Tuesday, October 2, 2012

But I Wanted A Girl...The Ethics of Prenatal Sex-Selection.

It has become medically possible for women to choose whether to conceive a male or female child – but are there ethical reasons why we should refrain from doing so? The most commonly raised concerns are creating imbalance in the societal ratio of male to female children, and perpetuating discrimination against women.  But these aren't the only concerns - what if it fails? If you raise parents' expectations so high (so high they often pay upwards of $11,000 dollars or more for the privilege) that they will have a son, what happens when they find out they're having a happy healthy daughter? A recent Slate article raises another red flag - the enormous pressure on these kids to live up to the gender expectations of their parents ("My husband and I stared at our daughter for that first year").
(Example of an image intended to evoke negative emotions towards sex selection.)
(Example of an image intended to evoke positive thoughts towards sex selection.)         
Some women choose to have female children to avoid passing on a serious genetic condition, and this has been termed “medical gender selection.” Considering the alternatives, sex-selection which is motivated purely by a desire to birth a healthy child appears to overcome the ethical concerns.  These procedures, standing alone, are unlikely to largely impact the natural ratio of men to women, and because this process favors conceiving female children, it does not promote discrimination against women (x-linked dominant chromosomal disorders are rare).

Trickier are the fertility clinics catering to families seeking purely elective pre-natal sex selection.  While they are growing in popularity in the U.S., in many countries they are not only discouraged they are illegal (i.e. Canada, India, Japan, France, Germany...).  In countries which have outlawed the practice, they have primarily done so in response to widely held beliefs that female babies are less desirable.  This attitude prevails in much of the world.  

China offers a troubling example of these ethical tensions.  In response to widespread infanticide of female children in response to its one-child birthing policy (estimates of 30-40 million more males than females by 2020: the equivalent of wiping Argentina off the map), China forbids all sex identification of a fetus by "technical means" (I presume this to mean both pre and post natal sex detection techniques).  This hasn't worked, of course, because the attitudes continue to exist (the Chinese Academy of Social Sciences predicts that 1/5 of men under 20 will be unable to find mates within the decade).  In recognition of the widespread belief that son's are more desirable, and declining female birth rates, enforcement of the one-child policy is often relaxed for rural parents who bear daughters

But the plot thickens - because in the U.S. we are told that a desire for female children is driving the majority of sex-selection services.  At first blush this seemed logical to me - because, although childless, I have always felt that I would prefer to have a daughter.  In addition, recent articles making this claim cite anecdotal evidence, such as the prevalence of Google search questions such as "how to have a girl", suggesting that this is the case (i.e. Jasmeet's Sidhu's How to Buy a Daughter?).  But many of these stories are in fact stories of what has been labeled 'family-balancing', where women who have a brood of football loving, gun shooting boys are desperate to increase the estrogen in the house.  What may be true, is that women are more likely to use family balancing to bear girls, and less likely to use it to bear sons when they already have daughters.  There is something about the mother-daughter bond that is impressed upon women from birth, influencing their feelings of loss when they have only sons.  But what you don't hear is that in a vacuum, among families who have yet to bear children, American couples prefer boys.  Thus, it is impossible to tout female preference as refutation of the claim that sex-selection perpetuates discrimination against women and girls in the U.S. - just as it does abroad.

What's the bottom line? The bottom line is that while the U.S. is still an outlier in this field, where most countries have barred the practice for non-medical use, there is widespread international demand (apparently there are now sex-selection apps).  Why do we care? Because eugenics does not have a pretty past, and just as likely it doesn't have a pretty future (i.e. clinics already starting to advertise hair and eye color selection).  We shouldn't be taken in by all the hype over family-balancing, and female-dominance.  Behind sex-selection practices lies a slippery slope of eugenics - one which at the very least engenders and derives from harmful gender stereotypes about the innate preferences and habits of boys and girls.  The bottom line is that we do not know the impact that these practices will have on children, but from this vantage it does not look good.


Patricija said...

I was really struck by your comment of family balance. It is so interesting the various efforts women undertake for the sake of the family. While I struggle what part of my nurturing personality is nature vs. social conditioning, I am quite aware of all the things I do for and on behalf of my family. Now that I am married to a man who is one of three boys, I feel it even more. I buy gifts and cards for special occasions (not to mention remember those occasions) and am responsible to thank people for their gifts. My husband doesn't tell me to do this, nor does he really expect me to. If it was up to him, it just wouldn't be done. But what isn't done gets an eye roll in his direction, and disapproval and judgment in my direction. I am continually shocked by both his lack of initiative in these endeavors, and the subsequent little negative consequences he faces. Maybe the Americans who want daughters would change their mind if we put the same societal pressures and consequences of taking care of the family to both genders.

Patricija said...

I also want to follow up that I have a lot of internal turmoil over this subject. Off the bat, I think medical gender selection is incredible practical and hence should be permitted (and perhaps even encouraged).

It is interesting when faced with the question of whether people should be able to select for hair color or eye color, my gut (and mind and heart) simply cannot get on board. Creating people as if it were a new car purchase, whereby you select the various features, simply seems too creepy to me. However, I'm not sure why selecting for gender doesn't hold this same "creep" factor for me. It is also interesting that I become even more sympathetic to couples who have had three or four children in the hopes of getting one particular sex. In one way, isn't that just another attempt at gender selection, but at greater risk of failure and at a higher cost to those families (and possibly society)?

