Reproductive technology has come far in the past twenty years. One of the more controversial developments is that it is now possible for parents to control for the gender of their baby with fairly high accuracy. There are medical reasons for doing so, like preventing sex-linked diseases and genetic abnormalities. Many people believe that medical reasons are a good and valid purpose for the use of sex selection technology. However, there has been quite a stir in the last few years over whether or not these procedures should be permitted for non-medical reasons, meaning the procedure is undertaken simply because the parents have a preferred biological sex for their baby. The arguments I came across in this debate were largely based on logic and ethics. Some believe sex selection is immoral and globally unacceptable, while others find it a required part of reproductive freedom and societally beneficial, or at least not harmful.
There are several methods of sex selection. One company, the Genetics & IVF Institute, offers MicroSort, which is sperm sorting involving separating X and Y chromosome sperm and then using the sperm in either intrauterine insemination or in-vitro fertilization (Jesudason, Yeung, & Shen). Pre-implantation Genetic Diagnosis (PGD) is used to determine the sex of an embryo before IVF, and there is also the more extreme sex-selective abortion method, which can follow analyzing fetal cells to determine the sex (Jesudason et al.).
Statistics have shown that even in the United States, the use of sex selection and preference for sons has resulted in more males than females being born amongst Asian-American communities (Jesudason et al.). This may be for the same reasons that sex selection is predominant in China, South Korea, and India, such as men contributing more to family income, and having an elevated social status among these cultures (Jesudason et al.). These communities in the U.S. are actively targeted by fertility clinics and doctors and in advertisements (Jesudason et al.). Sex selection for non-medical reasons has been banned in many industrialized countries, but in the U.S. there is almost no federal or state regulation (Jesudason et al.). The American Society for Reproductive Medicine’s Ethics Committee has stated that the use of PGD solely for sex selection should be discouraged, and this opinion includes the concern that sex selection may propagate gender role expectations and stereotypes (Jesudason et al.). The ethics board of the American College of Obstetricians and Gynecologists has declared both that sex selection is inappropriate and that pre-fertilization sex selection techniques (like MicroSort) have not been shown to be reliable (Jesudason et al.). There are also concerns amongst advocates for restricting sex selections that it will set up for allowing for parents to “select traits,” and encourage the pursuit of “perfect children” (Jesudason et al.). This could ultimately lead to a new private and personal form of eugenics, and could pose an issue for natural diversity and people with disabilities in the future. Disability advocates are concerned about sex selection even for medical reasons, because getting rid of embryos based on genetic conditions reinforces biases against those with disabilities (Jesudason et al.). Non-medical sex selection may encourages binary view of gender rather than fluid and as a result may encourage gender stereotypes and discrimination, which is a concern amongst LGBTQ communities (Jesudason et al.).
One of the most pervasive ethical arguments in favor of non-medical sex selection is for reproductive autonomy, which proponents believe should exist as long as they cause no harm to others. Some ethicists, however, refute this argument, saying that it does in fact cause harm. Sex selection creates child sex ratio disparities in South and East Asian countries that reinforce patriarchal societal structures; prenatal sex selection does not change the fact that this is “institutionalized discrimination” to the detriment of women and girls (Blyth, Frith, & Crawshaw, 2008, p. 42). Even westernized countries that are “lower risk” for this imbalance have shown some evidence for son preference, especially in certain localized communities (Blyth et al., 2008, p. 43). Permitting sex selection just in these northern-hemisphere countries could have effects through the rest of the world, legitimizing the techniques in the global view (Blyth et al., 2008, p. 43). Blyth, Frith, and Crawshaw argue that while it is clearly immoral to abort or kill a newborn because it is not the parentally desired sex, it is also morally unacceptable for a parent to have this desire so strongly that cannot overcome this individual desire; from a virtue ethics standpoint, this is not the type of choice is not one of a “good” parent (Blyth et al., 2008, p. 43). Some argue that sex selection begins to make children more like products, and increases the possibility of rejection; even if in westernized countries the preference for a certain sex is not strong and is only for family balancing, it opens the techniques to those with the strong preference, and additionally comes with possible harms that are not worth the risk if the desire in the parents is weak (Blyth et al., 2008, p. 43). In summary, we have seen in countries where the desire for a certain sex is widespread that there are obvious harms, and if there is only a weak preference, then this practice is not worth defending for the potential risks it could bring (Blyth et al., 2008). Preference for sons exists all over the world in varying degrees, and this may arise out of sexist societal constructs even in westernized countries — these decisions take place in a global social context (Blyth et al., 2008, p. 44). When sexism is present in a society, then it follows that sexism will be present in sex selection choices.
