TOPIC GUIDE: Sex Selection

"The UK ban on using assisted reproductive technology for sex-selection should be lifted"

PUBLISHED: 01 Aug 2013

AUTHOR: Tony Gilland & Ed Noel

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INTRODUCTION

Attempts by parents to influence their chances of giving birth to a baby of a specific sex, historically usually a boy, are as old as civilization. Whether involving unusual diets or specific sexual positions, efforts have been both unscientific and unsuccessful. Recent scientific advances have transformed this age-old desire of some parents into a genuine, if expensive, choice. Sperm-sorting technology, where sperm is filtered according to whether it is carrying the X or Y chromosomes and used to either inseminate directly or – via In Vitro Fertilisation (IVF) –  to create an embryo in the laboratory to be implanted in the womb, has a 70-80% accuracy rating. Even more accurate is Pre-Implantation Genetic Diagnosis (PGD), in which male and female embryos are produced, and an embryo of the selected sex is implanted [Ref: Wellcome Trust]. However, in the UK it is illegal for licensed fertility clinics to offer sex selection except for medical reasons –assisted reproductive technology (ART) can only be legally used to choose the sex of a child when it is medically justified to avoid producing a child with a serious sex-linked genetic disorder such as Duchenne muscular dystrophy or Haemophilia A [Ref: BioNews]. In some other countries, most notably the United States, fertility clinics may offer sex-selection services entirely legally and there are numerous reports of British couples travelling abroad to make use of them [Ref: Evening Standard]. Is it time, as some have recently argued, for UK authorities to adopt a more liberal approach to reproductive choice and allow sex selection for non-medical reasons?

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Sex Selection DEBATE IN CONTEXT

This section provides a summary of the key issues in the debate, set in the context of recent discussions and the competing positions that have been adopted.

Parental choice and societal concerns
The UK body which regulates the provision of ART treatments – most notably IVF and complementary treatments such as PGD – is the Human Fertilisation and Embryology Authority (HFEA). Following an HFEA public consultation exercise some years earlier, and debate in Parliament and elsewhere, the Human Fertilisation and Embryology Act 2008 introduced an explicit ban on selecting the sex of offspring for social reasons [Ref: HFEA]. One major societal concern raised about allowing sex-selection for social reasons is the danger of it resulting in a skewed population towards one gender – males. Those arguing for the UK ban to be lifted point out that whilst skewed populations, driven by preferences for male children, may be a legitimate concern in countries such as India and China, there is no evidence that this would be the case in the UK where, they argue, would-be parents are as likely to want to choose a girl as a boy [Ref: Independent]. Others counter that lifting the ban would, nevertheless, undermine the importance of women’s equality “in communities where sex-selection for male children is most likely to occur” and that this provides sufficient reason for the continuation of the prohibition [Ref: IJFAB]. Another argument made by the HFEA for the prohibition was that 80% of respondents to its public consultation objected to sex-selection for non-medical reasons; though a leading ethicist points out that such views are based on what has been dubbed the “wisdom of repugnance” and do not provide any ethical basis for prohibition at all [Ref: Practical Ethics].

Welfare of the child
The HFE Act of 2008 places a requirement on clinics to take account of ‘the welfare of the child’ when providing fertility treatment. Though the risks associated with PGD are relatively low, critics of sex-selection argue that if there is no benefit to the child to be born – only its parents – any risk is unacceptable. The other major ‘welfare-of-the-child’ concern raised by sex-selection is the potential impact on the psychological welfare of the child that is born. Critics argue that the desire to have a child of a specific sex is based on stereotypical assumptions about the behavioural characteristics of each sex, old-fashioned notions that boys and girls should be raised differently and,  in these enlightened times, such gender stereotypes are surely outdated? [Ref: Patheos]. For others it is perfectly understandable why parents with several children of one-sex might want to choose to have a child of the opposite sex and to have the “kind of relationship they feel will only be possible” with a child of that sex [Ref: Independent]. Furthermore, as one defender of parental choice argues, “why should parental expectation be stigmatised” when parental expectations are an integral and creative aspect of family relations? [Ref: spiked]. On the other-hand, do we really want to be in a situation where choosing the sex of your child is offered as a retail choice – albeit, at around $20,000, currently a very expensive choice? [Ref: National Post].

