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April 20, 2005

Sex selection

Last month a Parliamentary committee recommended that British couples who conceive by IVF be allowed to choose the sex of their offspring.

Sex selection is an interesting bioethical issue. Sex selection in during IVF is an especially interesting variant because the ethics of the practice aren't confounded by the abortion issue.

There might be good policy reasons to prohibit in vitro sex selection, even if we agree that it's permissible in the abstract. That's because it would be irresponsible to let the sex ratio drift too far from 50:50.

However, even if couples are allowed to select during IVF, IVF itself is unlikely to account for more than a fraction of the births in the UK. The procedure is painful, expensive, and unreliable. It's safe to assume that most people will prefer to make babies the old fashioned way. (Update: It was illustrative for me to consider the examples of those who are trying to have babies with IVF because they don't have a choice. These include Hardscrabble, A Little Pregnant, and others. It's not an easy road, folks. Many thanks, Ol Cranky, for reminding me to emphasize that.)

Emily Bazelon writes in Slate:

The committee also concluded that in the U.K., there is little reason to think that allowing sex selection would much alter the overall male-female ratio. Its thinking on this score isn't particularly convincing, however. In a recent poll, only 16 percent of British respondents said they didn't care about the sex of their children.

I think Bazelon is making the mistake here. Sure, people care about the sex of their offspring. But that doesn't mean that everybody has the same preference. If the boy-preferrers equal the girl-preferrers, the demographic problem takes care of itself. Even if there's a preference one way or the other, there probably will never be enough IVF births to significantly affect the demographics.


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I do not have a source for this, but I thought it was fairly well-known that while in Asia sex selection is overwhelmingly used to have boys, in western nations sex selection ends up half and half, with the usuall patern being that parents who already one or more kids of one sex wanting one of the other sex. Does anyone know if this is wrong?

Also, what's so wrong about letting the ratio slip away from 50-50?

I know that in China sex selection is used overwhelmingly to generate male heirs. If anyone has stats on sex selection in the West, I'd be really interested to know.

There are two big reasons why it's not a good idea to let the sex ratio drift too far. First, if monogamous heterosexual marriage is the social norm, it's not fair to the fraction of the next generation who won't be able to get married for lack of eligible partners. I don't know how far the ratios have to slip before this becomes a significant problem. But to the extent that this occurs, parents who choose the more common sex are bringing kids into the world with diminished opportunities.

Second, it's hard to predict the social effects of having a large cohort of unattached males (or females, but so far that's not an issue, except in communities where the eligible bachelors are whisked off to prison). On average, and across cultures, women tend to want to "marry up"--to older, richer men. Any policy that makes women rarer will exacerbate that trend by increasing women's bargaining power. So, in that case more younger, lower status guys will be left out in the cold. Some demographers expect this trend to be socially disruptive.

In the West, letting the sex ratio get out of whack would be an entirely preventable risk undertaken for no particularly good reason. Whereas, in some cultures there are huge social and economic incentives to produce male heirs. Individually, traditional Chinese parents have pretty compelling reasons to want a son who will support them in their old age vs. a daughter whose obligations will transfer to her in-laws. It's hard to tell those people they have to give up the technology that will make their family lives a lot better.

Except for cases in which there's concern to prevent an X linked trait that would want to make a couple avoid male children or Prince Prince Albert who needs a male heir to maintain Monaco's independence, I would think that any couple that has to resort to IVF to become pregnant would be ecstatic with a viable pregnancy that will lead to the birth of a much wanted child.

This isn't related to sex-selection via IVF, but when adopting internationally, more families want to adopt girls than boys. It's not just that more girls are available to adopt -- this is true if you're adopting from China or India, but not in most other places. The result is that if you want to adopt from anywhere except China or India, the waiting list is longer if you want a girl.

Janet, any guess as to why Western families prefer girls to boys in international adoptions?

I always imagined that if I ever adopted a kid it would be a baby girl from China, on the assumption that there is a surfeit of girls who a) aren't wanted by their family of origin, and b) would be even worse off than male orphans if they weren't adopted by Westerners because women in generally worse off than men in that society. Even in countries where there are equal numbers of male and female candidates, it might make utilitarian sense to adopt a girl because the relative benefit to the child would be even greater. I'm not assuming that all countries that contribute a significant number of infants to international adoption are also sexist, but the countries I know to be major contributors of international adoptees are all much more sexist (on average) than most segments of most Western societies.

It's a fascinating question, isn't it? My guess is that the answer is different depending on the adoptive family.

