In Pakistan, a woman’s marriage is rarely measured by companionship or compatibility. It is assessed by the speed with which she conceives and, preferably, produces a son. The pressure begins early, often before the henna has faded. If conception is delayed, or if a daughter is born, judgment is swift. She is labelled barren, cursed, or incapable. What biology says about the matter is irrelevant, because society has already chosen its culprit.
The belief that women determine a child’s sex remains deeply embedded in Pakistani households despite clear scientific evidence to the contrary. Men carry the Y chromosome that produces sons, yet women alone are blamed when one does not arrive. Even educated families cling to this myth. Science may be unambiguous, but patriarchy is louder.
Infertility is treated with the same bias. Pakistan has one of the highest infertility rates in South Asia, affecting both men and women. Research cited by the Journal of the Pakistan Medical Association (JPMA) and data referenced in Population Council Pakistan reports indicate that male factors account for up to 40 to 50 per cent of infertility cases. But when a couple struggles to conceive, only one person is dragged through tests, stigma and speculation: the woman. She is sent to gynaecologists, hakims, pirs and shrines. Her diet, prayers, womb and fate are examined. Meanwhile, the man is rarely asked for so much as a diagnostic sample. His fertility is assumed, his ego protected.
The silence around male infertility is not incidental. It is cultural. Pakistani masculinity is built on the presumption of virility, and questioning it is treated as humiliation. Many women quietly admit that their husbands refuse semen analysis outright, leaving them to endure invasive testing and social embarrassment. Some undergo procedures they do not need. Others remain silent because the alternative is blame, divorce or a second wife.
The transactional nature of fertility in marriage is barely concealed. If a woman does not conceive within a socially acceptable timeframe, polite concern quickly morphs into threats or veiled suggestions. Families begin to discuss backup plans and second marriages “just in case.” Even women who do conceive are not guaranteed acceptance. If the baby is a girl, celebrations are often replaced by disappointment. The woman is expected to apologise for biology, while the actual determinant of the child’s sex, the father, is never questioned.
Until Pakistan stops treating women as wombs and begins recognising that men are equally responsible for conception and infertility, the status quo will not change
Women are reduced to their reproductive function in more insidious ways, too. Their identities are frequently defined by their ability to produce children, produce sons and produce them on time. A married woman in her late twenties without a child is treated less as a person and more as a pending problem. If she does not conceive, her education, talents, relationships and ambitions are dismissed. Motherhood in Pakistan is not just a role. It is a performance requirement.
Male infertility, while common, is treated as taboo. Poor diet, smoking, drug use, stress, untreated infections and environmental factors all contribute to declining sperm quality, as highlighted in coverage by Dawn and Geo News on reproductive health trends. Yet no one asks men to change their habits. The burden of remedy is placed entirely on women: take medicines, try herbs, pray more, stay quiet. Men remain biologically central but socially exempt.
The healthcare system is not blameless. Many doctors admit off the record that they avoid insisting on male testing so as not to offend families or lose clients. Even when specialists do recommend it, in-laws often insist on focusing solely on the woman. The possibility of a male diagnosis is treated as more disgraceful than the suffering of the woman being blamed.
The absurdity reaches its peak in gender-selection rituals. Women are blamed for birthing daughters, yet the same families consult amulets, pirs or timed prayers as though wombs obey folklore. Some women undergo unnecessary hormone treatments or surgeries just to placate in-laws obsessed with sons. And if a woman dares to voice frustration, she is reminded that a “good mother” stays silent. Ironically, she is only honoured as a mother once she delivers a boy.
Divorce, emotional abuse and abandonment are common consequences of these myths. Countless women have been cast aside for infertility, only for the husband’s subsequent marriages to yield the same outcome. Even repeated evidence does not shift suspicion towards the man. Suggesting that a husband could be infertile is often considered more insulting than accusing his wife of witchcraft.
The cost of this social delusion is borne entirely by women. They endure medical procedures, gossip, psychological strain and spiritual scrutiny for conditions they may not even have. Their bodily autonomy is compromised while men are sheltered by custom and denial.
Ending this injustice requires more than awareness. It requires accountability. Men must be included in infertility diagnostics as a norm, not an exception. Gender myths must be challenged not only in academic circles but within households, media and religious discourse. Healthcare providers must prioritise fairness over cultural appeasement. Families must be reminded that fairness is not dishonour.
Until Pakistan stops treating women as wombs and begins recognising that men are equally responsible for conception and infertility, the status quo will not change. The problem is not science. It is the refusal to accept it.
When women are blamed for outcomes determined by men’s biology, it is not ignorance. It is convenient. And in Pakistan, convenience is often just patriarchy disguised as tradition.