What would happen if couples could choose the sex of their children?
Might the sex ratio alter with a bias towards males? More than 20 years
ago, the distinguished embryologist Anne McLaren, who is now at the University
of Cambridge, speculated on the possible consequences: 鈥楾hey might include
an increase in polyandry (women having several husbands) or in male homosexuality,
or a rise in the level of male aggression, whether expressed in the form
of juvenile delinquency or of military endeavour.鈥�
The recent opening of a 鈥榞ender clinic鈥� in London purporting to offer
couples their choice of a male or female baby has brought these issues alive.
The clinic uses a controversial technique for separating male-producing
sperm, which carry a Y chromosome, from the 鈥榝emale鈥� sperm with an X chromosome.
Although critics say its success rate is low (This Week, 30 January), few
doubt that a reliable sperm-sorting technique will soon be developed. So
should we welcome the technology when it comes, place tight restrictions
on it, or reject it out of hand?
As the London Gender Clinic opened its doors, the government鈥檚 watchdog
on embryo research and IVF clinics, the Human Fertilisation and Embryology
Authority, hurriedly began canvassing opinion. Their aim is to find out
if sex selection and artificial insemination appeals to couples, and what
implications there might be for society at large, and for our notions of
family, kinship and gender. Academics, clinicians and the public have until
the end of the month to present their views.
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Up to now, most speculation over the consequences has focused on what
will happen if one sex proves more popular than the other. McLaren鈥檚 prophecy
of more aggression if boys are the preferred choice has been widely echoed.
Michael Freeman, professor of English Law at University College London,
says: 鈥業f we are trying to move away from a society where aggression and
violence prevail, we would be moving in the wrong direction in creating
a society with a preponderance of males.鈥� Others, however, see little cause
for concern.
鈥楲et鈥檚 not panic about it until there is some evidence,鈥� says Bernadette
Modell, a leading medical geneticist from University College Hospital in
London who runs a clinic for couples at risk of passing on thalassaemia,
a severe inherited form of anaemia. 鈥楳y experience suggests that preferences
for boys or girls would be perfectly balanced in our society,鈥� she says.
鈥榃e have had very few requests for terminations on grounds of sex 鈥� which,
by the way, we will not do.鈥�
Modell agrees that the concerns of parents at risk of having seriously
ill children may not reflect those of the general public. Nonetheless,
she doubts that the advent of sperm sorting will change things. 鈥楪etting
pregnant by artificial insemination is quite a step. Most people don鈥檛 want
to interfere with nature if they don鈥檛 have to.鈥� She suspects that people
will use the technology only if they already have two children of the same
sex, and that there will be no overall impact on the sex ratio.
In support of her views, Modell quotes the work of Andrew Czeizel of
the National Institute of Hygiene in Budapest. He kept note of the women
visiting his clinic who were pregnant for the third time, and already had
two children of the same sex. He found that most women seeking an abortion
for social reasons said they would be happy to keep a child of the opposite
sex from their existing children, but would seek an abortion if it were
the same.
But another survey of 1500 couples in Hungary in the late 1970s, also
conducted by Czeizel, hinted at a sex bias. He asked the childless couples
whether they would use an accurate and harmless method for choosing a child鈥檚
sex, if it was available. Only 21 per cent said yes. But, of these, most
favoured boys. Among couples wanting a single child, 65 per cent wanted
it to be a male. The percentage fell to 57 per cent if more were planned.
Overall, a significant 87 per cent wanted the first baby to be a boy. The
consequence, Czeizel says, would be a shift in the ratio of boys to girls
at birth from the present 106:100, to 142:100. And more boys would be first-borns.
Yet an American study presented at the American Association for the
Advancement of Science in Detroit in 1983 concluded that many women pregnant
with their first child had no preference, and that the number wanting boys
was matched by those who preferred girls. And earlier this year, researchers
from the University of Cambridge, Helen Statham, Josephine Green and colleagues,
reported in The Lancet (27 February, p 564) that their survey of more than
2000 pregnant women suggests that most British women have no particular
preference for boys or girls. In their postal questionnaire, the researchers
asked if the women would 鈥榤ind鈥� the sex of their child. Most replied no,
and most said they did not even want to know the baby鈥檚 sex before birth.
Those who expressed a preference were as likely to prefer a girl as a boy.
The Cambridge researchers stress that their survey of pregnant women
鈥榯ells us nothing of what women would do if they could select the sex of
their baby鈥�. Teresa Marteau, who is director of the Wellcome Psychology
and Genetics Research Group at Guy鈥檚 Hospital in London, agrees. She says
asking someone if they would rather have a boy or a girl when they already
have one or the other in their womb is different from saying, 鈥業鈥檝e got
a new technology, would you like it?鈥� Yet this is the crux of the matter.
鈥楾hese studies throw us off the scent,鈥� says Marteau. 鈥榃e cannot assume
from one sort of situation how people would respond to the 辞迟丑别谤.鈥�
What鈥檚 more, Marteau argues, 鈥榤ost of these studies have asked women
what they would like, but we don鈥檛 even know that it would be women who
would make the decisions, were the technology available.鈥� One thing is
certain, she says: 鈥業f we had this technology 70 years ago, we certainly
wouldn鈥檛 have the Queen as monarch.鈥�
Predicting the impact of a new technology is difficult. Marilyn Strathern,
professor of social anthropology at the University of Manchester, argues
that the availability of choice can shift the way people think about themselves
and their relationships. 鈥榃hen there is choice things are altered fundamentally,鈥�
Strathern said last week at a conference on sex selection at the British
Medical Association, organised by a European Community project on fertility,
infertility and the embryo. Strathern argues that even if the technique
leaves the sex ratio unchanged, it may have unforeseen and insidious social
consequences.
