Who Wants a Country of Boys?

We mortals seem to be good at assumptions; they are shortcuts that allow us to function without the requirement of constantly checking the validity of beliefs or items in our environment. Part of it is trust; part of it is process, and yet I don’t want to get into a semantic discussion of the manifold vagaries of the word, nor a tedious list of definitions. I just want to concentrate on that very human characteristic of taking something for granted without the need for proof.

But of course that supposes –okay, assumes– that whatever we are considering has been vetted in a way that we are used to. A way that has the common consent of experts in the field, say, or at least something that accords with our experience. It would be acceptable, for example, to assume that if someone is talking about a bus, that they do not need to define it. They will not likely mean a train or a motorcycle…unless, that is, we include metaphors and their ilk -so let’s not.

I want to keep this simple for now. Some assumptions lead to others and so, like the weak link of a chain, conclusions based solely on a trail of assumptions can be a house of cards. At some stage, it would likely be prudent to search for verifiable sources if the issue is important.

I suspect that the trust with which we clothe assumptions is multi-fashioned. Sometimes it is the source, and sometimes it is the subject. Or the wording. Suppose, as an example, we are reading an article purporting to discuss discrepant sex ratios in a country and there is mention of the ‘sex ratio at birth’. (I have covered sex ratios and their definitions in a previous essay by the way: https://musingsonwomenshealth.wordpress.com/2015/08/25/pregnancy-stress/ ) Would we not be forgiven for the assumption that the definitions used would be the commonly understood ones in this context? And that when the ‘natural sex ratio at birth’ is mentioned in the same breath –or in this case, line- as the World Health Organization, couldn’t we relax. A little?

Well, I have to say I was initially seduced by this notion in an article in the BBC News, and then, intriguingly, disavowed of my naïveté. The article was titled ‘Why does Sweden have more boys than girls?’  http://www.bbc.com/news/magazine-35444173  My first thought, of course, was so what? The normal secondary sex ratio for humans would seem to average out around 5 extra boys, for every 100 girls that are born. Various reasons have been proposed to explain this, and I assumed (there we go again) that the article was reporting a new one –or at least new proof.

And then, when that didn’t prove to be the case in the first paragraph or two, I wondered if there were some hitherto unknown problems with northern sunlight, or perhaps residual effects from Chernobyl…

But I quickly became aware that they were using the term not as sex ratio at birth (the secondary sex ratio), but rather the sex ratio at ages 16 to 17 years of age (which would be closer to the tertiary sex ratio). I hadn’t expected this, and so now I had to again switch assumptions.

First of all, they gave a little background: ‘official statistics show that in 2014, there were 108 boys for every 100 girls among Sweden’s 16 and 17-year-olds.’ Okay, 108 boys per 100 girls is not so far off the 105 boys expected. I almost shrugged and moved on to another article until I read the next sentence: ‘But the country now has 123 boys for every 100 girls in this age group’. Whoa, that woke me up. So, not only do they talk in terms of a specific age group, they also report that in one year it has changed remarkably.

Time to examine my assumptions again, I realized. It turns out that the discrepancy is largely explained by immigration –or more accurately, refugees. But am I also to assume that it would be dominated by males -boys, actually? This requires another assumption: that more young men are able to make their ways through the turmoil and suffering of their native lands than their female counterparts. If the family is in dire need, and has little chance of making it out intact, perhaps it sends out the strongest, in hopes he (or sometimes she) will find refuge and then send for them. But is the male preponderance merely related to societal expectations and socially determined male roles?

The article purports to to explain the preponderance of males over females in that age range:  “If you’re underage, first of all, you get housing, you get more financial resources. You also have a lot of staff around you helping you with different issues,” says Hanif Bali, a member of the opposition Moderate Party in the Swedish parliament – which is on the centre right of the political spectrum. “If you need food, clothing, everything, you can go to the municipality and demand this money.” Presumably a young a young girl could do the same if the family had delegated her as the one to leave -but if you were the matriarch or patriarch of that family, would you send your daughter? Or would fear of the probable fate of a young, unaccompanied girl on a dangerous journey with unscrupulous smugglers likely convince you to send your son?

Of course that survivability benefits the young male asylum seeker all right, but what about the family? Were my assumptions about the strength of family ties naïve? Thankfully not. Fascinatingly not: ‘[…] there is another even bigger benefit, which Bali believes is significant. “You have the right to family reunification. So you can bring all of your family to Sweden, if you are underage.” Under 18, that is… And actually make it to Sweden.

So there are huge incentives for getting to Sweden before you turn 18.’

