Is Gender Selection of a Fetus Ethical?

By Brian Wolf, Kathleen Li


Brian Wolf argues that gender selection should be permitted, but Kathleen Li discusses its negative consequences.

The issue regarding
the selection
of a child’s gender
continues to produce a wide variety of
positions. The main argument in favor for
gender selection rests upon the notion that
individuals have a choice in the selection
of the sex of their offspring. While this
practice may be quite controversial, it is
essential to understand how and why this
technique is being utilized, and to create
an approach that appeases both those who
oppose and support gender selection.
The way in which individuals
can know the gender of their child is
through the post conceptual method
of in vitro fertilization (IVF) and preimplantation
genetic diagnosis (PGD).
PGD has been noted as an important
tool in determining whether the child
presents single gene defects and sexlinked
disorders. Additionally, this is a
method that enables a strong possibility
of a pregnancy with a fetus of the
chosen sex and a close-to-zero possibility
of a pregnancy with a fetus of the
non-chosen sex.1 Only within the past
decade, a technique for sex selection
which does not include pregnancy
termination has been presented.
An argument that supports the
need for gender selection is the high
risk of maternal mortality in certain
countries in the world. As stated in a
study by World Health Organization
(WHO), the report notes “the disturbing
statistics of maternal mortality
for developing countries, where
women are more than 400 times as
likely to die from complications during
pregnancy than women in Southern
Europe.”2 Maternal mortality and
morbidity can be linked to series of
consecutive pregnancies, in addition
to having children at a very young
age.1 An example of a situation in
which women must bear successive
pregnancies occurs when a family’s
religion demands that they produce
sons.1 If a family has the option to
choose their first child as male using
PGD, the women would not be burdened
with multiple pregnancies until a male is born. While it is necessary
to promote gender balance and
sex equality throughout the world, the
choice of gender selection has a strong
potential to save many women’s lives.
However, studies on gender selection
need to be understood before
opinions are formed on this matter. As
described in the following study:
“1001 British men and women
were asked about their gender preferences.
About two thirds of the respondents
stated that, if given a choice, they
would like to have a family with an
equal number of girls and boys. Most of
the remaining third claimed not to care
about the sex of their children. Asked
whether they wish their first-born child
to be male or female, 16 per cent liked
their first child to be a boy, 10 percent
liked their first child to be a girl, and
a vast majority of 73 percent said they
did not mind what sex their first-born
child was. Finally, when asked to imagine
they could have just one child, 19
percent preferred their only child to be
a boy, 17 percent preferred it to be a girl,
and 57 percent stated they did not care
about the sex of their only child (Dahl
et al., 2003).”3
While there may be a slight preference
for child to be male (19 v. 17 percent),
does this indicate that all these
parents who prefer a male for their
only child will utilize PGD and invitro
fertilization to select the gender
of their child? Probably not. It should
also be noted that, according to data
from American and British “Gender
Clinics,” individuals who are willing
to subject themselves to these invasive
and costly treatments are couples
who have two or three children of the
same sex and would want another
child of the opposite sex.3 A possible
solution to the utilization of gender
selection “can be addressed by permitting
sex selection only for second or
subsequent children, rather than by
absolute prohibition.”1 This allows sex
selection for purposes of family balancing
in countries where no distinct
male-dominance prejudice occurs and
for parents who are ethically neutral
on gender selection.
The clinics that offer this service of
gender selection are given the liberty
to offer, to curb, or to reject a prospective
patient when deemed necessary.
As described in various studies, there
is no conclusive evidence for a severe
sex ratio distortion to occur in various
countries (e.g., England and United
States), but the possibility of gender
bias in other societies needs to also be
considered. The clinics providing this
service must understand that when
there is a clear and present danger due
to sex bias they must use reasonable
judgment to refute this service. Therefore,
the post-conceptual method of
IVF and PGD should be permitted,
but only under certain circumstances.

