Increasingly, a type of abortion ban that exploits the Asian American and Pacific Islander (AAPI) community is becoming a trend in the United States. Using racial stereotypes and relying on information from Asian countries, lawmakers are passing laws that criminalize doctors for performing abortions that are based on the sex of the fetus. Sex-selective abortion bans are deceptive and harmful to AAPI women. They purport to end sex-selective abortions and promote women’s equality when they do nothing to address the problem of sex selection and in fact undermine women’s equality. Further, they put the health of AAPI women at risk and promote the idea that AAPI women and families hold dangerous values.
At this moment, some politicians in the United States are subjecting women across the country to extremist measures that restrict their health and well-being. Increasingly, anti-choice conservatives are including in their arsenal a particularly insidious type of abortion ban that exploits the Asian American and Pacific Islander (AAPI) community and intentionally singles out AAPI women as targets. Since 2009, seven states have enacted the ban and more than sixty of them were introduced at the state and national level. The measure was also the second most-proposed abortion restriction of 2013. Using racial stereotypes, leveraging xenophobia, and relying heavily on information from Asian countries, lawmakers are proposing and passing laws that criminalize doctors for performing abortions that are based on the sex of the fetus. These deceptive sex-selective abortion bans purport to end sex-selective abortions and promote women’s equality. In fact, they are ineffective solutions that undermine women’s equality and negatively impact AAPI women and the AAPI community in many ways.
This article sheds light on the incidence of and appropriate solutions for sex-selective abortions; the real purpose and strategy behind sex-selective abortion bans; how sex-selective abortion bans harm AAPI women and the AAPI community; and the current legislative landscape, including how AAPI and reproductive health, justice, and rights policy advocates are responding to these bans in state and federal legislatures and in the courts.
Sex-Selection Occurrences at Home and Abroad
Son preference and the sex-selective practices that can arise from it are devastating realities, especially in China and India where cultural practices and social norms dictate a stronger worth for sons than daughters. The number of girls missing in Asian countries like India and China due to infanticide, sex selection, or being neglected to death is estimated to be more than 160 million. This is undeniably one of the worst repercussions of gender inequality women and girls in the world are experiencing today. As a result of gender inequities in these countries—including the elevated status of men, the ability of sons to carry on the family name and perform certain rituals, men’s ability to contribute more to family income, and traditions that require sons to care for aging parents—the number of women and girls in some regions of the world are dwindling in what some have coined a “gendercide.”
Relying on U.S. Census data, some politicians are now claiming that Asian Americans are practicing sex-selective abortion. However, to date, there is no conclusive evidence that sex selection is happening in the United States. Two studies confirm the existence of skewed sex ratios at birth in Indian American, Chinese American, and Korean American populations in the United States. Among these Asian American populations, although the sex ratio for the oldest child is normal, it is male-biased for later births in families with older girls. The reasons for the imbalance are inconclusive. Indeed, there may be selection happening through pre-implantation technologies, and it is possible families are not engaging in sex selection at all. Instead, they may be practicing family balancing to ensure they have an equal, or close to equal, number of girls and boys. Coming from countries with population control policies that pressure families to limit the number of children they have, it is possible that Chinese American, Korean American, and Indian American women are family balancing because of the cultural notion that they should not have many children and therefore need to have an abortion if they want children of both sexes. Furthermore, 2012 National Asian American Survey opinion polling data shows no reported child gender preference in almost every Asian American community—Hmong were the only community that reported a son preference.
Despite the lingering questions, anti-choice activists have seized upon the U.S Census data and are using it to suggest that sex-selective abortion based on a preference for sons is occurring in the United States.
If sex-selection is in fact happening in the United States, the real solution is to eliminate its root: gender inequity. Contrary to what anti-choice U.S. legislators would like us to believe, banning abortion is not the solution. It is an ineffective method, and common sense alone tells us we cannot help women by undermining their reproductive rights.
Internationally, bans have not been shown to be effective, and issue experts warn that denying access to safe abortions can result in death or serious injury and is not an appropriate remedy. The international community, including multiple United Nations agencies and the World Health Organization, believes that abortion restrictions are not an acceptable solution because they put women’s health and lives in jeopardy. Indeed, even Mara Hvistendahl, whose work sex-selective abortion ban supporters rely on, writes that curtailing women’s rights will not solve the problem.