The article turned out to be thought provoking for me on several levels. One I have to attribute to age-naïveté: how does news of this kind of stuff leak out to people in a war-zone, fleeing for their lives? And secondly, how effectively the refugees have been able to use the Swedish social system to allow something on a scale for which it was likely not intended. But it also speaks volumes about assumptions and where they can lead us. You can almost hear the Hamlet-like defence of those 16-17 years olds when confronted with their manipulation of the system: ‘Why, man, they did make love to this employment, They are not near my conscience.’

 

Pregnancy Stress

Curiosity is a curse sometimes. It strikes in the most unusual circumstances and often with little warning. Some little thing will set it off and bang, you’re hooked. I’m an obstetrician, so procreative issues are constantly surfacing in my life. Environmental stressors and reproductive failure also seem to be de rigeur in the social media nowadays so there’s no escaping it. The worry may have started with animal data -animals are the easiest to study so we often look at what evidence they provide and then extrapolate. I’m thinking of those dark mysterious star-filled nights at summer camp when there is howling in the distance, and everybody huddles together with questions.

And worst of all are those important things that don’t have ready answers, or the answers have different explanations each time you look for them. Different causes. The secondary sex ratio has always been that type of enigma for me: why isn’t the ratio exactly 1:1 in humans? Well, first of all, some definitions. The primary sex ratio is the ratio between the sexes at fertilization, and the secondary sex ratio is their ratio at birth. There’s even a tertiary ratio -the sex difference in mature organisms.

In the past, the gender ratio at conception was unknowable, so the only useful ratio was the one at birth -and that seemed to favour males (1.1 males for every 1.0 female). So did that mean that male sperm somehow outswam the female ones or damaged them on the way to the egg? Did it speak to the quality of the gametes or merely suggest that to balance tertiary sex ratios (the ratio in sexually mature organisms, remember) more males were needed because, unlike females, they were less able to make it through childhood..? Until recently, as I mentioned, there was no way to measure the primary sex ratio, so it remained a mystery. Now it seems there is, and, surprise surprise, there would appear to be an equality of sexes -at conception at least: http://www.pnas.org/content/112/16/E2102.full.pdf  This fascinating study tracks gendered mortality during development in the uterus. There is a theory (the Trivers-Willard hypothesis) which posits that more males are born in a favourable environment and more females in an unfavourable one because just one sex will be better at ultimate reproduction under those differing conditions.

So what conditions might effect the secondary sex ratio? Well, amongst other things, there is some evidence that major stressors may influence it. Large disasters have certainly been implicated -earthquakes, for example: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881738/  And then, of course, there were the changes in secondary sex ratio immediately after the 9/11 World Trade Center attack in 2001… One explanation that has been offered to explain how this could occur is that males typically attain a critical fetal weight earlier than do females (the average weight of newborn males, for example, is ∼100 g greater than females) and this might exert a higher metabolic demand on mothers. So, depending on the gestational age and the extent of the stress, the mothers may be able to abort the male fetuses, but maintain the less physiologically demanding female ones. In other words, evolution would seem to have selected for those females that can regulate the sex of their offspring… Really?

That explanation seems rather contrived to me. Exactly how would the mother accomplish this feticide? And avoiding direct maternal involvement by referring it back to changes in placental function merely pushes the question back another layer. Of course, some have tried other approaches -for example citing the epigenetic environment (factors influencing the functionality of genes): http://humrep.oxfordjournals.org/content/20/9/2662.full But even when I force myself through the commentator’s words, the explanation still seems a little strained.

And yet, statistically, there does seem to be reason to believe that something is happening that relates to stress.

Of course pregnancy itself is a stress -levels of stress hormones increase as pregnancy unfolds: (http://www.jogc.ca/abstracts/full/201505_Editorial_1.pdf) -although, as the editorialist explains, ‘as a pregnant woman approaches term, environmental stress has less effect in triggering the usual response in the hypothalamic-pituitary-adrenal axis, and she becomes less responsive to the effects of stress’. Uhmm… So, pick your answer from a hat?

Well, in the rubble of destroyed answers and ever blossoming questions, what are we left with? Is there something special about violence that triggers it? Or does any stress threaten the ratio? And what constitutes a stress anyway? All imponderables, I suppose, but at least a recent article in the JOGC (Journal of Obstetrics and Gynaecology of Canada) brings it closer to home: http://www.jogc.ca/abstracts/full/201505_WomensHealth_1.pdf  And in an ‘Only in Canada, eh?’ fashion it demonstrates that we, too, can participate in the secondary sex ratio debate -on our own terms, of course. I mean, who would have thought that our two referenda on Quebec secession from Canada could provoke such a response? I’m almost proud that it did –it shows how involved we are in our country. How much it matters. And how we don’t need earthquakes, either.

And maybe the slight increase in female births that the worries about the referenda caused says something about our growing appreciation of women in Canadian society as well… I live in hope. But you gotta love this stuff, eh?