The impacts of profound gender discrimination on the survival of girls and women in son-preference countries-A systematic review

Amartya Sen first used the phrase 'missing women' to describe a survival disadvantage for women exposed to extreme gender discrimination in son-preference countries. In 1989 he estimated that, despite a biological survival advantage for females, there were 100 million fewer women in Asia and north Africa than ex-pected. He blamed corrosive gender discrimination restricting the resources needed for survival. This systematic review examined demographic evidence on the impacts of profound gender discrimination on the survival of girls and women in son-preference countries. Thirty-four included studies provided consistent evidence of lower-than-expected female survival in 15 societies. Male-to-female sex ratios rose particularly in China and India between the 1980s and 2010s, despite general improvements in female mortality. High sex ratios in South Korea, however, returned to biologically normal levels. The number of 'missing women' rose steadily from 61 million in 1970 to 126 million in 2010 and was predicted to continue to rise until 2035. The number of 'missing women' in the world increased in relative and absolute terms between 1980 and 2020. Profound discrimination reduces female survival at every stage of life. Future research is needed to understand the complete pathways and mechanisms leading to poorer survival and the major policy drivers of these trends to devise the best possible ways of preventing the tragedy of 'missing women'.