While the technology improves, the ethical debate intensifies
By Alanna Mitchell
Updated Jun 18, 2013When Arlene Walter and her husband, John, found out they were having a second baby, they didn’t give a lot of thought to its gender. But when an ultrasound showed that they would have a daughter to go along with their son, they were thrilled.
Arlene painted the nursery pink and bought enough frilly clothes to dress her daughter for years to come. She even had the perfect name picked out: Kayleigh Ellen Dorothy.
Except the ultrasound was wrong. The baby was a boy, George, who’s now six. Arlene was devastated. “It’s hard to explain,” she says from her home in Mississauga, Ont. “I’m still not over it. I honestly felt like I lost a child.”
And when she found out through ultrasound that her third was a boy too, her eyes filled with tears.
Now 34, Arlene is facing an agonizing decision. She and John long for a daughter, but feel they can’t keep having babies endlessly. They know a fourth would be the last.
They're so anxious to have a girl that they’ve looked into a controversial American technique that gives parents a better chance of choosing the baby’s gender. Called MicroSort, it involves sorting sperm that carry the Y chromosome (which makes a boy) from those that carry the X (a girl) and then artificially inseminating the mother.
John thinks they should go for it. Arlene would, except for the cost: $4,000 US just for a first try, plus the cost of staying in the States where the procedure can be done. She draws the line, though, at abortion if the baby ends up being another boy anyway.
In this era of unprecedented medical control over reproduction, Arlene and John are not the only parents dealing with troubling questions about how far they would go to choose a baby’s gender.
It’s an extremely emotional topic, going to the heart of why people have children in the first place.
Some think it is a purely personal choice to try to predetermine the sex of a child. They believe people should be able to take whatever steps their own conscience dictates.
For others, the whole idea is an abomination, a slippery slope that could lead to parents choosing eye colour, temperament or intelligence if and when the technology gets to that point.
Not only that, but the increasing ability to choose gender has to be viewed against the rising rates of infertility in modern society and all the treatments now available for that.
There, too, the arguments go both ways. Some say if medical technology can help a couple get pregnant, then medical technology should also be at the service of those who want to choose gender. Others say that when so many couples are infertile, it’s an unethical luxury for anybody to worry about gender. Getting a healthy baby, they say, is all anyone should wish for.
Arlene has heard all these arguments. She says the debate can get “pretty nasty.” She has to keep explaining that she adores her three boys.
But she looks at them, now seven, six and three, and wonders whether they and their partners will be there when she is old to take her to doctors’ appointments and share confidences.
“My feelings are my feelings,” she says. “I’m not telling anyone else what to do.”
The ethical issues around choosing gender have intensified in Canada over the past 10 years. That’s because, during that time, ultrasound techniques have improved dramatically, says Roger Pierson, the director of the Reproductive Biology Research Unit at the University of Saskatchewan in Saskatoon and past president of the Canadian Fertility and Andrology Society.
The sex of a fetus is clear at about 14 weeks and sometimes at 11½. That means parents who find out they have the “wrong” sex can opt for abortion.
And a tour of the Internet unearths a goldmine of tips on how to make one sex or another. One site offers couples the chance to artificially inseminate with sorted sperm in the comfort of their own home for a mere $1,000 US. Others offer couples in vitro fertilization followed by a procedure to find out the sex of each embryo. Then doctors discard the unwanted embryos and implant only those of the “right” sex.
At its core, says Pierson, the debate about choosing the sex is inescapably about the equality of the sexes. If they were equal, why would there be a debate at all? What can one gender do that another cannot? “It’s about cultural perceptions, the value of males vs. the value of females.”
The naked truth is that while some families, like the Walters, do long for girls — they tend to be the ones who’ve had only boys for generations or who want a girl to match the boy in a two-child family — the majority are looking for the guarantee of a male child.
“In some ethnic communities, there is a huge preference for male children. You never see a preference for female children,” says Pierson, adding: “It is a profound, profound sexism.” He points not only to the tales patients tell their doctors in the examination room, but also to advertisements in local ethnic papers in Canada where ultrasounds and subsequent abortions are on offer to expectant couples.
A recent study of abortion figures from Bombay, for example, showed that of 3,000 procedures, just three involved male fetuses. In China, where families are limited to a single child as a way to control population growth, the orphanages fill up with female children.
In Canada, doctors are trying to stop parents from aborting children of the “wrong” sex. They are lobbying hard for rules to prevent patients from knowing the sex of their baby until after the pregnancy is in its 24th week. After that stage, it’s tougher to get an abortion in Canada.
“We believe this technology should not be used except for medical cases, such as an X chromosome- or Y chromosome-linked devastating disease,” says Pierson, speaking on behalf of Canada’s obstetricians, gynaecologists and fertility experts.
But ethicists in other countries are divided on gender selection.
An American paper published in the journal Fertility and Sterility (from the American Society for Reproductive Medicine) in 2001 argued that high-tech methods to implant only embryos of the desired sex could be justified for “gender variety in a family.” The authors also say, however, that prospective parents ought to be prepared to accept the sex they end up with. As well, they say parents should be counselled to avoid placing exaggerated expectations on the child of the preferred sex.
A key French paper published in Human Reproduction in 1999 entitled “Gender Selection: A Crime Against Humanity or the Exercise of a Fundamental Right?” argued that the choice should be left up to the couple and the doctor involved. The article noted that low-tech methods to determine sex have rarely been subject to the scrutiny now given to high-tech options, and posed the question: “Does this mean that the moral justification or lack of justification of a social and medical attitude depends more upon its efficiency than on the underlying principle?”
While the ethical questions loom large, the demand still exists. Pat Buie is an Ontario nurse and teacher, whose book, Choose the Sex of Your Baby Naturally, explains her self-taught method, which she claims worked when she got pregnant with her son, Matthew. The book has sold throughout Canada, the US, Japan and even in Singapore, she says. “There’s an appetite.”
Sheldon Walker, a Calgary psychologist and family therapist, says he puts part of the phenomenon down to the human urge to prove that science can outwit nature. “It’s a control issue. We think that we can tailor-make our family to a certain model,” he says.
Pierson wonders whether the phenomenon is linked to the general attitudes of this generation of new parents. They are the so-called baby boomlet, a surge in the population that followed the massive baby boom. And they have been brought up to believe that they can control when they get pregnant, which is not always the case. Preventing pregnancy is not the same as controlling birth, he points out. He often sees couples who are confused when they go off the birth control pill and don’t get pregnant right away.
At his clinic, which has a seven-month waiting list for parents who would feel blessed to have a child of any sex at all, he just doesn’t waste time on the gender issue.
But he’s heard hopeful questions from would-be parents about every folk remedy for determining a baby’s sex. That includes the old saw about using a vinegar douche before intercourse to get a girl. “It works about half the time,” he says, deadpan.
Last Christmas, Arlene Walker’s three boys got an Xbox and spent all day playing video games with their dad. She spent the day reading a new book. That’s when her husband finally realized how alone she feels and began pushing to try for a girl. They’re still not sure whether they will and, if they do, whether it will be a low-tech or high-tech method they’ll try. “Knowing us, it will probably be another boy anyway,” she says.
Gender-bending
The desire to choose a baby’s sex is not new, nor is it that rare:
• Ancient German tales instructed parents to put a wooden spoon under the bed to conceive a girl.
• It’s believed that Romans used to expose unwanted girl babies to the elements.
• Men of 18th-century France would tie off the left testicle before intercourse in the belief that it would result in a male baby.
• In the UK, a 2003 study found that 21 percent of Britons would be prepared to pay for sperm sorting in an attempt to get the desired sex.
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