To meaningfully address sex selection, we must promote measures shown to be effective in decreasing discrimination and increasing the social standing of girls. We need remedies that undo gender inequity, of which son preference and resulting sex selection are simply offshoots. This deep-seated social bias can only be solved by working to change the values and circumstances that create a preference for sons. In South Korea, the only country that has successfully reduced its sex ratio imbalance, researchers credit exactly these types of measures—not abortion bans or other policies that undermine women’s rights. AAPI women’s organizations are already working on this problem in culturally competent ways that provide long-term sustainable solutions. They are working to empower women and girls by building the leadership capacity of women, improving women’s economic standing, creating better access to health care, lowering the rates of gender-based violence, and taking public stances against son preference. Instead of supporting them in this work, proponents of sex-selective abortion bans take the opposite approach. They ignore what AAPI women know is best for their own community and undermine their agency. Legislative measures that address violence against women and provide equal pay for women, health care coverage, and food security are also ways to reduce the preference for sons by creating a society where women can live fuller, healthier lives and support their families. However, these are the very measures that supporters of sex-selective abortion bans, who claim to stand for women, consistently reject.
The Truth and Hypocrisy Behind Sex-Selective Abortion Bans
Bill proponents are co-opting the language of women’s equality to mislead people into passing an anti-choice measure without a fight. The voting patterns of the politicians who support these bans illustrate this. The vast majority of bill sponsors have legislative histories that are hostile toward women’s rights, abortion, and health care access. Sponsors have voted against equal pay for women, against funding for safety net benefits that support women and children, against legislation to support survivors of domestic violence and sexual assault, to defund family planning, and to ban abortion at twenty weeks. It is clear that sex-selective abortion bans are wolves in sheep’s clothing.
These bans were carefully created as part of a coordinated national strategy to undermine abortion rights—a strategy executed on the backs of AAPI women. The measures are meant to put women’s rights supporters in an uncomfortable position if they choose to fight back. The discomfort and resulting silence surrounding these bans have meant that they pass through legislatures and legislative committees with relative ease—precisely what the bill drafters at Americans United for Life hoped for.
In 2011 and 2012, states enacted a record 135 new restrictions limiting access to abortion. Instead of overturning the Supreme Court’s 1973 Roe v. Wade decision and stripping women of their right to abortion altogether, the onslaught of attacks is a calculated attempt to chip away at women’s health and eventually render it meaningless. This ban is one small piece of the larger conservative blueprint to incrementally dissolve abortion rights. In 2008, Steven Mosher, president of the Population Research Institute and anti-choice activist, suggested that “we—the pro-life movement—adopt as our next goal the banning of sex-selective abortion.” For him and others like him, sex selection is the next logical battleground in the abortion wars because it is a cloak to hide under that might gain sympathy and support from those who are under-informed.
The Harm to AAPI Women
Sex-selective abortion bans squarely target AAPI women. It is not a coincidence that the states with the second, third, and fourth fastest-growing AAPI populations have also passed sex-selective abortion laws; these bans are not only anti-woman, they are anti-immigrant and, specifically, anti-Asian. For over one hundred years, AAPIs have endured debasing generalizations and systemic racism. Since the country’s first anti-immigrant law, the 1882 Chinese Exclusion Act, we have experienced a litany of legislative insults, including the Page Act, which stereotyped Chinese women as prostitutes and kept them from entering the country; laws forbidding Asians from owning property; and the internment of over 110,000 people of Japanese heritage during World War II. Sex-selective abortion bans, or “anti-Asian abortion bans,” follow in this tradition.
Perpetuates Xenophobia and Institutionalized Racism
This legislation perpetuates negative stereotypes of AAPIs. Those who designed it are capitalizing on the high numbers of sex selection in Asian countries, as well as xenophobic resentment toward the influx of new immigrants from Asia, to promote a fear that sex-selective abortion is widespread and growing rapidly in the United States—ripening the environment for deceiving people into chipping away at abortion rights. In doing so, supporters are painting a picture of AAPIs as “backward” and immoral and are intensifying the alienation our community already experiences. During a Congressional hearing on the proposed federal ban, Representative Steve King (R-Iowa) built a narrative about India that was saturated with Orientalism and finished by saying that, for Indians, “It is their custom to disrespect the little female lives in their culture.” The legislative history of Arizona’s ban reflects similar anti-Asian, anti-immigrant sentiment, as does the rhetoric around the pending South Dakota ban. Further evidencing their anti-immigrant stance, the primary sponsors of the federal versions of this bill have supported declaring English the official language of the United States and ending birthright citizenship for children of undocumented immigrants.