NO While embryonic
gender selection
via preimplantation
genetic diagnosis (PGD) is beneficial
for medical purposes, such as screening
out embryos with sex-linked disorders,
single gene defects, and chromosomal
disorders,1 the issues that
arise from non-medical gender selection
pose concerns about ethical obligations,
are damaging to the economy
and medical advancement, serve to
reinforce gender stereotypes, and may
lead to the establishment of selection
of genetic predispositions as a right.
Embryonic sex selection is a process
of in vitro fertilization (IVF)
whereby a woman’s embryo is fertilized
with a man’s sperm in a lab.
After three days incubation, a doctor
can extract a single cell from the
embryo to determine its gender. The
would-be mother then has the choice
of whether or not to implant the
embryo.2 Evidence suggests that children
born from PGD methods are not
any more likely to have physical health
The ability to choose the gender
of a healthy child is so appealing that
eager parents are willing to incur the
steep financial burdens that accompany
it. These procedures are costly,
often up to $18,000 for a single procedure.
Sometimes, a procedure might
not even produce any usable, chromosomally
normal embryos.
The gender selection industry
makes over $100 million a year performing
4,000-6,000 procedures.6
There is reasonable fear about human
resource allocation; for example,
fertility doctors may decide to stop
treating infertility and pursue gender
selection instead. Advertising for gender
selection procedures have begun
to scope out interested individuals
among the masses, posting and advertising
on social networking sites such
as Facebook, Twitter, and Youtube,
attempting to drive up the demand.
Framing gender selection as an industry,
and advertising it as a commodity,
we have parents such as Megan
Simpson addressing the success of
the procedure in a grossly inhumane
manner. “My husband and I stared at
our daughter for that first year. She
was worth every cent. Better than a new car, or a kitchen reno.”7
Simpson is a middle class, married
woman who grew up in a family
of four girls. She wanted a daughter
because she desired to engage in stereotypically
female bonding activities,
such as “sewing, baking, doing hair
and makeup,” which she had enjoyed
as a child. Other women share similar
sentiments. Jennifer Merrill Thompson,
self-published author of “Chasing
the Gender Dream,” states her reasoning
simply: “I’m not into sports. I’m
not into violent games. I’m not into a
lot of things boys represent and boys
do.” A report published by the Ethics
Committee of the American Society
for Reproductive Medicine indicates
the potential of psychological harm
placed on sex-selected offspring, with
parents expecting their child to behave
in a certain manner in accordance to
gender stereotypes.8 This in turn could
also lead to reinforced gender stereotypes
in society as a whole.
Also, the casual normalization of
sex selection might lead to the creation
and prevalence of other selective
procedures in the future. The
fears of the 1997 science fiction film
“GATTACA” may be realized; people
may start evaluating others based on
genetic traits. In the world of GATTACA,
natural conception is a choice
only those in lower social classes
would make. There is rampant genetic
discrimination, those born without
perfect genetic traits such as heart
defects, nearsightedness, possibility of
developing mental disorders, as well as
other unnecessary enhancements such
as height and hair color are considered
“invalid” in their society and only have
access to low-paying, manual labor
jobs. Encouraging selectivity in the
general population about children we
want born may strengthen the social
gap and the wealth gap.
Right now, doctors in the United
States can make the decision of
whether or not the patient will receive
the sex selection procedure. The issue
of ethical obligations arises. Should a
doctor discourage sex selection, based
on all the potential negative impacts,
or should they respect their patient’s
autonomy? There are economic incentives
for doctors to condone embryonic
sexual selection, a whole market
of women who are interested in
undergoing the expensive and unnecessary
procedures. The United States is
one of the only countries in the world
that still legally allows PGD for nonmedical
reasons. Kerry Bowman, bioethicist
at University of Toronto’s Joint
Centre for Bioethics in Ontario brings
up the point that “the gender of a child
is not directly related to the health and
well-being of a child.”9 We cannot have
a society that will allow the choosing
of children based on the fact that they
are a boy or girl.

Subject: Bioethics
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