There are also many who believe sex selection is not only morally acceptable but has potential benefits. Firstly, some argue that restrictions of any kind on sex selection impinge upon personal freedoms, especially to families in “one-child-only nations” and will lead to sex selective abortions (Kalfoglou, Kammersell, Philpott, & Dahl, 2013). The restrictions would be “unnecessarily oppressive” in countries without sex bias, and some even argue that government imposition on reproductive autonomy for the good of society is a form of eugenics (Kalfoglou et al. 2013). Others are afraid that in restricting sex selection, other reproductive rights such as abortion would be infringed upon as well; many US state legislatures have tried to or succeeded in passing laws banning abortion based on sex preference, and many fear this would spread to further restricted access (Kalfoglou et al. 2013). Sperm sorting is currently the only technique for sex selection that does not destroy any embryos or fetuses — many argue that regulation of this will actually lead to abortions, which are much more ethically concerning when done for sex selection than the MicroSort preconception method (Kalfoglou et al. 2013). In a related vein, proponents argue that sex selection may assist women who are living in oppressive societies, because they can attain the goal of a son or a gender-balanced family without having burdensome numbers of children, or undergoing physical/emotional stress of abortions or infidelity to obtain sons (Kalfoglou et al. 2013). Lastly, if parents have a desire for a specific sex, especially if it is culturally motivated, sex selection could actually allow a child to have a more positive future (as a boy in most cases), because the child has been chosen and does not have to face neglect or abuse (as a girl).
A medical director from India offers another set of ethical and logical arguments. In the same reasoning as reproductive freedom, Malpani asks why couples should not have the freedom to select the sex of their child when they have the freedom to decide how many children to have, when to have them, and when to terminate them (2002, p. 192). It is pragmatic, he argues, for a family to want to balance the sex ratio within their household, and statistics that say this is going to lead to populations that are more skewed have been sensationalized (Malpani, 2002, p. 193). It is an inevitability in India (and other such countries), that sons will be selected for in one way or another, as long as they are associated with economic and social benefit; parents are not going to have expensive sex selection procedures done unless they are benefitted (Malpani, 2002, p. 193). Reproductive choices are highly personal decisions made to maximize personal benefit, and preconception sex selection can let families stop reproducing and having unwanted children once the desired child is obtained (Malpani, 2002, p. 193). Furthermore, the selection of traits is something we conduct anyway, in adopting a child (and being able to choose the gender!) and even in the selection of our partner (intelligence, appearance, etc.) (Malpani, 2002, p. 193). Is it such a leap to determine the sex of one’s own child?
While both sides seem to agree that sexism is an underlying issue and needs to be addressed directly, what is done with policy and in the medical field is still a point of contention. From my research, it seems to me that the opponents of sex selection have stronger arguments. Like many people in class said today, this does not necessarily sit well with me, because I believe strongly in personal freedom (especially from governmental regulation and interference if no harm is being done). However, the ethical and logical arguments made by the opponents moved me to see that there could in fact be harm done if one thinks on a broader scale than for instance just a local American clinic and a couple who really wants a little girl. The implication globally for the acceptance of these practices is something that the proponent side seems to discount or overlook the importance of. The idea that sexism and discrimination based on binary gender roles is not an important factor in westernized countries is fallacious and dangerous — we still have sexism here, and convoluted attitudes toward gender. Adding in essentially eugenics (selection of certain desired genetic traits, or de-selection of undesired traits) to the already complicated interactions between genders is potentially quite unwise, as innocuous as it may seem in certain scenarios. This may seem like a slippery slope argument, but sex selection is by definition a eugenic procedure, and this makes it an ethical gray area (as well illustrated by the opposing points) whether or not it snowballs into selection for other traits in the future.
Proponents do make a good point that preconception sex selection may reduce sex selective abortions — this is important and should not be ignored. However, this accepts sexism as a cultural inevitability, and bandages rather than heals this dividing issue. The idea that making policies restricting sex selection necessarily restricts other reproductive freedoms is an oversimplification — policies could navigate the line between these two types of procedures, likely with great clarity over time. Malpani and the others may be right that sex selection is going to happen anyway, and that we might as well make it do the least harm (reduce loss of life, neglect, and abuse as much as we can) through preconception techniques. However, even in their own arguments, they make it clear that this is not an ideal solution, but a inevitable or temporary one, a quick fix until women no longer feel forced to bear children until they have a boy, until the tantamount issues of inequality and discrimination can be reconciled with personal and reproductive freedoms. Then perhaps it will be clear whether or not children should be picked out like one checks a carton of eggs before purchasing them, and then perhaps we can see the gravity this technology could hold. We need to be able to look through eyes unclouded by bias to see what responsibility this will give the human race no matter how we decide to proceed.
Blyth, E., Frith, L., & Crawshaw, M. (2008). Ethical objections to sex selection for
nonmedical reasons. Ethics, Bioscience and Life, 3(1), 41-45.
Jesudason, S., Yeung, M., & Shen, E. (n.d.). Taking a stand: Tools for action on sex
selection. Generations Ahead. Retrieved February 27, 2015.
Kalfoglou, A., Kammersell, M., Philpott, S., & Dahl, E. (2013). Ethical arguments for
and against sperm sorting for non-medical sex selection: A review. Reproductive
BioMedicine Online, 26(3), 231-239.
Malpani, A. (2002). Why shouldn’t couples be free to choose the sex of their baby?
Reproductive Health Matters 10(19), 192-193.