Gender Selection: Justifiable Preference, Discriminatory Practice, or Just a Special Item on the Menu?

Written by: Leah Jeunnette, Ph.D (c) 

In vitro fertilization (IVF), preimplantation genetic diagnosis (PGD), chorionic villus sampling (CVS), and amniocentesis have changed the entire approach to infertility. Meanwhile, bioethicists try to keep pace, addressing issues arising from any new reproductive technology. Moral status of embryos, benefits vs. risks of procedures, abortion rights, selective reduction of multiple fetuses, maternal-fetal medicine, designer babies, etc., all need consideration. Yet these critical discussions may elude public attention until a catchy headline reignites the discussion.

Yes, all it takes is a little celebrity gossip . . . like the recent chatter over gender selection of offspring involving Kim Kardashian and Kanye West. Some news outlets reported that Kardashian and West chose to identify (through PGD) and implant only male embryos (created through IVF) in an attempt to produce a male child. This story may be true or false; however, the gossip sparked renewed interest in the gender selection controversy.

Gender selection is part of the designer babies discussion, which raises multiple ethical issues — rejection and destruction of unselected embryos, identifying desirable vs. unacceptable traits, altering/manipulating embryos, and the inequality of access to such expensive options. Although sometimes critics and proponents are divided by the motivation, either for medical or nonmedical reasons, there is no sweeping consensus on the ethics of using technology for gender selection. Because of that, the American Society for Reproductive Medicine currently encourages healthcare facilities to develop their own policies regarding the practice.

Those who support the right to practice gender selection often reference patient autonomy and reproductive liberty. Some view this as a private, personal preference that needs no justification and should be respected. Others decry gender selection as a misuse of medical resources, opportunity for discrimination, perpetuation of social injustice, and an unwarranted manipulation of nature and the natural selection process.

Gender selection is subject only to state laws, as no US federal law either allows or bans it. Banned in Canada and many EU countries, Israel will allow gender selection in rare cases. In some situations, individuals resort to abortion or even infanticide to control gender of offspring, especially where it is more desirable (due to government policies or cultural impositions) to have male children. As a result, gender imbalances are appearing in both China and India, which may cause future shortages of available wives for the disproportionate number of males born—a seemingly remote concept to the US couple thinking, “we’d really just like to have a boy this time.”

So, is the capability for gender selection a blessing or a curse—or simply a choice? This bioethicist would love some feedback . . . .