CET said...

Not including women who opt to have daughters to avoid passing on serious genetic conditions or cultural considerations in countries like China, I don't understand why people are so concerned with the gender of their children. Is this desire based on our assumptions of what a "son" or "daughter" would be like? Would those who are determined to have a son be disappointed if he has strong feminine traits? I would guess, for many, the answer is yes. It seems one's desire for a child of a certain gender is based on some sort of vision for who the child will become. Parents, as much as they would like to, do not have control over their child's personality or likes and dislikes. Aside from health reasons to having a child of one gender over another, I'd love some examples of when medical gender selection would make sense.

Heather said...

I was thinking the same thing as CET, "I don't understand why people are so concerned with the gender of their children."
I think it is based on gender stereotypes and the 'ideal' child. Throwing all of these preconceived notions will help everyone realize that everyone, male of female, is equally valuable.

Charlene said...

This number strikes me as extraordinary - that in 80% of of those seeking fertility treatments do so with the end goal of a birthing a girl. That's an overwhelming preference, and if it's to find deeper "female bonding" as the Slate article suggests, I wonder if this is a symptom of a greater problem in American society. Does it speak to a growing disconnect between the sexes? Or does it speak to a growing disconnect between women, so that they seek their female bonding from their own daughters?

MC said...

I had no idea that it became medically possible to select the gender of your baby. The health arguments surrounding this practice sound reasonable. But I wonder if -- as Patricija suggests -- this could evolve into a "creepy" build-a-baby trend.

Currently the United States' gender ratio is relatively balanced: roughly 1 to 1. https://www.cia.gov/library/publications/the-world-factbook/fields/2018.html. If predetermination of our children's geneder becomes more accessible, we could face social issues similar to China's: too many men, not enough women. Or conversely, too many women, not enough men. Perhaps then we'd see a reduction in gender discrimination againt women.

Sam said...

I think that – except for objective medical reasons – sex-selection is immoral. Since men and women are equally valuable, there is no good reason to prefer one sex over the other. Therefore, if someone prefers one sex over the other, they are necessarily importing some type of unequal valuation.

This means that sex-selection is the equivalent of eye or hair color. While it may be acceptable to make musical or culinary decisions based on your whims, it is unacceptable to treat humans in this way.

The more interesting question in the area of designer babies is going to arise when we are able to select for personality traits. Is it OK to want your child to be extroverted? Or is this an imposition of the dominant culture’s values?

At what point does selecting for certain traits become eugenics?

Elizabeth said...

I think Charlene hit it on the nose. I would venture a guess that a lot of women want to have a girl to be her "best friend" and correct some of the psychic harm done by other women and particularly their own mothers.

Personally, I don't have a strong opinion either way on the debate. Honestly, I would be pretty sad to only have boys. I have a great relationship with my mom and I love the special bond that mothers and daughters can have. I would love a son too, but it's a different relationship.

I think it's a different question than hair and eye color, which has a sort of nazi-esque feel to it. Although it would definitely be a problem if a strong preference for one sex or the other affected the gender ratio in our country.

Pali said...
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Mo said...

I can’t say I’m as surprised that people “are so concerned with the gender of their children.” To me, it seems natural that prospective mothers might prefer daughters and prospective fathers might prefer sons. Women bearing women might feel more comfortable raising a child that will have, in her lifetime, similar experiences to those of the mother, and presumably the mother will be able to identify with and assist the daughter as she grows. (Same, of course, for fathers and sons.) I think, in general, we tend to prefer what we’re familiar with and thus more comfortable with. (Perhaps, the psychological path of least resistance?)

One thing I found interesting with respect to your “American couples prefer boys” citation (http://www.livescience.com/14757-americans-prefer-boys.html), was that the men’s responses skewed the result in favor of sons. According to that poll, 49% of men preferred a son and 22% preferred a daughter. Among women, 32% preferred a daughter, 31% preferred a son, and 47% had no preference. Of course, we could speculate for days as to the reason for the difference. Suffice to say, the conclusion that “Americans Like Baby Boys Best” is largely the result of the prospective fathers’ votes. Might it be different if our culture attributed to fathers greater caregiver responsibilities? Might those male voters feel more comfortable raising either a daughter or a son?

Pali said...

Sex selection is endemic in India and other Eastern countries primarily because boys are valued as your retirement plan. Daughters are considered a burden, one bringing expenses such as a wedding, or dowry, and the liabilities of bringing shame, getting pregnant, etc. whereas a son will take care of you in old age. Ultrasounds revealing sex are actually banned in India because of the stark imbalance of the male to female ratio due to female infanticide in rural areas. It is not as if these laws are actually enforced though. Back alley ultrasounds, in conjunction with abortion clinics are plentiful. Though my family is starkly pro life, the value placed on a male child is evident and an invisible presence even in my American upbringing. My dad's parents had seven girls before him. My mom's parents had three girls before my uncle. My mom had me and my sister and decided she was done. Up until maybe ten years ago, people, strangers, old Indian women at the park, in the street, at the grocery store, my grandmas, would tell my mom, that she is still young-- she should try for another, "Maybe this time you will get lucky and have a boy". My mother, bless her heart, with her sharp tongue would immediately retort with things like "your girls may have been unlucky, but mine have been luckier than any boy could have been", etc. Gender selection, whatever the reason, and whatever the preference (bar maybe medical), seems misplaced to me.