Normalizing the notion of AAPIs as savage and infusing it into the law, the legislators behind these bans perpetuate the institutionalized racism our community already faces. Sex-selective abortion bans join the list of harmful oversimplifications of our community enshrined into policy, including “yellow peril” at the time of anti-Asian immigration laws in the late nineteenth century; the “terrorist” stereotype and concurrent mandatory registration, detention, and deportation policies aimed at South Asians post–September 11; and the “model minority” myth that prevents government and independent research institutions from studying the real challenges our communities face.
Restricts AAPI Women’s Health
This discriminatory law relies on a woman facing scrutiny and interrogation in the doctor’s office simply because of her race or ethnicity. Having no real means of ensuring a woman has not decided on an abortion because of the sex of the fetus, doctors may rely on the ethnicity of their patients in determining whether to subject them to increased questioning. This means that, based on harmful stereotypes perpetuated by this legislation, AAPI women will be subjected to racial profiling in the doctor’s office that other women will not have to endure.
In doing so, these bans interfere with the doctor-patient relationship and cause distrust at a time when women need to feel safe and comfortable in the hands of their medical provider. Trust is an essential element of health care. It encourages use of services, facilitates disclosure of important medical information, and has an indirect influence on health outcomes through patient satisfaction, adherence, and continuity of provider.
Making matters worse, threatening providers with criminal and civil penalties has a chilling effect. Out of fear of imprisonment, doctors may be reluctant to provide care to AAPI women, decreasing AAPI women’s access to abortion care and erecting another barrier to health for them. AAPI women, like other women of color, already face barriers to health and resulting health disparities and do not need this additional obstacle. Despite the model minority stereotype, due to immigration status as well as financial, linguistic, and cultural barriers, AAPI women face difficulties accessing hormonal contraceptives, making regular well-women visits, protecting themselves from sexually transmitted diseases, and preventing deadly health conditions like cervical cancer. Cervical cancer incidence rates for Vietnamese women are among the highest in the United States. For AAPI women with a language barrier, a simple misunderstanding could result in denial of care. Roughly one out of every three Asian Americans are limited English proficient and experience difficulty communicating in English, increasing the chances that AAPI women will be denied care because of a misunderstanding.
Undermines Abortion Rights Law
The vast majority of Asian Americans support women’s reproductive rights. According to the 2012 National Asian American Survey, 78 percent of Asian Americans support some form of legal abortion and 69 percent agree that abortion is a private matter, not a decision for the government to interfere in. Chipping away at abortion rights, the true purpose behind sex-selective abortion bans, undermines the values of the Asian American community.
Sex-selective abortion bans not only make it more difficult for women to access abortion care in the immediate future, they also pose a potential threat to settled law. By applying equal rights protections to a nonviable fetus, these bans could be used to imply “personhood”—the declaration of fertilized human eggs to be legal persons, making abortion and some forms of birth control considered murder under the law. Indeed, only people can enjoy constitutional protections. According to the Supreme Court in Roe v. Wade, 410 U.S. 113 (1973), a person has the right to an abortion until the point of viability, defined as “potentially able to live outside the mother’s womb, albeit with artificial aid.” Viability is scientifically held to begin at twenty-four weeks into pregnancy, and the sex of a pregnancy can now be told with ultrasound as early as twelve weeks. Thus, sex-selective abortion bans complement the anti-choice agenda to flout Roe and enact earlier pre-viability abortion bans, many of which are being challenged on constitutional grounds in an effort to turn back the clock on women’s rights until the right to abortion is decimated altogether. Nine states now have twenty-week abortion bans. In 2013, Arkansas passed a twelve-week abortion ban and North Dakota passed a six-week ban, the earliest in the country.
Moreover, sex-selective abortion bans are the very first abortion restrictions based on the factors that go into a woman’s decision making, and they open the door to more bans of this kind. Already, anti-choice activists are pushing for bans on abortions based on genetic abnormality, and one such ban has already passed in North Dakota.
On the federal level, the sex-selective abortion ban has been proposed four times in the House of Representatives by Representative Trent Franks (R-Arizona) and once in the Senate by Senator David Vitter (R-Louisiana).[xix] In 2012, the bill received its first and only federal vote thus far under a suspension of rules in the House, and it failed to pass.[xx] The measure currently sits in both chambers of Congress, awaiting legislative action.
