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Feature
Last Updated: 07/10/2014
Playing God with pipettes: The ethics and implications of sex-selection technology in the United States
Christen Kramer

How does sex-selection technology challenge our understandings of personal agency, gender relations, and family structures? And how do the ethical implications of this technology fit with the intersecting dynamic of class and gender in the United States? Christen Kramer asks these questions and more in a provocative consideration of "family balancing".


Introduction

Gone are the days of learning the sex of a baby after birth. Emerging technology, in fact, can allow for the choice of the sex of an unborn child while still in utero, or before conception.

“Family Balancing” is a term used to describe modern medicinal science to select the sex of a baby before or during pregnancy. This article will primarily focus on the practice within the United States.

In spite of a trend in contemporary feminist discourse towards deconstructive postmodernism, I’m a fan of some of the results of modernity, and even am something of an essentialist (the four letter word of gender studies). I argue that we are all, in fact, more essentialistic than we’d allow ourselves to admit, and that certain rights which we adamantly defend are in contradiction to this covert and unacknowledged essentialism. The technologies of sex selection are perhaps a new tipping point in a shift in self-knowledge, and of the world we inhabit. The science of sex selection is poised to change our understanding of personal agency, our bodies and whether or not they contain innate knowledge, the ethical boundaries of science, and the boundaries of human rights.

Case Study (cited in Slate.com: Siddhu, J. “How to Buy A Daughter”)

Megan Simpson (name changed to protect privacy), ethnicity unspecified and a resident of Toronto Canada, grew up with four sisters. She loved sewing, baking, doing hair and makeup and dressing in pink and eagerly anticipated sharing these activities with the future daughters she assumed that she was sure to have.

Although Megan’s first two children were boys, she was not willing to let go of the dream of a long-cherished mother-daughter relationship, and so arranged for a procedure to medically arrange an assured baby girl. This $800 procedure, known as MicroSort® is founded on the idea that male sperm, because of less chromosomal material (XY vs XX) swim at a slower rate than sperm containing female chromosomes. This procedure is now under review in the United States by the Federal Drug Administration. (Darnovsky, M., “FDA Questions”)

Because the use of MicroSort® is currently illegal for the use of sex selection in her native country of Canada, Megan and her husband traveled to Michigan in the United States for the procedure. Fifteen weeks after being inseminated with the chosen, slow and purportedly male chromosome containing sperm, Megan was depressed to discover through an ultrasound that she was pregnant with a boy, again.

Jasmeet Sidhu quotes in Slate.com, “I lay in bed and cried for weeks” Megan said, and considered along with her husband, to abort the baby boy. In the end, they chose to have him in spite of his undesirable sex. No mention was made in the citing article of the psychological affect this pre-birth process may have had on the boy, or whether or not he is aware that his parents have posted their mis-attempt at ensuring his femaleness on a widely read online article. As an article entitled “Americans Prefer Sons to Daughters” in the Huffington Post questions, What ever happened to parents-to-be saying, "We don't care whether it's a boy or a girl, as long as it's healthy?"

Still desperate for a girl, Megan and her husband traveled to California and paid $18,000 for an operation known as PGD, or Pre Implantation Genetic Diagnosis. This procedure involves scientists in lab coats, playing god with pipettes. Ms. Sidhu describes the eerily suburban-situated process:

“Inside a fourth-floor office suite off a palm-tree-lined street in Encino, Calif., in an embryology lab, two men wearing maroon scrubs peer into high-tech microscopes. The men are fertilizing human eggs with sperm samples collected earlier that day. After fertilization and three days of incubation, an embryologist uses a laser to cut a hole through an embryo’s protective membrane and then picks out one of the eight cells. Fluorescent dyes allow the embryologist to see the chromosomes and determine whether the embryo is carrying the larger XX pair of chromosomes or the tinier XY. The remaining seven cells will go on to develop normally if the embryo is chosen and implanted in a client’s uterus.”

