The desire to choose the sex of your offspring isn't a new phenomenon. Various methods have been employed over
the centuries, primarily to ensure a son and heir, with most founded more on superstition than fact. The difference
now is that the application of science enables couples to make a reliable decision about their child's sex. It's
the stuff of Henry VIII's dreams.
Why choose your child's sex?
There may be cultural reasons for selecting a specific sex. This is seen in India and China, where pressure
to have male children causes women to resort to abortion of female fetuses, or abandoning the baby soon after it
is born.
Another reason is 'family balancing'. Having already had one or two children of a specific sex, parents may want
the next one to be the other sex. This was highlighted by the case of the Mastertons[1], whose only daughter died
in a bonfire accident in 1999. They wished to have another child, but wanted to ensure it was a girl, to balance
their family of four boys. Under current legal restrictions their application to the HFEA was denied.
Finally, sex selection can be used to avoid sex-linked disease. The use of preimplantation genetic diagnosis (PGD)
and in vitro fertilisation (IVF) for this purpose is legal in this country under the Human Fertilisation and Embryology
Act 1990 (HFE Act). The Human Fertilisation and Embryology Authority (HFEA) licenses all procedures governed by
the Act. PGD is currently licensed at five centres for specified disorders.[2]
Methods of sex selection
There are four stages at which parents can make a choice about their child's sex:
- Pre-fertilisation - the sex of a child is determined by whether the sperm carries an X (female) or Y (male)
chromosome. Sex can be chosen by 'sperm sorting' so that only X or Y sperm are used either for artificial insemination
(AI) or IVF.
- Post-fertilisation - IVF, embryo biopsy and PGD to select only those embryos of the desired gender for transferral
to the uterus. This method could be teamed with sperm sorting so that the majority of embryos are the desired sex,
resulting in less destruction of unwanted embryos.
- Post-implantation - ultrasound can be used to detect the sex of the developing fetus, and teamed with abortion
if it is not the desired sex.
- Post-birth - one or both parents may choose to kill the baby, or abandon it, if it is the 'wrong' sex.[3]
All of these methods are in use somewhere in the world today. The last two seem the most abhorrent to us. Many
in society would feel that abortion merely on the basis of sex is wrong, and certainly would not condone infanticide.
However, there are secular ethicists who argue in favour of infanticide on the basis that the newborn does not
yet count as a 'person'.[4] Generally, it may be assumed that couples will opt for one of the first two methods
where possible. These are already available abroad to those willing to seek them out. They may become more openly
available and socially acceptable in future years.
MicroSort and the law
Sperm sorting has been in the news recently following reports that the MicroSort technique, currently only available
at the USA clinic that developed it, may soon be brought to the UK. MicroSort uses flow cytometry to sort X and
Y sperm. It is thought that at least six British couples have travelled to America for the treatment. This method
of selection could be seen as harmless, since it avoids IVF and the associated embryo destruction. However, the
reported success rate for MicroSort is 91% for girls and 74% for boys.[5] Compared with the 95-99% success rate
of PGD,[6] some couples will prefer PGD, particularly if they want a boy.
There is currently no law that prevents MicroSort being used in this country, if it is teamed with AI rather than
IVF, since the HFEA's remit only covers methods that involve, 'bringing about the creation of an embryo outside
the human body'.[7] A 1993 Public Consultation on Sex Selection found the tide of opinion to be against sex selection
for social reasons. In October 2002, the HFEA launched a new consultation on sex selection, which closes on 22
January 2003. You can lodge your views using their online response form or submit a reply to their consultation
document.[8] The HFEA cannot govern this technique without an extension to the legislation, which will presumably
be informed by the responses to this consultation.
Arguments against sex selection will often be founded in objections to the methods used - those opposed to abortion
will object to sex selective abortions, those who believe the embryo has moral status will object to PGD methods.
However, is the use of these methods for other purposes opposed as strongly, or is there something intrinsically
wrong with sex selection? If a method of sex selection can use a less objectionable method, such as sperm sorting,
what are the grounds for opposing that?
Arguments against sex selection
Unbalanced population
One can argue against sex selection on the basis that it leaves the population unbalanced, generally with too
many men. This has happened as a result of China's one child policy, with 117 boys born to every 100 girls.[9]
However, western clinics that offer sex selection report that the number of couples wanting girls or boys has been
almost equal.[10]
Cost implications
The basic cost of MicroSort in the US is around $2,500.[11] Questions could be raised about whether this is
a good use of money, but since it is currently only available on a private basis, that is a question that each
individual couple must answer for themselves. However, some would argue that principles of equality and justice
demand that the service be made more widely available - perhaps in the same way that IVF is now. It is difficult
to see how an already overstretched health budget could justify such expenditure in the face of other more pressing
priorities.
Long term health implications
There are concerns that the sperm may be adversely affected by the sorting process, and most experts feel that
there is still too little known about the technique to give it the all clear.[12] The USA Food and Drug Administration
is undertaking an assessment of the technique. However, it is difficult to know the long term effects without allowing
treatment to go ahead and following up the offspring for many years.
Parental attitudes towards children
Sex selection is a further example of the commodification of children in our society. Reproduction is seen as
a 'right', with children produced as the fulfilment of that right. Nothing is left to chance, or taken on trust
as the provision of a good and gracious God. One may also wonder what happened to the role of unconditional parental
love towards their offspring, whether male or female.
Why stop there?
It is not possible to prove definitively that allowing sex selection will lead to choices about intelligence,
hair colour, height etc becoming available. However, allowing sex selection sets a precedent for frivolous choices
that will make selection for other characteristics hard to resist - if sex can be determined, then why not intelligence?
It also fuels people's belief that they have a 'right' to the family they expect, and that they should be free
to plan that family and bring it into being using technological means - if I have a right to the 'one boy, one
girl' family that I always dreamed of, then why not a tall athletic boy, and a pretty intelligent girl with brown
hair and green eyes? Sex selection promotes the commodification of children so that choices such as these will
cease to seem so far fetched.
Jacky Engel is CMF research and publications assistant
Copyright ©2002 Christian Medical Fellowship.
Comments, suggestions, information: email webmaster@ethicsforschools.org
CMF is a registered charity (No 1039823)
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