Possible motives:

1. As you say, families may like the idea of bringing a girl into a less sexist society. I think it's true that people who adopt internationally tend to be fairly progressive in outlook, on average at least.
2. Women tend to drive the adoption process, and are more likely to want girls.
3. No biological link means less of a priority on producing a "son and heir."
4. People believe that their families and communities will be more accepting of a adopted girl than an adopted boy, especially if it's an interracial or intercultural adoption. Or people feel that way themselves -- that a boy who's not biologically theirs is likely to be more of a canon than a girl would be.
5. Couples or singles that are adopting have usually gone through a very long ordeal of infertility and agonizing about the decision to adopt, and as a result they've thought a lot more explicitly about what they want their family to be like, what's really important to them. This might not lead to a preference for adopting a girl, but I think it would tend to erase any lingering preference for a boy. This is sort of the reverse of what happened to me. My husband and I are in the process of adopting from Kazakstan. We opted to be open to either sex and any race, and were told that this meant it was likely we'd be matched with a Kazak or mixed-race boy (rather than Russian, which is a large minority of the country's population). I've always kind of wanted to have a girl, but when it came down to it, we decided that what mattered most to us was that the baby be healthy and under a year old. Being open about factors we care less about will ideally help speed up the process.

Er, that should be "...more of a loose canon..."

"in western nations sex selection ends up half and half, with the usuall patern being that parents who already one or more kids of one sex wanting one of the other sex. Does anyone know if this is wrong?"

I can't find a link, but about a year and a half ago the NYTimes reported a study showing that married couples with all daughters were more likely to get divorced than couples with all sons; and the divorce differential increased the more children of the same sex you had. One plausible interpretation of this difference is that the stress of having kids who are all the "wrong" gender could contribute to divorce, thus revealing a slight preference for boys, rather than girls. (Or, maybe daughters are just more stressful than sons.)

Strangelove: It could easily be accomplished with a computer. And a computer could be set and programmed to accept factors from youth, health, sexual fertility, intelligence, and a cross section of necessary skills. Of course it would be absolutely vital that our top government and military men be included to foster and impart the required principles of leadership and tradition. Naturally, they would breed prodigiously, eh? There would be much time, and little to do. But ah with the proper breeding techniques and a ratio of say, ten females to each male, I would guess that they could then work their way back to the present gross national product within say, twenty years.

Muffley: But look here doctor, wouldn't this nucleus of survivors be so grief stricken and anguished that they'd, well, envy the dead and not want to go on living?

Strangelove: No sir...when they go down into the mine everyone would still be alive. There would be no shocking memories, and the prevailing emotion will be one of nostalgia for those left behind, combined with a spirit of bold curiosity for the adventure ahead!

Turgidson: Doctor, you mentioned the ration of ten women to each man. Now, wouldn't that necessitate the abandonment of the so called monogamous sexual relationship, I mean, as far as men were concerned?

Strangelove: Regrettably, yes. But it is, you know, a sacrifice required for the future of the human race. I hasten to add that since each man will be required to do prodigious... service along these lines, the women will have to be selected for their sexual characteristics which will have to be of a highly stimulating nature.

DeSadeski: I must confess, you have an astonishingly good idea there, Doctor.

It is much worse if there are too few girls than if there are too few boys,
as China and India are about to find out. When men don't have women, they give mayham a try.

A society with more women than men would likely work. The women would be in charge and the men would have sex a lot.

I don't buy the whole "Westerners will want a 50/50 ratio" thing. If this gets to be popular, boys will start outnumbering girls. It just makes sense--everything you want out of a child, you are more likely to get out of a boy. More successful, more money, less worry that the child will start another family. If you have a girl, you have the immediate problem of making sure she is attractive enough to get anywhere in life, and that's a genetic crapshoot. And even if your daughter gets the right dose of pretty genes, you have to watch her like a hawk to make sure that she doesn't get pregnant or ruined by men at a young age.

I'm not saying that these things are definitive fact, but they are overwhelming parenting issues.

My parents loved having girls but they haunted us like banshees--don't eat too much, don't wear that, where are you going--it's a huge headache you don't get with boys. With boys, you spend more time praising and being proud, less time worrying.

Of course, that's in adolescence. If most people are thinking in the more short term, girls might be preferable because it's widely believed they behave better.

I have to admit, I'm surprised to hear that Western families adopt female children out of preference - I really thought it was due to the ease of adopting from China & India which has a prevalence of unwanted female children. I do, however, think it is accurate that Westerners are probably much more willing to adopt female children. That is most likely based on the fact that female children are not some sort of liability to Western families; here they may be quite the opposite (in the West, the female children tend to have greater responsibilities to taking care of their parents in old age - in the West, they don't become part of the husband's family instead of her family).

