When I write and speak about the ethical questions raised by reproductive technologies, I do not argue that reproductive technologies are all good or all bad, or that using these technologies is clearly right or clearly wrong. My agenda, rather, is to encourage more robust and informed conversations around these technologies, because the science has developed faster than our cultural conversations around their promise and pitfalls.
But as I’ve researched and discussed the fraught questions around reproductive technologies, I have, of course, developed opinions, one of which is that it is unethical for fertility clinics to offer gender-selection services for nonmedical purposes.
In the U.S., unregulated fertility clinics are largely allowed to do whatever technology allows them to do, so long as clients are willing and able to pay for it. Anecdotal evidence and clinical data indicate that a growing number of prospective parents are willing to pay to have a baby of their desired gender.
There are two different techniques whereby couples can attempt gender selection: Microsort, a sperm-sorting technique, allows clinicians to sort X-bearing and Y-bearing sperm, and then use the sperm with the desired chromosome to inseminate the mother-to-be. A more accurate, but also more invasive and expensive technique for gender selection is preimplantation genetic diagnosis (PGD). PGD was developed as a way to screen for fatal or debilitating genetic disorders at the embryonic stage; my own experience with reproductive technology involved using PGD to try to avoid passing my genetic bone disorder on to my children. Many American clinics, however, now offer PGD as a way for couples to choose their baby’s gender by choosing only fertilized eggs of the desired gender for implantation in the mother’s uterus.
The United Kingdom, Canada, and Australia all ban the use of PGD for gender selection for nonmedical purposes. PGD for gender selection is only justified if a couple’s family history includes a particular sex-linked genetic disorder; that is, a disorder that predominantly or exclusively affects babies of one gender.
In the U.S., the growing use of technology to bear a child of a particular gender is driven by two different populations. Immigrant families from countries such as India and China use the technology to ensure the birth of the much-wanted boy child. Some U.S. fertility clinics have a history of advertising gender-selection services in foreign language newspapers targeting patriarchal cultures. There is also anecdotal evidence that couples of Indian, Chinese, and African background come to the U.S. from other countries to access gender-selection services.
The other population utilizing gender-selection technology are couples with one or more sons, in which the wife has an intense longing for a daughter. Jasmeet Sidhu, in her Slate article “How to Buy a Daughter,” profiled Megan Simpson, who used PGD to have a girl after having three boys: “[Simpson] had grown up in a family of four sisters. She liked sewing, baking, and doing hair and makeup. She hoped one day to share these interests with a little girl whom she could dress in pink.” Simpson uses highly emotional language in telling her story. After initially using sperm-sorting to become pregnant with her third baby, she “lay in bed and cried for weeks” upon discovering that she was pregnant with another boy. She ultimately decided not to abort her son and turned to PGD to ensure that her fourth child would be a girl.
I have no doubt that Simpson’s anguish was real. But that anguish does not justify use of PGD for gender selection.
Gender selection is bad for women.
Cultural preferences for male children stem from ancient, deep-seated ideals of what makes for stable families and communities. In cultures in which boys are more likely to be educated and employed in stable jobs that earn enough to support a family, families hope for boy children who will eventually contribute to the family’s well-being and care for aging parents. Girls, on the other hand, are perceived as liabilities rather than assets, as they will not have the same possibilities for education and lucrative employment, and might even cost their family money in the form of marriage dowries.
The assumptions behind these ideals no longer hold water in our 21st century global culture. We know, of course, that girls and women are just as capable of succeeding in education and the workplace if given opportunities. Furthermore, a body of research indicates that empowering women in poor communities, such as with microloans for starting small businesses, doesn’t just help individual women, but helps to raise entire families and communities out of poverty. Recognizing that girls and women have the same educational, economic, and cultural potential as boys and men, we cannot justify providing gender-selection services that support false and outdated patriarchal ideals.
Furthermore, a woman who comes to a clinic for help conceiving a boy is likely under pressure from her own and/or her husband’s families, and possibly her husband himself, to do her duty by providing a male heir. In the name of “reproductive choice,” we have allowed unregulated fertility clinics to provide gender-selection services that may, in very concrete ways, undermine individual women’s ability to make childbearing decisions free of coercion.
