Gender-biased sex selection must be addressed by all segments of government and society, an international Istanbul forum stressed Tuesday. Organized by the United Nations Population Fund (UNFPA) and the International Children's Center (ICC), the two-day forum "Son Preference and the Undervaluing of Girls" provided a platform for knowledge sharing on son preference and gender-biased sex selection and to foster South-South exchange and collaboration among affected countries. The gender-biased sex selection trend started in Asia, but it also spread to parts of Eastern Europe, said Alanna Armitage, the director of UNFPA's Regional Office for Eastern Europe and Central Asia, speaking at the opening session of the program. With around 115 boys born for every 100 girls, Azerbaijan has one of the highest sex-ratio-at-birth imbalances in the world, Armitage said.

"Armenia, Georgia, Albania and parts of North Macedonia and Kosovo also have many more boys born than girls," she said, and warned, "In Armenia alone, close to 100,000 girls will be ‘missing' by 2060 if current trends continue." The UNFPA director also noted that son preference had been "slowly decreasing" for the last decade thanks to a strong national commitment by governments and support of the EU and other partners. Stressing that the UNFPA has made gender-biased sex selection a priority program, Armitage said, "Through the global program on gender-biased sex selection, we have invested extensively in strengthening regional and national capacity to address son preference from a holistic perspective."

For her part, ICC President Tomris Turmen said the states had an obligation under human rights law to respect, protect and fulfill the human rights of girls and women. "But at the same time, states have an obligation to ensure that these injustices are addressed without denying women access to needed services like safe abortion," she said.

Christophe Z. Guilmoto, a professor of demographics at the University of Paris, said affected countries are clustered in East and South Asia, South Caucasus and Southeast Europe. The rise is caused mostly by sex-selective abortions such as prenatal sex diagnosis, ultrasound, followed by abortion of female fetuses, said Guilmoto, and added, "Today, it seems that Azerbaijan has the highest level of sex ratio at birth, based on the data from 2017 in the world."

Guilmoto pointed to a global decline in the level of gender-biased sex selection, sharing estimates that the highest level reported in the world is now below 115 male births per 100 female births. The number of sex ratio at birth has steadily declined in the South Caucasus, he said.

Three main factors behind the imbalances are son preference, sex selection technology, such as ultrasound, abortion, fetal blood test, preimplantation and fertility decline, Guilmoto added.

According to the UNFPA, around 126 million women and girls are believed to have not been born around the world due to gender-biased sex selection, which can include excess female mortality and prenatal sex selection.

These projections estimate that, by 2020, more than 142 million women will never have been born around the world as a result of a preference for sona and gender-biased sex selection, which is a form of discrimination, it says.