Sex Selection: No God Has the Monopoly of X and Y Chromosomes
Is it morally permissible for parents to select the sex of their child?
It is not my intention to hurt people by offending their religious beliefs. The title was constructed to remind the reader that we no longer justify ethical problems based solely on the individual upbringing of religious beliefs. Moreover, the ethical issue is built upon the fact that today human agents, not omnipotent beings, are the ones who perform sex selection using various methods.
In ancient history, Aristotle advised couples who wished to have a son to make love in the north wind and a daughter to make love in the south wind. Another method was tying a string around the man’s left testicle to produce a boy and tying the right one to produce a girl. In medieval times, alchemists proposed an even more bizarre method, which was to drink the blood of a lion and then have intercourse under a full moon to ensure the birth of a son (Davis cited in Dahl 2008, 21). Obviously, these are all primeval fantasies with no scientific basis. However, it is clear that the eagerness to influence the sex of a child by a prenatal intervention is an intrinsic human instinct since ancient history.
In terms of passing on genes from generation to the next generation, human genetics is gender bias (Mahowald 2000, 1). It can never be neutral due to the fact that some diseases have a sex-linked mode of inheritance. A female has two X chromosomes, whereas a male has only one X chromosome. Thus, if mutation occurs on the X chromosome, men are more likely to be affected than women in the case of an X-linked recessive disorder. Moreover, women with a disease-causing mutant gene on her X chromosome could be unaffected because their second X chromosome could have a normal variant of the gene and is therefore able to compensate for the mutant gene (Gilbert et al. 2005, 89). For instance, when a man who has normal chromosomes marries a woman who is a carrier of the disease, there is a 100% chance of having an unaffected daughter; but, a 50% chance of having an affected son. In the other condition of the rarer X-linked dominant disorder, women are much more likely to be affected than men because one mutant gene on X chromosome is enough to express the disease. In this situation, each daughter of an affected father has a 100% chance to inherit the disease. In Y-linked disorders, the disease is caused by mutation in the Y chromosome. Thus, every son of an affected father is going to be affected because males can only inherit a Y chromosome from their fathers.
These basic human emotions and genetic bias may account for, in part, the basis to why parents want to choose the sex of their child. However, there could also be other pressures such as economy, culture and religion specific to a part of the world. Furthermore, people no longer use the so-called ‘quasi-scientific’ routines to satisfy the need of having a child of particular gender. Modern science has provided us with three different reliable methods of sex selection: abortion, sperm sorting and preimplantation genetic diagnosis (Dahl 2008, 21-22; Gilbert et al. 2005, 91-92; Steinbock 2002, 24). The very last technique is the main focus of this essay.
I believe that it is morally permissible for parents to select the sex of their child using, at least two methods, the sperm sorting and the pre-implantation genetic diagnosis (PGD). In this essay, I am going to briefly describe the three methods that are available, followed by an ethical discussion or rather justification on the PGD specifically, including the moral status of the embryo and the liberty of choice. Finally I will discuss the practice of sex selection in general such as the issue of ‘playing God’, ‘unnatural’ processes, and the distorted sex ratio.
Methods of Sex Selection
Abortion has been facilitated by prenatal diagnosissuch as amniocentesis, chorionic villus sampling and ultrasound (Dahl 2002, 21). Prenatal diagnosis not only provides early detection of fetal abnormalities, but also provides information about the fetal sex. As a consequence, the fetus may be subjected to termination due to its undesired sex. In western societies, it is very rare that abortion is performed solely because it is the ‘wrong sex’ (Dahl 2002, 22). Most people believe that the fetus gains its moral status incrementally as it proceeds through the developmental process. Thus, it requires a much more serious reason, usually on medical basis, to justify the abortion. However, the practice of abortion after an ultrasound is common in countries like China and India to ensure the birth of male children (Steinbock 2002, 26). Furthermore, when abortion is performed to a healthy, but ‘wrong sex’ fetus, it may indicate a brutality towards human life and an astounding lack of maternal feeling. In short, the ethical issue focuses on abortion as a method of life terminationregardless of the preference of a particular sex, but not the idea of gender selection exclusively.
Sperm sorting has been made possible by a biomedical technique called flow cytometry (Dahl 2008, 22; Gilbert et al. 2005, 92; Steinbock 2002, 24). The basis of this procedure is the difference in the DNA content between X and Y chromosomes. The X chromosome is larger in size than the Y chromosome. Moreover, the separated sperm can be used in an intrauterine insemination procedure; thus, sperm sorting is pre-conceptual, that is, sperm selection occurs prior to fertilization. Although it is still ineffective in terms of obtaining a reliable result – at the moment there is still a small percentage of failure in separating X and Y chromosomes, it remains a potential method because it is probably the only technique that involves neither an abortion nor the destruction of “wrong sex” embryos (Gilbert et al. 2005, 92). Furthermore, reliable sperm sorting technology, such as MicroSort, could be the ultimate answer for preventing X-linked genetic disorders. In 1995, the first MicroSort baby girl was born to a woman who had a family history of X-linked hydrocephalus, a fatal swollen-brain disorder that occurs only in boys (Steinbock 2002, 24). Moreover, MicroSort has attracted the interest of couples who want to perform gender selection for nonmedical purposes. To tackle the issue of sex discrimination, MicroSort has developed the concept of ‘family balancing’. The technology is made available only to couples who have a first-born child and wish to select a child of the ‘non-dominant’ gender in their family (Sandel 2004, 53-54; Steinbock 2002, 24). In my view, this method has answered most of the ethical issues and there should not be any pause for its application, unless having preference towards a particular gender is intrinsically objectionable.