Reproductive freedom
One of the key arguments made for the lifting of the UK’s prohibition on sex-selection is that it is unethical and unjustified because the reasons given for the prohibition do not warrant trampling on the principle of reproductive freedom [Ref: IJFAB]. The bioethicist Professor John Harris has argued that it is fundamental to liberal democracy that “the liberty of its citizens should not be abridged unless good and sufficient cause can be shown as to why this is required” [Ref: Journal of Medical Ethics]. On this basis the case against the prohibition does not turn on the merits of using sex-selection for social reasons, but on whether the likely consequences of allowing parents to do so if they wish are sufficiently problematic to outweigh the principle of reproductive freedom. Others argue that when it comes to ART, which opens up all manner of possibilities not available to parents conceiving naturally, the question of reproductive freedom takes on a new dimension. From this perspective, making the sex of your child a legitimate choice sets society on a slippery slope to even more problematic attempts to design our children: from eye colour to skin colour or even intelligence [Ref: New Scientist].

ESSENTIAL READING

It is crucial for debaters to have read the articles in this section, which provide essential information and arguments for and against the debate motion. Students will be expected to have additional evidence and examples derived from independent research, but they can expect to be criticised if they lack a basic familiarity with the issues raised in the essential reading.

Is sex selection illegal and immoral?

Stevienna de Saille BioNews 28 March 2011

Sex selection: Getting the baby you want

Amanda Mitchison Guardian 3 April 2010

FOR

Embryo Sex Selection Shouldn’t Be Illegal

Stephen Wilkinson & Eve Garrard International Journal of Feminist Approaches to Bioethics (IJFAB) 16 August 2013

Can Liberals Support a Ban on Sex Selection?

Julian Savulescu Practical Ethics 13 January 2011

No sex selection please, we’re British

John Harris Journal of Medical Ethics 2005

Policing parents-to-be

Frank Furedi spiked 2 December 2003

AGAINST

Rethinking Sex Selection: A Feminist Critique

Alana Cattapan International Journal of Feminist Approaches to Bioethics (IJFAB) 13 August 2013

Gender selection: The West wants girls – but who decides?

Melanie McDonagh Telegraph 6 July 2013

Why Allowing Parents to Choose Their Baby’s Gender is Wrong

Ellen Painter Dollar Patheos 24 September 2012

How To Buy a Daughter

Jasmeet Sidhu Slate 14 September 2012

IN DEPTH

Eugenics and the Ethics of Selective Reproduction

Stephen Wilkinson & Eve Garrard Keele University Press 2013

Ethical issues with prenatal and preimplantation genetic diagnosis

Prof. Lawrence Nelson The Technological Citizen 20 October 2009

The case against perfection

Michael Sandel Atlantic April 2004

Gender Selction Cost

Gender Selection 101

KEY TERMS

Definitions of key concepts that are crucial for understanding the topic. Students should be familiar with these terms and the different ways in which they are used and interpreted and should be prepared to explain their significance.

BACKGROUNDERS

Useful websites and materials that provide a good starting point for research.

Should PGD be used for elective gender selection?

John A Robdertson & Timothy Hickman Contemorary OB/GYN 1 July 2013

The impact of China’s one-child policy

The World Outline 5 March 2013

What is PGS for Gender Selection?

Youtube 16 December 2011

Designer Babies

CNN 11 February 2009

Bias against girls in embryo selection has proved unfounded

Mark Henderson The Times 17 October 2007

The case against sex selection

Human Genetics Alert Campaign Briefing December 2002

Medical Reasons for Gender Selection

Gender Selection Authority

Debating Sex Selection

Wellcome Trust

ORGANISATIONS

Links to organisations, campaign groups and official bodies who are referenced within the Topic Guide or which will be of use in providing additional research information.

AUDIO/VISUAL

What is PGS for Gender Selection?

Youtube 16 December 2011

Designer Babies

CNN 11 February 2009

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