Seven states have enacted sex-selective abortion bans. Before the year 2010, only two states banned sex-selective abortions: an Illinois ban passed in 1975, which is not enforced today, and a Pennsylvania ban passed in 1982.[xxi] Since the ban was first introduced in the House in 2008, a legislative trend emerged. In addition to Illinois and Pennsylvania, Arizona, Kansas, North Carolina, North Dakota, and Oklahoma have passed sex-selective abortion bans.[xxii] The number of these bans being introduced is on the rise. In 2009, nine state bills were introduced to ban sex-selective abortion.[xxiii] During the first six months of 2013 alone, twenty-one state bills were introduced.[xxiv] In fact, the measure was the second most-proposed abortion restriction of 2013, which is quite notable given the vast array of restrictions making their way through state legislatures.[xxv]
Looking Toward the Future
As the AAPI community continues to grow at a rapid pace, we are certain to witness an increasing number of sex-selective abortion bans in the coming years. The people behind this novel amalgamation of sexism and xenophobia, thinly and insultingly veiled in equal rights language, will continue to exploit racial stereotypes and stoke anti-immigrant resentment to promote their agenda to restrict safe and legal abortion—creating real harm for AAPI women in the process.
As this is being written, the South Dakota legislature is on the verge of passing such a ban, and the bill is also sitting in the Missouri, Oregon and West Virginia state legislatures.
Those who value women and racial justice must fight back, and they are doing so. At this time, advocates for the AAPI community and for reproductive health, rights, and justice are conducting legislative advocacy calling for state and federal lawmakers to reject sex-selective abortion bans. They are also challenging the constitutionality of these laws in the courts: in May of 2013, the National Asian Pacific American Women’s Forum (NAPAWF) and the Maricopa County National Association for the Advancement of Colored People (NAACP), represented by the American Civil Liberties Union (ACLU), filed a suit in a U.S. District Court against Arizona state officials, arguing that the state’s race and sex-selective abortion ban stigmatizes and stereotypes the reproductive choices of African and Asian women based on their race and ethnicity.[xxvi] The case was dismissed and is currently being appealed in the 9th Circuit.[xxvii] The Center for Reproductive Rights filed a suit against North Dakota’s sex-selective abortion ban in June 2013 as part of a larger legal challenge.[xxviii] This piece of the suit was ultimately dismissed after the plaintiff, a clinic, determined the law did not apply to its practice and requested the dismissal.[xxix] There is also a proactive legislative response to these bans underway. In November 2013, the Women’s Health Protection Act (H.R. 3471, S. 1696) was introduced. If passed, this legislation would make illegal almost all of the restrictions on women’s health we have seen in the last three years, including restrictions on abortion based on a woman’s reasons or perceived reasons.
It is bold acts of courage like these that are needed to stem the flood of attacks on women’s health, including sex-selective abortion bans.
Shivana Jorawar is the Reproductive Justice Program Director at the National Asian Pacific American Women’s Forum (NAPAWF). She directs the organization’s federal and state advocacy around women’s health policy, including educating lawmakers and the public about legal barriers to health care access for immigrant women and the impact of sex-selective abortion bans on the AAPI community. She also builds the advocacy capacity of NAPAWF’s grassroots activists across the country. Jorawar has a background in the law as well as community education and organizing around issues of gender-based inequity and violence. She holds a bachelor’s degree in political science from Fordham University and a JD from Emory University School of Law.
Miriam W. Yeung, Executive Director of the National Asian Pacific American Women’s Forum guides the country’s only national, multi-issue, progressive organization dedicated to social justice and human rights for Asian and Pacific Islander women and girls in the United States. With offices in New York City and Washington, DC, and chapters in fourteen cities, NAPAWF’s current priorities include winning rights for immigrant women, leading community-based participatory research, and winning reproductive justice. NAPAWF has been a leading voice in opposition to sex-selective abortion bans in the United States. Yeung holds a master’s degree in public administration from Baruch College and a bachelor’s degree from New York University.
 National Asian Pacific American Women’s Forum (NAPAWF). Race and Sex Selective Abortion Bans: Wolves in Sheep’s Clothing. NAPAWF, July 2013.
 Hvistendahl, Mara. “Missing: 163 Million Women.” Mother Jones, 5 July 2011.