The main focus of this essay is on thepreimplantation genetic diagnosis (PGD) method which relies on the in vitro fertilization (IVF) technique (Dahl 2008, 22; Gilbert et al. 2005, 92; Steinbock 2002, 24). This method is widely used therapeutically to prevent X-linked diseases. PGD in conjunction with IVF provide an opportunity for couples, who have a risk of transmitting genetic disease, to create embryos and screen them for genetic abnormalities. Thus, only embryos that are free from any genetic defect would be implanted in the woman’s uterus to start pregnancy. PGD also reveals the sex of the embryos; hence, a woman often requests to transfer only those “desired-sex” embryos. This method is known to be more accurate than the sperm sorting method for determining the sex of the offspring (Steinbock 2002, 25). In fact, Gleicher (cited in Steinbock 2002, 25) suggested that “it would not be ethically permissible to offer patients an inferior method when a superior method was available”. Youngner (cited in Steinbock 2002, 25) stated that “PDG for sex selection should be discouraged due to the risk of gender bias, social harm, and the diversion of medical resources from the actual medical need”. However, if the idea of sex selection is for ‘family balancing’, then why should the PGD method be discouraged when the sperm sorting method is accepted, given that both methods may fall into similar objections? What is it that makes PGD more morally wrong than the sperm sorting method? Is it really morally wrong?
Ethical Discussion
I believe it is important to address the specific objections on the practice of PGD for sex selection, as well as the general objections of sex selection which are relevant to all methods, including the PGD.
The practice of PGD solely for sex selection is often regarded as morally objectionable; whereas the sperm sorting method is considered morally acceptable. This view may be caused by the fact that sperm sorting does not involve any embryo destruction, while PGD does (Steinbock 2002, 25). William Schoolcraft (cited in Steinbock 2002, 25) expressed that “with sperm sorting, you are not throwing away potential babies”. However, are we really discarding potential human beings who possess an equal moral status to us? The central argument for this problem is certainly on how we define the moral status of a human embryo. Moreover, in order to be a person, a being or embryo has to possess characteristics that provide an underlying reason to give it a particular moral status. John Locke (cited in Harris 1999, 302) stated that a person is “a thinking intelligent being, that has reason and reflection, and can consider itself the same thinking thing, in different times and places”. Personhood refers to an individual who has intelligence, the ability to think and reason, the capacity for reflection, the ability to value its own existence, self-consciousness, memory and foresight (Harris 1999, 303). Does an embryo meet Locke’s criteria of personhood? The answer must be ‘No, it does not’. Thus, it is very difficult to justify that an embryo has the same moral status as that of a human adult. One might argue that embryos have a potential to gain those characteristics, hence they deserve some moral status (Steinbock 2002, 25). However,having the potential to gain those characteristics does not imply that the embryo has the privilege of receiving the rights of being a person.Moreover, Harris (1999) proposed two arguments against the idea of potentiality, such as the logical difficulty and the scope of potential for personhood (298). He gave an example that we have the potential to be dead; however, none of us want to be treated as a corpse now. In addition, Harris (1999, 298) also argued that “if the human zygote has the potential to become an adult human being, and supposedly morally important in virtue of that potential, then what of the potential to become a zygote?” Should an unfertilized egg and sperm also have a claim on the moral status of a human adult? In cloning by nuclear transfer, the nucleus of an unfertilized egg is replaced by a nucleus taken from any adult cell; followed by, an electrical stimulation which, indeed, induces the development of embryo from an unfertilized egg (Harris 1999, 298). This means that any adult human cell has the potential to become the ‘clone’ of that individual. However, is it rational to think that every human cell should have the same moral status as us? I believe that it is ridiculous for anyone to give the answer ‘Yes’ to the two previous questions, simply because in answering ‘Yes’, that person demonstrates a loss of John Locke’s personhood qualities of rational and logical thinking. Furthermore, a human embryo has neither a future-directed desire nor an identifiable wish to live; therefore, discarding human embryos should not be considered as depriving an embryo from a life, as it neither values nor is aware of the possible future it may have had (Harris 1999, 307).
