Medical Examiner

Lads or Lasses

The British go for sex selection.

Illustration by Robert Neubecker

Last month, a committee of the British Parliament recommended allowing couples who conceive through in vitro fertilization to screen their embryos for sex. There are good reasons to take issue with easing the way for couples to choose whether to give birth to boys or girls. But whatever you think about the parliamentary committee’s conclusion, from an American perspective the committee’s existence and the tone of its report are enviable. The British government is taking on hard questions raised by reproductive technology. And while the committee split 6 to 5 on sex selection and research involving cloned human embryos, the division was about principles rather than partisanship, with members of the Labor and Conservative parties lining up on both sides.

American conservatives sometimes belittle British bioethics as chatter among liberals who inevitably say yes to whatever new practice is on the table. But a broader range of opinion in Congress hasn’t led the U.S. government to say no to sex selection or other questions raised by the genetic screening of embryos, like whether the parents of a child with a rare genetic disease should be able to test for a tissue match so they can bear a life-saving sibling. Instead, there’s been little civic debate on these topics at all.

The March report by Britain’s House of Commons Science and Technology Committee took up the question of sex selection for couples who use IVF. The committee gave some weight to sex selection’s troubling ramifications, chiefly demographic. Because of the preference for sons in China and India, the ratio of boys to girls has already been thrown off in those countries, in some places by as much as 140 to 100. Estimates suggest that nearly one in 10 female fetuses is aborted in India for reasons that have nothing to do with the health of the baby or the mother, even though sonograms performed to determine sex have been banned since 1994. “It could be argued that by permitting people to choose the sex of their child in this country we are legitimising the choices among cultures where boys are preferred,” the committee report admits. But its authors point out that sex-related abortion and infanticide is already happening abroad, and then punt the whole thing to Parliament for further consideration.

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. The committee suggested that sex selection could be restricted to parents who were using it to balance their families—those who have three sons and desperately want a daughter, or vice versa. But what if there are a lot more couples in the first camp than in the second? In the United States, the Virginia-based company MicroSort has been helping parents give nature a nudge since 1996, through a process called cytometry that separates X and Y chromosome-bearing sperm cells. Seventy-nine percent of the company’s clients shoot for girls.

MicroSort has worked with 2,040 couples so far—at between $3,000 and $4,500 a pop, its technology is a luxury item, and the Food and Drug Administration hasn’t finished a clinical trial that is tracking 750 sperm-sorted babies through their first year of life to make sure they don’t have a higher-than-usual rate of abnormalities. But if the price comes down and the news from the trial is good, it’s easy to imagine sperm-sorting as the next must-do upgrade. Perhaps the British or the Danish will be more restrained when MicroSort opens up shop in their countries, but it’s hard to see why.

Sex selection pits the individual interest—”I’ve always wanted a little girl!”—against the collective interest in a population that’s roughly balanced between men and women. If there were no regulation, price barrier, or social convention to hold prospective parents in check, for a lot of us the temptation to rig the sperm bet for the sex of one’s choice might be enormous. And by discounting evidence of collective harm, the parliamentary committee is further tempting parents. That’s not surprising, given the committee’s predilection in favor of individual autonomy and against government intrusion. Rather than proceeding only when there is solid evidence of no harm, the committee put technological advancement first. “Alleged harms to society or to patients need to be demonstrated before forward progress is unduly impeded,” the report urges.

None of this leaves a lot of room for what might seem an obvious starting point for a discussion about the ethics of sex selection—whether rejiggering nature in this way offends a core principle of human dignity. “Increasingly, children are seen as the object of ‘consumer choices,’ rather than as new human beings to be accepted unconditionally,” the Catholic Bishops of England and Wales bleat, but the committee disregards their warning.

As opponents of stem-cell research have learned, blocking the development of a new technology by one actor (the federal government) often means encouraging it by another (the state of California). And governments can easily go too far in the direction of oversight by creating bodies that lay claim to supreme and unquestioned authority. Even so, the knotty questions raised by the new tools of reproduction demand painstaking analysis. To that end, the U.K. has its House of Commons science committee. What have we got? A bunch of yammering senators.