Sex Selection Goes Mainstream
Several times over the past few months, a small but striking ad from a Virginia-based fertility clinic has appeared in the Sunday Styles section of the New York Times. Alongside a smiling baby, its boldface headline asks, "Do You Want To Choose the Gender Of Your Next Baby?"
If so, the ad continues, you can join "prospective parents...from all over the world" who come to the Genetics & IVF Institute (GIVF) for an "exclusive scientifically-based sperm sorting gender selection procedure." The technique, known by the trademarked name MicroSort, is offered as a way to choose a girl or boy either for the "prevention of genetic diseases" (selecting against the sex affected by an X-linked or Y-linked condition) or for "family balancing" (selecting for a girl in a family that already has one or more boys, or vice versa).
GIVF has been promoting MicroSort on its Web site for several years, and a few other fertility clinics offer other "family balancing" methods online. But the MicroSort ads in the New York Times represent a bolder and higher-profile approach. They mark the first time that high-tech methods for sex selection, and their use for clearly social purposes, have been openly marketed in a mainstream US publication.
Two years ago, when newspapers aimed at Indian expatriates in the United States and Canada carried fertility clinic ads for sex selection, the Times covered the event as a news story. The article included hard-hitting criticism from Indian feminists in the United States, and discussed the hugely skewed sex ratios in South and East Asia (some demographers estimate as many as 100 million "missing girls") that are the result of female infanticide, neglect of girl babies, and prenatal diagnosis followed by sex-selective abortion. It noted that the sex-selection ads would be illegal in India, and reported that one of the publications dropped them after controversy erupted.
The Times has also covered other aspects of the debate about sex selection. To date, however, it has taken no note of the MicroSort ad campaign. Nor have other newspapers.
The Marketing Tactics
GIVF's ads note that MicroSort sperm sorting is currently "investigational," and is being used in the context of an FDA clinical trial. But the company is marketing the procedure with a classic consumer come-on: It promises "FREE MicroSort for qualifying patients" who sign up for either its "Donor Egg" or "Preimplantation Genetic Diagnosis" program. GIVF repeats the offer in a pop-up ad on its MicroSort website, where another smiling baby sits in front of a pink-and-blue double helix.
Both egg "donation" and pre-implantation genetic diagnosis, or PGD (in which embryos are produced outside the body, and then screened and selected for genetic characteristics) require that women undergo an invasive egg-harvesting procedure. Sex selection via sperm sorting is usually accomplished by artificial insemination, and so doesn't require egg harvesting or in vitro fertilization. GIVF's offer can thus be read as luring women to undergo riskier (and in the case of PGD, more expensive) procedures.
The MicroSort Story
The technology behind MicroSort was developed in the late 1980s by a government scientist at the US Department of Agriculture for use in producing livestock. In 1992, USDA granted GIVF founder Dr. Joseph Schulman an exclusive US license to apply the method in humans for the patent's full 17-year life. The first MicroSort baby was born in 1995.
GIVF's Schulman is not only a technical and entrepreneurial pioneer of sex selection, but also an early popularizer of the notion of "family balancing." The concept has been floated in assisted reproduction circles as a justification for sex selection at least since the early 1990s. According to the website Word Spy, which traces the origins and usage of recently coined words and phrases, the earliest use of the term in the mainstream media was a quote from Schulman in a 1994 Fortune article.
"Family balancing" is, of course, an application of high-tech sex selection with considerable commercial potential. GIVF's base charge for MicroSort is $2300; couples try an average of three times before a pregnancy is achieved or they drop out. When Fortune followed up on MicroSort in 2001 with a long article, it quoted an analyst at OrbiMed Advisors, an asset management firm focused on the "global healthcare industry," who estimated a market for sperm sorting in the US alone of "between $200 million and $400 million, if [it] is aggressively marketed".
The Fertility Industry's Trade Organization
It's difficult to imagine that such projections did not play some role in a 2001 decision by the American Society of Reproductive Medicine (ASRM) -- the fertility industry's trade organization -- to give an ethical go-ahead to sperm sorting for "family balancing." A report by its Ethics Committee noted but overrode a range of social and ethical objections, including those that led to its rejection, just two years earlier, of using PGD for such purposes. In that earlier report, ASRM explicitly acknowledged that both PGD and sperm sorting have "the potential to reinforce gender bias in a society".
ASRM remains officially opposed to the use of PGD for "family balancing." While GIVF's website heralds ASRM's blessing of sperm sorting for "family balancing," it fails to mention the trade organization's disapproval of PGD for this purpose. Of course, adherence to ASRM guidelines is purely voluntary, and they are regularly flouted (for example, GIVF is not the only US fertility business openly offering PGD for "family-balancing" on the Internet). But the existence of the guidelines is often cited as an argument against effective regulation of the assisted reproduction industry.
There are no legislative limits on the applications of PGD or sperm sorting in the United States. In a significant number of other countries, however, legislative or regulatory prohibitions on "non-medical" sex selection procedures are in place or pending. The Council of Europe's Convention on Human Rights and Biomedicine explicitly forbids them. But new methods of sperm sorting and the promotion of "family balancing" in the US are sure to affect practices and policies worldwide. If Americans start controlling the sex of their children, people and policy makers in other parts of the world will take note.
South Asian feminists, for example, assert that any increased acceptance of sex selection in the US will legitimize its use and seriously aggravate urgent problems for women in societies where preference for sons is strong. They point to the persistence of female infanticide, neglect of girls, and sex-selective abortions, even in countries such as India with laws against them, and to the prevalence of violence against women who fail to give birth to sons.
"An abusive spouse may use the birth of a daughter as a pretext for violence towards his wife, and then be violent towards the unwanted daughter," says a fact sheet on sex selection prepared for a national conference later this month of South Asian women living in the US. Even Fortune recognizes the gravity of the problem. "It is hard to overstate the outrage and indignation that MicroSort prompts in people who spend their lives trying to improve women's lot overseas," its reporter notes.
What Technology Can Do; What Technology Should Do
High-tech sex selection poses a range of difficult policy dilemmas -- especially the problem of addressing it without in any way weakening women's rights and access to abortion. But address it we must, because of the grave concerns it raises about exacerbating sexism and gender stereotyping, undermining disability rights, putting children at risk (if the child turns out to be the "wrong" sex or the "wrong kind" of girl or boy), skewing sex ratios or the number of firstborn boys, and setting the stage for a consumer eugenics in which parents are sold techniques to select not just their child's sex, but a range of other traits as well. As the UK-based NGO Human Genetics Alert asks, if we allow sex selection, how will we be able effectively "to oppose `choice' of...appearance, height, intelligence?. The door to 'designer babies' will not have been opened a crack -- it will have been thrown wide open."
Of course, there are many reasons that people may wish for a daughter instead of a son, or a boy rather than a girl. But compelling though some of these longings may be, the issue raised by sex selection is not primarily one of the rightness or wrongness of parental desires. The preferences of prospective parents are obviously relevant in matters of child-bearing, but so are the well-being of future children, and the social consequences of a set of technologies that are certain to be "aggressively marketed."
From a social and political perspective, the paramount question is this: If new technologies make it possible to fulfill desires and satisfy preferences, is that reason enough to use them? More succinctly: If we can, does that mean we ought?
Marcy Darnovsky is Assistant Executive Director at the Center for Genetics and Society.