Simpson (the woman profiled in Sidhu’s Slate article) dreams of baking and sharing make-up secrets with her daughter. Liza Mundy, in researching her book on reproductive technology titled Everything Conceivable, noted that, “in the sex-selection chat rooms I looked at, there were lots of women looking forward to dressing little girls in pink outfits and putting pretty bows in their hair.” And as Sidhu noted in researching her article:
Interviews with several women from the forums at in-gender.com and genderdreaming.com yielded the same stories: a yearning for female bonding. Relationships with their own mothers that defined what kind of mother they wanted to be to a daughter. A desire to engage in stereotypical female activities that they thought would be impossible with a baby boy.
The problem, of course, is that little girls don’t always love pink and baking and girl talk and make-up, just as little boys don’t always love dirt and trucks and dinosaurs and football. The relationship between children’s gender and their preferences is not exact, unchanging, or predictable. Why is pink a feminine color and blue a masculine color? Because we say so (at least for today). Do we really want to allow parents in thrall to gender stereotypes to engineer their children for the sole purpose of meeting ephemeral and superficial cultural norms?
I have a daughter who prefers “boyish” colors and toys and clothes, and a boy who prefers “girlish” colors and toys and clothes. I have seen firsthand that non-gender-conforming children’s journeys through the judgment-laden landscape of childhood and adolescence is hard enough even if they have parents who don’t give a hoot whether or not they are interested in mother/daughter manicure sessions. How much harder will this journey be for a little girl who hates baking and make-up and the color pink, but who was conceived for the stated reason of giving her mother a companion in these pursuits?
From my experience with two non-gender-conforming kids, I also know that girls who veer toward boyish things have an easier time than boys who veer toward girlish things. So I’d like to think that all those moms who equate their longed-for daughters with bows and sparkles would rise to the occasion if they ended up with a scabby-kneed, jeans-wearing, Star Wars-loving girl instead. But I’d rather we encourage parents to prepare to embrace whatever child they receive before that child is conceived, rather than down the road when that child becomes capable of expressing her preferences.
The justifications for gender selection are almost purely parent-focused.
Why do I accept the use of PGD to screen for genetic disorders, under some circumstances, but not for gender?
Most of the time, when parents consider using PGD because of a genetic disorder in their family, they consider the needs of everyone who will be affected by that decision, including themselves, their other children, and the child-to-be. In contrast, when parents consider PGD to have a baby boy or girl for nonmedical reasons, they primarily consider their own desires.
For example, when my husband and I contemplated using PGD to have a baby free of my genetic bone disorder, we thought about how having a second child with this disorder (our first child, conceived naturally, had already inherited it) would affect us, our daughter, and our as-yet-unconceived second child. All-too-aware of the particular types of suffering that our bone disorder leads to, we considered whether we had an obligation to protect future children from that suffering. We thought about dozens of other factors, some of which were focused primarily on our needs and desires as parents, and many of which were focused on the needs and desires of our children.
When PGD is used for gender selection, in contrast, the primary needs and desires considered are those of the parents, and perhaps other family members. The essential questions are things like, “What gender child will make our family more secure?” “What gender child will I relate to better?” “What gender child will make me feel that I’ve fulfilled my destiny as a parent?” “What gender child will make my in-laws happiest?” The child’s needs and desires, as an autonomous being who will one day make his or her way in the world outside the nuclear family, are nowhere to be seen.
No one approaches childbearing from a purely selfless standpoint. We all bring our own needs, desires, and hopes to our childbearing, some of which are noble and uplifting, and some of which are self-serving and petty. This is human nature. And, as Huffington Post columnist Lisa Belkin pointed out in a column on gender selection last week, we must be careful not to cut off fruitful conversation by dismissing anyone who considers using reproductive technology as a selfish monsters. The availability of so many reproductive choices can have the beneficial effect of helping us, as individuals and as a culture, to be more thoughtful about the choices we end up making.
As I said in the opening to this post, I have no doubt that Megan Simpson’s tears and anguish over having only boys when she longed for a girl were genuine and heartfelt. This is part of what makes adulthood so painful—we must repeatedly learn to accept that our younger selves’ vision for what our life would be like, and our actual life, often differ in profound, sometimes profoundly difficult, ways.
There is nothing wrong or monstrously selfish about grieving the lack of a longed-for daughter or son. There is much that’s wrong, however, with using ethically, emotionally, medically, and financially fraught technologies in an attempt to fill the hole that such grief leaves behind.