“Is it a boy or a girl?”

Choosing the sex of babies born via IVF is a realistic, but illegal, possibility. However, a leading medical ethicist argues there’s no justification for the ban

Scientific research has the power to transform society but “with great power comes great responsibility” and so much of this is regulated by law.  Advances in reproductive technology are one example of this paradigm and raise a host of ethical dilemmas. We have the science and the tools, but the actual process is illegal in the UK under most circumstances. However, leading bioethicist, Professor Stephen Wilkinson has argued recently that this ban on choosing the sex of an unborn baby is not ethically justifiable.

“We examined the ethics of gender preference and sex-selection techniques in the British context and found no reason to expect harm to future children or the wider society if these techniques were made available for ‘social’ reasons within our regulated fertility treatment sector,” he told The Independent. Choosing – or trying to choose – a baby’s sex is hardly a new trend. From eating more bananas to using alkaline douches, history is peppered with people’s bizarre attempts to play God. In 2008, the first evidence to suggest that a woman could change her diet prior to pregnancy to influence the baby’s sex emerged. The scientists from Universities of Oxford and Exeter linked higher calorie intake (though not by very much) around the time of conception to the eventual birth of sons, but its affectability was called into question.

Nowadays there are also, of course, far more effective methods of choosing the sex of one’s progeny, such as embryo selection where a number of zygotes are created outside the womb by IVF but only ones of the desired sex are selected for implantation. Alternatively, sperm sorting is a method of ensuring sperm which will produce only male or only female babies are used to impregnate the mother. In the UK, the permitted method is flow cytometry which uses fluorescent dye to separate sperm carrying a Y chromosome.

Here, sex selection is only allowed for medical reasons, so parents can be confident that their child will be born free from a serious sex-linked illness. Muscular dystrophy (featured in November’s Laboratory News) is one example where exclusively male children are born with defects in muscle proteins leading to progressive disability.

But sex selection for other reasons (sometimes known as ‘social’ sex selection) is banned. The Human Fertilisation and Embryology Authority (HFEA) has argued several times over the last few decades that this process is not in the best interests of either society or the child. But Wilkinson and his colleague Eve Garrard have concluded that this is probably not the case at all.

Bioethicists base their work on an important background principle, namely that “we shouldn’t condemn people, or prevent them from doing what they want to, unless we can give a good reason for doing so.” So the authors had to determine if sex selection is sufficiently harmful to count as a good enough reason for preventing parents from going ahead with the process.

They state that while sex selection may have significant negative consequences in some countries (like China where, in 2005, the number of males under the age of 20 exceeded the number of females by around 32 million), there’s no reason to assume the same could happen here as our culture’s completely different. They also suggest regulatory measures could be put in place to combat concerns about population sex imbalance. For example, requiring clinics providing sex selection procedures to balance each couple selecting a boy with another couple selecting a girl, so roughly equal numbers of each sex would occur. Sounds reasonable in theory, but I just wonder if they’ve taken into account the low success rate for IVF? They also conclude that most parents that have a specific sex preference for their unborn baby probably don’t have “bad” motives for wanting to undergo the process. Yes, this might be sexism, they conclude, but it’s not damaging sexism. Hmm, I’m not so sure...

While I agree that sex selection IVF – an expensive and rather extreme procedure – probably won’t result in a population sex imbalance in the UK just yet, I do question a parent’s motives and desires for being desperate for a child of a particular sex. The case studies featured in the authors’ report tended to be from people that seemed very driven by gender stereotypes. A woman that wanted a daughter to go shopping with for example. Or a man that wanted a son to take to the footie. As if it’s beyond the realms of possibility that a girl could play football, or a boy could be interested in fashion. It’s this idea that “girls will be girls and boys will be boys” perpetuating a gender binary that I think is actually more damaging to society than the authors of the report have perhaps considered. What if the child that’s eventually born from this process doesn’t want to conform to these social constructs or worries they won’t be accepted by their parents if they do not? How will the siblings of the ‘wrong’ gender feel next to the ‘selected’ child?

I don’t think we need to lift the ban on IVF sex selection, we need to become more open-minded about gender and realise that it’s not what solely defines us.