Unfortunately for Megan, the embryonic chromosomes grown in the lab were found to be abnormal and couldn’t be used. No mention was made of any possible refund of the $18,000 in spite of the fact that an estimated 50-70% of embryos produced in the process are found to be abnormal (“Pre-Implantation Genetic Diagnosis (PGD)”, Gender-baby.com). Megan was devastated, but determined, and ordered another $15,000 round of PGD on credit to try again.

Finally, after $40,000 dollars of largely unsuccessful medical interventions, Megan was pregnant with a girl. After the girl was born, Megan said ““My husband and I stared at our daughter for that first year. She was worth every cent. Better than a new car, or a kitchen reno [sic]” (cited in Siddhu, J. “How to buy a daughter.”)

Scope

Pre-natal sex selection is a booming industry in the United States, with an estimated revenue of at least $100 million dollars annually. 4,000- 6,000 procedures are completed a year. (Ibid). Although there seems to be a dearth of recent quantitative data on the subject, sex selection is largely found to be used to make girl babies. According to Emily Kaiser of Minnesota Public Radio, about 80% of couples using sex-selection technology in the United States prefer females. Google search data upholds this statistic; “how to have a boy” is searched for three times less than “how to have a girl.” (Siddhu, J, “How to buy a daughter.”) However, public opinion collected from Gallup polls disagrees: “…if they could only have one child, Americans would rather have a boy. The poll of 1,020 men and women over the age of 18 found that 40 percent preferred a boy to the 28 percent who said a girl, with the rest having no opinion on the matter. In fact, Americans have repeatedly said they'd prefer having a son to a daughter in each of the 10 surveys Gallup has conducted since 1941.” (“Americans prefer sons to daughters, survey finds,” Huffington Post)

Who

The clients of sex-selection tend to be well-educated, middle to upper class, married and around 30 years old with a few children already. (Siddhu, J., “How to buy a daughter.”) Although sexual orientation and ethnicity have not been explicitly specified, from reading online forum discussions I assume that the majority are in heterosexual marriages. However, I recognize that this may not be the case. Generally, the clientele seem to come from privilege, educationally, economically and socially. Although the major clinics offering the services are in the United States, there are many anecdotal instances of couples traveling from countries where the procedure is illegal. Additionally, Dr. Jeffrey Steinberg, the head of one of the most successful fertility clinics in the United States and one of the most vocal proponents of the procedure said in an interview with CNN that 70 percent of his patients are from countries where the procedure is banned. (“Would you choose your child’s gender.” CNN).

The same doctor notoriously advertised sex-selection techniques in Indian-American and Chinese-American newspapers, but received significant criticism for attempting to gain revenue from cultural biases (specifically cultural norms of preferring boy babies over girls.) The advertisements were subsequently pulled from the papers. (Siddhu, J. “How to buy a daughter.”) When asked by the CNN interviewer about preferences for boy or girl babies, Dr. Steinberg responded “"China is strongly in favor of boys, as we would suspect. India, strongly in favor of boys. But when you look at the world in general, it's 50-50." (“Would you choose your child’s gender,” CNN).

Because of a lack of academic data on the demographics of the clients of these sex-selection techniques and their reasons for it, the majority of my research was done in forums where the hopeful soon-to-be parents discuss their fears and dreams in the anonymous solidarity of community discussion boards focused around various sex-selection topics. The forum and website I largely focused on was Genderdreaming.com, with the goal of supporting both a business of “natural gender swaying:” pre-pregnancy and prenatal techniques to change the sex of a baby, and the creation of a public forum for discussion. The website has an ethical disclaimer:

“Family Balancing is NOT, however, the creation of “Designer Babies”. All science is capable of analyzing are chromosomes which include the sex chromosomes X and Y. You cannot select eye color, hair color, intelligence, etc. Family Balancing is just that- balancing out your family a bit. It is not gender selection of a first child unless there is a medical need. It is for those that already have at least one child of a one gender that wish to have a child of the opposite gender.” (About, Genderdreaming.com)

Although I have not collected quantitative data, women are the majority participants in the forums, while the men seem to be a silent partner.