In many cases, PGD is mainly carried out to prevent the birth of a child with severe genetic defects and the aspect of sex selection is a side effect (Steinbock 2002, 25). For instance, when a couple who is going through the process of PGD in conjunction with IVF produces three healthy embryos, is it morally objectionable to decide which embryo to discard based on the gender, given that two of the embryos are female and one is male? I think it is morally acceptable, not only because embryos cannot claim a moral status as a human adult due to lack of John Locke’s personhood, but also women have the right to make their own decisions regarding their pregnancy. This is known as procreative autonomy, which was described by Savulescu (1999) as the freedom to decide when and how to have children based on the best judgment by the parents (374). At the end, parents are the ones who take care of and are responsible for the children.
A constantly opposing argument to sex selection by PGD or other methods is that choosing the sex of a child means ‘playing God’. This objection is most often an instinctive response rather than a clearly reasoned moral reaction. Literally, this objection means that human beings are not allowed to pre-select the sex of their children because it is considered as the prerogative of a supernatural being (Warren 1985, 81). However, does the supernatural being really exist? Richard Dawkins (2006) certainly argued against the existence of God (157-158). Even if there is a God, it is still extremely difficult to prove that this God claims the monopoly to determine the sex of human children (Warren 1985, 81). Is it morally right for any external authority to control the sex of our children without our consent? Furthermore, I would consider religious beliefs to have an even worse impact on the sex ratio. For instance, in India, a huge number of girls are aborted, abandoned, neglected, or even killed right after birth, which results in skewed sex ratio towards male due to religious reasons (Dahl 2002, 29). Dahl (2002, 29) wrote that “according to Hinduism, a man who has failed to sire a son cannot achieve salvation. Only a male descendant can perform the last funeral rites to ensure the redemption of the departed soul”. To me, this is a ridiculous premise regardless of which religion it comes from. Although it may promote the use of PGD for sex selection instead of the other more brutal procedures, the practice should be limited for ‘family balancing’ rather than to satisfy the nonsense attitudes based on religious faith.
Some reject the practice of sex selection because they consider it as ‘unnatural’ and hence immoral. This objection also seems to be a spontaneous emotional reaction as opposed to a clear reason-based response. Any human intervention, including PGD, which is unnatural, does not imply that it is immoral (Dahl 2008, 24). Today, many medical interventions such as heart and liver transplantations, work against the natural process. Dahl (2008, 24) stated that “ if we have to decide whether an action is morally right or wrong we cannot settle the issue by asking whether it is natural or unnatural”.
The dominant objection to sex selection is that it may distort the natural sex ratio which has occurred in China and India (Dahl 2008, 25; Mahowald 2000, 118; Steinbock 2002, 26). However, this situation may not be true in western societies. In fact, a survey revealed that 30% of Germans, 68% of British, and 50% of Americans prefer to have an equal number of boys and girls (Dahl 2008, 26). Moreover, only 6% of Germans, 8% of Americans, and 21% of British are interested in sex selection through sperm sorting (Dahl 2008, 26). In addition, 90% of American couples wanting to perform sex selection had the idea of ‘family balancing’ (Savulescu 1999, 374). It is clear that the widespread fear of a sex ratio distortion is unwarranted. There is no empirical evidence to support that there is a significant preference for children of a particular gender and a considerable interest in employing sex selection technology (Dahl 2008, 25). Furthermore, the threat of sex ratio distortion, particularly in Asian countries, may be addressed by proposing the scheme of ‘family balancing’ as the only reason for couples to undergo gender selection.
In conclusion, it is morally permissible for parents to select the sex of their child using, at least two methods, the sperm sorting and the PGD. The moral objections based on the moral status of an embryo, women’s autonomy, ‘playing God’, ‘unnatural’ processes, and sex ratio distortion seem to be unjustified. Moreover, gender selection may be good and it may be bad. It probably depends on the social, cultural, and economic aspects within the society. The question must not be greeted with an intuitive reaction based on religious fundamentalism and highly speculative sociological or psychological assumptions, but decided through empirical evidence and clear reasoned moral responses. We as human beings require less emotion and more thought because no God has the monopoly of the X and Y chromosomes.
References
Dahl, Edgar. 2008. Sex selection: sorting sperm as a gateway to the sorting society? In The Sorting Society: The Ethics of Genetic Screening and Therapy, ed. Loane Skene and Janna Thompson, 21- 35. New York: Cambridge University Press.
Dawkins, Richard. 2006. The God Delusion. London: Bantam.
Gilbert, Scott F., Anna L. Tyler, and Emily J. Zackin. 2005. Bioethics and the new embryology: springboards for debate. Sunderland: Sinauer Associates.
Harris, John. 1999. The Concept of the Person and the Value of Life. Kennedy Institute of Ethics Journal (9): 293-308.
Mahowald, Mary Briody. 2000. Genes, Woman, Equality. New York: Oxford University Press.
Sandel, Michael J. 2004. The Case against Perfection. Atlantic Monthly (April): 51-62.
Savulescu, Julian. 1999. Sex selection: the case for. The Medical Journal of Australia (171): 373-375.
Steinbock, Bonnie. 2002. Sex Selection: Not Obviously Wrong. Hasting Center Report (32): 23-28.
Warren, Mary Anne. 1985. Gendercide: the implications of sex selection. New Jersey: Rowman and Allanheld.





