that sex selective abortion has led to a scarcity of women and the problems inherent in that scarcity — such as sex trafficking and bride buying — pro-choice organizations have hesitated to address the practice for fear that any limitations on abortion could lead to the loss of hard-won reproductive rights. Indeed, Hvistendahl writes, although sex selective abortion has not been an issue in the United States, anti-abortion activists have long recognized sex selective abortion as an entry point in their campaign to end all abortion rights.

In 2008, Arizona congressman Trent Franks introduced the Susan B. Anthony and Frederick Douglass Prenatal Nondiscrimination Act in the House of Representatives, calling for a ban on sex-selective and race-selective abortions. The bill failed to make it out of committee, but bills banning sex selective abortions have been subsequently introduced into various state legislatures and bans have passed in four states.

America has not yet felt the consequences of sex selective activities, but Hvistendahl documents how the choices of women in one country can have impact beyond one nation’s borders and she presents several chilling outcomes of gender imbalance. In the course of her research, she visited a Vietnamese village that has prospered from selling off its daughters as brides to Taiwan, where sex selection led to too many bachelors. The village now has no women left for its own young men to marry. Through the examples of Indian schoolgirls and Vietnamese sex workers, she explains how the scarcity of women doesn’t make them more valuable — it makes them more vulnerable to harassment, violence and HIV infection. (Respect and safety for women isn’t dictated by free market principles — after all, most minorities wouldn’t argue their status endows them with privileges.)

By exploring the history of Ancient Rome, mid-19th-century China, and the American Wild West, she demonstrates how large, roving bands of young men have led to increased incidence of rape, murder and political mayhem. And she shows how the emergence of gender selection technologies perceived as less crude or ethically questionable than abortion, such as in vitro fertilization (IVF) and sperm sorting (PGD), have allowed Western practitioners and customers to rework the idea of “gender preference” to “family balancing,” an innocent entitlement divorced from the real dangers of interfering with natural sex ratios. The Asian preference for boys has been admonished as sexist, but, at home, America’s quest for its preferred gender — girls — has been recast as rational family planning.

Right now in the West, these new technologies are only affordable for the rich. But in Asia, access to sex selection technologies and abortion was also once only the province of the upper classes — until it became cheaper and more accessible. Sex selection via PGD is already offered in many countries. In those that forbid it, there’s always the medical tourism trip to California. If, like sex selective abortion, costs associated with these new technologies decrease and their use to select for sex is broadly embraced, the repercussions on global sex ratios could be devastating, the consequences dire.

Unnatural Selection is a riveting, important work. Let’s hope Hvistendahl doesn’t have to write the sequel.

Megan Shank is a freelance writer whose work has appeared in Newsweek International, Ms. Magazine, and Bloomberg News. She wrote a chapter for the forthcoming anthology Chinese Characters (University of California Press, 2012) and is researching her first book.

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