鈥楢t the moment, when you don鈥檛 have to think about choosing the sex
of a child, all kinds of hopes and fears about what the child would be
like are possible. Parents, grandparents and siblings might all have different
desires, but none have to be acted upon 鈥� you don鈥檛 have to prioritise different
viewpoints, and you can resolve to make the best of whatever comes,鈥� she
says. But with sex selection there is the impression that you can easily
prioritise these desires. 鈥楤ut you can鈥檛,鈥� she says. 鈥業t is not like deciding
whether you prefer potatoes or spaghetti.鈥�
One difficulty is that partners may not agree about the desired sex
of the child. Of course, it is likely that they will sort it out between
them 鈥� but possibly to one person鈥檚 advantage. 鈥榃ithout sex selection, there
is a sporting chance that someone will end up with what they want; with
sex selection, there is a sporting chance that the choices one partner would
have made will be permanently disadvantaged with respect to those of the
辞迟丑别谤.鈥�
Allowing people to choose the sex of their children may also have blatant
social effects. Choice turns on comparisons, so sex selection will encourage
comparisons between the sexes, a development that could easily worsen the
position of girls and women in society. 鈥楥omparisons go on all the time
鈥� we call it discrimination,鈥� says Strathern. 鈥楾o make sex an issue at
the point of conception, to select on gender grounds, will reinforce discrimination
. . . By even saying that one sex is preferable to another, we could
be legitimising discrimination.鈥�
Sex selection could also alter parenting for the worse, argues Marteau.
A document produced by the HFEA suggests that if parents can choose the
sex of their children, they will love them more. 鈥楾his is a very naive argument,鈥�
she says. 鈥楧o we want to encourage conditional parenting, the kind of parent
who says, 鈥業 will love you only if you鈥檙e a boy or a girl?鈥� The idea,
she says 鈥榚ats a tiny bit into our humanity鈥�.
Choosing the sex of their child might also give parents a spurious sense
of control over reproduction, leaving them less able to cope when things
go wrong. There is a clear financial incentive for those who run sex selection
services to push hard for public acceptance. The advent of a reliable technique
will also bring with it the notion that 鈥榮ince we have the technology we
ought to use it鈥�, says Marteau. To monitor this, there must be independent
assessment. 鈥楧uring its first few years of use there must be very tight
evaluation of the effects on families,鈥� she says.
Marteau warns against uncritical acceptance of sex selection. Its benefit
to individuals will be tiny compared with its great potential social disadvantages,
she suspects. 鈥業 don鈥檛 think there is great misery in this country from
not being able to choose the sex of your child, and it could possibly make
things significantly worse.鈥�
* * *
Killing girls and aborting female fetuses
In India, the goods or money that must be paid to the groom by the bride鈥檚
family under the Hindu dowry system make girls a financial liability. In
Bombay, companies offering pregnant women sex tests and abortions advertise
their services with the slogan, 鈥榠nvest 500 rupees now, save 50 000 rupees
later鈥�. A study in six Bombay hospitals during 1986 found that of 8000 abortions
carried out after amniocentesis, all but one were of female fetuses.
A pressure group, the Forum Against Sex Determination and Sex Preselection,
is now battling against the widespread use of prenatal tests for sex selection.
A leading member of the Forum, Vibhuti Patel of the SNDT University in Bombay,
says 鈥榩opulation control and money making are the concerns of those who
support the tests and the survival of women is the concern of those who
oppose the tests鈥�.
Kusum, of the Indian Law Institute in New Delhi, says new laws proposed
within The Pre-natal Diagnostic Techniques (Regulation and Prevention of
Misuse) Bill will make prenatal sex tests illegal throughout the country.
However, the new legislation is riddled with loopholes, says Patel, and
would 鈥榲ictimise the victim鈥�, making the women who succumb to social pressures
liable to up to three years鈥� imprisonment.
Bernadette Modell is optimistic. She speculates that if the sex ratio
changes dramatically in India as a result of sex selection, it 鈥榤ight increase
the value of women and so cure itself鈥�. But society does not always obey
simple market rules.
In 1989 in China, where killing girls at birth is widespread, 113.8
boys were born for every 100 girls. This shift has meant more men now fail
to find wives. But there has been no discernible change in the value of
women. What鈥檚 more, sex selection is not blamed. In an article on the country鈥檚
1990 census, The China Daily (23 March) quotes a senior statistician saying
that men鈥檚 failure to marry is put down to personal failings, especially
economic ones 鈥� they are regarded as too poor. This in turn increases pressure
to promote economic opportunities for men, often at the expense of jobs
for women.
So, says Strathern, sex selection may help to disadvantage people in
ways they cannot see, and are powerless to control. In future, she says,
鈥榳hatever the consequences of sex selection, we won鈥檛 make the connection;
we will conceal it from ourselves鈥�.