I take it the questions about the advisability of sex-selection in IVF center on potential conflicts between the freedom of the parents to exercise this choice about their potential offspring and what might be good for the community the child is born into (or for the gene-pool, if that's one's way of thinking). Presumably, if your heart is really set on a son, and you have good reason to believe that the other folks having babies are doing everything they can to have boys, too, you'd recognize that at a certain point the cumulative effect of everyone having just the family they envisioned might start sucking for junior. (Unless, of course, the Dean Hamer gay-gene test kit comes to market and you know it won't ...) Would this be enough to keep people from saying, "Yeah, but we really want a boy!"? I'm not optimistic. Does this mean society ought to impose some sort of constraint on IVF sex-selection? My gut says no, although I haven't got a great argument to back it up.

The big question: how the heck can we get society (any society!) to the point where a child's sex is as completely trivial as eye color or whether s/he has detached earlobes?

I've also read that while most couples would want one boy and one girl, they would prefer to have the boy be the older brother and the girl be the younger sister. If (and yes, that's a big if) this preference is indulged often enough, there could be sociological consequences even if the sex ratio stays stable.

What evidence is there that letting Western parents choose their children's sexes will unbalance the sex ratio? For instance, how much sex-selective abortion is there in the West?

Just think... when they locate the Gay Gene, prospective parents will be able to choose not to have a gay child. The end of the homosexual scourge...

Unless its not a genetic issue and just deviant perverse behavior... sux for them eh?


Yeah, but Amanda, while your boys are out being successful corporate lawyers raising their own families while you rot in a home, my daughters are going to be guilted into letting me live with them, where I can enjoy homecooked meals and sponge baths, because after all, women are natural caretakers.

But anyway, I'd read another article about the sperm spin cycle she mentions that separates, though not for certain, X sperm from Y sperm. In the article I read (though fucked if I can remember where or when it was from), the clinics that will do it found that the split between wanting girls or boys was split about 50/50, but it varied by economic class. The less affluent, the more likely the parents were to want a boy; more affluent couples were more likely to want a girl.

In any case, I doubt sex selection in IVF would really affect the Western population sex ratio, but not because people who chose would split evenly. The people I know who got multiple good embryos considered themselves remarkably lucky regardless of what sex they were genetically. After all the pain and expense, and the possibility of the embryo(s) not implanting at all, I'd think most would go for the embryo(s) in the best condition with no genetic funny business almost all of the time. So sex-selected IVF babies end up being a minority of an already small number of births, which doesn't really concern me as good or bad either way. Although it would really, really suck if you were born to a couple who chose your sex and you turned out to be intersex or transgendered.

Hmmm what a surprise parents are in for when they press the boy button and their daughter is born as a product of testicular feminization.

Most sex-linked genetic defects are carried on the X chromosome, which means that females carry the gene silently and males express it. So in that case sex-selection would favor girls over boys.

Ol Cranky -- That's what I used to think about international adoption of female children, too. I think it's because when people think "international adoption" they tend to think of China first. But the wait to adopt a girl is longer if you're adopting from Guatemala, Korea, Kazakstan, Russia, or Ukraine which are the other countries with the big international adoption programs.

Dr. Free Ride, thank you. Amartya Sen has studied the issue of the "missing women" which is how he refers to women and girls who are dead or were never born because of sex selection, inadequate food and medical care, and various other cultural practices that threaten the life and life expectancy of females. There are regions of India where sex selection is so rampant that there are very few prospective brides. It does not lead to placing greater value on women. However, there are also Indian states that have consistently worked to upgrade the status of women in education, medical care, and legal protection, and in these states, parents show markedly less inclination to engage in sex selection.

My understanding in the West is that parents tend to use sex selection for "family balancing" -- to get the child of the gender they don't already have. No one (well except perhaps a very wealthy person who can afford unlimited chances) would conceive through IVF just to sex select. Way, way too much effort and expense and uncertainty.

My daughter Bridget was adopted from China (you can see the two of us in the URL).

I think it is a possibility that there could be a subtle psychological reason for a preference for foreign-born girls over foreign-born boys.
It's not just babies:

An American man with an Asian wife is much more common than the other way around. Also, in American TV shows, it's always the wife (or girlfriend) who is a witch, or an alien, or a robot, or a genie. The husband is almost always all-American.

A little follow-up: we didn't only adopt girls from China. Click this URL, and scroll to the bottom to see Brennan, Katie and Dommiss.

(Sorry for being a Dad and pulling photos out of my virtual wallet)

On average, and across cultures, women tend to want to "marry up"--to older, richer men. Any policy that makes women rarer will exacerbate that trend by increasing women's bargaining power.

Leaving aside the impact on men for the minute -- couldn't this be a good thing for the women that do exist in such a situation?

Leaving aside the impact on men for the minute -- couldn't this be a good thing for the women that do exist in such a situation?

I wondered that as well.

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