How

The methods of sex-selection are various, but generally divided into two categories: typically pre-pregnancy medical procedures, known on the forums as “High Tech Family Balancing” or HT, and pre-pregnancy and prenatal non-medical interventions, or “Gender swaying”


High Tech Family Balancing

  1. MicroSort®. The subtitle of official website of Microsort® International, located in Fairfax, Virginia, USA is indicative of the target demographic and their emotional reasons for choosing gender selection: “where hope meets science.” The procedure is the initial one referenced in the case study of Megan Simpson: sperm with male chromosomes swim more quickly than those with female chromosomes and so sperm are chosen and implanted into an egg depending on the desired sex outcome. The procedure is legal in some countries for the use of sex-linked diseases, such as hemophilia. According to genderdreaming.com, the procedure is 90% successful for the choice of a girl, and 75% successful for the choice of a boy. Although the procedure is still legal in the United States for medical purposes, according to a citation in the Biopolitical Times, referencing an email in early April, 2011 from the Genetics and In Vitro Fertilization Institute (GIVF), “the FDA has notified it that "[a]t this time, MicroSort® cannot enroll new participants in the clinical trial for the family balancing indication." GIVF's positive spin was that the FDA is allowing it to continue offering MicroSort "for genetic disease prevention for families who have an increased risk of a sex-linked or sex-limited disease," at least for the next six months.”
  2. Pre-implantation Genetic Diagnosis PGD involves the growth of an embryo, review of the sex of the chromosomes there in, and implantation of the embryo of the desired sex. With 99.99% accuracy, PGD is the primary procedure chosen for sex selection in the United States now. It was originally only used to diagnosis genetic disorders, and now is still illegal for nonmedical reasons in most of the world.
  3. Ericsson Albumin Method Casually known as “sperm spinning,” this procedure is founded on the same premise as Microsort, that sperm containing differently sexed chromosomes swim at different speeds. The procedure costs about $600 to $1200 per attempt, and is estimated to be 73%- 85% accurate.

Gender Swaying

Shettles method A surprisingly premodern approach to sex selection, the Shettles method is based off of two premises: first that the swimming speeds of differently sexed sperm will be not be the same, and secondly due to the structure of the chromosomes involved, sperm containing male genes survive better in a more alkaline environment than those containing female genes, which can survive in more acidic environments. The vaginal canal and uterus are naturally acidic, but the pH varies on the location with the vagina. Female orgasms purportedly lessen the acidity of the vagina, so if a couple is seeking a boy baby, the Shettles method recommends that the woman orgasm. Additionally, to conceive a boy child, Shettles recommends:

“Time intercourse as close to ovulation as possible.
  1. Abstain from intercourse for four to five days prior to ovulation. Have intercourse only just at the time of ovulation and just before.
  2. Have intercourse that allows for deep penetration. Shettles recommends rear-entry. The idea is that the sperm will be deposited closer to the cervix where cervical fluid is most friendly to the Y-chromosome sperm and where the “boy sperm” are more likely to survive since there is less distance to travel.
  3. Men avoid tight clothes: heat kills off both types of sperm, but will kill off the less protected, smaller Y-chromosome sperm faster, according to Shettles.” (“The Shettles Method,” fertilityfriend.com)

Why

Considering the intentional sexual practices necessary and/or the large amounts of money needed to buy a baby of the sex of your choice, why are so many couples willing to do it? Perusing forums on the topic brought much surprising insight into the motives of the clients. In contrast to the sterile, surgical, economic industry, the bulk of the women chatting on the forums had simple reasons for their choice, the majority of which were anchored in culturally normed understandings of femininity.

For example, on July 9th, 2012, in a forum thread entitle “Why do you want that dream gender, anyway?” “craving salt” wrote “There are the cute dresses, and sweet temperament I would hope for, the daughter I can one day shop with and have grandbabies without fearing being shunned by a DIL [daughter in law].” Idealization of stereotypical feminine behaviors and desires was promoted in many of the posts explaining the motivating factors behind choosing sex selection.

Additionally, the women (the posters consistently identified as the future mothers of their ideal babies) chose certain sexes in order to mitigate anticipated future family tensions: not feeling adequately prepared to raise a boy, for example. “Craving salt” continues: “There’s also the family balancing factor. I have two boys and declare myself “queen of the sausage factory” to friends and co-workers…but behind my smile, despite my amazing boys, despite all the reason I feel boys are as good as girls, I still hide a little-girl shaped hole in my heart. Why? I feared raising boys at first, not knowing how to raise a man despite having a good one at my side.”

