Richard Quinton similarly claims to have seen no link between testosterone and aggression among his patients, despite the stereotype that testosterone makes people more violent. ‘I’m not sure where it comes from,’ he tells me. ‘Urban myth?’
The balance between nature and nurture is starting to be a little better understood. In academic circles at least, gender and sex are now recognised as two different things. Sex is something scientifically distinct for most people. It’s defined by a package of genes and hormones, as well as more obvious physical features, including a person’s genitals and gonads (although a small proportion of people are biologically intersex). Gender, meanwhile, is a social identity, influenced not only by biology, but also by external factors such as upbringing, culture and the effect of stereotypes. It’s defined by what the world tells us is masculine or feminine, and this makes it potentially fluid. There are many for whom their biological sex and their gender aren’t the same.
But we remain in the early days of this kind of research. The biggest questions are still unanswered. Does the balance of sex hormones have an effect beyond the sexual organs and deeper into our minds and behaviour, leading to pronounced differences between women and men? And what does this tell us about how we evolved? Is the traditional stereotype of the breadwinning father and the stay-at-home mother really part of our biological make-up, as Darwin assumed, or is it an elaborate social construction that’s unique to humans? Studies into sex differences are as powerful as they are controversial. In the same way that research on hormones challenged popular wisdom about masculinity and femininity in the twentieth century, science is now forcing us to question all aspects of ourselves.
The facts, as they emerge, are important. In a world in which so many women continue to suffer sexism, inequality and violence, they can transform the way we see each other. With good research and reliable data – with real facts – the strong can become weak, and the weak strong.
2
Females Get Sicker But Males Die Quicker
The evidence is clear: from the constitutional standpoint woman is the stronger sex.
Ashley Montagu, The Natural Superiority of Women (1953)
‘It’s wonderful,’ says Mitu Khurana, a hospital administrator living in New Delhi. ‘When you have your first pregnancy, everyone is very excited. It is a feeling beyond description.’
The time she’s so fondly remembering was a decade ago. She had become pregnant with twins just a few months after getting married, and she assumed that nothing could ruin her happiness. Raised in a family of sisters, Mitu didn’t care whether she was having boys or girls, or one of each. ‘I just wanted the children to be healthy,’ she tells me.
But her husband and his family didn’t feel the same way. They wanted sons.
So begins a common story. It’s one that has been repeated in millions of homes across India, China and other parts of South Asia, where cultures unashamedly prize sons above daughters. They are cultures, as Mitu learned all those years ago, that will sometimes go to terrible lengths to stop a girl from even being born. Some women keep having children until they finally have a boy. Others are pressured to abort female foetuses, even to the point of torture. If they do make it to the day of their birth, many female babies and young girls are routinely treated worse than boys. In the most appalling cases, they are killed. In 2007, police in Orissa in the east of India found skulls and body parts of what they believed to be three dozen female foetuses and infants down a disused well. A news report in 2013 described a baby buried alive in a forest in the central state of Madhya Pradesh. Another in 2014 told of a newborn in Bhopal dumped in a rubbish bin.
That year, a United Nations report described the problem as having reached emergency levels. India’s 2011 census had already revealed that there were more than seven million fewer girls than boys aged six and under. The overall sex ratio was more skewed in favour of boys than it had been a decade ago. Part of the reason was the growing availability of prenatal scans, which for the first time allowed parents to find out the sex of their babies easily, and early enough to have selective abortions.
In 1994 the Indian government outlawed sex selection tests, but unscrupulous independent clinics and doctors still offer them for a fee, in private and under the radar. Mitu never wanted to have one of these prenatal scans, she tells me. But in the end, she wasn’t given the choice. During her pregnancy, she claims she was tricked into eating some cake that contained egg, to which she is allergic. Her husband, a doctor, then took her to a hospital, where a gynaecologist advised her to have a kidney scan under sedation. It was then, she believes, that her husband found out the sex of her unborn babies without her consent or knowledge.
‘I knew it from his behaviour that I’m getting daughters,’ she explains. He and his family immediately began pressing her to have an abortion. ‘There was a lot of pressure.’ She says she was denied food and water, and was once pushed down the stairs. Desperate and frightened, Mitu went to stay with her parents, and eventually gave birth to her daughters there.
She managed to save her girls. But things didn’t change. ‘They were not at all warm,’ she recalls of her husband and his family’s attitude towards her daughters. A few years later she stumbled on an old hospital report revealing the sex of her foetuses. She read it as proof that her husband had indeed carried out an ultrasound scan on her while she was pregnant, without her consent. As a result of that discovery she launched a legal case against both him and the hospital, which is still making its way through the notoriously slow Indian courts at the time I interview her, ten years after the birth of her daughters. Her husband and the hospital have both strongly denied her allegations.
Now long-separated from her husband and awaiting a divorce, Mitu has become famous in India for being among the first women to take this kind of legal action. Taking her campaign across the country has confirmed to her just how widespread a problem this is, blind to class or religion. ‘I’m fighting because I don’t want my daughters to go through this. Women are wanted as wives and girlfriends, but not as daughters,’ she says. ‘Society has to change.’
However well-hidden the selective abortions, murders and abuse of mothers and their daughters, the countrywide statistics don’t lie. Reality is laid bare in the grotesquely uneven sex ratios. The 2015 United Nations report The World’s Women says, ‘For those countries in which the sex ratio falls close to or below the parity line, it can be assumed that discrimination against girls exists.’
It is a situation familiar to Joy Lawn, director of the Centre for Maternal, Adolescent, Reproductive and Child Health at the London School of Hygiene and Tropical Medicine. ‘You go to hospitals in South Asia and there can be whole wards of kids with illnesses, and you will find 80 per cent of them are boys, because the girls aren’t being brought to the hospital,’ she tells me. A similar gender imbalance was uncovered in a 2002 study in Nepal by public health researchers Miki Yamanaka and Ann Ashworth, also from the London School of Hygiene and Tropical Medicine. They looked at how much work children are expected to do to support their families, and found that girls worked twice as long as boys, and that their work was also heavier.
The effects that society can have on gender differences are profound, and include the taking of life itself. What makes the mortality figures even more shocking is that, contrary to assumptions about women being the weaker sex, a baby girl is statistically more robust than a baby boy. She’s naturally better built to live. As scientists explore the female body in fuller detail, they are learning just how powerful a girl’s survival edge is – even in a world that doesn’t always want her.
‘Pretty much at every age, women