20181008 Georgian Experience Image 01

Georgian Experience of Gender Biased Sex Selection

This policy brief presents the evidence on gender biased sex selection (GBSS) in Georgia, giving an overview of the so-called “sex ratio transition” process, and discussing the determinants of GBSS using a demand and supply-side approach. After its independence from the Soviet Union, Georgia started experiencing a significant rise of the sex ratio at birth (SRB) and in 2004 the country had reached one of the highest SRB rates in the world. A traditionally pronounced son preference was further strengthened by deteriorated economic conditions, decrease in fertility and relatively easy and cheap access to technologies for early sex determination and abortion. However, Georgia has managed to reverse and stabilize a skewed SRB rate. Among the factors that might have contributed are the strengthening of the social security system, improved economic conditions, a rise in fertility rates, economic empowerment of women, and the increased cultural influence of Western values. This trend reversal places Georgia in a unique position and may provide valuable insights for other countries who struggle with the same problem.

It is widely recognized that the Caucasus has traditionally been a “male-dominated region,” with a particularly strong son preference. However, before the dissolution of the Soviet Union in the early 1990s, sex ratios at birth in the Caucasus countries were very close to normal levels.

After independence from the Soviet Union, the SRB started rising immediately in Georgia, reaching 114.1 male births per 100 female births by 1999 (while the biologically normal SRB level is 105 male births per 100 female births). In the early 2000s, SRB peaked and stabilized between 112 and 115 male births per 100 female births for several years.  As Figure 1 shows, after reaching historically high levels in 2004, SRB started to decline and finally returned to a normal level by 2016.

Figure 1. Estimated sex ratio at birth in 1990-2016

Source: UNFPA, 2017.

The sex selection here is not discussed as “an archaic practice” in Georgia, but rather a modern reproductive behavior, a rational strategy responding to the surrounding environment – demand and supply factors. Demand-side factors include socio-economic and cultural factors that make having a boy more beneficial for a family and lower the value of girls – leading to son preference. The fertility rate is also accounted as a demand-side factor since low or decreasing fertility can increase incentives to perform selective abortions. As for the supply-side factors, they cover the ease of access to  technologies for early sex determination and selective abortion and its cost, as well as the content of the legislation regulating abortion.

Demand side factors

Factors increasing demand

Son preference and a patrilineal system. The traditional Georgian family is patrilineal. Patrilineality, also known as the male line, is a common kinship system in which an individual’s family membership derives from and is recorded through his or her father’s lineage. It generally involves the inheritance of property, rights, names, or titles by persons related through male kin. In such systems, women join their husbands’ families after marriage and are expected to care for their in-laws rather than their parents. Sons are expected to stay with their parents and take care of them. Thus, patrilineal systems make daughters less beneficial and desirable to their parents compared to sons. UNFPA (2017) concludes that the practice of post-marital co-residence with parents is still quite widespread in Georgian society, and this pattern is biased towards the male kin line, downplaying the role of women and their kin. The patrilocal residence (the situation in which a married couple resides with or near the husband’s parents) is more common in villages (more than 90%) than in urban areas (75%). The incidence of patrilocal residence is the lowest in Tbilisi (69%). In general, patrilocal residence decreases with improving economic conditions.

Demographic change – changes in fertility rates. Low or decreased fertility rates (when other factors favorable for GBSS are in place) mean that families are no longer able to ensure the birth of a son through repeated pregnancies. In societies characterized by strong son preference, and with increasing availability of sex detection technologies, couples start to opt for sex selection because they want to avoid additional births of girls, something that contraception cannot alone ensure. Therefore, low fertility acts as a “squeeze factor,” forcing parents to make choices ensuring the desired gender composition of their family.

An inverse relationship between fertility and SRB is observed in Georgia. The first decade of transition to market economy was severe for the country. Reducing household size was one strategy chosen by Georgian families to cope with increased rates of unemployment, deterioration of the social security system and deprivation of basic needs such as water and electricity. The decline of fertility during the years 1990-2003 coincided with increased SRB levels. When fertility started to rebound in 2003, the “squeeze factor” began to vanish, removing pressure on the SRB. At the same time, the SRB started to decline.