Some women experienced a deep connection with sisters or mothers as children and are willing to pay high prices in order to relive that connection; on the same forum thread “Aurora 78” on July 11th said “I just really, really want to experience the mother-daughter bond, as complicated as it can be.” Some women are striving to create the same for their husbands: “Moof4” on July 13th said “I wanted a girl for my husband to love, like a father and daughter relationship of a connection not even I would understand.” As these posts indicate, motivation for the procedures seems to originate in childhood: connection or the lack of connection, the experience of femininity or the lack of that experience instigates these women to become clients of the sex selection industry. Some are seeking friendship which they cannot find in the adult world: Mocha girl wrote on July 11th, “my Mom became my best friend…. As long as I can remember, I assumed that I'd have a little girl one day who would become my best friend.”

There are tens of forums dedicated to similar discussions, and a brief paper cannot do full justice to all of the available information. My most surprising finding was the stark contrast between a powerful, scientific industry, and women who are willing to submit their bodies and hopes to it for pink dresses and mother-daughter connections.

Ethics and Implications

Are these technologies simply sophisticated eugenics, the beginning of a slippery slope towards designer babies for the rich and privileged? Potentially. In 2009 Dr. Jeffrey Steinberg publically announced on the website of his fertility clinic that couples seeking in vitro fertilization and sex selection could also choose the hair and eye color of their baby. The Vatican wrote him a letter to knock it off, and he did. (Siddhu, J. “How to buy a daughter.”)

So for now, there is no publicly available trait selection option. However, considering the unstoppable combination of a multimillion dollar industry, increasing demand and ever-expanding technology, the Vatican may not have the sway to intervene similarly in the future. In a comment to Minnesota Public Radio, Tom Lenzmeir echoed the feelings of those opposed to such power in the hands of scientists: “I think selecting the sex of one's child is morally repugnant. Since when are we entitled to selectively breed our species?”

Arguably, we selectively breed our species every time we woo and date a heterosexual significant other with the eventual intent of procreation, selecting specific desired traits in courtship and breeding them through child-bearing. However, we seem to have an innate sense of discomfort once those half-conscious measures to have ideal babies shifts into full, conscious intentionality. There would be no debate of whether or not a woman should have babies with a more or less intelligent man. Or rather, at least in polite company we wouldn’t disparage her choice of mating with a more intelligent man, with the potential subtle implication that the traits of that man may carry into children in the future.

Again, this is not consciously recognized, but consistently practiced. We select the future of our children constantly, with education, nutrition, peer-groups, behavioral choices, etc. We manipulate the future of our children with science and interfere with nature already by prolonging the life of sick children, and by sustaining the life of others with disabilities that may have not survived in times before modern intervention.

As a feminist, I will stridently argue for the choice of abortion if a woman deems it appropriate, yet the same logic that allows me to make this choice also binds my hands against arguing that sex selection is unethical. I do not believe that consciousness begins at conception, and because of that I defer all agency of questions involved in undesired embryos and fetuses to the mother. However, because of this very belief, I can’t argue that well-intentioned parents who are willing to go to great lengths to choose the sex of their baby are more unethical or in a legal gray zone.

There are two concerns which arise from the consideration of this issue, however. First, the process must have psychological effects on the children that the mother has already raised and on the sex-selected child her or himself. Second is the potential (or, arguably, inevitability) of a massive rift in an already growing class divide. Firstly, the psychological impact of the procedure became apparent to me almost immediately while reading through the forum postings. The majority of the women already had a few children of the undesirable sex. These women are largely in dialogue with their significant others about their hopes for a baby of a different sex than they already have, and it wouldn’t be too far of a stretch to assume that existing children have been witness to these conversations. The feeling that Mom is willing to hope, travel, pay, pay again, eventually have a baby of a sex other than the one you are must be depressing, to say the least. I assume that the existing children must feel at least devalued.

