SO, YOU want a baby鈥� boy or girl? At the Genetics & IVF Institute in Fairfax, Virginia, prospective parents need no longer leave it to chance. For a few thousand dollars, this clinic will take a sample of sperm, colour its chromosomes with a fluorescent dye, and pass it through a laser instrument to separate Y-carrying 鈥渕ale鈥� sperm from X-carrying 鈥渇emale鈥� sperm. After that it鈥檚 just a matter of taking the batch you want for artificial insemination.
The method is not illegal in the US, and there would be few, if any, legal barriers to clinics in many other countries offering the same service. Small wonder that what is happening in Fairfax has triggered worldwide debate.
Take Britain, which has been at the forefront of reproductive regulation. Its Human Fertilisation and Embryology Authority forbids IVF clinics from implanting embryos of one particular sex for purely social reasons. But the watchdog鈥檚 remit is confined to eggs, embryos, frozen or donated sperm and fertility treatment; it has no powers over 鈥渟perm sorting鈥�. That is likely to change following last month鈥檚 launch of a programme of consultation, but in which direction? Should regulators ban sperm sorting? Permit it under licence? Or ease restrictions on implantation and permit both approaches?
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Passions run high. Some see sex selection as a recipe for doctors 鈥減laying God鈥�, and parents commodifying their children. Others argue that unless actual harm can be proven, the state should not restrict individual choice in this most personal of arenas. I believe the pros and cons of sex selection are more finely balanced than these views admit, but that there are nevertheless some real dangers.
Take the worry about sex selection reinforcing gender discrimination. In some parts of the world many parents already choose the sex of babies, through abortion or infanticide. A 1992 study reported in the British Medical Journal estimated that there were then up to 100 million 鈥渕issing鈥� women who were never born or who perished as infants. A worldwide survey of pre-implantation genetic diagnosis found that in 2001, the technique was used for social sex selection in 9 per cent of cases, mostly in the Middle East.
Fans of sex selection say that proper regulation could ensure it didn鈥檛 create a gender imbalance. A couple wanting a boy could be paired, via a register, with a couple wanting a girl. Or else sex selection could be limited, as it is in the Fairfax clinic, to 鈥渂alancing鈥� a family鈥檚 gender make-up. But such rules would not solve all potential problems.
Some bioethicists argue that couples who strongly desire a particular sex of child may have stereotypical gender views and be more likely to rear the child in a sex-stereotyped way. If a much-desired girl turns out to be a wilful tomboy, what would be the reaction of parents who longed for a dutiful, feminine daughter?
And what happens when sex selection fails? Sperm sorting, unless it is combined with IVF and pre-implantation genetic diagnosis, is far from foolproof. Even with the Fairfax method, 1 in 10 attempts for a girl produce a boy and 1 in 4 attempts for a boy produce a girl. And IVF itself remains costly and unreliable. If a couple spend a lot of time and money trying for a boy but end up with a girl, or vice versa, there is a danger the child might grow up feeling unwanted.
The libertarian may retort that we all know third or fourth-born children the same sex as their siblings who were only conceived to balance the family. And it鈥檚 true that sex selection might reduce the overall number of such 鈥渦nwanted鈥� children, as well as the sizes of families. But couples who try to balance their family the conventional way know that they only have a 50 per cent chance of success, and must surely be open to a child of either sex. Couples with heightened expectations of success might react very differently.
On balance, then, I believe that sperm sorting will in the long run do more harm than good. And this seems doubly true of sex selection via pre-implantation genetic diagnosis. Even if there is no 鈥済ene for鈥� intelligence, sporting prowess or artistic talent, few scientists doubt that gene-chip technologies will one day provide considerable information about genetic variations. Letting parents choose embryos on the basis of sex now, for no good medical reason, will make it far harder in future to say no when they ask to choose embryos on the basis of other traits.
A line has to be drawn somewhere, and social sex selection is the right place. Children should be accepted for themselves, not to the extent that they fulfil our wishes and desires. We should be more tolerant of disability and all imperfections, let alone imbalances of sex within a family. As previously with stem cells, next year鈥檚 decision by Britain will have global repercussions. Through an agreement called the Oviedo Convention, European nations have already expressed a consensus against sex selection. Britain鈥檚 regulators should hold the line.