 See Almond, Douglas, and Lena Edlund. “Son-Biased Sex Ratios in the 2000 United States Census.” Proceedings of the National Academy of Sciences of the United States of America 105(15), 15 April 2008; and Abrevaya, Jason. “Are There Missing Girls in the United States? Evidence from Birth Data.” American Economic Journal: Applied Economics 1(2): 1-34, April 2009.
 Almond and Edlund, “Son-Biased Sex Ratios.”
 Barot, Sneha. “A Problem-and-Solution Mismatch: Son Preference and Sex Selective Abortion Bans.” Guttmacher Policy Review 15(2), Spring 2012.
 See “Trent Franks’ Voting Records on Women’s Issues.” Project Vote Smart; Fox, Lauren. “Bill Banning Abortions After 20 Weeks Passes the House.” US News & World Report, 18 June 2013; and Testimony of Miriam W. Yeung. Hearing on H.R. 3541, The Susan B. Anthony and Frederick Douglass Prenatal Nondiscrimination Act of 2011, House Judiciary Committee Subcommittee on the Constitution. 6 December 2011.
 Americans United for Life. “Prenatal Nondiscrimination Act (Ban on Abortions for Sex Selection and Genetic Abnormalities) Model Legislation & Policy Guide.” Americans United for Life, 2013.
 Mosher, Steven W. “A New Front in the Abortion War.” Population Research Institute blog, 30 September 2008.
 One state legislator stated, “We know that people from those countries and from those cultures are moving and immigrating in some reasonable numbers to the United States and to Arizona,” and another intimated that the Chinese are “uncivilized.”
 Redden, Molly. “GOP Lawmaker: We Need to Ban Sex-Selective Abortions Because of Asian Immigrants.” Mother Jones, 25 February 2014.
 Trent Franks was one of the original sponsors of the Birthright Citizenship Act of 2009 and Senator David Vitter proposed a birthright citizenship resolution in the Senate, H.R. 1868 (111th): Birthright Citizenship Act of 2009. Also, see Strauss, Daniel. “Sens. Paul, Vitter Introduce Citizenship Resolution.” The Hill, 27 January 2011. Franks was a cosponsor of the English Language Unity Act (H.R.997), and Vitter voted yes on making English the country’s official language.
 Rowe, Rosemary, and Michael Calnan. “Trust Relations in Health Care—The New Agenda.” European Journal of Public Health 16(1): 4-6, February 2006.
 Chappell, Courtney. “Reclaiming Choice, Broadening the Movement: Sexual and Reproductive Justice and Asian Pacific American Women.” National Asian Pacific American Women’s Forum, 2005.
 Asian Pacific American Legal Center and the Asian American Justice Center. Community of Contrasts: Asian Americans in the United States: 2011. Asian American Center for Advancing Justice.
Guttmacher Institute. State Policies on Later-Term Abortions. Guttmacher Institute, 1 March 2014.
 Eckholm, Erik. “Arkansas Adopts a Ban on Abortion After 12 Weeks.” New York Times, 6 March 2013.
 Sheppard, Kate. “Judge Says North Dakota Abortion Ban is ‘Clearly Unconstitutional.’” Mother Jones, 22 July 2013.
 Marty, Robin. “North Dakota House Passes Ban on Gender or Genetic Abnormalities, Heartbeat Ban.” RH Reality Check, 11 February 2013.
[xix] NAPAWF, Race and Sex Selective Abortion Bans.
[xxv] Lee, Jaeah, and Molly Redden. “Meet 330 Lawmakers Who Made 2013 ‘A Terrible Year for Women’s Health.’” Mother Jones, 27 January 2014.
[xxvi] National Association for the Advancement of Colored People (NAACP), et al. v. Tom Horne, et al. American Civil Liberties Union, 29 May 2013.
[xxvii] NAACP, et al. v. Tom Horne, et al. 13-17247. U.S. Court of Appeals, 9th Circuit. (2013).
[xxviii] Center for Reproductive Rights. “Center for Reproductive Rights Files Lawsuit in North Dakota to Block Nation’s Earliest and Most Extreme Abortion Ban.” Center for Reproductive Rights, 25 June 2013.
[xxix] Pieklo, Jessica Mason. “Red River Clinic Asks Court to Dismiss Its Legal Challenge to Sex-Selection and Fetal Anomaly Bans.” RH Reality Check, 12 September 2013.