May 3, 2016

Choosing Your Child’s Gender Before Birth: A Woman’s Choice or the New Eugenics?


While we were driving to dinner, my significant other and I got onto the topic of marriage, buying a house, and having children—you know, all the most horrifying things that young, unmarried men could ever hope to talk about.

Jokes aside, the topic of conversation gradually shifted to what our future children would be like, whether they’d look more like me or like her, what sports they’d play, and what type of pets would keep them (and, let’s admit it, her and I) company.

The one thing we couldn’t agree on, however, was whether we’d be naming our future child Nikolai, after the great Nikolai Tesla, of course, or Tigerlily, which is a beautiful name, but not fitting for a baby boy.

Hold up, stop right there–who said anything about us having a boy? This is the part in the conversation where we joke about whether or not we’ll be conceiving a male or female child, only half-seriously because there’s no magic trick to deter mining sex in the womb.

Unless, she mentioned to me, we did an IVF birth like Chrissy Teigen and John Legend, who were recently making headlines for their decision to have a baby girl via IVF, and apparently reigniting global debate and controversy surrounding the topic of gender selection.

Fortunately, my partner and I are a long way off from having children, but even after the conversation and the date that followed, I found myself wondering: Do my partner or I have the right to determine our child’s sex before birth?

Fertility Tourism and Gender Selection—Only In America

Currently, under U.S. law there is no wording that directly states that the practice of prenatal sex determination is illegal or unethical. Because of this, it’s becoming increasingly popular for perfectly healthy couples such as Legend and Teigen who are capable of producing children by traditional means to opt for in vitro procedures instead, with IVF accounting for 1.5% of U.S. births in 2012, and rising .

As this practice becomes more and more widely used, it begs the question: What sort of impact will this have on gender distribution in the United States, as well as in the world? The loose laws on fertility in the U.S. have quickly secured its position as a fertilization hot spot for couples all over the world who, for one reason or another, wish to choose the gender of their child.

The laws are mainly taken advantage of by visitors from Korea, China, and India, whose cultures put special emphasis on the male sex. Families who have only had women born to them can have pressures put on them by both society and family to conceive a boy who will go on to pass on their family name. It is because of this that the majority of foreigners who make their way to the U.S. for IVF are taking part in what is becoming labeled as “fertility tourism.” Some 90% of these couples who travel to the United States seeking preimplantation genetic diagnosis (PGD) procedure are doing so in hopes of conceiving a male child.

Flipping the Script: The United States of Baby Girls

Conversely, when looking at the gender selection habits of women in the United States when compared to fertility tourists, the exact opposite is seen. According to an article by Slate, 80% of U.S. women are more likely to follow Chrissy Teigen’s lead and instead chose to select embryos that will later develop into daughters. Slate posits that this disparity in the U.S. is driven by the expectant mother’s wishes to connect with their daughter, and to further emulate the experience the new mother had with that of her own mother as a child.

This yet-to-be-born daughter fills a certain space in the expectant mother’s heart and mind, and even though she is not yet nascent, she is still a she to the mother, and an awesome bond begins to form. The problem is that even though sex selection via PGD procedures is nearly 100% accurate, there are still cases where expectant mothers shooting for female embryos ended up being pregnant with baby boys.

The worry here is that, in the same way a female birth may be unwanted by fertility tourists traveling to the U.S., a young boy who has replaced an expectant mother’s wishes for a female may also be unwanted. The psychological and physical effects of an unwanted birth may loom over those children from the moment they leave the womb, ranging from higher infant mortality likelihood early in life to social and cognitive problems later on. These cases, while obviously the exception and not the rule, still pit the world against a child before he or she has even set foot in it—but is this enough to say that PGD to determine sex is unethical?

A Woman’s Womb, A Woman’s Right… Right?

Unfortunately for men who want to weigh in on the situation, those without a uterus and ovaries trying to tell somebody with a uterus and ovaries what to do with them isn’t really the progressive look right now. Rob Pollak wrote a great article pointing out that the extent of a man’s role in the IVF process is basically to watch porn and masturbate into a cup, while women go through a myriad of extensive checkups, tests, and procedures.

Nevertheless, here I am, a man writing about the merits and setbacks surrounding whether or not a woman should do this or that with her reproductive organs. You see us do this most often in the pro-life versus pro-choice debate (which I’m not even going to touch), but not as often with any other “uterine” topic, indicating that many care more about whether or not a woman comes fully to term, even if they’re not as concerned with how.

For example, despite the risks and legal implications that can follow, many women around the world still choose planned home birth over a trip to the hospital, and despite the fact that doctors advise against it, midwives are still delivering babies underwater in tubs. One study by Dr. Amos Grunebaum even states that the risk of infant mortality is nearly four times higher during a home birth than a hospital delivery.

Yet, there’s no national debate surrounding the topic, nor are there any extremely vocal male pundits leading the charge against midwives delivering home births. Our society has deemed how a woman gives birth to be her choice, leading me to ask the question: If a woman has the right to a planned home birth, regardless of numerous heightened medical risks to her infant (and herself), why shouldn’t she be able to decide the sex of her baby, regardless of the risk of an unwanted birth?

Just to be clear, I also recognize that studies confirming the safety of home birth exist in contention with Grunebaum’s study and that plenty of elephant journal fans themselves have had beautiful experiences with home birth. I believe strongly in women’s right to choose and control their birth experiences, and I think you should too. Nevertheless, one side of the argument must be made in that while the womb belongs to the woman, the life inside of that womb is its own, regardless of whether it has a voice or not.

More importantly, the decisions that a mother and/or father might make regarding tweaking their unborn child’s genetics will most directly affect not the parent, but their child, a completely different person that, some argue, has the right to a life free from forced and “unnatural alterations at the genetic level—even if those alterations are as selfless as a mother choosing to have a daughter because she values the bond of mother-daughter as near-sacred.

The Broader Implications of Genetic Tinkering

Though we’ve covered a lot of ground, we’ve garnered more questions than answers—and we haven’t even begun to scratch the surface of the broader implications inherent in allowing gender selection as a practice. Many of these same questions arising from the PGD/gender selection debate have been framed to envelop the broader topic of eugenics as well.

For example: What happens to the embryos that have been fertilized outside of the body and don’t live up to or meet the parent’s “genetic” expectations? Do they get donated to science? Another couple in need? Destroyed? Should we treat these embryos any differently than the roughly 93% of embryos that are destroyed or dissected as a natural result of the IVF process anyway, or should we just live with the irony that we treat some embryos as people, but not most?

And what about other genetic markers and traits beyond gender? Should a couple be able to choose an embryo that will have a greater chance at being taller? Shorter? Less likely to develop Alzheimer’s at the age of 70? What about aptitudes? What about race? What will ultimately be deemed acceptable, and what preferences will be considered “taking it too far”?

The speed at which this technology is moving makes me feel like concepts found in science fiction movies such as Gattaca and The Island are bit close for comfort, extreme representations though they are—but what about you? What do you think? Are women (and their partners!) entitled to gender selection or other forms of pre-birth genetic selection? Or is gender selection in IVF too slippery a slope to deal with?

I’d love to hear your thoughts and stories below.





Author: Andrew Heikkila

Editor: Travis May

Photo: Movie Still-The Island

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