The second psychological effect which is detrimental is the effect of being paid a high price to exist within specific characteristics. I cannot imagine what having a price tag on your sex must feel like. I can’t imagine what the long-hoped for little girls felt like when they wanted to be tom-boys, but understood that their mothers passed out large amounts of cash, many times on credit, just so that they would wear pink fluffy dresses. The process of paying off the credit for their chosen children must also be interesting, and potentially psychologically damaging to the children involved.

Finally, I’m intrigued whether or not these children, once old enough to read and explore, are aware of their mothers’ posts on the public arena of the internet. The intimate yearnings of these women were easily accessible to me, and I can assume that at least one of the children born out of these operations has also been mesmerized by these posts. The burden of being bought at a high cost to fulfill a gender stereotype must be a large one, and warrants further study as these procedures become normalized and the number grows.


References

“About.” Microsort® International: where hope meets science. N. d. Retrieved from http://www.microsort.com/

“Americans prefer sons to daughters, survey finds” Huffington Post Women. June 6, 2012. Retrieved from http://www.huffingtonpost.com/2011/06/24/americans-prefer-sons-to-daughters_n_884220.html.

Darnovsky, M. “FDA Questions Sex Selection for ‘Family Balancing.’” Center for Genetics and Society: Biopolitcal Times. April 11, 2011. Retrieved from http://www.biopoliticaltimes.org/article.php?id=5668

“Genderdreaming. Website and forums. Retrieved from http://genderdreaming.com/

“Gender Selection Q and A: The Shettles Method.” Fertilityfriend.com. N.d. Retreived from http://www.fertilityfriend.com/Faqs/Gender-Selection-The-Shettles-Method.html.

Kaiser, E. “The ethics of sex-selection procedures in the womb.” Minnesota Public Radio. Oct. 5 2012. Retrieved from http://minnesota.publicradio.org/display/web/2012/10/02/daily-circuit-sex-selection-babies/

Kaschak, E. Lecture on the epistemology of the blind community. Gender and Peacebuilding MA Programme. The University for Peace: Gender Studies and Peacebuilding.El Rodeo de Mora, Costa Rica. Sept 2012.

“Pre-implantation Genetic Diagnosis (PGD)” Gender-baby.com N.d. Retrieved from http://www.gender-baby.com/methods/preimplantation-genetic-diagnosis-pgd/

Sidhu, J. “How to buy a daughter: Choosing the sex of your baby has become a multimillion dollar industry.” Slate.com. Sept. 14, 2012. Retrieved from http://www.slate.com/articles/health_and_science/medical_examiner/2012/09/sex_selection_in_babies_through_pgd_americans_are_paying_to_have_daughters_rather_than_sons_.html

“Should the sex selection of embryos be regulated in the United States” Huffington Post Science: The Blog. Sept 14, 2012. Retrieved from http://www.huffingtonpost.com/jasmeet-sidhu/should-sex-selection-of-embryos-be-regulated-in-the-united-states_b_1883586.html

Weiss, R. E. “MicroSort® for Sex Selection: Girl or Boy – You Choose.” About.com: Pregrancy and Childbirth. N.d. Retrieved from http://pregnancy.about.com/od/genderselection/a/microsort.htm

Weiss, R. E. “Girl or Boy? Sex Selection Techniques for Everyone before Pregnancy.” About.com: Pregnancy and Childbirth. N.d. Retrieved from http://pregnancy.about.com/od/boyorgirl/p/girlorboy.htm

“Would you choose your child’s gender?” Cable News Network Health (CNN Health). Dec 8, 2009. Retrieved from http://articles.cnn.com/2009-12-08/health/video.wall.gender.baby_1_gender-selection-pgd-gender-imbalance?_s=PM:HEALTH


A graduate of Social Science, Psychology and International Relations, Christen Kramer studied Gender and Peacebuilding at UN UPeace, with a thesis focus of sexual harrassment resistance groups. She has worked in a variety of disciplines, including for organizations focusing on gender based violence, assisting medical research, teaching art, and promoting literacy. Christen enjoys writing, astronomy, family, philosophizing, and more, but her true love is reading.
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