The low value of women. In Georgia, women are stereotypically perceived as natural caretakers, whose core responsibilities involve child care and household duties. They are also expected be obedient to their husbands and let them have leading positions in various activities (UNDP 2013). The majority of the population in the country thinks that men should be the ones who are the family’s decision-makers and that they should also be the main breadwinners. According to a 2010 study, 83% of respondents think that men should be the main breadwinners in the family, and 63% believe that they should also be the family’s decision-makers (CRRC, 2010). It is evident that such attitudes and values contribute to decrease the perceived value of girls in society, compared to boys, and add additional stimulus to GBSS.

Factors decreasing demand

The strengthening of state institutions and the social security system. Georgia has experienced a deep transformation of its social, economic and political systems in the last fifteen years. Reforms were carried out in all sectors. Most importantly, the country totally restructured its social security system, which was practically non-existent in Georgia at the beginning of the 1990’s. Currently, Georgian citizens are offered: a) universal pension system, above the subsistence minimum, which provides a flat rate benefit to all elderly; b) social assistance, which represents a monthly subsidy to poor families, is well targeted, and has contributed to reducing poverty (Kits et al. 2015), and (c) a universal health insurance system which covers all people who are uninsured by private companies and softens the burden of health care expenditures for households.

These changes, together with the improved general economic situation in the country, have decreased the role of the family as a buffer institution offering protection and stability (notably through sons), and provided more formal alternatives for social security, bank loans, contractual employment, etc. Due to this, the (large) intergenerational family is no longer perceived as the only strategy for coping with social and financial uncertainty.

New cultural influence of Western values. From the early 2000s, Georgia has been increasingly exposed to Western norms and culture through media, migration, increased tourism, and the process of economic integration with the European Union. According to experts, this process was accompanied by “media support and an enthusiastic, quasi-propagandistic hail. The general spirit was to promote an image of Georgia as a country open to the world with West-European views and lifestyles” (UNFPA 2017).

Supply side factors

While the availability of technologies for the early determination of sex and for abortion is not the root cause of GBSS, it constitutes a facilitating supply factor. Without prenatal diagnostics and accessibility of abortion, parents would not be able to resort to selective abortions even if they had a pronounced preference for boys.

Currently, Georgia is among the countries offering high-tech reproductive services. Private clinics, hospitals, and special reproductive medicine centers compete to supply reproductive services, and one can easily see the most recent ultrasound technologies in the great majority of the urban facilities. In addition, the cost of an ultrasound test is extremely low, depending on the service provider. This represents only 1.9%-4.8% of the average monthly incomes per Georgian household. In this context, the GBSS-related demand for prenatal diagnostics can easily be accommodated, when it arises.


Georgia has had a unique experience of “sex ratio transition” in the region, which was an integral part of its overall transformation process. The deteriorated social and economic conditions of households following the beginning of the transition process, coupled with easier and cheaper access to prenatal diagnostics were reflected in a skewed SRB and manifested son preference. Only when socio-economic conditions improved, and the country accelerated its institutional strengthening and modernization process, did the SRB returned to its normal level.

It is too early to conclusively state that Georgia is back to normal SRB levels for good. Birth masculinity still remains at a high level i) for third-order births, as the most of the couples are reluctant to have more than three children, and giving birth to a third child is the last chance for families to have a boy; ii) there is a significant urban-rural divide in the context of birth order. For three or higher order births, SRB is significantly distant from normal levels for almost all regions, reaching beyond 145, while in Tbilisi the bias remains moderate; iii) gender-biased sex selection remains high among poor people and ethnic minorities.

If Georgia is to minimize the incidence of GBSS in the future, it needs to act on several fronts: enhance gender equality through qualitative research and civic activism; increase the perceived value of girls and women in the society through policies and initiatives addressing cultural stereotypes, as well as by publicizing illuminated stories of success of girls and women that provide positive role models; monitor SRB trends; support advocacy actions and awareness-raising campaigns on GBSS and encourage the ethical use of sex detection technologies.


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